Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The indications for Primperan during pregnancy are presented: vomiting and pyrosis, prevention of Mendelsohn's syndrome when general anaesthesia is required during pregnancy or labour. 20 years of pharmacovigilance confirm the good maternal and foetal tolerance of this drug.
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PMID:[Primperan during pregnancy]. 403 9

The results are reported from the treatment of 30 patients with the Bulgarian preparation biomet, which is a blocker of histamine H2-receptors. The treatment lasted 20 days with 3 X 20 mg biomet, after meals, and 400 mg in the evening before going to bed. Pains disappeared in 86,6 per cent with biomet treatment, pyrosis--in 95,8 per cent, eructation--in 95,3 per cent, nausea--in 84,7 per cent, vomiting--in 100 per cent of the patients, etc. (the clinical symptoms completely disappeared in 76,7 per cent after the treatment and were substantially reduced in 16,7 per cent). A statistically significant reduction of the basic parameters of gastric secretion and acid output occurred after biomet treatment as compared with the initial values. The fibroendoscopic study of the duodenal ulcer, after the treatment, revealed a complete epithelization in 52 per cent and diminished ulcer size--in 44 per cent. No pronounced adverse effects were observed during biomet treatment. The Bulgarian preparation biomet is fully equivalent to the English Cimetidine (the latter being more expensive) and should find a broad application in the treatment of duodenal ulcer.
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PMID:[Treatment of duodenal ulcer with biomet]. 614 53

A total of 153 patients (124 male and 29 female) with uncomplicated chronic duodenal ulceration were studied in a prospective, randomized trial of proximal gastric vagotomy (PGV) and truncal vagotomy and pyloroplasty (TVP), conducted in four Manchester hospitals. Of these, 137 patients have now been followed up for 2.5 to 5.5 (mean 4.1) yr. There have been 15 (21 per cent) recurrent ulcers following PGV compared with 5 (7.5 per cent) after TVP (P less than 0.05). A satisfactory functional result was obtained in 82 per cent of patients after TVP compared with 73 per cent following PGV and there was little difference between the groups with regard to the incidence of dumping, heartburn and vomiting. There was significantly more diarrhoea following TVP (13 per cent) compared to PGV (1.4 per cent) but this represented only a minor clinical problem.
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PMID:A prospective randomized trial of vagotomy in chronic duodenal ulceration: 4-year follow-up. 634 56

Data from six randomized, placebo-controlled clinical trials of aspirin, involving a total of 10,703 postmyocardial infarction (MI) patients, are compared and combined. After adjustment for a number of prognostically important baseline factors, the reduction in total mortality by aspirin was 10% (P = 0.044). This beneficial trend was particularly pronounced during the 1st yr of daily aspirin ingestion, but did not differ between patients who entered the trial less than 6 mo and greater than 6 mo after their last MI. Significant beneficial effects of aspirin were noted with respect to 1) diagnosis of definite nonfatal MI and 2) hospitalization for greater than 2 wk for MI. Significant adverse effects of aspirin were noted with respect to the side effects of stomach pain, heartburn and vomiting, elevation of systolic blood pressure to greater than 160 mm Hg, and elevation of serum urea nitrogen and serum uric acid levels to the abnormal range.
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PMID:Aspirin in coronary heart disease. Comparison of six clinical trials. 634 61

The etiology, pathogenesis, diagnosis, and treatment of reflux esophagitis are reviewed. Reflux esophagitis is the subjective or objective response to gastroesophageal reflux (GER), which is defined as the entrance of gastroduodenal contents into the esophagus not associated with vomiting or belching. The pathogenesis of reflux esophagitis may involve a number of mechanisms, including changes in lower esophageal sphincter pressure, gastric volume, composition of the refluxate, esophageal acid clearance, and esophageal tissue resistance. The most common symptom of reflux esophagitis is heartburn. Regurgitation of fluid into the mouth, usually after bending or during the night, is an unequivocal symptom of GER. Treatment can be divided into three phases. Phase 1 involves the avoidance of certain foods and habits, elevation of the bed head, antacid, and alginic acid-antacid therapy. Phase 2 involves drug therapy with agents not yet approved by the FDA for this indication: bethanechol chloride, cimetidine, and metoclopramide hydrochloride. Bethanechol chloride 25 mg is generally given four times daily. Cimetidine is given in doses of 300-400 mg after meals and at bedtime. Metoclopramide hydrochloride is administered in doses of 10 mg before meals and at bedtime. Phase 3 is antireflux surgery. Clinical experience has shown that phase 1 therapy is successful for about 75% of all patients. Of the 25% that do not respond to phase 1 therapy, about 90% will respond to phase 2 therapy, leaving only 5-10% of all patients with this disorder who will require phase 3 treatment. Current data favor cimetidine and bethanechol over metoclopramide. The least proof of efficacy and the most frequent adverse side effects are seen with metoclopramide. Cimetidine and bethanechol appear to have similar efficacy and relatively infrequent side effects. Evidence confirming the superiority of cimetidine over bethanechol is lacking. Further research is needed to determine the optimal pharmacologic combinations and treatment regimens.
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PMID:Current concepts in the pathogenesis and treatment of reflux esophagitis. 636 Apr 95

