Influence of organic and functional dyspepsia on work productivity: the HEROES-DIP study.

Science.gov (United States)

Sander, Guilherme Becker; Mazzoleni, Luiz Edmundo; Francesconi, Carlos Ferrnando de Magalhães; Balbinotto, Giácomo; Mazzoleni, Felipe; Wortmann, Andre Castagna; Cardoso, Israel de Quadros; Klamt, Alexandre Luis; Milbradt, Tobias Cancian

2011-01-01

Dyspepsia is defined as persistent or recurrent abdominal pain or discomfort centered in the upper abdomen. Dyspepsia represents up to 8.3% of all primary care physician visits and causes huge economic costs to patients and to the economy as a whole. The aim of this study was to measure the influence of dyspepsia on work productivity of people within the Brazilian workforce. Adult patients were enrolled if they met the Roma III criteria for uninvestigated dyspepsia. All patients answered a demographic questionnaire. Productivity impairment was measured by the Work Productivity and Activity Impairment questionnaire. Subjects underwent upper gastrointestinal endoscopy and were classified as having functional or organic dyspepsia. The study protocol was approved by the Ethics Committee of Hospital de Clínicas de Porto Alegre, Brazil. Eight hundred fifty patients with dyspepsia were evaluated: 628 were women (73.9%); mean age was 46.4 ± 12.9 years; 387 (45.5%) were active workers. Among active workers, 32.2% mentioned that dyspepsia had caused absenteeism from work during the preceding week and 78% reported a reduction of the work productivity (presenteeism). The lost work productivity score was 35.7% among all employed patients. The affect on work productivity was similar between patients with functional or organic dyspepsia. Our study showed an important influence of dyspepsia on work productivity. We did not find any statistically significant difference on the influence on work between patients with organic dyspepsia and functional dyspepsia. The social impact of these findings is underscored by taking into account the prevalence (up to 40%) of this condition in Brazil. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Celiac disease prevalence is not increased in patients with functional dyspepsia.

Science.gov (United States)

Lasa, Juan; Spallone, Liliana; Gandara, Silvina; Chaar, Elsa; Berman, Saul; Zagalsky, David

2017-01-01

- Previous evidence trying to assess the risk of celiac disease among dyspeptic patients has been inconclusive, showing in some cases notorious discrepancies. - To determine the prevalence of celiac disease in patients with dyspepsia compared to healthy controls without dyspepsia. - Adult patients under evaluation for dyspepsia were invited to participate. These patients were offered an upper gastrointestinal endoscopy with duodenal biopsies. On the other hand, asymptomatic adult volunteers who performed a preventive visit to their primary care physician were invited to participate and agreed to undertake an upper gastrointestinal endoscopy with duodenal biopsies as well. Those patients with histologic signs of villous atrophy were furtherly evaluated and serological tests were performed in order to determine celiac disease diagnosis. Celiac disease prevalence was compared between groups. - Overall, 320 patients with dyspepsia and 320 healthy controls were recruited. There were no significant differences in terms of gender or age between groups. Celiac disease diagnosis was made in 1.25% (4/320) of patients in the dyspepsia group versus 0.62% (2/320) in the control group. - Patients with dyspepsia who underwent routine duodenal biopsies did not show an increased risk for celiac disease when compared to healthy individuals.

Functional Dyspepsia in Adults: Diagnosis and Treatment

Directory of Open Access Journals (Sweden)

Yu.I. Reshetilov

2013-11-01

Full Text Available The objective of the work was to determine the dynamics of clinical symptoms of functional dyspepsia in adults under the influence of treatment using M-cholinolytic (scopolamine butylbromide. We examined 45 patients with functional dyspepsia, 30 of them received M-cholinolytic (scopolamine butylbromide in addition to integrated treatment. As a result of administration of this drug, clinical and instrumental parameters improved. In adjustment of drug dosage and duration of its administration, side effects weren’t detected.

A placebo-controlled trial of itopride in functional dyspepsia.

Science.gov (United States)

Holtmann, Gerald; Talley, Nicholas J; Liebregts, Tobias; Adam, Birgit; Parow, Christopher

2006-02-23

The treatment of patients with functional dyspepsia remains unsatisfactory. We assessed the efficacy of itopride, a dopamine D2 antagonist with anti-acetylcholinesterase [corrected] effects, in patients with functional dyspepsia. Patients with functional dyspepsia were randomly assigned to receive either itopride (50, 100, or 200 mg three times daily) or placebo. After eight weeks of treatment, three primary efficacy end points were analyzed: the change from baseline in the severity of symptoms of functional dyspepsia (as assessed by the Leeds Dyspepsia Questionnaire), patients' global assessment of efficacy (the proportion of patients without symptoms or with marked improvement), and the severity of pain or fullness as rated on a five-grade scale. We randomly assigned 554 patients; 523 had outcome data and could be included in the analyses. After eight weeks, 41 percent of the patients receiving placebo were symptom-free or had marked improvement, as compared with 57 percent, 59 percent, and 64 percent receiving itopride at a dose of 50, 100, or 200 mg three times daily, respectively (Pitopride). Although the symptom score improved significantly in all four groups, an overall analysis revealed that itopride was significantly superior to placebo, with the greatest symptom-score improvement in the 100- and 200-mg groups (-6.24 and -6.27, vs. -4.50 in the placebo group; P=0.05). Analysis of the combined end point of pain and fullness showed that itopride yielded a greater rate of response than placebo (73 percent vs. 63 percent, P=0.04). Itopride significantly improves symptoms in patients with functional dyspepsia. (ClinicalTrials.gov number, NCT00272103.). Copyright 2006 Massachusetts Medical Society.

Effectiveness of amitriptyline for treating functional dyspepsia in adolescents

Directory of Open Access Journals (Sweden)

Indra Mustawa

2017-01-01

Full Text Available Background Functional dyspepsia is common among adolescents. Pain reduces children’s quality of life, psychosocial functioning, and school attendance. Amitriptyline is assumed to be one of the alternative treatments in functional dyspepsia. Objective To investigate the effectiveness of amytriptyline as a treatment  for  functional dyspepsia in adolescents. Methods We conducted a randomized, single-blind, controlled trial from January to March 2011 in junior and senior high school students in Dobo City, Aru Island District, Maluku Province. Adolescents suffering from functional dyspepsia and who fulfilled the inclusion criteria were eligible for the study. Subjects were randomized into two groups. Each group received 10 mg (for body weight < 35 kg or 20 mg (for body weight ≥ 35 kg amitriptyline or placebo once per day for 28 days. Pain frequency was measured in terms of abdominal pain episodes per month, and duration was measured in minutes. Data were analyzed using t-test. Results Eighty-eight students participated in this study: the amitriptyline group (43 subjects and the placebo group (45 subjects. There were no statistically significant differences between the amitriptyline and placebo groups in frequency (P=0.777; 95%CI -0.846 to 1.129 or duration (P=0.728 of abdominal pain after treatment. Conclusion  Amitriptyline is not more effective than placebo for treating functional dyspepsia in adolescents.

The association between adult-type hypolactasia and symptoms of functional dyspepsia

Directory of Open Access Journals (Sweden)

André Castagna Wortmann

2018-01-01

Full Text Available Abstract Functional dyspepsia and lactose intolerance (adult-type hypolactasia, ATH are common conditions that may coexist or even be confounded. Their clinical presentation can be similar, however, lactose intolerance does not form part of the diagnostic investigation of functional dyspepsia. Studies on the association between functional dyspepsia and ATH are scarce. This study aimed to evaluate whether ATH is associated with symptoms of functional dyspepsia. Patients fulfilling the Rome III diagnostic criteria for functional dyspepsia underwent genetic testing for ATH. Dyspeptic symptoms were evaluated and scored according to a validated questionnaire. The diagnostic criteria for ATH was a CC genotype for the -13910C/T polymorphism, located upstream of the lactase gene. The mean scores for dyspeptic symptoms were compared between patients with ATH and those with lactase persistence. A total of 197 functional dyspeptic patients were included in the study. Mean age was 47.7 years and 82.7% patients were women. Eighty-eight patients (44.7% had a diagnosis of ATH. Abdominal bloating scores were higher in ATH patients compared to the lactase persistent patients (P=0.014. The remaining dyspeptic symptom scores were not significantly different between the two groups. The study results demonstrate an association between ATH and bloating in patients with functional dyspepsia.

Celiac disease prevalence is not increased in patients with functional dyspepsia

Directory of Open Access Journals (Sweden)

Juan LASA

Full Text Available ABSTRACT BACKGROUND Previous evidence trying to assess the risk of celiac disease among dyspeptic patients has been inconclusive, showing in some cases notorious discrepancies. OBJECTIVE To determine the prevalence of celiac disease in patients with dyspepsia compared to healthy controls without dyspepsia. METHODS Adult patients under evaluation for dyspepsia were invited to participate. These patients were offered an upper gastrointestinal endoscopy with duodenal biopsies. On the other hand, asymptomatic adult volunteers who performed a preventive visit to their primary care physician were invited to participate and agreed to undertake an upper gastrointestinal endoscopy with duodenal biopsies as well. Those patients with histologic signs of villous atrophy were furtherly evaluated and serological tests were performed in order to determine celiac disease diagnosis. Celiac disease prevalence was compared between groups. RESULTS Overall, 320 patients with dyspepsia and 320 healthy controls were recruited. There were no significant differences in terms of gender or age between groups. Celiac disease diagnosis was made in 1.25% (4/320 of patients in the dyspepsia group versus 0.62% (2/320 in the control group. CONCLUSION Patients with dyspepsia who underwent routine duodenal biopsies did not show an increased risk for celiac disease when compared to healthy individuals.

Evidence-Based Recommendations for Short- and Long-Term Management of Uninvestigated Dyspepsia in Primary Care: An Update of the Canadian Dyspepsia Working Group (CanDys Clinical Management Tool

Directory of Open Access Journals (Sweden)

Sander JO Veldhuyzen van Zanten

2005-01-01

Full Text Available The present paper is an update to and extension of the previous systematic review on the primary care management of patients with uninvestigated dyspepsia (UD. The original publication of the clinical management tool focused on the initial four- to eight-week assessment of UD. This update is based on new data from systematic reviews and clinical trials relevant to UD. There is now direct clinical evidence supporting a test-and-treat approach in patients with nondominant heartburn dyspepsia symptoms, and head-to-head comparisons show that use of a proton pump inhibitor is superior to the use of H2-receptor antagonists (H2RAs in the initial treatment of Helicobacter pylori-negative dyspepsia patients. Cisapride is no longer available as a treatment option and evidence for other prokinetic agents is lacking. In patients with long-standing heartburn-dominant (ie, gastroesophageal reflux disease and nonheartburn-dominant dyspepsia, a once-in-a-lifetime endoscopy is recommended. Endoscopy should also be considered in patients with new-onset dyspepsia that develops after the age of 50 years. Conventional nonsteroidal anti-inflammatory drugs, acetylsalicylic acid and cyclooxygenase-2-selective inhibitors can all cause dyspepsia. If their use cannot be discontinued, cotherapy with either a proton pump inhibitor, misoprostol or high-dose H2RAs is recommended, although the evidence is based on ulcer data and not dyspepsia data. In patients with nonheartburn-dominant dyspepsia, noninvasive testing for H pylori should be performed and treatment given if positive. When starting nonsteroidal anti-inflammatory drugs for a prolonged course, testing and treatment with H2RAs are advised if patients have a history of previous ulcers or ulcer bleeding.

Detection of H. Pylori infection on dyspepsia patients with IgA H. Pylori antibody

Science.gov (United States)

Loesnihari, R.

2018-03-01

Helicobacter pylori (H. pylori) has a big role in the relapse and pathogenesis of the upper gastrointestinal disease. Dyspepsia is characterized by uncomfortable feeling at the upper gastrointestinal area. IgA H. pylori antibody was in two-thirds of H. pylori infected patients, but about 7.2% of IgA H. Pylori antibody became the only positive result of the test between the two serology test (IgG and IgA). A cross-sectional study was conducted in 38 patients with dyspepsia. The IgA antibody test for H. pylori in the serum of dyspepsia patient conducted through the ELISA test. The hemoglobin levels, leukocytes, platelets number, and H. pylori infection via IgA antibody test on ulcer and non-ulcer dyspepsia patient had no significant difference. There was a relation between the number of platelets in the infected H. pylori patients compared to the non-infected patients. H. pylori infection in the ulcer and non-ulcer dyspepsia patient with serology method was 18%. H. pylori infection number on ulcer dyspepsia was not higher than the non-ulcer dyspepsia, all ulcer dyspepsia patients who were with H. pylori found with a lesion on the antrum.

The significance of Helicobacter pylori in the approach of dyspepsia in primary care

NARCIS (Netherlands)

Arents, Nicolaas Lodevikus Augustinus

2003-01-01

Summary and conclusions In this thesis the management of dyspepsia in primary care in relation to Helicobacter pylori (H. pylori) infection was studied. In chapter two several important issues considering the approach of dyspepsia are discussed. It is clear that dyspepsia is not a disease but merely

Herbal Remedies for Functional Dyspepsia and Traditional Iranian Medicine Perspective

Science.gov (United States)

Babaeian, Mahmoud; Naseri, Mohsen; Kamalinejad, Mohammad; Ghaffari, Farzaneh; Emadi, Fatemeh; Feizi, Awat; Hosseini Yekta, Nafiseh; Adibi, Peyman

2015-01-01

Context: Functional dyspepsia (FD) is a functional gastro-intestinal disorder with high prevalence. Among various treatment options, treatment by complementary and alternative medicines especially herbal remedies also practiced. Traditional Iranian medicine (TIM), a valuable resource of valid applied studies of ancient Iranian scholars, recommends numerous medicinal plants to treat dyspepsia symptoms. In this study, through investigation of TIM references, we aimed to identify medicinal plants for treatment of digestion insufficiency. Evidence Acquisition: In this qualitative study, dyspepsia symptoms including fullness, early satiety, bloating, nausea, and belching were checked under reliable sources of traditional medicine. Then medicinal plants recommended for the treatment of the symptoms were extracted from the books. Likewise, for investigating the pharmacological properties of medicinal plants used for the relieving of dyspepsia symptoms, electronic databases such as PubMed, Scopus, Google Scholar and some Iranian databases like SID and IranMedex were employed. Results: The study yielded 105 plants from 37 families which could treat various dyspepsia symptoms; fifty-seven plants, mainly from Apiaceae, Lamiaceae, Amaryllidaceae and Zingiberaceae had digestive effects. In this research, based on the information in TIM reference texts, we obtained 58 plants effective for bloating, 40 for nausea, 37 for appetite loss and 7 for belching. In human clinical trials conducted on medicinal plants effective for FD symptoms, 7 single plants were used. Conclusions: Finding the medicinal plants effective on digestion insufficiency based on TIM could suggest a better strategy for the relieving of dyspepsia symptoms. Traditional Iranian medicine prescribes medicinal plants based on each patient’s personal characteristics and practices multiple target therapies. PMID:26734483

Vagal activation by sham feeding improves gastric motility in functional dyspepsia.

Science.gov (United States)

Lunding, J A; Nordström, L M; Haukelid, A-O; Gilja, O H; Berstad, A; Hausken, T

2008-06-01

Antral hypomotility and impaired gastric accommodation in patients with functional dyspepsia have been ascribed to vagal dysfunction. We investigated whether vagal stimulation by sham feeding would improve meal-induced gastric motor function in these patients. Fourteen healthy volunteers and 14 functional dyspepsia patients underwent a drink test twice, once with and once without simultaneous sham feeding. After ingesting 500 mL clear meat soup (20 kcal, 37 degrees C) in 4 min, sham feeding was performed for 10 min by chewing a sugar-containing chewing gum while spitting out saliva. Using two- and three-dimensional ultrasound, antral motility index (contraction amplitude x frequency) and intragastric volumes were estimated. Without sham feeding, functional dyspepsia patients had lower motility index than healthy volunteers (area under curve 8.0 +/- 1.2 vs 4.4 +/- 1.0 min(-1), P = 0.04). In functional dyspepsia patients, but not in healthy volunteers, motility index increased and intragastric volume tended to increase by sham feeding (P = 0.04 and P = 0.06 respectively). The change in motility index was negatively correlated to the change in pain score (r = -0.59, P = 0.007). In functional dyspepsia patients, vagal stimulation by sham feeding improves antral motility in response to a soup meal. The result supports the view that impaired vagal stimulation is implicated in the pathogenesis of gastric motility disturbances in functional dyspepsia.

Effect of herb drug medicine Treatment for Functional Dyspepsia:Controlled Trial

Directory of Open Access Journals (Sweden)

Lee Jae-Jin

2009-06-01

Full Text Available Obejective : Functional dyspepsia is a prevalent disease. It impedes subjective quality of life. The purpose of this research is to examine the equivalent effect of herb drug medicine treatment(H-Dand Over the Counter(OTC for functional dyspepsia. Method : In this controlled study, we compared herb drug medicine(H-D with Over the Counter(OTC of functional dyspepsia. 30 volunteers who satisfied the requirements were enrolled in study. Severity of dyspepsia was measured by Nepean Dyspepsia Index(NDI-K before and after treatments. Result : The results are summarized as follows. 1. In Herb drug medicine and Over the Counter groups, total key symptoms score of after treatment were significantly decreased and improve rate of key symptoms was higher than before treatment, but there were no statistical significance between two groups. 2. In Herb drug medicine and Over the Counter groups, each symptoms score of after treatment were significantly decreased and improve rate of key symptoms was higher than before treatment, but there were no statistical significance between two groups. 3. In Herb drug medicine and Over the Counter groups, quality of life score of after treatment were significantly decreased and improve rate of key symptoms was higher than before treatment, but there were no statistical significance between two groups. Conclusion : Herb drug medicine treatment(H-D is effective to improve the symptoms and quality of life in patients with functional dyspepsia.

Persistent organic dyspepsia of infrequent cause. Case presentation

International Nuclear Information System (INIS)

Rodriguez, Roberto; Medina, Juan Fernando; Roberto Olivares, Carlos

2008-01-01

For the Rome III consensus criteria, the dyspepsia is defined as any pain or discomfort located in the central part of the superior abdomen and that it can be associated to a sensation of fullness, satiety precocious distension, burps, nauseas and vomits that can improve or to worsen with the foods, begun in the last 6 months and with present symptoms once a week in the 3 previous months. The dyspepsia this incorporated one for two big groups: the organic one and the functional one and it can be secondary to local or systemic alterations. Considered that between the 60 and 70% of the dyspeptic they are functional and that a 30 to 40% are of organic origin. The gastritis, ulcerates peptic either gastric or duodenal, the cancer and some medications, they are the frequently implied organic factors. The incidence of the dyspepsia for systemic alterations is not very well-known and its appearance is variable. We present a case that was derived to the gastroenterology service to present a dyspepsia related with Helycobacter pylori that persisted after the eradication of the infection, evidencing after the clinical study and paraclinic a symptomatic hypercalcaemia secondary to primary hyperparathyroidism (HPTP) like cause of their gastrointestinal square; and next the revision of the pathology will be made in mention and of its gastrointestinal component.

Efficacy of acupuncture treatment for functional dyspepsia: A systematic review and meta-analysis.

Science.gov (United States)

Kim, Ka-Na; Chung, Sun-Yong; Cho, Seung-Hun

2015-12-01

The use of acupuncture treatment (AT) for functional dyspepsia is increasing, particularly in Asia. However, the efficacy of AT and its side effects have not been assessed. We performed a systematic review and meta-analysis of studies related to the effectiveness of AT for functional dyspepsia. This study is a systemic review and meta-analysis. Seven electronic databases, including those in the English and Chinese languages, were systematically searched for randomized controlled trials of AT for functional dyspepsia through November 2012. There were no language restrictions. Randomized controlled trials (RCT) AT compared with placebo control or a comparative intervention were considered. The methodological qualities of the studies were evaluated using the risk of bias (ROB). Subgroups were analyzed according to the kinds of controls. The primary outcomes were symptom scores. These included visual analogue scale (VAS) and Nepean Dyspepsia Index (NDI). Secondary outcomes were the total effective rate and adverse effects. Twenty studies, including 1423 individual cases, were systematically reviewed. The risk of bias was high. Compared to sham AT, AT was associated with a significant positive effect in patients with functional dyspepsia (2.66, 95% CI 1.85-3.82). AT also improved symptoms for functional dyspepsia (1.18, 95% CI 1.01-2.60) compared to GI tract regulators on total effective rate. In addition, two articles produced a scale in favor of AT compared to medication (0.54, 95% CI 0.18-0.90). Two RCTs reported minimal AT-related adverse events. The evidence suggests that AT is effective for functional dyspepsia. However, well-planned, long-term studies are necessary to evaluate the efficacy of AT for functional dyspepsia. Copyright © 2015. Published by Elsevier Ltd.

Burden of comorbidities among Japanese patients with atrial fibrillation: a case study of dyspepsia

Directory of Open Access Journals (Sweden)

Kinoshita Y

2013-05-01

Full Text Available Yoshikazu Kinoshita,1 Marco DiBonaventura,2 Bruno Rossi,3 Kazuya Iwamoto,4 Edward C Y Wang,5 Jean-Baptiste Briere51Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan; 2Health Sciences Practice, Kantar Health, New York, NY, USA; 3Market Access, 4Medical Affairs Cardiovascular and Neurology, 5Health Economics and Outcomes Research, Bayer Yakuhin Ltd, Osaka, JapanBackground: The aim of this study was to investigate the link between atrial fibrillation (AF and dyspepsia, as well as the contribution of dyspepsia to the overall burden of AF.Methods: The 2008, 2009, and 2010 Japan National Health and Wellness Survey (NHWS datasets were used in this study. The NHWS is an Internet-based survey administered to the adult population in Japan using a random stratified sampling framework to ensure demographic representativeness. The presence of dyspepsia was compared between those with and without AF. Among those with AF, the effect of dyspepsia on health status, work productivity, and activity impairment was examined, along with health care resource use using multivariable regression modeling and controlling for baseline differences.Results: Among patients with AF (n = 565, the three most commonly reported comorbidities were hypertension (38.76%, dyspepsia (37.35%, and overactive bladder (28.72%. Patients with AF had 48.59% greater odds of reporting dyspepsia than those without AF (P < 0.05. Patients with dyspepsia used more AF medications (2.05 versus 1.54 and had been diagnosed more recently (9.97 versus 10.58 years. Dyspepsia was associated with significantly worse physical health status (P < 0.05 and significantly more absenteeism, overall work impairment, activity impairment, physician visits, and emergency room visits (all P < 0.05.Conclusion: Patients with AF in Japan experience a number of comorbidities, with dyspepsia being the most common noncardiovascular comorbidity. Given the prevalence and

[Prevalence and relation of dyspepsia to irritable bowel syndrome in a native community of the Peruvian jungle].

Science.gov (United States)

Curioso, Walter H; Donaires Mendoza, Ninoska; Bacilio Zerpa, Carlos; Ganoza Gallardo, Christian; León Barúa, Raúl

2002-01-01

Dyspepsia and irritable bowel syndrome (IBS) are two of the most frequent syndromes in gastroenterology. However, very few epidemiological studies have been conducted in Peru and none in the Peruvian Jungle. The objective of this study is to determine the prevalence of dyspepsia and irritable bowel syndrome in a jungle community of Peru and the recurrence percentage of these syndromes. A sample was taken from 231 persons randomly selected using the "home by home" method, according to the map provided by Punta del Este Medical Center (city of Tarapoto - Department of San Mart n). The persons, considered to best typify the general population of the city, took two tests (Dyspepsia Test and Manning Test) that were previously validated during the months of January through March 1999. The prevalence of dyspepsia was 37.6%, and that of IBS, 22.0%. From those with dyspepsia, 38% had also IBS. From those with IBS, 65% reported dyspepsia symptoms. Prevalence of IBS was higher in individuals with dyspepsia (37.9%) than in individuals without dyspepsia (12.5% p< 0.01). The prevalence of both dyspepsia and IBS decreases as age increases. A statistically significant difference related to ethnicity was found in individuals with IBS. Dyspepsia and ethnicity were associated in 31.4% to individuals having both pathologies (p< 0.0001 and OR=4.28). The dyspepsia/IBS ratio was 1.7/1. There is a high prevalence of IBS and dyspepsia in the study population. The high association found between both syndromes may be due to the common etiopathogenic mechanisms they share such as: a visceral hypersensibility due to peripheral or central mechanisms, bowel motility disturbances or parasitosis. Our study suggests that both dyspepsia and IBS are the manifestations of the same digestive disorder, which has not been fully clarified yet.

Rabeto plus: a valuable drug for managing functional dyspepsia.

Science.gov (United States)

Ghosh, Asim; Halder, Susanta; Mandal, Sanjoy; Mandal, Arpan; Basu, Mitali; Dabholkar, Pareen

2008-11-01

The aim of the study was to evaluate and document the efficacy and tolerability of rabeto plus (FDC of rabeprazole and itopride) in management of functional dyspepsia. It was an open, prospective, non-comparative, multidose study. The patients with functional dyspepsia (NERD or non-erosive reflux disease) attending OPD of a leading, tertiary care, teaching hospital in West Bengal (BS Medical College, Bankura) were inducted in the study. A total of 46 adult patients of either sex with functional dyspepsia and a clinical diagnosis of NERD were given 1 capsule of rabeto plus before breakfast, for up to 4 weeks. Primary efficacy variables were relief from symptoms of heartburn, nausea, vomiting, waterbrash and fullness. Secondary efficacy variables were global assessment of efficacy and toleration by patients and treating physicians. The tolerability was assessed on the basis of record of spontaneously reported adverse events with their nature, intensity and outcome. Out of 55 patients enrolled in the study, 46 completed the study as planned, while 9 patients were lost to follow-up (dropped). Most patients reported near total symptom relief by the end of study. Total symptom score showed remarkable and significant improvement from baseline to end of the study. Importantly, none of the patients reported any side-effect. All participants tolerated the drug well. Moreover, response to study drug was rated as excellent or good by over 93% patients and their treating physicians. This means that 9 out 10 patients receiving rabeto plus reported desired symptom relief from dyspepsia. Thus it was concluded that rabeto plus is a valuable drug for treatment of functional dyspepsia or NERD.

Mexican consensus on dyspepsia

Directory of Open Access Journals (Sweden)

R. Carmona-Sánchez

2017-10-01

Full Text Available Since the publication of the 2007 dyspepsia guidelines of the Asociación Mexicana de Gastroenterología, there have been significant advances in the knowledge of this disease. A systematic search of the literature in PubMed (01/2007 to 06/2016 was carried out to review and update the 2007 guidelines and to provide new evidence-based recommendations. All high-quality articles in Spanish and English were included. Statements were formulated and voted upon using the Delphi method. The level of evidence and strength of recommendation of each statement were established according to the GRADE system. Thirty-one statements were formulated, voted upon, and graded. New definition, classification, epidemiology, and pathophysiology data were provided and include the following information: Endoscopy should be carried out in cases of uninvestigated dyspepsia when there are alarm symptoms or no response to treatment. Gastric and duodenal biopsies can confirm Helicobacter pylori infection and rule out celiac disease, respectively. Establishing a strong doctor-patient relationship, as well as dietary and lifestyle changes, are useful initial measures. H2-blockers, proton-pump inhibitors, prokinetics, and antidepressants are effective pharmacologic therapies. H. pylori eradication may be effective in a subgroup of patients. There is no evidence that complementary and alternative therapies are beneficial, with the exception of Iberogast and rikkunshito, nor is there evidence on the usefulness of prebiotics, probiotics, or psychologic therapies. The new consensus statements on dyspepsia provide guidelines based on up-to-date evidence. A discussion, level of evidence, and strength of recommendation are presented for each statement. Resumen: Desde la publicación de las guías de dispepsia 2007 de la Asociación Mexicana de Gastroenterología ha habido avances significativos en el conocimiento de esta enfermedad. Se realizó una revisión sistemática de la

Work productivity improvement after acid suppression in patients with uninvestigated dyspepsia

DEFF Research Database (Denmark)

Bytzer, Peter; Langkilde, Lars K; Christensen, Erik

2012-01-01

Lost productivity accounts for a significant part of the costs caused by gastrointestinal symptoms. We aimed to describe selfreported productivity in patients presenting with dyspepsia.......Lost productivity accounts for a significant part of the costs caused by gastrointestinal symptoms. We aimed to describe selfreported productivity in patients presenting with dyspepsia....

Histopathological analysis of gastric mucosal biopsies in non ulcer dyspepsia

International Nuclear Information System (INIS)

Sarfraz, T.; Hafeez, M.; Tariq, H.; Azhar, M.

2016-01-01

Objective: To find out the pattern of gastric mucosal histopathological findings in gastric biopsies of patients with non ulcer dyspepsia. Study Design: Prospective descriptive study. Place and Duration of Study: Histopathology department Combined Military Hospital (CMH) Kharian Pakistan from Jan to Dec 2015. Material and Methods: One hundred patients presenting at outpatient gastroenterology department with dyspepsia having no endoscopic lesion were included in the study. Two gastric mucosal biopsies from antrum and two from corpus were taken. The specimens were processed and examined histologically to see the changes. Results: Gastric biopsies of 100 patients including 65 males and 35 females presenting with non ulcer dyspepsia were studied. Most of the patients were between the age group of 31-50 years. Histological examination of gastric biopsies revealed 70 percent of patients having histological features of gastritis, while 30 percent having no significant histological finding. Chronic inflammation was seen in 70 cases (70 percent), activity in 15 cases (15 percent), glandular atrophy in 2 cases (2 percent) and intestinal metaplasia in 2 cases (2 percent). H.Pylori were identified in 25 cases (25 percent) based on haematoxylin and eosin (H and E) staining and modified giemsa staining. Conclusion: Most the cases of non ulcer dyspepsia show histological evidence of gastritis, however a significant number of patients showed no gastric mucosal histological abnormality. A significantly low frequency of H. Pylori in gastric biopsies noted in non ulcer dyspepsia cases may be due to more frequent use of antibiotics and acid suppressant drugs used by general practitioners at some stage of disease. (author)

Attentional and physiological processing of food images in functional dyspepsia patients: A pilot study.

Science.gov (United States)

Lee, In-Seon; Preissl, Hubert; Giel, Katrin; Schag, Kathrin; Enck, Paul

2018-01-23

The food-related behavior of functional dyspepsia has been attracting more interest of late. This pilot study aims to provide evidence of the physiological, emotional, and attentional aspects of food processing in functional dyspepsia patients. The study was performed in 15 functional dyspepsia patients and 17 healthy controls after a standard breakfast. We measured autonomic nervous system activity using skin conductance response and heart rate variability, emotional response using facial electromyography, and visual attention using eyetracking during the visual stimuli of food/non-food images. In comparison to healthy controls, functional dyspepsia patients showed a greater craving for food, a decreased intake of food, more dyspeptic symptoms, lower pleasantness rating of food images (particularly of high fat), decreased low frequency/high frequency ratio of heart rate variability, and suppressed total processing time of food images. There were no significant differences of skin conductance response and facial electromyography data between groups. The results suggest that high level cognitive functions rather than autonomic and emotional mechanisms are more liable to function differently in functional dyspepsia patients. Abnormal dietary behavior, reduced subjective rating of pleasantness and visual attention to food should be considered as important pathophysiological characteristics in functional dyspepsia.

The impact of dyspepsia on symptom severity and quality of life in adults with headache.

Directory of Open Access Journals (Sweden)

Mei-Ling Sharon Tai

Full Text Available BACKGROUND: Dyspepsia and headache frequently co-exist, but the clinical implication of this association is uncertain. We planned to examine the prevalence and impact of dyspepsia in adults with headache. METHODS: A cross-sectional study was conducted in a secondary care setting. Clinical, psychological and health-related quality of life (HRQOL data were compared between subjects with headache and controls (non-headache subjects. The impact of dyspepsia was analysed further in subjects with headache alone. RESULTS: 280 subjects (93 cases with headache and 187 matched controls were recruited. The following baseline characteristics of subjects were as follows: mean age 45.0 ± 17.3 years, 57.0% females and ethnic distribution-Malaysian = 45 (48.4%, Chinese n = 24 (25.8% and Indians n = 24 (25.8%. Headache sub-types among cases with headache were as follows: tension-type headache (TTH n = 53 (57.0% and migraine n = 40 (43.0%. Dyspepsia was more prevalent in cases with headache compared to controls (25.8% vs 12.8%, p = 0.011, and headache was independently associated with dyspepsia (OR 2.75, 95% CI 1.39-5.43. Among cases with headache, there was a trend towards a higher prevalence of dyspepsia in those with migraine (27.5% compared to TTH (24.5%. Subjects with headache and dyspepsia, compared to those with headache alone, had a greater severity of headache symptoms (63.67 ± 22.85 mm vs 51.20 ± 24.0 mm VAS, p = 0.029. Overall HRQOL scores were lower in headache subjects with dyspepsia (EQ-5D summary score 0.82 ± 0.18 vs 0.90 ± 0.16, p = 0.037 and EQ-5D VAS 62.08 ± 17.50 mm vs 72.62 ± 18.85 mm, p = 0.018, compared to those without dyspepsia. CONCLUSION: Dyspepsia is associated with more severe headache symptoms and results in a lower HRQOL in patients with headache.

Dietary and Lifestyle Factors Associated with Dyspepsia among Pre-clinical Medical Students in Ajman, United Arab Emirates

Directory of Open Access Journals (Sweden)

Noorallah Jaber

2016-08-01

Conclusion: Dyspepsia was reported by 43.8% of the repondents. These findings emphasize the importance of improving lifestyle and dietary factors associated with dyspepsia and raising awareness of reducing risk factors associated with dyspepsia. Further studies are needed on dyspepsia in a larger cohort of students in order to fully understand the complexity of this problem and be able to generalize the findings to other cohorts.

Helicobacter pylori eradication treatment does not benefit patients with nonulcer dyspepsia.

Science.gov (United States)

Froehlich, F; Gonvers, J J; Wietlisbach, V; Burnand, B; Hildebrand, P; Schneider, C; Saraga, E; Beglinger, C; Vader, J P

2001-08-01

The aim of this study was to assess the still controversial role of treatment of Helicobacter pylori (H. pylori) infection in patients with nonulcer dyspepsia. We conducted a double-blind, randomized, placebo-controlled, multicenter trial comparing the efficacy of 7 days of eradication treatment (lansoprazole 15 mg b.i.d., amoxicillin I g b.i.d., and clarithromycin 500 mg b.i.d.) with a control treatment (lansoprazole 15 mg b.i.d. and placebo) in H. pylori-infected patients with nonulcer dyspepsia. 13C breath tests were performed at baseline and during follow-up. We assessed patient symptoms, health status (based on the SF-12 questionnaire), patient satisfaction, drug consumption, health care consultation behavior, and absenteeism related to dyspepsia over a 1-yr period. A total of 74 patients randomized to eradication treatment and 70 patients randomized to placebo were compared. The rate of eradication of H. pylori infection was 75% in the active treatment group and 4% in the placebo group (p absenteeism or satisfaction with management of NUD. Patients receiving active treatment were more likely not to have had to use any dyspepsia treatment over the 12 months (60.8% vs 44.3%; p = 0.047). This study did not demonstrate any substantial benefit of curing H. pylori infection in patients with nonulcer dyspepsia. The study adds further evidence that H. pylori is not the main pathogenetic or therapeutic target in these patients.

ACUPUNCTURE EFFECTIVENESS AS A COMPLEMENTARY THERAPY IN FUNCTIONAL DYSPEPSIA PATIENTS

Directory of Open Access Journals (Sweden)

Flavia Altaf da Rocha LIMA

2013-09-01

Full Text Available Context Functional dyspepsia represents a frequent gastrointestinal disorder in clinical practice. According to the Roma III criteria, functional dyspepsia can be classified into two types as the predominant sympton: epigastric pain and postprandial discomfort. Even though the pathophysiology is still uncertain, the functional dyspepsia seems to be related to multiple mechanisms, among them visceral hypersensitivity, changes in the gastroduodenal motility and gastric accommodation and psychological factors. Objective Evaluate the effectiveness of acupuncture as a complementary to conventional treatment in functional dyspepsia patients. Methods Randomized clinical trial in which were enrolled patients with functional dyspepsia patients in according with Rome III criteria. One group was submitted to drug therapy and specific acupuncture (GI and the other to drug therapy and non-specific acupuncture (GII. The gastrointestinal symptoms, presence of psychiatric disorders and quality of life were evaluated, at the end and three months after treatment. Results After 4 weeks of treatment there was improvement of gastrointestinal symptoms in Group I (55 ± 12 vs 29 ± 8.8; P = 0.001 and Group II (50.5 ± 10.2 vs 46 ± 10.5; P = 0.001. Quality of life was significantly better in Group I than group II (93.4 ± 7.3 vs 102.4 ± 5.1; P = 0.001. Anxiety (93.3% vs 0%; P = 0.001 and depression (46.7% vs 0%; P = 0.004 were significantly lower in Group I than group II. When comparing the two groups after 4 weeks of treatment, gastrointestinal symptoms (29 ± 8.8 vs 46 ± 10.5; P<0.001 and quality of life (102.4 ± 5.1 vs 96 ± 6.1; P = 0.021 were significantly better in Group I than group II. Three months after the treatment, gastrointestinal symptoms remained better only in Group I, when compared to the pre-treatment values (38 ± 11.3 vs 55 ± 12; P = 0.001. Conclusion In patients with functional dyspepsia the complementary acupuncture treatment is superior to

Clinical characteristics and effectiveness of lansoprazole in Japanese patients with gastroesophageal reflux disease and dyspepsia.

Science.gov (United States)

Kinoshita, Yoshikazu; Miwa, Hiroto; Sanada, Katsuyuki; Miyata, Koji; Haruma, Ken

2014-04-01

Patients with gastroesophageal reflux disease (GERD) frequently have symptoms of dyspepsia in addition to reflux symptoms. Treatment options for dyspepsia are not standardized. The aim of this study was to clarify the therapeutic effect of lansoprazole on dyspepsia in Japanese patients with GERD. GERD patients with dyspepsia were enrolled and treated with lansoprazole 15 or 30 mg once daily for 4 weeks. Reflux and dyspeptic symptoms were assessed by questionnaires before treatment, and 2 and 4 weeks after the start of lansoprazole treatment. In the effectiveness analysis set (n = 12,653), heartburn was reported by 91.6 % of patients at study enrollment. Postprandial fullness was the most frequently reported dyspepsia symptom at the start of the study, reported by 79.0 % of enrolled patients. After 4 weeks of lansoprazole treatment, heartburn symptoms were improved in 75.7 % of patients and symptoms of postprandial fullness were improved in 68.7 % of patients. The therapeutic effect of low and high doses of lansoprazole on dyspepsia, as well as on reflux symptoms, was approximately 10 % higher in patients with endoscopy-confirmed erosive esophagitis (60.1-82.2 %), than in patients with non-erosive reflux diseases (53.0-73.3 %). Lansoprazole was well tolerated. In this large-scale clinical study, lansoprazole effectively relieved dyspepsia in addition to reflux symptoms in patients with GERD.

Air swallowing, belching, acid and non-acid reflux in patients with functional dyspepsia

NARCIS (Netherlands)

Conchillo, J. M.; Selimah, M.; Bredenoord, A. J.; Samsom, M.; Smout, A. J. P. M.

2007-01-01

BACKGROUND: Frequent belching is a common symptom in patients with functional dyspepsia with a reported incidence up to 80%. We hypothesized that patients with functional dyspepsia possibly have a higher frequency of belching than healthy subjects secondary to frequent air swallowing. AIM: To assess

Validation study of the Leeds Dyspepsia Questionnaire in a multi-ethnic Asian population.

Science.gov (United States)

Mahadeva, Sanjiv; Chan, Wah-Kheong; Mohazmi, Mohammed; Sujarita, Ramanujam; Goh, Khean-Lee

2011-11-01

Outcome measures for clinical trials in dyspepsia require an assessment of symptom response. There is a lack of validated instruments assessing dyspepsia symptoms in the Asian region. We aimed to translate and validate the Leeds Dyspepsia Questionnaire (LDQ) in a multi-ethnic Asian population. A Malay and culturally adapted English version of the LDQ were developed according to established protocols. Psychometric evaluation was performed by assessing the validity, internal consistency, test-retest reliability and responsiveness of the instruments in both primary and secondary care patients. Between April and September 2010, both Malay (n=166) and Malaysian English (n=154) versions were assessed in primary and secondary care patients. Both language versions were found to be reliable (internal consistency was 0.80 and 0.74 (Cronbach's α) for Malay and English, respectively; spearman's correlation coefficient for test-retest reliability was 0.98 for both versions), valid (area under receiver operating curve for accuracy of diagnosing dyspepsia was 0.71 and 0.77 for Malay and English versions, respectively), discriminative (median LDQ score discriminated between primary and secondary care patients in Malay (11.0 vs 20.0, PAsian population with dyspepsia. © 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.

Prevalência de dispepsia e fatores sociodemográficos Prevalence of dyspepsia and associated sociodemographic factors

Directory of Open Access Journals (Sweden)

Sandro Schreiber de Oliveira

2006-06-01

Full Text Available OBJETIVO: Medir a prevalência e distribuição de dispepsia e dispepsia freqüente por subtipos na população com 20 anos ou mais segundo características socioeconômicas e demográficas. MÉTODOS: Estudo transversal, de base populacional, com 3.934 indivíduos moradores na cidade de Pelotas (RS, entrevistados em seus domicílios, de outubro de 1999 a janeiro de 2000. Dispepsia foi definida como dor ou desconforto no andar superior do abdome e/ou náuseas no ano anterior à entrevista (conforme critérios Roma I e II. Dispepsia freqüente incluiu o registro de dispepsia mais de seis vezes e/ou náuseas, uma vez por mês ou mais. Esses desfechos foram analisados por idade, sexo, cor da pele, escolaridade, renda e estado civil. Os dados foram analisados por meio do teste qui-quadrado de Pearson de associação para variáveis categóricas e teste de tendência linear, quando aplicável. RESULTADOS: A prevalência de dispepsia foi de 44,4% e de dispepsia freqüente, 27,4%. A prevalência de dispepsia tipo refluxo, úlcera, dismotilidade e não especificada foi, respectivamente, 19,4%, 6,3%, 13,9% e 16,6%; para dispepsia freqüente foram 14,7%, 4,9%, 11,2% e 6,8%, respectivamente. As mulheres apresentaram cerca de 50% mais dispepsia freqüente. Indivíduos mais jovens e de menor renda apresentaram maiores prevalências de dispepsia e dispepsia freqüente. Análise de acordo com critérios de Roma II mostrou prevalências de 15,9% e 7,5% para dispepsia e dispepsia freqüente, respectivamente. CONCLUSÕES: A dispepsia constitui um problema prevalente na população estudada. A maioria dos indivíduos apresentaram mais de um subtipo de dispepsia.OBJECTIVE: To assess prevalence of dyspepsia and distribution of dyspepsia and frequent dyspepsia in subgroups of adults (20 years and older according to their demographic and socioeconomic characteristics. METHODS: A cross-sectional population-based study was carried out comprising 3,934 subjects living in

Frequency of peptic ulcer disease in patients of dyspepsia an analysis of upper gastrointestinal endoscopy

International Nuclear Information System (INIS)

Anwar, S.O.; Ambreen, S.; Ashraf, H.M.

2010-01-01

To evaluate the frequency of peptic ulcer disease in patients of dyspepsia on upper gastrointestinal endoscopy. A convenient non probability sampling was done and one hundred patients were selected from out patient department presenting within six months of dyspeptic symptoms. They were all subjected to upper gastrointestinal endoscopy Of all patients 61% (n=61) were males and 39% (n=39) were females with age ranging between 20 - 45 years. Study revealed functional dyspepsia (76%), duodenal ulcer (11%), gastric ulcer (4%) and esophagitis including gastoesophageal reflux disease (9%). This showed an overall frequency of peptic ulcer disease to be 15% in the studied population.Conclusion: Peptic ulcer disease is a common structural cause of dyspepsia and was responsible for 15% of dyspepsia. (author)

Defining functional dyspepsia Definiendo la dispepsia funcional

Directory of Open Access Journals (Sweden)

Fermín Mearin

2011-12-01

Full Text Available Dyspepsia and functional dyspepsia represent a highly significant public health issue. A good definition of dyspepsia is key for helping us to better approach symptoms, decision making, and therapy indications. During the last few years many attempts were made at establishing a definition of dyspepsia. Results were little successful on most occasions, and clear discrepancies arose on whether symptoms should be associated with digestion, which types of symptoms were to be included, which anatomic location should symptoms have, etc. The Rome III Committee defined dyspepsia as "a symptom or set of symptoms that most physicians consider to originate from the gastroduodenal area", including the following: postprandial heaviness, early satiety, and epigastric pain or burning. Two new entities were defined: a food-induced dyspeptic symptoms (postprandial distress syndrome; and b epigastric pain (epigastric pain syndrome. These and other definitions have shown both strengths and weaknesses. At times they have been much too complex, at times much too simple; furthermore, they have commonly erred on the side of being inaccurate and impractical. On the other hand, some (the most recent ones are difficult to translate into the Spanish language. In a meeting of gastroenterologists with a special interest in digestive functional disorders, the various aspects of dyspepsia definition were discussed and put to the vote, and the following conclusions were arrived at: dyspepsia is defined as a set of symptoms, either related or unrelated to food ingestion, localized on the upper half of the abdomen. They include: a epigastric discomfort (as a category of severity or pain; b postprandial heaviness; and c early satiety. Associated complaints include: nausea, belching, bloating, and epigastric burn (heartburn. All these must be scored according to severity and frequency. Furthermore, psychological factors may be involved in the origin of functional dyspepsia. On the

Relationship between vomiting reflex during esophagogastroduodenoscopy and dyspepsia symptoms.

Science.gov (United States)

Enomoto, Shotaro; Watanabe, Mika; Yoshida, Takeichi; Mukoubayashi, Chizu; Moribata, Kosaku; Muraki, Yosuke; Shingaki, Naoki; Deguchi, Hisanobu; Ueda, Kazuki; Inoue, Izumi; Maekita, Takao; Iguchi, Mikitaka; Tamai, Hideyuki; Kato, Jun; Fujishiro, Mitsuhiro; Oka, Masashi; Mohara, Osamu; Ichinose, Masao

2012-09-01

Although frequent vomiting reflexes during esophagogastroduodenoscopy (EGD) causes suffering in patients, very few studies have investigated the characteristics of subjects who frequently develop vomiting reflexes. This study examined the incidence of the vomiting reflex and related factors, especially upper gastrointestinal symptoms, among individuals undergoing transoral EGD. Subjects included 488 consecutive adults (mean age, 56.1 ± 8.9 years) who underwent transoral EGD for gastric cancer screening between February 2010 and March 2011. All procedures were performed by an endoscopist with 15 years of experience. Based on a questionnaire survey using the frequency scale for the symptoms of gastroesophageal reflux disease (FSSG), symptoms (dyspepsia and acid reflux symptoms) and the number of vomiting reflexes during EGD were recorded. Of the 488 subjects, 271 (56%) developed vomiting reflexes (mean, 4.2 times). This reflex-positive group was younger (54.3 ± 9.5 years) than the reflex-negative group (58.3 ± 7.7 years, P reflex-positive group with a high FSSG dyspepsia score (2.27 ± 2.57 vs 1.23 ± 1.84; P acid reflux symptom score (1.96 ± 2.22 vs 1.34 ± 2.14; P reflex-negative group. Multivariate analysis also showed a significant correlation between these four factors and the occurrence of vomiting reflexes. Using an FSSG dyspepsia score of 1 as the cut-off offered 68% sensitivity and 57% specificity for predicting the occurrence of vomiting reflexes. Based on FSSG questionnaire responses on upper gastrointestinal symptoms, dyspepsia symptoms, in particular, are related to presence of vomiting reflexes during EGD. © 2012 The Authors. Digestive Endoscopy © 2012 Japan Gastroenterological Endoscopy Society.

Functional dyspepsia: The role of visceral hypersensitivity in its pathogenesis

Institute of Scientific and Technical Information of China (English)

John Keohane; Eamonn M M Quigley

2006-01-01

Functional, or non-ulcer, dyspepsia (FD) is one of the most common reasons for referral to gastroenterologists.It is associated with significant morbidity and impaired quality of life. Many authorities believe that functional dyspepsia and irritable bowel syndrome represent part of the spectrum of the same disease process.The pathophysiology of FD remains unclear but several theories have been proposed including visceral hypersensitivity, gastric motor dysfunction, Helicobacter pylori infection and psychosocial factors. In this review,we look at the evidence, to date, for the role of visceral hypersensitivity in the aetiology of FD.

Functional dyspepsia: the role of visceral hypersensitivity in its pathogenesis.

LENUS (Irish Health Repository)

Keohane, John

2012-02-03

Functional, or non-ulcer, dyspepsia (FD) is one of the most common reasons for referral to gastroenterologists. It is associated with significant morbidity and impaired quality of life. Many authorities believe that functional dyspepsia and irritable bowel syndrome represent part of the spectrum of the same disease process. The pathophysiology of FD remains unclear but several theories have been proposed including visceral hypersensitivity, gastric motor dysfunction, Helicobacter pylori infection and psychosocial factors. In this review, we look at the evidence, to date, for the role of visceral hypersensitivity in the aetiology of FD.

History of dyspepsia in Scotland. Admissions to the Edinburgh Royal Infirmary 1729-1830, doctoral theses 1726-1823, and contemporary British publications.

Science.gov (United States)

Baron, J H; Sonnenberg, A

2008-08-01

The aim of the study was to assess whether the rise in the occurrence of dyspepsia in Scotland during the eighteenth century was a true epidemiologic phenomenon or just an increase in medical awareness. Admissions for dyspepsia to the Edinburgh Royal Infirmary from 1729 until 1830 were analysed by consecutive five-year time periods. The titles of MD theses on dyspepsia from 1726 to 1823 were extracted from the Edinburgh University index. Monographs and articles on dyspepsia from Britain during the same time period were sought in the Catalogues of the US Surgeon-General's Library. During the eighteenth century, the annual number of dyspepsia patients admitted to the Edinburgh Royal Infirmary showed an extraordinary increase from none in 1730 to 900 per million population in 1760. About 4000 MD theses were presented to the Edinburgh University between 1726 and 1823. There were none on dyspepsia or gastritis between 1726 and 1749, after when it gradually started to rise. British publications on dyspepsia similarly appeared only in the 1790s and then rapidly increased. We suggest that the rise in MD theses and publications on dyspepsia were responses to a real increase in dyspepsia during the mid eighteenth century.

Burden of common mental disorders in patients with Functional Dyspepsia

International Nuclear Information System (INIS)

Sattar, A.; Salih, M.; Jafri, W.

2010-01-01

Objective: To assess the frequency of common mental disorders among diagnosed functional dyspepsia patients. Methods: A case-control study with 150 cases of functional dyspepsia (FD) and 150 healthy controls were recruited from Gastroenterology Clinic at the Aga Khan University Hospital Karachi from 1, March 2009 through 31, August 2009. Urdu version of WHO-developed Self-Reporting Questionnaire (SRQ) was administered to diagnose patients of FD and healthy controls. A cut off score of 8 on SRQ was used to confirm cases of Common mental disorders (CMD). Data was entered and analyzed by SPSS version 16.0. Result: There was significant difference in CMD i.e. 107 (71.33%) versus 23 (15.33%) in cases and controls respectively (p- <0.001). Among cases CMD was more common in females i.e. in 57 (80.3%) as compared 50 (63.3%) in males (p- 0.022). Conclusion: There is high prevalence of Common mental disorders among patients with functional dyspepsia and this needs to be addressed while treating patients. (author)

Association Between Functional Dyspepsia And Severity Of Depression

International Nuclear Information System (INIS)

Jamil, O.; Sarwar, S.; Hussain, Z.; Fiaz, R. O.; Chaudary, R. D.

2016-01-01

Objective: To determine the association between functional dyspepsia and the severity of depression. Study Design: Cross-sectional study. Place and Duration of Study: Department of Medicine, King Edward Medical University/Mayo Hospital, Lahore, from September 2012 till January 2013. Methodology: After taking informed written consent, patients with symptoms of dyspepsia fulfilling the Rome III criteria were included in the study. All patients were evaluated for depression, using Hamilton depression rating scale (HDRS). Upper gastrointestinal endoscopy was done. Fischers' exact test and independent t-test were used for determining significance of association. Result: One hundred and one patients with mean age of 35.81 14.81) years and male to female ratio of 1.41:1 (54/47) were included. Predominant symptoms were early satiety (72.3 percentage), epigastric pain (65.3 percentage), bloating (49.5 percentage), postprandial fullness (40.6 percentage), and regurgitation (40.6 percentage). Alarm symptoms were positive in 44 (43.6 percentage) patients. Dyspepsia were classified as epigastric pain syndrome (EPS, 69.3 percentage), and postprandial distress syndrome (PDS, 30.7 percentage). Significantly more females had PDS (p=0.04), with positive endoscopic findings in EPS (p=0.03). Positive endoscopic findings noted were esophagitis in 21.8 percentage, and gastritis in 48.5 percentage patients. All patients except one had depression, mild in 22.8 percentage, moderate in 33.7 percentage, severe in 31.7 percentage, and very severe in 10.9 percentage patients. Severe depression was seen in 32 (45.7 percentage) patients with EPS and PDS; whereas very severe depression was in 11 (15.7 percentage) patients of EPS, while 11 (35.4 percentage) patients of PDS had severe depression but the difference was not significant. Conclusion: Functional dyspepsia is associated with depression, while positive endoscopic findings are more likely in patients with EPS. Very severe depression

Emerging pharmacological therapy for functional dyspepsia.

Science.gov (United States)

Hojo, Mariko; Nagahara, Akihito; Asaoka, Daisuke; Watanabe, Sumio

2013-10-01

Functional dyspepsia (FD) is a multifactorial disease with complex underlying pathophysiology. To date, there is no established treatment for FD. This review summarizes recent progress in pharmacological therapy for the disease. A newly developed drug, acotiamide, is expected to improve symptoms of postprandial distress syndrome. Herbal medicines are also expected to become options for FD treatment.

Clinical Efficacy of Proton Pump Inhibitor versus Prompt Endoscopy for Management of People with Dyspepsia

DEFF Research Database (Denmark)

Kjeldsen, Hans Christian; Lauritzen, Torsten; Christensen, Bo

  Title:   Clinical Efficacy of Proton Pump Inhibitor versus Prompt Endoscopy for Management of People with Dyspepsia: A Randomized Clinical Trial in General Practice.     Purpose: To compare the clinical efficacy of two strategies for management of dyspepsia in general practice in a RCT design.......   Setting: June 2000 to August 2002, 41 GPs, Aarhus County, Denmark   Methods: 368 people with dyspepsia (epigastric pain/discomfort, no alarm symptoms) were randomly assigned to treatment with omeprazol 40 mg/day for two weeks (PPI group, n:185) or endoscopy (endoscopy group, n:183). Due to migration......, dyspeptic contacts to GP or patients' satisfaction. Conclusions: Prompt endoscopy was superior to proton pump inhibitor concerning symptom improvement in management of dyspepsia in general practice when pain/discomfort was the primary symptom. There were no differences between the two strategies in respect...

