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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eighteen patients with irritable colon syndrome were treated with a new anticholinergic drug (prifinium bromide) and with a placebo in a 6-wk, randomized, double-blind cross-over study. The drug was orally administered in a daily dose of 90 mg before meals. Three manifestations (pain, flatulence, constipation, and/or diarrhea), scored weekly, were used as assessment criteria. Mean over-all ratings showed a difference in favor of the drug, and were statistically significant. Side effects were rare and mild. We have come to the conclusion that this anticholinergic drug may be of benefit to patients with pain-predominant forms of irritable colon syndrome.
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PMID:Prifinium bromide in the treatment of the irritable colon syndrome. 3 42

The indication field of Nortase, a combination of microbial lipolytic and proteolytic enzymes, comprises the replacement therapy of maldigestion and insufficiency of pancreas. Its efficacy and tolerance were tested in 100 patients in an open study under the conditions of general practice. During the 15-day treatment the following symptoms were evaluated: anorexia, flatulence, pressure and pain in the epigastrium, nausea after the meals, belching, pyrosis, the quality of feces and the body weight. 96% of the patients showed relief of the symptoms after treatment, 65% a therapeutic result ranging from very good to good. In 53% an improvement of the quality of feces was observed and 76% reached an increase in weight. 6 patients had some small side effects, in 1 case the treatment had to be interrupted. The altogether good results confirmed the results of former investigations on the acid stability and the high lipolytic activity of lipase from Rhizopus arrhizus.
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PMID:[Experiences with substitution therapy using a new pancreatic enzyme of plant origin]. 70 May 83

The controversy about gallbladder polyps has centered chiefly around their potential for malignancy. Among 3,525 cholecystectomies done over a 25-year period, there were 26 cases of carcinoma with only 9% not associated with stones. Thirty-nine cases of polypoid lesions of the acalculous gallbladder were investigated. The classic symptoms of pain, flatulence, food intolerance, and nausea were present in the great majority of cases. Most patients, especially those with symptoms of short duration, reported improvement following cholecystectomy.
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PMID:Polypoid lesions of the acalculous gallbladder. 80 59

A case is described in which trigeminal neuralgia was controlled primarily by a programme of mandibular relaxation. The symptoms and the success of the management were consistent with the hypothesis that trigeminal neuralgia is caused by chronic compression of the trigeminal nerve and surrounding tissues in the vicinity of the temporomandibular joint. The triggering of attacks appears to be a result of stimulation of individual pain receptors associated with neurons in which transmission thresholds have been reduced by cumulative nerve damage. Extracranial and systemic trigger factors, of cervical and abdominal origin, are described. The conservative management involved mandibular relaxation, avoidance of flatulence and constipation, occasional use of an acrylic occlusal splint, and when necessary, use of Dilantin in prescribed amounts.
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PMID:Trigeminal neuralgia: induced remission without surgery, and observations on its aetiology. 93 71

A patient over 40 years of age who complains of lower abdominal pain, constipation or diarrhea or both, and increased flatulence should be suspected of having diverticulosis. When pain becomes more severe and persistent, diverticulitis must be considered. Diagnosis depends on roentgen demonstration of the presence of diverticula. Sigmoidoscopy and barium enema study are essential to exclude coexisting disease but in diverticulitis may need to be postponed until severe local and systemic signs of inflammation have subsided. A number of diseases can simulate diverticulitis, and differential diagnosis may present considerable difficulty. Irritable colon syndrome and acute appendicitis may be indistinguishable clinically from diverticulitis. Differentiation from carcinoma is usually not difficult, but exclusion of coexistent carcinoma may be impossible except by resection. Ulcerative colitis is also easily distinguished except when, rarely, it coexists. Crohn's disease of the colon is less easily differentiated, especially in patients over 40, in whom the two diseases often coexist. Other colonic diseases, such as ischemic colitis, and pelvic inflammatory diseases usually show characteristic features which make them readily distinguishable from diverticulitis.
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PMID:Diagnosis and differential diagnosis of colonic diverticulitis. 103 35

Patients with functional bowel disease commonly complain of abdominal pain, bloating, and excessive flatulence and eructation. Pain and bloating may be primarily caused by abnormal intestinal motility rather than by excessive intestinal gas. As yet there are no data available that prove excessive flatulence is actually caused by the presence of excessive intestinal gas. A study of the composition of intestinal gas provides insight into whether it is derived from swallowed air or from intraluminal metabolism. Therapy aims primarily at excluding the presence of organic disease as a cause and reassuring the patient that the disorder is functional in nature. Dietary manipulation, changing the habit of aerophagia, exercise, and pressure and heat applied to be abdominal area are all possibilities to be tried.
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PMID:Intestinal gas. 110 99

