Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C1291077 (bloating)
 1,674 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

32 patients with abdominal tumours or inflammatory abdominal diseases were examined by MRI (0.5 T) prior to and after oral administration of gadolinium-DTPA (Gd-DTPA). T1- and T2-weighted sequences were employed. 10 ml/kg body weight of a Gd-DTPA formulation were administered (1.0 mmol/l, 15 g mannitol/l). Gd-DTPA provided markedly hyperintensive opacification of the gastrointestinal tract. In 19 of 32 studies Gd-DTPA-enhanced scans showed improved delineation of abdominal pathologies. In most cases Gd-DTPA-enhanced T1-weighted multislice gradient echo images provided the most useful diagnostic result. Meteorism and diarrhea were recorded in 13 patients.
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PMID:[Oral contrast media for magnetic resonance tomography of the abdomen. III. Initial patient research with gadolinium-DTPA]. 283 6

We describe a 63-yr-old man with disseminated medullary carcinoma of the thyroid and pancreatic nesidioblastosis and microadenosis with pancreatic polypeptide (PP) hypersecretion. His major symptoms were watery diarrhea, flushing, and abdominal bloating; these and the elevated plasma PP levels did not change after resection of the distal two thirds of the pancreas, which contained a 2-cm mass of nesidioblastotic tissue. Postoperatively, a long-acting somatostatin analog, SMS 201-995 (100 micrograms/day), normalized PP secretion acutely and chronically (7 months) and ameliorated his symptoms. The analog had no side-effects and did not alter glucose tolerance, calcitonin hypersecretion, or growth of the medullary carcinoma, but it did inhibit GH secretion. After withdrawal from therapy for 1 month, PP hypersecretion and all symptoms except diarrhea recurred. The coexistence of medullary carcinoma of the thyroid and PP cell nesidioblastosis represents a new variant of the overlap syndromes between multiple endocrine neoplasia types I and II. Patients with medullary carcinoma and unexplained watery diarrhea should have fasting gastroenteropancreatic hormone assays done to screen for a potential gastrointestinal or pancreatic origin for the diarrhea.
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PMID:Medullary carcinoma of the thyroid, pancreatic nesidioblastosis and microadenosis, and pancreatic polypeptide hypersecretion: a new association and clinical and hormonal responses to long-acting somatostatin analog SMS 201-995. 288 96

Persistent gastrointestinal symptoms are common postoperatively in children with intestinal malrotation. We investigated this problem in 14 children with intestinal malrotation who had a Ladd procedure (3 patients), gastroschisis repaired (6 patients), or omphalocele repaired (5 patients) between one month and 15 years prior to study. In 13 patients, gastric emptying was measured at 30 minutes (%GE30) and at 60 minutes (%GE60) following ingestion of 99m-Tc sulfur colloid in apple juice. We estimated the degree of gastric peristalsis using the %GE corrected for immediate postcibal gastroesophageal reflux (corrected %GE). Patients with vomiting exhibited slow gastric emptying compared to patients without vomiting (%GE30: 14.0 +/- 5.5 v 32.5 +/- 4.2, P less than .005). The slow gastric emptying was related to slow gastric peristalsis (corrected %GE30: 20.3 +/- 5.0 v 47.1 +/- 6.0, P less than .005). In all 5 patients with persistent bloating and diarrhea, gastric peristalsis was rapid at 30 minutes (corrected %GE30 = 56.7 +/- 4.2) and at 60 minutes (corrected %GE60 = 69.5 +/- 5.3). To assess the role of gastroesophageal reflux (GER) in persisting symptoms, all children had extended (18 to 24 hours) esophageal pH monitoring. Eleven (79%) of the 14 patients demonstrated GER by esophageal pH monitoring, including four of six patients without reflux symptoms. All ten children under two years of age demonstrated GER regardless of symptoms or congenital anatomic abnormality. In conclusion, GER is common in patients under two years of age with intestinal malrotation, but clinical symptoms seem related more to extreme variations in gastric peristalsis than to GER.
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PMID:The significance of gastric emptying in children with intestinal malrotation. 293 9

To study the intracolonic digestion of starch, 5 healthy volunteers were maintained on a constant diet for 7 days. On the fourth day, the cecum was intubated and a suspension of raw wheat starch (50 g, in 500 ml of 154 mM NaCl and containing 10 g of polyethylene glycol 4000) was infused into the distal ileum at 2 ml/min. Hydrogen excretion in breath was measured, cecal contents were sampled, and symptoms were recorded. For the 2-3 days before and after starch infusions, fecal weight, pH, and percentage of dry matter were monitored; fecal outputs of starch, volatile fatty acids, lactic acid, ethanol, polyethylene glycol, alpha-amylase, nitrogen, and ammonia were also measured. A lactulose (10 g) hydrogen breath test was performed 5-7 days after the starch infusions. After the infusion of starch, concentrations of lactic and volatile fatty acids increased and pH decreased markedly in cecal contents. None of the fecal values changed significantly after starch, however, indicating that carbohydrate catabolism was nearly complete and that the colon absorbed the catabolic products efficiently. Abdominal symptoms, especially bloating, were noted by all subjects, and 2 subjects complained of cramping pain. No subject experienced diarrhea. The amounts of starch metabolized in the colon (47.3 +/- 2.9 g), as calculated from the excretion of H2 in breath compared to the hydrogen breath test after lactulose, were close to the actual load (50 g).
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PMID:Colonic metabolism of wheat starch in healthy humans. Effects on fecal outputs and clinical symptoms. 299 17

