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

This study has investigated the relationship between duodenogastric reflux, gastritis and certain symptoms 6-12 months after three operations for uncomplicated duodenal ulcer. The operations studied were proximal gastric vagotomy (PGV, 20 cases), truncal vagotomy and pyloroplasty (TV+P, 22 cases) and truncal vagotomy and antrectomy (TV+A, 21 cases). Duodenogastric reflux was assessed both by a radiological technique and by measuring the concentration of bilirubin in the gastric aspirate before and after operation. Incidence and severity of postoperative gastritis were determined by endoscopic biopsy. Symptoms were assessed by symptomatic score and Visick grading. There was a significant correlation between duodenal reflux and histological evidence of both severe superficial gastritis and glandular atrophy (P less than 0-01). There was also a close association between the degree of reflux and the presence of severe heartburn, epigastric pain and bile vomiting after operation. The amount of reflux did not differ before operation. There was significantly less reflux following PGV than after either TV+P (P less than 0-025) or TV+A (P less than 0-001). The results indicate that an operation which preserves an innervated and intact antrum and pylorus will protect against postoperative duodenogastric reflux, gastritis and symptoms.
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PMID:The importance of an innervated and intact antrum and pylorus in preventing postoperative duodenogastric reflux and gastritis. 0 Jan 23

Reflux gastritis is a symptom-complex consisting of antacid-resistent epigastric pain, nausea and frequent vomiting, weight loss and anaemia, sometimes with evident gastrointestinal haemorrhage. Gastric secretory studies usually show achlorhydria. The onset of symptoms is usually abrupt in previously healthy subjects. From 1973 to 1977, eleven patients with the established diagnosis of reflux gastritis have been treated with a Roux-en-Y reconstruction, as a remedial operation. There was no mortality in the series. At follow-up after a mean time of two years, the result was graded as excellent in ten patients and as fair in one. It is concluded that the Roux-en-Y procedure can be recommended in patients with reflux gastritis.
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PMID:Roux-en-Y loop reconstruction as remedial operation for reflux gastritis after gastric resection. 27 33

In a prospective study of patients with haematemesis and melaena, there were 22 admissions of patients with bleeding stomal ulceration, representing 2.5% of total admissions to the Unit. In 16 patients the bleeding was from superficial stomal lesions. These lesions, endoscopically and histologically, resembled alkaline reflux gastritis, a recently defined cause of postgastrectomy bile vomiting. Five patients presented with chronic ulceration following inadequate gastric surgery. One patient was admitted on two occasions. Nine patients received more than five units of blood and came to operation for continued bleeding. In seven of the surgical cases, the bleeding was from superficial stomal lesions. Our experience suggests that truncal vagotomy is necessary to control the bleeding in these patients. One patient presented with superficial stomal ulceration and carcinomatous change. This patient died. It is important to subject these lesions to biopsy, and biopsy with extension of a previous gastrectomy is indicated to control bleeding, and to exclude malignancy.
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PMID:Bleeding stomal ulceration. 28 21

Alkaline gastritis and alkaline esophagitis are now precisely defined syndromes. They occur most often after gastric surgery in which function of the pyloric and lower esophageal sphincter is compromised. Reflux of bile in these patients can then lead to severe inflammation of the gastric and lower esophageal mucosa. Epigastric pain, nausea and bilious vomiting are characteristic symptoms. Gastroscopy with biopsy is, therefore, the definitive diagnostic test; during endoscopy bile is seen in the lower esophagus or stomach, and the mucosa is red, friable and contains acute erosions. Conservative therapy including the administration of cholestyramine has not been helpful. Surgery consisting of diversion of the duodenal contents away from the stomach and lower esophagus is the treatment of choice. The Roux-en-Y procedure has been used most often and has resulted in the amelioration of the symptoms and signs in most patients.
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PMID:Alkaline gastritis and alkaline esophagitis: a review. 32 67

Bile acids have been proposed to be important in the pathophysiology of the syndrome of "bile reflux gastritis" after surgery. To examine the role of cholestyramine, an ion exchange resin that binds bile acids, on symptoms of this syndrome, we did a randomized, double-blind crossover study on 16 patients. No differences in frequency of abdominal pain, nausea, vomiting, or bitter taste were observed among cholestyramine (4 g, three times daily for 3 weeks), placebo, and routine (dietary restriction and ad libitum antacid) treatment periods. We conclude that this regimen of cholestyramine was ineffective in symptomatic treatment of bile reflux gastritis.
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PMID:Effect of cholestyramine on the symptoms of reflux gastritis. A randomized, double blind, crossover study. 33 Mar 2