  A Cost-Effectiveness Analysis of Two Management Strategies for Dyspepsia

DEFF Research Database (Denmark)

Kjeldsen, Hans Chr; Bech, Mickael; Christensen, Bo

2007-01-01

Objectives: To compare the cost-effectiveness of endoscopy and empirical proton pump inhibition (PPI) therapy for management of dyspepsia in primary care. Methods: A randomized controlled trial (RCT) including prospective collection of economic resource data was conducted in general practice from...... of dyspeptic symptoms and proportion of patients with dyspepsia after one year based on patients' and general practitioners' (GPs') assessment. Costs were estimated from patient and GP questionnaires and from medical records. Results: The incremental cost-effectiveness (CE) ratio for one day free of dyspeptic...

CLINICAL AND MORPHOLOGICAL CHARACTERISTICS OF THE CHRONIC GASTRITIS WITH FUNCTIONAL DYSPEPSIA IN THE REPUBLIC OF SAKHA (YAKUTIA).

Science.gov (United States)

Avvakumova, N V; Chibyeva, L G; Vasiliev, N N

2015-01-01

Chronic gastritis with syndrome, functional dyspepsia (SFD) is one of the most pressing problems in medicine. Certain scientific and practical interest is the elucidation of the frequency and clinical manifestations of functional dyspepsia in patients hospitalized in the gastroenterology department YAGKB and frequency combinations of chronic gastritis (including H. pylori) with functional dyspepsia. The aim of the study was to investigate the clinical and morphological features of the chronic gastritis with syndrome pattern of functional dyspepsia in native-born and people of the Republic of Sakha (Yakutia), and to assess the effectiveness of treatment, depending on the gastric acid and H. pylori. This study examined 105 patients with functional dyspepsia, including 41 patients with epigastric pain syndrome and 64 patients with postprandial distress syndrome. Considered groups of patients were homogeneous for age, gender, by ethnicity. Of the 105 patients included in the study, I group were 57 indigenous people (80% of them--Yakutia), 11 group--48 people visiting (Caucasians). Clinical presentation and course of chronic gastritis with functional dyspepsia in the Republic of Sakha (Yakutia) have a number of distinctive features: epigastric pain syndrome occurs in 26.8% of patients and 73.2% of the indigenous population of the visitor, the intensity of pain in the root is much lower than that of visitors--12 and 85% respectively. Postprandial distress syndrome was diagnosed in 71.9% of patients and 28.1% of the indigenous newcomers. At endoscopy in all patients with functional dyspepsia diagnosed chronic gastritis. The native inhabitants of the most common mixed gastritis (54.5%), the newcomers--superficial gastritis (66.7%). The found features of a current of functional dyspepsia can be further the basis for the individualized and differentiated approaches to treatment of this disease.

Thermal Care of Functional Dyspepsia Based on Bicarbonate-Sulphate-Calcium Water: A Sequential Clinical Trial

Directory of Open Access Journals (Sweden)

Giuseppe Rocca

2007-01-01

Full Text Available Drug treatment of functional dyspepsia is often unsatisfactory. We assessed the efficacy of a bicarbonate-sulphate-calcium thermal water cycle of 12 days, in patients with functional dyspepsia. Patients with functional dyspepsia were sent by their general practitioners to 12 days of treatment with thermal water, 200–400 ml in the morning, at temperature of 33°C (91.4 F and were evaluated on a strict intention to treat basis. Four efficacy endpoints were analyzed as follows: (i reduction of the global symptoms score, (ii reduction of intensity to a level not interfering with everyday activities, (iii specific efficacy on ulcer-like or dysmotility-like dyspepsia and (iv esophageal or abdominal-associated symptoms. Statistical significance was reached for all three primary outcomes after the first 29 consecutive patients. Thermal water reduced the global symptom score, reduced intensity of symptoms to a level not interfering with everyday activity, but was unable to completely suppress all symptoms. A parallel effect emerged for ulcer-like and dyspepsia-like subgroups. The effect on heartburn and abdominal symptoms was not significant, suggesting a specific effect of the water on the gastric and duodenal wall. The Roma II criteria identify a natural kind of dyspepsia that improves with thermal water. Ulcer-like and dysmotility-like are not therapeutically distinguishable subgroups. Patients with dominant esophageal or abdominal symptoms should receive a different therapy. Sequential methods are very effective for the evaluation of traditional care practices and should be considered preliminary and integrative to randomized controlled trials in this context.

Food and functional dyspepsia: a systematic review.

Science.gov (United States)

Duncanson, K R; Talley, N J; Walker, M M; Burrows, T L

2018-06-01

Functional dyspepsia (FD) is a debilitating functional gastrointestinal disorder characterised by early satiety, post-prandial fullness or epigastric pain related to meals, which affects up to 20% of western populations. A high dietary fat intake has been linked to FD and duodenal eosinophilia has been noted in FD. We hypothesised that an allergen such as wheat is a risk factor for FD and that withdrawal will improve symptoms of FD. We aimed to investigate the relationship between food and functional dyspepsia. Sixteen out of 6451 studies identified in a database search of six databases met the inclusion criteria of studies examining the effect of nutrients, foods and food components in adults with FD or FD symptoms. Wheat-containing foods were implicated in FD symptom induction in six studies, four of which were not specifically investigating gluten and two that were gluten-specific, with the implementation of a gluten-free diet demonstrating a reduction in symptoms. Dietary fat was associated with FD in all three studies that specifically measured this association. Specific foods reported as inducing symptoms were high in either natural food chemicals, high in fermentable carbohydrates or high in wheat/gluten. Caffeine was associated with FD in four studies, although any association with alcohol was uncertain. Wheat and dietary fats may play key roles in the generation of FD symptoms and reduction or withdrawal eased symptoms. Randomised trials investigating the roles of gluten, FODMAPs (fermentable oligosaccharide, disaccharide, monosaccharide and polyols) and high fat ingestion and naturally occurring food chemicals in the generation of functional dyspepsia symptoms are warranted and further investigation of the mechanisms is now required. © 2017 The British Dietetic Association Ltd.

Lactobacillus probiotics for treating functional dyspepsia in children

Directory of Open Access Journals (Sweden)

Tuty Ahyani

2016-05-01

Conclusion There are no significant differences in recovery from functional dyspepsia, pain severity, or pain duration between the probiotics and placebo groups. However, the probiotics group has significantly reduced frequency of pain compared to that of the placebo group.

Functional dyspepsia. Different mechanisms, comprehensive treatment

Directory of Open Access Journals (Sweden)

A.E. Dorofeyev

2017-09-01

Full Text Available Functional dyspepsia (FD is a disease with different prevailing pathogenetic mechanisms. The prevalence of FD varies widely from 10 to 30 % of the population, depending on the country and the surveyed cohort. There are two forms of FD: postprandial distress syndrome manifested by a fullness/early satiety after eating, and epigastric pain syndrome — pain/burning in the epigastrium, which may worsen after eating. In a significant part of patients with FD, there are manifestations of both syndromes, the so-called overlap, or a mixed type. In the Ukrainian population, all patients with dyspepsia should be diagnosed and, if found, — undergo mandatory eradication of H.pylori. In patients with persistent symptoms or in those initially not infected with H.pylori, in our opinion, it is advisable to use the combination of proton pomp inhibitor and prokinetic as starting treatment. In our country, a fixed combination of omeprazole and domperidone is available in two dosages. This is Omez D containing 10 mg of both components and a more highly dosed Omez DSR containing 20 mg of omeprazole and 30 mg of domperidone in the form of sustained-release pellets.

Effects of itopride hydrochloride and ranitidine in patients with functional dyspepsia: comparison between prokinetic and acid suppression therapies.

Science.gov (United States)

Chiba, Toshimi; Tokunaga, Yumi; Ikeda, Keisei; Takagi, Ryo; Chishima, Raita; Terui, Torahiko; Kudara, Norihiko; Endo, Masaki; Inomata, Masaaki; Orii, Seishi; Suzuki, Kazuyuki

2007-09-01

The effect of itopride hydrochloride or ranitidine on the health-related quality of life (HRQoL) of functional dyspepsia is not well known. Our aim was to assess the HRQoL before and after administration of itopride hydrochloride or ranitidine in patients with functional dyspepsia. A total of 18 functional dyspepsia patients (12 women, 6 men; mean age 52.5 y.o.) were enrolled. We determined the HRQoL using two different inquiry systems: the 36 item short form of the Medical Outcome Study Questionnaire (SF-36) and the Gastrointestinal Symptom Rating Scale (GSRS). The HRQoL was determined before administration of drug, and two, four, and eight weeks after administration of drug. After administration of itopride hydrochloride, the SF-36 mental health scale and GSRS indigestion syndrome score and constipation syndrome score were significantly improved compared to before administration (p Itopride hydrochloride would be useful for the treatment of dysmotility-type functional dyspepsia, whereas ranitidine would be beneficial for ulcer-type functional dyspepsia.

Prevalence of Helicobacter pylori and risk factors among dyspepsia ...

African Journals Online (AJOL)

unhcc

It is also an important risk factor for the development of gastric cancer and mucosal associated lymphoid tissue. (MALT) lymphoma. ..... dyspepsia, methodological weaknesses, including low ... In the current finding, a significant association was.

The Epidemiology, Diagnosis, and Cost of Dyspepsia and Helicobater pylori Gastritis: A Case–Control Analysis in the Southwestern United States

Science.gov (United States)

Mapel, Douglas; Roberts, Melissa; Overhiser, Andrew; Mason, Andrew

2013-01-01

Background Dyspepsia is among the most common complaints evaluated by gastroenterologists, but there are few studies examining its current epidemiology, evaluation, and costs. We examined these issues in a large managed care system in the Southwestern United States. Methods We conducted a retrospective case–control analysis of adults with incident dyspepsia or a Helicobacter pylori-related condition in years 2006 through 2010 using utilization data. Medical record abstraction of 400 cases was conducted to obtain additional clinical information. Results A total of 6989 cases met all inclusion and exclusion criteria. Women had a substantially higher risk of dyspepsia than men (14 per 1000 per year vs 10 per 1000; p < .001), and the incidence of dyspepsia increased with age such that persons in their seventh decade had almost twice the risk of those aged 18–29. Hispanic persons had a significantly higher risk of dyspepsia and positive H. pylori testing. Dyspepsia cases had a higher prevalence of other chronic comorbidities than their matched controls. Dyspepsia patients had healthcare costs 54% higher than controls even before the diagnosis was made, and costs in the initial diagnostic period were $483 greater per person, but subsequent costs were not greatly affected. Among those aged 55 and younger, the “test and treat” approach was used in 53% and another 18% had an initial esophagogastroduodenoscopy, as compared to 47 and 27%, respectively, among those over the age of 55. Conclusions Women and older adults have a higher incidence of dyspepsia than previously appreciated, and Hispanics in this region also have a higher risk. Current guidelines for dyspepsia evaluation are only loosely followed. PMID:23067108

Effect of Helicobacter pylori Eradication on Functional Dyspepsia

Science.gov (United States)

Kim, Sung Eun; Park, Young Soo; Kim, Min Soo; Jo, Hyun Jin; Shin, Cheol Min; Lee, Sang Hyub; Hwang, Jin-Hyeok; Kim, Jin-Wook; Jeong, Sook-Hyang; Lee, Dong Ho; Jung, Hyun Chae

2013-01-01

Background/Aims This study evaluated the effect of Helicobacter pylori eradication on functional dyspepsia (FD), and the relationship between the changes of histological gastritis and FD symptom responses. Methods A total of 213 FD patients diagnosed by Rome III criteria were consecutively enrolled. H. pylori tests and gastritis grade by the Sydney system were performed before and 1 year after the proton pump based-eradication therapy for 7 days. Serum levels of pepsinogen, and genetic polymorphisms IL-6, IL-8 and IL-10 were investigated. Results Total of 91 patients completed the 1 year follow-up. When the response rate of dyspepsia was compared at 1 year between the non-eradicated group (n = 24) and eradicated group (n = 67), each group showed complete response of 62.5% and 62.7%; satisfactory response (≥ 50%) of 0.0% and 19.4%; partial response (gastritis at 1 year, suggesting that inflammation mediates FD. PMID:23667755

The EQ-5D (Euroqol is a valid generic instrument for measuring quality of life in patients with dyspepsia

Directory of Open Access Journals (Sweden)

Goh Khean-Lee

2009-03-01

Full Text Available Abstract Background There is little information of the validity of generic instruments in measuring health-related quality of life (HRQOL in patients with dyspepsia. We aimed to assess the reliability and validity of the EQ-5D, a brief and simple instrument, in measuring HRQOL in adult patients with dyspepsia. Methods Consecutive adults with dyspepsia attending the Gastroenterology clinic in a tertiary referral center were interviewed with the EQ-5D (both English and Malay versions, the short-form Nepean Dyspepsia Index (SF-NDI, the SF-36 and Leeds Dyspepsia Questionnaire (LDQ. Known-groups and convergent construct validity were investigated by testing hypotheses at attribute and overall levels. A repeat telephone interview was conducted 2 weeks later to assess test-retest reliability. Results A total of 113 patients (mean (SD age: 53.7 (14 years; 49.5% male; 24.8% Malays, 37.2% Chinese; 70.8% functional dyspepsia were recruited. Response rate was 100% with nil missing data. Known-groups validation revealed 20/26 hypotheses fulfillment. Patients with more severe dyspepsia reported more problems with their usual activity (p = 0.07 and pain (p = 0.06 and demonstrated lower median VAS scores (60 vs 70, p = 0.002 and EQ-5D utility scores (0.72 vs 0.78, p = 0.002. Those reporting problems in various EQ-5D dimensions had significantly lower scores in relevant SF-36 and SF-NDI dimensions. The overall EQ-5D utility score also demonstrated good correlation with the SF-36 summary physical and mental scores and the SF-NDI total score. Intraclass correlation coefficient for test-retest reliability was 0.66 (95% CI = 0.55 – 0.76. Conclusion The EQ-5D is an acceptable, valid and reliable generic instrument for measuring HRQOL in adult patients with dyspepsia.

THE STUDY OF REACTIVE AND PERSONAL ANXIETY, QUALITY OF LIFE IN PATIENTS WITH DYSPEPSIA IN OUTPATIENT DEPARTMENT

Directory of Open Access Journals (Sweden)

E. G. Kunakbaeva

2016-01-01

Full Text Available Conducted  a comprehensive  examination  of patients  in the  outpatient department, including laboratory  and instrumental methods,  the  test of Spielberg-Hanina to determine  the level of anxiety, the SF 36 test to determine  the level of quality of life. The survey revealed a decline in the quality of life in patients  with dyspepsia, the indicators of psychological health in organic and functional dyspepsia is lower than in healthy people. The intensity of pain was higher in patients  with epigastric pain syndrome. Lower quality of life were in the group with organic lesions of the upper gastrointestinal tract. The results of the test of Spielberg-Hanin demonstrated high personal anxiety in patients with different types of dyspepsia in comparison with healthy group. The obtained results complement the clinical and pathogenetic information regarding the different kinds of dyspepsia. 

Endoscopic evaluation of patients with dyspepsia in a secondary ...

African Journals Online (AJOL)

Ahmed Gado

2013-11-05

Nov 5, 2013 ... Abstract Background: Dyspepsia is a common clinical problem. More than half of patients ... The diagnostic test of choice is endoscopy. Age specific ... in the general population in Great Britain.2 More than half of these patients ...

Dietary and lifestyle factors in functional dyspepsia.

Science.gov (United States)

Feinle-Bisset, Christine; Azpiroz, Fernando

2013-03-01

Dietary factors are increasingly recognized to have an important role in triggering symptoms in a large proportion of patients with functional dyspepsia. Fatty foods seem to be the main culprits, but other foods (including carbohydrate-containing foods, milk and dairy products, citrus fruits, spicy foods, coffee and alcohol) have also been implicated. However, blind challenge tests do not provide consistent results. Moreover, although patients identify specific foods as triggers of their symptoms, these patients often do not seem to make behavioural adjustments in an attempt to improve symptoms; that is, any differences in dietary intake and lifestyle between patients and healthy individuals are small. Patients with functional dyspepsia exhibit mixed sensory-motor abnormalities, such as gastric hypersensitivity and impaired gastric accommodation of a meal. Nutrients, particularly fat, exacerbate these abnormalities and might thereby trigger postprandial symptoms. Cognitive factors, including anticipation related to previous negative experience with certain foods, might also have a role in triggering symptoms. Studies evaluating the potential beneficial effect of dietary interventions and changes in lifestyle are lacking, and this Review outlines a number of options that could be used as starting points for meaningful large-scale studies in the future.

Functional dyspepsia, upper gastrointestinal symptoms, and transit in children

NARCIS (Netherlands)

Chitkara, Denesh K.; Delgado-Aros, Silvia; Bredenoord, Albert J.; Cremonini, Filippo; El-Youssef, Mounif; Freese, Deborah; Camilleri, Michael

2003-01-01

To assess the prevalence of abnormal gastric emptying and small bowel transit in children with functional dyspepsia at a tertiary care center, and the relationship between abnormal gastric and small bowel transit and symptoms in pediatric patients with functional gastrointestinal disorders. Patients

Systematic Approach toward the Clinical Diagnosis of Functional Dyspepsia

Directory of Open Access Journals (Sweden)

Pierre Paré

1999-01-01

Full Text Available Functional dyspepsia (FD is the most common condition in patients consulting with upper gastrointestinal tract symptoms, resulting in up to 5% of visits to family physicians. By definition, patients with FD have no clinical, biochemical or endoscopic evidence of an organic disease that is likely to explain their symptoms. The process to be used in a structured interview for establishing a clinical diagnosis of FD is presented. The steps are as follows: determine the duration and the course of the disease; characterize the current syndrome and review the alarm symptoms; elicit the patient-perceived dominant symptom and/or condition; and identify the patient’s reason for consulting and address the psychosocial factors. According to the clinical characteristics of the three most frequent causes of dyspepsia (peptic ulcer, gastroesophageal reflux and FD and acknowledging that these conditions may coexist rather than overlap in some patients, an algorithm is suggested for establishing a working diagnosis of FD and indications for investigation, and initiating a management strategy.

The effect of Buspirone on symptoms and quality of life in patients with functional dyspepsia

Directory of Open Access Journals (Sweden)

Seyed masood Tabib

2007-09-01

Full Text Available Background: Functional dyspepsia (FD is a heterogeneous disorder of yet unknown etiology which causes a significant reduction in the quality of life. In this study, we compared the effect of buspirone as an agonist of serotonin 5HT1A receptor with amitriptyline and placebo on improving the symptoms and quality of life in patients with functional dyspepsia. Methods: This study was a double-blinded, randomized controlled clinical trial. Using a sequential sampling, patients with the diagnostic criteria of Rome 2 and normal gastrointestinal findings were selected. The subjects were randomly divided into three therapeutic groups receiving amitriptyline, buspirone, and placebo. We used Nepean Dyspepsia Inde (NDI to evaluate the quality of life before and after the treatment. Results: The mean age of subjects was 35.38±12.94 years. Symptom and quality of life scores of the three groups were equal at the beginning but at the end of treatment, these scores were different. Buspirone was more effective than both amitriptyline and placebo in reducing the symptom of early satiety. Buspirone showed a better improvement in quality of life compared to placebo. Both Buspirone and amitriptyline were more effective than placebo in decreasing the symptom of epigastric pain. Conclusion: Our study confirmed the positive effect of buspirone on the quality of life and symptoms (like early satiety and abdominal pain in patients with functional dyspepsia. Since the mechanism of action of buspirone and also the pathophysiology of functional dyspepsia are still unknown, further studies are necessary to clarify every aspect of the disease and therapeutic effects of various treatments on it.

Counselling by primary care physicians may help patients with heartburn-predominant uninvestigated dyspepsia

Science.gov (United States)

Paré, Pierre; Math, Joanna Lee M; Hawes, Ian A

2010-01-01

OBJECTIVE: To determine whether strategies to counsel and empower patients with heartburn-predominant dyspepsia could improve health-related quality of life. METHODS: Using a cluster randomized, parallel group, multicentre design, nine centres were assigned to provide either basic or comprehensive counselling to patients (age range 18 to 50 years) presenting with heartburn-predominant upper gastrointestinal symptoms, who would be considered for drug therapy without further investigation. Patients were treated for four weeks with esomeprazole 40 mg once daily, followed by six months of treatment that was at the physician’s discretion. The primary end point was the baseline change in Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire score. RESULTS: A total of 135 patients from nine centres were included in the intention-to-treat analysis. There was a statistically significant baseline improvement in all domains of the QOLRAD questionnaire in both study arms at four and seven months (Pheartburn-predominant uninvestigated dyspepsia. Further investigation is needed to confirm the potential benefits of providing patients with comprehensive counselling regarding disease management. PMID:20352148

Factors leading to dyspepsia in renal transplant recipients | Nazeer ...

African Journals Online (AJOL)

The objective of this study was to determine factors leading to dyspepsia in renal (kidney) transplant recipients. Methods: it was a cross sectional study conducted at department of hepatogastroenterology and transplant sciences, SIUT Karachi, from 1-6-15 to 1-12-15 for six months. All renal transplanted patients having ...

Functional dyspepsia in adolescents: particulars of its etiology, premorbid background, and a comprehensive treatment approach

Directory of Open Access Journals (Sweden)

D. V. Pechkurov

2017-01-01

Full Text Available The adolescence is characterized by high rates of gastroenterological morbidity due to physiological characteristics of the body and social and psychological status of the teenager. Dyspepsia takes the leading position in the structure of functional pathology. Studies have shown the role of family, unhealthy habits and addictions in the development of this disorder. One should also bear in mind that the adolescence is characterized by an increase in organic pathology. There is a  close association of the functional dyspepsia and the premorbid background, such as autonomous dysfunction and vertebral abnormalities. The use of cholinolytics, prokinetics, opioid receptor antagonists, antacids and anti-secretory agents seems rational for treatment of dyspepsia. If the above mentioned groups of agents lack efficacy, the second line therapy is proposed, which includes tricyclic antidepressants.

Gastric emptying in chronic dyspepsia

International Nuclear Information System (INIS)

Sielaff, F.; Jahnel, P.; Sest, C.; Sydow, K.; Sapia, C.; Hass, A.; Buchali, K.

1987-01-01

Gastric emptying of a semiliquid test meal with 5 MBq /sup 99m/Tc-sulfur colloid as a marker was measured in 97 chronic dyspeptic patients and 16 healthy subjects. A comparison of half emptying time between both showed that chronic dyspeptic patients empty semiliquid meal at a significantly (p < 0.005) slower rate (at 70 +- 33 min) than healthy controls (at 52 x 20 min). The studies indicate that gastric stasis in chronic dyspepsia is not caused by inflammatory changes in gastric or duodenal mucosa nor by different gastric acid secretion. The presence of stasis cannot be predicted sufficiently by anamnestic complaints or endoscopic findings. (author)

Management of New Symptoms of Dyspepsia in the Elderly in Quebec

Directory of Open Access Journals (Sweden)

Jacques LeLorier

1997-01-01

Full Text Available OBJECTIVE: To use the Régie de l'assurance-maladie du Québec (RAMQ database to study the clinical strategies used by Quebec physicians in the management of dyspepsia in the elderly.

  A Cost-Effectiveness Analysis of Two Management Strategies for Dyspepsia

DEFF Research Database (Denmark)

Kjeldsen, Hans Chr; Bech, Mickael; Christensen, Bo

2007-01-01

Objectives: To compare the cost-effectiveness of endoscopy and empirical proton pump inhibition (PPI) therapy for management of dyspepsia in primary care. Methods: A randomized controlled trial (RCT) including prospective collection of economic resource data was conducted in general practice from...... of dyspeptic symptoms and proportion of patients with dyspepsia after one year based on patients' and general practitioners' (GPs') assessment. Costs were estimated from patient and GP questionnaires and from medical records. Results: The incremental cost-effectiveness (CE) ratio for one day free of dyspeptic...... symptoms using the endoscopy strategy was €/day 154 compared with the PPI strategy. The incremental CE ratio for one person free of dyspeptic symptoms after one year using the endoscopy strategy was € 13,905 based on the patients' evaluation and the incremental CE ratio for one person free of predominant...

Association of Low Fecal Elastase-1 and Non-Ulcer Dyspepsia

Directory of Open Access Journals (Sweden)

Mustafa Tahtaci

2018-06-01

Full Text Available Non-ulcer dyspepsia (NUD is a term used to define a set of symptoms that are believed to originate from the gastroduodenal region, and no underlying organic, systemic, or metabolic reason can be found. The majority of patients suffer from chronic symptoms although half of the patients report improvement in symptoms with time. The potential role exocrine pancreatic insufficiency in NUD patients has not been clarified yet. We aimed to identify exocrine pancreas function with pancreatic fecal elastase-1 in patients diagnosed with non-ulcer dyspepsia and no typical exocrine pancreatic insufficiency (EPI symptoms. Thirty-five patients referred to gastroenterology clinics with NUD and 35 people with no dyspeptic symptoms as a control group were included in this prospective study. Non-ulcer dyspepsia patients were classified as group 1 and control subjects classified as group 2. Upper gastrointestinal endoscopies were performed in both groups. Assessment of exocrine pancreatic function was performed by measuring fecal elastase-1 concentration with a commercial ELISA kit using polyclonal antibodies (BioServ Diagnostics in NUD patients compared to control subjects. Mean fecal elastase-1 levels were significantly lower in group 1 patients compared with group 2 (367.47 ± 43.27; 502.48 ± 50.94 respectively; p = 0.04. The percentage of the patients with EPI was significantly higher in group 1 (p = 0.02. Patients with NUD should be re-evaluated if they do not show satisfactory improvement with treatment. Exocrine pancreatic insufficiency was significantly higher in patients with NUD in our study. Evaluation for the presence of EPI can be a cost effective approach in management of refractory patients during the process of ruling out organic reasons.

Non-ulcer dyspepsia associated with NSAID intake: possibility of antacid drugs application

Directory of Open Access Journals (Sweden)

A. E. Karateev

2003-01-01

Full Text Available Objective. To investigate the comparative efficacy of Magalphil 800 in NSAID-associated dyspepsia. Patients and methods. 30 pts with rheumatic diseases (RD receiving NSAIDs and having dyspeptic symptoms were included. Pts were divided into 2 groups: group 1 (n=20, 2 males, 18 females, mean age 51,7+12,3 yTs, 7 pts had single erosion of stomach, 1 - multiple erosions, 1 - ulcer of stomach; group 2 (n=10, 1 male. 9 females, mean age 46,2±14,6 yrs, 2 pts had single erosion of stomach. Concomitant therapies (corticosteroids, cytotoxics were approximately the same in both groups. Pts in Group 1 received one tablet of Magalphil 800 four times a day; pts in Group 2 were treated by ranitidine 150 mg bid. Therapy of RD was not changed during the study. Subjective complains were controlled after 2 weeks. Results. Complains related to dyspepsia disappeared in all pts of Group 1 and in 8 pts of Group 2 after 5,2±2,4 and 7,3±3,8 days of treatment respectively (p>0,05. Healing of ulcer in 1 and healing of erosions in 5 pnts was observed in Group 1. Conclusions. Magalphil 800 is effective in NSAID-associated dyspepsia and can be used for treatment of NSAID-induced gastropathy.

Prevalence of Helicobacter pylori infection in maintenance hemodialysis patients with non-ulcer dyspepsia

International Nuclear Information System (INIS)

Nasri, Hamid; Asl, Mohammad Kazem Hosseini

2009-01-01

The purpose of this prospective study is to determine the prevalence of Helicobacter pylori (H. pylori) infection among stable chronic hemodialysis (HD) patients having non ulcer dyspepsia. The study was carried out on 80 patients consisting of 40 patients with dyspepsia and 40 consecutive control subjects without renal disease and dyspepsic symptoms. Mean age of patients were 56 +- 14 and 47 +- 15 respectively. This study showed no significant difference of H. pylori infection between the two groups. Tissue examination of gastric antrum showed higher localization of H. pylori in HD patients in contrast to controls. This finding has not been reported before and needs further confirmation and evaluation for its significance. (author)

Patient adherence to prescribed medication instructions for dyspepsia: the DIAMOND-study

NARCIS (Netherlands)

Fransen, G.A.J.; Mesters, I.; Muris, J.W.M.; Marrewijk, C.J. van; Mujakovic, S.; Laheij, R.J.F.; Numans, M.E.; de Wit, N.J.; Samsom, M.; Jansen, J.B.M.J.; Knottnerus, J.A.

2012-01-01

BACKGROUND: Insight into patient adherence is needed to enable an effect evaluation of medication for dyspepsia. OBJECTIVES: Adherence was explored by investigating two adherence outcome measures (completeness and intake fidelity) using data from the DIAMOND-study. METHODS: The DIAMOND-study is a

[Assesing the effect of Lepidium meyenii "Maca" on the gastric mucosa in patients with functional dyspepsia].

Science.gov (United States)

Benites Goñi, Harold Eduardo; Cok García, Jaime; Bussalleu Cavero, Alejandra; Bustamente Robles, Katherine Yelenia; Zegarra Chang, Arturo; Bravo, Eduar; Bussalleu Rivera, Alejandro

2014-01-01

The present study was designed to determine the histological effect of Lepidium meyenii "Maca" on the gastric mucosa in patients with functional dyspepsia. This study consists of a clinical case series, in which the effect of Maca on the gastric histopathology of 29 Peruvian patients diagnosed with functional dyspepsia was examined. The presence of H. pylori, as well as the degree and depth of the gastric mucosa inflammation was evaluated from biopsies obtained before and after the treatment based solely of Maca 3 grams per day for four weeks. Average values of the degree and depth of mucosal inflammation before and after the treatment were compared showing no statistical difference among the samples. Sixteen patients were infected with H. pylori, and they remained infected after the treatment with Maca. A four week long treatment with Maca does not produce significant changes on gastric mucosa of patients with functional dyspepsia, neither on H. pylori eradication.

Advantages and disadvantages of lumping together gastroesophageal reflux disease and dyspepsia

NARCIS (Netherlands)

Smout, André J. P. M.

2006-01-01

PURPOSE OF REVIEW: The aim of this article is to identify and to balance the arguments in favor of and against lumping together gastroesophageal reflux disease and functional dyspepsia. RECENT FINDINGS: In at least half of the patients diagnosed with gastroesophageal reflux disease no organic

The effect of acotiamide on epigastric pain syndrome and postprandial distress syndrome in patients with functional dyspepsia.

Science.gov (United States)

Shinozaki, Satoshi; Osawa, Hiroyuki; Sakamoto, Hirotsugu; Hayashi, Yoshikazu; Kawarai Lefor, Alan; Yamamoto, Hironori

2016-01-01

The effect of acotiamide on gastrointestinal symptoms is undefined. The aim of this study is to evaluate the effect of acotiamide on abdominal symptoms in patients with functional dyspepsia. We retrospectively reviewed 51 patients treated with acotiamide. We evaluated patient quality of life using the Izumo scale that detects changes in quality of life caused by abdominal symptoms. Acotiamide ameliorated the symptoms of functional dyspepsia at one and three months (improved: 61% vs 80%, p=0.029 and resolved: 17% vs 33%, p=0.069). We then evaluated the effect of acotiamide on epigastric pain syndrome (EPS) (n=33) and postprandial distress syndrome (PDS) (n=41). Acotiamide treatment showed an early effect on rates of improvement (63%) and resolution (42%) of EPS symptoms at one month, maintained up to three months (69% and 39%, respectively). Both rates of improvement and resolution of PDS symptoms showed a significant increase from one month to three months (56% vs 78%, p=0.021 and 17% vs 46%, p=0.004, respectively). The severity of functional dyspepsia symptoms before treatment was significantly associated with failed resolution of functional dyspepsia symptoms (p=0.013). Acotiamide improves and resolves EPS symptoms as well as PDS symptoms. PDS symptoms take longer to resolve than EPS symptoms. J. Med. Invest. 63: 230-235, August, 2016.

Itopride therapy for functional dyspepsia: a meta-analysis.

Science.gov (United States)

Huang, Xuan; Lv, Bin; Zhang, Shuo; Fan, Yi-Hong; Meng, Li-Na

2012-12-28

To evaluate the therapeutic effects of itopride vs other drugs (placebo, domperidone, mosapride) for functional dyspepsia (FD). Randomized controlled trials (RCTs) of itopride for FD were retrieved from databases. Relevant information was extracted and analyzed, using the relative risk (RR) and weighted mean deviation, as appropriate. A random or fixed effect model was used, based on the heterogeneity of the included articles, and visual inspection of funnel plots was used to evaluate publication bias. Nine RCTs enrolling 2620 FD cases were included; 1372 cases received itopride treatment and 1248 cases received placebo or other drugs (control groups). Compared with control groups, itopride had superior RR values of 1.11 [95%CI: (1.03, 1.19), P = 0.006], 1.21 [95%CI: (1.03, 1.44), P = 0.02], and 1.24 [95%CI: (1.01, 1.53), P = 0.04] for global patient assessment, postprandial fullness, and early satiety, respectively. For the Leeds Dyspepsia Questionnaire score, the weighted mean deviation was -1.38 [95%CI: (-1.75, -1.01), P itopride and control groups. The funnel plots for all indicators showed no evidence of publication bias. Itopride has good efficacy in terms of global patients assessment, postprandial fullness, and early satiety in the treatment of patients with FD and shows a low rate of adverse reactions. Itopride can greatly improve FD syndromes-score.

Management of functional dyspepsia: Unsolved problems and new perspectives

OpenAIRE

Madisch, Ahmed; Miehlke, Stephan; Labenz, Joachim

2005-01-01

The common characteristic criteria of all functional gastrointestinal (GI) disorders are the persistence and recurrence of variable gastrointestinal symptoms that cannot be explained by any structural or biochemical abnormalities. Functional dyspepsia (FD) represents one of the important GI disorders in Western countries because of its remarkably high prevalence in general population and its impact on quality of life. Due to its dependence on both subjective determinants and diverse country-s...

Systematic review: frequency and reasons for consultation for gastro-oesophageal reflux disease and dyspepsia.

Science.gov (United States)

Hungin, A P S; Hill, C; Raghunath, A

2009-08-15

Upper gastrointestinal symptoms impose a substantial illness burden and management costs. Understanding perceptions and reasons for seeking healthcare is a prerequisite for meeting patients' needs effectively. To review systematically findings on consultation frequencies for gastro-oesophageal reflux disease (GERD) and dyspepsia and patients' reasons for consultation. Systematic literature searches. Reported consultation rates ranged from 5.4% to 56% for GERD and from 26% to 70% for dyspepsia. Consultation for GERD was associated with increased symptom severity and frequency, interference with social activities, sleep disturbance, lack of timetabled work, higher levels of comorbidity, depression, anxiety, phobia, somatization and obsessionality. Some consulted because of fears that their symptoms represented serious disease; others avoided consultation because of this. Inconsistent associations were seen with medication use. Patients were less likely to consult if they felt that their doctor would trivialize their symptoms. Few factors were consistently associated with dyspepsia consultation. However, lower socio-economic status and Helicobacter pylori infection were associated with increased consultation. Patients' perceptions of their condition, comorbid factors and external reasons such as work and social factors are related to consultation rates for GERD. Awareness of these factors can guide the clinician towards a more effective strategy than one based on drug therapy alone.

Serotonin receptor 3A polymorphism c.-42C > T is associated with severe dyspepsia

Directory of Open Access Journals (Sweden)

Grobbee Diederick E

2011-10-01

Full Text Available Abstract Background The association between anxiety and depression related traits and dyspepsia may reflect a common genetic predisposition. Furthermore, genetic factors may contribute to the risk of having increased visceral sensitivity, which has been implicated in dyspeptic symptom generation. Serotonin (5-HT modulates visceral sensitivity by its action on 5-HT3 receptors. Interestingly, a functional polymorphism in HTR3A, encoding the 5-HT3 receptor A subunit, has been reported to be associated with depression and anxiety related traits. A functional polymorphism in the serotonin transporter (5-HTT, which terminates serotonergic signalling, was also found associated with these psychiatric comorbidities and increased visceral sensitivity in irritable bowel syndrome, which coexistence is associated with higher dyspeptic symptom severity. We investigated the association between these functional polymorphisms and dyspeptic symptom severity. Methods Data from 592 unrelated, Caucasian, primary care patients with dyspepsia participating in a randomised clinical trial comparing step-up and step-down antacid drug treatment (The DIAMOND trial were analysed. Patients were genotyped for HTR3A c.-42C > T SNP and the 44 bp insertion/deletion polymorphism in the 5-HTT promoter (5-HTTLPR. Intensity of 8 dyspeptic symptoms at baseline was assessed using a validated questionnaire (0 = none; 6 = very severe. Sum score ≥20 was defined severe dyspepsia. Results HTR3A c.-42T allele carriers were more prevalent in patients with severe dyspepsia (OR 1.50, 95% CI 1.06-2.20. This association appeared to be stronger in females (OR 2.05, 95% CI 1.25-3.39 and patients homozygous for the long (L variant of the 5-HTTLPR genotype (OR 2.00, 95% CI 1.01-3.94. Females with 5-HTTLPR LL genotype showed the strongest association (OR = 3.50, 95% CI = 1.37-8.90. Conclusions The HTR3A c.-42T allele is associated with severe dyspeptic symptoms. The stronger association among

Functional dyspepsia: A new approach from traditional Persian medicine

Science.gov (United States)

Pasalar, Mehdi; Nimrouzi, Majid; Choopani, Rasool; Mosaddegh, Mahmoud; Kamalinejad, Mohammad; Mohagheghzadeh, Abdolali; Bagheri Lankarani, Kamran

2016-01-01

Objective: One of the most common global disorders is related to gastrointestinal system. Functional dyspepsia (FD) defined as upper abdominal pain and discomfort in the absence of organic ailments is a prevalent disease without any confirmed medication. The purpose of this study was to find gastric disorders which might be coincidental to FD based on traditional Persian medicine (TPM). Materials and Methods: We searched the main textbooks of TPM including Al-Havi (by Rhazes), Canon of medicine (by Avicenna), ZakhireKhawrazmshahi (by Ismail Jorjani), Moalijat-e Aghili and Makhzan Al-adviya (by Mohammad Hosein AghiliShirazi), and ExirAzam (by Hakim Azam Khan). Also, we searched Pubmed, Scopus, Science Direct, Medline, scientific information database (SID), Iranmedex and Google Scholar from 1980 to 1 August 2014 for dyspepsia, gastrointestinal disease, traditional Persian medicine, and gastric dystemperaments. Results: There is no equivalent term for FD in traditional Persian medicine although similar signs and symptoms are visible in terms like simple cold dystemperament of stomach, indigestion, and digestion debility in TPM sources. Some treatments mentioned in TPM have shown promising results in the current experimental tests. Conclusion: Finding these similarities in complementary and alternative medicine (CAM) textbooks may lead to discovering new remedies for this widespread disease. PMID:27222829

Functional dyspepsia: A new approach from traditional Persian medicine

Directory of Open Access Journals (Sweden)

Mehdi Pasalar

2016-03-01

Full Text Available Objective: One of the most common global disorders is related to gastrointestinal system. Functional dyspepsia (FD defined as upper abdominal pain and discomfort in the absence of organic ailments is a prevalent disease without any confirmed medication. The purpose of this study was to find gastric disorders which might be coincidental to FD based on traditional Persian medicine (TPM. Materials and Methods: We searched the main textbooks of TPM including Al-Havi (by Rhazes, Canon of medicine (by Avicenna, ZakhireKhawrazmshahi (by Ismail Jorjani, Moalijat-e Aghili and Makhzan Al-adviya (by Mohammad Hosein AghiliShirazi, and ExirAzam (by Hakim Azam Khan. Also, we searched Pubmed, Scopus, Science Direct, Medline, scientific information database (SID, Iranmedex and Google Scholar from 1980 to 1 August 2014 for dyspepsia, gastrointestinal disease, traditional Persian medicine, and gastric dystemperaments. Results: There is no equivalent term for FD in traditional Persian medicine although similar signs and symptoms are visible in terms like simple cold dystemperament of stomach, indigestion, and digestion debility in TPM sources. Some treatments mentioned in TPM have shown promising results in the current experimental tests. Conclusion: Finding these similarities in complementary and alternative medicine (CAM textbooks may lead to discovering new remedies for this widespread disease.

Helicobacter pylori infection as a cause of gastritis, duodenal ulcer, gastric cancer and nonulcer dyspepsia: a systematic overview.

Science.gov (United States)

Veldhuyzen van Zanten, S J; Sherman, P M

1994-01-15

To evaluate current evidence for a causal relation between Helicobacter pylori infection and gastritis, duodenal ulcer, gastric cancer and nonulcer dyspepsia. A MEDLINE search for articles published in English between January 1983 and December 1992 with the use of MeSH terms Helicobacter pylori, gastritis, duodenal ulcer, gastric cancer, dyspepsia and clinical trial; abstracts were excluded. Six journals and Current Contents were searched manually for pertinent articles published in that time frame. Original studies with at least 25 patients, case reports and reviews that examined the relation between H. pylori and the four gastrointestinal disorders; 350 articles were on gastritis, 122 on duodenal ulcer, 44 on gastric cancer and 96 on nonulcer dyspepsia. The quality of the studies was rated independently on a four-point scale. The strength of the evidence was assessed using a six-point scale for each of the eight established guidelines for determining a causal relation. There was conclusive evidence of a causal relation between H. pylori infection and histologic gastritis. Koch's postulates for the identification of a microorganism as the causative agent of a disease were fulfilled for H. pylori as a causative agent of gastritis. There was strong evidence that H. pylori is the main cause of duodenal ulcers not induced by nonsteroidal anti-inflammatory drugs, but all of Koch's postulates were not fulfilled. There was moderate epidemiologic evidence of an association between chronic H. pylori infection and gastric cancer. There was a lack of convincing evidence of a causal association between H. pylori and nonulcer dyspepsia. The evidence supports a strong causal relation between H. pylori infection and gastritis and duodenal ulcer and a moderate relation between such infection and gastric cancer. Further studies are needed to clarify the role of H. pylori in these disorders. Thus far, there is no evidence of a causal relation between H. pylori and nonulcer

[Brief analysis of professor YAN Jie's academic thought on functional dyspepsia treated with acupuncture and moxibustion].

Science.gov (United States)

Tan, Tao; Yan, Jie

2016-01-01

The brief discussion is introduced in the paper on the academic thought of professor YAN Jie, the contemporary famous TCM doctor, on functional dyspepsia treated with acupuncture and moxibustion. Treatment based on "the three-regional acupoint selection" is applied to professor YAN's treatment for functional dyspepsia, in which, acupuncture is on Sibai (ST 2), Liangmen (ST 21) and Zusanli (ST 36), and the supplementary points are added accordingly. The academic thought is described as the combination of acupuncture and moxibustion based on strengthening healthy qi, supplemented by soothing the liver and psychological counseling. Also, an example is provided.

The Role of RANTES Promoter Polymorphism in Functional Dyspepsia

OpenAIRE

Tahara, Tomomitsu; Shibata, Tomoyuki; Yamashita, Hiromi; Hirata, Ichiro; Arisawa, Tomiyasu

2009-01-01

Altered inflammatory immune responses have been shown to be associated with functional gastro intestinal disorder. We aimed to clarify the effect of functional promoter polymorphism of RANTES, which is a potent chemoattractant peptide for memory T lymphocytes and eosinophils, on the risk of functional dyspepsia in a Japanese population. RANTES promoter C-28G polymorphism was genotyped in 246 subjects including 134 FD patients according to Roma III criteria and 112 non-symptomatic healthy cont...

[Relationship between the frequency of work-related stress and prevalence of functional dyspepsia in Lima Geriatric Army Hospital].

Science.gov (United States)

Valenzuela Narváez, Daniel Raúl; Gayoso Cervantes, Milagros

2017-01-01

To determine the relationship between the frequency of work-related stress and prevalence of functional dyspepsia in a sample of 218 military older 50 years in 2010 in Lima Military Hospital Geriatric. Descriptive and explanatory study and for the data collection on stress, were used the Vital Events Scale Holmes-Rahe and clinical records for clinical and upper endoscopy registration that comply the criteria of Rome III for functional dyspepsia. For processing and data analysis the statistical software package SPSS (Statistical Package for Social Sciences) was used. 100% of military showed some level of work stress during the study year; thus, 36.7% had a high level, 31.2% medium or moderate level, and 32.1% had low stress level; these percentages medium and high stress levels accounted for 67.9%. These results establish that job stress is a common discomfort in the study population (tabulated Chi2 = 3.841, chi2 observed = 27,908). Regarding functional dyspepsia prevalence of 37.2%, which indicates that it is a common condition in those military (tabular Z = 1.96, Z c = 9.163) it was determined. There is a significant relationship between the frequency of work-related stress and prevalence of functional dyspepsia in military activity in older than 50 years (tabulated Chi2 = 5.991, chi2 observed = 28,878, contingency coefficient = 0.342).

An Extract of Glycyrrhiza glabra (GutGard Alleviates Symptoms of Functional Dyspepsia: A Randomized, Double-Blind, Placebo-Controlled Study

Directory of Open Access Journals (Sweden)

Kadur Ramamurthy Raveendra

2012-01-01

Full Text Available A randomized, double-blind, placebo-controlled study was conducted to evaluate the efficacy of GutGard, an extract of Glycyrrhiza glabra, in patients with functional dyspepsia. The primary outcome variables of the study were the change in the severity symptoms and the global assessment of efficacy. The quality of life was evaluated as a secondary outcome measure. The patients received either placebo or GutGard (75 mg twice daily for 30 days. Efficacy was evaluated in terms of change in the severity of symptoms (as measured by 7-point Likert scale, the global assessment of efficacy, and the assessment of quality of life using the short-form Nepean Dyspepsia Index. In comparison with placebo, GutGard showed a significant decrease (P≤.05 in total symptom scores on day 15 and day 30, respectively. Similarly, GutGard showed marked improvement in the global assessment of efficacy in comparison to the placebo. The GutGard group also showed a significant decrease (P≤.05 in the Nepean dyspepsia index on day 15 and 30, respectively, when compared to placebo. GutGard was generally found to be safe and well-tolerated by all patients. GutGard has shown significant efficacy in the management of functional dyspepsia.

Randomised clinical trial: an assessment of acupuncture on specific meridian or specific acupoint vs. sham acupuncture for treating functional dyspepsia.

Science.gov (United States)

Ma, T T; Yu, S Y; Li, Y; Liang, F R; Tian, X P; Zheng, H; Yan, J; Sun, G J; Chang, X R; Zhao, L; Wu, X; Zeng, F

2012-03-01

Functional dyspepsia (FD) is a common disease without an established optimal treatment. To determine (i) the effect of acupuncture in relieving FD symptoms and improving life quality; (ii) the effect difference between acupoint and non-acupoint; and (iii) the effect difference among different acupoints. A total of 712 eligible patients were included and randomly assigned to six groups (Group A: specific acupoints of the stomach meridian; Group B: non-specific acupoints of the stomach meridian; Group C: specific acupoints of alarm and transport points; Group D: specific acupoints of the gallbladder meridian; Group E: sham acupuncture of non-acupoints; and Group F: itopride). A treatment period of 4 weeks (continuous five sessions per week), and a follow-up period of 12 weeks were arranged. The outcomes were the (i) patients' response, (ii) symptoms improvement measured using the Symptom Index of Dyspepsia and (iii) quality-of-life improvement based on Nepean Dyspepsia Index. All groups had an improvement in dyspepsia symptoms and the QoL at the end of treatment, and the improvement was sustained for 4 weeks and 12 weeks. The overall response rate was significantly higher in acupuncture group A (70.69%), and lower in sham acupuncture group (34.75%), compared with itopride and other acupuncture groups. Similarly, the difference in symptoms and QoL improvement was significant between group A and the other acupuncture groups. Acupuncture is effective in the treatment of functional dyspepsia, and is superior to non-acupoint puncture. The benefit of acupuncture relies on acupoint specificity. © 2012 Blackwell Publishing Ltd.

Efficacy and tolerability of itopride hydrochloride in patients with non-ulcer dyspepsia.

Science.gov (United States)

Shenoy, K T; Veenasree; Leena, K B

2003-06-01

To document the clinical efficacy and tolerability of itopride hydrochloride in patients with non-ulcer dyspepsia an open-label, non-comparative study, was undertaken at the Medical College, Thiruvananthapuram, among patients with endoscopically confirmed diagnosis of non-ulcer dyspepsia or chronic gastritis. Itopride hydrochloride 50 mg (1 tablet) thrice a day for 2 weeks was administered among them. Relief of symptoms at the end of two weeks treatment, assessed as marked/complete, moderate, slight, none or worse; QT interval on ECG; adverse events; haemogram; serum chemistry for hepatic and renal functions. None had QT prolongation on ECG. At the end of 2 weeks' treatment, moderate to complete relief of symptoms was reported by 22 patients (73%), whereas 5 (17%) reproted slight improvement, and 3 (10%) reported no improvement. Clinical tolerability was excellent in 28 patients (93%) and good in 2 (7%). None of the patients had any prolongation of QT on ECG, nor did any patient show any abnormality in haemogram or serum chemistry during the treatment.

The effects of trimebutine maleate on gastric emptying in patients with non-ulcer dyspepsia

Energy Technology Data Exchange (ETDEWEB)

Aktas, A. [Baskent Univ., Ankara (Turkey); Caner, B.; Ozturk, F.; Bayhan, H.; Narin, Y.; Mentes, T.

1999-08-01

The study was designed to investigate the effect of trimebutine maleate, a drug used in both hyperkinetic and hypokinetic motility disorders, on gastric emptying in patients with non-ulcer dyspepsia having prolonged gastric emptying rates and to compare the parameters used for the determination of the lag period observed during the emptying of solid foods from the stomach. Gastric emptying was measured by the radionuclide technique. Twenty normal volunteers and 43 patients with non-ulcer dyspepsia participated in the study. Radionuclide imaging was performed by using a solid meal labeled with {sup 99m}Tc-tin colloid. Of the patients with non-ulcer dyspepsia, 20 had prolonged gastric emptying. They were given three weeks of oral treatment with trimebutine maleate and had their radionuclide gastric emptying study repeated. Treatment with trimebutine maleate resulted in reduction in duration of the lag period and less retention of food at 100 minutes (p<0.0005). After treatment with trimebutine maleate, no significant difference has been observed in the mean symptom score of patients with prolonged gastric emptying. Among the parameters used for the determination of the lag period, lag period determined by a mathematical equation (TLAG) has been found to be longer than the lag period determined by visual inspection of the images (VLAG) and there was correlation between the two parameters when the lag time was short. (author)

Homespun remedy, homespun toxicity: baking soda ingestion for dyspepsia.

Science.gov (United States)

Ajbani, Keyur; Chansky, Michael E; Baumann, Brigitte M

2011-04-01

A 68-year-old man presented to the Emergency Department with a severe metabolic alkalosis after ingesting large quantities of baking soda to treat his dyspepsia. His underlying pulmonary disease and a progressively worsening mental status necessitated intubation for respiratory failure. Laboratory studies revealed a hyponatremic, hypochloremic, hypokalemic metabolic alkalosis. The patient was successfully treated after cessation of the oral bicarbonate, initiation of intravenous hydration, and correction of electrolyte abnormalities. Copyright © 2011 Elsevier Inc. All rights reserved.

Systematic review: Antacids, H2-receptor antagonists, prokinetics, bismuth and sucralfate therapy for non-ulcer dyspepsia.

Science.gov (United States)

Moayyedi, P; Soo, S; Deeks, J; Forman, D; Harris, A; Innes, M; Delaney, B

2003-05-15

Evidence for the effectiveness of antacids, histamine-2 receptor antagonists, bismuth salts, sucralfate and prokinetic therapy in non-ulcer dyspepsia is conflicting. To conduct a systematic review evaluating these therapies in non-ulcer dyspepsia. Electronic searches were performed using the Cochrane Controlled Trials Register, Medline, EMBASE, Cinahl and SIGLE until September 2002. Dyspepsia outcomes were dichotomized into cured/improved vs. same/worse. Prokinetics [14 trials, 1053 patients; relative risk reduction (RRR), 48%; 95% confidence interval (95% CI), 27-63%] and histamine-2 receptor antagonists (11 trials, 2164 patients; RRR, 22%; 95% CI, 7-35%) were significantly more effective than placebo. Bismuth salts (RRR, 40%; 95% CI, - 3% to 65%) were superior to placebo, but this was of marginal statistical significance. Antacids and sucralfate were not statistically significantly superior to placebo. A funnel plot suggested that the prokinetic and histamine-2 receptor antagonist results could be due to publication bias. The meta-analyses suggest that histamine-2 receptor antagonists and prokinetics are superior to placebo. These data are difficult to interpret, however, as funnel plot asymmetry suggests that the magnitude of the effect could be due to publication bias or other heterogeneity-related issues.

Minimal differences in prevalence and spectrum of organic disease at upper gastrointestinal endoscopy between selected secondary care patients with symptoms of gastro-oesophageal reflux or dyspepsia.

Science.gov (United States)

Irvine, Andrew J; Pinto-Sanchez, Maria Ines; Bercik, Premysl; Moayyedi, Paul; Ford, Alexander C

2017-04-01

Gastro-oesophageal reflux and dyspepsia are felt to be separate upper gastrointestinal (GI) conditions. We aimed to measure the degree of overlap between them, and assess whether endoscopic findings differed. Demographic, symptom, upper GI endoscopy and histology data were collected from consecutive adults in secondary care. Patients were categorised according to whether they reported gastro-oesophageal reflux alone, dyspepsia alone or both, and patient demographics and endoscopic findings were compared. Of 1167 patients, 97 (8.3%) had gastro-oesophageal reflux alone, 571 (48.9%) dyspepsia alone, and 499 (42.8%) overlap. Patients with overlap symptoms were more likely to smoke, compared with those with gastro-oesophageal reflux alone, or dyspepsia alone (p = .009), but there were no other differences. Patients with gastro-oesophageal reflux alone or overlap had a higher prevalence of erosive oesophagitis (18.6% and 15.4% respectively, p Gastro-oesophageal reflux and dyspepsia symptoms commonly overlap. There were minimal differences in demographics or spectrum of underlying organic disease between various symptom groups, suggesting that restrictive classifications according to predominant symptom may not be clinically useful.

Epidemiology, clinical characteristics, and associations for symptom-based Rome IV functional dyspepsia in adults in the USA, Canada, and the UK: a cross-sectional population-based study.

