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Query: UMLS:C1291077 (bloating)
1,674 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Small bowel involvement in rheumatoid arthritis is rare and is caused by vasculitis, which results in ulceration, perforation, and necrosis of the small bowel. The authors present a case of rheumatoid vasculitis associated with a small bowel stricture. The patient had a 3-week history of daily postprandial bloating, abdominal cramping, and vomiting. Barium study demonstrated partial small bowel obstruction. Pathologic examination of a resected segment of the small bowel proved that the stricture was caused by rheumatoid vasculitis. To the authors' knowledge, this is the first reported case of such an association in the radiology literature.
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PMID:Small bowel stricture caused by rheumatoid vasculitis. 160 82

The efficacy, adverse reactions, and long-term effects of intestinal lavage treatment with a balanced electrolyte solution (Golytely) was evaluated in patients with cystic fibrosis and distal intestinal obstruction syndrome. Twenty-two patients with cystic fibrosis (mean age 21.8 years, range 14 to 34 years, 15 boys or men) who sought medical attention because of abdominal pain and a mass in the right iliac fossa received Golytely, 5.6 +/- 1.9 L (mean +/- 1 SD), either orally (n = 14) or via nasogastric tube (n = 8) during 5.6 +/- 2.4 hours. No serious side effects occurred. Serum electrolyte values remained within normal limits. Body weight did not change significantly. Minor adverse reactions included bloating (n = 12), nausea (n = 8), vomiting (n = 1), and chills (n = 3). All but one patient reported impressive relief of symptoms and remained pain free for an average of 3 months (range 1 to 19 months). Symptoms of abdominal pain and radiologic signs of fecal impaction assessed before and after lavage both decreased significantly (P less than .0001). During follow-up (mean 15.2 months, range 4 to 26 months), 11 patients required a total of 38 (range one to nine) additional doses of Golytely. Seven patients drank the solution at home (21 treatments); only two patients chose a nasogastric tube. In ten patients with symptoms of recurrent distal intestinal obstruction syndrome prior to institution of therapy, duration of hospitalization was significantly reduced by this treatment (5.1 +/- 7.6 v 2.3 +/- 6.3 hospital days per annum, P less than .02).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Lavage treatment of distal intestinal obstruction syndrome in children with cystic fibrosis. 271 90

An increased incidence of small bowel lymphoma in patients with long-standing celiac sprue is well documented in the literature. Less common is the association of adenocarcinoma of the small intestine. We report a patient with celiac sprue who initially responded to a gluten-free diet. Eighteen months later, diarrhea, abdominal cramps, and bloating was found to have its origin in partial small bowel obstruction. At laparotomy, two distinct adenocarcinomas of the jejunum were resected. Celiac patients who initially respond to gluten withdrawal and subsequently suffer exacerbation while adhering to strict dietary therapy should be carefully evaluated for evidence of a small bowel malignancy.
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PMID:Adenocarcinoma of the jejunum in association with celiac sprue. 275 19

Forty-seven patients with jejunal diverticulosis were identified at the University California, Davis Medical Center, Sacramento, by a review of patient medical records from 1980 to 1986. Fourteen patients had complications that could be directly attributed to the presence of diverticula. Six patients had evidence of a malabsorption syndrome and responded to administration of broad-spectrum oral antibiotics. One patient had recurrent bouts of an asymptomatic pneumoperitoneum. A total of seven patients required operative intervention for the following conditions: massive gastrointestinal tract bleeding, two patients; mechanical small-bowel obstruction, two patients; and diverticulitis with perforation, three patients. One patient died. Nineteen patients had symptoms of epigastric pain, early satiety, and bloating for which no cause other than the presence of jejunal diverticulosis was found. Jejunal diverticulosis was an incidental finding in 14 patients treated for other gastrointestinal tract problems.
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PMID:Jejunal diverticulosis. 313 9

Meteorism might be a symptom of organic intestinal obstruction, which needs surgical treatment in most cases. However it is often a functional phenomenon. It may be produced by aerophagy, followed by sonor, non fetid flatulence. Large amounts of gas are produced by the contact of gastric acidity with alcaline pancreatic secretion and by enzymatic digestion of food. Most of these gases are absorbed by the intestine and exhaled. In the colon bacterial fermentation and putrefaction produce fetid gas which is expulsed as flatus. Overeating, bacterial invasion of the small intestin, inflammatory and circulatory disturbances of the small bowel and obstipation favour meteorism. The treatment depends of the origin of meteorism.
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PMID:[Pathogenetic basis and therapeutic management of meteorism (author's transl)]. 611 Mar 77

Chronic intestinal pseudo-obstruction is the term applied to a heterogeneous group of functional motility disorders sharing a common clinical expression: signs and symptoms of bowel obstruction in absence of mechanical occlusion. It is caused by ineffective intestinal propulsion. The chronic form of intestinal pseudo-obstruction may be primary or secondary. Primary pseudo-obstruction or chronic idiopathic pseudo-obstruction (CIIP) defines a group of propulsive disorders having no recognized underlying diseases. This study presents four female patients, aged between 4 months to 7 years, and makes a review of the literature. The symptoms, very similar in three of them, were bilious vomiting, abdominal distention and constipation, alternating with diarrhea and malnutrition. The fourth patient, different from the others in the age of onset and evolution, only had severe constipation and abdominal bloating. The diagnostic was made by full thickness biopsies during laparotomy, getting specimens by mapping, at different heights of intestine and stomach. Samples were studied by optic and electronic microscopy and visceral myopathies were found. None of them had urinary disorders. Medical treatment consisted of total parental nutrition and/or enteral nutrition. Cisapride was not effective in the two patients who received it.
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PMID:[Chronic idiopathic intestinal pseudo-obstruction: visceral myopathy. Report of 4 cases]. 820 87

