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

Bulimia is an eating disorder characterized by binge eating followed by purging, i.e. self-induced vomiting, abuse of cathartic or diuretic drugs, increased activity or periods of restrictive dieting. Studies show that persons with bulimia are prone to a number of medical complications as a result of binge-eating, vomiting and drug abuse. Vomiting is the most harmful in terms of medical risk, and also the most common source of complications. Both vomiting and purging lead to loss of body fluids and electrolytes, often resulting in hypokalemia. Vomiting also leads to sore throats and dental problems such as destruction of enamel. Gastric dilatation is the only complication directly associated with binge-eating. Harmless symptoms, such as abdominal pain, diarrhoea, constipation and neuromuscular symptoms are common. This article discusses the pathophysiology behind the complications and their treatment.
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PMID:[Somatic and biochemical complications in bulimia]. 218 71

The use of spinally administered opioids to manage pain is discussed. Central action on opioid receptors of the substantia gelatinosa allows opioids to be administered spinally for pain originating anywhere inferior to the cranial nerves. Spinal opioids are most commonly administered for intractable midline sacral and perineal pain. The best candidates for spinal opioids are patients in whom appropriate "conventional" therapy no longer provides adequate relief, patients who experience severe adverse effects from conventional therapy, and patients for whom alternative anesthetic procedures are inappropriate or have failed. A reasonably safe initial dose is morphine sulfate 1 mg intrathecally. The availability of preservative-free, concentrated morphine sulfate enables larger doses to be safely and comfortably administered. Increased dosage requirements may result from tolerance, progression of disease, increased systemic absorption, or slippage of the catheter tip. As with systemically administered opioids, care must be exercised when discontinuing spinal opioid therapy. Adjuvant drugs used with spinal opioids include systemically administered analgesics, antidepressants, corticosteroids, and spinal local anesthetics. The administration of spinal opioids with systemic opioids or other CNS depressants may result in excessive sedation, respiratory depression, nausea, vomiting, constipation, pruritus, and other adverse effects. Spinally administered opioids can be used to manage severe chronic pain effectively, safely, and comfortably.
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PMID:Pain management with spinally administered opioids. 220 8

Based on recent epidemiologic studies of functional intestinal disorders, we have attempted to answer the following two questions: a) what is the prevalence of functional intestinal disorder in the Western world, b) are there epidemiologic variations in the different modes of symptomatic presentation of functional intestinal disorders? The overall prevalence of functional intestinal disorders in the Western world ranges between 17 and 23 percent according to the country considered, and is between 14 and 18 percent for the irritable bowel syndrome and 4 to 8 percent for painless constipation. The "irritable intestine" group is characterized by a sex ratio of close to one, a median age near 40, a strong influence of stress on symptoms, and the frequency of complaints such as nausea, vomiting, migraine, and pyrosis. The syndrome is seen in active subjects, who believe that they are "sick", and as such, seek medical advice often. Anxiety and depression are frequently encountered. Patients are often athletes, smokers, and have diarrhea. On the other hand, "painless constipation" is characterized by a high prevalence of women and age over 50. Often these subjects do not have any active professional activity. Stress-related and extradigestive symptoms are rare. They do not consider themselves "sick" and do not seek medical advice very often. Conversely, they use laxatives frequently. Individualization of epidemiologically different groups suggests that the pathophysiology may differ between the two groups and perhaps that there are specific therapeutic and diagnostic approaches accordingly.
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PMID:[Epidemiology of the irritable bowel syndrome]. 221 Jan 92

From a total of 174 children treated with malrotations from 1971 to 1988, 148 could be evaluated for long-term results of surgical treatment. The various modalities of treatment were: no correction, dissection of Ladd's bands only, caecoascendopexy, Ladd's procedure and the so-called total correction. Comparing the late results in children with and without correction it was found that those without correction, i.e. without pexy, had to be reoperated in 17% of the cases, whereas the totally corrected children required reoperation in 8% of the cases only. Corrected cases needed to be admitted but not operated later because of pain, constipation, vomiting or poor weight gain in 23%, the uncorrected ones in 6%. Likewise, corrected malrotations resulted in complaints in 27% in contrast to the noncorrected ones in 9%. The conclusion is that total correction results in fewer reoperations but in more symptoms not requiring surgery.
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PMID:[Surgical therapy of malrotations in childhood]. 223 46

