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)

Among 51 patients with refractory symptomatic reflux esophagitis seen during an 18-month period, 8 (16%) had undergone previous partial gastrectomy. Either Billroth II (n = 6) or Billroth I (n = 2) resection had been carried out for peptic ulceration 18 months to 30 years beforehand. Each patients was evaluated by symptom scoring, endoscopy, and 24-hour pH monitoring plus a 16-hour esophageal aspiration study, in which 2-hourly aliquots were measured for acid, pepsin, conjugated and unconjugated bile acids, and trypsin. After conversion to a 45 cm Roux-en-Y gastroenterostomy, symptom scoring and endoscopy were repeated at 6 to 12 months in all eight patients. Pepsin, acid, and unconjugated bile acids were seldom present in esophageal aspirates. Conjugated bile acids in concentrations up to 30 mmol/L and trypsin up to 428 micrograms/ml were found in cases of severe esophagitis, mostly during nocturnal rest. Esophagitis, heartburn, regurgitation, and bilious vomiting were eradicated by Roux-en-Y conversion, but other postgastrectomy symptoms (early satiety, dumping, epigastric pain, and diarrhea) were largely unchanged. Postgastrectomy esophagitis resistant to medical therapy seems likely to be caused by nocturnal exposure to trypsin and conjugated bile acids; it is well controlled by a 45 cm Roux-en-Y conversion.
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PMID:Evaluation and surgical correction of esophagitis after partial gastrectomy. 172 72

The frequency and the possible age-related characteristics of gastro-oesophageal reflux disease (GORD) were investigated in 195 consecutive elderly subjects (mean age 74 years), referred to endoscopy for abdominal symptoms or sideropenic anaemia. In the 105 of these patients in whom there was any suspicion of GORD, 24-hour pH monitoring was carried out. All the patients were interviewed before the examinations. Erosive or complicated (grade 2-4) oesophagitis was found in 18% of patients. The main symptoms in these patients were dysphagia, respiratory symptoms and vomiting. Chronic cough, hoarseness or wheezing were present in 57% of patients with oesophagitis compared with 33% of those without oesophagitis (p less than 0.001). The occurrence of heartburn and regurgitation did not differ significantly between patients with or without oesophagitis, although the mean symptom scores were higher in those with oesophagitis. Dyspepsia and chest pain were not typical symptoms in oesophagitis. Of patients with oesophagitis 29% had no typical symptoms of GORD; only 24% of patients with regurgitation had oesophagitis. In 24-hour pH monitoring, a significant increase in the occurrence of symptoms was not seen until total reflux time pH less than 4 exceeded 10%. The occurrence of heartburn did not correlate with the extent of reflux in the pH study. In conclusion, typical symptoms of GORD in the aged were regurgitation, dysphagia, respiratory symptoms and vomiting rather than heartburn.
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PMID:Symptoms of gastro-oesophageal reflux disease in elderly people. 175 93

An interrelationship of regurgitation and a motor reaction (MR) of the type of a shudder was revealed in infants. A jerking motor activity occurred in lower rate of respiration and decrease of its amplitude. The muscles of respiration are also involved in the activity in this case, which leads at first to expiration and regurgitation and then to inspiration only. Expiration is attended by a specific component of a vomiting reaction--jerky contraction of the abdominal muscles directed at evacuation of the food from the gastrointestinal tract. It is shown that regurgitation occurs most frequently in babies born in a state of asphyxia in whom a shudder-type MR occurs very often.
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PMID:[Regurgitation and motor reactions in infants]. 180 95

Dopamine antagonists are effective anti-emetics. Domperidone does not readily cross the blood-brain barrier and is less likely to cause central nervous system side-effects than metoclopramide. However, a direct comparison of the safety and efficacy of the two drugs has not hitherto been made. Ninety-five patients, with symptoms of nausea and vomiting due to a variety of oesophageal or gastric disorders, were recruited into a randomised, double-blind, three-part, parallel-group comparative study of controlled release metoclopramide 15 mg (Gastrobid Continus tablets, Napp Laboratories) given twice daily, and domperidone 10 mg or 20 mg given three times daily. Assessments for nausea, vomiting, reflux symptoms and adverse events were made on entry to the study. Patients were randomly allocated to one of the three treatment regimes for a period of seven days, throughout which daily symptomatology and use of escape medication were recorded on a diary card. At the end of the treatment period, nausea, vomiting and reflux symptoms, adverse events and a global assessment of patients' symptom control were recorded by the investigator. Both controlled release metoclopramide and high and low dose domperidone significantly reduced symptoms of belching, flatulence, distension, heartburn, regurgitation, reflux, nausea and vomiting compared to baseline. There were no significant differences between the three treatments in efficacy or in the number and severity of side-effects.
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PMID:A comparison of controlled release metoclopramide and domperidone in the treatment of nausea and vomiting. 181 Mar 56

By means of two of our own cases we report on congenital esophagostenosis which occurs in a proportion of 1:50,000. The typical clinical symptoms consist of frequent vomiting, regurgitation of undigested food particles which have no acid smell, and regurgitation of viscous mucus and saliva. In the last decade direct operative treatment has taken the place of primary bougienage therapy.
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PMID:Congenital esophagostenosis. 189 99