Seventeen patients have completed a double-blind cross-over study of hydrotalcite against placebo in the treatment of bile vomiting after surgery for peptic ulcer. Overall there was no significant difference between the two treatments, with 9 patients improving on hydrotalcite and 5 on placebo. The original operation had been peformed less than 3 years before the study in 9 patients; in this subgroup there was an improvement on hydrotalcite treatment in 8 patients but in only 1 on placebo. These differences are statistically significant (P less than 0.005). Nausea, vomiting, heartburn and epigastric tenderness were improved although gastritis and endoscopic changes were not affected. It appears that hydrotalcite can help palliate symptoms of bile vomiting occuring soon after surgery for peptic ulcer.
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PMID:Hydrotalcite in the treatment of bile vomiting. 33 90

This study reports on ten patients with typical bile gastritis who had no prior gastric surgery. Clinical symptoms included burning epigastric pain unrelieved by food or antacid, episodic nausea, and vomiting of bile. In all patients the symptoms appeared after cholecystectomy, with (four patients) or without (six patients) transduodenal sphincterotomy; the symptoms were often initially attributed to chronic pancreatitis. Six patients had hypochromic, microcytic anemia. Eight patients had basal achlorhydria; stimulated acid secretion was low or absent in seven patients. Gastroscopic examination revealed gastritis, most prominent in the prepyloric antrum, and abundant bile lakes. Mucosal biopsy disclosed chronic gastritis. Although medical therapy failed, seven of eight patients treated by vagotomy, hemigastrectomy, and long Roux-en-Y gastrojejunostomy had immediate and sustained relief. Cholecystectomy appears to be a critical factor in the pathogenesis of bile gastritis in patients who have not had prior gastric surgery. Without the reservoir function of the gallbladder, the unregulated flow of bile into the duodenum probably promotes the access of bile to the unprotected gastric mucosa.
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PMID:Bile gastritis without prior gastric surgery: contributing role of cholecystectomy. 42 2

A 5-month-old infant presented with vomiting and severe hypoproteinemia from exsudation of proteins into the digestive tract, confirmed by isotopic tests. The association of hypertrophic edematous gastritis, interstitial jejunitis, and severe blood eosinophilia suggested the diagnosis of an exsudative eosinophil-type gastro-enteropathy. An allergy to cow's milk proteins was suspected because of the onset of the disorders at the time of weaning and the appearance of the eczema during the same period. Clinical, biological, and radiological recovery occurred after an exclusion diet and corticotherapy, and this persisted for 8 months, but the eczema remained. The authors describe a similar case (12) in an infant of 21 months with vomiting edema, and hypoproteinemia due to exsudation of proteins into the digestive tract. Radiological examination revealed the presence of hypertrophic gastritis. A relationship with Mentrier's disease had been suggested but not confirmed because of the rapid favourable outcome after a simple low protein diet.
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PMID:[Hypertrophic gastritis in an infant with eczema and intolerance to cow's milk proteins (author's transl)]. 57 73

Eighteen patients with dyspepsia and vomiting which followed surgery for peptic ulcer have completed a study to examine the role of diverting bile from the stomach by a Roux-en-Y procedure. Bile regurgitation and mild epigastric pain relieved by vomiting were abolished. Measurements of bile acids in the fasting gastric aspirate were useful in predicting the outcome of surgery; good results were obtained when initially there was reflex into the stomach of more than 120 mumol/hour of bile acids. A wider group of patients than those selected in previous series may benefit from this operation, as good results can be obtained in patients with dyspepsia relieved by alkali and without achlorhydria or gastritis. Endoscopy was repeated one year after Roux-en-Y operation. Erythema of the mucosa was improved, but gastritis did not improve.
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PMID:Selection of patients for bile diversion surgery: use of bile acid measurement in fasting gastric aspirates. 63 35

We observed 16 patients suffering from postoperative gastritis: 8 after a truncal vagotomy with pyloroplasty, 6 after a Billroth II type gastrectomy, 1 after a truncal vagotomy with a Billroth I type antrectomy, 1 after correction of a hiatal hernia with pyloroplasty. Symptoms appeared from 1 month to 16 years after surgery. They consisted in epigastric pain, nausea, vomiting, weight loss. The diagnosis is established essentially on the clinical picture and the endoscopy, which shows the presence of bile in the stomach and hyperemia of the mucosa. Microscopic lesions are constant, but there is no histologic specificity. 12 of 16 patients were operated on (Roux-enY loop). The reflux was suppressed in each case. Results of the operation were excellent or good in 10 patients, fair in one and unsatisfactory in one.
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PMID:[Postoperative gastritis caused by reflux. Apropos of 16 cases]. 65 39


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