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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Behavioral research in gastroenterology has grown exponentially over the last decade. Controlled studies demonstrate that psychotherapy, stress management, and hypnosis are effective for irritable bowel syndrome; and behavioral treatments are preferred over medical management for some types of fecal incontinence and vomiting. For peptic ulcer disease, interest in behavioral treatments has declined. However, a new syndrome, functional dyspepsia, is now recognized, in which ulcerlike symptoms occur without ulcer and frequently in association with psychological symptoms. For inflammatory bowel disease, stress management training has produced inconsistent outcomes. Newly recognized disorders for which behavioral treatments are needed include constipation associated with inability to relax the pelvic floor muscles during defecation, functional rectal pain (proctalgia), noncardiac chest pain, and aerophagia (excessive air swallowing).
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PMID:Behavioral medicine approaches to gastrointestinal disorders. 150 8

In Nazi-occupied Europe (1939-1945), Jews were submitted to extreme mental and physical hardships (the Holocaust). This study was designed to investigate the impact of the severe protracted suffering on the development of chronic functional gastrointestinal symptoms. Thus, we studied 623 consecutive patients of Eastern European origin who had been admitted for nongastrointestinal complaints. They filled out detailed questionnaires, and were divided into the following two groups: A) Holocaust survivors [237 subjects who had been for at least 6 months in either German concentration/extermination camps (95 subjects), ghetto and/or underground movements (65 subjects), labor camps not directly supervised by Germans (79 subjects)], and B) a control group (384 subjects from the same demographic background, who had not been exposed to Nazi persecutions). The symptoms investigated were the following: abdominal pain, irregular bowel habits, diarrhea, constipation, abdominal distension, heartburn, flatulence, anorexia, nausea, vomiting, mucus in stool, tenesmus, and aerophagia. Patients were defined as having functional symptoms after these had been present for at least 5 yr and relevant organic disease had been excluded. The prevalence, duration of suffering, and frequency of appearance of most symptoms were significantly higher in the group of Holocaust survivors. This study supports the clinical observations that severe and protracted suffering contributes to the development of chronic functional gastrointestinal symptomatology.
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PMID:Chronic functional gastrointestinal symptoms in Holocaust survivors. 201 42

Medical records, radiographs, and bronchial cytologic abnormalities of 65 cats with bronchial disease were reviewed. Bronchial disease was defined as abnormality of the lower airways to the exclusion of disease originating or mainly involving the alveoli, interstitium, vasculature, or pleura. Cats with bronchial disease were more likely to be female and older. Siamese cats were overrepresented and had more chronic disease. In order of frequency, the following clinical signs were reported: coughing, dyspnea, occasional sneezing, wheezing, and vomiting. Radiography revealed prominent bronchial markings, with some cats having collapse of the middle lobe of the right lung (n = 7), overinflation of the lungs (n = 9), or aerophagia (n = 13). Of 65 bronchial washes, 58 were considered exudative, with the predominant cell type being eosinophil in 24%, neutrophil in 33%, macrophage in 22%, and mixed population of cells in 21%. Cultures for bacteria were considered positive in 24% of the cats. Circulating eosinophilia was not helpful in predicting the predominant cell type in bronchial cytologic exudates. Hyperproteinemia without dehydration was present in a third of the cats, indicating an immunologic response. Half the cats had resolution of clinical signs, whereas half the cats required continuing medication with bronchodilators, antimicrobial agents, or corticosteroids.
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PMID:Clinical, radiographic, and bronchial cytologic features of cats with bronchial disease: 65 cases (1980-1986). 247 Jul 10

The human cricopharyngeus muscle was investigated by dissection and by histological, histochemical and morphometric methods. Muscle fibres in the cricopharyngeus were found to be similar in appearance to those of the lateral part of the quadriceps femoris, although they were generally much smaller and more variable in size. The endomysial connective tissue was markedly increased in the cricopharyngeus and muscle spindles were not found. Certain features normally considered to be pathological were also noted in the cricopharyngeus muscles. The fibre type population consisted mainly of histochemically 'slow-twitch' richly oxidative fibres. This finding is consistent with the proposed function of this muscle in its sphincteric role in deglutition, vomiting, eructation and in the control of aerophagia.
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PMID:A histological and histochemical study of the cricopharyngeus muscle in man. 297 Oct 31