The authors reviewed the ultrasonographic (US) images and medical records of 145 consecutive infants who were seen for evaluation of the upper gastrointestinal tract because of chronic vomiting and/or regurgitation. At US, the antropyloric muscle of each patient was measured in the midlongitudinal plane. On the basis of this measurement, the patients were divided into the following categories: group 1 (1-2 mm; 99 patients), group 2 (greater than or equal to 3 mm; 40 patients), and group 3 (2- less than 3 mm; six patients). Patients in group 1 were considered to have normal antropyloric muscle thickness, those in group 2 had abnormal thickness, and those in group 3 had muscle thickness that was not definitely normal or abnormal. The final clinical diagnoses for all of the infants in the three groups confirmed the authors' initial impressions that antropyloric muscle thickness of less than 2 mm was anatomically normal, muscle measuring 3 mm or greater was abnormal and diagnostic for pyloric stenosis, and muscle from 2 to less than 3 mm was abnormal but not specifically diagnostic for pyloric stenosis. Two of the six patients in group 3 eventually were diagnosed as having pyloric stenosis; thus, the authors believe that only those patients with antropyloric muscle less than 2 mm thick should be considered unequivocably normal.
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PMID:Antropyloric muscle thickness at US in infants: what is normal? 199 26

The results are presented of an investigation by barium swallow of 271 younger siblings of children with hiatal hernia (HH). The incidence of HH among younger siblings with a history of repeated vomiting and regurgitation was 41% and in those without symptoms was 4.3%.
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PMID:Findings on barium swallow in younger siblings of children with hiatal hernia (partial thoracic stomach). 205 Dec 68

In a double-blind, placebo-controlled, crossover trial, we investigated the effects of the prokinetic drug cisapride in patients with cystic fibrosis and chronic recurrent distal intestinal obstruction syndrome (DIOS). After a baseline period, 17 patients (12.9 to 34.9 years; 12 boys) received, in random order, cisapride (7.5 to 10 mg) and placebo three times daily by mouth, each for 6 months. Gastrointestinal symptoms (flatulence, abdominal pain, fullness, abdominal distension, nausea, anorexia, heartburn, diarrhea, vomiting and regurgitation) were scored three times monthly and physical examinations assessed. At baseline and at each 6-month period, assessment included food intake for 7 days, 3-day stool collection, pulmonary function tests, and abdominal radiographs. During cisapride therapy compared with placebo, there were significant reductions in flatulence (p less than 0.005), fullness, and nausea (p less than 0.05). Patients with the worst symptom scores benefited most from cisapride. With cisapride, 12 patients felt better and three worse (p less than 0.05); physicians judged 11 patients improved and two worse (p less than 0.05). No side effects were noted. There were no significant differences between cisapride and placebo periods in nutritional status, x-ray scores, pulmonary function, food intake (fat, protein, calories), stool size and consistency, and fecal losses of fat, bile acids, chymotrypsin, and calories. For acute episodes of DIOS, intestinal lavage was needed 6 times in 4 patients during treatment with cisapride, and 11 times in 6 patients receiving placebo. In comparison with unselected patients with cystic fibrosis and pancreatic insufficiency who were receiving enzyme supplements and who had no distal intestinal obstruction, fecal fat losses (percentage of intake) were almost twice as high in the study group with DIOS (31.2 +/- 20.6% vs 16.2 +/- 17.6%; p less than 0.01). We conclude that in the dosage used, long-term treatment with cisapride appears to improve chronic abdominal symptoms in patients with cystic fibrosis and DIOS, but fails to abolish the need for intestinal lavage. Cisapride treatment had no effect on digestion and nutritional status of cystic fibrosis patients with pancreatic insufficiency.
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PMID:Effects of cisapride in patients with cystic fibrosis and distal intestinal obstruction syndrome. 223 Dec 17

The case of a young women with dysphagia, regurgitation, and weight loss, who was diagnosed as having anorexia nervosa but in whom reevaluation showed that achalasia was causing the symptoms, is presented together with related observations. Misinterpretation of esophageal symptoms may occur not only as a consequence of inadequate history taking and of being biased by a patient's emaciation, age, and gender, which leads to view certain aspects of the patient's history and behavior as suggesting a pathologic attitude towards eating and body weight, but also as a consequence of a misinterpretation of the symptoms as indicative of an eating disorder by the patients themselves. In some cases a disordered attitude toward eating and body weight may develop together or coexist with achalasia. The clinical evaluation of patients with symptoms suggestive of anorexia nervosa but also of bulimia nervosa should include the taking of a thorough history regarding swallowing and vomiting in order to recognize a possible esophageal motor disorder.
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PMID:Symptoms of achalasia in young women mistaken as indicating primary anorexia nervosa. 227 21

Chronic intermittent duodenal obstruction caused by stenosis of the distal duodenum is a rare disease. Tight fixation of the ligament of Treitz, compression due to mesenteric lymphomatas or abnormal attachment of the mesocolon can cause intermittent impairment of intestinal passage. It will be necessary to differentiate this against genuine arterio-mesenteric duodenal obstruction as well as nerve motility disorders. History in the appropriate cases reports on postprandial episodes of regurgitation, sensation of fullness, nausea, vomiting and paroxysmal upper abdominal colicky pain. Radiograms always reveal gastroptosis and a varying degree of duodenal obstruction, usually with retroperistalsis. The passage is markedly delayed, with an impairment sometimes at the site of the duodenojejunal flexure. Therapy is always surgical. 8 own cases were cured by leftsided duodenal mobilisation according to Clairmont with additional caudad positioning and fixation of the duodenojejunal flexure.
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PMID:[Chronic intermittent duodenal obstruction in childhood]. 229 39


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