This study of 200 Uruguayans between 0 and 86 years old was designed to determine the prevalence of lactose malabsorption. Lactose intolerance is defined as a clinical syndrome of abdominal pain, diarrhea, flatulence, and bloating after the ingestion of a standard lactose tolerance test dose (2 g of lactose per kilogram of body weight or 50 g/m2 of body surface area, maximum 50 g in a 20% water solution). Lactose malabsorption refers to the state in which dietary lactose remains unhydrolyzed and subsequently unabsorbed from the gastrointestinal tract; symptoms may or may not result from lactose malabsorption. The technique of breath hydrogen (H2) was used after ingestion of 2 g/kg body weight to a maximum of 50 g in a 20% solution. There was no lactose malabsorption in children younger than 5 years old. The prevalence increases progressively after the age of 5, and in adolescence the percentage of malabsorption is similar to that in adults, who show 65% lactose malabsorption, with 25% asymptomatic and 40% intolerant. In 109 white adults, the prevalence of lactose malabsorption is 63%, with 24% asymptomatic and 39% intolerant. In 11 black adults, lactose malabsorption is 82%, with 27% asymptomatic and 55% intolerant. The difference between white and black adults is statistically significant (p less than 0.05). The H2 test is simple, reliable, noninvasive, and appropriate to study large populations.
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PMID:Lactose malabsorption and intolerance in Uruguayan population by breath hydrogen test (H2). 350 60

Nissen's fundoplication is associated with a high morbidity rate in children. The symptoms are expressed as dysphagia, bloating, diarrhea, and neurotic behavioral changes. On the basis of our own experience, Nissen's fundoplication is not the treatment of choice in children. It is indicated only in cases where a total absence of reflux is tolerable (reflux followed by episodes of apnea, children with cerebral damage, etc.).
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PMID:To Nissen or not to Nissen. 392 37

Parenteral therapy is frequently indicated for initial repletion in the severely malnourished patient. Attention should be paid to the nutrients required for initial repletion based on the patient's metabolic needs at the time of therapy, as well as allowance for adequate calories for repletion of body and muscle mass. After the initiation of parenteral therapy and the adequate replacement of fluids and electrolytes, slow introduction of oral or enteric feeding is reasonable. This probably is best handled initially by the use of a nasogastric or nasoenteric feeding tube. However, if the patient willingly ingests oral feedings, the oral route is certainly favorable. Close attention should be paid to the adequacy of gastric emptying. Symptoms of abdominal bloating and diarrhea may require modification of the rate at which oral intake is progressing.
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PMID:Gastrointestinal dysfunction in the critically ill: nutritional implications. 393 Jan 34

Sorbitol is a commonly used sugar substitute in "sugar-free" food products. Although sorbitol intolerance manifested by abdominal pain, bloating, and diarrhea has been observed in children, it has not been well documented in adults. Forty-two healthy adults (23 whites, 19 nonwhites) participated in this study. After ingestion of 10 g of sorbitol solution, end expiratory breath samples were collected at 15-min intervals for 4 h and analyzed for H2 concentration. Clinical sorbitol intolerance was detected in 43% of the whites and 55% of the nonwhites, the difference not being statistically significant. However, severe clinical sorbitol intolerance was significantly more prevalent in nonwhites (32%) as compared to whites (4%). There was a good correlation between the severity of symptoms and the amount of hydrogen exhaled. Dietetic foods, many of them containing sorbitol, are very popular with diabetics and "weight watchers." Based on our observations, we believe that a large number of adults could be suffering from sorbitol-induced nonspecific abdominal symptoms and diarrhea. These symptoms could lead to an extensive diagnostic work-up and lifelong diagnosis of irritable bowel syndrome.
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PMID:Sorbitol intolerance in adults. 403 46

A high index of suspicion and careful application of diagnostic methods are essential for accurate diagnosis of parasitic bowel diseases. The varied clinical spectrum of giardiasis, amebiasis, and strongyloidiasis emphasizes the need to consider these pathogens when patients present with gastrointestinal complaints. Giardiasis should be suspected in patients, especially returned travelers, with unexplained increase in stool frequency, particularly with bloating, flatulence, or vague systemic symptoms. Amebiasis must be considered in the differential diagnosis of any patient who presents with persistent diarrhea or signs of inflammatory bowel disease. Unexplained diarrheal illnesses associated with upper abdominal symptoms and eosinophilia should raise suspicion of the presence of strongyloidiasis. These findings in a patient with a compromised immune system or in a candidate for immunosuppressive therapy should prompt a thorough investigation to rule out this parasite, since disseminated strongyloidiasis often is fatal.
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PMID:Parasitic bowel disease: three pathogens important in primary care. 628 Jan 60

Gastroduodenal Crohn's disease usually, but not always, occurs in patients with previously established ileal and/or colonic Crohn's disease. Symptoms include postprandial epigastric pain accompanied by nausea and sometimes vomiting, weight loss, anorexia, bloating, and diarrhea. Obstruction is the most common complication. Diagnosis can usually be made radiographically or endoscopically. Certain radiographic patterns are almost diagnostic, eg, obliteration of a distinct pyloric channel and a rigidly narrowed antrum tapering into a diseased duodenal bulb. Endoscopic mucosal biopsy of abnormal areas almost always shows chronic inflammation, although granulomas are not common. In patients with symptoms other than intractable obstruction, medical management, such as intermittent corticosteroid therapy, should be attempted. Surgery is usually indicated for refractory obstruction; gastrojejunostomy is the preferred approach.
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PMID:Gastroduodenal Crohn's disease. Differential diagnosis and treatment. 664 59


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