The aim of this study was to describe the clinical features of patients with chronic unexplained dyspepsia and compare the symptoms with peptic ulcer and biliary pain, and determine the prevalence of symptoms that may indicate psychoneurotic traits and measure chronic illness behaviour (days lost from work and doctor visits). Studied were: 113 patients with essential dyspepsia, defined as endoscopically confirmed non-ulcer dyspepsia where gallstones, the irritable bowel syndrome and gastro-esophageal reflux have been excluded and there is no ascertainable cause for the dyspepsia; 55 patients with dyspepsia and peptic ulceration at endoscopy; and 53 patients with diagnosed biliary pain and cholelithiasis, proven at cholecystectomy. All patients completed a detailed structured history questionnaire in the presence of one investigator. More patients with peptic ulcer than with essential dyspepsia experienced night pain, pain relieved by food, and vomiting, while more patients with essential dyspepsia than with cholelithiasis experienced epigastric pain, lack of radiation of pain, continuous pain, mild to moderate pain, pain before meals, pain relieved by food and antacids, pain aggravated by food and alcohol, and an absence of vomiting (all p less than 0.01). Symptoms suggesting psychoneurosis, aerophagy symptoms, and chronic illness behaviour were similar in all groups. We conclude that certain symptoms may be of value in diagnosing the underlying cause of dyspepsia.
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PMID:Comparison of the clinical features and illness behaviour of patients presenting with dyspepsia of unknown cause (essential dyspepsia) and organic disease. 346 12

Functional disorders mainly occur in young, anxious hyperactive, sometimes obsessional patients and involve all parts of digestive tract: feeling of obstruction the upper oesophagus or dysphagia; aerophagia related to a slow gastric emptying or gastric fullness relieved by eructation; biliary vomiting and pain in right abdominal upper quadrant which might correspond to a form of migraine without headache; irritable bowel, characterized by abdominal discomfort and constipation. Obviously, the diagnosis of functional disorders required elimination of an organic disease by appropriate endoscopic investigations. Psychosomatic disorders mainly comprise gastroduodenal ulcers and inflammatory bowel diseases. Although psychologic profiles have been associated with gastro-duodenal ulcer, these are not necessary for the development of the disease. The role of emotional factors has decreased since very efficient anti-secretory drugs are available. Inflammatory bowel diseases, in particular ulcerative colitis is frequently associated to behaviour disorders. The patient is usually a young woman brought up by an overprotective family. It is generally recognized that attacks of ulcerative colitis may be triggered by emotional factors. Thus, Stress may interact with digestive tract. In some cases, as in patients with irritable bowel or distal ulcerative colitis, psychotherapy such as Schultz's Autogenous Training, improves the patient's condition.
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PMID:[Stress and the digestive system]. 828 96

Questionnaires were used to obtain data about Irish setters with gastric dilatation (GD) and control Irish setters. The risk of GD increased with age (P < 0.01) but was not associated with gender. Age and gender-matched controls were compared with cases (n = 74). Predisposing risks were aerophagia (unadjusted odds ratio 12.44, P < 0.001), a single food type (adjusted odds ratio 3.15, P < 0.01) and feeding once daily (adjusted odds ratio 2.90, P < 0.02). Apparent risk from a dry food diet and a condition score of less than 2 was not confirmed by logistic regression. Precipitating risks were recent kennelling (unadjusted odds ratio 100, P < 0.005) or a car journey (unadjusted odds ratio 3.29, P < 0.025). No risk was attributed to intensity or duration of exercise, temperament, appetite, speed of eating, vomiting or diarrhoea.
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PMID:Risk factors for gastric dilatation in Irish setter dogs. 957 60