A study of 118 patients, operated on with Billroth II gastrectomy for peptic disease and affected by postgastrectomy syndromes, was carried out. Fifty patients were investigated by means of technetium-99m HIDA hepatobiliary scanning. In 18 patients, in whom an afferent loop syndrome was clinically suspected, hepatobiliary scanning demonstrated an altered afferent loop emptying in 8 and atonic distension of the gallbladder without afferent loop motility changes in 10. Among the patients in the first group, four were treated with a biliary diversion surgical procedure and in the second group, two patients underwent cholecystectomy. Our findings indicate that biliary vomiting, right upper abdominal pain pyrosis, and biliary diarrhea in Billroth II gastrectomized patients are not always pathognomonic symptoms of afferent loop syndrome. Technetium-99m HIDA hepatobiliary scanning represents the only diagnostic means of afferent loop syndrome definition. A differential diagnosis of abnormal afferent loop emptying and gallbladder dyskinesia is necessary for the management planning of these patients, and furthermore, when a surgical treatment is required, biliary diversion with Roux-Y anastomosis or Braun's biliary diversion seems the treatment of choice for afferent loop syndrome, whereas cholecystectomy represents the best procedure for atonic distension of the gallbladder.
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PMID:Technetium-99m HIDA hepatobiliary scanning in evaluation of afferent loop syndrome. 646 34

Nineteen patients with a history of heartburn, bile vomiting, and postprandial pain after gastric surgery have been compared with 16 symptom-free gastrectomized patients with regard to bile reflux, gastric emptying rate, and gastric mucosal changes. Bile reflux was determined by an isotope-derivative method. Gastric emptying of a liquid meal was studied by a dye dilution technique. Gastric mucosal morphology was studied in biopsies taken at gastroscopy. A significantly higher degree of bile reflux could be demonstrated in patients with symptoms than in symptom-free patients. Gastric emptying of a liquid meal occurred at the same rate in both groups. There was no correlation between the gastric emptying rate and the amount of bile reflux. The gastritis was of the same severity in patients with and without symptoms and was not related to the degree of bile reflux.
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PMID:Duodenogastric reflux after gastric surgery. 666 36

It is widely acknowledged that Barrett's esophagus in adults is an acquired condition resulting from prolonged gastroesophageal reflux. Barrett's esophagus is rare in childhood, even though gastroesophageal reflux occurs commonly in the pediatric age group. When a columnar-lined esophagus is present in children, it is often regarded as a congenital anomaly rather than as a consequence of chronic gastroesophageal reflux. Over a 5-yr period (1978-1982), we retrospectively studied Barrett's esophagus in children 19 yr of age or younger who were evaluated for gastroesophageal reflux and whose symptoms warranted esophagoscopy and esophageal biopsy. Esophageal biopsies were performed on 103 patients with gastroesophageal reflux. Thirteen children (age range, 8 mo-19 yr) had Barrett's esophagus, for a prevalence of 13%. Gastroesophageal reflux was documented in these children by upper gastrointestinal radiographs or pH monitoring. Radiographs demonstrated esophageal stricture in 5 of the 13 children; none had hiatal hernia. Children presented with symptoms suggestive of gastroesophageal reflux and esophagitis: vomiting, abdominal pain, odynophagia, dysphagia, and heartburn. All children had a past history of excessive regurgitation during infancy. Histologically, three types of columnar epithelium were present: gastric fundic type (11 patients), junctional-type columnar epithelium reminiscent of gastric cardia (7 patients), and specialized columnar (metaplastic intestinal) type (2 patients). We believe that Barrett's esophagus is more common in children than had previously been appreciated. In these children, we suggest that the distal columnar-lined esophagus resulted from chronic gastroesophageal reflux and is not a congenital anomaly.
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PMID:Barrett's esophagus in children: a consequence of chronic gastroesophageal reflux. 669 Mar 59

Between 1973 and 1976, 153 patients (124 men, 29 women) with uncomplicated, chronic, duodenal ulcer were entered into a prospective randomized trial of highly selective vagotomy (HSV) or truncal vagotomy and pyloroplasty (TVP). The study was conducted in four Manchester hospitals and the operations were performed by consultants or chief registrars. The follow-up was conducted by personal interview using a standardized questionnaire. The medical gastroenterologist did not know which type of operation the patient had had. The patients who had symptoms were referred back to the surgeon who performed the operation. The clinical laboratory and follow-up data were analysed by computer. There were no operative deaths. Three patients died from unrelated causes, 13 were lost to follow-up; 137 (89.5%) were followed up for a mean of 4.1 years (range from 2.5 to 5.5 years). A modified Visick grading was used to assess the results of surgery. The outcome was good in 82% after TVP and 73% after HSV. This difference and those in the incidences of early or late postprandial dumping, bilious vomiting, weight loss, anemia and heartburn were not significant. Diarrhea was more frequent after TVP (13.4%) than after HSV (1.4%); although the difference was significant (p less than 0.025), this complaint did not present a serious clinical problem. Ulcers recurred in 15 (21.4%) patients following HSV and in 5 (7.5%) after TVP; this difference was statistically significant (p less than 0.05).
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PMID:Randomized trial of elective highly selective or truncal vagotomy in chronic duodenal ulceration. 682 97

Although bile reflux into the stomach has been a subject of major interest during the last 15 years, its role in gastric pathology is not fully understood. The simple technique of sampling gastric contents and measuring bile acids is probably the most useful and reliable method available. Whether the reflux always precedes ulceration or is caused in some way by the gastritis remains unresolved, for bile reflux is common in many clinical situations where gastritis is present. After gastric surgery bile has been blamed for the gastritis which occurs as well as symptoms of post prandial epigastric discomfort, heartburn and bile vomiting. This is probably the only clinical situation where further procedures have been examined which specifically divert bile away from the stomach with good results. Bile reflux is also very common in patients with heartburn suggesting that bile and acid are both necessary to produce oesophagitis and heartburn. This is borne out by clinical observations and experimental work in animals. With the exception of those patients who have had gastric surgery, we have little or no evidence of the consequences of bile exclusion from the stomach in other pathological situations.
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PMID:The clinical significance of bile reflux. 694


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