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)

324 patients were given 1437 intramuscular injections of 200 mg norethisterone enanthate in 1 ml castor oil and benzyl benzoate between 1974-77, for a total of 3503 woman-months of protection. 87.5% of injection intervals were 70 days although some intervals of 84 days were employed. Patients were seen halfway between the 1st and 2nd injection and subsequently at injections, and noted all bleeding on diary cards. 141 patients chose the method for personal reasons, 71 had medical contraindications to other methods, 68 were unable to use other methods effectively, and 44 used it temporarily while awaiting sterilization. Mean age of patients was 27.8 years; 92% were of proven fertility, and 79% were white. 151 women received their 1st injection during menstruation, 94 within 6 weeks of delivery, and 71 within 6 weeks of abortion. Excluding the temporary users, the continuation rate after 1 year was 63.6%. 4 patients discontinued due to pregnancy within 70 days of injection, 58 due to unacceptability of menstrual irregularity, 7 for other side effects, and 21 for other methods. 51 discontinuances were apparently unrelated to the method. The life table failure rate was 1.3 pregnancies/100 woman years. 3 of the 4 failures had normal intrauterine pregnancies, 2 delivering normal babies. 1 patient with a history of pelvic inflammatory disease had an ectopic pregnancy. The only side effects apart from menstrual irregularity, which all patients had, were occasional abdominal bloating and discomfort in the breasts or injection site. There was no tendency for blood pressure or weight to rise. Menstrual diary cards from 118 women accounting for 1290 woman-months showed an average of 2 episodes of bleeding during each injection interval, with mean cycle length of 28.45 days and mean duration of bleeding of 3.6-7.1 days. 6% of the subjects experienced 68.5% of the epidodes of amenorrhea lasting more than 70 days. It was concluded that norethisterone enanthate 200 mg is a safe, effective, and useful contraceptive method despite imperfect cycle control.
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PMID:Clinical experience with intramuscular norethisterone oenanthate as a contraceptive. 1226 97

All medications have side effects in certain patients; none is 100% "safe" and the physicain must determine the benefit-to-risk ratio of each contraceptive method for a particular patient. 81% of white, nonCatholic women aged 20-24 who are college graduates use oral contraceptives, an extraordinary acceptance level for a method not even available in 1960. The various preparations available in the U.S, amount of estrogen and progestogen in each, and side effects are then surveyed. Estrogen irritates the gastric mucosa and diminishes rate of sodium excretion by the kidneys; this causes the nausea, edema, general bloating, tension, and headaches which most commonly cause women to discontinue the medication. The patient with full breasts who menstruates normally should not be overloaded with estrogen while a high-estrogen compound might benefit the woman with small breasts and scanty menses. Estrogens are known stimulants for the growth of uterine leiomyomas; if such lesions are present an antiestrogenic progestogen is indicated. High estrogen pills are more likely to stimulate breast growth and increase discomfort from fibrocyctic disease while a progestin-dominant combination will reduce this discomfort. The "19-nor" progestins are essentailly variants of testosterone and may produce hirsutism, alopecia, acne, hypomenorrhea, or even amenorrhea. T hey also may increase appetite and cause excessive weight gain. The total effect is complicated by such factors as the particular progestin used. The 19-norsteroid compounds are partly metabolized to estrogen and increase the estrogenic effect while norgestrel produces antiestrogenic activity. Newer marketing methods have tried to simplify administration by inserting 7 iron tablets or 7 placebos so the user takes a pill every day for 28 days. For patients who have noted side effects during the 7-day interval they are not taking the pill (undoubtedly related to temporary estrogen insufficiency) .02 mg ethinyl estradiol may be used. The sequential method more closely simulates the normal menstrual cycle and can be used to advantage in women who suffer prolonged anovulation after cessaton of combination therapy and in women past 35 in whom the increased risk of pregnancy is offset by declining fertility potential. Both serious and minor adverse reactions to various forms of therapy are detailed. These include cutaneous, nervous system, metabloic, and endocrine system changes.
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PMID:Present status of oral contraceptives: 1. effectiveness; basis for selection; side effects; metabolic changes. 1230 85