Idiopathic infantile hypercalcaemia is a rare state characterized by failure to thrive, anorexia, vomiting, constipation and psychomotor retardation. We report a case of an infant with this syndrome.
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PMID:[Idiopathic infantile hypercalcemia]. 225 89

Twelve patients with chronic constipation refractory to the vigorous use of emollients, enemas, and/or laxatives were chosen for study of the investigational prokinetic agent, Cisapride. The patients included 8 boys and 4 girls with diagnoses of functional constipation. Ages ranged from 2 to 13 years; duration of symptoms before Cisapride use ranged from 1.5 to 9.75 years; duration of previous treatment ranged from 0.75 to 6 years. The mean number of doses of anticonstipation agents employed per week was 14. Of the 12 patients, 10 had persistent encopresis, while 11 required hospitalization for disimpaction an average of 1.6 times in the year prior to Cisapride use. Three had chronic urinary tract complaints. Anal manometry suggested a sensory deficit in 8 of 10 patients tested. Ganglion cells were identified by rectal biopsy in all 12 patients. Cisapride treatment (0.14-0.3 mg/kg/dose) spanned 26-72 weeks (61 +/- 12). Stool frequency per week was not significantly changed, but five of seven patients who had reported hard stools had softer stools on the drug (p less than 0.05). Encopresis ceased in 8 of 10 cases, while the number of episodes decreased substantially in the other 2 cases (p less than 0.05). All alternate forms of anticonstipation therapy were withdrawn in 8 of 12 cases (p less than 0.001). Urinary problems improved in two of the three patients reporting symptoms. One patient showed no improvement in any parameter while on the agent, despite 26 weeks of administration. Side effects were infrequent, generally occurred early, and were limited to cramping, nausea, mild vomiting, anorexia, and headaches. One patient ceased use of the drug for persistent headaches.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Cisapride for intractable constipation in children: observations from an open trial. 226 39

This work presents a review of the enterosorption procedure, spheres of its application, the results achieved and prospects for use in the future. This technique was developed by the author in the late 1970's and is based on peroral administration of high doses of synthetic activated carbons. This review also summarises new experimental and clinical reports by Soviet researchers who studied the use of enterosorption procedure in liver and biliary tract diseases, endogenous intoxications, acute intestinal infections, renal pathologies and immuno-dependent diseases, metabolism in aged animals, in oncologic patients, abstinence syndrome in alcohol and drug-abuse patients. The peroral application of activated carbons has been known for a long time. The most extensive list of usage of activated carbons has been presented by Adler in the first quarter of this century. The powdery activated charcoal usually was prescribed in doses of 2-10 g per day, since larger doses caused nausea, vomiting and constipation, and that demanded simultaneous usage of cathartics. The Carbon sorption therapy, soon became neglected owing to development of potent antibacterial preparations, and probably due to depleted enteric content of the components which are necessary for the organism. Later, carbon sorption therapy was investigated for use in uremia. In 1979, the author of this article proposed the use of oral administration of high doses (up to 100-150 g/day) of synthetic activated carbons with diameters 0.2-1.0 mm, derived through pyrolysis of various polymeric resins. The reasons for this approach which we termed enterosorption, were good adsorptive properties, smooth surface, strength and uniformal nature of synthetic carbon adsorbents, causing practically no symptoms of enteropathy which are typical for high doses of powdery carbons. We have described our earlier clinical results of this approach. Since that time the number of studies has substantially increased in the USSR. Accordingly, the author deemed it expedient to attempt a review of the results.
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PMID:Peroral application of synthetic activated charcoal in USSR. 228 20