We report for the first time the treatment of rectal prolapse by laparoscopically assisted anterior resection. A 52-year-old woman, institutionalized for the last 10 years after diffuse cerebral injury secondary to toxic shock syndrome, developed rectal prolapse. A long life span is anticipated for this otherwise healthy middle-aged woman. Anterior resection was selected as treatment because of the low, long-term rates of recurrence of rectal prolapse. Approximately 2 1/2 ft of sigmoid colon and proximal rectum were resected. The anastomosis was constructed using a double-stapling technique. After surgery, the patient experienced virtually no pain and received only a single injection of pain medicine in the postoperative period. She was started on clear liquids on the first postoperative day and a regular diet on the second. She passed flatus on postoperative day 2 and stool on day 5. She was discharged 7 days after the operation. We believe that laparoscopically assisted anterior resection offers a promising new option for the treatment of rectal prolapse.
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PMID:Laparoscopically assisted anterior resection for rectal prolapse. 134 37

The safety and efficacy of patient-controlled analgesia used for postoperative pain relief were evaluated. Cumulative 24-hour requirements were analyzed for possible correlation with patient characteristics. All patients who used a patient-controlled analgesia device for postoperative pain relief were reviewed from June to October 1991. The device Baxter's basal/bolus infusor with patient control module, was used to deliver fentanyl in 379 patients. The fentanyl requirement, verbal analog pain score, first passage of flatus, side effects, sedative score, and degree of satisfaction were examined. The fentanyl requirement during the first 24 hours after operation was analyzed with regard to age, body weight, and sex. The daily fentanyl consumption in the first three postoperative days was 928 +/- 352 micrograms (n = 338), 553 +/- 259 micrograms (n = 220), and 490 +/- 222 micrograms (n = 71), respectively. The requirement for fentanyl during the first 24 hours after surgery was significantly higher than for the next two days (p-value < 0.001). Fentanyl consumption correlated well with body weight, and inversely with age. No difference was found between fentanyl consumption and sex (p-value = 0.4687). The mean time to the first passage of flatus in patients with abdominal surgery was 54.6 +/- 26.4 hours. The incidence of nausea, vomiting, and dizziness was similar, about 20% of patients. Itching was noted in 7% of patients. Oversedation (class 4) was found in three patients during the first operative day, the sedative score for other patients were around class 1-3. No patient exhibited signs of respiratory depression or withdrawal syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The efficacy of intravenous fentanyl patient-controlled analgesia for postoperative pain relief]. 134 40

Fifty-six patients have been examined in a prospective randomized study on the effects of air and carbon dioxide on post-procedural discomfort following colonoscopy. A significant reduction in post-procedural pain was observed at 6 hours (p = < 0.0005) and was still present the next day (p = 0.01). This was associated with a difference in the grading of flatus at 6 and 24 hours (p = < 0.0001 and < 0.05, respectively). An abdominal radiograph 1 hour after the procedure showed minimal gas in the CO2 patients, while the patients who had air showed distention of large and small bowel (p = < 0.0001 and < 0.01, respectively). Seventeen of 29 patients who had air suffered post-procedural pain, compared with 2 of 27 of the CO2 patients. Fifty-seven percent of the patients who were given air had colonic diameters over 6 cm on a 1-hour post-colonoscopy radiograph and 18% over 10-cm diameter. Provision by equipment manufacturers of simple and safe devices for routine delivery of CO2 for lower gastrointestinal endoscopy is long overdue.
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PMID:Pain following colonoscopy: elimination with carbon dioxide. 139 11

Pharmacological studies on Oltipraz [4-methyl-5(pyrazinyl-2)-1-2-dithiole-3-thione)] were conducted with normal healthy subjects using various doses and schedules. Administration of single doses (1, 2 and 3 mg/kg) resulted in detectable drug levels in the serum (mean peak serum concentrations 16, 61 and 205 ng, respectively) and urine. The t1/2 was short (4.4, 4.1 and 5.3 hours respectively) and no steady state was achieved after multiple daily doses for 12 days. Introduction of a loading dose during the first day produced a steady state when 1.5 and 2.0 mg/kg/day were used. Daily administration of Oltipraz sustained the steady state with insignificant variations. Consumption of a high fat diet increased the serum and urine concentrations of Oltipraz (30-60%) compared to the low fat diet. Two subjects experienced flatulence during the administration of the drug. One subject developed numbness and pain in the thumbs with occurrence of small purplish-black spots resembling those observed in subacute endocarditis. These changes disappeared 10 days after discontinuation of the drug. No changes in peripheral blood counts, biochemical profile or thyroid function tests were observed after four weeks of Oltipraz. Further studies with a larger number of healthy subjects are needed for clarification of the safety and biological efficacy of small doses of Oltipraz during chronic administration.
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PMID:Clinical pharmacology studies of oltipraz--a potential chemopreventive agent. 148 2


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