Science.gov (United States)

Aziz, Imran; Palsson, Olafur S; Törnblom, Hans; Sperber, Ami D; Whitehead, William E; Simrén, Magnus

2018-04-01

The population prevalence, clinical characteristics, and associations for Rome IV functional dyspepsia are not known. Following the publication of the Rome IV criteria for functional gastrointestinal disorders, we aimed to assess the prevalence, characteristics, and associations for symptom-based Rome IV functional dyspepsia in adults across the USA, Canada, and the UK. We sent an internet-based cross-sectional health survey to adults in the general population of three English-speaking countries: the USA, Canada, and the UK. We used quota-based sampling to generate demographically balanced and population-representative samples. Individuals were invited to complete an online questionnaire on general health, without mention that the purpose of this survey was to examine gastrointestinal symptoms. We excluded participants who failed two attention-test questions or were excessively inconsistent on the three gastrointestinal questions that were presented twice in the survey for this particular purpose. The survey enquired about demographics, health-care visits, medications, somatisation, quality of life, and symptom-based criteria for Rome IV functional dyspepsia as well as for irritable bowel syndrome (IBS) and functional heartburn. We made subsequent comparisons between participants with Rome IV functional dyspepsia and controls without dyspepsia. The primary objective was to identify participants who fulfilled symptom-based criteria for Rome IV functional dyspepsia and categorise them into postprandial distress syndrome, epigastric pain syndrome, or overlapping subtypes. 6300 general population adults completed the health survey; 2100 each from the USA, Canada, and the UK. 369 responses were deemed inconsistent, leaving data for 5931 adults. Rome IV functional dyspepsia was significantly more prevalent in the USA (232 [12%] of 1949) than in Canada (167 [8%] of 1988) and the UK (152 [8%] of 1994; p<0·0001). The subtype distribution was 61% postprandial distress

Helicobacter pylori in Diabetic and Non-Diabetic Patients with Dyspepsia

Directory of Open Access Journals (Sweden)

Mohammad Hossein Hashemi

2012-05-01

Full Text Available Helicobacter pylori (H. pylori is one of the most common chronic infections in patients with gastrointestinal disorders. Recent reports suggested that H. pylori might have high prevalence among patients with diabetes. The aim of this cross-sectional study was to assess the prevalence of H. pylori infection in diabetes mellitus and to study the relationship between histological findings and H. pylori infection in diabetic patients. Eighty patients with dyspepsia that were referred to our gastrointestinal department between May 2007 and May 2008 were included in our study. We checked fasting blood sugar for all of the study samples. All of patients underwent upper endoscopy and biopsy specimens were obtained from the antrum and the corpus. The specimens for the presence of H. pylori were colored by Giemsa stains. A single pathologist evaluated the histology slides. We found that prevalence of H. pylori infection was significantly higher in diabetics than in non-diabetics (P=0.001. Indeed, the prevalence of gastritis did differ significantly between the two groups (P=0.001. According to our results diabetes mellitus is one of the risk factor that must be considered in evaluation of H. pylori infection in diabetic patients with dyspepsia.

Lafutidine 10 mg versus Rabeprazole 20 mg in the Treatment of Patients with Heartburn-Dominant Uninvestigated Dyspepsia: A Randomized, Multicentric Trial

Directory of Open Access Journals (Sweden)

Bhupesh Dewan

2011-01-01

Full Text Available Background. Empirical therapy with antisecretory agents like PPIs and H2RAs has long been the traditional approach in the initial management of uninvestigated dyspepsia. Aim. The objective of the study was to examine relief of dyspepsia with lafutidine, a second-generation H2-RA, and rabeprazole and to compare their efficacy. Methods. This was a randomized, open, comparative trial in adult uninvestigated dyspeptic patients, who had at least moderate severity of symptoms, defined as a score of ≥4 on a 7-point global overall symptom (GOS scale, and were randomized to receive once daily either lafutidine 10 mg or rabeprazole 20 mg for 4 weeks. Results. A total of 236 patients were enrolled, out of which 194 patients were included in the analysis. At the end of week 4, a significant difference was observed for symptom relief (lafutidine 89.90% versus rabeprazole 65.26%, P<.01 and symptom resolution (lafutidine 70.71% versus rabeprazole 25.26%, P<.01. Both the drugs were well tolerated. Conclusion. Both lafutidine and rabeprazole provide symptom relief in patients with heartburn-dominant uninvestigated dyspepsia. The present study confirms the appropriateness of lafutidine as an empiric treatment and superior efficacy for primary care practice patients with dyspepsia.

Randomized-controlled trial of esomeprazole in functional dyspepsia patients with epigastric pain or burning

DEFF Research Database (Denmark)

Talley, N J; Vakil, N; Lauritsen, K

2007-01-01

BACKGROUND: Early identification of true responders to acid suppression in functional dyspepsia patients with symptoms of epigastric pain or burning may enable clinicians to optimally tailor treatment. AIM: To evaluate whether a 1-w acid suppression trial is useful for identifying true responders...

Breathing exercises with vagal biofeedback may benefit patients with functional dyspepsia.

Science.gov (United States)

Hjelland, Ina E; Svebak, Sven; Berstad, Arnold; Flatabø, Geir; Hausken, Trygve

2007-09-01

Many patients with functional dyspepsia (FD) have postprandial symptoms, impaired gastric accommodation and low vagal tone. The aim of this study was to improve vagal tone, and thereby also drinking capacity, intragastric volume and quality of life, using breathing exercises with vagal biofeedback. Forty FD patients were randomized to either a biofeedback group or a control group. The patients received similar information and care. Patients in the biofeedback group were trained in breathing exercises, 6 breaths/min, 5 min each day for 4 weeks, using specially designed software for vagal biofeedback. Effect variables included maximal drinking capacity using a drink test (Toro clear meat soup 100 ml/min), intragastric volume at maximal drinking capacity, respiratory sinus arrhythmia (RSA), skin conductance (SC) and dyspepsia-related quality of life scores. Drinking capacity and quality of life improved significantly more in the biofeedback group than in the control group (p=0.02 and p=0.01) without any significant change in baseline autonomic activity (RSA and SC) or intragastric volume. After the treatment period, RSA during breathing exercises was significantly correlated to drinking capacity (r=0.6, p=0.008). Breathing exercises with vagal biofeedback increased drinking capacity and improved quality of life in FD patients, but did not improve baseline vagal tone.

Antroduodenal manometry: 24-hour ambulatory monitoring versus short-term stationary manometry in patients with functional dyspepsia

NARCIS (Netherlands)

Jebbink, R. J.; vanBerge-Henegouwen, G. P.; Akkermans, L. M.; Smout, A. J.

1995-01-01

OBJECTIVES: To examine the interdigestive and postprandial antroduodenal motility patterns of patients with functional dyspepsia using prolonged ambulatory antroduodenal manometry and to compare these findings with conventional stationary manometry. METHODS: Prolonged ambulatory and short-term

Helicobacter Pylori Related Functional Dyspepsia in a Defined Malaysian Population

OpenAIRE

Nafeeza, M.I.; Isa, M.R.; Kudva, M.V.; Ishak, M.S.; Mazlam, M.Z.; Haron, A.; Najib, R.; Shahimi, M.M.

2000-01-01

The objective of the study was to determine the prevalence of H. pylori in functional dyspepsia among the three main races in Malaysia. Gastric antral biopsies from 233 (98 males, 135 females; age range: 17–75 years, mean age 39.5 years) patients attending the Universiti Kebangsaan Malaysia (UKM) gastroenterology clinic were assessed for the presence of H. pylori by culture and histology. About a third of the cases (79 of 233 (34%); 34 males, 45 females; mean age 42.6 yrs) were positive for H...

Which subtype of functional dyspepsia patients responses better to acupuncture? A retrospective analysis of a randomized controlled trial.

Science.gov (United States)

Ma, Tingting; Zeng, Fang; Li, Ying; Wang, Chieh-Mei; Tian, Xiaoping; Yu, Shuyuan; Zhao, Ling; Wu, Xi; Yang, Min; Wang, Dejun; Liang, Fanrong

2015-01-01

Whether subgroups of functional dyspepsia (FD) should be treated with different approaches is controversially discussed in research. As our previous study has demonstrated the effect of acupuncture in FD treatment, we now further analyze the therapeutic effect of acupuncture in the treatment of postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS). A retrospective analysis was conducted in 465 eligible PDS patients and 241 EPS patients. 4 acupuncture groups (group A: specific acupoints along the stomach meridian; group B: non-specific acupoints along the stomach meridian; group C: alarm and transport acupoints; group D: specific acupoints along the gallbladder meridian) were compared with a non-acupoint sham acupuncture group and an itopride group. The patients were treated in 5 consecutive sessions per week for 4 weeks and were followed-up for 12 weeks afterwards. Primary outcome of the study was defined as response rate and symptom improvement as measured by the Symptom Index of Dyspepsia, while secondary outcome was designated as improvement in quality of life (QoL) as determined by the Nepean Dyspepsia Index. Symptoms of dyspepsia and QoL were improved from baseline in all groups. In EPS patients, no statistically significant differences could be observed in response rate (p = 0.239) and symptoms improvement (p = 0.344 for epigastric pain; p = 0.465 for epigastric burning). In contrast, PDS patients of the acupuncture group A showed higher response rate (53.2% vs. 19.7%, pitopride group. FD patients with PDS responded better to the acupuncture therapies, especially at the specific acupoints along the stomach meridian. The positive therapeutic effect of acupuncture on PDS was correlated with the improvement in postprandial fullness. ClinicalTrial.gov NCT00599677. © 2015 S. Karger GmbH, Freiburg.

Overlap of symptoms of gastroesophageal reflux disease, dyspepsia and irritable bowel syndrome in the general population

DEFF Research Database (Denmark)

Rasmussen, Sanne; Jensen, Trine Holm; Henriksen, Susanne Lund

2014-01-01

Abstract Introduction. Gastroesophageal reflux disease (GERD), functional dyspepsia (FD) and irritable bowel syndrome (IBS) are common functional gastrointestinal conditions with significant impact on the daily lives of individuals. The objective was to investigate the prevalence and overlap...

Assessment of gastric motor function in childhood functional dyspepsia and obesity.

Science.gov (United States)

Hoffman, I; Tack, J

2012-02-01

The aim was to compare gastric emptying rate and nutrient tolerance during a satiety drinking test in children with functional dyspepsia (FD) and obesity and to study the relationship between daily caloric intake and the satiety drinking test. A total of 28 dyspeptic children (22 girls, mean age 12.5 ± 3.1 years) and 15 obese children (five girls, 13.3 ± 1.8 years) were studied. The patients underwent an octanoic acid gastric emptying breath test and a satiety drinking test. Prior to both tests, a dyspepsia questionnaire was filled out to calculate the mean calorie intake. The most prevalent dyspeptic symptoms were early satiety (96.4%), postprandial fullness (89.2%), and epigastric pain (78.6%), followed by nausea (50%). All dyspeptic and obese children (n = 43) started the satiety drinking test and 41 children completed the test until a score of 5 was reached. The maximum ingested volume in FD was significantly lower than in obesity or in age-matched healthy controls (252 ± 85 vs 479 ± 199 and 359 ± 29 mL respectively, both P obese children (89.7 ± 54.8 min vs 72.5 ± 26.0 min, P = 0.05). Daily calorie intake was significantly higher in obese children than that in dyspeptic children (2325 ± 469 vs 1503 ± 272 cal, P obesity. © 2011 Blackwell Publishing Ltd.

Prevalence of Helicobacter pylori cagA, babA2, and dupA genotypes andcorrelation with clinical outcome in Malaysian patients with dyspepsia

OpenAIRE

OSMAN, HUSSEIN ALI; HASAN, HABSAH; SUPPIAN, RAPEAH; HASSAN, SYED; ANDEE, DZULKARNAEN ZAKARIA; MAJID, NOORIZAN ABDUL; ZILFALIL, BIN ALWI

2015-01-01

Background/aim: The severity of disease outcome in dyspepsia has been attributed to Helicobacter pylori virulence genes. The aim of this study was to determine the distribution of H. pylori virulence genes (cagA, babA2, and dupA) and to determine whether or not there arises a significant correlation with clinical dyspepsia outcomes. Materials and methods: H. pylori genotypes cagA, babA2, and dupA were identified by polymerase chain reactions from gastric biopsy samples in 105 H. pylori-posit...

Clinical trial: a randomized trial of early endoscopy, Helicobacter pylori testing and empirical therapy for the management of dyspepsia in primary care.

Science.gov (United States)

Duggan, A E; Elliott, C A; Miller, P; Hawkey, C J; Logan, R F A

2009-01-01

Early endoscopy, Helicobacter pylori eradication and empirical acid suppression are commonly used dyspepsia management strategies in primary care but have not been directly compared in a single trial. To compare endoscopy, H. pylori test and refer, H. pylori test and treat and empirical acid suppression for dyspepsia in primary care. Patients presenting to their general practitioner with dyspepsia were randomized to endoscopy, H. pylori'test and treat', H. pylori test and endoscope positives, or empirical therapy with symptoms, patient satisfaction, healthcare costs and cost effectiveness at 12 months being the outcomes. At 2 months, the proportion of patients reporting no or minimal dyspeptic symptoms ranged from 74% for those having early endoscopy to 55% for those on empirical therapy (P = 0.009), but at 1 year, there was little difference among the four strategies. Early endoscopy was associated with fewer subsequent consultations for dyspepsia (P = 0.003). 'Test and treat' resulted in fewer endoscopies overall and was most cost-effective over a range of cost assumptions. Empirical therapy resulted in the lowest initial costs, but the highest rate of subsequent endoscopy. Gastro-oesophageal cancers were found in four patients randomized to the H. pylori testing strategies. While early endoscopy offered some advantages 'Test and treat' was the most cost-effective strategy. In older patients, early endoscopy may be an appropriate strategy in view of the greater risk of malignant disease. © 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Ltd.

Itopride for gastric volume, gastric emptying and drinking capacity in functional dyspepsia

OpenAIRE

Abid, Shahab; Jafri, Wasim; Zaman, Maseeh Uz; Bilal, Rakhshanda; Awan, Safia; Abbas, Aamir

2017-01-01

AIM To study the effect of itopride on gastric accommodation, gastric emptying and drinking capacity in functional dyspepsia (FD). METHODS Randomized controlled trial was conducted to check the effect of itopride on gastric accommodation, gastric emptying, capacity of tolerating nutrient liquid and symptoms of FD. We recruited a total of 31 patients having FD on the basis of ROME III criteria. After randomization, itopride was received by 15 patients while 16 patients received placebo. Gastri...

Upper gastrointestinal endoscopy for dyspepsia: Εxploratory study of factors influencing patient compliance in Greece

Directory of Open Access Journals (Sweden)

Kouroumalis Elias

2011-02-01

Full Text Available Abstract Background Upper gastrointestinal endoscopy is the most preferable diagnostic examination for patients over fifty when upper gastrointestinal symptoms appear. However, limited knowledge exists in concerns to the compliance of primary care patients' to the doctors' recommendations for endoscopy. Methods Patients who visited primary care practices in Greece and experienced upper gastrointestinal symptoms within a 10 days screening study, were referred for an upper endoscopy exam. The patients which refused to complete the endoscopy exam, were interviewed by the use of an open- ended translated and validated questionnaire, the Identification of Dyspepsia in General Population (IDGP questionnaire. A qualitative thematic analysis grounded on the theory of planned behavior was performed to reveal the reasons for patients' refusal, while socio-demographic predictors were also assessed. Results Nine hundred and ninety two patients were recorded, 159 of them (16% were found positive for dyspepsia and gastro-esophageal reflux disease according to the IDGP questionnaire. Out of the above, 131 (83.6% patients refused further investigation with endoscopy. Patients who refused upper endoscopy were predominantly female (87.8% (p = 0.036 and over the age of 50. The lack of severe symptoms, fear of pain, concerns of sedation, comorbidity and competing life demands were reported by patients as barriers to performing an endoscopic investigation. Conclusions Patients with dyspepsia in rural Greece tend to avoid upper gastrointestinal endoscopy, with two major axons considered to be the causes of patients' refusal: their beliefs towards endoscopy and their personal capability to cope with it. Future research examining reasons of low compliance should be carried out in combination with modern behavioral theories so as to investigate into the above.

Cortical-limbic regions modulate depression and anxiety factors in functional dyspepsia. A PET-CT study

International Nuclear Information System (INIS)

Liu Mailan; Liang Fanrong; Zeng Fang; Tang Yong; Lan Lei; Song Wenzhong

2012-01-01

The objective of this study was to observe some specific brain areas or cerebral functional network participating in the modulation of depression and anxiety factors in functional dyspepsia (FD) patients by detecting cerebral glucose metabolism (CGM) in fluorine-18 fluorodeoxyglucose ( 18 F-FDG) positron emission tomography-computed tomography (PET-CT) scans. Eight FD patients with depression and anxiety (DA-FD group) and eight FD patients without depression and anxiety (non-DA-FD group) were recruited and evaluated by the Nepean Dyspepsia Index (NDI) and Dyspepsia Symptom Scores (DSS). Cerebral 18 F-FDG PET-CT scans were performed on the DA-FD group and non-DA-FD group, respectively. The differences in CGM between the two groups were analyzed with Statistical Parametric Mapping 2.0 (SPM2). Extensive changes in the CGM signals were observed in the cerebral cortex and limbic system of FD patients with depression and anxiety. Compared to non-DA-FD patients, DA-FD patients showed a higher glucose metabolism in the right postcentral gyrus (BA 1 and 5), inferior frontal gyrus (BA 45), superior temporal gyrus (BA 22), middle temporal gyrus (BA 22), inferior parietal lobule (BA 40), lingual gyrus (BA 18) and the left middle occipital gyrus (BA 37), as well as the limbic system including the left thalamus, lateral globus pallidus, parahippocampal gyrus (BA 35), right insular cortex (BA 13) and parahippocampal gyrus (BA 18); a lower glucose metabolism was presented in the left middle cingulated gyrus (BA 24), the right superior frontal gyrus (BA 6), the medial frontal gyrus (BA 6) and middle temporal gyrus (BA 21). An extensive cortical-limbic brain network might modulate the procession of FD patients with depression and anxiety factors. (author)

A randomised controlled trial of four management strategies for dyspepsia : relationships between symptom subgroups and strategy outcome

NARCIS (Netherlands)

Lewin-van den Broek, NT; Numans, ME; Buskens, E; Verheij, TJM; Smout, AJPM

Background: The first step in the management of uncomplicated dyspepsia in primary care often consists of prescribing empirical therapy, bite in certain cases prompt endoscopy might be preferred. Any decision is usually based on the patient's symptoms and the presumed underlying pathology that

Concomitant functional dyspepsia and irritable bowel syndrome decrease health-related quality of life in gastroesophageal reflux disease

NARCIS (Netherlands)

de Vries, Durk R.; van Herwaarden, Margot A.; Baron, Astrid; Smout, André J. P. M.; Samsom, Melvin

2007-01-01

OBJECTIVE: Previous studies have reported an overlap between gastroesophageal reflux symptoms, functional dyspepsia (FD) and irritable bowel syndrome (IBS). The aim of this study was to investigate the prevalence of FD and IBS in gastroesophageal reflux disease (GERD) and the effect on

AN OPEN-LABEL MULTICENTER OBSERVATIONAL STUDY OF THE EFFICACY, TOLERABILITY, AND SAFETY OF THE NONSTEROIDAL ANTI-INFLAMMATORY DRUG AMTOLMETIN GUACIL IN PATIENTS WITH KNEE OSTEOARTHRITIS AND DYSPEPSIA

Directory of Open Access Journals (Sweden)

E. S. Tsvetkova

2016-01-01

Full Text Available Objective: to investigate the efficacy and tolerability of amtolmetin guacil (AMG; Niselat®, Dr. Reddy's Laboratories Ltd, India versus previous therapy with nonsteroidal anti-inflammatory drugs (NSAIDs in patients with knee osteoarthritis (OA and signs of dyspepsia.Subjects and methods. The open-label observational study included 220 patients aged 30–65 years who suffered from knee OA and intense pain during NSAID intake and had symptoms of dyspepsia in the absence of contraindications to the use of AMG. Among the comorbidities that generally occurred in 68% of the patients, there was a preponderance of hypertension (42%, lower extremity varicose veins (6.4%, and diabetes mellitus (6%. Treatment efficacy was evaluated using three domains of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC, by also taking into account pain intensity and general health assessment on the visual analogue scale. A Severity of Dyspepsia Assessment (SODA scale was used to rate dyspepsia.Results and discussion. AMG had a marked analgesic effect confirmed by 40% or more pain reduction that occurred in 72.5% of the patients. The high analgesic effect of AMG was confirmed by a statistically significant (p <0.001 reduction in the WOMAC index (pain and stiffness and by an increase in functional activity. There was a significant decrease in painless and painful signs of dyspepsia, as well as positive changes in the measures “overall assessment of dyspepsia severity” (p < 0.001 and “satisfaction with treatment”. Overall assessment of AMG tolerability was only positive: excellent (33%, good (56%, and satisfactory (11%. There were no serious adverse events (AE. AE were graded as moderate and mild in 8 and 82% of cases, respectively. AE were recorded in 7.7% of the patients. Conclusion. The findings suggest that AMG offers good prospects for knee OA treatment.

Efficacy of camostat mesilate against dyspepsia associated with non-alcoholic mild pancreatic disease

International Nuclear Information System (INIS)

Sai, J.K.; Suyama, Masafumi; Kubokawa, Yoshihiro; Matsumura, Yuji; Inami, Koichi; Watanabe, Sumio

2010-01-01

The aim of the present study was to examine the potential efficacy of camostat mesilate, a protease inhibitor, against dyspepsia associated with non-alcoholic mild pancreatic disease. Patients with upper abdominal pain suggesting pancreatic disease (persistent over hours, pain aggravated by ingestion of food, epigastric pain radiating to the back), without a history of alcohol consumption and who exhibited no abnormalities regarding serum amylase and lipase, ultrasonography, CT and upper gastrointestinal endoscopy, were prescribed 200 mg camostat mesilate three times daily for 2 weeks. The patients were subjected to endoscopic ultrasonography (EUS) while under treatment and were distributed into those who had 4 or more suggestive findings of chronic pancreatitis (suspected pancreatic disease group), 2 or 3 (equivalent group) and those with 1 or no findings (control group). Symptom severity was recorded before and after treatment using a 10-cm visual analog scale (VAS). Among 95 patients, 40 were in the suspected pancreatic disease group, 30 were in the equivalent group and 25 served as controls. A significant intra- and inter-group improvement of symptoms was observed not only in the suspected pancreatic disease group but also in the equivalent group. Camostat mesilate may serve as a therapeutic agent for patients with dyspepsia associated with mild pancreatic disease, who do not habitually drink alcohol. (author)

Pharmacy Students' Learning and Satisfaction With High-Fidelity Simulation to Teach Drug-Induced Dyspepsia

Science.gov (United States)

2013-01-01

Objective. To assess second-year pharmacy students’ acquisition of pharmacotherapy knowledge and clinical competence from participation in a high-fidelity simulation, and to determine the impact on the simulation experience of implementing feedback from previous students. Design. A high-fidelity simulation was used to present a patient case scenario of drug-induced dyspepsia with gastrointestinal bleeding. The simulation was revised based on feedback from a previous class of students to include a smaller group size, provision of session material to students in advance, and an improved learning environment. Assessment. Student performance on pre- and post-simulation knowledge and clinical competence tests documented significant improvements in students' knowledge of dyspepsia and associated symptoms, with the greatest improvement on questions relating to the hemodynamic effects of gastrointestinal bleeding. Students were more satisfied with the simulation experience compared to students in the earlier study. Conclusion. Participation in a high-fidelity simulation allowed pharmacy students to apply knowledge and skills learned in the classroom. Improved student satisfaction with the simulation suggests that implementing feedback obtained through student course evaluations can be an effective means of improving the curriculum. PMID:23519773

Itopride in functional dyspepsia: results of two phase III multicentre, randomised, double-blind, placebo-controlled trials.

Science.gov (United States)

Talley, N J; Tack, J; Ptak, T; Gupta, R; Giguère, M

2008-06-01

Functional dyspepsia (FD) is a common disorder but there is currently little efficacious drug therapy. Itopride, a prokinetic approved in several countries, showed promising efficacy in FD in a phase IIb trial. The aim of this study was to test the efficacy and safety of this drug in FD. Two similar placebo-controlled clinical trials were conducted (International and North America). Males and females, 18-65 years old, with a diagnosis of FD (Rome II) and the absence (by upper endoscopy) of any relevant structural disease were recruited. All were negative for Helicobacter pylori and, if present, heartburn could not exceed one episode per week. Following screening, patients were randomised to itopride 100 mg three times daily or identical placebo. The co-primary end points were: (1) global patient assessment (GPA) of efficacy; and (2) Leeds Dyspepsia Questionnaire (LDQ). Symptoms were evaluated at weeks 2, 4 and 8. Secondary measures of efficacy included Nepean Dyspepsia Index (NDI) quality of life. The GPA responder rates at week 8 on itopride versus placebo were similar in both trials (45.2% vs 45.6% and 37.8 vs 35.4%, respectively; p = NS). A significant benefit of itopride over placebo was observed for the LDQ responders in the International (62% vs 52.7%, p = 0.04) but not the North American trial (46.9% vs 44.8%). The safety and tolerability profile were comparable with placebo, with the exception of prolactin elevations, which occurred more frequently on itopride (18/579) than placebo (1/591). In this population with FD, itopride did not show a difference in symptom response from placebo.

Implementation and evaluation of early gastroscopy for patients with dyspepsia and warning signs in Primary Care.

Science.gov (United States)

García-Alonso, Francisco Javier; Hernández Tejero, María; Rubio Benito, Elvira; Valer, Paz; Guerra, Iván; García Ceballos, Victoria Gema; Noguerol, Mar; Llinares, Victoria; Bermejo, Fernando

2017-05-01

Dyspepsia is a common disorder in both Primary (PC) and Specialised Care (SC). Gastroscopy is recommended at the start of the study if there are warning signs, although it is not always available in PC. We developed a pilot project establishing an early gastroscopy programme for patients with dyspepsia and warning signs in PC, subsequently extending it to the entire healthcare area. The aim was to evaluate the requirements, impact and opinion of this service at the PC level. Demographic, symptomatic and endoscopic variables on the patients referred to SC from the pilot centre were recorded. A satisfaction survey was conducted among the PC physicians. The one-year pilot study and the first year of implementation of the programme were evaluated. A total of 355 patients were included (median age 56.4 years; IQR 45.5-64.3); 61.2% (56.1-66.3%) were women. The waiting time for examination was 1.5 weeks (IQR 1.5-2.5). Gastroscopy was correctly indicated in 82.7% (78.4-86.3%) of patients. The median number of requests per month was 1.1 per 10,000 adults (range 0.8-1.6). Monthly referrals to SC clinics from the pilot centre fell by 11 subjects (95% CI 5.9-16) with respect to the previous median of 58 (IQR 48-64.5). Almost all those polled (98.4%) considered the programme useful in routine practice. The availability of an early gastroscopy programme in PC for patients with dyspepsia and warning signs reduced the number of referrals to SC. Copyright © 2016 Elsevier España, S.L.U., AEEH y AEG. All rights reserved.

A randomised controlled trial of four management strategies for dyspepsia: relationships between symptom subgroups and strategy outcome

NARCIS (Netherlands)

Lewin van den Broek, N. T.; Numans, M. E.; Buskens, E.; Verheij, T. J.; de Wit, N. J.; Smout, A. J.

2001-01-01

BACKGROUND: The first step in the management of uncomplicated dyspepsia in primary care often consists of prescribing empirical therapy, but in certain cases prompt endoscopy might be preferred. Any decision is usually based on the patient's symptoms and the presumed underlying pathology that causes

Acupuncture for functional dyspepsia.

Science.gov (United States)

Lan, Lei; Zeng, Fang; Liu, Guan J; Ying, Li; Wu, Xi; Liu, Mailan; Liang, Fan-Rong

2014-10-13

Functional dyspepsia (FD) has been a worldwide complaint. More effective therapies are needed with fewer adverse effects than are seen with conventional medications. Acupuncture, as a traditional therapeutic method, has been widely used for functional gastrointestinal disorders in the East. Manual acupuncture and electroacupuncture have been recognized treatments for FD, but to date, no robust evidence has been found for the effectiveness and safety of these interventions in the treatment of this condition. This review was conducted to assess the efficacy and safety of manual acupuncture and electroacupuncture in the treatment of FD. Trials meeting the inclusion criteria were identified through electronic searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, the Allied and Complementary Medicine Database (AMED), Chinese Biology Medicine Disc (CBMdisc), China National Knowledge Infrastructure (CNKI), the Wanfang Database, the VIP Database, and six trial registries. Handsearching was done to screen the reference sections of potential trials and reviews. Randomized controlled trials (RCTs) were included if investigators reported efficacy and safety of manual acupuncture or electroacupuncture for patients with FD diagnosed by Rome II or Rome III criteria, compared with medications, blank control, or sham acupuncture. Data were extracted by independent review authors. Study limitations were assessed by using the tool of The Cochrane Collabration for assessing risk of bias. For dichotomous data, risk ratios (RRs) and 95% confidence intervals (95% CIs) would be applied, and for continuous data, mean differences (MDs) and 95% CIs. A fixed-effect model was applied in the meta-analysis, or a descriptive analysis was performed. The quality of evidence for the outcome measure was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methods. Seven studies were included in the review, involving 542

Nonsteroidal antiinflammatory drugs and dyspepsia in general practice – a prospective, controlled study

Directory of Open Access Journals (Sweden)

Marija Skok

2005-01-01

Full Text Available Background: Treatment of dyspeptic patients is a diagnostic and therapeutic problem frequently encountered by general and family practitioners, by internists and gastroenterologists.Aims: In our study we attempted to assess the prevalence of dyspeptic symptoms in patients over 60 who are regular users of nonsteroidal antiinflammatory drugs.Patients and methods: This is a prospective cohort study based on an interview during examination in the OPC, the results obtained by the diagnostic procedures and follow-up. It was carried out between 1999 and 2003 at a family practitioner’s and a gastroenterologic OPC. In patients who were regular users of nonsteroidal antiinflammatory drugs, we established the prevalence of dyspeptic symptoms, the most often used drugs and the type of diagnostic procedure applied to define the cause of dyspepsia. The control group was composed of patients over 60 who were also exhibiting dyspeptic symptoms but not using any NSAID.Results: The study comprised 50 patients, 27 women and 23 men, the mean age was 67.3 years, the range 60–80 years. The control group comprised 50 patients, 28 women and 22 men, the mean age was 66.6 years, the range 61–80 years. All patients of the study group had used NSAR or preparations of acetylsalicylic acid during the past 3 months. There were no statistically significant differences between the patients of both groups as regards the number and use of other drugs, p = 0.65. The average score of dyspeptic complaints in our study group was 3.02, SD ± 0.6, and 70% of patients wished to use H2 antagonists or proton pump inhibitors for these complaints. In patients of the control group, the average score of complaints was 2.72, SD ± 0.7, and they also took drugs for the alleviation of their complaints more rarely.Conclusions: Nonsteroidal antiinflammatory drugs belong among the important causes of dyspepsia in the elderly. When making decisions about the various diagnostic procedures for

PREVALENCE OF HELICOBACTER PYLORI IN PATIENTS WITH DYSPEPSIA UNDERGOING UPPER GASTRO INTESTINAL ENDOSCOPY IN TERTIARY CARE HOSPITAL

Directory of Open Access Journals (Sweden)

Ajay Babu K

2017-12-01

Full Text Available BACKGROUND Acid peptic disease comprises of a wide spectrum of diseases, which cause considerable morbidity. Helicobacter pylori, a curved rod-shaped bacterium, has been consistently associated with patients suffering from acid peptic diseases, more in ulcer disease than in non-ulcer disease. Due to this high association, it is now believed that Helicobacter pylori plays an important role in the aetiopathogenesis of acid peptic disease. Several studies have revealed the association of Helicobacter pylori in 70-75 percent of patients with dyspepsia. Endoscopic studies have shown that, Helicobacter pylori is found in 80-100% of patients with duodenal ulcers and 60-75 per cent of patients with gastric ulcers. Amidst these profound variations proposed by many workers in the previous studies, we have attempted to study the prevalence of Helicobacter pylori in patients undergoing upper gastrointestinal endoscopy at our hospital and its association with acid-peptic disease. The objectives of this study were- 1. To study the prevalence of Helicobacter pylori in patients with dyspepsia undergoing upper gastrointestinal endoscopy. 2. To study the association of Helicobacter pylori with acid peptic Diseases. MATERIALS AND METHODS 344 cases of dyspepsia were studied clinically as per the proforma over a period of one and half years from July 2014 to October 2015. The inclusion and exclusion criteria were as follows; RESULTS Out of 344 patients, there were 224 male patients and 120 female patients, age ranging from 19 years to 60 years (Mean44.8. Out of 344 patients, 156 patients were diagnosed to have been infected with Helicobacter pylori (45.3%. CONCLUSION This was a prospective study conducted to determine the role of Helicobacter pylori in acid-peptic diseases. This study design was based on clinical study and endoscopic biopsy of gastric mucosa (and duodenal mucosa whenever necessary in 344 patients with a history of dyspepsia. Endoscopy confirmed the

Peptide YY3-36 and glucagon-like peptide-1 in functional dyspepsia. Secretion and role in symptom generation

DEFF Research Database (Denmark)

Witte, Anne-Barbara; Hilsted, Linda; Holst, Jens Juul

2016-01-01

method. Secondly, participants drank 75 mL (90 kcal) per five min until maximal satiety. PYY3-36, GLP-1, glucose, and insulin concentrations were assessed. Satiety measures and dyspeptic symptoms were registered using visual analogue scales. RESULTS: Gastric emptying, glucose, PYY3-36, and GLP-1......OBJECTIVE: The role of peptide YY3-36 (PYY3-36), glucagon-like peptide-1 (GLP-1), and glucose homoeostasis in symptom development in functional dyspepsia (FD) is unclear. The aim was to investigate postprandial changes in plasma PYY3-36, GLP-1, glucose and insulin, and the relationship between PYY3......-36, GLP-1, dyspeptic symptoms, and satiety measurements. MATERIALS AND METHODS: Thirty-six patients with functional dyspepsia and 18 healthy controls consumed a liquid meal at two occasions. Firstly, a fixed amount of 250 mL (300 kcal) was consumed and gastric emptying was assessed using the paracetamol...

The effects of concomitant GERD, dyspepsia, and rhinosinusitis on asthma symptoms and FeNO in asthmatic patients taking controller medications

Directory of Open Access Journals (Sweden)

Ishizuka T

2014-09-01

Full Text Available Tamotsu Ishizuka,1,2 Takeshi Hisada,2 Yosuke Kamide,2 Haruka Aoki,2 Kaori Seki,2 Chisato Honjo,1 Hiroyuki Sakai,1 Maiko Kadowaki,1 Yukihiro Umeda,1 Miwa Morikawa,1 Masaki Anzai,1 Shingo Ameshima,1 Takeshi Ishizaki,1 Kunio Dobashi,2 Masanobu Yamada,2 Motoyasu Kusano3 1Third Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, 2Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3Department of Endoscopy and Endoscopic Surgery, Gunma University Hospital, Maebashi, Japan Background: Losing the sense of smell, which suggests eosinophilic rhinosinusitis, is a subjective symptom, sometimes reported in asthmatic patients taking controller medication. Upper abdominal symptoms, suggesting gastroesophageal reflux disease (GERD or functional dyspepsia, occur also in these patients. However, the relationship between these symptoms, concomitant with asthma, and the intensity of eosinophilic airway inflammation remains obscure. Objective: To assess the symptoms of asthma and rhinosinusitis, and to examine the relationship between the symptoms and bronchial inflammation, a new questionnaire, the G scale, was developed. To investigate the effects of GERD, dyspepsia, and rhinosinusitis on asthma symptoms and bronchial inflammation, the symptoms of asthma and rhinosinusitis obtained by the G scale, upper abdominal symptoms obtained by the modified F scale, a questionnaire for GERD and dyspepsia, and fractional exhaled nitric oxide (FeNO were analyzed. Methods: A prospective, observational study was performed in four hospitals in Gunma prefecture, and a retrospective analysis was done using data obtained from five hospitals in Gunma prefecture and Fukui prefecture, Japan. A total of 252 patients diagnosed as having asthma participated in the prospective study. Results: The frequency of daytime phlegm or losing the sense of smell had a positive correlation with FeNO levels in asthmatic

Efecto del tratamiento erradicador para Helicobacter pylori en pacientes con dispepsia funcional Effect to Helicobacter pylori eradication on patients with functional dyspepsia

Directory of Open Access Journals (Sweden)

T. de Artaza Varasa

2008-09-01

Full Text Available Objetivo: este estudio ha tenido un doble objetivo: por un lado, evaluar el efecto del tratamiento erradicador para Helicobacter pylori en la respuesta sintomática de pacientes diagnosticados de dispepsia funcional y, por otro, determinar si los hallazgos histológicos podían servir como predictor de la efectividad de la terapia. En particular, se trató de averiguar si la presencia de gastritis antral (la que se asocia a la enfermedad ulcerosa péptica podría predecir una mayor respuesta sintomática al tratamiento erradicador en los pacientes con dispepsia funcional e infección por Helicobacter pylori. Pacientes y métodos: estudio prospectivo, monocéntrico y aleatorizado, que incluyó a 48 pacientes con dispepsia funcional e infección por Helicobacter pylori (27 mujeres y 21 hombres, con edad media de 37 ± 13,5 años. Veintisiete pacientes recibieron el tratamiento erradicador (rabeprazol, claritromicina y amoxicilina durante 10 días, seguido de 20 mg/día de rabeprazol 3 meses y 21 el tratamiento control (20 mg/día de rabeprazol 3 meses. Los pacientes fueron seguidos durante un año. Todos rellenaron el Cuestionario de calidad de vida asociada a dispepsia, que evalúa cuatro apartados: intensidad de los síntomas habituales, intensidad del dolor de estómago, incapacidad debida al dolor y satisfacción con la salud. Resultados: existió una mejoría significativa (p Objective: this study evaluated Helicobacter pylori eradication therapy in terms of symptomatic response in patients with functional dyspepsia. On the other hand, we analyzed the importance of histologic findings as a predictor of treatment response. In particular, we studied whether antral gastritis (which is associated with peptic ulcer may predict a greater symptomatic response to Helicobacter pylori eradication in functional dyspepsia. Patients and methods: this prospective, randomized, single-center trial included 48 patients with functional dyspepsia and

Prevalence of helicobacter pylori among Nigerian patients with dyspepsia in Ibadan

Directory of Open Access Journals (Sweden)

Adegboyega Akere

2010-09-01

Full Text Available INTRODUCTION: Determination of the true prevalence of Helicobacter pylori (H. pylori is difficult in a hyper-endemic area like Nigeria with use of serological tests because of their low discriminatory power between previous and current infections. The use of biopsy based methods will go a long way to mitigate this problem. We investigated the prevalence of H. pylori in dyspeptic patients and its relationship with gastroduodenal pathologies using gastric biopsy histology and rapid urease test. METHODS: Eighty-six consecutive adult patients with dyspepsia underwent upper gastrointestinal endoscopy using forward-viewing endoscopes. Antral biopsy specimens were collected for histology and rapid urease test. Diagnosis of H. pylori infection was made if both or either of the tests was positive. RESULTS: Of the 86 subjects, there were 39 (45.3% males and 47(54.7% females. The age range was 23 to 85 years with a mean of 49.19 plus or minus 13.75 years. Diagnosis of H. pylori was made in 55(64% patients. Gastritis was the commonest endoscopic finding (60.5%, serious gastroduodenal pathology (gastric ulcer, duodenal ulcer and gastric cancer were documented in only 12 (14% patients. Thirty three (63.5% of the 55 patients with gastritis had H. pylori infection while 7(58.3% of the 12 patients with serious gastroduodenal lesions had the infection. Thirteen (72.2% of the 18 patients that had normal endoscopic findings were H. pylori positive. CONCLUSION: The prevalence of H. pylori among dyspeptics using biopsy based methods is high in the South-Western part of Nigeria. It is therefore important to test and treat H. pylori among Nigerians with dyspepsia.

Life event stress in duodenal ulcer compared with functional dyspepsia: A case-control study

OpenAIRE

Abdel Hafeiz Hassan; Al Quorain Abdulaziz; Karim Ahmed; Al-Mangoor Shuaa

1997-01-01

This is a prospective study of life event stress in 80 duodenal ulcer patients compared with 80 patients with functional dyspepsia and 80 healthy controls; matched for age, sex and marital status. A semi structured psychiatric interview was used in the psychiatric assessment of the dyspeptic patients and controls. A modified version of Life Events Scale by Tennant and Andrews was used in the assessment of life event stress. More dyspeptic patients reported life events than the controls, but, ...

Randomised, double-blind, comparative study to evaluate the efficacy and safety of ganaton (itopride hydrochloride) and mosapride citrate in the management of functional dyspepsia.

Science.gov (United States)

Amarapurkar, Deepak N; Rane, Priya

2004-12-01

Prokinetic agents like itopride hydrochloride and mosapride citrate are commonly used in the management of functional dyspepsia. However, in a recently conducted international, multicentric study, efficacy of 3 different regimens of mosapride was shown to be comparable to placebo. The objective of this phase 4 randomised, double blind, prospective study was to compare the efficacy and safety of ganaton (itopride hydrochloride) and mosapride citrate in the management of functional dyspepsia among patients attending the gastroenterology outpatient department of a tertiary care hospital. Ganaton 50 mg or mosapride citrate 5 mg three times daily before meals for a period of 2 weeks was administered orally. Thirty functional dyspepsia patients in each group (total = 60) were randomised to receive itopride hydrochloride or mosapride citrate treatment for 2 weeks. In itopride versus mosapride groups, global efficacy as judged by patients was excellent in 17 versus 9 (p itopride versus mosapride group global efficacy as judged by physician was excellent in 24 (80%) versus 15 (50%) and poor in 0 (0%) versus 3 (10%) patients respectively. The global efficacy was rated as excellent to good in significantly (p itopride (93.3%) group as compared to mosapride (63.33 %) group. None of the patients reported any adverse events with itopride treatment. In the mosapride group 5 patients (16.7%) reported adverse events. Two patients (6.7%) were withdrawn from mosapride treatment due to adverse events. The physician rated global tolerability ofitopride versus mosapride treatment as excellent in 23 (76.7%) versus 8 (26.7%) (p itopride hydrochloride) is superior in efficacy and safety over mosapride citrate in the management of functional dyspepsia.

[Effect of clebopride on gastric emptying studied using a physiologic meal marked with Tc 99m colloid in subjects with non-ulcer dyspepsia].

Science.gov (United States)

Costa, R; Cottone, C; Cirrincione, M; Chinnici, M; Scaffidi, A

1990-01-31

The authors studied the action of clebopride on gastric emptying in subjects with non-ulcer dyspepsia by using radioactive isotopes. Eighteen subjects complaining of dyspeptic symptoms were studied in whom the tests undertaken had not shown organic lesions of the digestive tract. Tests with radioactive isotopes were performed before and after administration of clebopride (0.5 mg, three times daily for 15 days). In all patients gastric emptying time was normalized and gastric peristalsis became regular. In addition, in 85% of the patients, symptoms disappeared or were markedly reduced. Side effects requiring withdrawal of the drug were not observed. The above study, therefore, showed clebopride to be a useful drug for the treatment of non-ulcer dyspepsia, thus confirming data found in the literature.

Feasibility study of structured diagnosis methods for functional dyspepsia in Korean medicine clinics

Directory of Open Access Journals (Sweden)

Jeong Hwan Park

2017-12-01

Full Text Available Background: Functional dyspepsia (FD is the seventh most common disease encountered in Korean medicine (KM clinics. Despite the large number of FD patients visiting KM clinics, the accumulated medical records have no utility in evidence development, due to being unstructured. This study aimed to construct a standard operating procedure (SOP with appropriate structured diagnostic methods for FD, and assess the feasibility for use in KM clinics. Methods: Two rounds of professional surveys were conducted by 10 Korean internal medicine professors to select the representative diagnostic methods. A feasibility study was conducted to evaluate compliance and time required for using the structured diagnostic methods by three specialists in two hospitals. Results: As per the results of the professional survey, five questionnaires and one basic diagnostic method were selected. An SOP was constructed based on the survey results, and a feasibility study showed that the SOP compliance score (out of 5 was 3.45 among the subjects, and 3.25 among the practitioners. The SOP was acceptable and was not deemed difficult to execute. The total execution time was 136.5 minutes, out of which the gastric emptying test time was 129 minutes. Conclusion: This feasibility study of the SOP with structured diagnostic methods for FD confirmed it was adequate for use in KM clinics. It is expected that these study findings will be helpful to clinicians who wish to conduct observational studies as well as to generate quantitative medical records to facilitate Big Data research. Keywords: Big Data, Dyspepsia, Korean medicine, Feasibility studies, Observational study

Can gastritis symptoms be evaluated in clinical trials? An overview of treatment of gastritis, nonulcer dyspepsia and Campylobacter-associated gastritis

NARCIS (Netherlands)

Veldhuyzen van Zanten, S. J.; Tytgat, K. M.; Jalali, S.; Goodacre, R. L.; Hunt, R. H.

1989-01-01

We carried out a review of the literature on Campylobacter pylori-associated gastritis and nonulcer dyspepsia (NUD) to determine whether or not symptoms related to these conditions can be measured reliably and whether or not any study to date has shown that treatment alters symptoms. Search

Application of gastric emptying imaging in the therapy of functional dyspepsia

International Nuclear Information System (INIS)

Wen Qingxiang; Shi Jin; Rong Rong; Wang Hongbing

2012-01-01

Objective: To investigate the application of gastric emptying imaging in the therapy of functional dyspepsia (FD) of Spleen deficiency and qi stagnation. Methods: 78 cases of patients with FD were divide into Chinese herbal medicine group (40 cases treated with Chinese herbal medicine of Decoction of invigorating spleen) and Western medicine group (38 cases treated with regulating qi and Domperidone). The gastric emptying imagings were carried out before and after treatment. Results: The gastric emptying imaging results showed that both traditional Chinese Medicine and Western medicine treatments had good curative effects (P<0.01), and the traditional Chinese Medicine was better than that of Wester medicine (P<0.05). Conclusion: Gastric emptying imaging is very useful in observation curative effect of FD treatment. (authors)

[Use of itopride in the symptoms of functional dyspepsia in Russia: results of a phase IV prospective open-label multicenter clinical trial].

Science.gov (United States)

Kas'ianenko, V I; Denisov, N L; Vasil'ev, Iu V

2014-01-01

To evaluate the efficacy and safety of itopride used to treat the symptoms of functional dyspepsia (FD) of the upper gastrointestinal tract. A prospective, open-label, multicenter trial using as a control the placebo response obtained in the previous investigations enrolled 96 adult patients. The diagnosis of FD corresponded to its Rome II criteria. Patients received itopride (Ganaton) oral tablets (50 mg) 3 times daily for 8 weeks. When included into the trial, the patients were orally given itopride (ganaton) tablets (50 mg) thrice daily before meals for 8 weeks. The patients' status was evaluated during (at weeks 4 and 8) and after (at week 12) treatment. Treatment response was assessed using the Global Patient Assessment (GPA) and the Leeds Dyspepsia Questionnaire (LDQ). To evaluate the safety of itopride use, the investigators studied the frequency of adverse events and carried out laboratory tests (renal and liver function tests) and electrocardiography (ECG). The GPA showed that 53.76, 85.71, and 82.22% of the patients achieved a therapeutic effect of itopride at weeks 4, 8, and 12, respectively. The proportion of the patients who achieved the therapeutic effect (86%) at week 8 was higher than the historical placebo controls in the previous studies--45% (86% vs 45%; X2 = 68.868, df = 3; p Itopride is an effective and well-tolerated drug in the treatment of functional dyspepsia in the Russian patients.

The Prevalence of Occult Celiac Disease among Patients with Functional Dyspepsia: A Study from the Western Region of Iran

Directory of Open Access Journals (Sweden)

Ali Asghar Keshavarz

2010-01-01

Full Text Available Objective. The prevalence of Celiac Disease (CD is high in Iran, and evaluation of CD is not part of the routine screening procedure for dyspeptic patients; therefore, cases of occult CD may be missed. This study aimed to investigate the prevalence of occult CD among dyspeptic patients who presented at a gastroenterology clinic in the Western region of Iran. Methods. In this descriptive, cross-sectional prospective study, patients who had a history of at least 12 weeks of upper abdominal discomfort were eligible to participate in the study during a 14-month recruitment period. Patients with a clinical or paraclinical data in favor of organic causes were excluded from the study. Enrolled patients were screened for IgA antiendomysium antibody (EMA and IgA antitissue transglutaminase antibody (tTG. Those who screened positive for EMA/tTG received a confirmatory diagnostic biopsy for Marsh classification of CD. Results. From 225 potential participants with dyspepsia, 55 patients were excluded due to having explainable organic causes. The study sample included 170 patients with “functional dyspepsia.” Mean age of participants was 31 years and 55.8% were female. Twelve patients (7% had positive tests (EMA/tTG, of which 10 were female (83.4%. According to Rome II criteria, all twelve patients with positive tests had “dysmotility type dyspepsia.” Based on Marsh classification, six patients were consistent with “Marsh I,” four with “Marsh II,” and two with the “Marsh III” classification. Conclusions. In this study, the prevalence of CD in dyspeptic patients was high. As a result, this study suggests that screening by serology tests (EMA/tTG is justifiable for the detection of CD among functional dyspeptic patients in the tertiary centers in our country.

Economic evaluation of empirical antisecretory therapy versus Helicobacter pylori test for management of dyspepsia: a randomized trial in primary care.

Science.gov (United States)

Jarbol, Dorte Ejg; Bech, Mickael; Kragstrup, Jakob; Havelund, Troels; Schaffalitzky de Muckadell, Ove B

2006-01-01

An economic evaluation was performed of empirical antisecretory therapy versus test for Helicobacter pylori in the management of dyspepsia patients presenting in primary care. A randomized trial in 106 general practices in the County of Funen, Denmark, was designed to include prospective collection of clinical outcome measures and resource utilization data. Dyspepsia patients (n = 722) presenting in general practice with more than 2 weeks of epigastric pain or discomfort were managed according to one of three initial management strategies: (i) empirical antisecretory therapy, (ii) testing for Helicobacter pylori, or (iii) empirical antisecretory therapy, followed by Helicobacter pylori testing if symptoms improved. Cost-effectiveness and incremental cost-effectiveness ratios of the strategies were determined. The mean proportion of days without dyspeptic symptoms during the 1-year follow-up was 0.59 in the group treated with empirical antisecretory therapy, 0.57 in the H. pylori test-and-eradicate group, and 0.53 in the combination group. After 1 year, 23 percent, 26 percent, and 22 percent, respectively, were symptom-free. Applying the proportion of days without dyspeptic symptoms, the cost-effectiveness for empirical treatment, H. pylori test and the combination were 12,131 Danish kroner (DKK), 9,576 DKK, and 7,301 DKK, respectively. The incremental cost-effectiveness going from the combination strategy to empirical antisecretory treatment or H. pylori test alone was 54,783 DKK and 39,700 DKK per additional proportion of days without dyspeptic symptoms. Empirical antisecretory therapy confers a small insignificant benefit but costs more than strategies based on test for H. pylori and is probably not a cost-effective strategy for the management of dyspepsia in primary care.

The short-term effects of Helicobacter pylori eradication on symptoms of functional dyspepsia

Directory of Open Access Journals (Sweden)

Ayla Tezer

2010-09-01

Full Text Available Objectives: Helicobacter pylori (H.pylori infection is major etiologic factor of chronic active gastritis and peptic ulcer disease. Functional dyspepsia (FD is defined as “persistent or recurrent abdominal pain or discomfort centered in the upper abdomen in patient who has no definite structural or biochemical explanation of their symptoms. It is uncertain whether treatment of H.pylori infection relieves symptoms in patients with FD. We searched short term effects of H.pylori eradication for symptoms in patients with FD.Material and method: We enrolled patients with dyspeptic symptoms which were diagnosed FD and satisfied en-rollment criteria of trial. Endoscopic biopsy was taken from each patient during upper gastrointestinal endoscopy. H.pylori infected patients were assigned to seven days of treatment with 30 mgr of lansoprozole twice daily, 1000 mg of amoksisilin twice daily, and 500 mg levofloxacin once daily. Patients were assessed whether treatment was suc-cessful or not by 14C urea breathe test after 6-8 week. Also pretreatment and post treatment symptom scores were questioned.Results: There were 99 female and 68 male patients. After treatment 114 patients (68% was negative for H. pylori, 53 patients (32% remained positive. Mean of age and proportion of sex was similar in H.pylori (+ and (- groups. While 111 (97.4% of H.pylori (- patients’ symptom scores decreased, 38 (71.7% of H.pylori (+ patients’ scores de-creased. There was significant differences between two groups (p=0.001.Conclusion: Eradication of H.pylori relieves the symptoms of functional dyspepsia. New trials for long term effect of H.pylori eradication on symptoms must be conducted in future.

Functional heartburn has more in common with functional dyspepsia than with non-erosive reflux disease

Science.gov (United States)

Savarino, E; Pohl, D; Zentilin, P; Dulbecco, P; Sammito, G; Sconfienza, L; Vigneri, S; Camerini, G; Tutuian, R; Savarino, V

2009-01-01

Introduction: Functional dyspepsia and non-erosive reflux disease (NERD) are prevalent gastrointestinal conditions with accumulating evidence regarding an overlap between the two. Still, patients with NERD represent a very heterogeneous group and limited data on dyspeptic symptoms in various subgroups of NERD are available. Aim: To evaluate the prevalence of dyspeptic symptoms in patients with NERD subclassified by using 24 h impedance-pH monitoring (MII-pH). Methods: Patients with typical reflux symptoms and normal endoscopy underwent impedance-pH monitoring off proton pump inhibitor treatment. Oesophageal acid exposure time (AET), type of acid and non-acid reflux episodes, and symptom association probability (SAP) were calculated. A validated dyspepsia questionnaire was used to quantify dyspeptic symptoms prior to reflux monitoring. Results: Of 200 patients with NERD (105 female; median age, 48 years), 81 (41%) had an abnormal oesophageal AET (NERD pH-POS), 65 (32%) had normal oesophageal AET and positive SAP for acid and/or non-acid reflux (hypersensitive oesophagus), and 54 (27%) had normal oesophageal AET and negative SAP (functional heartburn). Patients with functional heartburn had more frequent (pheartburn reinforces the concept that functional gastrointestinal disorders extend beyond the boundaries suggested by the anatomical location of symptoms. This should be regarded as a further argument to test patients with symptoms of gastro-oesophageal reflux disease in order to separate patients with functional heartburn from patients with NERD in whom symptoms are associated with gastro-oesophageal reflux. PMID:19460766

Development of a Symptom-Based Patient-Reported Outcome Instrument for Functional Dyspepsia: A Preliminary Conceptual Model and an Evaluation of the Adequacy of Existing Instruments.