This randomized, double-blind, multi-centre study was undertaken to evaluate the efficacy and safety of treatment for 4 weeks with codeine plus paracetamol versus paracetamol in relieving chronic pain due to osteoarthritis of the hip. A total of 158 outclinic patients entered the study. Eighty-three patients (mean age 66 years) were treated with codeine 60 mg plus paracetamol 1 g 3 times daily, and 75 patients (mean age 67 years) with paracetamol 1 g 3 times daily. Ibuprofen 400 mg was prescribed as rescue medication. Due to an unexpected high rate of adverse drug reactions, the study was closed before the planned 400 patients had entered. Over weeks 1-4, 87%, 64%, 61% and 52% of patients in the codeine plus paracetamol group, and 38%, 31%, 22% and 29% of patients in the paracetamol group had one or more adverse drug reactions. Significantly more patients in the codeine plus paracetamol group had adverse drug reactions in each of the 4 weeks. Nausea, dizziness, vomiting and constipation were predominant adverse reactions in the codeine plus paracetamol group. During the first week of treatment, 30 patients (36%) in the codeine plus paracetamol group and 9 (12%) in the paracetamol group dropped out. As evaluated from patients completing the first week of treatment, the pain intensity during that week compared to their baseline pain was significantly lower in the codeine plus paracetamol group than in the paracetamol group. Moreover, during the first week the paracetamol group received rescue medicine significantly more frequently. In conclusion, when evaluated after 7 days of treatment, the daily addition of codeine 180 mg to paracetamol 3 g significantly reduced the intensity of chronic pain due to osteoarthritis of the hip joint. However, several adverse drug reactions, mainly of the gastrointestinal tract, and the larger number of patients withdrawing from treatment means that the addition of such doses of codeine cannot be recommended for longer-term treatment of chronic pain in elderly patients.
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PMID:Codeine plus paracetamol versus paracetamol in longer-term treatment of chronic pain due to osteoarthritis of the hip. A randomised, double-blind, multi-centre study. 229 42

Undiagnosed abdominal emergencies account for 10 percent of all fatalities among patients with spinal cord injuries. A large number of these emergencies involve the lower gastrointestinal tract. The purpose of this study is to bring attention to the occult nature of colorectal disease in spinal cord patients and to highlight the subtle, but characteristic, symptoms and signs that develop in these patients. The authors identified 13 spinal cord patients in whom a lesion developed in either the appendix, colon, rectum, or anus. The average age of all patients was 36.2 years. Trauma and multiple sclerosis were the most common etiology of spinal cord injury. The most common presenting symptoms were abdominal distention, vomiting, and constipation. The average delay in diagnosis of the colorectal disease was 35.8 hours. An 84% morbidity and 22% mortality were observed. This study indicates that any deviation from the normal lifestyle of the spinal cord patient should alert one to the possibility of visceral inflammation. Furthermore, close attention to the signs of autonomic dysreflexia or changes in spasticity, along with a thorough evaluation of the ill-appearing spinal cord patient, may uncover occult colonic or rectal disease.
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PMID:Colorectal disease in spinal cord patients. An occult diagnosis. 229 99

10-Edam (10-ethyl-10-deaza-aminopterin), an antifolate derivative, was administered to 14 chemotherapy-naive patients with advanced colorectal carcinoma. The drug was given weekly by intravenous route at an initial dose of 80 mg/m2, with escalation or attenuation according to tolerance. Mucositis was dose limiting and occurred in 11 of 14 patients (78.6%). Removal from the study was required in one patient due to progressive pulmonary fibrosis that was histologically identical to methotrexate-induced lung damage. Toxicity was otherwise mild to moderate and included diarrhea, constipation, abdominal discomfort, anorexia, nausea/vomiting, rash, and fatigue. There were no responses to 10-Edam in this study, 95% confidence interval (0-0.23). Stable disease was achieved in four patients; the remaining 10 patients demonstrated progression within 9 weeks of initiating systemic therapy. 10-Edam employed at this dosage and schedule was not effective as a treatment against advanced colorectal carcinoma.
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PMID:Phase II trial of 10-Edam in patients with advanced colorectal carcinoma. 230 19


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