While widely used in research, the 1991 Rome criteria for the gastroduodenal disorders, especially symptom subgroups in dyspepsia, remain contentious. After a comprehensive literature search, a consensus-based approach was applied, supplemented by input from international experts who reviewed the report. Three functional gastroduodenal disorders are defined. Functional dyspepsia is persistent or recurrent pain or discomfort centered in the upper abdomen; evidence of organic disease likely to explain the symptoms is absent, including at upper endoscopy. Discomfort refers to a subjective, negative feeling that may be characterized by or associated with a number of non-painful symptoms including upper abdominal fullness, early satiety, bloating, or nausea. A dyspepsia subgroup classification is proposed for research purposes, based on the predominant (most bothersome) symptom: (a) ulcer-like dyspepsia when pain (from mild to severe) is the predominant symptom, and (b) dysmotility-like dyspepsia when discomfort (not pain) is the predominant symptom. This classification is supported by recent evidence suggesting that predominant symptoms, but not symptom clusters, identify subgroups with distinct underlying pathophysiological disturbances and responses to treatment. Aerophagia is an unusual complaint characterized by air swallowing that is objectively observed and troublesome repetitive belching. Functional vomiting refers to frequent episodes of recurrent vomiting that is not self-induced nor medication induced, and occurs in the absence of eating disorders, major psychiatric diseases, abnormalities in the gut or central nervous system, or metabolic diseases that can explain the symptom. The current classification requires careful validation but the criteria should be of value in future research.
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PMID:Functional gastroduodenal disorders. 1045 43

This is the first attempt at defining criteria for functional gastrointestinal disorders (FGIDs) in infancy, childhood, and adolescence. The decision-making process was as for adults and consisted of arriving at consensus, based on clinical experience. This paper is intended to be a quick reference. The classification system selected differs from the one used in the adult population in that it is organized according to main complaints instead of being organ-targeted. Because the child is still developing, some disorders such as toddler's diarrhea (or functional diarrhea) are linked to certain physiologic stages; others may result from behavioral responses to sphincter function acquisition such as fecal retention; others will only be recognizable after the child is cognitively mature enough to report the symptoms (e.g., dyspepsia). Infant regurgitation, rumination, and cyclic vomiting constitute the vomiting disorders. Abdominal pain disorders are classified as: functional dyspepsia, irritable bowel syndrome (IBS), functional abdominal pain, abdominal migraine, and aerophagia. Disorders of defecation include: infant dyschezia, functional constipation, functional fecal retention, and functional non-retentive fecal soiling. Some disorders, such as IBS and dyspepsia and functional abdominal pain, are exact replications of the adult criteria because there are enough data to confirm that they represent specific and similar disorders in pediatrics. Other disorders not included in the pediatric classification, such as functional biliary disorders, do occur in children; however, existing data are insufficient to warrant including them at the present time. For these disorders, it is suggested that, for the time being, clinicians refer to the criteria established for the adult population.
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PMID:Childhood functional gastrointestinal disorders. 1045 47

The purpose of this study was to describe presenting symptoms, diagnostic testing, treatments and outcomes in a group of children with a diagnosis of aerophagia. A computerized diagnostic index was used to identify all children between the age of 1 and 17 years diagnosed with aerophagia at a tertiary care medical centre between 1975 and 2003. Individual medical charts were abstracted for information on the demographics, clinical features, co-morbid diagnoses, diagnostic work up and treatment of children with aerophagia. Information on presenting symptoms was also collected for a group of children who were retrospectively classified as having functional dyspepsia for comparison (n = 40). Forty-five children had a diagnosis of aerophagia. The mean duration of symptoms in children with aerophagia was 16 +/- 5 months. The most common gastrointestinal symptoms were abdominal pain, distention and frequent belching. Children with functional dyspepsia had a higher prevalence of nausea, vomiting, abdominal pain and unintentional weight loss compared to children with aerophagia (all P < 0.05). In conclusion, aerophagia is a disorder that is diagnosed in neurologically normal males and females, who can experience prolonged symptoms. Although many children with aerophagia present with upper gastrointestinal symptoms, the disorder appears to be distinct from functional dyspepsia.
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PMID:Aerophagia in children: characterization of a functional gastrointestinal disorder. 1607 40


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