Science.gov (United States)

Taylor, Fiona; Reasner, David S; Carson, Robyn T; Deal, Linda S; Foley, Catherine; Iovin, Ramon; Lundy, J Jason; Pompilus, Farrah; Shields, Alan L; Silberg, Debra G

2016-10-01

The aim was to document, from the perspective of the empirical literature, the primary symptoms of functional dyspepsia (FD), evaluate the extent to which existing questionnaires target those symptoms, and, finally, identify any missing evidence that would impact the questionnaires' use in regulated clinical trials to assess treatment efficacy claims intended for product labeling. A literature review was conducted to identify the primary symptoms of FD and existing symptom-based FD patient-reported outcome (PRO) instruments. Following a database search, abstracts were screened and articles were retrieved for review. The primary symptoms of FD were organized into a conceptual model and the PRO instruments were evaluated for conceptual coverage as well as compared against evidentiary requirements presented in the FDA's PRO Guidance for Industry. Fifty-six articles and 16 instruments assessing FD symptoms were reviewed. Concepts listed in the Rome III criteria for FD (n = 7), those assessed by existing FD instruments (n = 34), and symptoms reported by patients in published qualitative research (n = 6) were summarized in the FD conceptual model. Except for vomiting, all of the identified symptoms from the published qualitative research reports were also specified in the Rome III criteria. Only three of the 16 instruments, the Dyspepsia Symptom Severity Index (DSSI), Nepean Dyspepsia Index (NDI), and Short-Form Nepean Dyspepsia Index (SF-NDI), measure all seven FD symptoms defined by the Rome III criteria. Among these three, each utilizes a 2-week recall period and 5-point Likert-type scale, and had evidence of patient involvement in development. Despite their coverage, when these instruments were evaluated in light of regulatory expectations, several issues jeopardized their potential qualification for substantiation of a labeling claim. No existing PRO instruments that measured all seven symptoms adhered to the regulatory principles necessary to support product

Randomised clinical trial: the effects of amitriptyline on drinking capacity and symptoms in patients with functional dyspepsia, a double-blind placebo-controlled study

NARCIS (Netherlands)

Braak, B.; Klooker, T. K.; Wouters, M. M.; Lei, A.; van den Wijngaard, R. M.; Boeckxstaens, G. E.

2011-01-01

Functional dyspepsia is one of the most prevalent (15-40%) functional gastrointestinal disorders. Antidepressants such as amitriptyline are often used in these patients, but clinical studies are currently lacking. To evaluate the effect of 8 weeks of treatment with amitriptyline on drinking

Functional dyspepsia: Are psychosocial factors of relevance?

Institute of Scientific and Technical Information of China (English)

Sandra Barry; Timothy G Dinan

2006-01-01

The pathogenesis of Functional Dyspepsia (FD) remains unclear, appears diverse and is thus inadequately understood. Akin to other functional gastrointestinal disorders, research has demonstrated an association between this common diagnosis and psychosocial factors and psychiatric morbidity. Conceptualising the relevance of these factors within the syndrome of FD requires application of the biopsychosocial model of disease.Using this paradigm, dysregulation of the reciprocal communication between the brain and the gut is central to symptom generation, interpretation and exacerbation.Appreciation and understanding of the neurobiological correlates of various psychological states is also relevant.The view that psychosocial factors exert their influence in FD predominantly through motivation of health care seeking also persists. This appears too one-dimensional an assertion in light of the evidence available supporting a more intrinsic aetiological link. Evolving understanding of pathogenic mechanisms and the heterogeneous nature of the syndrome will facilitate effective management.Co-morbid psychiatric illness warrants treatment with conventional therapies. Acknowledging the relevance of psychosocial variables in FD, the degree of which is subject to variation, has implications for assessment and management. Available evidence suggests psychological therapies may benefit FD patients particularly those with chronic symptoms. The rationale for use of psychotropic medications in FD is apparent but the evidence base to support the use of antidepressant pharmacotherapy is to date limited.

[Efficacy of sulpiride and itopride in the treatment of functional dyspepsia in women with emotional and eating disorders].

Science.gov (United States)

Wachowska-Kelly, Patrycja; Walecka-Kapica, Ewa; Wojtkiewicz, Paweł; Pawłowicz, Monika; Klupińska, Grazyna; Chojnacki, Cezary

2014-07-01

Functional dyspepsia is often accompanied by emotional disturbances, especially in postmenopausal women. Impaired homeostasis of the dopaminergic system maybe one of the common pathogenetic factors. The aim of the study was to assess the effect of drugs which block dopamine D2 receptors on psychosomatic condition in postmenopausal women. The study was conducted in a group of 60 women, aged 53-61 years, with postprandial distress syndrome (PDS) that met the Rome Criteria III. The severity of dyspeptic symptoms was determined statistically using a 10-point Visual Analogue Scale (VAS). The emotional state was estimated with the Hamilton Anxiety Rating Scale (HARS) and the Beck Depression Inventory (BDI), whereas the body mass index (BMI) was the indicator of the nutritional status. Sulpiride (2 x 50 mg) was administered to 30 women for 16 weeks and itopride (2 x 50 mg) to 30 others. After sulpiride and itopride treatment equal decrease of dyspeptic symptoms was observed, respectively from 9.08 to 4.76 pts and from 9.02 to 4.64 pts. Significant reduction in the level of anxiety (p itopride are effective in the treatment of dyspepsia in the form of postprandial distress syndrome. These drugs in the several-month treatment have no significant effect on body weight.

Dietary fat intake and functional dyspepsia

Directory of Open Access Journals (Sweden)

Mahdieh Khodarahm

2016-01-01

Full Text Available A few studies have assessed the effects of fat intake in the induction of dyspeptic symptoms. So, the aim of this study was to review the articles regarding the dietary fat intake and FD. We used electronic database of PubMed to search. These key words were chosen: FD, dietary fat, dyspeptic symptom, energy intake and nutrients. First, articles that their title and abstract were related to the mentioned subject were gathered. Then, full texts of related articles were selected for reading. Finally, by excluding four articles that was irrelevant to subject, 19 relevant English papers by designing clinical trial, cross-sectional, case–control, prospective cohort, and review that published from 1992 to 2012 were investigated. Anecdotally, specific food items or food groups, particularly fatty foods have been related to dyspepsia. Laboratory studies have shown that the addition of fat to a meal resulted in more symptoms of fullness, bloating, and nausea in dyspeptic patients. Studies have reported that hypersensitivity of the stomach to postprandial distension is an essential factor in the generation of dyspeptic symptoms. Small intestinal infusions of nutrients, particularly fat, exacerbate this hypersensitivity. Moreover, evidence showed that perception of gastric distension increased by lipids but not by glucose. Long chain triglycerides appear to be more potent than medium chain triglycerides in inducing symptoms of fullness, nausea, and suppression of hunger. Thus, Fatty foods may exacerbate dyspeptic symptoms. Therefore, it seems that a reduction in intake of fatty foods may useful, although this requires more evaluations.

The Association between Oral Hygiene and Gastric Pathology in Patients with Dyspepsia: a Cross-Sectional Study in Southeast Iran

OpenAIRE

Zahedi, Leili; Jafari, Elham; Torabi Parizi, Molook; Shafieipour, Sara; Hayat Bakhsh Abbasi, Mehdi; Darvish Moghadam, Sodaif; Zahedi, Mohammad Javad

2017-01-01

BACKGROUND Many studies have reported an association between periodontal infections and some systemic diseases such as respiratory and cardiovascular diseases. Some studies found a direct association between chronic gastritis caused by Helicobacter pylori (HP) infection and poor periodontal health. METHODS In a cross-sectional study from November 2014 to December 2015 in Kerman, the largest province in southeast Iran, patients with dyspepsia who were candidate for diagnostic upper gastrointes...

Acupuncture for Functional Dyspepsia: What Strength Does It Have? A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Science.gov (United States)

Li, Jing; Li, Bo; Hu, Ya-Cai; Cai, Qiu-Han

2016-01-01

Background. Although the effectiveness of acupuncture therapy on functional dyspepsia (FD) has been systematically reviewed, the available reports are still contradictive and no robust evidence has been provided to date. Objective. To assess the current evidence of high quality on the effects of acupuncture for patients with FD. Methods. A comprehensive literature database search was conducted to identify randomized controlled trials (RCTs) comparing acupuncture therapies (including manual acupuncture and electroacupuncture) to sham acupuncture and medication use. A meta-analysis was performed following a strict methodology. Results. 16 RCTs involving 1436 participants were included. The majority of the trials were determined to be of low quality. Positive results were found for acupuncture in improving the Nepean Dyspepsia Index (NDI) and scores of the MOS 36-Item Short-Form Health Survey (SF-36), as well as in alleviating relevant symptoms (especially postprandial fullness and early satiation) of FD patients. Conclusion. Based on current available evidence, acupuncture therapy achieves statistically significant effect for FD in comparison with sham acupuncture and is superior to medication (prokinetic agents) in improving the symptoms and quality of life of FD patients. Nonetheless, despite stringent methodological analyses, the conclusion of our review still needs to be strengthened by additional RCTs of higher quality. PMID:28119758

A study on gallbladder empty of patients with functional dyspepsia by radionuclide imaging and on assessment of plasma levels of gastrointestinal hormones

International Nuclear Information System (INIS)

Li Juan; Sun Xiaoning; Liu Baojun; Zhang Li

2001-01-01

Objective: To study the role of gallbladder kinetics and plasma levels of gastrointestinal hormones in the mechanism of functional dyspepsia. Methods: Gallbladder ejection fractions (GBEF) were determined with 99 Tc m radionuclide imaging, and plasma levels of motilin (MTL), cholecystokinin (CCK), vasoactive intestinal peptide (VIP) and somatostatin (SS) were measured with radioimmunoassay. Thirty-two patients with functional dyspepsia of dyskinetic type (FD group) and 20 normal volunteers in control group were studied. Results: The preprandial and postprandial gallbladder ejection fractions (GBEF) and MTL levels were both obviously lower in FD group (P preprandial = 0.82, P postprandial 0.94, P 0.05), while the levels of postprandial CCK were significantly decreased in FD group (P preprandial -0.81, P postprandial = - 0.47, P 0.05). Conclusions: Patients with FD of dyskinetic type might have a significant decrease of preprandial and postprandial gallbladder emptying. The decrease of plasma levels of gastrointestinal hormones. MTL, CCK and the elevation of VIP might be the cause of slow gallbladder emptying and part of the basic pathophysiology in FD

Oxytocin prolongs the gastric emptying time in patients with diabetes mellitus and gastroparesis, but does not affect satiety or volume intake in patients with functional dyspepsia

Directory of Open Access Journals (Sweden)

Borg Julia

2012-03-01

Full Text Available Abstract Background Oxytocin is released in response to a fatty meal. Blockage of the oxytocin receptor led to slower gastric emptying whereas stimulation resulted in less satiety in healthy volunteers. Patients with diabetes mellitus and gastroparesis lack oxytocin elevation, and dyspepsia is partly caused by reduced fundus accommodation causing early satiety and related symptoms. The aim of this study was thus to examine the effect of oxytocin on gastric emptying, satiety and volume intake in patients with gastrointestinal pathology. Results Gastric emptying scintigraphy was performed twice in 12 patients with diabetic gastroparesis, once with oxytocin and once with saline as intravenous infusions. The patients scored their sensation of satiety using a visual analogue scale (VAS. The gastric emptying in patients with gastroparesis was prolonged during oxytocin infusion (p = 0.034 without affecting satiety. A slow satiety drinking test was performed in 14 patients with functional dyspepsia. The patients scored their satiety every five minutes until maximal satiety was reached, and the total volume was determined. The VAS was also completed 30 minutes afterwards. The test was performed twice, once with oxytocin and once with saline as intravenous infusions. There was no difference in satiety scores or volume of nutrient intake between saline and oxytocin infusions, either before, during or after the meal. Conclusions Oxytocin prolongs gastric emptying in patients with diabetes mellitus and gastroparesis, but has no effect on volume of nutrient intake or satiety and other related symptoms in patients with functional dyspepsia.

Specific count model for investing the related factors of cost of GERD and functional dyspepsia

Science.gov (United States)

Abadi, Alireza; Chaibakhsh, Samira; Safaee, Azadeh; Moghimi-Dehkordi, Bijan

2013-01-01

Aim The purpose of this study is to analyze the cost of GERD and functional dyspepsia for investing its related factors. Background Gastro-oesophageal reflux disease GERD and dyspepsia are the most common symptoms of gastrointestinal disorders. Recent studies showed high prevalence and variety of clinical presentation of these two symptoms imposed enormous economic burden to the society. Cost data that related to economics burden have specific characteristics. So this kind of data needs to specific models. Poisson regression (PR) and negative binomial regression (NB) are the models that were used for analyzing cost data in this paper. Patients and methods This study designed as a cross-sectional household survey from May 2006 to December 2007 on a random sample of individual in the Tehran province, Iran to find the prevalence of gastrointestinal symptoms and disorders and its related factors. The Cost in each item was counted. PR and NB were carried out to the data respectively. Likelihood ratio test was performed for comparison between models. Also Log likelihood, Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) were used to compare performance of the models. Results According to Likelihood ratio test and all three criterions that we used to compare performance of the models, NB was the best model for analyzing this cost data. Sex, age and insurance statues were being significant. Conclusion PR and NB models were carried out for this data and according the results improved fit of the NB model over PR, it clearly indicates that over-dispersion is involved due to unobserved heterogeneity and/or clustering. NB model in cost data more appropriate fit than PR. PMID:24834282

Prevalence of Helicobacter pylori among patients with dyspepsia and correlation between endoscopic and histological diagnosis

Directory of Open Access Journals (Sweden)

Shiva Raj K.C.

2016-03-01

Full Text Available Background: Dyspepsia is a prevalent complaint in general practice and gastrointestinal clinics. Helicobacter pylori have major causal relationship with gastro duodenal disease. The following study seeks to identify the prevalence of H. pylori based on histology and to correlate endoscopic findings with histopathology.Materials and Methods: This was a cross-sectional observational study conducted in GRP Polyclinic and Om Hospital and research centre from April 2015-September 2015. The upper gastrointestinal endoscopic findings were recorded and were correlated with histopathological findings. All the relevant data were collected and analysed using Statistical Package of Social Sciences version 16 for windows.  Results: Endoscopy finding was divided into reflux esophagitis, antral gastritis, duodenitis, duodenal ulcer, gastric ulcer, and gastric cancer. Duodenal ulcer and gastric ulcer was noted more frequently in males than in females (55.0% vs. 45.0% and 58.2% vs. 41.8%, respectively, P < 0.001.Chronic follicular gastritis was the most common in gastric ulcer (41.7%, whereas chronic persistent gastritis was common in non-ulcerative disease. Chronic active gastritis and chronic follicular gastritis were more common in ulcerative diseases, whereas chronic persistent gastritis was more common in gastritis and duodenitis (P < 0.001. The overall prevalence of H. pylori infection was 68.1% with male preponderance. Chronic active gastritis had highest prevalence of H. pylori (84.8%, followed by chronic follicular gastritis (84.1% and chronic persistent gastritis (p value < 0.001.Conclusion: Rate of H. pylori infected patients with dyspepsia was high. Ulcerative lesions were more common in males than in females with higher rate of infection with H. Pylori.  Histological diagnosis of chronic active gastritis and chronic follicular gastritis was the most common pathologies in ulcerative lesions. 

Diagnostic accuracy of age and alarm symptoms for upper GI malignancy in patients with dyspepsia in a GI clinic: a 7-year cross-sectional study.

Directory of Open Access Journals (Sweden)

Hooman Khademi

Full Text Available OBJECTIVES: We investigated whether using demographic characteristics and alarm symptoms can accurately predict cancer in patients with dyspepsia in Iran, where upper GI cancers and H. pylori infection are common. METHODS: All consecutive patients referred to a tertiary gastroenterology clinic in Tehran, Iran, from 2002 to 2009 were invited to participate in this study. Each patient completed a standard questionnaire and underwent upper gastrointestinal endoscopy. Alarm symptoms included in the questionnaire were weight loss, dysphagia, GI bleeding, and persistent vomiting. We used logistic regression models to estimate the diagnostic value of each variable in combination with other ones, and to develop a risk-prediction model. RESULTS: A total of 2,847 patients with dyspepsia participated in this study, of whom 87 (3.1% had upper GI malignancy. Patients reporting at least one of the alarm symptoms constituted 66.7% of cancer patients compared to 38.9% in patients without cancer (p<0.001. Esophageal or gastric cancers in patients with dyspepsia was associated with older age, being male, and symptoms of weight loss and vomiting. Each single predictor had low sensitivity and specificity. Using a combination of age, alarm symptoms, and smoking, we built a risk-prediction model that distinguished between high-risk and low-risk individuals with an area under the ROC curve of 0.85 and acceptable calibration. CONCLUSIONS: None of the predictors demonstrated high diagnostic accuracy. While our risk-prediction model had reasonable accuracy, some cancer cases would have remained undiagnosed. Therefore, where available, low cost endoscopy may be preferable for dyspeptic older patient or those with history of weight loss.

Why do dyspeptic patients over the age of 50 consult their general practitioner? A qualitative investigation of health beliefs relating to dyspepsia.

Science.gov (United States)

Delaney, B C

1998-01-01

BACKGROUND: The prognosis of late-diagnosed gastric cancer is poor, yet less than half of dyspeptic patients consult their general practitioner (GP). AIM: To construct an explanatory model of the decision to consult with dyspepsia in older patients. METHOD: A total of 75 patients over the age of 50 years who had consulted with dyspepsia at one of two inner city general practices were invited to an in-depth interview. The interviews were taped, transcribed, and analysed using the computer software NUD.IST, according to the principles of grounded theory. RESULTS: Altogether, 31 interviews were conducted. The perceived threat of cancer and the need for reassurance were key influences on the decision to consult. Cues such as a change in symptoms were important in prompting a re-evaluation of the likely cause. Personal vulnerability to serious illness was often mentioned in the context of family or friends' experience, but tempered by an individual's life expectations. CONCLUSION: Most patients who had delayed consultation put their symptoms down to 'old age' or 'spicy food'. However, a significant minority were fatalistic, suspecting the worst but fearing medical interventions. PMID:10024706

Helicobacter pylori-associated gastritis and dyspepsia. The influence on migrating motor complexes

DEFF Research Database (Denmark)

Qvist, N; Rasmussen, L; Axelsson, C K

1994-01-01

Twenty-five patients with dyspepsia were included. In 19 patients with a median age of 48 (range, 20-72) years endoscopy and histologic examination of biopsy specimens from the antrum and corpus of the stomach showed Helicobacter pylori-positive gastritis as the only pathologic finding. In six...... patients with a median age of 42 (range, 32-56) years H. pylori-negative gastritis was found. After an overnight fast the patients underwent an ambulatory duodenal motility study for 6-8 h. Twenty-five young healthy men served as the control group. In patients with H. pylori-positive gastritis the duration...... (22-89 min) in the control group. The duration of phase III and the whole MMC cycle was similar in the two groups. However, in the patients with H. pylori-negative gastritis the values of the duration of the different phases of the MMC were similar to those of the patients with H. pylori...

Gastric motility measurement and evaluation of functional dyspepsia by a bio-impedance method

International Nuclear Information System (INIS)

Li, Zhangyong; Ren, Chaoshi

2008-01-01

In order to investigate the complex course of the electrical and mechanical processes of functional dyspepsia (FD), it is necessary to extract gastric motility information on both electricity and mechanism. According to the clinical standardization, 36 volunteers with functional dyspepsia were selected. The signal processing device has been designed by Chongqing University of Posts and Telecommunications. Multi-resolution analysis (MRA) decomposed the two signals of impedance gastric motility (IGM) and electrogastrogram (EGG) collected from the body surface. The wavelet transform is addressed to separate the IGM and EGG signals from impedance signals due to breathing and blood flow. By means of the energy and frequency spectrum analysis technique, the signals can be classified according to the dominant power and dominant frequency. Some indices, such as frequencies of EGG and IGM, signal power spectrum and dynamic spectrum, the rates of rhythm and power for the normal EGG and IGM and so on, can also be calculated. The primary experiments of gastric motility measurement and evaluation are executed by including healthy humans (control group: CG) and patients with FD (pathologic group: PG). There are significant differences in the temporal-domain and frequency-domain properties between the two groups. The main frequency of the CG belongs to 2–4 CPM and is clear and very regular, while the main frequency of the PG is much disordered. The peak of the maximal power of the CG belongs to 2–4 CPM and 1–2 CPM for the PG. The percentage of normal frequency (PNF) for the CG is 0.704 ± 0.255 and 0.402 ± 1.145 for the PG. The frequency instability coefficient (FIC) for the CG is 0.182 ± 0.059 and 0.374 ± 0.086 for the PG. The percentage of normal power (PNP) for the CG is 0.592 ± 0.044 and 0.468 ± 0.142 for the PG. The power instability coefficient (PIC) for the CG is 1.576 ± 0.481 and 4.006 ± 0.711 for the PG. The results of the experiments show that the proposed

DIAGNOSTIC ACCURACY OF UREA BREATH TEST FOR HELICOBACTER PYLORI INFECTION IN CHILDREN WITH DYSPEPSIA IN COMPARISON TO HISTOPATHOLOGY

Directory of Open Access Journals (Sweden)

Naser HONAR

Full Text Available ABSTRACT Background - Helicobacter pylori infection is the gram negative bacillus with the close association with chronic antral gastritis. Objective - In this study, we evaluate the accuracy of urea breath test (UBT with carbon isotope 13 in comparison with histopathology of gastric antrum for detection of H. pylori infection in children with dyspepsia. Methods - This cross-sectional study was performed at specialized laboratory of Shiraz Gastroenterohepatology Research Center and Nemazee Hospital, Iran, during a 12-months period. This study investigated the sensitivity, specificity, and positive and negative predictive values of UBT in comparison with biopsy-based tests. We included a consecutive selection of 60 children who fulfilled Rome III criteria for dyspepsia. All children were referred for performing UBT with carbon isotope 13 (C13 as well as endoscopy. Biopsies were taken from antrum of stomach and duodenum. The pathologic diagnosis was considered as the standard test. Results - The mean age of the participants was 10.1±2.6 (range 7-17 years. From our total 60 patients, 28 (46.7% had positive UBT results and 32 (53.3% had negative UBT results. Pathologic report of 16 (57.1% out of 28 patients who had positive UBT were positive for H. pylori and 12 (42.9% ones were negative. Sensitivity and specificity of C13-UBT for detection of H. pylori infection were 76.2% and 69.2% respectively. Conclusion - Sensitivity and specificity of C13-UBT for detection of H. pylori infection were 76.2% and 69.2% respectively. Another multicenter study from our country is recommended.

Acupuncture and related therapies used as add-on or alternative to prokinetics for functional dyspepsia: overview of systematic reviews and network meta-analysis

OpenAIRE

Ho, Robin S. T.; Chung, Vincent C. H.; Wong, Charlene H. L.; Wu, Justin C. Y.; Wong, Samuel Y. S.; Wu, Irene X. Y.

2017-01-01

Prokinetics for functional dyspepsia (FD) have relatively higher number needed to treat values. Acupuncture and related therapies could be used as add-on or alternative. An overview of systematic reviews (SRs) and network meta-analyses (NMA) were performed to evaluate the comparative effectiveness of different acupuncture and related therapies. We conducted a comprehensive literature search for SRs of randomized controlled trials (RCTs) in eight international and Chinese databases. Data from ...

Burden of impaired sleep quality on work productivity in functional dyspepsia.

Science.gov (United States)

Matsuzaki, Juntaro; Suzuki, Hidekazu; Togawa, Koji; Yamane, Tsuyoshi; Mori, Hideki; Komori, Takahiro; Masaoka, Tatsuhiro; Kanai, Takanori

2018-04-01

Impaired sleep quality is common, and can reduce work productivity in patients with functional dyspepsia (FD). The objective of this article is to evaluate whether there is a direct association between the presence of FD and the severity of impaired sleep quality, and to calculate the economic loss due to the decreased work productivity associated with sleep quality. In Study 1, using a web-based survey completed by workers with and without FD, we evaluated impaired sleep quality, work and daily productivity, and the severity of reflux and bowel symptoms. In Study 2, the association between the presence of FD and the severity of impaired sleep quality was validated in a hospital-based cohort. In both Study 1 and 2, although impaired sleep quality was more frequent in participants with FD than in those without FD, the independent association between the presence of FD and the severity of impaired sleep quality was not observed after adjustment for the severity of reflux and bowel symptoms. FD participants with impaired sleep quality reported additional economic loss of 53,500 Japanese yen/month. Although the association between impaired sleep quality and FD was indirect, concomitant impaired sleep quality could worsen economic loss.

Efficacy of the natural antioxidant astaxanthin in the treatment of functional dyspepsia in patients with or without Helicobacter pylori infection: a prospective, randomized, double blind, and placebo-controlled study5

DEFF Research Database (Denmark)

Kupcinskas, L.; Lafolie, P.; Lignell, A.

2008-01-01

OBJECTIVES: The aim of this study was to evaluate the efficacy of the natural antioxidant astaxanthin in functional dyspepsia in different doses and compared with placebo. DESIGN: The study was a controlled, prospective, randomized, and double blind trial. PARTICIPANTS: Patients with functional d...

Detection of Helicobacter pylori CagA gene and Its Association with Endoscopic Appearance in Balinese Dyspepsia Patients

Directory of Open Access Journals (Sweden)

I Ketut Mariadi

2016-09-01

Full Text Available Background: Helicobacter pylori (H. pylori infection causes various abnormalities in the stomach. Only particular strain can cause severe problems in the stomach. CagA is a microbial virulent factor which is associated with more severe stomach problems, such as: peptic ulcer and stomach cancer. We would like to know the prevalence of CagA in Balinese population, and the association of H. Pylori CagA status with the severity of endoscopic appearance in dyspepsia patients. Method: Study design being used was analytic cross sectional study, involving 71 dyspepsia patients who underwent upper gastrointestinal endoscopic examination in Surya Husada Hospital and Balimed Hospital in June-December 2013. Sample was chosen in consecutive manner. Later, polymerase chain reaction (PCR examinations of the stomach mucous biopsy tissue to determine H. pylori infection status and CagA status were performed. Further, Chi square test was used to identify the difference in proportion of H. pylori and CagA between mild and severe endoscopic appearance. Results: In this study, we found that the prevalence of H. pylori infection was 22.5% using PCR examination. Prevalence of CagA positive in H. pylori positive was 62.5%. There was significant association between status of H. Pylori infection and severity of endoscopic appearance (p = 0.038; OR= 2.67; 95% CI = 1.18-6.05. Status of CagA in H. pylori infected patients was not associated with the severity of endoscopic appearance. Additionally, there was significant association between patients’ age and severity of endoscopic appearance. Conclusion: The prevalence of CagA in H. pylori positive was 62.5%. H. pylori infection was associated with severity of endoscopic appearance and CagA status in H. pylori infected patients was not associated with severity of endoscopic appearance.

Abnormal duodenal loop demonstrated by X-ray. Correlation to symptoms and prognosis of dyspepsia

Energy Technology Data Exchange (ETDEWEB)

Thommesen, P.; Funch-Jensen, P.

1986-01-01

The occurrence of dyspeptic symptoms has previously been correlated with the shape of the duodenal loop in patients with X-ray-negative dyspepsia. An abnormal duodenal loop was associated with a significantly higher incidence of symtoms provoked by meals, vomiting, regurgitations, heartburn, and the irritable bowel syndrome. 89% of these patients (26 patients with a normal duodenal loop and 39 patients with abnormal duodenal loop) were available for a 5-year follow-up study of symptomatic outcome. The incidence of symptoms provoked by meals was still significantly higher in patients with an abnormal duodenal loop, and there was also a significant difference concerning symptomatic outcome. Approximately 75% of the patients with a normal duodenal loop had improved, and 25% had unchanged clinical conditions. Approximately 50% of the patients with an abnormal duodenal loop had improved, and 50% had an unchanged or even deteriorated clinical condition.

Adaptive upregulation of gastric and hypothalamic ghrelin receptors and increased plasma ghrelin in a model of cancer chemotherapy-induced dyspepsia.

Science.gov (United States)

Malik, N M; Moore, G B T; Kaur, R; Liu, Y-L; Wood, S L; Morrow, R W; Sanger, G J; Andrews, P L R

2008-06-05

Chemotherapy treatment can lead to delayed gastric emptying, early satiety, anorexia, nausea and vomiting, described collectively as the cancer-associated dyspepsia syndrome (CADS). Administration of ghrelin (GHRL), an endogenous orexigenic peptide known to stimulate gastric motility, has been shown to reduce the symptoms of CADS induced in relevant animal models with the potent chemotherapeutic agent, cisplatin. We examined the effects in the rat of cisplatin (6 mg/kg i.p.) treatment on the expression of GHRL and ghrelin receptor (GHSR) mRNAs in the hypothalamus and the stomach at a time-point (2 days) when the effects of cisplatin are pronounced. In addition, plasma levels of GHRL (acylated and total including des-acyl GHRL) were measured and the effect on these levels of treatment with the synthetic glucocorticoid dexamethasone (2 mg/kg s.c. bd.) was investigated. Cisplatin increased GHSR mRNA expression in the stomach (67%) and hypothalamus (52%) but not GHRL mRNA expression and increased the percentage of acylated GHRL (7.03+/-1.35% vs. 11.38+/-2.40%) in the plasma. Dexamethasone reduced the plasma level of acylated GHRL and the percentage of acylated GHRL to values below those in animals treated with saline alone (7.03+/-1.35% vs. 2.60+/-0.49%). Our findings support the hypothesis that an adaptive upregulation of the ghrelin receptor may occur during cancer chemotherapy-associated dyspepsia. This may have a role in defensive responses to toxic challenges to the gut. In addition, our results provide preliminary evidence for glucocorticoid modulation of plasma ghrelin levels.

Efficacy of DA-9701 (Motilitone) in Functional Dyspepsia Compared to Pantoprazole: A Multicenter, Randomized, Double-blind, Non-inferiority Study.

Science.gov (United States)

Jung, Hye-Kyung; Lee, Kwang Jae; Choi, Myung-Gyu; Park, Hyojin; Lee, Joon Seong; Rhee, Poong-Lyul; Kim, Nayoung; Park, KyungSik; Choi, Suck Chei; Lee, Oh Young; Huh, Kyu Chan; Song, Geun Am; Hong, Su Jin; Sohn, Chong Il; Jung, Hwoon-Yong; Lee, Yong Chan; Rew, Jong Sun; Jee, Sam Ryong; Kwon, Joong Goo

2016-04-30

The effect of proton pump inhibitors (PPI) in Asian functional dyspepsia (FD) patients has not been well established as in Westerncountries. DA-9701, a novel prokinetic agent, stimulates gastric emptying and modulates visceral hypersensitivity in vivo and in human studies. This study was conducted to compare the efficacy of DA-9701 with a conventional PPI in mono or combination therapy in patients with FD. In this double-blind, randomized, non-inferiority trial, 389 patients diagnosed with FD using Rome III criteria were allocated among3 groups: 30-mg DA-9701 t.i.d (means 3 times a day), 40-mg pantoprazole, and 30-mg DA-9701 t.i.d + 40-mg pantoprazole. Theprimary efficacy end-point was a global assessment of the patient binary response or response on a 5-Likert scale after 4 weeks. The global symptomatic improvement was 60.5% in the DA-9701 group, 65.6% in the pantoprazole group, and 63.5% in the DA-9701 + pantoprazole group using a 5-Likert scale at week 4 with no significant difference among 3 groups (P = 0.685). Symptomimprovement measured by binary outcome was significantly achieved in each of the 3 groups, but not different among groups.Patients in all treatment groups reported significant improvement in the response rate and symptoms according to FD subtypes anddyspepsia-related quality of life (P DA-9701 improves global and individual symptoms and increases dyspepsia-specific quality of life in patients with FD. The efficacyof DA-9701 monotherapy is comparable with pantoprazole and there is no additive effect with combination of DA-9701 andpantoprazole in patients with FD.

Randomized, Controlled, Multi-center Trial: Comparing the Safety and Efficacy of DA-9701 and Itopride Hydrochloride in Patients With Functional Dyspepsia.

Science.gov (United States)

Choi, Myung-Gyu; Rhee, Poong-Lyul; Park, Hyojin; Lee, Oh Young; Lee, Kwang Jae; Choi, Suck Chei; Seol, Sang Young; Chun, Hoon Jai; Rew, Jong-Sun; Lee, Dong Ho; Song, Geun Am; Jung, Hwoon Yong; Jeong, Hyung Yong; Sung, In Kyung; Lee, Joon Seong; Lee, Soo Teik; Kim, Sung Kook; Shin, Yong Woon

2015-07-30

Therapies of functional dyspepsia (FD) are limited. DA-9701 is a novel prokinetic agent formulated with Pharbitis semen and Corydalis Tuber. We aimed to assess the efficacy of DA-9701 compared with itopride in FD patients. Patients with FD randomly received either itopride 50 mg or DA-9701 30 mg t.i.d after a 2-week baseline period. After 4 weeks of treatment, 2 primary efficacy endpoints were analyzed: the change from baseline in composite score of the 8 dyspep-tic symptoms and the overall treatment effect. Impact on patients' quality of life was assessed using the Nepean Dyspepsia Index (NDI) questionnaire. We randomly assigned 464 patients with 455 having outcome data. The difference of the composite score change of the 8 symptoms between the 2 groups was 0.62, indicating that DA-9701 was not inferior to itopride. The overall treatment effect response rate was not different between the groups. When responder was defined as ≥ 5 of the 7 Likert scale, responder rates were 37% of DA-9701 and 36% of itopride group. Patients receiving DA-9701 experienced similar mean percentage of days with adequate relief during the 4-week treatment period compared with those receiving itopride (56.8% vs 59.1%). Both drugs increased the NDI score of 5 domains without any difference in change of the NDI score between the groups. The safety profile of both drugs was comparable. DA-9701 significantly improves symptoms in patients with FD. DA-9701 showed non-inferior efficacy to itopride with com-parable safety.

Irritable bowel syndrome and upper dyspepsia among the elderly: a study of symptom clusters in a random 70 year old population

DEFF Research Database (Denmark)

Kay, L; Jørgensen, Torben; Schultz-Larsen, K

1996-01-01

. Heartburn/acid regurgitation did not show a consistent association to any other symptoms and may be considered as a cluster of it own. Pain characteristics traditionally related to upper dyspepsia did not specifically relate to any cluster. It is concluded that, in this 70-year-old population abdominal......With the aim to assess the clustering of abdominal symptoms in a random population, data from a cohort study of a 70 year old Danish population were analysed. The cohort comprised 1,119 subjects of which 72% participated in a primary study and 91% of the survivors in a similar study five years...

Altered structural covariance of the striatum in functional dyspepsia patients.

Science.gov (United States)

Liu, P; Zeng, F; Yang, F; Wang, J; Liu, X; Wang, Q; Zhou, G; Zhang, D; Zhu, M; Zhao, R; Wang, A; Gong, Q; Liang, F

2014-08-01

Functional dyspepsia (FD) is thought to be involved in dysregulation within the brain-gut axis. Recently, altered striatum activation has been reported in patients with FD. However, the gray matter (GM) volumes in the striatum and structural covariance patterns of this area are rarely explored. The purpose of this study was to examine the GM volumes and structural covariance patterns of the striatum between FD patients and healthy controls (HCs). T1-weighted magnetic resonance images were obtained from 44 FD patients and 39 HCs. Voxel-based morphometry (VBM) analysis was adopted to examine the GM volumes in the two groups. The caudate- or putamen-related regions identified from VBM analysis were then used as seeds to map the whole brain voxel-wise structural covariance patterns. Finally, a correlation analysis was used to investigate the effects of FD symptoms on the striatum. The results showed increased GM volumes in the bilateral putamen and right caudate. Compared with the structural covariance patterns of the HCs, the FD-related differences were mainly located in the amygdala, hippocampus/parahippocampus (HIPP/paraHIPP), thalamus, lingual gyrus, and cerebellum. And significant positive correlations were found between the volumes in the striatum and the FD duration in the patients. These findings provided preliminary evidence for GM changes in the striatum and different structural covariance patterns in patients with FD. The current results might expand our understanding of the pathophysiology of FD. © 2014 John Wiley & Sons Ltd.

Down-regulation of A-type potassium channel in gastric-specific DRG neurons in a rat model of functional dyspepsia.

Science.gov (United States)

Li, S; Chen, J D Z

2014-07-01

Although without evidence of organic structural abnormalities, pain or discomfort is a prominent symptom of functional dyspepsia and considered to reflect visceral hypersensitivity whose underlying mechanism is poorly understood. Here, we studied electrophysiological properties and expression of voltage-gated potassium channels in dorsal root ganglion (DRG) neurons in a rat model of functional dyspepsia induced by neonatal gastric irritation. Male Sprague-Dawley rat pups at 10-day old received 0.1% iodoacetamide (IA) or vehicle by oral gavage for 6 days and studied at adulthood. Retrograde tracer-labeled gastric-specific T8 -T12 DRG neurons were harvested for the patch-clamp study in voltage and current-clamp modes and protein expression of K(+) channel in T8 -T12 DRGs was examined by western blotting. (1) Gastric specific but not non-gastric DRG neurons showed an enhanced excitability in neonatal IA-treated rats compared to the control: depolarized resting membrane potentials, a lower current threshold for action potential (AP) activation, and an increase in the number of APs in response to current stimulation. (2) The current density of tetraethylammonium insensitive (transiently inactivating A-type current), but not the tetraethylammonium sensitive (slow-inactivating delayed rectifier K(+) currents), was significantly smaller in IA-treated rats (65.4 ± 6.9 pA/pF), compared to that of control (93.1 ± 8.3 pA/pF). (3) Protein expression of KV 4.3 was down-regulated in IA-treated rats. A-type potassium channels are significantly down-regulated in the gastric-specific DRG neurons in adult rats with mild neonatal gastric irritation, which in part contribute to the enhanced DRG neuron excitabilities that leads to the development of gastric hypersensitivity. © 2014 John Wiley & Sons Ltd.

Prevalence of Helicobacter pylori cagA, babA2, and dupA genotypes and correlation with clinical outcome in Malaysian patients with dyspepsia.

Science.gov (United States)

Osman, Hussein Ali; Hasan, Habsah; Suppian, Rapeah; Hassan, Syed; Andee, Dzulkarnaen Zakaria; Abdul Majid, Noorizan; Zilfalil, Bin-alwi

2015-01-01

The severity of disease outcome in dyspepsia has been attributed to Helicobacter pylori virulence genes. The aim of this study was to determine the distribution of H. pylori virulence genes (cagA, babA2, and dupA) and to determine whether or not there arises a significant correlation with clinical dyspepsia outcomes. H. pylori genotypes cagA, babA2, and dupA were identified by polymerase chain reactions from gastric biopsy samples in 105 H. pylori-positive patients. The positive rates for cagA, babA2, and dupA genes in H. pylori dyspeptic patients were 69.5%, 41.0%, and 22.9%, respectivel cagA was more prevalent in Indians (39.7%), babA2 was more prevalent in Malays (39.5%), and dupA detection occurred more frequently in both Indians and Malays and at the same rate (37.5%). The Chinese inhabitants had the lowest prevalence of the three genes. Nonulcer disease patients had a significantly higher distribution of cagA (76.7%), babA2 (74.4%), and dupA (75.0%). There was no apparent association between these virulence genes and the clinical outcomes. The lower prevalence of these genes and variations among different ethnicities implies that the strains are geographically and ethnically dependent. None of the virulence genes were knowingly beneficial in predicting the clinical outcome of H. pylori infection in our subjects.

Management of functional dyspepsia: Unsolved problems and new perspectives

Institute of Scientific and Technical Information of China (English)

Ahmed Madisch; Stephan Miehlke; Joachim Labenz

2005-01-01

The common characteristic criteria of all functional gastrointestinal(GI)disorders are the persistence and recurrence of variable gastrointestinal symptoms that cannot be explained by any structural or biochemical abnormalities. Functional dyspepsia (FD) represents one of the important GI disorders in Western countries because of its remarkably high prevalence in general population and its impact on quality of life. Due to its dependence on both subjective determinants and diverse country-specific circumstances, the definition and management strategies of FD are still variably stated.Clinical trials with several drug classes (e.g., proton pump inhibitors, H2-blockers, prokinetic drugs) have been performed frequently without validated diseasespecific test instruments for the outcome measurements.Therefore, the interpretation of such trials remains difficult and controversial with respect to comparability and evaluation of drug efficacy, and definite conclusions can be drawn neither for diagnostic management nor for efficacious drug therapy so far. In view of these unsolved problems, guidelines both on the clinical management of FD and on the performance of clinical trials are needed. In recent years, increasing research work has been done in this area. Clinical trials conducted in adequately diagnosed patients that provided validated outcome measurements may result in better insights leading to more effective treatment strategies.Encouraging perspectives have been recently performed by methodologically well-designed treatment studies with herbal drug preparations. Herbal drugs, given their proven efficacy in clinical trials, offer a safe therapeutic alternative in the treatment of FD which is often favored by both patients and physicians. A fixed combination of peppermint oil and caraway oil in patients suffering from FD could be proven effective by well-designed clinical trials.

Management of functional dyspepsia: Unsolved problems and new perspectives.

Science.gov (United States)

Madisch, Ahmed; Miehlke, Stephan; Labenz, Joachim

2005-11-14

The common characteristic criteria of all functional gastrointestinal (GI) disorders are the persistence and recurrence of variable gastrointestinal symptoms that cannot be explained by any structural or biochemical abnormalities. Functional dyspepsia (FD) represents one of the important GI disorders in Western countries because of its remarkably high prevalence in general population and its impact on quality of life. Due to its dependence on both subjective determinants and diverse country-specific circumstances, the definition and management strategies of FD are still variably stated. Clinical trials with several drug classes (e.g., proton pump inhibitors, H2-blockers, prokinetic drugs) have been performed frequently without validated disease-specific test instruments for the outcome measurements. Therefore, the interpretation of such trials remains difficult and controversial with respect to comparability and evaluation of drug efficacy, and definite conclusions can be drawn neither for diagnostic management nor for efficacious drug therapy so far. In view of these unsolved problems, guidelines both on the clinical management of FD and on the performance of clinical trials are needed. In recent years, increasing research work has been done in this area. Clinical trials conducted in adequately diagnosed patients that provided validated outcome measurements may result in better insights leading to more effective treatment strategies. Encouraging perspectives have been recently performed by methodologically well-designed treatment studies with herbal drug preparations. Herbal drugs, given their proven efficacy in clinical trials, offer a safe therapeutic alternative in the treatment of FD which is often favored by both patients and physicians. A fixed combination of peppermint oil and caraway oil in patients suffering from FD could be proven effective by well-designed clinical trials.

[Symptom overlaps between functional heartburn, functional dyspepsia, and irritable bowel syndrome].

Science.gov (United States)

2014-05-01

To determine symptom overlaps between functional heartburn (FH), functional dyspepsia (FD), and irritable bowel syndrome (IBS). One hundred and ten patients with frequent heartburn but no mucosa breakage under endoscopy were enrolled consecutively. They were required to fill out a questionnaire. The overlapped symptoms of FD and IBS symptoms were screened using Rome ill criteria. The participants were also examined using Hamilton anxiety scale/Hamilton depression scale. All of the participants were followed with 24 h esophageal multichannel intra-luminal impedance monitoring with pH sensor (MII-pH) monitoring and proton pump inhibitor (PPI) trials. The participants were divided into non-erosive reflux disease (NERD) and FH groups. The prevalence of symptom overlaps FD and IBS, between NERD and FH groups was analyzed. Women were more likely to present with FH than with NERD (P heartburn symptom had FD symptoms; 31 (28.2%) had IBS symptoms, and 10 (9.09%) had both FD and IBS symptoms. Patients with FH were more likely to have symptom overlaps of FD and IBS than those with NERD (62% vs. 35%, 48% vs. 11.7%, respectively; P 0.05). IBS-diarrhea was also slightly more likely to have overlapped NERD and FH symptoms than IBS-constipation. Again, the difference was not significant (16.4% vs. 11.8%, P > 0.05). Female, higher prevalence of anxiety and depression, overlapped FD and IBS symptoms are more likely to appear in FH patients than in NERD patients.

Comparative evaluation of the efficacy and tolerability of itopride hydrochloride and domperidone in patients with non-ulcer dyspepsia.

Science.gov (United States)

Sawant, Prabha; Das, H S; Desai, Nutan; Kalokhe, S; Patil, S

2004-08-01

Prokinetic drugs are widely used for treatment of non-ulcer dyspepsia (NUD). To assess the efficacy and tolerability of a new prokinetic agent, itopride hydrochloride in patients of NUD and compare it with domperidone. Fifty-six patients who fulfilled the inclusion and exclusion criteria were enrolled in the study. Patients underwent upper gastrointestinal endoscopy to rule out organic pathology as a cause for their symptoms. The patient's symptoms were graded on a 4-point scale (0 to 3) at the beginning of treatment and at the end of Week-one and Week-two Patients were randomly allocated to receive either one tablet of itopride hydrochloride 50mg three times daily or one tablet of domperidone 10mg three times daily for two weeks. Pre-treatment and post-treatment hemogram, liver function and renal function tests, prolactin level and ECG were done in all patients. The response to therapy was evaluated by assessing the relief of symptoms at the end of two weeks on a 5-point scale. Statistical analysis was done using two-tailed paired t-test; Wilcoxon matched pairs ranks sum test, Mann-Whitney-U test and chi-square test as applicable. Of the fifty-five patients enrolled in the study (age range of 18-60 yrs, median age of 35yrs), 26 were males and twenty nine were females. They had a median duration of symptoms for 4 weeks. Twenty-seven patients received itopride and 28 received domperidone. One patient did not follow up in the domperidone group, thus 54 patients were evaluable for analysis. Moderate to complete symptomatic relief was observed in 22 (81%) patients in the itopride group and 19 patients (70%) in the domperidone group (p > 0.05, NS). Both the drugs were well tolerated and neither caused prolongation of QT interval nor any abnormality in any serum biochemistry values. Therapy with itopride resulted in good symptomatic relief, was safe, well tolerated and comparable in efficacy to domperidone in relieving the symptoms of NUD. By virtue of its efficacy and

Electroacupuncture plus standard of care for managing refractory functional dyspepsia: protocol of a pragmatic trial with economic evaluation.

Science.gov (United States)

Chung, Vincent C H; Wong, Charlene H L; Ching, Jessica Y L; Sun, Wai Zhu; Ju, Yan Li; Hung, Sheung Sheung; Lin, Wai Ling; Leung, Ka Chun; Wong, Samuel Y S; Wu, Justin C Y

2018-03-27

This trial proposes to compare the effectiveness and cost-effectiveness of electroacupuncture (EA) plus on-demand gastrocaine with waiting list for EA plus on-demand gastrocaine in providing symptom relief and quality-of-life improvement among patients with functional dyspepsia (FD). This is a single-centre, pragmatic, randomised parallel-group, superiority trial comparing the outcomes of (1) EA plus on-demand gastrocaine group and (2) waiting list to EA plus on-demand gastrocaine group. 132 (66/arm) endoscopically confirmed, Helicobacter pylori -negative patients with FD will be recruited. Enrolled patients will respectively be receiving (1) 20 sessions of EA over 10 weeks plus on-demand gastrocaine; or (2) on-demand gastrocaine and being nominated on to a waiting list for EA, which entitles them 20 sessions of EA over 10 weeks after 12 weeks of waiting. The primary outcome will be the between-group difference in proportion of patients achieving adequate relief of symptoms over 12 weeks. The secondary outcomes will include patient-reported change in global symptoms and individual symptoms, Nepean Dyspepsia Index, Nutrient Drink Test, 9-item Patient Health Questionnaire (PHQ9), and 7-item Generalised Anxiety Disorder Scale (GAD7). Adverse events will be assessed formally. Results on direct medical costs and on the EuroQol (EQ-5D) questionnaire will also be used to assess cost-effectiveness. Analysis will follow the intention-to-treat principle using appropriate univariate and multivariate methods. A mixed model analysis taking into account missing data of these outcomes will be performed. Cost-effectiveness analysis will be performed using established approach. The study is supported by the Health and Medical Research Fund, Government of the Hong Kong Special Administrative Region of China. It has been approved by the Joint Chinese University of Hong Kong - New Territories East Cluster Clinical Research Ethics Committee. Results will be published in peer

Prevalence of gastroesophageal reflux disease symptoms and effects of esomeprazole on the quality of life related to reflux and dyspepsia in patients on maintenance hemodialysis.

Science.gov (United States)

Namikoshi, Tamehachi; Harada, Kazuhiro; Hatta, Hidekazu; Tokura, Takehiko; Oshiro, Yoshiyuki; Nishizaki, Tetsuichi; Obata, Takahiro; Mori, Masahiro; Fueki, Takaaki; Fujimoto, Sohachi; Haruna, Yoshisuke; Kuwabara, Atsunori; Yorimitsu, Daisuke; Ihoriya, Chieko; Kadoya, Hiroyuki; Itano, Seiji; Fujimoto, Yasuo; Komai, Norio; Sasaki, Tamaki; Kashihara, Naoki

2016-02-01

The prevalence of gastroesophageal reflux disease (GERD) symptoms has not been investigated in patients on maintenance hemodialysis in Japan, and few studies have reported the effect of proton pump inhibitors (PPIs) in hemodialysis patients with GERD symptoms. Here, we investigated the prevalence of GERD symptoms and the effects of the PPI esomeprazole on the quality of life related to reflux and dyspepsia in patients on maintenance hemodialysis. This was a cross-sectional/cohort study of hemodialysis outpatients implemented in 10 Japanese medical facilities from October 2012 to March 2014. The trial was registered in the UMIN Clinical Trial Registry (UMIN000009124). Forty-one of 385 patients (11%) reported GERD symptoms on the Global Overall Symptom (GOS) questionnaire. Multivariate logistic regression analysis identified the independent prognostic factors for GERD symptoms as a history of gastric ulcer and use of sevelamer hydrochloride or calcium polystyrene sulfonate. Participants with GERD symptoms completed the Quality of Life in Reflux and Dyspepsia, Japanese version (QOLRAD-J) questionnaire and were assigned to receive 4-week esomeprazole treatment (20 mg/day). This PPI therapy significantly improved all QOLRAD-J domains in the full analysis set (n = 28) and improved the GERD symptoms listed in the GOS questionnaire. Significantly impaired disease-specific quality of life (QOL) in the QOLRAD-J domains was observed in 44.4-74.1% of patients who had symptoms before treatment. The mean GOS and QOLRAD-J scores correlated significantly. Therapy with 20 mg/day esomeprazole appears to be efficacious for improving disease-specific QOL and GERD symptoms in Japanese patients on maintenance hemodialysis.

Applying novel nutrient drink to clinical trial of functional dyspepsia.

Science.gov (United States)

Lim, Chul-Hyun; Choi, Myung-Gyu; Baeg, Myong Ki; Moon, Sung Jin; Kim, Jin Su; Cho, Yu Kyung; Park, Jae Myung; Lee, In Seok; Kim, Sang Woo; Choi, Kyu Yong

2014-04-30

The drink test has been regarded as a surrogate marker of gastric accommodation. The aims of this study were to develop a novel nutrient drink test (NDT) protocol and investigate its potential for application to a clinical trial of functional dyspepsia (FD). A novel NDT was designed, involving drinking 125 mL of nutrient 4 times at 5-minute intervals or until maximal tolerability. Healthy volunteers and patients with FD rated their symptoms every 5 minutes for 20 minutes in a developmental study. Patients with FD were enrolled in an open trial of itopride for 4 weeks. NDT was performed before and after treatment. Improvement of integrative symptoms score during NDT after treatment for more than 50% compared with baseline was de-fined as responder. Total aggregate symptom scores, sum of symptom scores measured during NDT, were higher in FD patients (n = 40, 368.1 ± 245.3) than in controls (n = 19, 215.9 ± 171.2) (P = 0.018) in a developmental study. In an open trial of itopride, symp-tom scores measured during NDT decreased significantly at all time points after treatment in responders (n = 49), whereas did not in non-responders (n = 25). Total aggregate symptom score for NDT correlated significantly with integrative dyspeptic symptom score, sum of 8 symptom scores of NDI questionnaire, at baseline (r = 0.374, P = 0.001) and after treatment (r = 0.480, P ＜ 0.001). Our novel NDT can quantify dyspeptic symptoms and reflected therapeutic effects of itopride treatment in a clinical trial of FD patients. This NDT can be used as an effective parameter in clinical trials or drug development programs for assessing effects of novel therapies on postprandial symptoms.

Psychological factors in patients with peptic ulcerand functional dyspepsia.

Science.gov (United States)

Faramarzi, Mahbobeh; Kheirkhah, Farzan; Shokri-Shirvani, Javad; Mosavi, Shokofeh; Zarini, Soroush

2014-01-01

The role of psychological factors in peptic ulcer disease (PUD) and functional dyspepsia (FD) has not been clearly determined. In this study the role of conflict management styles, psychiatric symptoms, and alexithymia were assessed in patients with PUD and FD and in the healthy individuals. Ninety subjects [30 PUD (15 women, 15 men), 30 FD (15 women, 15 men), and 30 healthy individuals (15 women, 15 men)] in two endoscopy wards of Babol University of Medical Sciences were evaluated. Three groups were matched with regard to demographic variables. Conflict management styles, psychiatric symptoms, and alexithymia were evaluated by appropriate questionnaires. The patients with PUD reported less mean scores on psychiatric symptoms than the FD patients (depression 12.6±7.5 vs 28±9.5, anxiety 8.2±5.9 vs 18.7±6. obsessive-compulsive disorder 15.7±7.5 vs 21.8±8.4, interpersonal sensitivity 9.5±7.4 vs 16±7, psychoticism 8.03±4.5 vs 14.3±6.3, somatization 12.5±10.8 vs 20.7±8.1, and the total score of psychiatric symptoms 94.4±49.9 vs 160.1±46.6). The mean scores use of unconstructive conflict management styles in PUD patients were lower than FD (dominating 17.7±3.5 vs 20.2±2.7, avoiding 17.5±3 vs 23.8±4.4). Alexithymia symptoms were higher in FD patients than PUD individuals (difficulty in identifying feelings 23.5±6.3 vs 27.8±3.9, difficulty in describing feeling 16.5±4.4 vs 17.3±3.6). The PUD and FD patients had higher scores regarding these variables than the healthy subjects. The results show that both PUD and FD patients experienced more psychiatric symptoms, unconstructive conflict management styles, and alexithymia than the healthy subjects. FD patients had worse psychiatric problems than PUD.

Functional dyspepsia (FD) and non-erosive reflux disease (NERD): overlapping or discrete entities?