Dyspepsia describes a symptom complex thought to arise in the upper gastrointestinal tract and includes, in addition to epigastric pain or discomfort, symptoms such as heartburn, acid regurgitation, excessive burping or belching, a feeling of slow digestion, early satiety, nausea and bloating. Based on the evidence that heartburn cannot be reliably distinguished from other dyspeptic symptoms, the Rome definition appears to be too narrow and restrictive. It is particularly ill suited to the management of uninvestigated dyspepsia at the level of primary care. In patients presenting with uninvestigated dyspepsia, a symptom benefit is associated with a 'test and treat' approach for Helicobacter pylori infection. A substantial proportion of those who do not benefit prove to have esophagitis on endoscopy. In those with functional dyspepsia, the benefits of H pylori eradication, if any, appear to be modest. Hence, a 'symptom and treat' acid-suppression trial with proton pump inhibitors, and a 'test and treat' strategy for H pylori are two acceptable empirical therapies for patients with univestigated dyspepsia.
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PMID:Etiology of dyspepsia: implications for empirical therapy. 1236 18

Epigastric pain may occur as a specific and localized symptom, as part of a group of symptoms that include heartburn, or in association with bloating or early satiety. The current classification (Rome II) characterizes ulcer-like dyspepsia by predominant pain centered in the upper abdomen and characterizes dysmotility-like dyspepsia by discomfort. The large number of patients presenting with epigastric pain has led to the development of empirical strategies.
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PMID:Epigastric pain in dyspepsia and reflux disease. 1467 10

BACKGROUND: Eosinophilic gastritis is related to eosinophilic gastroenteritis, varying only in regards to the extent of disease and small bowel involvement. Common symptoms reported are similar to our patient's including: abdominal pain, epigastric pain, anorexia, bloating, weight loss, diarrhea, ankle edema, dysphagia, melaena and postprandial nausea and vomiting. Microscopic features of eosinophilic infiltration usually occur in the lamina propria or submucosa with perivascular aggregates. The disease is likely mediated by eosinophils activated by various cytokines and chemokines. Therapy centers around the use of immunosuppressive agents and dietary therapy if food allergy is a factor. CASE PRESENTATION: The patient is a 31 year old Caucasian female with a past medical history significant for ulcerative colitis. She presented with recurrent bouts of vomiting, abdominal pain and chest discomfort of 11 months duration. The bouts of vomiting had been reoccurring every 7-10 days, with each episode lasting for 1-3 days. This was associated with extreme weakness and cachexia. Gastric biopsies revealed intense eosinophilic infiltration. The patient responded to glucocorticoids and azathioprine. The differential diagnosis and molecular pathogenesis of eosinophilic gastritis as well as the molecular effects of glucocorticoids in eosinophilic disorders are discussed. CONCLUSIONS: The patient responded to a combination of glucocorticosteroids and azathioprine with decreased eosinophilia and symptoms. It is likely that eosinophil-active cytokines such as interleukin-3 (IL-3), granulocyte macrophage colony stimulating factor (GM-CSF) and IL-5 play pivotal roles in this disease. Chemokines such as eotaxin may be involved in eosinophil recruitment. These mediators are downregulated or inhibited by the use of immunosuppressive medications.
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PMID:Eosinophilia in a patient with cyclical vomiting: a case report. 1514 61

Tegaserod is a drug in a new class of compounds called aminoguanidine indoles and is structurally similar to serotonin (5-HT) with modifications that make the drug selective for the 5-HT(4) receptor. Tegaserod has a stimulatory effect on gastrointestinal (GI) motility that has been demonstrated in animal studies and in healthy adults. Tegaserod also increases GI secretion and reduces rectal sensitivity. Tegaserod is currently approved by the FDA for the treatment of women with constipation-predominant irritable bowel syndrome (C-IBS). Eight large Phase III clinical trials involving > 5000 IBS patients support the clinical efficacy of tegaserod in this group of patients. Patients who were treated with tegaserod had an overall improvement in IBS symptoms (Subject's Assessment of Global Relief) as well as in secondary end points, such as abdominal pain and discomfort, stool consistency, change in bowel movements and relief of bloating. Tegaserod was well-tolerated. The most common adverse reaction in clinical trials was diarrhoea, which was usually temporary and mild, although severe diarrhoea requiring hospitalisation has been rarely (< 1%) reported.
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PMID:Review of tegaserod in the treatment of irritable bowel syndrome. 1550 Mar 84