Enteral feedings demonstrably lower the risk of septic complications. However, complications associated with the specific method of enteral feeding may diminish the intended benefits. The objective was to determine the short and long-term complications associated with needle catheter jejunostomy (NCJ). All NCJs placed at a Level I trauma center over an 8-year period were reviewed. Short-term complications directly attributable to NCJ were defined as tube leakage with intraabdominal or intraparietal spillage, intraabdominal abscess, small bowel obstruction at the catheter site, tube blockage or dislodgement, or soft tissue infection. Telephone interviews were conducted to elicit long-term complications, including operations to correct a complication of the NCJ, chronic nausea, vomiting, diarrhea, bloating, hernia, or change in appetite. Of 122 study patients, short-term complications (N = 22) included two abscesses, one bowel obstruction, two abdominal wall infections, three leaks, one local soft tissue infection, one enterocutaneous fistula, three blocked catheters, and nine tube dislodgements. Fifty patients were contacted by telephone; 19 had long-term complications, including two operations for adhesions. Complications associated with NCJ are common, may be life-threatening, and may require surgical intervention. In many cases, other methods of enteral feeding access may be preferable to NCJ.
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PMID:Analysis of complications and long-term outcome of trauma patients with needle catheter jejunostomy. 854 Jun 44

Intestinal involvement by endometriotic tissue occurs in up to 37% of patients with endometriosis. The vast majority of patients do not experience symptoms related to the gastrointestinal tract. In particular, the complications of intestinal obstruction and malabsorption secondary to endometriosis are exceedingly uncommon. We present a 42-year-old woman with intestinal obstruction, protein-losing enteropathy, and anasarca secondary to endometriosis. She had a 1-year history of watery diarrhea, bloating, and abdominal pain with a 30-lb weight-loss over 3 months. She had no previous history of endometriosis, and laboratory investigations showed severe hypoalbuminemia, hypokalemia, and metabolic acidosis. Abdominal x-rays revealed air-fluid levels and dilated loops of small bowel. She underwent surgical resection with primary anastomosis. Pathologic evaluation showed extensive endometriosis of the small bowel and appendix, which resulted in complete obstruction. Segments of ileum also demonstrated moderate-to-marked blunting of the villi. Postoperatively, the patient had a slow recovery with resolution of anasarca and a gradual increase in her weight. This report illuminates the rare, yet significant, complications of intestinal endometriosis, including small bowel obstruction, the development of a protein-losing enteropathy, and anasarca. One should consider the possibility of intestinal endometriosis in the differential diagnosis of bowel obstruction in women of childbearing age.
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PMID:Anasarca and small bowel obstruction secondary to endometriosis. 1120 57

Laxatives are among the most commonly used drugs or additives. Most are quite safe when used judiciously, intermittently when possible, and in the absence of contraindications. Bulking agents and nonabsorbable compounds such as lactulose can cause bloating but have very few serious adverse effects except for the allergic reaction to psyllium preparations. Osmotic laxatives containing poorly absorbable ions such as magnesium or phosphate can cause metabolic disturbances, particularly in the presence of renal impairment. However, if taken intermittently, in the absence of conditions such as ileus or bowel obstruction, they have few adverse effects. Polyethylene glycol solutions are emerging as an effective and safe mode of treatment for chronic constipation. Of stimulant laxatives, senna compounds and bisacodyl are the most commonly used. Although there are data to support the neoplastic potential of this class of drugs in in vitro studies, epidemiologic data in humans so far has not established a clear link between these laxatives and colonic neoplasia. The link between stimulant laxatives and structural changes, such as the "cathartic colon" or enteric nerve damage, is not well established either. Danthron compounds should be avoided because of hepatotoxicity.
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PMID:Adverse effects of laxatives. 1153 63

Colonic inertia is an uncommon condition, usually occurring in women in the third decade of life. Severity of symptoms may lead some patients to a surgical consultation. This is a retrospective review of 14 patients who underwent laparoscopic subtotal colectomy for colonic inertia, performed by a single surgeon from August 1993 to November 2002. The mean age of the patients was 38.5 years (range 26-50 years); 93% of the patients were women. The common presenting symptoms included abdominal pain (93%), bloating (100%), constipation (100%), and nausea (57%). Median duration of symptoms before surgery was 4.5 years (range 1-30 years). Subtotal colectomy was completed laparoscopically in 13 patients. There was one conversion (7%) because of adhesions. Eleven patients (78.6%) had undergone previous abdominal surgery. The mean operating room time was 153 minutes (range 113-210 minutes). The median time to full bowel action was 2 days. One patient developed postoperative small bowel obstruction that required open exploration. Complete follow-up was available for 11 patients at a median follow-up of 18 months (range 2-96 months). Ninety-one percent of the patients reported excellent satisfaction with surgery, and their bowel movement frequency changed from 1.2 (+/-0.2) per week preoperatives to 17.2 (+/-2.9) per week postoperatively (P < 0.001). Three patients (27%) continued to report abdominal pain and 3 patients (27%) continued to require laxatives postoperatively. Laparoscopic subtotal colectomy provides excellent symptom relief in patients with colonic inertia who do not respond to medical measures.
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PMID:Laparoscopic subtotal colectomy for colonic inertia. 1598 35


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