LENUS (Irish Health Repository)

Quigley, Eamonn M M

2012-02-03

As the incidence of both gastric cancer and peptic ulcer disease have declined, that of gastro-oesophageal reflux disease (GORD) and non-ulcer, or functional dyspepsia (FD) have reached virtually epidemic proportions. As we come to appreciate the expression of these disorders in the community, the real spectrum of each disease has become evident. FD and non-erosive reflux disease (NERD), the most prevalent manifestation of GORD, frequently overlap. Where then does GORD end and FD begin? Is it realistic, or even clinically relevant, to attempt a clear separation between these entities? These are more than issues of mere semantics; therapeutic options may be dictated by the classification of the patient as one or the other. Recent work indicates clearly that NERD is a heterogeneous disorder incorporating some patients who may well harbour subtle manifestations of oesophagitis and others who have entirely normal 24-hour pH studies. These differences may be crucial to the concept of NERD\\/FD overlap. While evidence in support of this concept is far from complete, it would appear that this overlap is most relevant to those NERD patients who do not exhibit abnormal esophageal acid exposure. These patients truly belong in the spectrum of functional gastrointestinal disorders rather than in GORD; attempts to shoe-horn these individuals into the spectrum of GORD will result in therapeutic disappointment and surgical disaster.

Meta-analysis of the effects of prokinetic agents in patients with functional dyspepsia.

Science.gov (United States)

Hiyama, Toru; Yoshihara, Masaharu; Matsuo, Keitaro; Kusunoki, Hiroaki; Kamada, Tomoari; Ito, Masanori; Tanaka, Shinji; Nishi, Nobuo; Chayama, Kazuaki; Haruma, Ken

2007-03-01

Functional dyspepsia (FD) is often treated with prokinetic agents; however, the efficacy of prokinetic agents in patients with FD has been questioned recently. The aim of this study was to perform a meta-analysis of the effects of prokinetic agents in patients with FD. Prokinetic agents, including metoclopramide, domperidone, trimebutine, cisapride, itopride and mosapride, used for treatment of FD between 1951 and 2005 were identified. Twenty-seven studies were selected. Difference in the probability of response between the interventional drug and placebo was used as a summary statistic for the treatment effect. Meta-regression analysis was used to detect sources of heterogeneity. In total, 1844 subjects were assigned to an experimental arm, and 1591 subjects were assigned to a placebo arm. Publication bias was ruled out by funnel plot and statistical testing (P = 0.975). In the overall analysis, the summary statistic was 0.295 (95% confidence interval: 0.208-0.382, P < 0.001), indicating that the interventional drug has 30% excess probability of producing a response compared with placebo. The most significant source of heterogeneity was the year of publication (P < 0.001). The data clearly indicate that prokinetic agents are significantly more effective than placebo in the treatment of FD. Although FD is a chronic condition, efficacy was assessed over short periods. Long-term randomized controlled trials are needed to confirm the effect.

Clinical efficacy and safety of cisapride and clebopride in the management of chronic functional dyspepsia: a double-blind, randomized study.

Science.gov (United States)

Sabbatini, F; Minieri, M; Manzi, G; Piai, G; D'Angelo, V; Mazzacca, G

1991-01-01

The clinical efficacy and the safety of chronic oral administration of cisapride, a new gastrointestinal prokinetic agent, (10 mg tid) and clebopride (0.5 mg tid) was assayed in 48 outpatients affected with functional dyspepsia, in a randomized double-blind study. Each of the drugs induced a significant reduction in dyspeptic symptoms after 2 and 4 weeks (p less than 0.001). Two patients, given clebopride, dropped out of the study because of severe side effects during the first week of treatment. Mild adverse reactions were reported in 6 out of 23 cisapride-treated patients and in 10 out of 20 clebopride-treated patients who completed the study. The most common side effect of cisapride was diarrhoea and that of clebopride was drowsiness. Cisapride appears to be as effective as clebopride in reducing dyspeptic symptoms and seems to induce less severe side effects.

Electrogastrography associated with symptomatic changes after prokinetic drug treatment for functional dyspepsia.

Science.gov (United States)

Lim, Hyun Chul; Lee, Sang In; Chen, Jiande D Z; Park, Hyojin

2012-11-07

To evaluate the effect of prokinetic drugs on electrogastrography (EGG) parameters according to symptomatic changes in patients with functional dyspepsia (FD). Seventy-four patients with FD were prospectively enrolled in this study between December 2006 and December 2010. We surveyed the patients using a questionnaire on dyspeptic symptoms before and after an 8-wk course of prokinetic drug treatment. We also measured cutaneous pre-prandial and post-prandial EGG recordings including percentage of gastric waves (normogastria, bradygastria, tachygastria), dominant frequency (DF), dominant power (DP), dominant frequency instability coefficient (DFIC), dominant power instability coefficient (DPIC), and the ratio of post-prandial to fasting in DP before and after the 8-wk course of prokinetic drug treatment. Fifty-two patients (70%) achieved symptomatic improvement after prokinetic drug treatment. Patients who had normal gastric slow waves showed symptom improvement group after treatment. Post-prandial DF showed a downward trend in the symptom improvement group, especially in the itopride group. Post-prandial DP was increased regardless of symptom improvement, especially in the itopride group and mosapride group. Post-prandial DFIC and DPIC in the symptom improvement group were significantly increased after the treatment. The EGG power ratio was increased after treatment in the symptom improvement group (0.50 ± 0.70 vs 0.93 ± 1.77, P = 0.002), especially in the itopride and levosulpiride groups. Prokinetics could improve the symptoms of FD by regulating gastric myoelectrical activity, and EGG could be a useful tool in evaluating the effects of various prokinetics.

Anti-CagA positivity in duodenal ulcer and functional dyspepsia patients infected with Helicobacter pylori and its effect on the outcome of eradication treatment

Directory of Open Access Journals (Sweden)

Yaşar Nazlıgül

2011-03-01

Full Text Available Objectives: CagA positive H. pylori strains are considered to be more virulent than other strains. In this study, we aimed to investigate the rate of CagA positivity in duodenal ulcer (DU and functional dyspepsia (FD, and its effect on H. pylori eradication response.Materials and methods: The study was performed on H. pylori positive 60 patients with DU and 50 patients with FD, who underwent upper gastrointestinal endoscopy. H. pylori infection was identified by histology. All patients received a quadriple therapy consisted of esomeprazole 20 mg b.i.d., colloidal bismuth subcitrate 600 mg b.i.d., tetracycline 500 mg q.i.d. and metronidazole 500 mg t.i.d. for 7 days. H.pylori status was rechecked using C14-urea breath test 6 weeks after the end of treatment to confirm cure. Specific IgG antibodies for CagA status were determined by enzyme linked immunosorbent assay.Results: CagA positivities in the patients with DU and FD were calculated respectivily 70% and 68% (P>0.05. H. pylori was eradicated in 85.5% of the patients infected with CagA (+ strains, in 50% of those infected with CagA (- strains (P=0.001. The eradication rates were 95.2% and 55.6% in CagA positive and negative DU subgroups (P=0.001, and 73.5% and 43.8% in CagA positive and negative FD subgroups (P=0.04.Conclusion: CagA positivities were not different in duodenal ulcer and functional dyspepsia. CagA (+ strains was susceptible to the eradication treatment. The titres of serum anti-CagA antibodies may be used in the prediction of eradication outcome, and the modification of eradication therapy.

Gastroesophageal reflux symptoms not responding to proton pump inhibitor: GERD, NERD, NARD, esophageal hypersensitivity or dyspepsia?

Science.gov (United States)

Bashashati, Mohammad; Hejazi, Reza A; Andrews, Christopher N; Storr, Martin A

2014-01-01

Gastroesophageal reflux (GER) is a common gastrointestinal process that can generate symptoms of heartburn and chest pain. Proton pump inhibitors (PPIs) are the gold standard for the treatment of GER; however, a substantial group of GER patients fail to respond to PPIs. In the past, it was believed that acid reflux into the esophagus causes all, or at least the majority, of symptoms attributed to GER, with both erosive esophagitis and nonerosive outcomes. However, with modern testing techniques it has been shown that, in addition to acid reflux, the reflux of nonacid gastric and duodenal contents into the esophagus may also induce GER symptoms. It remains unknown how weakly acidic or alkaline refluxate with a pH similar to a normal diet induces GER symptoms. Esophageal hypersensitivity or functional dyspepsia with superimposed heartburn may be other mechanisms of symptom generation, often completely unrelated to GER. Detailed studies investigating the pathophysiology of esophageal hypersensitivity are not conclusive, and definitions of the various disease states may overlap and are often confusing. The authors aim to clarify the pathophysiology, definition, diagnostic techniques and medical treatment of patients with heartburn symptoms who fail PPI therapy. PMID:24719900

Comparison of psychiatric morbidity in patients with irritable bowel syndrome and non-ulcer dyspepsia

Directory of Open Access Journals (Sweden)

Susanta Kumar Padhy

2016-01-01

Full Text Available Background and Aims: The present study aimed to find psychiatric morbidity, stress, anxiety, and depression in patients with irritable bowel syndrome (IBS and compare it with patients having non-ulcer dyspepsia (NUD. Methods: This case NUD study compared 50 patients each with IBS and NUD. The two groups were compared on demographic data, psychiatric diagnosis using the Structured Clinical Interview for DSM-IV Axis 1 disorders, anxiety levels using the Hamilton Anxiety Rating Scale (HAM-A, and depression using the Hamilton Depression Rating Scale (HAM-D. The Presumptive Stressful Life Events Scale (PSLES was used to measure stress. Results: The cases of IBS were more likely to be of female gender (P = 0.012, married (P = 0.009, and employed (P < 0.001. Psychiatric diagnoses were more common in the cases of IBS than NUDs (88% vs. 30%, P< 0.001, the most common being major depression and somatization disorder. Symptoms of anxiety and depression were more common in patients with IBS (P < 0.001 for HAM-A and HAM-D. Logistic regression revealed that having IBS and increased age were independent predictors of having a psychiatric diagnosis. Conclusions: IBS is associated with the considerable degree of psychiatric morbidity. Adequate attention should be paid toward comorbid psychiatric illnesses, and prompt treatment should be instituted.

IBS, NERD and functional dyspepsia are immuno-neuronal disorders of mucosal cytokine imbalances clinically reversible with high potency sucralfate.

Science.gov (United States)

McCullough, Ricky W

2013-03-01

Irritable bowel syndrome (IBS), non-erosive reflux disorder (NERD), and functional dyspepsia (FD) are best classified as immuno-neuronal disorders of the mucosa or functional mucosal syndromes (FMS). Each appears to be clinically reversible using high potency sucralfate (HPS). In FMS of the GI tract, postprandial nausea, altered motility, discordant peristalsis, vomiting, diarrhea, and hyperalgesia are the clinical expressions of a mucosal imbalance between pro-inflammatory cytokines of up-regulated intra-epithelial lymphocytes (IELs) and feedback anti-inflammatory cytokines tasked with moderating the antigenic response of IELs. Normal functioning GI tract requires an operative balance between pro-inflammatory and anti-inflammatrory cytokines, a balance governed by locally expressed growth factors. The surface concentration of sucralfate can be enhanced 7-23-fold by suspending it in a select concentration of cations and multi-dentate cationic chelators. Increased surface concentration of sucralfate facilitates novel dose effects which include efficient activation of growth factors, quiescence of gated-nociceptor firing and resultant restoration of normal GI function. Published by Elsevier Ltd.

Prokinetics for the treatment of functional dyspepsia: Bayesian network meta-analysis.

Science.gov (United States)

Yang, Young Joo; Bang, Chang Seok; Baik, Gwang Ho; Park, Tae Young; Shin, Suk Pyo; Suk, Ki Tae; Kim, Dong Joon

2017-06-26

Controversies persist regarding the effect of prokinetics for the treatment of functional dyspepsia (FD). This study aimed to assess the comparative efficacy of prokinetic agents for the treatment of FD. Randomized controlled trials (RCTs) of prokinetics for the treatment of FD were identified from core databases. Symptom response rates were extracted and analyzed using odds ratios (ORs). A Bayesian network meta-analysis was performed using the Markov chain Monte Carlo method in WinBUGS and NetMetaXL. In total, 25 RCTs, which included 4473 patients with FD who were treated with 6 different prokinetics or placebo, were identified and analyzed. Metoclopramide showed the best surface under the cumulative ranking curve (SUCRA) probability (92.5%), followed by trimebutine (74.5%) and mosapride (63.3%). However, the therapeutic efficacy of metoclopramide was not significantly different from that of trimebutine (OR:1.32, 95% credible interval: 0.27-6.06), mosapride (OR: 1.99, 95% credible interval: 0.87-4.72), or domperidone (OR: 2.04, 95% credible interval: 0.92-4.60). Metoclopramide showed better efficacy than itopride (OR: 2.79, 95% credible interval: 1.29-6.21) and acotiamide (OR: 3.07, 95% credible interval: 1.43-6.75). Domperidone (SUCRA probability 62.9%) showed better efficacy than itopride (OR: 1.37, 95% credible interval: 1.07-1.77) and acotiamide (OR: 1.51, 95% credible interval: 1.04-2.18). Metoclopramide, trimebutine, mosapride, and domperidone showed better efficacy for the treatment of FD than itopride or acotiamide. Considering the adverse events related to metoclopramide or domperidone, the short-term use of these agents or the alternative use of trimebutine or mosapride could be recommended for the symptomatic relief of FD.

Can gastritis symptoms be evaluated in clinical trials? An overview of treatment of gastritis, nonulcer dyspepsia and Campylobacter-associated gastritis.

Science.gov (United States)

Veldhuyzen van Zanten, S J; Tytgat, K M; Jalali, S; Goodacre, R L; Hunt, R H

1989-10-01

We carried out a review of the literature on Campylobacter pylori-associated gastritis and nonulcer dyspepsia (NUD) to determine whether or not symptoms related to these conditions can be measured reliably and whether or not any study to date has shown that treatment alters symptoms. Search strategies consisted of online Medline searching, a forward search of three articles using the Science Citation Index, a manual search of five gastroenterological journals, and a fully recursive search of cited references. Inclusion and quality criteria were applied to all retrieved studies. Nine of 23 studies did not fulfill the inclusion criteria. Of the 14 studies analyzed, two measured symptoms reliably. Neither showed a therapeutic benefit on symptoms. The difficulties encountered in conducting such studies and the methods of recording symptoms reliably are discussed. We conclude that to date, no treatment is of proven benefit in the relief of symptoms associated with C. pylori gastritis and NUD.

Itopride for gastric volume, gastric emptying and drinking capacity in functional dyspepsia.

Science.gov (United States)

Abid, Shahab; Jafri, Wasim; Zaman, Maseeh Uz; Bilal, Rakhshanda; Awan, Safia; Abbas, Aamir

2017-02-06

To study the effect of itopride on gastric accommodation, gastric emptying and drinking capacity in functional dyspepsia (FD). Randomized controlled trial was conducted to check the effect of itopride on gastric accommodation, gastric emptying, capacity of tolerating nutrient liquid and symptoms of FD. We recruited a total of 31 patients having FD on the basis of ROME III criteria. After randomization, itopride was received by 15 patients while 16 patients received placebo. Gastric accommodation was determined using Gastric Scintigraphy. 13 C labeled octanoic breadth test was performed to assess gastric emptying. Capacity of tolerating nutrient liquid drink was checked using satiety drinking capacity test. The intervention group comprised of 150 mg itopride. Patients in both arms were followed for 4 wk. Mean age of the recruited participant 33 years (SD = 7.6) and most of the recruited individuals, i.e ., 21 (67.7%) were males. We found that there was no effect of itopride on gastric accommodation as measured at different in volumes in the itopride and control group with the empty stomach ( P = 0.14), at 20 min ( P = 0.38), 30 min ( P = 0.30), 40 min ( P = 0.43), 50 min ( P = 0.50), 60 min ( P = 0.81), 90 min ( P = 0.25) and 120 min ( P = 0.67). Gastric emptying done on a sub sample ( n = 11) showed no significant difference ( P = 0.58) between itopride and placebo group. There was no significant improvement in the capacity to tolerate liquid in the itopride group as compared to placebo ( P = 0.51). Similarly there was no significant improvement of symptoms as assessed through a composite symptom score ( P = 0.74). The change in QT interval in itopride group was not significantly different from placebo (0.10). Our study found no effect of itopride on gastric accommodation, gastric emptying and maximum tolerated volume in patients with FD.

One-week acid suppression trial in uninvestigated dyspepsia patients with epigastric pain or burning to predict response to 8 weeks' treatment with esomeprazole

DEFF Research Database (Denmark)

van Zanten, S V; Flook, N; Talley, N J

2007-01-01

BACKGROUND: While empiric acid-suppressive therapy for uninvestigated dyspepsia patients with symptoms of epigastric pain or burning is standard practice, it is unknown whether an early response to therapy predicts outcome. AIM: To evaluate whether a 1-w acid suppression trial is effective...... for predicting 8-w response in such patients. METHODS: Helicobacter pylori-negative patients (aged 18-50 years) in primary care with uninvestigated epigastric pain or burning were randomized to esomeprazole 40 mg q.d.s. or b.d. for 1w, followed by esomeprazole 40 mg q.d.s. or placebo for 7w. Each day, patients......, respectively, and 47% (339 of 716) and 34% (124 of 368), respectively, at 8w (both P treatment were 58% and 70%, respectively, at 8w. CONCLUSION: A 1-w acid suppression trial is of limited clinical value for predicting 8-w response...

Serotonin transporter gene polymorphism may be associated with functional dyspepsia in a Japanese population

Directory of Open Access Journals (Sweden)

Matsumoto Takayuki

2011-06-01

Full Text Available Abstract Background Although familial clustering of functional dyspepsia (FD has been reported, the role of genetics in the susceptibility to FD is still not well understood. In the present study, the association between serotonin transporter (SERT gene (SLC6A4 polymorphism and FD was explored. Methods Subjects were divided into either a postprandial distress syndrome (PDS group or an epigastric pain syndrome (EPS group according to the Rome III criteria. The healthy controls were those who had visited a hospital for an annual health check-up. The presence of the SLC6A4 promoter polymorphism, 5-hydroxytryptamin transporter gene linked polymorphic region (5-HTTLPR, was then evaluated, and logistic regression analysis was used to test all variables. Results The 5-HTTLPR genotype distribution was 448 SS, 174 SL, and 24 LL in controls and 30 SS, 20 SL, and 3 LL in FD subjects. No significant correlation was found between the 5-HTTLPR genotype and FD. When the genotypes and subtypes of FD were exploratory evaluated, the SL genotype was significantly associated with PDS [odds ratio (OR = 2.24, 95% confidence interval (CI; 1.16-4.32, P = 0.034 after Bonferroni correction] compared to the SS genotype adjusted for sex and age. Comparison of the SS genotype with the SL/LL genotype also showed a significant association of genotype with PDS (OR = 2.32, 95% CI; 1.23-4.37, P = 0.009. Conclusion The present results suggest that 5-HTTLPR L allele may influence the susceptibility to PDS.

Effect of Apium graveolens and Trachyspermum copticom on clinical symptoms of patients with functional dyspepsia

Directory of Open Access Journals (Sweden)

Maryam Azimi

2017-10-01

Full Text Available Objectives:This study aimed at investigating the effect of Iranian traditional remedy prepared from Apium graveolens and Trachyspermum copticom (AT on the severity and frequency of symptoms in patients with functional dyspepsia (FD. Material and Methods:In total, 150 FD patients were included in this randomized double-blind trial, based on the ROME III diagnostic criteria, and they were divided into three intervention groups namely, AT, Placebo and omeprazole. Then, severity and frequency of symptoms during this eight-week trial were measured. Obtained information was analyzed using Chi-square test and repeated measures test. Result:In general, the severity and frequency of symptoms after the 4th week significantly decreased in the AT group as compared to the omeprazole and placebo groups, and continued to reduce by the end of the eighth week. General reduction of symptom severity and frequency in the omeprazole group was significantly different from the placebo group by the end of the 4th and 8th weeks. With respect to each individual symptom, AT markedly improved symptoms, such as burning, pain, early satiation, fullness, bloating, belching and nausea, as compared to placebo-treated group. Moreover, AT significantly improved symptoms, like vomiting, and nausea, except for pain, as compared to omeprazole-treated subjects. Conclusion:According to the results, AT, as Iranian traditional remedy, was more effective than omeprazole and placebo in reducing the symptoms in FD patients.

[Study on effects of low frequency pulse plus auricular point magnetic therapy on electrogastrogram and clinical therapeutic effect in the patient of functional dyspepsia].

Science.gov (United States)

Wang, Yan-Gang; Yao, Shu-Kun

2007-04-01

To compare therapeutic effects of low frequency pulse plus auricular point magnetic therapy and prepulsid on functional dyspepsia (FD). Fifty cases of FD were randomly divided into a treatment group and a control group. The treatment group were treated with low frequency pulse stimulation on Zhongwan (CV 12), Weishu (BL 21), Neiguan (PC 6), Zusanli (ST 36), with Fenglong (ST 40) and Sanyinjiao (SP 6) selected according to syndrome differentiation, once a day, 30 min each session. The control group were treated with oral administration of prepulsid. Five days constituted one course. The scores of symptoms and parameters of electrogastrogram (EGG) before and after treatment and the therapeutic effect were investigated. After treatment, the symptom scores significantly decreased (P magnetic therapy can significantly improve the clinical symptoms and gastric activities in the patient of FD, with a better therapeutic effect than prepulsid.

Masaje Tuina en el tratamiento de la dispepsia funcional en los niños Tuina massage in the treatment of functional dyspepsia in children

Directory of Open Access Journals (Sweden)

Lesbia Infante Tamayo

2008-03-01

the Chinese traditional medicine. The aim of this paper was to show the efficacy of the Tuina massage in the treatment of functional dyspepsia in children. METHODS. A controlled clinical trial was conducted among patients with functional dyspepsia that met the previously established inclusion criteria. The sample consisted of 100 patients divided into 2 groups: group A with patients that were applied massage, and group B that was made up of patients that received conventional treatment. The technique used was push and massage (tonification and dispersion. The stimulated zones were Ban Men, Zhong Wan (Vc12, ZusanLi (E36, San Guan, Liu Fu. The conventional treatment consisted in the administration of metoclopramide at doses of 0.1 mg/kg every 8 hours by intramuscular route. Once the emetic picture was controlled, the same drug was orally administered and with the same frequency. Both groups were evaluated at 12, 24, 48, 72 h of the initial treatment. RESULTS. The response to the conventional treatment was higher in the study group (48; 96 % compared with the control group (46; 92 %, but the differences were not statistically significant. The complications found were extrapyramidal reactions and skin irritation, but the differences between the 2 groups were not marked either. The length of hospital stay of most of the patients was between 25 and 48 hours. CONCLUSIONS. It was concluded that the Tuina massage is as efficient as the conventional treatment for controlling functional dyspepsia in children.

[Electrogastrography and gastric emptying in non organic dyspepsia].

Science.gov (United States)

López Gastón, A R; López De Luise, G A; Sarmiento, A

1996-01-01

normal gastric emptying. Needle recording increased about 200-300% the signal power. It would be the better choice in cases of hairy abdominal skin. a) More than 76% of patients with N.O.D. had abnormal recording of E.C.A. beyond these observed in controls; b) tachygastria was the more frequent abnormality observed; c) the more severe clinical cases were associated with bradygastria; d) No association between symptoms and abnormal gastric emptying was found; e) E.G.G. abnormalities were seen in 96% of patients with abnormal gastric emptying, Vs 50% in normal gastric emptying; f) Needle electrodes let a better recording of E.G.G. signal; g) No association was found between abnormalities in gastric emptying and/or E.G.G., and clinical subtypes of Dyspepsia.

A multicenter randomized trial comparing rabeprazole and itopride in patients with functional dyspepsia in Japan: the NAGOYA study.

Science.gov (United States)

Kamiya, Takeshi; Shikano, Michiko; Kubota, Eiji; Mizoshita, Tsutomu; Wada, Tsuneya; Tanida, Satoshi; Kataoka, Hiromi; Adachi, Hiroshi; Hirako, Makoto; Okuda, Noriaki; Joh, Takashi

2017-03-01

The aims of this study were to compare the therapeutic effects of a proton pump inhibitor (PPI), rabeprazole (RPZ), and a prokinetic agent, itopride (ITO), and to investigate the role of PPI in the treatment strategy for Japanese functional dyspepsia (FD) patients. We randomly assigned 134 patients diagnosed by Rome III criteria to 4 weeks treatment with RPZ 10 mg/day ( n  = 69) or ITO 150 mg/day ( n  = 65). Dyspeptic symptoms were evaluated using FD scores at baseline and after 1, 2 and 4 weeks of treatment. We also divided subjects into predominantly epigastric pain syndrome (EPS) or postprandial distress syndrome (PDS), and evaluated the efficacy of RPZ and ITO respectively. RPZ showed a significant decrease in the Rate of Change (RC) in FD score within 1 week, which was maintained until after 4 weeks, with RPZ a significant effect compared with ITO at all evaluation points. In addition, RPZ showed a significant decrease in FD score in subjects with both EPS and PDS, whereas a significant decrease in the RC with ITO was only shown in those with predominant PDS. Acid-suppressive therapy with RPZ is useful for PDS as well EPS in Japanese FD patients (UMIN Clinical Trials Registry number: UMIN 000013962).

Comparison of Sequential Regimen and Standard Therapy for Helicobacter pylori Eradication in Patients with Dyspepsia

Directory of Open Access Journals (Sweden)

Gh. Roshanaei

2013-10-01

Full Text Available Introduction & Objective: Some studies have reported successful eradication rates using se-quential therapy but more recent studies performed in Asia did not find a similar benefit. Due to inconsistencies in the comparison of standard triple drugs therapy and sequential regimen, in the previous researches we decided to compare these treatments in Persian patients. Materials & Methods: This study is a randomized clinical trial, performed in one hundred and forty patients suffering from dyspepsia with indication for H. pylori eradication between No-vember 2010 and March 2012.Patients were randomized in two equal groups. The patients in the first group (standard were treated by omeprazole capsule 20 mg BID, amoxicillin cap-sule 1 gr BID, clarithromycin tablet 500mg BID for 14 days; while the patients in the second group (sequential were treated by omeprazole capsule 20 mg for 10 days, amoxicillin cap-sule 1 gr BID for 5 days, then clarithromycin tablet 500 mg and tinidazole tablet 500 mg BID for other 5 days. 4-6 weeks after the treatment, we compared the eradication of H.pylori be-tween the two groups by urease breathe test with C14. Results: H. pylori infection was successfully cured in 57/70 (81.43% with a 10-day sequen-tial therapy, in 60/70 (85.75% with the standard fourteen-day triple therapy, respectively. Conclusion: We detected no significant differences between the 10-day sequential eradication therapy for H. pylori and 14-day standard triple treatment among the patients. (Sci J Hamadan Univ Med Sci 2013; 20 (3:184-193

Overdiagnosis of gastro-esophageal reflux disease and underdiagnosis of functional dyspepsia in a USA community.

Science.gov (United States)

Pleyer, C; Bittner, H; Locke, G R; Choung, R S; Zinsmeister, A R; Schleck, C D; Herrick, L M; Talley, N J

2014-08-01

There is symptom overlap between gastro-esophageal reflux disease (GERD) and functional dyspepsia (FD). We aimed to test the hypothesis that FD cases are now more likely mislabeled as GERD. In subjects from Olmsted County, MN seen at Mayo Clinic: (i) Investigation of GERD and FD diagnosis rates between 1985 and 2009. (ii) Assessment of survey-based upper gastrointestinal symptoms between 1988 and 2009. (iii) Analysis of patients reporting GERD and/or FD symptoms and subsequently receiving a consistent diagnosis of GERD and/or FD during a medical encounter. (iv) Assess the association between PPI use and GERD and/or FD symptoms and between actual diagnoses received. (i) Yearly GERD diagnosis rates rose between 1985 and 2009 (325-1866 per 100 000). FD diagnosis rates rose from 45 in 1985, to 964 in 1999 but decreased to 452 per 100 000 in 2009. (ii) Reported GERD symptoms did not significantly change between three survey waves in the years 1988-2009 (p = 0.052), whereas FD symptoms slightly increased (p = 0.01). (iii) 62.9% of subjects reporting GERD symptoms received a GERD diagnosis, however only 12.5% of subjects reporting FD symptoms received a FD diagnosis. (iv) PPI use was associated with documented GERD diagnosis (p < 0.001), however there was no significant association between GERD symptoms and PPI use (p = 0.078). We have found evidence supporting a systematic bias away from diagnosing FD, favoring a GERD diagnosis. © 2014 John Wiley & Sons Ltd.

Depressive mood and quality of life in functional gastrointestinal disorders: differences between functional dyspepsia, irritable bowel syndrome and overlap syndrome.

Science.gov (United States)

Lee, Heon-Jeong; Lee, Sun-Young; Kim, Jeong Hwan; Sung, In-Kyung; Park, Hyung Seok; Jin, Choon Jo; Kang, Seung-Gul; Yoon, Hiejin; Chun, Hoon Jai

2010-01-01

To investigate the differences in depressive mood and quality of life in patients with between functional dyspepsia (FD), irritable bowel syndrome (IBS), and FD-IBS overlap as diagnosed based on Rome III criteria. The subjects completed a questionnaire based on Rome III criteria, the Beck Depressive Inventory (BDI) including Cognitive Depression Index (CDI) for depressive mood evaluation and the 36-item Short Form general health survey (SF-36) for quality of life assessment. Upper gastrointestinal endoscopy and colonoscopy were performed to exclude organic disease. Of 279 subjects, 70 and 124 subjects were diagnosed as FD and IBS, respectively. FD-IBS overlap patients (n=42) and FD alone patients (n=28) showed higher BDI scores than normal subjects (n=127) (PIBS alone patients (n=82) did not show difference (P=.17). All the SF-36 subscores of the FD-IBS overlap patients were significantly lower than normal subjects (Pmood was significantly related to FD and FD-IBS overlap but not to IBS based on Rome III criteria. FD-IBS overlap patients have worse quality of life than FD-alone and IBS-alone patients. Copyright © 2010 Elsevier Inc. All rights reserved.

Pimpinella anisum in the treatment of functional dyspepsia: A double-blind, randomized clinical trial

Directory of Open Access Journals (Sweden)

S Ashraffodin Ghoshegir

2015-01-01

Full Text Available Background: We aimed to evaluate the effects of Pimpinella anisum (anise from Apiaceae family on relieving the symptoms of postprandial distress syndrome (PDS in this double-blind randomized clinical trial. Materials and Methods: Totally, 107 patients attending the gastroenterology clinic, aged 18-65 years, diagnosed with PDS according to ROME III criteria and signed a written consent form were enrolled. They were randomized to receive either anise or placebo, blindly, for 4 weeks. Anise group included 47 patients and received anise powders, 3 g after each meal (3 times/day. Control group involved 60 patients and received placebo powders (corn starch, 3 gafter each meal (3 times/day. The severity of Functional dyspepsia (FD symptoms was assessed by FD severity scale. Assessments were done at baseline and by the end of weeks 2, 4 and 12. Mean scores of severity of FD symptoms and the frequency distribution of patients across the study period were compared. Results: The age, sex, body mass index, smoking history, and coffee drinking pattern of the intervention and control groups were not significantly different. Mean (standard deviation total scores of FD severity scale before intervention in the anise and control groups were 10.6 (4.1 and 10.96 (4.1, respectively (P = 0.6. They were 7.04 (4.1 and 12.30 (4.3 by week 2, respectively (P = 0.0001, 2.44 (4.2 and 13.05 (5.2 by week 4, respectively (P = 0.0001, and 1.08 (3.8 and 13.30 (6.2 by week 12, respectively (P = 0.0001. Conclusion: This study showed the effectiveness of anise in relieving the symptoms of postpartum depression. The findings were consistent across the study period at weeks 2, 4 and 12.

Postprandial symptoms in dysmotility-like functional dyspepsia are not related to disturbances of gastric myoelectrical activity

Directory of Open Access Journals (Sweden)

A.S. Oba-Kuniyoshi

2004-01-01

Full Text Available Gastric dysrhythmias, such as tachy- or bradygastria, have been reported in patients with functional dyspepsia (FD, but their role in symptom production is uncertain. It is also not known whether gastric dysrhythmias in these patients can be elicited by physiological gastric distension with a meal. We investigated the relationships between symptoms after ingestion of different volumes of water following a test meal and gastric dysrhythmias in FD patients. Fourteen patients with dysmotility-like FD and 13 healthy volunteers underwent paired electrogastrography (EGG studies. Fasted subjects ingested 150 ml of yoghurt with either 150 ml (low volume or 300 ml (high volume water in random order. Fasting and fed EGGs with monitoring of symptoms were performed in both studies. Ten FD patients (71.4% reported upper abdominal discomfort and bloating after the low volume meal, but only one (7.1% presented an abnormal EGG (dominant frequency in the 2-4-cpm range: 58%. Following the high volume meal, 7 patients (50% had symptoms, but none had EGG abnormalities. No significant differences were found between FD patients and controls for any of the EGG variables, in any test. In FD patients with postprandial symptoms, the percentage of the EGG dominant frequency in the normal range (median, 84.6%; range, 76.0-100.0% was similar (P > 0.20 to that in those without symptoms (88.5%; 75.0-100.0%. We conclude that disturbances of gastric myoelectrical activity are unlikely to play a role in the origin of postprandial upper abdominal discomfort and bloating in dysmotility-like FD.

Cultural characteristics and antibiotic susceptibility pattern of Helicobacter Pylori isolated from dyspepsia patients

Directory of Open Access Journals (Sweden)

Bolanle A. Adeniyi

2012-11-01

Full Text Available Helicobacter pylori consist in a helical shaped Gram-negative bacterium, approximately 3 micrometers long with a diameter of approximately 0.5 micrometers. It has 4-6 flagella. It is microaerophilic and tests positive for oxidase, catalase and urease. With its flagella, the bacterium moves through the stomach lumen and drills into the mucus gel layer of the stomach. In humans, H. pylori have been associated with peptic ulcers, chronic gastritis, duodenitis and stomach cancer. It is widely believed that in the absence of treatment, H. pylori infection, once established in its gastric niche, persists for life. The aim of this research is to study the cultural characteristics and antibiotic susceptibility pattern of H. pylori strains isolated from southwest Nigeria. The cultural characteristics and antibiotic susceptibility pattern of Helicobacter pylori strains isolated from gastric mucosal antral biopsy specimens collected from 43 of 52 dyspepsia patients in the University College Hospital Ibadan, Oyo State, Nigeria, were determined using standard microbiological methods for Helicobacter pylori isolation. The 43 isolates were subjected to 23 different antibiotics and each of the antibiotics demonstrated a variable degree of activity against the isolates. Among the antibiotics to which the organism was most susceptible are: ofloxacin (30 μg 100% activity, ciprofloxacin (5 μg 97.67% activity, gentamicin (120 μg 95.35 activity, amikacin (30 μg, kanamycin (30 μg and chloramphenicol (30 μg each 90.70% activity, clarithromycin (15 μg 93.02, while the less active antibiotics are: augmentin (30 μg 23.26% active, amoxycillin (25 μg and metronidazole (50 μg each 27.91% active and clindamycin (2 mg 30.23% active. From the result of the antibiotic susceptibility pattern of the strains of the organism, 95.35% of the total isolates are multi drug resistant. Resistance was developed to, among others, augmentin (30 μg, amoxycillin (25 �

Meal frequency in relation to prevalence of functional dyspepsia among Iranian adults.

Science.gov (United States)

Hassanzadeh, Shakiba; Saneei, Parvane; Keshteli, Ammar Hassanzadeh; Daghaghzadeh, Hamed; Esmaillzadeh, Ahmad; Adibi, Peyman

2016-02-01

Limited data are available linking diet-related practices to functional dyspepsia (FD). The aim of this study was to investigate the association between meal frequency and prevalence of FD among a large sample of Iranian adults. In this cross-sectional study, 4763 individuals from the general adult population in Isfahan were asked to report on how many main meals and snacks they consumed each day. Frequency of total meals was defined by summing up the frequency of main meals and snacks. Participants were grouped into four categories: less than three, three to five, six to seven, and eight or more meals daily. FD symptoms were assessed using a validated Persian version of the Rome III questionnaire, and FD was defined as bothersome postprandial fullness, early satiation, and/or epigastric pain or epigastric burning. Compared with individuals who had one main meal per day, those who consumed three main meals daily had a lower chance for early satiation (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.21-0.90). Findings from the analysis on snack frequency revealed that, compared with those who never consumed snacks, individuals who consumed three to five snacks daily were 39% less likely to have FD (OR, 0.61; 95% CI, 0.40-0.92), had 42% lower odds of postprandial fullness (OR, 0.58; 95% CI, 0.34-0.98), and were at 43% lower risk for epigastric pain (OR, 0.57; 95% CI, 0.34-0.97). After adjustment for potential confounders, including diet-related behaviors, individuals who consumed six to seven total meals and snacks per day had lower odds of FD (OR, 0.51; 95% CI, 0.31-0.82) compared with those with who ate fewer than three meals and snacks daily. A similar inverse association was seen between meal and snack frequency and early satiation (OR, 0.32; 95% CI, 0.16-0.63) and postprandial fullness (OR, 0.54; 95% CI, 0.29-0.98). Results from the present study demonstrated an inverse association between meal and snack frequency and prevalence of FD and its components

Could gastric histology be a useful marker for making decision on Helicobacter pylori eradication therapy in patients with dyspepsia? É a histologia gástrica um marcador útil na decisão de erradicar o Helicobacter pylori nos pacientes com dispepsia?

Directory of Open Access Journals (Sweden)

Severino Marcos Borba de Arruda

2009-09-01

Full Text Available CONTEXT: It still remains an open debate whether Helicobacter pylori eradication is beneficial or not for the improvement of symptoms in functional dyspepsia. Differences in geographic distribution, the worldwide H. pylori genetic variability and the fact that the outcome of infection is strongly related to the virulence of the infecting strain are factors that might be driving ongoing controversies. OBJECTIVE: To study the correlation between gastric histology and H. pylori serology status in patients with dyspepsia. METHODS: This is a cross-sectional study where 40 consecutive dyspeptic patients (28 women and 12 men, mean age 48.5 years with endoscopically normal stomachs were selected from the endoscopy unit at a university hospital in Recife, PE, Northeast of Brazil, between March 1998 and July 1999. Patients underwent gastric mucosal biopsy and serological tests (anti-Hp and anti-CagA antibodies. Gastric biopsies were examined using H-E and Giemsa stains and gastritis was classified and graded (mild, moderate or severe according to "the updated Sydney System - Houston, 1994". RESULTS: Among 40 patients with dyspepsia the gastric histology revealed that about ¼ had moderate (25% or severe (2.5% gastritis. This subgroup of patients also had a greater positive frequency of anti-Hp (100% vs 41%; P = 0.0005 and anti-CagA (91% vs 58%; P = 0.09 antibodies when compared with those with normal histology (27.5% or mild gastritis (45%. CONCLUSION: Since upper gastrointestinal endoscopy is part of the functional dyspepsia investigation and serology for anti-CagA antibody is not available in daily clinical practice, by biopsying gastric mucosa we would only be able to selectively apply H. pylori eradication therapy for those with histology that best correlate with virulent infecting strains (moderate or severe gastritis - around ¼ of our study patients with dyspepsia.CONTEXTO: O benefício da terapia de erradicação do H. pylori como parte do

Impact of coexisting irritable bowel syndrome and non-erosive reflux disease on postprandial abdominal fullness and sleep disorders in functional dyspepsia.

Science.gov (United States)

Futagami, Seiji; Yamawaki, Hiroshi; Shimpuku, Mayumi; Izumi, Nikki; Wakabayashi, Taiga; Kodaka, Yasuhiro; Nagoya, Hiroyuki; Shindo, Tomotaka; Kawagoe, Tetsuro; Sakamoto, Choitsu

2013-01-01

The association between clinical symptoms and sleep disorders in functional dyspepsia (FD)-overlap syndrome has not been studied in detail. The subjects were 139 patients with FD, 14 with irritable bowel syndrome (IBS), 12 with nonerosive reflux disease (NERD), and 41 healthy volunteers. Gastric motility was evaluated with the (13)C-acetate breath test. We used Rome III criteria to evaluate upper abdominal symptoms, and Self-Rating Questionnaire for Depression (SRQ-D) scores to determine depression status. Sleep disorders were evaluated with Pittsburgh Sleep Quality Index (PSQI) scores. There were no significant differences in age, body-mass index, alcohol intake, and smoking rate between patients with FD alone and those with FD-overlap syndrome. The postprandial abdominal fullness score in patients with FD-NERD-IBS was significantly greater than that in patients with FD-NERD overlap syndrome (pSleep Quality Index score in subjects with FD-NERD-IBS overlap syndrome was significantly greater than that in subjects with FD alone. Symptom scores, such as those for postprandial abdominal fullness, heartburn, and the feeling of hunger, in patients with FD-overlap syndromes are significantly greater than those in patients with FD alone. Further studies are necessary to clarify whether various symptoms are related to sleep disorders in patients with FD-NERD-IBS overlap syndrome.

Gender Difference of Gastric Emptying in Healthy Volunteers and Patients with Functional Dyspepsia.

Science.gov (United States)

Mori, Hideki; Suzuki, Hidekazu; Matsuzaki, Juntaro; Taniguchi, Kanami; Shimizu, Toshiyuki; Yamane, Tsuyoshi; Masaoka, Tatsuhiro; Kanai, Takanori

2017-01-01

Delayed gastric emptying is one of the reasons why functional dyspepsia (FD) occurs. The 13C-acetate breath test is widely used to evaluate gastric emptying. Nevertheless, the standard value of 13C-acetate breath test has not taken into account the gender difference of gastric emptying among healthy individuals. The main aim of this study was to readjust the standard value of 13C-acetate breath test in the light of gender differences. In addition, we clarified the prevalence and clinical characteristics of delayed gastric emptying in patients with FD using the modified standard values of 13C-acetate breath test. Fifty-two healthy individuals and 126 patients with patients with FD were enrolled. Gastric emptying was evaluated by the 13C-acetate breath test. The cut-off points of Tmax for the diagnosis of delayed gastric emptying were determined on the basis of results from healthy individuals making a distinction of genders. Gastroesophageal reflux symptoms, dyspeptic symptoms, scores of anxiety and depression, age, body mass index (BMI), smoking and alcohol consumption were compared between the delayed gastric emptying group and the non-delayed gastric emptying group. Since gastric emptying was delayed in healthy women compared with that in healthy men (Tmax, 53.6 ± 19.3 vs. 42.7 ± 16.9 min, p = 0.04), we set the cut-off points of Tmax at 60 min in men and at 75 min in women. In patients with FD, the prevalence of delayed gastric emptying was not different between men and women with the modified standard values of 13C-acetate breath test. (31.0 vs. 27.4%, p = 0.68). BMI was lower in the delayed gastric emptying group than in the non-delayed group among the male patients. Reflux symptoms were more severe in delayed gastric emptying group than in the non-delayed group among the female patients. The standard values of 13C-acetate breath test should be modified bearing the gender difference in mind. It provides us more appropriate information to understand the

Evidence that independent gut-to-brain and brain-to-gut pathways operate in the irritable bowel syndrome and functional dyspepsia: a 1-year population-based prospective study.

Science.gov (United States)

Koloski, N A; Jones, M; Talley, N J

2016-09-01

Traditionally, functional gastrointestinal disorders (FGIDs) are conceptualised as originating in the brain via stress pathways (brain-to-gut). It is uncertain how many with irritable bowel syndrome (IBS) and functional dyspepsia (FD) have a gut origin of symptoms (gut-to-brain pathway). To determine if there is a distinct brain-to-gut FGID (where psychological symptoms begin first) and separately a distinct gut-to-brain FGID (where gut symptoms start first). A prospective random population sample from Newcastle, Australia who responded to a validated survey in 2012 and completed a 1-year follow-up survey (n = 1900). The surveys contained questions on Rome III IBS and FD and the Hospital Anxiety and Depression Scale. We found that higher levels of anxiety and depression at baseline were significant predictors of developing IBS (OR = 1.31; 95% CI 1.06-1.61, P = 0.01; OR = 1.54; 95% CI 1.29-1.83, P intestinal features in many cases. © 2016 John Wiley & Sons Ltd.

Is Endoscopy Really Necessary in My Case? A Four Year Retrospective Study.

Science.gov (United States)

Dinesh, H N; Kumar, Cd Jagadish; Sanjay, H M; Sachin, V; Basavaraju

2015-07-01

About 40% of the general population report dyspepsia at some time in their life making it a fairly common disease. Uncomplicated dyspepsia refers to patients whose dyspepsia is not accompanied by alarm features or associated with NSAIDS usage. To assess the need for UGI Endoscopy and find out the patterns of different endoscopic presentations in patients presenting with uncomplicated dyspepsia. Our study conducted in KR Hospital, Mysore, Department of General Surgery is a retrospective endoscopic study of 1450 patients with uncomplicated dysepsia. A significant 64% of the patients presenting with uncomplicated dyspepsia were found to have findings on endoscopy. The most common age range for positive endoscopic findings was 40-50 years in our hospital. Malignancy was diagnosed in 2.5% patients. We recommend upper GI endoscopy in patients presenting with uncomplicated dyspepsia for patients above 40 years of age in our hospital.

Itopride in the treatment of functional dyspepsia in Chinese patients: a prospective, multicentre, post-marketing observational study.

Science.gov (United States)

Sun, Jing; Yuan, Yao-Zong; Holtmann, Gerald

2011-12-01

Prokinetic agents are commonly used in the symptomatic treatment of functional dyspepsia (FD). Safety or efficacy issues associated with the use of available prokinetics, such as metoclopramide, domperidone, cisapride and mosapride, mean there is a need for an effective and well tolerated prokinetic agent. Itopride is a novel prokinetic agent with a dual mode of action, good safety profile and documented efficacy in placebo-controlled trials. The objective of this study was to assess the effectiveness and safety of itopride in the management of FD. This was a prospective, multicentre, post-marketing observational study carried out in private outpatient clinics throughout China. The study included patients with symptomatic FD aged ≥18 years. Patients were prescribed itopride 50 mg three times daily before meals for 4 weeks, after which there was a 2-week follow-up period during which they did not take itopride. Effectiveness and tolerability data obtained from patients who completed 4 weeks of therapy were analysed. The treatment response rate after 4 weeks was measured by patient global assessment; scores at the end of treatment were compared with baseline scores. Response rate based on symptom scoring was also measured after 4 weeks, with an effective treatment being defined as a symptom improvement of ≥50%. In total, 587 patients with FD were enrolled. The mean ± SD difference in the total symptom score before and after the 4-week treatment period was -5.62 ± 3.27, corresponding to a 69.23 ± 26.53% reduction from baseline (p Itopride was an effective and well tolerated drug in the management of FD in this patient population.

Gastric Activity and Gut Peptides in Patients With Functional Dyspepsia: Postprandial Distress Syndrome Versus Epigastric Pain Syndrome.

Science.gov (United States)

Russo, Francesco; Chimienti, Guglielmina; Clemente, Caterina; Riezzo, Giuseppe; D'Attoma, Benedetta; Martulli, Manuela

2017-02-01

The goals of the study were to investigate in both postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS) the gastric electrical activity and the gastric emptying (GE) time together with the circulating concentrations of motilin, somatostatin, corticotrophin-releasing factor, and neurotensin, and to establish whether the genetic variability in the neurotensin system genes differs between these 2 categories of functional dyspepsia (FD). The current FD classification is based on symptoms and it has been proven not to be completely satisfying because of a high degree of symptom overlap between subgroups. Gastric electrical activity was evaluated by cutaneous electrogastrography: the GE time by C-octanoic acid breast test. Circulating concentrations of gut peptides were measured by a radioimmunoassay. NTS 479 A/G and NTSR1 rs6090453 SNPs were evaluated by PCR and endonuclease digestion. Fifty-four FD patients (50 female/4 male) were studied. Using a symptom questionnaire, 42 patients were classified as PDS and 12 as EPS, although an overlap between the symptom profiles of the 2 subgroups was recorded. The electrogastrographic parameters (the postprandial instability coefficient of dominant frequency, the dominant power, and the power ratio) were significantly different between the subgroups, whereas the GE time did not differ significantly. In addition, EPS was characterized by a different gut peptide profile compared with PDS. Finally, neurotensin polymorphism was shown to be associated with neurotensin levels. This evidence deserves further studies in consideration of an analgesic role of neurotensin. Analysis of gut peptide profiles could represent an interesting tool to enhance FD diagnosis and overcome limitations due to a distinction based solely on symptoms.

A prospective study on symptom generation according to spicy food intake and TRPV1 genotypes in functional dyspepsia patients.

Science.gov (United States)

Lee, S-Y; Masaoka, T; Han, H S; Matsuzaki, J; Hong, M J; Fukuhara, S; Choi, H S; Suzuki, H

2016-09-01

Capsaicin is an ingredient of red peppers that binds to transient receptor potential vanilloid subtype 1 (TRPV1), and Koreans eat more capsaicin-rich food than do Japanese. This study aimed to compare symptom generation according to TRPV1 genotypes and the intake of spicy foods. Consecutive functional dyspepsia (FD) patients who were evaluated at Konkuk University Medical Centre (Korea) and Keio University Hospital (Japan) were included. Questionnaires on spicy food intake, patient assessment of gastrointestinal symptoms (PAGI-SYM), patient assessment of quality of life, and hospital anxiety and depression scale were provided. Blood was sampled for the detection of TRPV1 polymorphisms, and upper gastrointestinal endoscopy was performed with biopsies. Of 121 included subjects, 35 and 28 carried the TRPV1 CC and GG genotypes, respectively, with the prevalence rates not differing between Japan and Korea. The prevalence of FD subtypes did not differ with the spicy food intake, TRPV1 genotypes, or Helicobacter pylori infection. Neither TRPV1 polymorphisms nor H. pylori infections were related to scores on the PAGI-SYM questionnaires, but spicy food intake was positively correlated with the scores for stomach fullness (p = 0.001) and retching (p = 0.001). Using the linear regression analysis, stomach fullness was associated with spicy food intake (p = 0.007), whereas retching was related to younger age (p foods, younger age and female gender, regardless of TRPV1 genotypes and the H. pylori infection status. Capsaicin-rich foods may induce stomach fullness. © 2016 John Wiley & Sons Ltd.

Acupuncture and related therapies used as add-on or alternative to prokinetics for functional dyspepsia: overview of systematic reviews and network meta-analysis.

Science.gov (United States)

Ho, Robin S T; Chung, Vincent C H; Wong, Charlene H L; Wu, Justin C Y; Wong, Samuel Y S; Wu, Irene X Y

2017-09-04

Prokinetics for functional dyspepsia (FD) have relatively higher number needed to treat values. Acupuncture and related therapies could be used as add-on or alternative. An overview of systematic reviews (SRs) and network meta-analyses (NMA) were performed to evaluate the comparative effectiveness of different acupuncture and related therapies. We conducted a comprehensive literature search for SRs of randomized controlled trials (RCTs) in eight international and Chinese databases. Data from eligible RCTs were extracted for random effect pairwise meta-analyses. NMA was used to explore the most effective treatment among acupuncture and related therapies used alone or as add-on to prokinetics, compared to prokinetics alone. From five SRs, 22 RCTs assessing various acupuncture and related therapies were included. No serious adverse events were reported. Two pairwise meta-analyses showed manual acupuncture has marginally stronger effect in alleviating global FD symptoms, compared to domperidone or itopride. Results from NMA showed combination of manual acupuncture and clebopride has the highest probability in alleviating patient reported global FD symptom. Combination of manual acupuncture and clebopride has the highest probability of being the most effective treatment for FD symptoms. Patients who are contraindicated for prokinetics may use manual acupuncture or moxibustion as alternative. Future confirmatory comparative effectiveness trials should compare clebopride add-on manual acupuncture with domperidone add-on manual acupuncture and moxibustion.

Irritable Bowel Syndrome in a Population of African Patients

Directory of Open Access Journals (Sweden)

Sylvester Chuks Nwokediuko

2012-01-01

Full Text Available Background. Functional dyspepsia is the prototype functional gastrointestinal disorder. This study was designed to determine its prevalence, subtypes, and risk factors associated with the subtypes. Method. Patients with upper gastrointestinal symptoms who presented for endoscopy were administered a questionnaire containing the functional dyspepsia and irritable bowel syndrome modules of the Rome III diagnostic criteria. Results. Of 192 patients who had functional dyspepsia, epigastric pain syndrome, postprandial distress syndrome, and combination of the two subtypes accounted for 79.2%, 62.5%, and 50%, respectively. Multivariate analysis of the risk factors showed that independent predictors of postprandial distress syndrome were alcohol and irritable bowel syndrome while irritable bowel syndrome was independent predictor of epigastric pain syndrome. Alcohol, smoking, and use of nonsteroidal anti-inflammatory drugs were independent predictors of cooccurrence of postprandial distress syndrome and epigastric pain syndrome. Conclusion. Functional dyspepsia accounts for 62.5% of dyspepsia in a population of black African patients. Regarding symptomatology, epigastric pain syndrome, postprandial distress syndrome, and combination of the two subtypes account for 79.2%, 62.5%, and 50%, respectively. Risk factors for functional dyspepsia are irritable bowel syndrome, alcohol, smoking, and use of nonsteroidal anti-inflammatory drugs.

Eradication of Helicobacter pylori infection in patients with duodenal ulcer and non-ulcer dyspepsia and analysis of one-year reinfection rates

Directory of Open Access Journals (Sweden)

Della Libera E.

2001-01-01

Full Text Available Helicobacter pylori (HP infection is endemic worldwide. The proposed treatment is expensive and there are few reports regarding reinfection rates in Brazil. The aim of this study was to compare the eradication rates obtained with two therapeutic options and to evaluate reinfection one year after treatment. This was a prospective randomized trial with 55 patients. Thirty-nine patients had active duodenal ulcer (DU and 16 non-ulcer dyspepsia (NUD, and all tested positive for HP. Diagnosis was based on at least two positive tests: ultrarapid urease test, histology and/or culture. Patients were randomized to two groups: group OMC treated with 40 mg omeprazole (once a day, 500 mg metronidazole and 250 mg clarithromycin (twice daily for 7 days, or group NA treated with 300 mg nizatidine (once a day and 1000 mg amoxicillin (twice daily for 14 days. Those patients in whom HP was eradicated were followed up for one year to evaluate reinfection. Twenty-five patients were randomized for OMC and 30 for NA. HP eradication occurred in 20/25 patients (80% treated with OMC and 13/30 (43% treated with NA (P = 0.01. After reallocation because of initial treatment failure, the overall eradication rate was 44/51 patients (86%. After an average follow-up of one year, we evaluated 34 patients (23 with DU and 11 with NUD. Reinfection occurred in 3/34 patients (7.6%. We conclude that OMC is effective for HP eradication, and that NA should not be used. Reinfection occurs in 7.6% of the patients in the first year after eradication.

