Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Forty consecutive African patients found to have duodenogastric bile reflux at endoscopy were studied. Bile reflux was found more commonly among males than females, giving a male/female ratio of 2.3:1, with a peak age at 41-60 years. ABO blood groups had no significant influence on duodenogastric bile reflux. Flatulence and borborygmi were the most consistent symptoms other than the classical dyspeptic pain pattern. Bilious vomiting was a rare finding. Duodenogastric bile reflux was more commonly associated with endoscopic gastritis (67.5%), gastric ulcer (35%) and oesophagitis (30%) than with duodenal ulcer (22.5%), deformed pyloric ring (5%) or distorted duodenal bulb (2.5%). The dysfunction in the pyloric sphincter in people with duodenogastric bile reflux appears to be more of a physiological defect than structural.
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PMID:The clinical pattern of duodenogastric bile reflux in the Kenyan Africans. 291 97

The results of 48 Roux-en-Y (RY) diversion procedures are reported: 41 were performed as secondary procedures and 7 as part of a primary operation for peptic ulcer. There was no operative mortality, but four patients developed temporary fistulae in the postoperative period and three patients required reoperation. Good clinical results were found when RY diversion was performed as a primary procedure or when the indication for operation was peptic ulceration. The overall results, however, were poor: 24 patients (50 per cent) felt that they had not benefited and 32 patients (67 per cent) remained in Visick grades III or IV. The main cause of failure was gastric stasis, especially of solid food. Gastric emptying studies were carried out after RY diversion in 22 patients, most of whom had symptoms of stasis. Emptying of liquids was found to be normal in most patients, but emptying of solids was delayed, the median t 1/2 for solids being 160 (75-370) min compared with 67 (50-85) min in DU patients. Bilious vomiting improved significantly after RY diversion, but 18 patients (38 per cent) complained of vomiting food and 32 patients (67 per cent) experienced postprandial distress or pain. Loss of the antral mill, vagotomy of the gastric remnant and, perhaps, resistance to gastric emptying by the Roux loop itself may together explain the delay in gastric emptying of solids after RY diversion.
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PMID:Gastric emptying and clinical outcome after Roux-en-Y diversion. 366 21

In 1977, a controlled, prospective trial was initiated to test the hypothesis that excessive enterogastric (EG) reflux was responsible for a unique postgastrectomy syndrome, "alkaline reflux gastritis." Late (42 +/- 3 months) follow-up on all treated patients (N = 14; Rx = 45 cm Roux Y limb) is reported. The following parameters were assessed in symptomatic (N = 11 nonrefluxers, 15 refluxers) and asymptomatic postgastrectomy patients (N = 9): CCK-stimulated scintographically determined EG reflux (EGRI %), intragastric (IG) concentration of bile acids (BA, mM), net bile acid reflux/hr (microM), maximum acid output (mEq/hr), intragastric pH, gastric emptying of 99Tc-labeled solids (T 1/2; minutes), gastritis score (GS = 0-15), and specific symptomotology. A significant linear relationship was noted between intragastric BA concentration and the severity of histologic gastritis in the residual gastric pouch. As a group, excessive refluxers demonstrated significantly greater IG BA concentration, net BA reflux/hour, and EGRI than did either nonrefluxers or controls. Gastritis score in this group was also greater, intragastric pH higher, and maximal acid output (MAO) lower. Gastric emptying was not different between groups. Following Roux (N = 14), reflux was eliminated early and late, pH fell, MAO increased, and gastritis improved. Early marked delays in emptying occurred but normalized late and were rarely a clinical problem. Early symptomatic results were pain eliminated in 14/14, nausea in 8/14, vomiting 11/14, bilious vomiting in 14/14. Complications were one marginal ulcer (no vagotomy), two severe delays in emptying (simultaneous Roux + vagotomy). Late symptomatic results were recurrent or persistent pain in 4/14, nausea in 7/14, vomiting in 5/14. Bilious vomiting remains eliminated.
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PMID:Alkaline reflux gastritis. Late results on a controlled trial of diagnosis and treatment. 370 33