Application of N-methyl-D-aspartate (NMDA)-receptor antagonists may hold promise for the treatment of visceral pain. In this study we evaluated the effect of oral S(+)-ketamine (sKET), a non-competitive NMDA-receptor antagonist, on visceral sensitivity in healthy volunteers. Eight healthy volunteers (five male, three female) underwent a gastric barostat study following oral administration of placebo, 25 mg sKET, and 50 mg sKET. Studies were performed in a double-blind randomized crossover fashion. Sensations evoked by stepwise isobaric distension (2 mm Hg/2 min) were scored on a 100-mm visual analogue scale. In addition, fasting and postprandial fundic volume were measured at a fixed pressure level (MDP + 2 mm Hg). During gastric distension, sKET did not alter sensation scores for bloating, nausea, satiation, and pain compared to placebo. sKET had also no effects on the thresholds for pain/discomfort, fundic wall compliance, fundic tone, or meal-induced fundic relaxation. sKET does not reduce visceral perception or gastric motility in healthy volunteers. The role of sKET in conditions characterized by visceral hypersensitivity needs to be studied further.
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PMID:Oral S(+)-ketamine does not change visceral perception in health. 1562 96

Activation of serotonin 5-HT(4) receptors has been proposed as treatment for irritable bowel syndrome, a common, complex and distressing gastrointestinal disorder. Abnormal intestinal motility and sensitivity in irritable bowel syndrome patients can result in diarrhea, constipation, abdominal pain, bloating, headache and fatigue; these and other symptoms can lead to exacerbation of psychological stress, which may in turn induce further physiological abnormalities and patient discomfort. The serotonin agonist tegaserod binds with high affinity to 5-HT(4) receptors and has demonstrated potent pharmacological effects on the mid- and distal gut. Tegaserod has been safely employed in clinical trials where it has demonstrated efficacy in normalizing intestinal function, thereby improving irritable bowel syndrome symptoms.
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PMID:Tegaserod: a serotonin 5-HT4 receptor agonist for treatment of constipation-predominant irritable bowel syndrome. 1564 12

Gastroparesis is a condition of abnormal gastric motility characterised by delayed gastric emptying in the absence of mechanical outlet obstruction. It is seen commonly in people with diabetes but is idiopathic in a third of patients. Symptoms include nausea and vomiting, post-prandial fullness and early satiety, and abdominal bloating and discomfort. Investigations fall into three categories: gastric emptying studies, intraluminal pressure measurements and recording of gastric myoelectrical activity. Nuclear scintigraphy is considered the gold standard for diagnosing and quantifying delayed gastric emptying. Treatment options include diet and behavioural changes, prokinetic drugs and surgical interventions. New advances in drug therapy and gastric electrical stimulation techniques hold considerable promise.
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PMID:Current perspectives on the management of gastroparesis. 1579 44

We aimed to improve symptoms by means of mesalazine in symptomatic colonic diverticular disease patients. One hundred seventy outpatients (98 M, 72 F; age, 67.1 years; range, 39-84 years) were assigned to four different schedules: rifaximin, 200 mg bid (Group R1: 39 pts), rifaximin, 400 mg bid (Group R2: 43 pts), mesalazine, 400 mg bid (Group M1: 40 pts), and mesalazine, 800 mg bid (Group M2: 48 pts), for 10 days per month. At baseline and after 3 months we recorded 11 clinical variables (upper/lower abdominal pain/discomfort, bloating, tenesmus, diarrhea, abdominal tenderness, fever, general illness, nausea, emesis, dysuria), scored from 0 = no symptoms to 3 = severe. The global symptomatic score was the sum of all symptom scores. After 3 months in all schedules but Group R1, 3 of the 11 symptoms improved (P < 0.03); the global score decreased in all groups but Group R1 (P < 0.0001). Mesalazine-treated patients had the lowest global score at 3 months (P < 0.001). Mesalazine is as effective as rifaximin (higher dosage schedule) for diminishing some symptoms, but it appears to be better than rifaximin for improving the global score in those patients.
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PMID:Efficacy of mesalazine in the treatment of symptomatic diverticular disease. 1581 Jun 46


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