The effects of cholelithiasis and cholecystectomy on gastric emptying.

Science.gov (United States)

Köksoy, F N; Bulut, T; Köse, H; Soybir, G; Yalçin, O; Aker, Y

In this clinical study, four groups, each consisting of 12 patients are established to determine how gastric emptying is influenced in cholelithiasis with accompanied flatulent dyspepsia and the relationship of symptoms and gastric emptying after cholecystectomy. 1. group: healthy people, 2. group: patients with dyspeptic cholelithiasis, 3. group: patients who have no dyspepsia after cholecystectomy, 4. group: patients whose dyspepsia is continued after cholecystectomy. Groups are compared according to solid phase gastric emptying scintigraphies performed with Tc 99m sulfur colloid bound with scrambled eggs. Gastric emptying delayed in second (p 0.005). These results demonstrate that dyspepsia, in cholelithiasis and persisting after cholecystectomy have a close relation with delay in gastric emptying.

Effects of cholelithiasis and cholecystectomy on gastric emptying.

Science.gov (United States)

Köksoy, F N; Bulut, T; Köse, H; Soybir, G; Yalçin, O; Aker, Y

1994-06-01

In this prospective, clinical study, four groups, each consisting of 12 patients were established to determine how gastric emptying is influenced in cholelithiasis with accompanied flatulent dyspepsia and the relationship of symptoms and gastric emptying after cholecystectomy: group 1--healthy people; group 2--patients with dyspeptic cholelithiasis; group 3--patients with no dyspepsia after cholecystectomy; group 4--patients with dyspepsia after cholecystectomy. Groups are compared according to solid phase gastric emptying scintigraphies performed with Tc 99m sulphur colloid bound with scrambled eggs. Gastric emptying delayed in groups 2 (P 0.005). These results demonstrate that dyspepsia, in cholelithiasis and persisting after cholecystectomy, has a close relation with delay in gastric emptying.

Effect of a community screening for Helicobacter pylori: a 5-Yr follow-up study

DEFF Research Database (Denmark)

Hansen, Jane M; Wildner-Christensen, Mette; Hallas, Jesper

2008-01-01

of community H. pylori screening and treatment on the prevalence of dyspepsia, and as secondary outcomes, the effect on dyspepsia-related health-care consumption and quality of life over 5 yr. METHODS: In 1998-1999, individuals aged 40-65 yr were randomized to H. pylori screening and treatment...... ulcers vs 148 ulcers) was seen in the screened group compared to the unscreened group. CONCLUSION: A population H. pylori screening and treatment program in an H. pylori low-prevalence area had only a modest, but insignificant, effect on the rate of dyspepsia, and a modest, significant effect...... on the consultation rate and sick leave days for dyspepsia, but resulted in a decreased ulcer incidence. The intervention resulted in an increased cost due to H. pylori screening and treatment....

Leu72Met408 Polymorphism of the Ghrelin Gene Is Associated With Early Phase of Gastric Emptying in the Patients With Functional Dyspepsia in Japan.

Science.gov (United States)

Yamawaki, Hiroshi; Futagami, Seiji; Shimpuku, Mayumi; Shindo, Tomotaka; Maruki, Yuuta; Nagoya, Hiroyuki; Kodaka, Yasuhiro; Sato, Hitomi; Gudis, Katya; Kawagoe, Tetsuro; Sakamoto, Choitsu

2015-01-01

There are no available data about the relationship between ghrelin gene genotypes and early phase of gastric emptying in functional dyspepsia (FD) as defined by Rome III classification. We enrolled 74 patients presenting with typical symptoms of FD and 64 healthy volunteers. Gastric motility was evaluated using the 13C-acetate breath test. We used Rome III criteria to evaluate upper abdominal symptoms and self-rating questionnaires for depression (SRQ-D) scores to determine status of depression. The Arg51Gln (346G->A), preproghrelin (3056T->C), Leu72Met (408C->A), Gln90Leu (3412T->A) and G-protein 3 (825C->T) polymorphisms were analyzed in the DNA from blood samples of enrolled subjects. Genotyping was performed by polymerase chain reaction. There was a significant relationship between the Gln90Leu3412 genotype and SRQ-D score in FD patients (P = 0.009). Area under the curve at 15 minutes (AUC15) value was significantly associated with the Leu72Met408 genotype (P = 0.015) but not with entire gastric emptying. The Leu72Met (408C->A) single nucleotide polymorphism was significantly associated with early phase of gastric emptying in FD patients. Further studies will be necessary to clarify the association between ghrelin gene single nucleotide polymorphisms and early phase of gastric emptying in FD patients.

The corpus-predominant gastritis index can be an early and reversible marker to identify the gastric cancer risk of Helicobacter pylori-infected nonulcer dyspepsia.

Science.gov (United States)

Cheng, Hsiu-Chi; Tsai, Yu-Ching; Yang, Hsiao-Bai; Yeh, Yi-Chun; Chang, Wei-Lun; Kuo, Hsin-Yu; Lu, Cheng-Chan; Sheu, Bor-Shyang

2017-08-01

Corpus-predominant gastritis index (CGI) is an early histological marker to identify Helicobacter pylori-infected gastric cancer relatives at risk of cancer. This study validated whether CGI is more prevalent in H. pylori-infected nonulcer dyspepsia (NUD) subjects than in duodenal ulcer (DU) controls and whether it is reversible after H. pylori eradication or is correlated with noninvasive biomarkers. In this longitudinal cohort study, 573 H. pylori-infected subjects were enrolled, including 349 NUD and 224 DU. Gastric specimens were provided to assess CGI, spasmolyic polypeptide-expressing metaplasia (SPEM), and Operative Link on Gastric Intestinal Metaplasia assessment (OLGIM). Serum pepsinogen I and II levels were assessed using enzyme-linked immunosorbent assay. CGI subjected were followed up at least 1 year after H. pylori eradication. NUD subjects had higher prevalence rates of CGI (47.0% vs 29.9%, Pgastritis and intestinal metaplasia. NUD subjects with CGI had higher risk of SPEM (OR 2.86, P<.001) and lower serum pepsinogen I/II ratios (P<.001) than those without CGI. Serum pepsinogen I/II ratios <9 could predict CGI modestly (AUROC 0.69, 95% CI: 0.63-0.74). CGI was regressed after eradication (P<.001). CGI was more prevalent in H. pylori-infected NUD subjects than in controls, was correlated with SPEM, and may serve as a marker earlier than OLGIM to indicate risk of gastric cancer. Moreover, CGI could be regressed after eradication. © 2017 John Wiley & Sons Ltd.

Kyoto global consensus report on Helicobacter pylori gastritis

NARCIS (Netherlands)

K. Sugano (Kentaro); J. Tack (Jan); E.J. Kuipers (Ernst); D.Y. Graham (David Y.); E. El-Omar; S. Miura (Soichiro); K. Haruma (Ken); M. Asaka (Masahiro); N. Uemura (Naomi); P. Malfertheiner

2015-01-01

textabstractObjective To present results of the Kyoto Global Consensus Meeting, which was convened to develop global consensus on (1) classification of chronic gastritis and duodenitis, (2) clinical distinction of dyspepsia caused by Helicobacter pylori from functional dyspepsia, (3) appropriate

Arrest of chronic acid suppressant drug use after successful Helicobacter pylori eradication in patients with peptic ulcer disease: a six-month follow-up study

NARCIS (Netherlands)

Hurenkamp, G. J.; Grundmeijer, H. G.; van der Ende, A.; Tytgat, G. N.; Assendelft, W. J.; van der Hulst, R. W.

2001-01-01

BACKGROUND: It remains controversial whether successful H. pylori eradication leads to relief of dyspepsia and the subsequent arrest or tapering of acid-suppressant drug therapy, or to an aggravation of acid-related dyspepsia requiring more acid-suppressant drug intake. AIM: To evaluate

Gastric pain | Schellack | South African Family Practice

African Journals Online (AJOL)

Therefore, this article provides an overview of the aetiology, classification, risk factors, diagnostic criteria and management strategies aimed at gastric pain, and its two more distinct gastrointestinal-related manifestations, namely epigastric pain and dyspepsia. Keywords: gastric pain, epigastric pain, dyspepsia, peptic ulcer ...

The Effect of Ginger (Zingiber officinalis and Artichoke (Cynara cardunculus Extract Supplementation on Functional Dyspepsia: A Randomised, Double-Blind, and Placebo-Controlled Clinical Trial

Directory of Open Access Journals (Sweden)

Attilio Giacosa

2015-01-01

Full Text Available Objective. Functional dyspepsia (FD is a frequent clinical finding in western world. The aim of this study is to compare the efficacy of a ginger and artichoke supplementation versus placebo in the treatment of FD. Methods. A prospective multicentre, double blind, randomized, placebo controlled, parallel-group comparison of the supplement and placebo over a period of 4 weeks was performed. Two capsules/day were supplied (before lunch and dinner to 126 FD patients (supplementation/placebo: 65/61. Results. After 14 days of treatment, only supplementation group (SG showed a significant amelioration (SG: αS=+1.195 MCA score units (u, P=0.017; placebo: αP=+0.347 u, P=0.513. The intercept (α resulted to be significantly higher in SG than in placebo (αS-αP=+0.848 u, P<0.001. At the end of the study, the advantage of SG versus placebo persists without variation (βS-βP=+0.077 u, P=0.542. In SG, a significant advantage is observed for nausea (βS-βP=-0.398 u, P<0.001, epigastric fullness (βS-βP=-0.241, P<0.001, epigastric pain (βS-βP=-0.173 u, P=0.002, and bloating (βS-βP=-0.167 u, P=0.017. Conclusions. The association between ginger and artichoke leaf extracts appears safe and efficacious in the treatment of FD and could represent a promising treatment for this disease.

Helicobacter Pylori : Serological Testing and Treatment in ...

African Journals Online (AJOL)

Purpose: Helicobacter pylori has been strongly associated with dyspepsia and eradication of H. pylori after a non-invasive testing is an integral part of most management guidelines. This study evaluated the benefit of serological testing and treatment of H. pylori in Nigerian patients presenting with uninvestigated dyspepsia.

Kyoto global consensus report on Helicobacter pylori gastritis and its impact on Chinese clinical practice.

Science.gov (United States)

Chen, Qi; Lu, Hong

2016-06-01

The Kyoto global consensus report on Helicobacter pylori (H. pylori) gastritis has had a great effect on the field of H. pylori studies worldwide. For the first time H. pylori gastritis was defined entirely as an infectious disease and H. pylori-associated dyspepsia as a new category of organic dyspepsia apart from functional dyspepsia, together with a proposed diagnostic algorithm. Accordingly, the report states that the eradication of H. pylori should be regarded as the first-line treatment for dyspepsia. Moreover, H. pylori eradication before the development of pre-neoplastic changes is recommended to reduce the risk of more serious complications of H. pylori gastritis. Despite the recommendations of this new global consensus, the task of transforming them into feasible and practical recommendations for individual countries will require them to become region-specific, which requires further discussion. © 2016 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

The Association between Oral Hygiene and Gastric Pathology in Patients with Dyspepsia: a Cross-Sectional Study in Southeast Iran.

Science.gov (United States)

Zahedi, Leili; Jafari, Elham; Torabi Parizi, Molook; Shafieipour, Sara; Hayat Bakhsh Abbasi, Mehdi; Darvish Moghadam, Sodaif; Zahedi, Mohammad Javad

2017-01-01

BACKGROUND Many studies have reported an association between periodontal infections and some systemic diseases such as respiratory and cardiovascular diseases. Some studies found a direct association between chronic gastritis caused by Helicobacter pylori (HP) infection and poor periodontal health. METHODS In a cross-sectional study from November 2014 to December 2015 in Kerman, the largest province in southeast Iran, patients with dyspepsia who were candidate for diagnostic upper gastrointestinal (GI) endoscopy were included in our study. Decayed, Missing, and Filled Teeth (DMFT) index and Loe plaque index that are two popular indexes in dental epidemiology were used to assess the oral health by a dentist before the upper GI endoscopy. According to the Loe plaque index, score: 0= no plaque, score: 1= a film of plaque attaching to the free gingival border and near area of the tooth, score: 2= moderate reposition of deposits within the gingival pocket, score :3= plenty of soft matter within the gingival pocket±on the tooth and gingival border. Scores ≤1, 2 and 3 equal to good, moderate, and poor oral hygiene, respectively. During upper GI endoscopy a total of six biopsy samples were taken from fundus, body, and antrum. A pathologist reported these samples according to Sidney's classification into superficial gastritis, atrophic gastritis, intestinal metaplasia, and dysplasia. RESULTS According to Sidney's classification 77 (89.5%) patients had superficial gastritis, 3 (3.5%) had atrophic gastritis, and 6 (7%) had intestinal metaplasia. HP was found in 80.2% of the gastric mucosal biopsy samples. There were not statistically significant relationship between Sidney's classification, presence of HP in gastric mucosal biopsies, and hygiene indicators ( p >0.05). No relation was found between the DMFT index and superficial gastritis, atrophic gastritis, and intestinal metaplasia ( p >0.05). Gastric infection with HP was found in 70%, 75%, and 100% of patients with

Psychometric validation of the Dutch translation of the quality of life in reflux and dyspepsia (QOLRAD questionnaire in patients with gastroesophageal reflux disease

Directory of Open Access Journals (Sweden)

Engels Leopold GJB

2010-08-01

Full Text Available Abstract Background The Quality of Life in Reflux and Dyspepsia (QOLRAD questionnaire is one of the best-characterized disease-specific instruments that captures health-related problems and symptom-patterns in patients with gastroesophageal reflux disease (GERD. This paper reports the psychometric validation of a Dutch translation of the QOLRAD questionnaire in gastroenterology outpatients with GERD. Methods Patients completed the QOLRAD questionnaire at visit 1 (baseline, visit 2 (after 2, 4 or 8 weeks of acute treatment with esomeprazole 40 mg once daily, and visit 4 (after 6 months with on-demand esomeprazole 40 mg once daily or continuous esomeprazole 20 mg once daily. Symptoms were assessed at each visit, and patient satisfaction was assessed at visits 2 and 4. Results Of the 1166 patients entered in the study, 97.3% had moderate or severe heartburn and 55.5% had moderate or severe regurgitation at baseline. At visit 2, symptoms of heartburn and regurgitation were mild or absent in 96.7% and 97.7%, respectively, and 95.3% of patients reported being satisfied with the treatment. The internal consistency and reliability of the QOLRAD questionnaire (range: 0.83-0.92 supported construct validity. Convergent validity was moderate to low. Known-groups validity was confirmed by a negative correlation between the QOLRAD score and clinician-assessed severity of GERD symptoms. Effect sizes (1.15-1.93 and standardized response means (1.17-1.86 showed good responsiveness to change. GERD symptoms had a negative impact on patients' lives. Conclusions The psychometric characteristics of the Dutch translation of the QOLRAD questionnaire were found to be satisfactory, with good reliability and responsiveness to change, although convergent validity was at best moderate.

Determination of relative frequency of eosinophils and mast cells in gastric and duodenal mucosal biopsies in adults with non-ulcer dyspepsia

International Nuclear Information System (INIS)

Binesh, F.; Rajabzadeh, Y.; Pourmirafzali, H.; Akhondei, M.

2013-01-01

Objective: To determine eosinophil and mast cell populations in gastric and duodenal mucosal biopsies of adults with nonulcer dyspepsia (NUD) as compared to non-dyspeptic adults. Study Design: A case control study. Place and Duration of Study: Shahid Sadoughi University of Medical Sciences, Yazd, Iran, from January 2010 to June 2011. Methodology: A total of 52 (25 non-ulcer dyspeptic patients as case and 27 non-dyspeptic patients as control) patients underwent endoscopy. All patients had a minimum of 2 forceps biopsies obtained from stomach and duodenum. Routine histological evaluation was performed and additionally evaluated to determine eosinophil and mast cell counts. The statistical analysis was performed on SPSS version 17.0, using Mann-Whitney test with significance at p < 0.05. Results: The mean age in the case and control groups was 31.72 +- 12.17 and 35.74 +- 12.42 years respectively. The median eosinophil density in gastric mucosa in case group was 5.0 (ranging from 1 to 20) and 4.0 in control group (ranging from 0 to 16; p = 0.140). The median eosinophil density in duodenal mucosa in case group was 16.0 (ranging from 2 to 24) and 13 in control group (ranging from 2 to 45; p = 0.147). The median mast cell density in gastric mucosa in case group was 4.0 (ranging from 0 to 33) and 4.0 in control group (ranging from 0 to 26; p = 0.827). The median mast cell density in duodenal mucosa in case group was 4.0 (ranging from 0 to 31) and 3.0 in control group (ranging from 1 to 23; p = 0.704). The frequency of Helicobacter pylori infection in both the groups was similar. Conclusion: Although there were not statistically significant differences in eosinophil and mast cell densities between case and control groups, there was a trend toward mild eosinophilia in gastric and duodenal mucosa. The specific role of eosinophils and mast cells in NUD is yet to be completely defined. (author)

Gastroscintigraphic signs of motor-evacuation disorders of the stomach

International Nuclear Information System (INIS)

Mazur, A.G.; Mironova, E.V.; Tkachenko, M.N.

2017-01-01

The article deals with evaluation findings of diagnostic possibilities of gastroscintigraphy in assessment of motoric evacuatory function of the stomach in case of pathology of various origin. Gastroscintigraphy was conducted for 122 patients (56 men and 66 women) aged from 18 to 72 with different gastroduodenal pathology (functional dyspepsia, chronic gastritis, chronic cholecystitis, ulcer of the stomach and duodenum. Radiopharmaceutical agent 99 mTc-pertechnetate with activity of 1 MBq/kg was applied. Impaired motoric evacuatory function of the stomach was observed in 63 patients: regarding hypotonic type in most patients with functional dyspepsia (13.3%) and with chronic gastritis (19.8%); according to hypertonic type - 32 patients, mainly with functional dyspepsia (9.8%) and gastric ulcer (6.6%). Increased motoric evacuatory function of the stomach was revealed in 40 patients: with functional dyspepsia (14.8%) and in gastric ulcer (16.4%). The gastroesophageal reflux was observed in 59 patients and duodenogastric one - in 36 patients. Therefore, gastroscintigraphy in assessment of motoric evacuatory function of the stomach can completely replace X-ray examination.

Acotiamide Hydrochloride, a Therapeutic Agent for Functional Dyspepsia, Enhances Acetylcholine-induced Contraction via Inhibition of Acetylcholinesterase Activity in Circular Muscle Strips of Guinea Pig Stomach.

Science.gov (United States)

Ito, K; Kawachi, M; Matsunaga, Y; Hori, Y; Ozaki, T; Nagahama, K; Hirayama, M; Kawabata, Y; Shiraishi, Y; Takei, M; Tanaka, T

2016-04-01

Acotiamide is a first-in-class prokinetic drug approved in Japan for the treatment of functional dyspepsia. Given that acotiamide enhances gastric motility in conscious dogs and rats, we assessed the in vitro effects of this drug on the contraction of guinea pig stomach strips and on acetylcholinesterase (AChE) activity in stomach homogenate following fundus removal. We also investigated the serotonin 5-HT4 receptor agonist mosapride, dopamine D2 receptor and AChE inhibitor itopride, and representative AChE inhibitor neostigmine. Acotiamide (0.3 and 1 μM) and itopride (1 and 3 μM) significantly enhanced the contraction of gastric body strips induced by electrical field stimulation (EFS), but mosapride (1 and 10 μM) did not. Acotiamide and itopride significantly enhanced the contraction of gastric body and antrum strips induced by acetylcholine (ACh), but not that induced by carbachol (CCh). Neostigmine also significantly enhanced the contraction of gastric body strips induced by ACh, but not that by CCh. In contrast, mosapride failed to enhance contractions induced by either ACh or CCh in gastric antrum strips. Acotiamide exerted mixed inhibition of AChE, and the percentage inhibition of acotiamide (100 μM) against AChE activity was markedly reduced after the reaction mixture was dialyzed. In contrast, itopride exerted noncompetitive inhibition on AChE activity. These results indicate that acotiamide enhances ACh-dependent contraction in gastric strips of guinea pigs via the inhibition of AChE activity, and that it exerts mixed and reversible inhibition of AChE derived from guinea pig stomach. © Georg Thieme Verlag KG Stuttgart · New York.

H. Pylori Positivity and Various Pathological, Endoscopic and Clinical Features Correlated with Each Other

International Nuclear Information System (INIS)

Coskun, A.; Yukselen, V.; Yasa, M. H.; Karaoglu, A. O.; Meteoglu, I.; Ergin, F.; Kadikoylu, G.

2015-01-01

Objective: To investigate the relationship between dyspepsia symptom scores and endoscopic appearances, and histopathological findings and helicobacter pylori positivity in patients having dyspepsia symptom. Methods: The study was conducted at the gastroenterology outpatient clinic of Adnan Menderes University, School of Medicine, Aydin, Turkey from April 2012 to July 2012 and comprised patients between 18-65 years of age who were admitted with dyspepsia. Glasgow dyspepsia severity scoring was done with questions posed orally to the patients. In histopathological evaluation of biopsy specimens according to Sydney criteria, chronic inflammation, activity, atrophy, intestinal metaplasia and helicobacter pylori parameters were used. Total number of eosinophils and number of mast cells were recorded. Results: Of the 60 patients with dyspepsia, 38(63.3 percent) were female and 22(36.7 percent) were male. The degree of activation and severity of inflammation increased significantly with increasing helicobacter pylori positivity(r=0.459'p<0.0001; r=0.475'p<0.0001). A significant relationship was found between inflammation, activation and the number of mast cells (p<0.05).There was no relationship between helicobacter pylori intensity and the eosinophil count (r=0.171; p=0.093). There was also a statistically significant correlation between severity of inflammation and activation and the number of eosinophils (r=0.313;p=0.002;r=0.245;p=0.016). Conclusion: Mast cell density was seen to have a role in the inflammatory processes of helicobacter pylori infection. (author)

Gastrointestinal symptoms and motility disorders in patients with systemic scleroderma

Directory of Open Access Journals (Sweden)

Palasciano Giuseppe

2008-02-01

Full Text Available Abstract Background Studies on gastrointestinal symptoms, dysfunctions, and neurological disorders in systemic scleroderma are lacking so far. Methods Thirty-eight scleroderma patients (34 limited, 4 diffuse, 60 healthy controls and 68 dyspeptic controls were scored for upper and lower gastrointestinal symptoms (dyspepsia, bowel habits, gastric and gallbladder emptying to liquid meal (functional ultrasonography and small bowel transit (H2-breath test. Autonomic nerve function was assessed by cardiovascular tests. Results The score for dyspepsia (mainly gastric fullness was greater in scleroderma patients than healthy controls, but lower than dyspeptic controls who had multiple symptoms, instead. Scleroderma patients with dyspepsia had a longer disease duration. Fasting antral area and postprandial antral dilatation were smaller in scleroderma patients than dyspeptic and healthy controls. Gastric emptying was delayed in both scleroderma patients (particularly in those with abnormal dyspeptic score and dyspeptic controls, who also showed a larger residual area. Despite gallbladder fasting and postprandial volumes were comparable across the three groups, gallbladder refilling appeared delayed in dyspeptic controls and mainly dependent on delayed gastric emptying in scleroderma. Small intestinal transit was also delayed in 74% of scleroderma and 66% of dyspeptic controls. Bowel habits were similar among the three groups. Autonomic neuropathy was not associated with dyspepsia, gastric and gallbladder motility and small intestinal transit. Conclusion In scleroderma patients dyspepsia (mainly gastric fullness, restricted distension of the gastric antrum and diffuse gastrointestinal dysmotility are frequent features. These defects are independent from the occurrence of autonomic neuropathy.

From Bench to Bedside to Bug: An Update of Clinically Relevant Advances in the Care of Persons with Helicobacter pylori Associated Diseases

Directory of Open Access Journals (Sweden)

N Chiba

2000-01-01

Full Text Available In-depth meetings of the XIth International Workshop on Gastroduodenal Pathology and Helicobacter pylori led to the presentation and discussion of extensive new data on H pylori and its diseases. The mode of transmission of H pylori remains unclear, and it remains unknown why only a small proportion of infected individuals develop duodenal or gastric ulcer disease and even fewer develop gastric cancer. The role of H pylori eradication in persons with uninvestigated dyspepsia remains controversial. New clinical trials of H pylori treatment show symptom relief and improvement in the quality of life of persons with functional dyspepsia, especially in those with ulcer-like or reflux-like dyspepsia. Clearly the move is toward symptom-based management of persons with dyspepsia, with fewer endoscopies being needed in the otherwise healthy young dyspeptic patients. It remains controversial whether eradicating H pylori in duodenal ulcer or functional dyspepsia increases the risk of subsequent development of gastroesophageal reflux disease. The one-week proton pump inhibitor-based triple regimens remain the gold standard of H pylori therapy, but some of the ranitidine bismuth citrate plus two antibiotic regimens also achieve an 80% H pylori eradication rate on an intention-to-treat basis. While the urea breath test remains the noninvasive test of choice, interesting new data are available on the use of stool antigen testing to diagnose H pylori infection. The number of H pylori-associated gastroduodenal diseases grows to include possible liver, vascular, immune and skin conditions.

Evaluation of new gastro-intestinal prokinetic (ENGIP-II) study.

Science.gov (United States)

Walwaikar, Pradeep P; Kulkarni, Sujay S; Bargaje, Rahul S

2005-12-01

Non-ulcer dyspepsia is a common clinical disorder characterised by reduced gastric motility. Safety concerns have restricted use of currently available prokinetic drugs. Itopride is a new safer prokinetic drug with dopamine D2 antagonism and acetylcholinesterase inhibitory actions. The ENGIP-II study was conducted to investigate the efficacy, and safety of itopride in patients of non-ulcer dyspepsia. There were significant reductions in upper abdominal pain, heartburn frequency, gastro-oesophageal regurgitation, nausea, bloating, early satiety after meals at day 3 only; whereas significant improvements were noted in belching, anorexia at day 6 and in vomiting at day 9. Thus, ENGIP-II study shows that itopride was well tolerated patients and appears to be the drug of choice in patients with non-ulcer dyspepsia.

UPPER GASTROINTESTINAL ENDOSCOPY FINDINGS IN PATIENTS REFERRED WITH UPPER GASTROINTESTINAL SYMPTOMS IN ELDORET, KENYA: A RETROSPECTIVE REVIEW.

Science.gov (United States)

Ayuo, P O; Some, F F; Kiplagat, J

2014-08-01

Dyspepsia is one of the major indications for upper gastrointestinal endoscopy. Other indications include dysphagia, odynophagia and gastrointestinal bleeding. Endoscopy is an expensive procedure that is out of reach of many patients in resource constrained region such as western Kenya. We reviewed endoscopy records from both public and private health institutions spanning ten years. To determine the pattern of referral and endoscopy diagnoses in patients referred for upper gastrointestinal endoscopy in Eldoret, Kenya. Retrospective chart review. Moi Teaching and Referral Hospital, private hospitals and private clinics in Eldoret, Kenya. One thousand six hundred and ninety (1690) Patients who underwent upper GI endoscopy from 1993 to 2003 were reviewed after obtaining clearances from the respective institutions. Information on age, sex, symptoms, and endoscopy diagnosis were extracted and subjected to statistical analysis. The most common symptom was dyspepsia in 1059 (62.7%) followed by dysphagia in 224 (13.3%). Others were referred with diagnosis of cancer of the stomach or oesophagus. Common endoscopy diagnoses were cancer of the oesophagus in 199 (11.8%) and duodenal ulcer in 186 (11.0%). The majority of the patients (30.4%) had normal endoscopy findings. Of the 1059 patients with dyspepsia, only 154 (14.5%) had duodenal ulcer and 34 (3.2%) had gastric ulcers, the majority, 37.2% had normal endoscopy findings. Dyspepsia was main reason for referral, but the majority of such patients had normal findings. Cancer of the oesophagus was the main diagnosis in patients with dysphagia. In view of the cost of endoscopy, only those with dyspepsia and alarm symptoms be referred for the procedure.

The dopaminergic system in patients with functional dyspepsia analysed by single photon emission computed tomography (SPECT) and an alpha-methyl-para-tyrosine (AMPT) challenge test

International Nuclear Information System (INIS)

Braak, Breg; Klooker, Tamira K.; Booij, Jan; Wijngaard, Rene M.J. van den; Boeckxstaens, Guy E.E.

2012-01-01

Functional dyspepsia (FD) is a chronic condition characterized by upper abdominal symptoms without an identifiable cause. While the serotonergic system is thought to play a key role in the regulation of gut physiology, the role of the dopaminergic system, which is important in the regulation of visceral pain and stress, is under-studied. Therefore, this study investigated the dopaminergic system and its relationship with drinking capacity and symptoms in FD patients. In FD patients and healthy volunteers (HV) the dopaminergic system was investigated by in-vivo assessment of central dopamine D2 receptors (D2Rs) with [ 123 I]IBZM SPECT and by an acute, but reversible, dopamine depletion alpha-methyl-para-tyrosine (AMPT) challenge test. A nutrient drink test was performed to investigate the association between maximal ingested volume, evoked symptoms, and D2Rs. The HV subjects comprised 12 women and 8 men (mean age 31 ± 3 years), and the FD patients comprised 5 women and 3 men (mean age 39 ± 5 years). The FD patients had a lower left plus right average striatal binding potential (BP NP ) for the caudate nucleus (p = 0.02), but not for putamen (p = 0.15), which in the FD patients was correlated with maximal ingested volume (r = 0.756, p = 0.03). The D2R BP NP in the putamen was correlated with nausea (r = 0.857, p = 0.01). The acute dopamine depletion test, however, failed to reveal differences in prolactin release between the FD patients and the HV subjects. These preliminary data suggest that chronic rather than acute alterations in the dopaminergic system may be involved in the pathogenesis of FD. Further studies are required to reproduce our novel findings and to evaluate to what extent the dopaminergic changes may be secondary to abnormalities in serotonergic pathways. (orig.)

The dopaminergic system in patients with functional dyspepsia analysed by single photon emission computed tomography (SPECT) and an alpha-methyl-para-tyrosine (AMPT) challenge test

Energy Technology Data Exchange (ETDEWEB)

Braak, Breg; Klooker, Tamira K. [Academic Medical Center, Department of Gastroenterology and Hepatology, Amsterdam (Netherlands); Booij, Jan [Academic Medical Center, Department of Nuclear Medicine, Amsterdam (Netherlands); Wijngaard, Rene M.J. van den [Academic Medical Center, Tytgat Institute of Liver and Intestinal Research, Amsterdam (Netherlands); Boeckxstaens, Guy E.E. [Academic Medical Center, Department of Gastroenterology and Hepatology, Amsterdam (Netherlands); University Hospital Leuven, Catholic University Leuven, Department of Gastroenterology, Leuven (Belgium)

2012-04-15

Functional dyspepsia (FD) is a chronic condition characterized by upper abdominal symptoms without an identifiable cause. While the serotonergic system is thought to play a key role in the regulation of gut physiology, the role of the dopaminergic system, which is important in the regulation of visceral pain and stress, is under-studied. Therefore, this study investigated the dopaminergic system and its relationship with drinking capacity and symptoms in FD patients. In FD patients and healthy volunteers (HV) the dopaminergic system was investigated by in-vivo assessment of central dopamine D2 receptors (D2Rs) with [{sup 123}I]IBZM SPECT and by an acute, but reversible, dopamine depletion alpha-methyl-para-tyrosine (AMPT) challenge test. A nutrient drink test was performed to investigate the association between maximal ingested volume, evoked symptoms, and D2Rs. The HV subjects comprised 12 women and 8 men (mean age 31 {+-} 3 years), and the FD patients comprised 5 women and 3 men (mean age 39 {+-} 5 years). The FD patients had a lower left plus right average striatal binding potential (BP{sub NP}) for the caudate nucleus (p = 0.02), but not for putamen (p = 0.15), which in the FD patients was correlated with maximal ingested volume (r = 0.756, p = 0.03). The D2R BP{sub NP} in the putamen was correlated with nausea (r = 0.857, p = 0.01). The acute dopamine depletion test, however, failed to reveal differences in prolactin release between the FD patients and the HV subjects. These preliminary data suggest that chronic rather than acute alterations in the dopaminergic system may be involved in the pathogenesis of FD. Further studies are required to reproduce our novel findings and to evaluate to what extent the dopaminergic changes may be secondary to abnormalities in serotonergic pathways. (orig.)

Indications for treatment of Helicobacter pylori infection: a systematic overview.

Science.gov (United States)

Veldhuyzen van Zanten, S J; Sherman, P M

1994-01-15

To determine (a) the advantages and disadvantages of treatment options for the eradication of Helicobacter pylori and (b) whether eradication of H. pylori is indicated in patients with duodenal ulcer, nonucler dyspepsia and gastric cancer. A MEDLINE search for articles published in English between January 1983 and December 1992 with the use of MeSH terms Helicobacter pylori (called Campylobacter pylori before 1990) and duodenal ulcer, gastric cancer, dyspepsia and clinical trial. Six journals and Current Contents were searched manually for pertinent articles published in that time frame. For duodenal ulcer the search was limited to studies involving adults, studies of H. pylori eradication and randomized clinical trials comparing anti-H. pylori therapy with conventional ulcer treatment. For nonulcer dyspepsia with H. pylori infection the search was limited to placebo-controlled randomized clinical trials. The quality of each study was rated independently on a four-point scale by each author. For the studies of duodenal ulcer the outcome measures assessed were acute ulcer healing and time required for healing, H. pylori eradication and ulcer relapse. For the studies of nonulcer dyspepsia with H. pylori infection the authors assessed H. pylori eradication, the symptoms used as outcome measures and whether validated outcome measures had been used. Eight trials involving duodenal ulcer met our inclusion criteria: five were considered high quality, two were of reasonable quality, and one was weak. Six trials involving nonulcer dyspepsia met the criteria, but all were rated as weak. Among treatment options triple therapy with a bismuth compound, metronidazole and either amoxicillin or tetracycline achieved the highest eradication rates (73% to 94%). Results concerning treatment indications for duodenal ulcer were consistent among all of the studies: when anti-H. pylori therapy was added to conventional ulcer treatment acute ulcers healed more rapidly. Ulcer relapse rates

Dynamics of Serum Pepsinogens on the Background of Double Standard Doses of Omeprazole in Patients with Gastroesophageal Reflux Disease and Functional Gastric Dyspepsia

Directory of Open Access Journals (Sweden)

S.G. Melashchenko

2013-09-01

Full Text Available In literature it has been reported that concentrations of serum pepsinogens increase during administration of proton pump inhibitors (PPI. However, the magnitude of these changes is still to be assessed. The aim of this study was to evaluate the changes in levels of pepsinogen I (PG-1 and pepsinogen II (PG-2 on the background of therapy with omeprazole which has been administered before breakfast in double standard dose (40 mg. The regimen of PPI administration completely corresponds to conventional PPI-test. There were two groups of patients: 1st one (gastroesophageal reflux desiase — 10 women and 9 men, mean age (52.37 ± 3.25 years; 2nd one (functional dyspepsia — 11 women and 8 men, mean age (48.37 ± 3.56 years. It was found that in 1st group PGI rises from (141.90 ± 7.99 mcg/l to (177.61 ± 7.81 mcg/l, in 2nd group — from (115.02 ± 10.16 mcg/l to (152.37 ± 12.33 mcg/l (p < 0.05. PG-2 level changes in the same. In 1st group PG-2 rises from (21.65 ± 3.13 mcg/l to (32.64 ± 3.42 mcg/l, in 2nd group — from (14.84 ± 1.64 mcg/l to (23.55 ± 2.37 mcg/l (p < 0.05. In 6 cases absolute increase of PGI (ΔPG-2 didn’t reach threshold of 7.0 mcg/l considered by us as level of insufficient acid inhibition. Two of these patients had atrophic gastritis (PG-1 < 50 mcg/l; ratio PG-/PG-2 < 3.0, rest 4 patients didn’t have atrophic gastritis but in half cases they hadn’t adequate answer to PPI administration. There was a significant correlation between increase of PG-1 level and disappearance of reflux complaints evaluated by dynamics in RS-cluster of GSRS-questionnaire.

GASTROESOPHAGEAL REFLUX DISEASE IN PATIENTS WITH FUNCTIONAL DYSPEPSIA AND CONSTIPATION PREDOMINANT IRRITABLE BOWEL SYNDROME: CLINICAL FEATURES AND EFFICACY OF LACTULOSE AND ITOPRIDE HYDROCHLORIDE

Directory of Open Access Journals (Sweden)

O. V. Krapivnaya

2014-01-01

Full Text Available Background: The frequent coexistence of gastroesophageal reflux disease (GERD with functional dyspepsia (FD and an irritable bowel syndrome (IBS has been described in the literature. Aim: To study the specific features of GERD clinical course and diagnosis in patients with GERD in combination with FD and constipation predominant IBS (IBS-C in comparison to patients with isolated GERD; to assess the efficacy of lactulose and itopride hydrochloride. Materials and methods: A total of 60 patients with GERD, FD (Rome criteria III, and IBS-C (Rome criteria III and 29 patients with isolated GERD were examined. GERD diagnosis was based on clinical, endoscopic, and pH-metric criteria. For 4 weeks 10 patients with combination of non-erosive reflux disease (NERD, FD and IBS-C received lactulose monotherapy and other 10 patients received combination of lactulose with itopride hydrochloride. Clinical symptoms and pH-metric parameters were assessed before and 4 weeks after treatment. Results: Combination of GERD, FD and IBS-C was noted more frequently in women under 40 with normal body mass index (р<0.05. Classic GERD symptoms were absent in 43.4% of patients with gastrointestinal comorbidity and in 10.3% of patients with isolated GERD (р=0.004. A higher prevalence of belching and nausea was found in patients, suffering from GERD, FD and IBS-C, than in those with isolated GERD (р<0.05. After 4-week lactulose and itopride hydrochloride treatment all the patients with GERD, FD and IBS-C showed a reduction of clinical symptoms (p<0.05 and normalization of pH-metric parameters (р<0.001. Conclusion: GERD course in patients with concomitant FD and IBS-C has the following peculiarities: predominance of women, absence of classic GERD-symptoms in almost half of these patients, and frequent combination with other functional symptoms. Combination therapy with lactulose and itopride hydrochloride enables successful control of GERD and FD symptoms as well as

The preproghrelin 3056 TT genotype is associated with the feeling of hunger and low acylated ghrelin levels in Japanese patients with Helicobacter pylori-negative functional dyspepsia.

Science.gov (United States)

Futagami, Seiji; Shimpuku, Mayumi; Kawagoe, Tetsuro; Izumi, Nikki; Ohishi, Noriko; Yamawaki, Hiroshi; Shindo, Tomotaka; Nagoya, Hiroyuki; Horie, Akane; Kodaka, Yasuhiro; Gudis, Katya; Itoh, Takashi; Sakamoto, Choitsu

2013-01-01

An impairment of gastric motility is strongly associated with the pathophysiology of functional dyspepsia (FD). Plasma ghrelin is one of the key molecules linked to gastric motility. Therefore, this study aimed to evaluate whether ghrelin (GHRL) gene polymorphisms are associated with clinical symptoms, the plasma ghrelin levels and gastric emptying in patients with FD as defined by the Rome III classification. We enrolled 74 Helicobacter pylori-negative patients presenting with typical symptoms of FD (epigastric pain syndrome (EPS), n=23; postprandial distress syndrome (PDS), n=51) and 102 healthy volunteers. Gastric motility was evaluated according to the Tmax value and T1/2 using the (13)C-acetate breath test. We used the Rome III criteria to evaluate upper abdominal symptoms and SRQ-D scores to determine the depression status. The Arg51Gln(346G->A), preproghrelin3056T->C, Leu72Met(408C->A) and Gln90Leu(3412T->A) polymorphisms were analyzed in DNA in blood samples obtained from the enrolled subjects. Genotyping was performed using polymerase chain reaction. There was a significant relationship (p=0.048) between the preproghrelin 3056TT genotype and the serum levels of acylated ghrelin in the H. pylori-negative FD patients. The preproghrelin 3056TT genotype was significantly (p=0.047) associated with the feeling of hunger in the H. pylori-negative FD patients. The preproghrelin 3056TT genotype is significantly associated with the acylated ghrelin levels and the feeling of hunger in H. pylori-negative FD patients. Further studies are needed to clarify the association between the preproghrelin 3056TT genotype and lower plasma acylated ghrelin levels and the impact of this relationship on the feeling of hunger in H. pylori-negative FD patients.

Abnormal Gastroesophageal Flap Valve Is Associated With High Gastresophageal Reflux Disease Questionnaire Score and the Severity of Gastroesophageal Reflux Disease in Vietnamese Patients With Upper Gastrointestinal Symptoms.

Science.gov (United States)

Quach, Duc T; Nguyen, Trang T; Hiyama, Toru

2018-04-30

There have been no studies investigating the distribution of abnormal gastroesophageal flap valve (GEFV) among patients with dyspepsia, non-erosive reflux disease (NERD), and reflux esophagitis (RE) in the same set of patients. The aims of this study are to investigate (1) the association between GEFV and gastroesophageal reflux disease questionnaire (GERDQ) score, and (2) the distribution of abnormal GEFV in Vietnamese patients presenting with upper gastrointestinal symptoms. Three hundred and thirty-one patients recruited in this prospective cross-sectional study were classified into 3 groups: reflux esophagitis (RE), non-erosive reflux disease (NERD) (GERDQ score ≥ 8, no endoscopic mucosal injury), and dyspepsia (GERDQ score < 8, no endoscopic mucosal injury). The GEFV was graded endoscopically according to the Hill classification. GEFV grades I and II were regarded as normal, while grades III and IV were regarded as abnormal GEFV. There were 215 (65.0%) patients with dyspepsia, 55 (16.6%) patients with NERD, and 61 (18.4%) patients with RE. Abnormal GEFV was an independent risk factor for GERD (OR, 2.93; CI 95%, 1.76-4.88) and RE (OR, 3.41; CI 95%, 1.78-6.53). The mean GERDQ score of patients with abnormal GEFV was significantly higher than that of patients with normal GEFV (5.7 ± 2.4 vs 4.9 ± 2.7, P = 0.011). The prevalence of abnormal GEFV gradually increased in patients with dyspepsia (27.4%), NERD (43.6%), grade A RE (56.8%), and grades B/C RE (80.0%) ( P ＜ 0.001). Abnormal GEFV was significantly associated with high GERDQ score. Its prevalence gradually increased in patients with dyspepsia, NERD, and RE, respectively.

Paediatric Rome III Criteria-Related Abdominal Pain Is Associated With Helicobacter pylori and Not With Calprotectin.

Science.gov (United States)

Sýkora, Josef; Huml, Michal; Siala, Konrad; Pomahačová, Renáta; Jehlička, Petr; Liška, Jiří; Kuntscherová, Jana; Schwarz, Jan

2016-10-01

Abdominal pain-related functional gastrointestinal disorders in children include functional dyspepsia, functional abdominal pain, irritable bowel syndrome, and abdominal migraine. We aimed to evaluate a possible association between functional abdominal pain disorders and Helicobacter pylori infection and faecal calprotectin level. Prospective observational study including consecutive children with functional gastrointestinal disorders fulfilling Rome III criteria (cases) and age/sex-matched healthy controls. H pylori has been detected by biopsy-based tests and stool-antigen detection, faecal calprotectin by enzyme-linked immunosorbent assay. A total of 56 cases (27 with functional dyspepsia) and 56 controls were enrolled. H pylori being detected in 17 of 56 cases (30.4%) and 4 of 56 controls (7.1%, odds ratio: 5.7; 95% confidence interval [CI]: 1.8-18.2, P = 0.003). H pylori was detected significantly more frequently in cases with functional dyspepsia (14/27, 51.9% odds ratio: 14.0; 95% CI: 3.9-49.7, P = 0.00001) than in controls and not in cases with other well-recognized functional gastrointestinal complaints (3/29, 10.3%). The median faecal calprotectin level was similar in cases (7.8 μg/g, 95% CI: 7.8-8.4) including those with gastritis, and controls (9.1 μg/g, 95% CI: 7.8-11.3). Gastritis features were more frequent in H pylori-infected and noninfected cases with functional dyspepsia (27/27, 100%) than in cases with other abdominal functional complaints (15/29, 51.7%, P = 0.007). H pylori gastritis and noninfectious gastritis were associated with functional dyspepsia in children referred for abdominal pain-related functional gastrointestinal disorders while faecal calprotectin is not a predictor of gastritis and is similar in children with functional abdominal pain symptoms and in controls.

Morgagni's Hernia

International Nuclear Information System (INIS)

Khalid, M.M.

2004-01-01

Congenital diaphragmatic hernias, including Morgagni's hernia, usually present in early childhood and are treated by surgical repair. This case report is about an unusual Morgagni's hernia, presenting with dyspepsia and chest pain, at the age 45 years. For many years the diagnosis remained a dilemma because patient's chest x-ray was not done and she was treated for 'ngina' and 'dyspepsia' Diagnosis was obvious once a chest x-ray was done, however, barium studies were performed for further confirmation. (author)

[The use of prokinetics for the correction of motor and tonic digestive disorders].

Science.gov (United States)

Maev, I V; Samsonov, A A; Karmanova, E A; Ivanchenko, E A

2009-01-01

Abnormal tonic-motor activity is a key component in pathogenesis of many digestive disorders. Secondary disturbance of tonic-motor activity of digestive organs and the accompanying symptoms are known to develop in conjunction with diseases of other organs and systems, diabetes mellitus, Parkinson's disease, myotonic muscular dystrophy, amyloidosis, hyper- and hypothyroidism, hypoparathyroidism, etc. Disturbed motor activity in the gastro-duodenal region most frequently underlies functional dyspepsia, i.e. a group of symptoms unrelated to organic, systemic and metabolic diseases. Prokinetics are an important class of medicinal products for the treatment of all clinical forms of dyspepsia. One of the new ones is itopride hdrochloride having combined mechanism of action. Clinical studies of this drug revealed its high efficiency in patients with functional dyspepsia, chronic gastritis, and diabetic gastroparesis. It is well tolerated by the patients and produces no serious side effects. Inclusion of this drug in therapy improves the outcome of the treatment of disturbed motor activity of the gastrointestinal tract.

Investigation of gastric motility in patients with the overlap syndrome of the gastroesophageal reflux disease and functional dyspepsia

Directory of Open Access Journals (Sweden)

V. D. Pasechnikov

2017-01-01

Full Text Available Rationale:  The phenomenon of overlap  of two disorders, non-erosive gastroesophageal reflux disease (NERD and functional dyspepsia (FD is an important clinical problem,  while the  symptoms in such  patients  are  more  severe  and  prevalent than  in those  with non-overlapping NERD or FD. This phenomenon may lead to treatment failure, if therapy  does not take into account  the specific pathophysiological mechanisms  of the NERD and FD overlap.Aim: To study motility of the proximal and  distal parts  of the  stomach  in patients  with the overlap syndrome of NERD with FD.Materials and  methods:  The  study  enrolled  56  patients (34 women and 22 men, aged from 18 to 45 years, who met the diagnostic  criteria for NERD and FD (the Rome criteria III, esophageal endoscopy, 24-hour  pH  measurement  or  24-hour  impedance pH measurement, and  had  both  NERD  and  FD symptoms  simultaneously  (overlap; 46 healthy volunteers. The accommodation of the  proximal (fundal part  of the  stomach  and  motility of the distal gastric part  was assessed  by ultrasonography (Aixplorer, SuperSonic Imagine, France, with convex probe  1–6 MHz before  and  after the  intake of the liquid test food. The patients  filled in questionnaires to assess the symptoms  and their severity (scored from 0 to 3. The difference  between their mean ± standard  deviation (SD values was assessed  by Students  t-test  and  was considered  significant at p < 0.05.Results: After intake of the  liquid test  food, the  patients  with the  FD and NERD overlap syndrome demonstrated an advanced and statistically significant gastric motility abnormality  both  in its proximal and distal parts, compared to healthy control: accommodation disturbances and its reduction, decreased amplitude  (61.4 ± 7.5 vs 90.2 ± 6.9%, p < 0.05, frequency of contractions of the antrum during 3-minute interval (4.3 ± 1.5 vs 9.7 ± 1

Efficacy of a potassium-competitive acid blocker for improving symptoms in patients with reflux esophagitis, non-erosive reflux disease, and functional dyspepsia.

Science.gov (United States)

Asaoka, Daisuke; Nagahara, Akihito; Hojo, Mariko; Matsumoto, Kenshi; Ueyama, Hiroya; Matsumoto, Kohei; Izumi, Kentaro; Takeda, Tsutomu; Komori, Hiroyuki; Akazawa, Yoichi; Shimada, Yuji; Osada, Taro; Watanabe, Sumio

2017-02-01

The aim of the present study was to investigate the efficacy of a potassium-competitive acid blocker (PCAB) named vonoprazan (VPZ) for improving symptoms in patients with reflux esophagitis (RE), non-erosive reflux disease (NERD), and functional dyspepsia (FD). A hospital-based, retrospective study of outpatients in our department (Department of Gastroenterology, University of Juntendo, Tokyo, Japan) between March 2015 and August 2016 was performed. The patients who were experiencing heartburn, acid regurgitation, gastric pain, and/or a heavy feeling in the stomach of at least moderate severity at baseline were treated with 20 mg VPZ once daily for 4 weeks. The patients completed the global overall symptom (GOS) scale to determine their symptom severity at baseline and after the 4 week treatment period. The proportions of patients with RE, NERD, and FD achieving improvement of their symptoms, defined as a GOS scale score of 1 ('no problem') or 2 ('minimal problem'), were evaluated. During 4 weeks of VPZ therapy, changes in the gastroesophageal reflux disease (GERD) score, which was defined as the total points for heartburn and acid regurgitation on the GOS scale in patients with RE and NERD, and in the FD score, which was defined as the total points for gastric pain and a heavy feeling in the stomach on the GOS scale in patients with FD, were also evaluated. A total of 88 eligible cases were included in the present study, comprising 20 patients with RE, 25 patients with NERD, and 43 patients with FD. The rates of symptomatic improvement in patients with RE, NERD, and FD were 75.0, 60.0, and 48.8%, respectively. For the patients who were first administered VPZ, the rates of symptomatic improvement were 90.9, 66.7, and 58.8% in patients with RE, NERD, and FD, respectively. For those patients who were resistant to 8 weeks of proton pump inhibitor therapy, the rates of symptomatic improvement were 55.6, 53.8, and 42.3% in patients with RE, NERD, and FD, respectively

Prevalence of duodenal ulcer-promoting gene (dupA) of Helicobacter pylori in patients with duodenal ulcer in North Indian population.

Science.gov (United States)

Arachchi, H S Jayasinghe; Kalra, Vijay; Lal, Banwari; Bhatia, Vikram; Baba, C S; Chakravarthy, S; Rohatgi, S; Sarma, Priyangshu M; Mishra, V; Das, Bimal; Ahuja, Vineet

2007-12-01

The duodenal ulcer (DU)-promoting gene (dupA) of Helicobacter pylori has been identified as a novel virulent marker associated with an increased risk for DU. The presence or absence of dupA gene of H. pylori present in patients with DU and functional dyspepsia in North Indian population was studied by polymerase chain reaction (PCR) and hybridization analysis. One hundred and sixty-six patients (96 DU and 70 functional dyspepsia) were included in this study. In addition, sequence diversity of dupA gene of H. pylori found in these patients was analyzed by sequencing the PCR products jhp0917 and jhp0918 on both strands with appropriate primers. PCR and hybridization analyses indicated that dupA gene was present in 37.5% (36/96) of H. pylori strains isolated from DU patients and 22.86% (16/70) of functional dyspepsia patients (p dupA was significantly associated with the cagA-positive genotype (p dupA gene with DU in this population. The dupA gene can be considered as a novel virulent marker for DU in this population.

Pharmacotherapy of gastroparesis.

LENUS (Irish Health Repository)

Quigley, E M

2012-02-03

The evaluation and management of gastric motor dysfunction continues to represent a significant clinical challenge. The very definition of what constitutes a clinically relevant disturbance of gastric motility remains unclear. The spectrum of gastroparesis extends from those with classical symptoms and severe delay of gastric emptying to those with dyspepsia and a mild delay in emptying rate. Indeed, for many patients with dyspepsia, the role of gastric emptying delay in the pathogenesis of symptoms, remains unclear. Any assessment of the efficacy of any therapeutic class in gastroparesis must be mindful, therefore, of these variations in definition. For those individuals with severe established gastroparesis, therapeutic success often remains elusive and i.v. erythromycin and oral dopamine antagonists, or substituted benzamides, remain the best options for acute severe exacerbations and chronic maintenance therapy, respectively. Alternatives, currently under investigation, include a number of 5-HT4 agonists, macrolides devoid of antibiotic activity, CCK antagonists and gastric electrical stimulation. Other novel approaches include strategies to address some of the regional abnormalities in gastric motor function that have been identified in some patients with dyspepsia.

Co-infection with Helicobacter pylori and Epstein-Barr virus in benign upper digestive diseases: An endoscopic and serologic pilot study.

Science.gov (United States)

Buzás, György M; Konderák, Judith

2016-06-01

Some gastric cancers are Epstein-Barr virus associated. To assess the prevalence of Helicobacter pylori and viral co-infection in benign upper digestive diseases. One hundred and four outpatients were included in a prospective endoscopic-serologic study. Epstein-Barr virus immunoglobulin G (IgG), immunoglobulin M and viral capsid antigen titres were assayed with an ELISA test. Helicobacter pylori was determined by the modified Giemsa stain and by IgG-chemiluminescence. The overall prevalence of Helicobacter pylori was 56.7%. Duodenal ulcer patients were infected in 72.5 % of the cases, with the prevalence being 33.3% in functional dyspepsia (p = 0.0008) and 25.8% in reflux patients (p = 0.0001). Epstein-Barr virus IgG was detected in 70.1% of the whole group, 75% of duodenal ulcer patients, 51.2% of functional dyspepsia patients (p = 0.04) and 51.6% of the reflux disease cases (p = 0.04). Co-infection with both agents was detected in 60% of duodenal ulcer patients, 18.1% of functional dyspepsia (p = 0.00014) and 12.9% of reflux disease patients (p = 0.00012). Anti-viral IgG titre displayed a 31.7 ± 3.0 cut-off index in duodenal ulcer, 20.5 ± 3.5 in functional dyspepsia (p = 0.01) and 21.4 ± 3.6 in reflux cases (p = 0.03). Both Helicobacter pylori and Epstein-Barr virus, and co-infection with these agents, were significantly more prevalent in duodenal ulcer patients than in dyspeptic/reflux patients.

Prevalence of dyspeptic symptoms and heartburn of adults in Belo Horizonte, Brazil.

Science.gov (United States)

Almeida, Alessandra Maciel; Martins, Luísa Alvarenga Guerra; Cunha, Patrícia Liz Terenzi; Brasil, Viviane Willig; Félix, Lucas Galuppo Fernandes; Passos, Maria do Carmo Friche

2017-01-01

- Medical literature has shown dyspepsia and heartburn-related symptoms occur among 15% to 40% of the population. These symptoms can occur at any age and are more prevalent in women. - Investigate the prevalence of dyspeptic symptoms and heartburn among individuals over 18. - Individuals over 18 were randomly selected in public venues in Belo Horizonte/MG to participate. A standardized questionnaire that included questions related to social-demographic characteristics, eating habits, digestive symptoms, medical appointments, medications, exams, previous surgeries and comorbidities was applied. A questionnaire about functional dyspepsia diagnosis (Rome III) was also applied. - A total of 548 individuals were interviewed. Among these, 58.4% were women, 59.3% were white, 55.9% were single and the average age was 36 years. Within this group, 376 individuals (68.6%) declared to have some symptom and/or use medication to relieve dyspepsia symptoms, and for these patients were applied the Rome III questionnaire. Based on the diagnostic criteria for the questionnaire proposed by the Rome III consensus, the symptom of postprandial fullness was reported by 6.7% of the individuals, early satiety (3.5%) and epigastric pain (10.6%). The overlap of these symptoms was very frequent. The prevalence of functional dyspepsia was 10.6% (postprandial discomfort syndrome (8.2%) and epigastric pain syndrome (2.4%). Among all participants, 52.5% reported heartburn, and 11.1% presented this symptom at least once a week. The most used drug was omeprazole. - The prevalence of dyspeptic symptoms and heartburn among a Brazilian adult urban population is similar to those described in other countries.

The investigation of Helicobacter pylori in the dental biofilm and saliva samples of children with dyspeptic complaints.

Science.gov (United States)

Aksit Bıcak, Damla; Akyuz, Serap; Kıratlı, Binnur; Usta, Merve; Urganci, Nafiye; Alev, Burcin; Yarat, Aysen; Sahin, Fikrettin

2017-03-21

The oral cavity can be an extra-gastric reservoir for Helicobacter pylori (H.pylori). This can play a role in the pathogenesis of halitosis, glossitis, recurrent aphthous stomatitis, and dental caries. The present study was conducted to detect the presence of H.pylori within the dental biofilm and in saliva samples collected from children suffering from dyspepsia and children without any gastrointestinal complaints. Associations with gastric infection, halitosis, and some oral parameters were also evaluated. Seventy children (aged between 5-16) with dyspepsia were selected for the study group and control group composed of 30 healthy children without dyspepsia were also included in the study. After detailed oral and clinical examinations for oral parameters, saliva, and supragingival dental biofilm samples were collected for 16S rRNA and 23S rRNA genes detection by real-time polymerase chain reaction (RT-PCR). The presence of gastric H.pylori was evaluated in endoscopic biopsy specimens histopathologically. Halitosis was evaluated by benzoyl-DL-arginine-naphthylamid (BANA) test. Salivary S.mutans and Lactobacilli sp. counts were also carried out by commercial kits. H.pylori was histopathologically detected amongst 83% of the children with the dyspeptic condition. The detection rate of this bacteria in dental biofilm and saliva samples and halitosis were found relatively higher in the dyspeptic children rather than the control group (p pylori (p > 0.05). In the gastric H.pylori positive group with dyspepsia, DMFT/S and dmft/s numbers and plaque indices were found higher than the control group (p pylori negative group with dyspepsia were found higher than the control group (p pylori positive and negative groups (p > 0.05). Comparing to those with negative for both genes, in children whose dental biofilm and saliva samples were positive for both 16S rRNA and 23S rRNA genes, significantly higher results for halitosis, and DMFS numbers and significantly

Dyspeptic symptoms in patients with type 1 diabetes: endoscopic findings, Helicobacter pylori infection, and associations with metabolic control, mood disorders and nutritional factors.

Science.gov (United States)

Faria, Mariza; Pavin, Elizabeth João; Parisi, Maria Cândida Ribeiro; Nagasako, Cristiane Kibune; Mesquita, Maria Aparecida

2015-04-01

To evaluate, in a group of patients with long-standing type 1 diabetes (DM1), an association of dyspepsia symptoms with: changes in the gastroduodenal mucosa, infection by Helicobacter pylori, glycemic control, and psychological and nutritional factors. A total of 32 patient with DM1 were studied (age: 38 ± 9 years; females: 25; diabetes duration: 22 ± 5 years). All patients answered a standardized questionnaire for the evaluation of gastrointestinal symptoms and underwent upper gastrointestinal endoscopy, with gastric biopsies for the evaluation of Helicobacter pylori infection. The presence of anxiety and depression was evaluated by the HAD scale. Nutritional parameters were BMI, arm and waist circumference, skinfold measurement, and body fat percentage. Upper endoscopy detected lesions in the gastric mucosa in 34.4% of the patients, with similar frequency in those with (n = 21) and without dyspepsia (n = 11). The patients with dyspepsia complaints showed greater frequency of depression (60% vs. 0%; p = 0.001), higher values for HbA1c (9.6 ± 1.7 vs. 8.2 ± 1.3%; p = 0.01) and lower values for BMI (24.3 ± 4.1 vs. 27.2 ± 2.6 kg/m2; p = 0.02), body fat percentage (26.6 ± 6.2 vs. 30.8 ± 7.7%; p = 0.04), and waist circumference (78.7 ± 8 vs. 85.8 ± 8.1 cm; p = 0.02). No association was found between the symptoms and the presence of Helicobacter pylori. Dyspepsia symptoms in patients with long-standing DM1 were associated with glycemic control and depression, and they seem to negatively influence the nutritional status of these patients.

Deregulation of sale of over-the-counter drugs outside of pharmacies in the Republic of Korea: interrupted-time-series analysis of outpatient visits before and after the policy.

Science.gov (United States)

Chun, Sung-Youn; Park, Hye-Ki; Han, Kyu-Tae; Kim, Woorim; Lee, Hyo-Jung; Park, Eun-Cheol

2017-07-12

We evaluated the effectiveness of a policy allowing for the sale of over-the-counter drugs outside of pharmacies by examining its effect on number of monthly outpatient visits for acute upper respiratory infections, dyspepsia, and migraine. We used medical claims data extracted from the Korean National Health Insurance Cohort Database from 2009 to 2013. The Korean National Health Insurance Cohort Database comprises a nationally representative sample of claims - about 2% of the entire population - obtained from the medical record data held by the Korean National Health Insurance Corporation (which has data on the entire nation). The analysis included26,284,706 person-months of 1,042,728 individuals. An interrupted-time series analysis was performed. Outcome measures were monthly outpatient visits for acute upper respiratory infections, dyspepsia, and migraine. To investigate the effect of the policy, we compared the number of monthly visits before and after the policy's implementation in 2012. For acute upper respiratory infections, monthly outpatient visits showed a decreasing trend before the policy (ß = -0.0003);after it, a prompt change and increasing trend in monthly outpatient visits were observed, but these were non-significant. For dyspepsia, the trend was increasing before implementation (ß = -0.0101), but this reversed after implementation(ß = -0.007). For migraine, an increasing trend was observed before the policy (ß = 0.0057). After it, we observed a significant prompt change (ß = -0.0314) but no significant trend. Deregulation of selling over-the-counter medication outside of pharmacies reduced monthly outpatient visits for dyspepsia and migraine symptoms, but not acute upper respiratory infections.

Prevalence of dyspeptic symptoms and heartburn of adults in Belo Horizonte, Brazil

Directory of Open Access Journals (Sweden)

Alessandra Maciel ALMEIDA

Full Text Available ABSTRACT BACKGROUND Medical literature has shown dyspepsia and heartburn-related symptoms occur among 15% to 40% of the population. These symptoms can occur at any age and are more prevalent in women. OBJECTIVE Investigate the prevalence of dyspeptic symptoms and heartburn among individuals over 18. METHODS Individuals over 18 were randomly selected in public venues in Belo Horizonte/MG to participate. A standardized questionnaire that included questions related to social-demographic characteristics, eating habits, digestive symptoms, medical appointments, medications, exams, previous surgeries and comorbidities was applied. A questionnaire about functional dyspepsia diagnosis (Rome III was also applied. RESULTS A total of 548 individuals were interviewed. Among these, 58.4% were women, 59.3% were white, 55.9% were single and the average age was 36 years. Within this group, 376 individuals (68.6% declared to have some symptom and/or use medication to relieve dyspepsia symptoms, and for these patients were applied the Rome III questionnaire. Based on the diagnostic criteria for the questionnaire proposed by the Rome III consensus, the symptom of postprandial fullness was reported by 6.7% of the individuals, early satiety (3.5% and epigastric pain (10.6%. The overlap of these symptoms was very frequent. The prevalence of functional dyspepsia was 10.6% (postprandial discomfort syndrome (8.2% and epigastric pain syndrome (2.4%. Among all participants, 52.5% reported heartburn, and 11.1% presented this symptom at least once a week. The most used drug was omeprazole. CONCLUSION The prevalence of dyspeptic symptoms and heartburn among a Brazilian adult urban population is similar to those described in other countries.

'Horses for courses' in the upper gastrointestinal tract: a rational approach to diagnosis

International Nuclear Information System (INIS)

Mendelson, R.M.

1989-01-01

In Australia, the number of barium studies performed in teaching hospitals has fallen markedly while in the community at large a 113% increase occurred in the number of upper gastrointestinal endoscopic procedures performed between 1980 and 1986. Protagonists of primary endoscopy cite studies that report on the superiority of oesophagogastroduodenoscopy in patients with dyspepsia and related symptoms but several studies have shown that upper gastrointestinal barium studies miss very few important lesions. Fibreoptic endoscopy and radiology each have strengths and weaknesses which determine their respective places in the investigation of the different symptom complexes that are referable to the upper gastrointestinal tract. Double-contrast barium-meal examination is the suggested imaging modality for simple dyspepsia, for the oesophagitis-reflux-hiatus hernia complex and for dysphagia; while oesophagogastroduodenoscopy is the method of choice for the investigation of complicated dyspepsia, haematemesis and melaena. In patients who have previously undergone gastric surgery, endoscopy and radiology are complementary procedures - the former more accurate in the diagnosis of recurrent disease like ulceration, and the later useful for the delineation of anatomical changes. The time for the across-the-board replacement of barium studies by primary endoscopy has not yet arrived. 57 refs

 Cost-effectiveness of medicine vs. endoscopy for dyspeptic patients

DEFF Research Database (Denmark)

Kjeldsen, Hans Christian; Lauritzen, Torsten; Christensen, Bo

  Background: Decision analyses conclude that empirical anti-secretory therapy is more cost-effective than endoscopy for managing patients with dyspepsia however RCTs including economic evaluation come to diverging results Aim: to compare the cost-effectiveness of two strategies for management.......   Results The incremental cost effectiveness (CE) ratio for one day free of dyspeptic symptoms using the endoscopy strategy was €/day 300 compared with the PPI strategy. The incremental CE ratio for one patient free of dyspeptic symptoms after one year using the endoscopy strategy was € 13,600 based....... The empirical PPI strategy was hence the more cost-effective strategy for managing patients with dyspepsia in general practice especially if reflux was the predominant symptom.  ...

Gastroesophageal reflux disease

Science.gov (United States)

Peptic esophagitis; Reflux esophagitis; GERD; Heartburn - chronic; Dyspepsia - GERD ... into the esophagus. This is called reflux or gastroesophageal reflux. Reflux may cause symptoms. Harsh stomach acids can ...

Adding to the Burden: Gastrointestinal Symptoms and Syndromes in Multiple Sclerosis

Directory of Open Access Journals (Sweden)

David J. Levinthal

2013-01-01

Full Text Available Background. Multiple sclerosis (MS patients often suffer from gastrointestinal (GI symptoms. However, the full extent and prevalence of such symptoms are not clearly established. Thus, we sought to define the prevalence of GI symptoms and syndromes in those with MS. Methods. 218 MS patients completed self-reported demographic and clinical data questionnaires as well as several standardized surveys probing MS severity and GI health. Results. Nearly two thirds (65.6% of patients endorsed at least one persistent GI symptom. Constipation (36.6%, dysphagia (21.1%, and fecal incontinence (15.1% were common. Surprisingly, nearly 30% (28.4% of the patients reported dyspeptic symptoms. Using validated diagnostic algorithms, patients met criteria for functional dysphagia (14.7%, functional dyspepsia (16.5%, functional constipation (31.7%, and IBS (19.3%, among others. Functional dysphagia, functional dyspepsia, and IBS were significantly more common in those with self-identified mood disorders. Conclusions. Constipation, fecal incontinence, and dysphagia are indeed frequent symptoms seen in MS patients. We also noted a ~30% prevalence of dyspepsia in this population. The mechanisms driving this association are not clear and require further study. However, due to this high prevalence, dyspeptic symptoms should be incorporated into the routine assessment of MS patients and, if found, may warrant collaborative referral with a GI specialist.

Upper gastrointestinal symptoms in autoimmune gastritis

Science.gov (United States)

Carabotti, Marilia; Lahner, Edith; Esposito, Gianluca; Sacchi, Maria Carlotta; Severi, Carola; Annibale, Bruno

2017-01-01

Abstract Autoimmune gastritis is often suspected for its hematologic findings, and rarely the diagnosis is made for the presence of gastrointestinal symptoms. Aims of this cross-sectional study were to assess in a large cohort of patients affected by autoimmune gastritis the occurrence and the pattern of gastrointestinal symptoms and to evaluate whether symptomatic patients are characterized by specific clinical features. Gastrointestinal symptoms of 379 consecutive autoimmune gastritis patients were systematically assessed and classified following Rome III Criteria. Association between symptoms and anemia pattern, positivity to gastric autoantibodies, Helicobacter pylori infection, and concomitant autoimmune disease were evaluated. In total, 70.2% of patients were female, median age 55 years (range 17–83). Pernicious anemia (53.6%), iron deficiency anemia (34.8%), gastric autoantibodies (68.8%), and autoimmune disorders (41.7%) were present. However, 56.7% of patients complained of gastrointestinal symptoms, 69.8% of them had exclusively upper symptoms, 15.8% only lower and 14.4% concomitant upper and lower symptoms. Dyspepsia, subtype postprandial distress syndrome was the most represented, being present in 60.2% of symptomatic patients. Univariate and multivariate analyses showed that age gastritis is associated in almost 60% of cases with gastrointestinal symptoms, in particular dyspepsia. Dyspepsia is strictly related to younger age, no smoking, and absence of anemia. PMID:28072728

Upper gastrointestinal symptoms in autoimmune gastritis: A cross-sectional study.

Science.gov (United States)

Carabotti, Marilia; Lahner, Edith; Esposito, Gianluca; Sacchi, Maria Carlotta; Severi, Carola; Annibale, Bruno

2017-01-01

Autoimmune gastritis is often suspected for its hematologic findings, and rarely the diagnosis is made for the presence of gastrointestinal symptoms. Aims of this cross-sectional study were to assess in a large cohort of patients affected by autoimmune gastritis the occurrence and the pattern of gastrointestinal symptoms and to evaluate whether symptomatic patients are characterized by specific clinical features.Gastrointestinal symptoms of 379 consecutive autoimmune gastritis patients were systematically assessed and classified following Rome III Criteria. Association between symptoms and anemia pattern, positivity to gastric autoantibodies, Helicobacter pylori infection, and concomitant autoimmune disease were evaluated.In total, 70.2% of patients were female, median age 55 years (range 17-83). Pernicious anemia (53.6%), iron deficiency anemia (34.8%), gastric autoantibodies (68.8%), and autoimmune disorders (41.7%) were present. However, 56.7% of patients complained of gastrointestinal symptoms, 69.8% of them had exclusively upper symptoms, 15.8% only lower and 14.4% concomitant upper and lower symptoms. Dyspepsia, subtype postprandial distress syndrome was the most represented, being present in 60.2% of symptomatic patients. Univariate and multivariate analyses showed that age gastritis is associated in almost 60% of cases with gastrointestinal symptoms, in particular dyspepsia. Dyspepsia is strictly related to younger age, no smoking, and absence of anemia.

Validation and results of a questionnaire for functional bowel disease in out-patients

Directory of Open Access Journals (Sweden)

Skordilis Panagiotis

2002-05-01

Full Text Available Abstract Background The aim was to evaluate and validate a bowel disease questionnaire in patients attending an out-patient gastroenterology clinic in Greece. Methods This was a prospective study. Diagnosis was based on detailed clinical and laboratory evaluation. The questionnaire was tested on a pilot group of patients. Interviewer-administration technique was used. One-hundred-and-forty consecutive patients attending the out-patient clinic for the first time and fifty healthy controls selected randomly participated in the study. Reliability (kappa statistics and validity of the questionnaire were tested. We used logistic regression models and binary recursive partitioning for assessing distinguishing ability among irritable bowel syndrome (IBS, functional dyspepsia and organic disease patients. Results Mean time for questionnaire completion was 18 min. In test-retest procedure a good agreement was obtained (kappa statistics 0.82. There were 55 patients diagnosed as having IBS, 18 with functional dyspepsia (Rome I criteria, 38 with organic disease. Location of pain was a significant distinguishing factor, patients with functional dyspepsia having no lower abdominal pain (p Conclusions This questionnaire for functional bowel disease is a valid and reliable instrument that can distinguish satisfactorily between organic and functional disease in an out-patient setting.

Dispepsia funcional: Nuevos conocimientos en la fisiopatogenia con implicaciones terapéuticas Functional dyspepsia: New pathophysiologic knowledge with therapeutic implications

Directory of Open Access Journals (Sweden)

Ana C. Hernando-Harder

2007-08-01

Full Text Available La dispepsia funcional (DF es un complejo sintomático, heterogéneo y altamente prevalente en la comunidad y en la práctica general. La DF se define como la presencia de síntomas que se piensan originados en la región gastroduodenal, en ausencia de enfermedad orgánica, sistémica o metabólica que pueda explicarlos. Entre los factores fisiopatogénicos se incluyen los trastornos de la acomodación y del vaciamiento gástrico, dismotilidad duodenal, sensibilidad aumentada, factores psicosociales y una asociación con un estado postinfeccioso. Se han hecho numerosos esfuerzos para aumentar los conocimientos en la etiopatogenia del síndrome, incluyendo nuevos aspectos moleculares y genéticos. Sin embargo, el mecanismo etiopatogénico exacto que causa los síntomas en un paciente individual sigue siendo difícil de identificar. Los nuevos criterios de Roma III redefinen y subclasifican la DF basándose en sus síntomas principales, lo cual es de gran valor para la investigación, el desarrollo y el control estandarizados de nuevas estrategias terapéuticas así como la formulación de recomendaciones para la práctica clínica. Las modalidades terapéuticas que se han empleado incluyen: modificaciones dietéticas, agentes farmacológicos dirigidos a actuar sobre distintos blancos dentro del aparato gastrointestinal, del sistema nervioso central y periférico, y terapias psicológicas incluyendo la hipnoterapia. Desafortunadamente, hasta la fecha, todas estas terapias han rendido solamente resultados marginales. Después de excluir enfermedad orgánica, es esencial que el paciente esté informado sobre la naturaleza y el pronóstico benignos de su enfermedad, y esto puede ser, a veces, la inversión más provechosa tanto para el paciente como para su médico.Functional dyspepsia (FD is a heterogeneous, highly prevalent symptom complex in the community and general practice. FD is defined as the presence of symptoms considered as originated in

Diagnostic outcome of patients referred to psychiatry with medically ...

African Journals Online (AJOL)

of patients have disabling medically unexplained symptoms. (MUS), many of whom have ... dyspepsia, fibromyalgia and chronic fatigue syndrome) in particular, have been ..... An Epidemiological Study in Seven Specialities. J Psychosom Res.

Gastroesophageal reflux disease - children

Science.gov (United States)

Peptic esophagitis - children; Reflux esophagitis - children; GERD - children; Heartburn - chronic - children; Dyspepsia - GERD - children ... GERD. Certain factors can lead to GERD in children, including: Birth defects, such as hiatal hernia , a ...

Bugs on the brain; brain in the gut--seeking explanations for common gastrointestinal symptoms.

LENUS (Irish Health Repository)

Quigley, E M M

2013-03-01

Gastrointestinal symptoms such as heartburn, indigestion (or dyspepsia), bloating, distension, constipation, abdominal pain, abdominal discomfort and diarrhoea are extremely common worldwide. For some, such symptoms can prove to be chronic and disabling.

Randomised clinical trial: the clinical efficacy and safety of an alginate-antacid (Gaviscon Double Action) versus placebo, for decreasing upper gastrointestinal symptoms in symptomatic gastroesophageal reflux disease (GERD) in China.

Science.gov (United States)

Sun, J; Yang, C; Zhao, H; Zheng, P; Wilkinson, J; Ng, B; Yuan, Y

2015-10-01

There is a paucity of large-scale studies evaluating the clinical benefit of the Gaviscon Double Action (DA) alginate-antacid formulation for treating gastroesophageal reflux disease (GERD) symptoms. Randomised double-blind placebo-controlled parallel-group study to evaluate efficacy and safety of Gaviscon DA in reducing heartburn, regurgitation and dyspepsia symptoms in individuals with mild-to-moderate GERD in China. Participants with symptomatic GERD (n = 1107) were randomised to receive Gaviscon DA or placebo (two tablets four times daily) for seven consecutive days. The primary endpoint compared the change in Reflux Disease Questionnaire (RDQ) score for the GERD (heartburn + regurgitation) dimension between Gaviscon DA and placebo. Secondary endpoints compared the change in RDQ scores for individual heartburn, regurgitation and dyspepsia dimensions, overall treatment evaluation (OTE) scores and incidence of adverse events (AEs). Mean RDQ GERD scores: 2.51 for Gaviscon DA and 2.50 for placebo at baseline; 1.25 for Gaviscon DA and 1.46 for placebo post treatment. Gaviscon DA was statistically superior to placebo in reducing GERD and dyspepsia RDQ scores [least-squares mean (LSM) difference: GERD -0.21, P GERD symptoms was observed both in those with non-erosive and those with erosive reflux disease (LSM difference -0.14 [P = 0.038] and -0.29 [P GERD. ClinicalTrials.gov: NCT01869491. © 2015 The Authors. Alimentary Pharmacology & Therapeutics Published by John Wiley & Sons Ltd.

Anxiety Level in Dyspeptic Patients at the Gastroenterohepatology Outpatient Clinic of Dr. Hasan Sadikin General Hospital Bandung, Indonesia

Directory of Open Access Journals (Sweden)

Radistrya Sekaranti Brahmanti

2015-03-01

Full Text Available Background: Dyspepsia is a disease with a high worldwide prevalence, including in Asia; however, the pathophysiology of the disease is still unclear. Recent studies suggest adapting a biopsychosocial model to understand the pathophysiology of dyspepsia that proposes the important role of anxiety. The aim of this study was to assess the anxiety level in dyspeptic patients who visited the Gastroenterohepatology Outpatient Clinic in Dr. Hasan Sadikin General Hospital Bandung. Methods: A cross-sectional descriptive study using total sampling method was conducted from September–November 2012 to 19 patients aged 36−85 years old who consisted of 11 women and 8 men patients dyspepsia syndrome in the Gastroenterohepatology outpatient clinic Dr Hasan Sadikin General Hospital Bandung. The anxiety levels were measured using the Zung Self-Rating Anxiety Scale. All data were analyzed based on gender, age, and occupational status of the patients. Results: Eleven of the nineteen patients had high anxiety levels. Women were more likely to experience high anxiety levels (8 of 11. The group with the highest number of patients with high anxiety was the 46−55 years old group, the high anxiety level was more common among patients who were government or private sector employees. Conclusion: The anxiety level in dyspeptic patients who visited the Gastroenterohepatology outpatient clinic in Dr. Hasan Sadikin General Hospital Bandung was high.

Effect of hypo- and hyperthyroidism on gastric myoelectrical activity.

Science.gov (United States)

Gunsar, Fulya; Yilmaz, Sema; Bor, Serhat; Kumanlioğlu, Kamil; Cetinkalp, Sevki; Kabalak, Taylan; Ozutemiz, Omer Ahmet

2003-04-01

Although hypo- and hyperthyroid patients have different symptoms in the gastrointestinal tract, the mechanism of thyroid action on the gut remains poorly understood. Thus the aim of this study was to investigate the effect of hypo- and hyperthyroidism on gastric myoelectrical activity, gastric emptying, dyspeptic symptoms. Twenty-two hyperthyroid (median age 45, 15 females) and 11 hypothyroid (median age 42, 10 females) patients were included into the study. Dyspepsia score, hypo- and hyperthyroid symptom scale, abdominal ultrasonography and upper gastrointestinal endoscopy were performed. Gastric myoelectrical activity was measured by electrogastrograpy (EGG) before and after therapy both preprandially and postprandially and compared with age, gender, and body-matched controls (12 for hypothyroid, 15 for hyperthyroid patients). Radionuclide gastric emptying studies were performed with a solid meal. Hypothyroid patients revealed a significant increase in preprandial tachygastria as compared with controls (12.3% vs 4.8%). The percentage of preprandial normal slow waves (2.4-3.7 cpm) was below 70% (dysmotility) in 7 of 11 hypothyroid patients versus 2 of 12 controls (P Hyperthyroid patients revealed a significantly higher preprandial (3.1 vs 2.8) and postprandial (3.4 vs 3) DF when compared with the controls (P hyperthyroid patients than in the controls (P hyperthyroid group and 1 in controls (P hyperthyroid patients vs 1 of 15 controls (P hyperthyroid symptom scale correlated to dyspepsia score. Dyspepsia score in hyperthyroidism correlated to power ratios in hyperthyroid patients. We detected some correlations between serum levels of fT3 or fT4 and some EGG parameters in hypo- and hyperthyroidism. Dyspepsia score and hypo- and hyperthyroid symptom scale were improved significantly after therapy in the euthyroid state. In conclusions, we showed gastric dysrhythmia by EGG in both hypo- and hyperthyroid patients. Dyspeptic symptoms correlated to the activity of

Peng et al., Afr J Tradit Complement Altern Med. (2015) 12(5):35-45 ...

African Journals Online (AJOL)

Proff.Adewunmi

as a kind of specific application of syndrome differentiation, You Gu Wu Yun, documented .... Zhi-Zhu-Wan (ZZW), a famous Chinese medical preparation used to treat functional dyspepsia, contains Aurantii fructus ..... Abdominal pain, vomiting,.

Helicobacter pylori and nonmalignant diseases.

LENUS (Irish Health Repository)

Alakkari, Alaa

2012-02-01

Research published over the past year has documented the continued decline of Helicobacter pylori-related peptic ulcer disease and increased recognition of non-H. pylori, non-steroidal anti-inflammatory drugs ulcer disease--idiopathic ulcers. Despite reduced prevalence of uncomplicated PUD, rates of ulcer complications and associated mortality remain stubbornly high. The role of H. pylori in functional dyspepsia is unclear, with some authors considering H. pylori-associated nonulcer dyspepsia a distinct organic entity. There is increasing acceptance of an inverse relationship between H. pylori and gastroesophageal reflux disease (GERD), but little understanding of how GERD might be more common\\/severe in H. pylori-negative subjects. Research has focused on factors such as different H. pylori phenotypes, weight gain after H. pylori eradication, and effects on hormones such as ghrelin that control appetite.

Eray et al., Afr J Tradit Complement Altern Med. (2015) 12(5):8-13 ...

African Journals Online (AJOL)

Proff.Adewunmi

common cold as well as in the treatment of chronic diseases such as cancer, diabetes ... cancer, chronic liver disease, irritable bowel disease, gastroesophageal reflux disease, dyspepsia and constipation (Soeken, 2004; Kong et al., 2005; ...

ISSN 2073 ISSN 2073 9990 East Cent. Afr. J. s 9990 East Cent. Afr ...

African Journals Online (AJOL)

Hp 630 Dual Core

intra muscular/ intra venous) pentazocine (30mg) or tramadol 50mg, and .... Complications encountered were single case each of surgical site infection ... localized to the epigastrium and may present as dyspepsia mimicking peptic ulcer disease.

To compare the efficacy of two kinds of Zhizhu pills in the treatment of functional dyspepsia of spleen-deficiency and qi-stagnation syndrome:a randomized group sequential comparative trial

Science.gov (United States)

2011-01-01

Background In Traditional Chinese Medicine (TCM) theory, functional dyspepsia (FD) can be divided into different syndromes according to different clinical symptoms and signs, and the most common one is spleen-deficiency and qi-stagnation syndrome that can be treated by Chinese traditional patent medicine ---- two kinds of Zhizhu pills, between which the primary difference in ingredients is that one contains immature orange fruit of Citrus aurantium L.(IFCA) and the other contains that of Citrus sinensis Osbeck (IFCS). The trial's objective was to compare the efficacy of two kinds of Zhizhu pills on symptom changes in patients with FD of spleen-deficiency and qi-stagnation syndrome. Methods A randomized, group sequential, double-blinded, multicenter trial was conducted in patients with FD of spleen-deficiency and qi-stagnation syndrome at 3 hospitals in Beijing between June 2003 and May 2005. Participants were randomly allocated into two groups (IFCA group and IFCS group) in a 1:1 ratio, and respectively took one of the two kinds of Zhizhu pills orally, 6 g each time, 3 times a day, for 4 weeks. Statistical analysis was performed with use of a group sequential method, the triangular test (TT). Results A total of 163 patients were randomized, and 3 patients were excluded from analysis because of early dropouts, leaving 160 patients (IFCA group: n = 82; IFCS group: n = 78) for statistical analysis. Three interim analyses were done after 62, 116, and 160 patients had completed their 4-week treatment, respectively. At the third interim analysis, the sample path crossed the upper boundary and the trial was stopped, the cure-markedly effective rates were 45% for IFCS group and 67% for IFCA group, respectively, the one-sided p-value was 0.0036, the median unbiased estimate of the odds ratio (OR) for the benefit of IFCA relative to IFCS was 2.91 with 95%CI: 1.40 to 6.06. No adverse events were observed in the two groups. Conclusions Zhizhu pills containing IFCA was superior

Prevalence of Helicobacter pylori among Nigerian patients with ...

African Journals Online (AJOL)

pylori positive. Conclusion: The prevalence of H. pylori among dyspeptics using biopsy based methods is high in the South-Western part of Nigeria. It is therefore important to test and treat H. pylori among Nigerians with dyspepsia.

Efficacy of traditional Chinese herbal medicine in the treatment of ...

African Journals Online (AJOL)

polyps, inflammatory polyps, and hyperplastic polyps according to ... gastric diseases, such as functional dyspepsia. [5,6] and diarrhea ... come in contact with dogs, cats, or birds. He had ... nodules, intestinal polyps, and nasal polyps. Figure 1: ...

P83

Directory of Open Access Journals (Sweden)

O. Ephimova

2015-11-01

Conclusion: The combination of nonspecific clinical signs (pain, dyspepsia with biochemical markers of biliary pathology and endocrine pancreatic insufficiency – of PCa patients demonstrates the obligatoriness of differential diagnostic pancreatic and biliary pathology in their earlier stages.

Ranitidine vooral werkzaam bij functionele dyspepsie met klachten passend bij refluxziekten

NARCIS (Netherlands)

Jebbink, H. J.; Smout, A. J.; van Berge Henegouwen, G. P.

1993-01-01

OBJECTIVE: To investigate the effect of ranitidine in patients with functional dyspepsia according to different subgroups. SETTING: University Hospital Utrecht, department of gastroenterology. DESIGN: Prospective double blind cross-over study. METHOD: Thirty patients with chronic upper abdominal

Research

African Journals Online (AJOL)

abp

2017-10-06

Oct 6, 2017 ... Factors leading to dyspepsia in renal transplant recipients. Aisha Nazeer1,& ..... immunosuppressants to avoid rejection including tacrolimus [19]. To the best of our ... Machnicki G et al. Increased risk of graft failure in kidney.

The clinical meaning of gastric-wall hyperactivity observed on sestamibi cardiac single-photon emission computed tomography

Energy Technology Data Exchange (ETDEWEB)

Cote, C.; Dumont, M. [Centre Hospitalier Universitaire de Quebec, Dept. of Nuclear Medicine, Quebec, Quebec (Canada)]. E-mail: christian.cote@chuq.qc.ca

2004-06-01

To evaluate prospectively the incidence and clinical meaning, if any, of gastric-wall hyperactivity observed on sestamibi cardiac single-photon emission computed tomography (SPECT). This phenomenon is completely different from the well-known intraluminal gastric reflux of sestamibi. A group of 819 patients who underwent sestamibi cardiac SPECT was studied from January 2000 to October 2000. Gastric-wall activity was graded qualitatively. Only patients with gastric-wall activity near or equivalent to their heart activity were considered for subsequent analysis. The medical records of patient candidates were reviewed, and their family physicians were asked to respond to a questionnaire by telephone when further information was needed. We identified 13 patients with significant gastric-wall hyperactivity, which was more intense on rest images. Our review of the clinical data shows that all these patients were suffering from dyspepsia and were taking gastric medication. These 13 cases were assigned to 3 groups: gastroesophageal reflux, chronic functional dyspepsia and nonspecific gastritis. Significant gastric-wall hyperactivity is an infrequent observation on sestamibi cardiac SPECT. Our results indicate that the presence of significant gastric-wall hyperactivity is associated with dyspepsia. It is important to realize that this gastric-wall hyperactivity by its proximity to the inferior myocardial wall could in some circumstances lead to either false-negative or false-positive findings, representing a diagnostic problem. Although infrequent, this situation could be avoided by proper quality control, including a systematic review of the raw cine data before reading the images. (author)

Symptoms of Functional Intestinal Disorders Are Common in Patients with Celiac Disease Following Transition to a Gluten-Free Diet.

Science.gov (United States)

Silvester, Jocelyn A; Graff, Lesley A; Rigaux, Lisa; Bernstein, Charles N; Leffler, Daniel A; Kelly, Ciarán P; Walker, John R; Duerksen, Donald R

2017-09-01

Celiac disease and functional intestinal disorders may overlap, yet the natural history of functional symptoms in patients with celiac disease is unknown. To investigate the prevalence of irritable bowel syndrome (IBS), functional dyspepsia (FD), and functional bloating (FB) symptoms among patients with celiac disease at diagnosis and during the first year of a gluten-free diet. Adults with a new diagnosis of celiac disease were surveyed at baseline, 6 months and 1 year using standardized measures for intestinal symptoms [Rome III diagnostic questionnaire and celiac symptom index (CSI)] and gluten-free diet adherence [gluten-free eating assessment tool (GF-EAT) and celiac diet adherence test]. At diagnosis, two-thirds fulfilled Rome III diagnostic questionnaire symptom criteria for IBS (52%), functional dyspepsia (27%), and/or functional bloating (9%). One year post-diagnosis, there was high adherence to a gluten-free diet as 93% reported gluten exposure less than once per month on the GF-EAT and only 8% had ongoing celiac disease symptoms (CSI score >45). The rates of those meeting IBS (22%) and functional dyspepsia (8%) symptom criteria both decreased significantly on a gluten-free diet. The prevalence of functional symptoms (any of IBS, FD or FB) at 1 year was 47%. Long-term follow-up of patients with celiac disease is necessary because many patients with celiac disease who are adherent to a gluten-free diet have persistent gastrointestinal symptoms.

Adnan et al., Afr J Tradit Complement Altern Med. (2015) 12(5):99 ...

African Journals Online (AJOL)

Proff.Adewunmi

people of Pakistan, some medicinal plants need to be conserved for the future. Key words: .... Therefore, they should be checked for gastrointestinal cancer in Pakistan. Dyspepsia .... Roots are dip in earthen pot for whole night. In morning the.

Anti-t B toxopla Balsam asma g mocitru gondii us cam activit merune ...

African Journals Online (AJOL)

SAM

and for fever, dyspepsia, cholera, Carminative and stomachic ... system diseases (Lewis and Elin-Lewis, 1977; Metou et al., 1988 ... yielded a yellow-brown residue (31.5 g). A part (30 g) ..... Surveillance for AIDS-defining opportunistic illnesses ...

Nigerian Journal of Gastroenterology and Hepatology - Vol 2, No 2 ...

African Journals Online (AJOL)

Correlation between Endoscopic and Histological Gastritis in South-Western Nigerians with Dyspepsia · EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. AC Jemilohun, JA Otegbayo, SO Ola, AO Oluwasola, A Akere, 73-76 ...

Khan et al., Afr J Tradit Complement Altern Med. (2015) 12(2):60-64 ...

African Journals Online (AJOL)

cadewumi

alkalinity, chronic catarrh, renal disorders, dyspepsia, bloody dysentery and coronary (Madhavashetty et al., 2008), vomiting (Khan et al., 2013), leucoderma, antiviral, lymphatic glyndular system disease, antidiabetic, rectal prolapsus, aphrodisiac, anti-cholesterol, impetigo and carbubuncles (Nardkarnis, 2008; Pullaiah and ...

Detection of Helicobacter pylori vacA, cagA and iceA1 virulence ...

African Journals Online (AJOL)

Ahmed El-Shenawy

related genes in different age group patients with ... vacA and iceA1 genotypes of H. pylori strains recovered from patients with dyspepsia. Subjects and methods: ..... many decades in the absence of antimicrobial treatment. Longitu- dinal studies ...

Is Dysguesia Going to be a Rare or a Common Side‑effect of ...

African Journals Online (AJOL)

amlodipine are peripheral edema (8.3%), fatigue (4.5%), dizziness, palpitations, myalgia, stomachache, headache, dyspepsia, nausea, blood disorders, gynecomastia, .... Coulter DM. Eye pain with nifedipine and disturbance of taste with captopril: A mutually controlled study showing a method of postmarketing surveillance.

Management of Helicobacter pylori infection--the Maastricht IV/ Florence Consensus Report

DEFF Research Database (Denmark)

Malfertheiner, Peter; Megraud, Francis; O'Morain, Colm A

2012-01-01

and examined key clinical aspects in three subdivided workshops: (1) Indications and contraindications for diagnosis and treatment, focusing on dyspepsia, non-steroidal anti-inflammatory drugs or aspirin use, gastro-oesophageal reflux disease and extraintestinal manifestations of the infection. (2) Diagnostic...

Sequelae to torture. A controlled study of torture victims living in exile

DEFF Research Database (Denmark)

Hougen, H P; Kelstrup, Jesper Dahl; Petersen, H D

1988-01-01

with nightmares and impaired memory. Emotional lability and concentration disturbances were also frequent. Physically the torture victims suffered from headache, various cardio-pulmonary and muscular pains, dyspepsia and reading disturbances. All reported that they had been healthy before torture. The clinical...

Preoperative prediction model of outcome after cholecystectomy for symptomatic gallstones

DEFF Research Database (Denmark)

Borly, L; Anderson, I B; Bardram, L

1999-01-01

patients completed all questionnaires. Twenty-one patients continued to have abdominal pain after the operation. Patients with pain 1 year after cholecystectomy were characterized by the preoperative presence of a high dyspepsia score, 'irritating' abdominal pain, and an introverted personality...

2010 Aerospace Medical Certification Statistical Handbook

Science.gov (United States)

2012-02-01

from the Aviation Medical Examiner Information System (AMEIS). The current status of each AME was determined for each year of the study period from...severe gastritis, esophageal reflux, achalasia, GERD, gastroplasty, dysphagia , dyspepsia, thrombus abdomen aorta# 21,902 3.66 Other skin

Upper gastrointestinal endoscopic findings and prevalence of ...

African Journals Online (AJOL)

Upper gastrointestinal endoscopic findings and prevalence of Helicobacter pylori infection among adult patients with dyspepsia in northern Tanzania. ... Endoscopy (EGD) for initial work up. Study on antimicrobial susceptibility pattern of H. pylori is recommended to guide choices for evidence based treatment option.

Risk of gastrointestinal adverse effects of dabigatran compared with warfarin among patients with atrial fibrillation

DEFF Research Database (Denmark)

Staerk, Laila; Gislason, Gunnar H.; Lip, Gregory Y.H.

2015-01-01

Danish nationwide registries from 22 August 2011 until 31 December 2012. Patients were classified as naive or experienced users, according to prior use of oral anticoagulant (OAC) therapy. The risk of subsequent proton pump inhibitor (PPI) use, upper dyspepsia-like diagnoses (gastroesophageal reflux...

Effects of Community Screening for Helicobacter pylori

DEFF Research Database (Denmark)

Bomme, Maria; Hansen, Jane Møller; Wildner-Christensen, Mette

2017-01-01

the long-term effect of Hp population screening and eradication on dyspepsia prevalence and the incidence of PUD, and as secondary outcomes to assess the effect on health-care consumption and quality of life. METHODS: At baseline in 1998-1999 20,011 individuals aged 40-65 years were randomized to Hp...... positive. Complete symptom data were obtained for 8,658 (69%) individuals after 13 years. Dyspepsia prevalence decreased in both groups during follow-up, but multivariate analysis showed no effect of Hp screening and eradication (adjusted OR=0.93 (0.82-1.04)); compared to usual care. Intention to treat...... and per protocol analysis of register data gave similar results. Hp screening did neither reduce the PUD incidence significantly (adjusted OR=0.88 (0.70-1.11)) nor did it have beneficial effect on health care consumption. Hp screening had no long-term effect on quality of life. CONCLUSION: This randomized...

NOD2/CARD15 genotype and common gastrointestinal diseases in 43 600 individuals

DEFF Research Database (Denmark)

Yazdanyar, S.; Nordestgaard, B.G.

2010-01-01

associate with risk of nine common gastrointestinal diseases. Design and setting. We genotyped 43 596 white individuals from the Danish general population followed for 31 years, during which time 782 developed oesophagitis and reflux, 1395 ulcus ventriculi and duodeni, 1384 gastritis and dyspepsia, 1407...

Nigerian Journal of Gastroenterology and Hepatology - Vol 4, No 1 ...

African Journals Online (AJOL)

Management of Liver Metastasis from Colo-Rectal Carcinoma with Laparoscopy: A Literature Review · EMAIL FULL TEXT EMAIL FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. E Ray-Offor, EF Alufohai, AB Allison, 9-16. Helicobacter Pylori: Serological Testing and Treatment in Uninvestigated Dyspepsia: ...

Empiric treatment based on Helicobacter Pylori serology cannont ...

African Journals Online (AJOL)

Background: Evidence that chronic gastric Helicobacter pylori (HP) infection is an aetiological factor in dyspepsia, peptic ulcer disease, gastric carcinoma and lymphoma has led to the suggestion that all serologically positive dyspeptic patients should be treated empirically with antibiotics to eradicate the infection, without ...

Anatomy of the aerial parts and chemical composition of the essential oil of Orthodon chinensis Maxim. from Vietnam

NARCIS (Netherlands)

Lo, V.N.; An, N.T.K.; Dung, N.X.; Nam, Vu Viet; Leclercq, P.A.

1994-01-01

The aerial parts of Orthodon chinensis Maxim. (syn. Mosla chinensis Maxim.) are used for the treatment of some common diseases (dyspepsia, diarrhoea, epidermophytosis, etc.) and for the production of traditional alcohol yeast. The anatomic structure of the stem and leaves has been studied and is

The spectra of selected functional gastrointestinal disorders in ...

African Journals Online (AJOL)

Background: The prevalence of functional gastrointestinal disorders (FGIDs) including functional dyspepsia (FD), irritable bowel syndrome (IBS) and functional constipation (FC) was not studied in Sudan. Objectives: The aim of this study is to estimate prevalence of these disorders in Sudanese university students using ...

PATTERNS OF SEVEN AND COMPLICATED MALARIA IN CHILDREN

African Journals Online (AJOL)

GB

2017-11-01

Nov 1, 2017 ... BACKGROUND: Helicobacter pylori (H.pylori) infection is predominantly acquired in childhood from family members. The infection can cause dypepepsia, chronic and acute gastritis and gastric cancer. Dyspepsia is the most common illness in the. Ethiopian population visiting outpatient department of ...

Managing "Helicobacter Pylori" in College Health, with Special Considerations for International Students

Science.gov (United States)

Hillard, James Randolph; Kashup, Suman

2016-01-01

Objective: "Helicobacter pylori" infection is the major cause of dyspepsia, peptic ulcer disease, and gastric cancer. This paper will make specific recommendations for a diagnostic and treatment strategy tailored to the international student population. Participants/Methods: This paper is a case report and narrative review based on…

14C-urea breath test as a method to detect Campylobacter pylori colonization

NARCIS (Netherlands)

Rauws, E. A.; van Royen, E. A.; Tytgat, G. N.

1989-01-01

Campylobacter pylori may cause type B gastritis. C. pylori produces urease, and the presence of this enzyme in gastric mucosal biopsies is a marker for colonization with the microorganism. The value of a breath test to detect C. pylori colonization in non-ulcer dyspepsia patients was investigated.

Total pepsin activity and gastrin in sera as markers of eradication of Helicobacter pylori

NARCIS (Netherlands)

Khoshkholgh, M.; Saberi-Firoozi, M.; Fattahi, M.; Siavoshi, F.; Khatibian, M.; Vahedi, H.; Mikaeli, J.; Ansari, R.; Alizadeh, B.; Malekzadeh, R.; Massarrat, S.

1994-01-01

The measurement of total pepsin activity by colorimetry, and gastrin by radioimmunoassay method was performed on the sera of 100 patients (80 with duodenal ulcer and 20 with non-ulcer dyspepsia) before and 4 weeks after the end of antibacterial treatment for eradication of Helicobacter pylori. While

Magnitude of Helicobacter pylori among Dyspeptic patients ...

African Journals Online (AJOL)

Background: Helicobacter pylori (H.pylori) infection is predominantly acquired in childhood from family members. The infection can cause dypepepsia, chronic and acute gastritis and gastric cancer. Dyspepsia is the most common illness in the Ethiopian population visiting outpatient department of health facilities, and it has ...

Antiradical capacity and reducing power of different extraction ...

African Journals Online (AJOL)

Areca catechu is a common traditional Chinese medicinal plant used to treat dyspepsia, constipation, beriberi and oedema. The antiradical capacities of different extraction method of A. catechu extracts were evaluated by scavenging activity on 1,1-diphenyl-2-picrylhydrazyl (DPPH) and superoxide radicals. Reducing power ...

Further evidence of ethnic and gender differences for Helicobacter pylori infection among endoscoped patients.

Science.gov (United States)

Sasidharan, S; Uyub, A M; Azlan, A A

2008-12-01

HeIicobacter pylori infection rate was determined in 697 consecutive patients with ulcer, gastritis, duodenitis and non-ulcer dyspepsia by endoscopy at a Malaysian hospital in 1999-2002. Biopsies of the gastric antrum and body were subjected to the urease test, Gram staining of impression smears and culture examination. Infection was defined as a positive result in at least one test. The infection rates were 32.1, 10.4, 20.0 and 16.2% in ulcer, gastritis, duodenitis and non-ulcer dyspepsia patients, respectively. Overall, the prevalence of H. pylori infection was 14.6%, with the rate among the Indian (21.7%), Chinese (19.2%) and Bangladeshi foreign worker (23.1%) groups significantly higher (Pdifferences (Pgender, the prevalence rates of Malay males and females were also significantly lower (Pdifference in H. pylori infection prevalence rates among ethnic groups (highest in Indians, then Chinese and unusually low in Malays) and gender groups (highest in males) in Malaysia.

A 12 years audit of upper gastrointestinal endoscopic procedures

International Nuclear Information System (INIS)

Khurram, M.; Khaar, H.B.; Hasan, Z.; Umar, M.; Javed, S.; Asghar, T.; Minhas, Z.; Akbar, A.; Atta, N.; Nassar, F.; Sultana, Q.; Pervaiz, A.; Masoom, A.

2003-01-01

Objective: Evaluation of upper gastrointestinal (GI) endoscopy in terms of indications, diagnostic efficacy, and diseases diagnosed. Results: Of the 8481 patients, 4935 (58.2%) were female and 3546 (41.8%) male. Mean patient age was 40.5 years. Dyspepsia (42.6%), upper GI bleed (32.8%), and evaluation of chronic liver disease (10.2%) were common indications of the procedure. An endoscopic diagnosis was possible in 82.6% patients. Varices, gastritis, duodenitis, and combined lesions were common endoscopic diagnosis. Gastritis and duodenitis were most frequent causes of upper GI bleed. We noted more gastric ulcers compared to duodenal ulcers. Females had significantly more normal endoscopies, p-value = 0.02. Conclusion: Upper GI endoscopy is an effective procedure. Dyspepsia evaluation is commonest indication for upper GI endoscopy in our patients. Etiology of upper GI bleed, and incidence of duodenal ulcer compared to gastric ulcer in our patients are different than described in literature. Females have significantly more normal endoscopies. (author)

62 . ORIGINAL ARTICLE

African Journals Online (AJOL)

Dr Oboro VO

ABSTRACT. Background: The strong association of Helicobacter pylori (H. pylori) with dyspepsia has caused a major paradigm shift in ... Objective: This study evaluated the diagnostic accuracy of rapid urease test (RUT) in the diagnosis of Helicobacter pylori (H. pylori) in ... Those who were previously treated for H. pylori ...

Management of Helicobacter Pylori Infection

African Journals Online (AJOL)

Dr Olaleye

90%, the sequential therapy seems to have a potential of becoming the standard first-line treatment for H pylori infection in the interim, while search is being made for the ideal antimicrobial monotherapy. . Keywords: Helicobacter pylori, Dyspepsia, Gastric cancer, Gastric Ulcer, Duodenal ulcer. INTRODUCTION. 1. Since the ...

Author Details

African Journals Online (AJOL)

Correlation between Endoscopic and Histological Gastritis in South-Western Nigerians with Dyspepsia Abstract · Vol 2, No 2 (2010) - Articles Association between Body Mass Index and Gastroesophageal Reflux Disease in Blacks Abstract · Vol 4, No 1 (2012) - Articles Advanced Hepatocellular Carcinoma in 3rd Trimester of ...

Association Between Khat ( Catha edulis ) Chewing and Infection ...

African Journals Online (AJOL)

Setting: KEMRI's Centre for Clinical Research (CCR) and St. Michael's Digestive Disease and Medical Care. Subjects: Ninety three cases were selected using Rome III criteria for functional dyspepsia, and the controls (n=93) were matched on age and gender. Results: Khat Chewing was associated with infection with H.

Functional disorders of the stomach

Science.gov (United States)

Koch, K. L.; Stern, R. M.

1990-01-01

Gastroenterologists frequently encounter patients who report vague epigastric discomforts or sensations of fullness, bloating, and distention in the upper abdomen. The discomfort is neither burning in character nor severe in intensity; there is no nocturnal pain. The epigastric location of discomfort and lack of radiation may help to exclude biliary tract and pancreatic diseases. Nausea may be present, but there is little or no vomiting. After these patients ingest liquids or solid foods, the symptoms of easy filling or early satiety and increasing discomfort and nausea are almost always present. The patient may only report "indigestion," but a specific chief complaint, such as pain, discomfort, nausea, or bloating may be elicited with further inquiries. Solid foods usually provoke more symptoms than do liquids. Symptoms of early satiety, nausea, bloating, and abdominal discomfort may culminate in the vomiting of undigested food. These vague upper gastrointestinal (GI) symptoms have been termed "dyspepsia." When peptic diseases of the stomach are excluded, the symptom complex has been called "nonulcer" dyspepsia, a vague syndrome with symptoms attributed to stomach dysfunction. Nonulcer dyspepsia has been reviewed recently. Such symptoms, commonly attributed to a "functional" disorder, are very common in clinical practice, with an incidence of 30% of patients. In this review, we will discuss an approach to the evaluation and treatment of patients with symptoms of nausea, early satiety, bloating, and vague epigastric discomfort--dyspeptic symptoms associated with functional stomach disorders. We will review the anatomy and motility of the stomach and suggest potential neuromuscular malfunctions of the stomach that may result in epigastric symptoms. The potential role of stress and other brain-gut interactions, which may underlie these symptoms, will also be reviewed.

Access to specialist gastroenterology care in Canada: Comparison of wait times and consensus targets

Science.gov (United States)

Leddin, Desmond; Armstrong, David; Barkun, Alan NG; Chen, Ying; Daniels, Sandra; Hollingworth, Roger; Hunt, Richard H; Paterson, William G

2008-01-01

BACKGROUND: Monitoring wait times and defining targets for care have been advocated to improve health care delivery related to cancer, heart, diagnostic imaging, joint replacements and sight restoration. There are few data on access to care for digestive diseases, although they pose a greater economic burden than cancer or heart disease in Canada. The present study compared wait times for specialist gastroenterology care with recent, evidence-based, consensus-defined benchmark wait times for a range of digestive diseases. METHODS: Total wait times from primary care referral to investigation were measured for seven digestive disease indications by using the Practice Audit in Gastroenterology program, and were benchmarked against consensus recommendations. RESULTS: Total wait times for 1903 patients who were undergoing investigation exceeded targets for those with probable cancer (median 26 days [25th to 75th percentiles eight to 56 days] versus target of two weeks); probable inflammatory bowel disease (101 days [35 to 209 days] versus two weeks); documented iron deficiency anemia (71 days [19 to 142 days] versus two months); positive fecal occult blood test (73 days [36 to 148 days] versus two months); dyspepsia with alarm symptoms (60 days [23 to 140 days] versus two months); refractory dyspepsia without alarm symptoms (126 days [42 to 225 days] versus two months); and chronic constipation and diarrhea (141 days [68 to 264 days] versus two months). A minority of patients were seen within target times: probable cancer (33% [95% CI 20% to 47%]); probable inflammatory bowel disease (12% [95% CI 1% to 23%]); iron deficiency anemia (46% [95% CI 37% to 55%]); positive occult blood test (41% [95% CI 28% to 54%]); dyspepsia with alarm symptoms (51% [95% CI 41% to 60%]); refractory dyspepsia without alarm symptoms (33% [95% CI 19% to 47%]); and chronic constipation and diarrhea (21% [95% CI 14% to 29%]). DISCUSSION: Total wait times for the seven indications exceeded the

Short report: evaluation of Helicobacter pylori eradication with bismuth sucralfate

NARCIS (Netherlands)

Reijers, M. H.; Noach, L. A.; Tytgat, G. N.

1994-01-01

In a pilot study we have evaluated the clinical efficacy of bismuth sucralfate to eradicate H. pylori. Ten consecutive patients with chronic dyspepsia and H. pylori associated gastritis were treated with bismuth sucralfate (220 mg bismuth per tablet, 4 tablets per day for 4 weeks). If a 14C urea

Kyoto global consensus report on Helicobacter pylori gastritis.

Science.gov (United States)

Sugano, Kentaro; Tack, Jan; Kuipers, Ernst J; Graham, David Y; El-Omar, Emad M; Miura, Soichiro; Haruma, Ken; Asaka, Masahiro; Uemura, Naomi; Malfertheiner, Peter

2015-09-01

To present results of the Kyoto Global Consensus Meeting, which was convened to develop global consensus on (1) classification of chronic gastritis and duodenitis, (2) clinical distinction of dyspepsia caused by Helicobacter pylori from functional dyspepsia, (3) appropriate diagnostic assessment of gastritis and (4) when, whom and how to treat H. pylori gastritis. Twenty-three clinical questions addressing the above-mentioned four domains were drafted for which expert panels were asked to formulate relevant statements. A Delphi method using an anonymous electronic system was adopted to develop the consensus, the level of which was predefined as ≥80%. Final modifications of clinical questions and consensus were achieved at the face-to-face meeting in Kyoto. All 24 statements for 22 clinical questions after extensive modifications and omission of one clinical question were achieved with a consensus level of >80%. To better organise classification of gastritis and duodenitis based on aetiology, a new classification of gastritis and duodenitis is recommended for the 11th international classification. A new category of H. pylori-associated dyspepsia together with a diagnostic algorithm was proposed. The adoption of grading systems for gastric cancer risk stratification, and modern image-enhancing endoscopy for the diagnosis of gastritis, were recommended. Treatment to eradicate H. pylori infection before preneoplastic changes develop, if feasible, was recommended to minimise the risk of more serious complications of the infection. A global consensus for gastritis was developed for the first time, which will be the basis for an international classification system and for further research on the subject. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Gulf War veterans' health: medical evaluation of a U.S. cohort.

Science.gov (United States)

Eisen, Seth A; Kang, Han K; Murphy, Frances M; Blanchard, Melvin S; Reda, Domenic J; Henderson, William G; Toomey, Rosemary; Jackson, Leila W; Alpern, Renee; Parks, Becky J; Klimas, Nancy; Hall, Coleen; Pak, Hon S; Hunter, Joyce; Karlinsky, Joel; Battistone, Michael J; Lyons, Michael J

2005-06-07

United States military personnel reported various symptoms after deployment to the Persian Gulf during the 1991 Gulf War. However, the symptoms' long-term prevalence and association with deployment remain controversial. To assess and compare the prevalence of selected medical conditions in a national cohort of deployed and nondeployed Gulf War veterans who were evaluated by direct medical and teledermatologic examinations. A cross-sectional prevalence study performed 10 years after the 1991 Gulf War. Veterans were examined at 1 of 16 Veterans Affairs medical centers. Deployed (n = 1061) and nondeployed (n = 1128) veterans of the 1991 Gulf War. Primary outcome measures included fibromyalgia, the chronic fatigue syndrome, dermatologic conditions, dyspepsia, physical health-related quality of life (Short Form-36 [SF-36]), hypertension, obstructive lung disease, arthralgias, and peripheral neuropathy. Of 12 conditions, only 4 conditions were more prevalent among deployed than nondeployed veterans: fibromyalgia (deployed, 2.0%; nondeployed, 1.2%; odds ratio, 2.32 [95% CI, 1.02 to 5.27]); the chronic fatigue syndrome (deployed, 1.6%; nondeployed 0.1%; odds ratio, 40.6 [CI, 10.2 to 161]); dermatologic conditions (deployed, 34.6%; nondeployed, 26.8%; odds ratio, 1.38 [CI, 1.06 to 1.80]), and dyspepsia (deployed, 9.1%; nondeployed, 6.0%; odds ratio, 1.87 [CI, 1.16 to 2.99]). The mean physical component summary score of the SF-36 for deployed and nondeployed veterans was 49.3 and 50.8, respectively. Relatively low participation rates introduce potential participation bias, and deployment-related illnesses that resolved before the research examination could not, by design, be detected. Ten years after the Gulf War, the physical health of deployed and nondeployed veterans is similar. However, Gulf War deployment is associated with an increased risk for fibromyalgia, the chronic fatigue syndrome, skin conditions, dyspepsia, and a clinically insignificant decrease in the SF-36

Co-morbidities of Interstitial Cystitis

Directory of Open Access Journals (Sweden)

Gisela eChelimsky

2012-08-01

Full Text Available Introduction: This study aimed to estimate the proportion of patients with Interstitial Cystitis/Painful Bladder Syndrome (IC/BPS with systemic dysfunction associated co-morbidities such as irritable bowel syndrome (IBS and fibromyalgia (FM. Material and Methods: Two groups of subjects with IC/BPS were included: 1 Physician diagnosed patients with IC/BPS and 2 Subjects meeting NIDDK IC/PBS criteria based on a questionnaire (ODYSA. These groups were compared to healthy controls matched for age and socio-economic status. NIDDK criteria required: pain with bladder filling that improves with emptying, urinary urgency due to discomfort or pain, polyuria > 11 times/24 hrs, and nocturia > 2 times/night. The ODYSA instrument evaluates symptoms pertaining to a range of disorders including chronic fatigue, orthostatic intolerance, syncope, IBS, dyspepsia, cyclic vomiting syndrome, headaches and migraines, sleep, Raynaud’s syndrome and chronic aches and pains. Results: IC/BPS was diagnosed in 26 subjects (mean age 47 +/- 16 yrs, 92% females, 58 had symptoms of IC/BPS by NIDDK criteria, (mean age 40 +/- 17 yrs, 79% females and 48 were healthy controls (mean age 31+/- 14 yrs, mean age 77%. Co-morbid complaints in the IC/BPS groups included gastrointestinal symptoms suggestive of IBS and dyspepsia, sleep abnormalities with delayed onset of sleep, feeling poorly refreshed in the morning, waking up before needed, snoring, severe chronic fatigue and chronic generalized pain, migraines and syncope. Discussion: Patients with IC/BPS had co-morbid central and autonomic nervous system disorders. Our findings mirror those of others in regard to IBS, symptoms suggestive of FM, chronic pain and migraine. High rates of syncope and functional dyspepsia found in the IC/BPS groups merit further study to determine if IC/BPS is part of a diffuse disorder of central, autonomic and sensory processing affecting multiple organs outside the bladder.

Mechanism of resveratrol-induced relaxation of the guinea pig fundus.

Science.gov (United States)

Tsai, Ching-Chung; Tey, Shu-Leei; Lee, Ming-Che; Liu, Ching-Wen; Su, Yu-Tsun; Huang, Shih-Che

2018-04-01

Resveratrol is a polyphenolic compound that can be isolated from plants and also is a constituent of red wine. Resveratrol induces relaxation of vascular smooth muscle and may prevent cardiovascular diseases. Impaired gastric accommodation plays an important role in functional dyspepsia and fundic relaxation and is a therapeutic target of functional dyspepsia. Although drugs for fundic relaxation have been developed, these types of drugs are still rare. The purpose of this study was to investigate the relaxant effects of resveratrol in the guinea pig fundus. We studied the relaxant effects of resveratrol in the guinea pig fundus. In addition, we investigated the mechanism of resveratrol-induced relaxation on the guinea pig fundus by using tetraethylammonium (a non-selective potassium channel blocker), apamine (a selective inhibitor of the small conductance calcium-activated potassium channel), iberiotoxin (an inhibitor of large conductance calcium-activated potassium channels), glibenclamide (an ATP-sensitive potassium channel blocker), KT 5720 (a cAMP-dependent protein kinase A inhibitor), KT 5823 (a cGMP-dependent protein kinase G inhibitor), NG-nitro-L-arginine (a competitive inhibitor of nitric oxide synthase), tetrodotoxin (a selective neuronal Na + channel blocker), ω-conotoxin GVIA (a selective neuronal Ca 2+ channel blocker) and G-15 (a G-protein coupled estrogen receptor antagonist). The results of this study showed that resveratrol has potent and dose-dependent relaxant effects on the guinea pig fundic muscle. In addition, the results showed that resveratrol-induced relaxation of the guinea pig fundus occurs through nitric oxide and ATP-sensitive potassium channels. This study provides the first evidence concerning the relaxant effects of resveratrol in the guinea pig fundic muscle strips. Furthermore, resveratrol may be a potential drug to relieve gastrointestinal dyspepsia. Copyright © 2018 Elsevier GmbH. All rights reserved.

Author Details

African Journals Online (AJOL)

Yuan, Xing-xing. Vol 14, No 6 (2017) - Articles Efficacy of manual acupuncture on functional dyspepsia: a meta-analysis of randomized, controlled trials. Abstract PDF. ISSN: 0189-6016. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's ...

Author Details

African Journals Online (AJOL)

Zhang, Ya-li. Vol 14, No 6 (2017) - Articles Efficacy of manual acupuncture on functional dyspepsia: a meta-analysis of randomized, controlled trials. Abstract PDF. ISSN: 0189-6016. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners ...

Detection of Helicobacter pylori in rural school children using 13C ...

African Journals Online (AJOL)

ulcer, gastric ulcer, non-ulcer dyspepsia and gastritis. Several diagnostic methods are available for the detection of H. pylori, with direct methods based on gastric biopsies. The 13C- Urea Breath Test (UBT) used in this study has advantage over the other methods in that, it is easy to perform, specific (100%), highly sensitive ...

A Prokinetic Agent with a Dual Effect – Itopride – In the Treatment of Dysmotility

Directory of Open Access Journals (Sweden)

Petr Dite

2014-12-01

Full Text Available A wide range of dyspeptic symptoms in clinical practice reflect the high prevalence of functional disorders of the gastrointestinal (GI tract. Prokinetic agents are the current mainstay in the therapy of functional dyspepsia. One of these drugs is itopride. We evaluated therapeutic efficacy of itopride according to the literature review. The therapeutic potential of itopride is connected with a dual effect: influencing of enzyme acetylcholinesterase activity and blocking dopamine D2 receptors. After the itopride administration, the contractility of smooth muscle in the upper GI tract increases. Itopride is a drug with rapid absorption from the small bowel; its peak serum concentration occurs 35 minutes after oral administration. Itopride does not pass the blood-brain barrier and does not affect the heart rate by influencing the QT segment. Itopride is a safe prokinetic agent with positive influence on the symptoms of functional dyspepsia such as postprandial fullness, bloating, and gastric emptying. Itopride could also be used for the therapy of the mild form of gastro-oesophageal reflux.

A Case-Control study of the prevalence of neurological diseases in inflammatory bowel disease (IBD

Directory of Open Access Journals (Sweden)

Francisco de Assis Aquino Gondim

2015-02-01

Full Text Available Neurological diseases are common in inflammatory bowel disease (IBD patients, but their exact prevalence is unknown. Method We prospectively evaluated the presence of neurological disorders in 121 patients with IBD [51 with Crohn's disease (CD and 70 with ulcerative colitis (UC] and 50 controls (gastritis and dyspepsia over 3 years. Results Our standard neurological evaluation (that included electrodiagnostic testing revealed that CD patients were 7.4 times more likely to develop large-fiber neuropathy than controls (p = 0.045, 7.1 times more likely to develop any type of neuromuscular condition (p = 0.001 and 5.1 times more likely to develop autonomic complaints (p = 0.027. UC patients were 5 times more likely to develop large-fiber neuropathy (p = 0.027 and 3.1 times more likely to develop any type of neuromuscular condition (p = 0.015. Conclusion In summary, this is the first study to prospectively establish that both CD and UC patients are more prone to neuromuscular diseases than patients with gastritis and dyspepsia.

Liu Jun Zi Tang—A Potential, Multi-Herbal Complementary Therapy for Chemotherapy-Induced Neurotoxicity

Directory of Open Access Journals (Sweden)

Chun-Tang Chiou

2018-04-01

Full Text Available Liu Jun Zi Tang (LJZT has been used to treat functional dyspepsia and depression, suggesting its effects on gastrointestinal and neurological functions. LJZT is currently used as a complementary therapy to attenuate cisplatin-induced side effects, such as dyspepsia. However, its effect on chemotherapy-induced neuropathic pain or neurotoxicity has rarely been studied. Thus, we explored potential mechanisms underlying LJZT protection against cisplatin-induced neurotoxicity. We observed that LJZT attenuated cisplatin-induced thermal hyperalgesia in mice and apoptosis in human neuroblastoma SH-SY5Y cells. Furthermore, it also attenuated cisplatin-induced cytosolic and mitochondrial free radical formation, reversed the cisplatin-induced decrease in mitochondrial membrane potential, and increased the release of mitochondrial pro-apoptotic factors. LJZT not only activated the peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α promoter region, but also attenuated the cisplatin-induced reduction of PGC-1α expression. Silencing of the PGC-1α gene counteracted the protection of LJZT. Taken together, LJZT mediated, through anti-oxidative effect and mitochondrial function regulation, to prevent cisplatin-induced neurotoxicity.

NSAID og ulcuskomplikationer. En analyse af risikofaktorer

DEFF Research Database (Denmark)

Hansen, J M; Hallas, J; Lauritsen, Jens

1997-01-01

Use of NSAIDs is recognized as an important cause of peptic ulcer complications. The aim of this nested case-control study was to identify risk factors for NSAID-related ulcer complications. Cases were consecutive NSAID users admitted with an ulcer complication (n = 94), and controls were a random...... sample of all NSAID users without ulcer complication identified by a pharmaco-epidemiological database (n = 324). Risk factors for patients at start of NSAID-therapy were: high age: 60-75 yr; Odds Ratio (OR) 3.5 (95% CI: 1.8-7.0); > 75 yr: OR 8.8 (4.3-18.1); male sex: OR 1.7 (1.0-3.0); ulcer history......: OR 2.5 (1.2-5.1); steroid treatment: OR 2.0 (0.8-4.6); smoking: OR 1.6 (0.9-2.7); alcohol use: OR 1.8 (0.9-3.6). Risk factors for patients on NSAID-therapy were: high age, male sex, ulcer history, and smoking, and furthermore dyspepsia: OR 2.1 (1.0-4.2), especially NSAID-related dyspepsia: OR 8.9 (4...

In vitro antioxidant activity and inhibitory hepatic steatosis effect on ...

African Journals Online (AJOL)

aghomotsegin

induced (OA-induced) fatty liver in vitro was also the EA fraction. Further, it was ... dyspepsia, nursing the blood, anti-aging and anti-fatigue. Recently .... 540 nm. Glucose was used to calculate the standard curve. (y=0.9615x-0.1011; R2 = 0.9981). Fatty acid. Fat was extracted by soxhlet extraction. RDF (10 g) was accurately ...

Psychoemotional features of a doubtful disorder: functional dyspepsia.

Science.gov (United States)

Dragoş, D; Ionescu, O; Micuţ, R; Ojog, D G; Tănăsescu, M D

2012-09-15

To delineate the psychological profile of individuals prone to FD-like symptoms (FDLS). A triple questionnaire of 614 items (including psychological and medical ones) was given to 10192 respondents, the results were analyzed by means of Cronbach alpha, and Chi square test, together with an ad-hoc designed method that implied ranking and outliers detecting. FDLS appears to be an accompanying feature of many (if not most) human emotions and are more frequent in anxious, timid, pessimistic, discontent, irascible, tense, success-doubting, unexpected-dreading individuals, bothered by persistent thoughts and tormented by the professional requirements and the lack of time. A higher degree of specificity might have: chiefly fear of failure, susceptibility, and tension, secondarily emotivity, fear of unpredictable events, sense of insufficient time, preoccupation with authority factors, and tendency to endure unacceptable situations, and also faulty patience and lack of punctuality. Rumination appears to be the psychological tendency most strongly associated with FD. Nocturnal epigastric pain seems to indicate a submissive nature but a rather responsibilities-free childhood, while early satiety is associated with inclination to work and responsibility and preoccupation with self-image. The superposition of FD symptoms with biliary and esophageal symptoms cast a doubt over the distinctness and even the materiality of the various functional digestive disorders.

Symptomatic pancreatic heterotopia treated by local excision.

Science.gov (United States)

De Friend, D J; Saa-Gandi, F W; Humphrey, C S; Foster, D N

1991-01-01

Non-ulcer dyspepsia is a continuing problem and in many cases a precise cause is never identified. We present five patients with an allegedly uncommon condition--pancreatic heterotopia. They were managed by local excision of the tumour and after a mean (range) follow up of 42 (9-80) months all remain free of the original symptoms. Images Figure 1 Figure 2 PMID:2013433

Gallblader cancer

International Nuclear Information System (INIS)

Escalona Veloz, Rafael; Mila Pascual, Milagros de la Caridad

2011-01-01

The precise information about a 43 year-old patient, with a history of dyspepsias, in whom a gallbladder polyp was diagnosed by means of echography is presented. She was surgically treated because of it and a cholecystectomy was carried out, with a satisfactory clinical course; but the result of biopsy confirmed the presence of an adenoma in her gallbladder, with malignant transformation.(author)

Helicobacter pylori and non-malignant diseases.

Science.gov (United States)

Furuta, Takahisa; Delchier, Jean-Charles

2009-09-01

It is well known that Helicobacter pylori infection is associated with many nonmalignant disorders such as gastritis, peptic ulcer, gastroesophageal reflux disease (GERD), gastric polyp, nonsteroidal anti-inflammatory drug (NSAID)/aspirin-induced gastric injury, and functional dyspepsia. In 2008, interesting articles on the association of H. pylori infection with these disorders were presented, some of which intended to reveal the mechanisms of inter-individual differences in response to H. pylori infection, and have demonstrated that genetic differences in host and bacterial factors as well as environmental factors account for these differences. A decline in the occurrence of peptic ulcer related to H. pylori was confirmed. An inverse relationship between H. pylori infection and GERD was also confirmed but the impact of gastric atrophy on the prevention of GERD remained debatable. For NSAID-induced gastric injury, eradication of H. pylori infection has been recommended. During this year, eradication of H. pylori infection was recommended for patients treated with antiplatelet therapy as well as aspirin and NSAID. It was also reported that for patients with functional dyspepsia, eradication of H. pylori offers a modest but significant benefit.

A New Strategy Using Rikkunshito to Treat Anorexia and Gastrointestinal Dysfunction

Directory of Open Access Journals (Sweden)

Yayoi Saegusa

2015-01-01

Full Text Available Because the clinical condition of gastrointestinal dysfunction, including functional dyspepsia, involves tangled combinations of pathologies, there are some cases of insufficient curative efficacy. Thus, traditional herbal medicines (Kampo medicines uniquely developed in Japan are thought to contribute to medical treatment for upper gastrointestinal symptoms. Rikkunshito is a Kampo medicine often used to treat dyspeptic symptoms. Over the past few years, several studies have investigated the efficacy of rikkunshito for dysmotility, for example, upper abdominal complaints, in animals and humans. Rikkunshito ameliorated the decrease in gastric motility and anorexia in cisplatin-treated rats, stress-loaded mice, and selective serotonin reuptake inhibitor-treated rats by enhancing plasma ghrelin levels via serotonin2B/2C receptor antagonism. In addition, rikkunshito ameliorated the decrease in food intake in aged mice and stress-loaded decreased gastric motility via enhanced ghrelin receptor signaling. Several clinical studies revealed that rikkunshito was effective in ameliorating upper gastrointestinal symptoms, including dyspepsia, epigastric pain, and postprandial fullness. In this review, we discuss these studies and propose additional evidence-based research that may promote the clinical use of Kampo medicines, particularly rikkunshito, for treating anorexia and gastrointestinal dysfunction.

Effects of Kampo on functional gastrointestinal disorders

OpenAIRE

Oka, Takakazu; Okumi, Hirokuni; Nishida, Shinji; Ito, Takashi; Morikiyo, Shinichi; Kimura, Yoko; Murakami, Masato

2014-01-01

This article reviews the effectiveness of Kampo (traditional Japanese herbal medicine) in the treatment of functional gastrointestinal disorders, especially functional dyspepsia (FD) and irritable bowel syndrome (IBS). The results of four randomized, controlled trials (RCTs) suggested the usefulness of rikkunshito in relieving the subjective symptoms of patients with FD. Rikkunshito significantly improved not only gastric symptoms, such as epigastiric discomfort, but also extra-gastric sympto...

Hospital admissions for peptic ulcer and indigestion in London and New York in the 19th and early 20th centuries

Science.gov (United States)

Baron, J H; Sonnenberg, A

2002-01-01

The occurrence of peptic ulcer increased rapidly in all Western countries from the 19th to the 20th century, attributed to a possible epidemic of Helicobacter pylori, a new pathogenic strain, or a change in host susceptibility. The early trends in hospital admissions for peptic ulcer and dyspepsia in London and New York during the 19th century are reviewed to test these hypotheses. PMID:11889081

The increasing prevalence of HIV/Helicobacter pylori co-infection over time, along with the evolution of antiretroviral therapy (ART

Directory of Open Access Journals (Sweden)

Aleksandra Radovanović Spurnić

2017-05-01

Full Text Available Helicobacter pylori (H. pylori is one of the most common human bacterial infections with prevalence rates between 10–80% depending upon geographical location, age and socioeconomic status. H. pylori is commonly found in patients complaining of dyspepsia and is a common cause of gastritis. During the course of their infection, people living with HIV (PLHIV often have a variety of gastrointestinal symptoms including dyspepsia and while previous studies have reported HIV and H. pylori co-infection, there has been little data clarifying the factors influencing this. The aim of this case-control study was to document the prevalence of H. pylori co-infection within the HIV community as well as to describe endoscopic findings, gastritis topography and histology, along with patient demographic characteristics across three different periods of time during which antiretroviral therapy (ART has evolved, from pre- highly active antiretroviral therapy (HAART to early and modern HAART eras. These data were compared to well-matched HIV negative controls. Two hundred and twelve PLHIV were compared with 1,617 controls who underwent their first esophagogastroduodenoscopy (EGD to investigate dyspepsia. The prevalence of H. pylori co-infection among PLHIV was significantly higher in the early (30.2% and modern HAART period (34.4% compared with those with coinfection from the pre-HAART period (18.2%. The higher rates seen in patients from the HAART eras were similar to those observed among HIV negative controls (38.5%. This prevalence increase among co-infected patients was in contrast to the fall in prevalence observed among controls, from 60.7% in the early period to 52.9% in the second observed period. The three PLHIV co-infected subgroups differed regarding gastritis topography, morphology and pathology. This study suggests that ART has an important impact on the endoscopic and histological features of gastritis among HIV/H. pylori co-infected individuals

Antenatal screening of women for hepatitis B and C in an out-patient department

International Nuclear Information System (INIS)

Batool, A.; Bano, K.A.; Khan, M.U.I.; Hussain, R.

2008-01-01

To determine frequency of hepatitis B virus (HBV) and hepatitis C virus (HCV) and its clinical manifestation in pregnant women. Pregnant women visiting the Gynaecology and Obstetrics out patient's department of Sir Ganga Ram Hospital Lahore for antenatal check-ups from October 2006 to March 2007 were screened for hepatitis B and C. Immune- chromatography was used for initial screening and diagnosis was confirmed by ELISA technique. Data collection included maternal age, parity, symptoms or past history of jaundice, fatigue, tiredness, insomnia, depression, dyspepsia, fever, anorexia and pale stool. Risk factors investigated include past history of some surgical procedures, the dental visit, blood transfusion, tattooing, hospitalization and history of injection. Among the screened population, 7.3% out of 2439 ladies were positive for anti HCV and 2.2% for HBsAg while dual infection with HBV and HCV was observed in 0.08 % . Symptoms observed in hepatitis B patients were fatigue (90%), depression and pale stool (70%), anorexia (60%), jaundice (57.2%), fever (56.4%) and dyspepsia (51.2%). In hepatitis C antibody positive patients fatigue was the main symptom (95.7%) followed by pale stool (84.5%) and depression (80.2%); 63.3% had insomnia, 59.1% had anorexia, 50.7% had fever, 50.7% had jaundice and 43.6% had dyspepsia. Past history of blood transfusion was reported by 32.3% patients, surgery by 42.2% and tattooing was observed in 0.70%. One or more tooth extraction was reported by 50.2% subjects, and 49.25% had history of repeated injections. The frequency of sero-positivity for HBsAg and HCV among pregnant women is alarming. These sero-positive mothers are not only predisposed to chronic consequences of hepatitis, but also are a continuous threat to their offsprings and care providers. Hence, there is a direct need for further epidemiological studies and to take measures for prevention and control of the disease. (author)

dyspepsia management in a resource poor setting feature article

African Journals Online (AJOL)

Methods: Extensive internet literature search was made through. Google scholar, Pubmed ... tests for H. pylori are not available or not cost-effective. Conclusion: Considering the .... and cognitive-behavioral therapy but they cannot be generally ...

Prevalence of Helicobacter pylori and risk factors among dyspepsia ...

African Journals Online (AJOL)

Helicobacter pylori antibody conjugated with colloid gold nitrocellulose membrane strip and a structured face-to-face interview was also administered to assess risk factors for H. pylori infection. Data were analyzed using SPSS version 20. Logistic ...

2011 Aerospace Medical Certification Statistical Handbook

Science.gov (United States)

2013-01-01

from the Aviation Medical Examiner Information System (AMEIS). The current status of each AME was determined for each year of the study period from 2009...current status of each AME was determined for each year of the study period from 2009-2011, retaining only those with an active status. Airman...gastroplasty, dysphagia , dyspepsia, thrombus abdomen aorta# 22,187 3.73 Other skin conditions – includes acne, abnormal pigmentation, vitiligo

Gastroduodenal Morphology and Related Symptoms in Chronic Alcoholics

Directory of Open Access Journals (Sweden)

T. Hauge

1997-01-01

Full Text Available Twenty-four chronic alcoholics admitted to hospital for detoxification after a drinking spree were examined by upper gastrointestinal endoscopy. Biopsy specimens were taken from corpus/fundus, antrum and duodenum for tissue histology (eosin stain. From the duodenum villus index and ultrastructure (scanning electron microscopy, SEM were also performed. As a control group 12 subjectively healthy non-alcoholics referred to upper gastrointestinal endoscopy mainly for dyspepsia were chosen.

The role of gastric scintigraphy in primary or post surgical disorders of gastric emptying

International Nuclear Information System (INIS)

Jian, R.; Lemann, M.; Rain, J.D.

1996-01-01

Gastric scintigraphy is the gold standard for the measurement of the gastric emptying of a meal because of its reliability and its reproducibility and the respect of physiological conditions. Moreover, this technique allows to measure the emptying of solid and liquid phases simultaneously. Symptoms motivating a gastric scintigraphy, suggest either a gastric stasis (dyspepsia) or a gastric incontinence (dumping syndrome). The two most frequent clinical conditions triggering this test are motility disorders following vagotomy, a delayed emptying of solids is often associated to an accelerated emptying of liquids. Gastric scintigraphy proves quite useful in these conditions, since the diagnosis of such complex abnormalities is uneasy to establish exclusively on a clinical basis. In idiopathic dyspepsia, gastric stasis is proved only in 50 % of the patients. However, a radionuclide study of gastric emptying is seldom ordered because of the common character and good tolerance of these symptoms. In everyday practice, gastric scintigraphy is considered only when gastric or intestinal obstructive lesions have been ruled out. A suggestive clinical picture and/or absence of a deteriorated general condition allow to prescribe a symptomatic treatment. More rarely, equivocal symptoms, degradation of the general condition and unresponsiveness to symptomatic drugs call for gastric scintigraphy. (authors). 241 refs., 2 figs

A Comparison of Dysautonomias Comorbid with Cyclic Vomiting Syndrome and with Migraine

Directory of Open Access Journals (Sweden)

Gisela Chelimsky

2009-01-01

Full Text Available Cyclic vomiting syndrome (CVS shares many features with migraine headache, including auras, photophobia, and antimigrainous treatment response being traditionally viewed as a migraine variant. Aims. To determine whether CVS is associated with the same disorders as migraine headache, and compare these associations to those in healthy control subjects. Methods. Cross-sectional study of patients utilizing the ODYSA instrument, evaluating the probability of 12 functional/autonomic diagnoses, CVS, migraine, orthostatic intolerance (OI, reflex syncope, interstitial cystitis, Raynaud's syndrome, complex regional pain syndrome (CRPS, irritable bowel syndrome, functional dyspepsia, functional abdominal pain, fibromyalgia, and chronic fatigue syndrome. Control subjects were age-matched gender-matched friends. Patients had to fulfill criteria for CVS or migraine, while control subjects could not. Results. 103 subjects were studied, 21 with CVS, 46 with migraine and 36 healthy controls. CVS and migraine did not differ in the relative frequencies of fibromyalgia, OI, syncope, and functional dyspepsia. However, CVS patients did demonstrate a significantly elevated frequency of CRPS. Conclusions. Although CVS and migraine clearly share many of the same comorbidities, they do differ in one important association, suggesting that they may not be identical in pathophysiology. Since OI is common in CVS, treatment strategies could also target this abnormality.

Impact of gastroesophageal reflux disease symptoms on the quality of life in pregnant women: a prospective study.

Science.gov (United States)

Fill Malfertheiner, Sara; Seelbach-Göbel, Birgit; Costa, Serban-Dan; Ernst, Wolfgang; Reuschel, Edith; Zeman, Florian; Malfertheiner, Peter; Malfertheiner, Maximilian V

2017-08-01

Pregnant women often suffer from gastroesophageal reflux disease (GERD). GERD symptoms are known to influence the quality of life; however, there is a lack of data in pregnant women. The aim of this study was to establish the impact of GERD symptoms on health-related quality of life (HRQOL) during pregnancy. A prospective longitudinal cohort study to investigate the impact of GERD symptoms on the HRQOL was carried out in 510 pregnant women and 330 nonpregnant women as controls. Two validated questionnaires, the Reflux Disease Questionnaire and the Quality of Life in Reflux and Dyspepsia Questionnaire, were used. The study showed a significant negative impact on HRQOL in pregnant women with GERD symptoms. All five areas, emotional distress, sleep disturbance, vitality, food/drink problems, and physical/social functioning, were significantly reduced, but the most significant impact was on sleep (Quality of Life in Reflux and Dyspepsia Questionnaire score -35%). Overall, quality of life in women with GERD worsened throughout pregnancy. GERD is frequently seen in pregnant women and has a negative impact on HRQOL, especially in late pregnancy. Therefore, there is a need for adequate therapy of GERD in pregnant women and HRQOL could be an adequate monitoring tool in this population.

Helicobacter pylori in dental plaque; is it related to brushing frequency, plaque load and oral health status?

Science.gov (United States)

Chaudhry, Saima; Khan, Ayyaz Ali; Butt, Arshad Kamal; Idrees, Muhammad; Izhar, Mateen; Iqbal, Hafiz Aamer

2011-10-01

To determine the relation between presence of H. pylori in supra-gingival dental plaque with oral hygiene habits and oral health status of patients suffering from symptomatic dyspepsia. Descriptive study. The Department of Oral Health Sciences, Shaikh Zayed FPGMI, Lahore, from September 2008 to August 2009. One hundred and fifty dyspeptic subjects with dental plaque were enrolled. After recording brushing frequency, oral health status and plaque load, the supra-gingival dental plaque samples were collected by sterile curettes. Helicobacter pylori were detected in dental plaque samples through PCR assay. Presence of H. pylori in dental plaque was found to be 37.5% in the sample. Most of the subjects brushed once daily, had plaque index score of 1 and had fair to poor oral hygiene status. Approximately 35% of the individuals who brushed once or twice a day harbored the bacterium in their dental plaque. There was no difference between bacterial detection rates among different categories of plaque index and oral health status of the study subjects. Presence of H. pylori in dental plaque was found to be associated with neither brushing frequency nor with the plaque load nor with the oral health status of individuals suffering from symptomatic dyspepsia.

Helicobacter pylori and non-malignant diseases.

Science.gov (United States)

Matysiak-Budnik, Tamara; Laszewicz, Wiktor; Lamarque, Dominique; Chaussade, Stanislas

2006-10-01

The prevalence of Helicobacter pylori-associated peptic ulcers, in particular duodenal ulcers, is decreasing following decreasing prevalence of H. pylori infection, while the frequency of non-steroidal anti-inflammatory drugs (NSAIDs)-induced and H. pylori-negative idiopathic ulcers is increasing. The incidence of bleeding ulcers has been stable during the last decades. Several putative H. pylori virulence genes, i.e., cag, vacA, babA, or dupA, as well as host-related genetic factors like IL-1beta and TNFalpha-gene polymorphism, have been proposed as risk factors for duodenal ulcer. H. pylori eradication may prevent NSAID complications, in particular, when it is performed before introduction of NSAIDs. There is a complex association between H. pylori and gastroesophageal reflux disease (GERD), and the impact of H. pylori eradication on the appearance of GERD symptoms depends on various host- and bacteria-related factors. Eradication of H. pylori in GERD is recommended in patients before instauration of a long-term PPI treatment to prevent the development of gastric atrophy. A small proportion (10%) of non-ulcer dyspepsia cases may be attributed to H. pylori and may benefit from eradication treatment. A test-and-treat strategy is more cost-effective than prompt endoscopy in the initial management of dyspepsia.

A comparative study on the effects of domperidone, metoclopramide, clebopride and trimebutine on the gastro-duodenal preparation of the guinea pig.

Science.gov (United States)

Schuurkes, J A; Helsen, L F; Van Nueten, J M

1985-10-01

Domperidone (dopamine antagonist), metoclopramide and clebopride (both dopamine antagonists and stimulators of the intramural cholinergic system), and trimebutine (spasmolytic) are used in the treatment of digestive disorders such as dyspepsia or gastritis. Our aim was to compare the effects of these compounds on the isolated intact gastroduodenal preparation of the guinea pig. Domperidone (IC50 = 10(-6) M), clebopride (10(-5) M) and metoclopramide (2 X 10(-5) M) antagonized gastric relaxations induced by dopamine. In contrast with clebopride, domperidone and metoclopramide enhanced the amplitude of gastric contractions, moderately reduced contractile frequency, and enhanced antroduodenal coordination in a dose-dependent manner (EC50 for domperidone 3 X 10(-7) M, for metoclopramide 2 X 10(-5) M). Trimebutine reduced gastric spontaneous activity and antroduodenal coordination. Trimebutine had a direct relaxatory effect on gastric tone (EC50 = 4 X 10(-6) M). The mechanism of this inhibitory effect remains unknown but our data indicate that it is not mediated via dopamine or opiate receptor subtypes. domperidone, clebopride, metoclopramide and trimebutine exert distinct and diverse effects on the motility parameters of the gastroduodenal preparation of the guinea pig. These diverging actions may help explain the differences in patients' responsiveness to the treatment of digestive disorders such as dyspepsia or gastritis.

Recent effectiveness of proton pump inhibitors for severe reflux esophagitis: the first multicenter prospective study in Japan.

Science.gov (United States)

Mizuno, Hideki; Matsuhashi, Nobuyuki; Sakaguchi, Masahiro; Inoue, Syuji; Nakada, Koji; Higuchi, Kazuhide; Haruma, Ken; Joh, Takashi

2015-11-01

Proton pump inhibitors are the first-line treatment for reflux esophagitis. Because severe reflux esophagitis has very low prevalence in Japan, little is known about the effectiveness of proton pump inhibitors in these patients. This prospective multicenter study assessed the effectiveness of proton pump inhibitors for severe reflux esophagitis in Japan. Patients with modified Los Angeles grade C or D reflux esophagitis were treated with daily omeprazole (10 or 20 mg), lansoprazole (15 or 30 mg), or rabeprazole (10, 20, or 40 mg) for 8 weeks. Healing was assessed endoscopically, with questionnaires administered before and after treatment to measure the extent of reflux and dyspepsia symptoms. Factors affecting healing rates, including patient characteristics and endoscopic findings, were analyzed. Of the 115 patients enrolled, 64 with grade C and 19 with grade D reflux esophagitis completed the study. The healing rate was 67.5% (56/83), with 15 of the other 27 patients (55.6%) improving to grade A or B. No patient characteristic or endoscopic comorbidity was significantly associated with healing rate. Reflux and dyspepsia symptoms improved significantly with treatment. The low healing rate suggests the need of endoscopic examination to assess healing of reflux esophagitis at the end of therapy. (UMIN000005271).

Assessment of Gastric Emptying in Patients with Autoimmune Gastritis.

Science.gov (United States)

Kalkan, Çağdaş; Soykan, Irfan; Soydal, Çiğdem; Özkan, Elgin; Kalkan, Emra

2016-06-01

Symptoms of patients with autoimmune gastritis are not specific, and some patients may present symptoms suggestive of delayed gastric emptying. This study aims to investigate whether any delay in gastric emptying of solid food exists in patients with autoimmune gastritis and, if so, to identify the factors that might affect delayed gastric emptying. A total of 165 patients (106 women) diagnosed as having autoimmune gastritis were analyzed by means of a gastric emptying test. All patients underwent a standardized scintigraphic gastric emptying study. Patients with delayed gastric emptying and normal gastric emptying tests were then compared by means of factors that might affect gastric emptying. Also 65 patients with functional dyspepsia who had a gastric emptying study constituted the control group. The median gastric emptying T ½ time was 127.43 min (min-max 50-953) for patients with AIG and 81 min (min-max 21-121.6) for functional dyspepsia patients (p gastritis, gastric emptying is generally delayed. Autoimmune gastritis is an important etiology to explain the finding of delayed gastric emptying on a radionuclide test. This new finding is likely to be relevant to clinicians when evaluating and initiating appropriate medical treatment for patients with autoimmune gastritis manifesting upper gastrointestinal symptoms.

The role of gastric scintigraphy in primary or post surgical disorders of gastric emptying; Interet de la scintigraphie gastrique dans l`exploration des troubles primitifs et postchirurgicaux de la vidange gastrique

Energy Technology Data Exchange (ETDEWEB)

Jian, R.; Lemann, M.; Rain, J.D.

1996-12-31

Gastric scintigraphy is the gold standard for the measurement of the gastric emptying of a meal because of its reliability and its reproducibility and the respect of physiological conditions. Moreover, this technique allows to measure the emptying of solid and liquid phases simultaneously. Symptoms motivating a gastric scintigraphy, suggest either a gastric stasis (dyspepsia) or a gastric incontinence (dumping syndrome). The two most frequent clinical conditions triggering this test are motility disorders following vagotomy, a delayed emptying of solids is often associated to an accelerated emptying of liquids. Gastric scintigraphy proves quite useful in these conditions, since the diagnosis of such complex abnormalities is uneasy to establish exclusively on a clinical basis. In idiopathic dyspepsia, gastric stasis is proved only in 50 % of the patients. However, a radionuclide study of gastric emptying is seldom ordered because of the common character and good tolerance of these symptoms. In everyday practice, gastric scintigraphy is considered only when gastric or intestinal obstructive lesions have been ruled out. A suggestive clinical picture and/or absence of a deteriorated general condition allow to prescribe a symptomatic treatment. More rarely, equivocal symptoms, degradation of the general condition and unresponsiveness to symptomatic drugs call for gastric scintigraphy. (authors). 241 refs., 2 figs.

Prevalence of Celiac Disease and Helicobacter Pylori in Patients Referred to Endoscopy Section of Taleghani Hospital

Directory of Open Access Journals (Sweden)

P Mohammadi

2012-07-01

Full Text Available Introduction: According to previous studies celiac disease(CD is frequently associated with chronic gastritis. The aim of this study was to assess the prevalence of CD and Helicobacter pylori in patients with dyspepsia. Methods: 325 patients were studied from April 2008 to April 2009 who underwent endoscopic procedures for dyspepsia. Gastric antrum, duodenal biopsies, serology with tissue Transglutaminase Antibodies(tTGA and total IgA were performed for detection of H. pylori and CD. Results: Out of 325 patients 312(96% had a positive H. pylori. Heart burn and bloating were the most prevalent symptoms in this study. Twenty one of 25 patients with positive histology for CD who had gastric biopsies were positive for H. pylori(84%. Duodenal biopsy specimens results have shown normal histology in 213(65.5%, hyperplastic polyps in 1(0.4%, duodenitis in 79(24.3% and abnormality in small bowel (Marsh I-IIIc in 25(10%. In term of the serological analysis, 9 of 26 tTGA positive patients had abnormal histology (Marsh I-IIIc(2.7%. Conclusion: Similar to previous reports, we found a high prevalence of H. pylori infection and celiac disease in dyspeptic patients. Therefore, further studies for screening occult CD in dyspeptic patients is seems necessary.

Hemorrhagic Encephalopathy From Acute Baking Soda Ingestion.

Science.gov (United States)

Hughes, Adrienne; Brown, Alisha; Valento, Matthew

2016-09-01

Baking soda is a readily available household product composed of sodium bicarbonate. It can be used as a home remedy to treat dyspepsia. If used in excessive amounts, baking soda has the potential to cause a variety of serious metabolic abnormalities. We believe this is the first reported case of hemorrhagic encephalopathy induced by baking soda ingestion. Healthcare providers should be aware of the dangers of baking soda misuse and the associated adverse effects.

A Prokinetic Agent with a Dual Effect – Itopride – In the Treatment of Dysmotility

OpenAIRE

Petr Dite; Martin Rydlo; Milan Dockal; Arnost Martinek

2014-01-01

A wide range of dyspeptic symptoms in clinical practice reflect the high prevalence of functional disorders of the gastrointestinal (GI) tract. Prokinetic agents are the current mainstay in the therapy of functional dyspepsia. One of these drugs is itopride. We evaluated therapeutic efficacy of itopride according to the literature review. The therapeutic potential of itopride is connected with a dual effect: influencing of enzyme acetylcholinesterase activity and blocking dopamine D2 receptor...

The investigation of Helicobacter pylori in the dental biofilm and saliva samples of children with dyspeptic complaints

OpenAIRE

Aksit B?cak, Damla; Akyuz, Serap; K?ratl?, Binnur; Usta, Merve; Urganci, Nafiye; Alev, Burcin; Yarat, Aysen; Sahin, Fikrettin

2017-01-01

Background The oral cavity can be an extra-gastric reservoir for Helicobacter pylori (H.pylori). This can play a role in the pathogenesis of halitosis, glossitis, recurrent aphthous stomatitis, and dental caries. The present study was conducted to detect the presence of H.pylori within the dental biofilm and in saliva samples collected from children suffering from dyspepsia and children without any gastrointestinal complaints. Associations with gastric infection, halitosis, and some oral para...

Epidemiology, diagnosis and management of functional abdominal pain in children: A look beyond the belly

OpenAIRE

Korterink, J.J.

2015-01-01

Chronic abdominal pain represents a common problem in children. In almost 90% of children presenting with chronic abdominal pain, no organic cause is found and a diagnosis of functional abdominal pain is made. Initially this condition was referred to as ‘recurrent abdominal pain’ by Apley and Naish and it is currently defined as abdominal pain-related functional gastrointestinal disorders (AP-FGIDs); divided into functional dyspepsia (FD), irritable bowel syndrome (IBS), abdominal migraine (A...

Histology of chronic gastritis with and without duodenitis in patients with Helicobacter pylori infection.

OpenAIRE

Phull, P S; Price, A B; Stephens, J; Rathbone, B J; Jacyna, M R

1996-01-01

AIM: To compare the histological characteristics of Helicobacter pylori positive chronic gastritis in patients with and without associated duodenitis. METHODS: Gastric mucosal biopsy specimens were obtained from patients undergoing endoscopy for dyspepsia. Severity of gastritis and density of H pylori infection were graded according to the Sydney system. RESULTS: Of the 69 patients studied, 15 had normal histology, 22 had chronic gastritis only (77.3% H pylori positive), 21 had duodenitis (90...

Hemorrhagic Encephalopathy From Acute Baking Soda Ingestion

Directory of Open Access Journals (Sweden)

Adrienne Hughes

2016-09-01

Full Text Available Baking soda is a readily available household product composed of sodium bicarbonate. It can be used as a home remedy to treat dyspepsia. If used in excessive amounts, baking soda has the potential to cause a variety of serious metabolic abnormalities. We believe this is the first reported case of hemorrhagic encephalopathy induced by baking soda ingestion. Healthcare providers should be aware of the dangers of baking soda misuse and the associated adverse effects.

Hemorrhagic Encephalopathy From Acute Baking Soda Ingestion

OpenAIRE

Hughes, Adrienne; Brown, Alisha; Valento, Matthew

2016-01-01

Baking soda is a readily available household product composed of sodium bicarbonate. It can be used asa home remedy to treat dyspepsia. If used in excessive amounts, baking soda has the potential to causea variety of serious metabolic abnormalities. We believe this is the first reported case of hemorrhagicencephalopathy induced by baking soda ingestion. Healthcare providers should be aware of the dangers ofbaking soda misuse and the associated adverse effects. [West J Emerg Med. 2016;17(5)619...

Prevalensi Gastropati Obat Anti Inflamasi Non Steroid di RSUP Haji Adam Malik Medan pada Periode Juli-Desember 2012

OpenAIRE

Shelia, Carina

2014-01-01

Gastropathy is a condition that shows epithelial or endothelial damage without inflammation at gastric mucosa. Clinical symptoms of gastropathy are dyspepsia-like syndromes such as anorexia, epigastric pain, nausea, and vomiting. One of the crucial causes of gastropathy is the side effect of Non-Steroidal Anti Inflammatory Drug (NSAID) usage. NSAID is one of the most widely used and prescribed over the counter (OTC) drugs around the world. These drugs have therapeutic effects, which are analg...

Immunomodulatory activity of extracts from Cordia superba Cham. and Cordia rufescens A. DC. (Boraginaceae), plant species native from Brazilian Semi-arid

OpenAIRE

Costa,José Fernando Oliveira; David,Juceni P. L.; David,Jorge M.; Giulietti,Ana M.; Queiroz,Luciano P.; Santos,Ricardo R.; Soares,Milena Botelho P.

2008-01-01

The family Boraginaceae is widely distributed in Brazil and in the Northeastern region some species are popularly used to treat symptoms of rheumatism, painful menstruation and dyspepsia. In this work we studied Cordia superba Cham. and C. rufescens A. DC., native from Brazilian Semi-arid region, in order to investigate their immunomodulatory activity. Six extracts were prepared from aerial parts of C. superba and C. rufescens. The cytotoxicity was evaluated using splenocytes from BALB/c mice...

Helicobacter pylori: From Infection to Cure

Directory of Open Access Journals (Sweden)

ABR Thomson

1996-01-01

Full Text Available Over 380 abstracts, presentations and posters of recent advances were highlighted at the European and International Helicobacter pylori meeting held July 7 to 9, 1995 in Edinburgh, Scotland. New advances abound, with major interest focusing on the simple, safe, inexpensive new `gold standard’ for H pylori eradication therapy: a single week of tid omeprazole 20 mg, metronidazole 400 mg and clarithromycin 250 mg, or omeprazole 20 mg, amoxicillin 1000 mg and clarithromycin 500 mg. To avoid false negative results, two biopsies must be taken from the antrum and two from the gastric body at least four weeks after completion of eradication therapy, and ideally should be supplemented with at least one further H pylori test such as a biopsy for urease activity or culture, or a urea breath test. While most patients with a gastric or duodenal ulcer (DU who do not consume nonsteroidal anti-inflammatory drugs are infected with H pylori, the association is much less apparent in those with a DU who present with an upper gastrointestinal hemorrhage. H pylori eradication for nonulcer dyspepsia is not widely recommended, and the patient with a DU given effective H pylori eradication who presents with dyspepsia likely has erosive esophagitis rather than recurrent DU or H pylori. Gastroenterologists are at increased risk of H pylori infection, particularly older gastroenterologists who are very busy endoscopists.

Chronic fatigue in patients with unexplained self-reported food hypersensitivity and irritable bowel syndrome: validation of a Norwegian translation of the Fatigue Impact Scale.

Science.gov (United States)

Lind, Ragna; Berstad, Arnold; Hatlebakk, Jan; Valeur, Jørgen

2013-01-01

Patients with unexplained self-reported food hypersensitivity and irritable bowel syndrome (IBS) suffer from several health complaints, including fatigue. The aim of the present study was to validate a Norwegian translation of the Fatigue Impact Scale (FIS), and to assess the impact of fatigue in patients with self-reported food hypersensitivity and IBS, as compared with healthy controls. Thirty-eight patients with unexplained self-reported food hypersensitivity and IBS, who participated in the validation of the FIS completed the following additional questionnaires: the Short Form of Nepean Dyspepsia Index for assessment of quality of life, the Subjective Health Complaint Inventory, and questionnaires for diagnosis and severity of IBS. Impact of fatigue was studied in 43 patients with unexplained self-reported food hypersensitivity, 70% diagnosed with IBS, and 42 healthy controls. Cronbach's α for the FIS was 0.98, indicating excellent agreement between individual items. Scores on the FIS correlated with scores on the Short Form of Nepean Dyspepsia Index (r = 0.50, P = 0.001), indicating good convergent validity, and were higher in patients (median 85.0, interquartile range 36.8-105.3) than in controls (median 14.0, interquartile range 3.0-29.0, P ≤ 0.0001). The Norwegian translation of the FIS performed excellently in patients with unexplained self-reported food hypersensitivity and IBS, with patients reporting significantly more impact of chronic fatigue than healthy controls.

Anti-CagA IgG Antibody is Independent from Helicobacter pylori vacA and cagA Genotypes

Directory of Open Access Journals (Sweden)

Hashem Fakhre Yaseri

2015-12-01

Full Text Available Background: Helicobacter pylori strains have two classical virulence genes, the cytotoxinassociated A (cagA gene and the vacuolating cytotoxin A (vacA gene, which are located in thecag pathogenicity island (cagPAI. Serum immunoglobulin G (IgG antibodies to H. pylori,especially, the CagA antigen may be a reliable marker for selection of dyspeptic patients for upperendoscopy.Methods: Serum sample of 129 dyspeptic patients with positive H. pylori, were tested for serumIgG Anti-CagA antibody by ELISA. The presence of the cagA and vacA genotypes weredetermined using polymerase chain reaction (PCR on biopsy samples taken via endoscopy.Results: Positive serum IgG anti-CagA antibodies in patients with cagA+/vacA+ and cagA+/vacA- genotypes were 22/23 (95.6% and 18/19 (94.7%, respectively. In addition, serum IgG anti-CagAantibodies in patients with cagA-/vacA+ and cagA-/vacA- genotypes were 22/47 (46.8% and 33/40(82.5%, respectively.Conclusions: It can be concluded that the serum IgG anti-CagA antibody alone could selectpatients with dyspepsia following upper endoscopy. The assessment of vacuolating cytotoxinactivity of H. Pylori is, therefore, not required, even when vacA gene is positive. This hypothesisneeds to be studied in a large number of patients with dyspepsia.

Dental erosion in patients seeking treatment for gastrointestinal complaints: a case series.

Science.gov (United States)

Bruno, Vincenzo; Amato, Massimo; Catapano, Santo; Iovino, Paola

2015-10-30

Eating disorders which embrace anorexia nervosa, bulimia nervosa, and eating disorders not otherwise specified can be life-threatening due to general medical complications; however, the diagnosis of eating disorder is often delayed due to a low suspicion index. Gastroenterologists are health care providers who may come into contact with patients with undiagnosed eating disorders; it has been previously demonstrated that patients with eating disorders frequently have a significant association with functional dyspepsia. Signs of dental erosion have been described in patients with eating disorders; hence, they may help to identify eating disorders in patients who present with functional dyspepsia and deny having an eating disorder. In this report we describe three cases (a 25-year-old white woman, a 24-year-old white woman, and a 40-year-old white man) with undiagnosed eating disorders, in which a more comprehensive approach, such as the recognition of dental erosion joined with a careful gastrointestinal investigation, was performed to reach a final diagnosis of an eating disorder. The screening for dental erosion in patients seeking or receiving medical treatment for dyspeptic symptoms in a gastrointestinal out-patient clinic could be an aid for gastroenterologists to recognize the presence of an underlying eating disorder. A close collaboration with dentists, in addition to psychiatrists, could provide a more favorable treatment outcome.

Dyspepsia: preliminary experience with upper gastrointestinal fibreoptic endoscopy in Eldoret.

Science.gov (United States)

Ayuo, P O; Nugent, C E

1994-04-01

Fibreoptic oesophagogastroduodenoscopy (OGD) was performed on 45 dysplastic patients suspected of having peptic ulcer (PU). Evidence of PU was found in 39.9% and no abnormality was detected in 60%. Epigastric pain alone (62.2%) and with vomiting (15.5%) were the major reasons for suspecting PU. There were no complications arising from the procedure. It is concluded that OGD is a safe procedure which should be made more available and that the pattern of PUD in Eldoret is similar to that in Nairobi.

Helicobacter pylori in dyspepsia: Phenotypic and genotypic methods of diagnosis

Directory of Open Access Journals (Sweden)

Vignesh Shetty

2017-01-01

Full Text Available Background: Helicobacter pylori affects almost half of the world's population and therefore is one of the most frequent and persistent bacterial infections worldwide. H. pylori is associated with chronic gastritis, ulcer disease (gastric and duodenal, mucosa-associated lymphoid tissue lymphoma, and gastric cancer. Several diagnostic methods exist to detect infection and the option of one method or another depends on various genes, such as availability, advantages and disadvantages of each method, monetary value, and the age of patients. Materials and Methods: Patients with complaints of abdominal pain, discomfort, acidity, and loss of appetite were chosen for endoscopy, detailed history was contained, and a physical examination was conducted before endoscopy. Biopsies (antrum + body were received from each patient and subjected to rapid urease test (RUT, histopathological examination (HPE, polymerase chain reaction (PCR, and culture. Results: Of the total 223 biopsy specimens obtained from dyspeptic patients, 122 (54.7% were positive for H. pylori for HPE, 109 (48.9% by RUT, 65 (29.1% by culture, and 117 (52.5% by PCR. The specificity and sensitivity were as follows: RUT (99% and 88.5%, phosphoglucosamine mutase PCR assay (100% and 95.9%, and culture (100% and 53.3%, respectively. Conclusion: In this study, we compared the various diagnostic methods used to identify H. pylori infection indicating that, in comparison with histology as gold standard for detection of H. pylori infection, culture and PCR showed 100% specificity whereas RUT and PCR showed 99% and 100% sensitivity, respectively.

Clinicians' management strategies for patients with dyspepsia: a qualitative approach

Directory of Open Access Journals (Sweden)

Ohlsson Bodil

2005-05-01

Full Text Available Abstract Background Symptoms from the upper gastrointestinal tract are frequently encountered in clinical practice and may be of either organic or functional origin. For some of these conditions, according to the literature, certain management strategies can be recommended. For other conditions, the evidence is more ambiguous. The hypothesis that guided our study design was twofold: Management strategies and treatments suggested by different clinicians vary considerably, even when optimal treatment is clear-cut, as documented by evidence in the literature. Clinicians believe that the management strategies of their colleagues are similar to their own. Methods Simulated case histories of four patients with symptoms from the upper gastrointestinal tract were presented to 27 Swedish clinicians who were specialists in medical gastroenterology, surgery, and general practice and worked at three hospitals in the southern part of Sweden. The patients' histories contained information on the patient's sex and age and the localisation of the symptoms, but descriptions of subjective symptoms and findings from examinations differed from history to history. Interviews containing open-ended questions were conducted. Results For the same patient, the management strategies and treatments suggested by the clinicians varied widely, as did the strategies suggested by clinicians in the same speciality. Variation was more pronounced if the case history noted symptoms but no organic findings than if the case history noted unambiguous findings and symptoms. However, even in cases with a consensus in the scientific literature on treatment, the variations in clinicians' opinion on management were pronounced. Conclusion Despite these variations, the clinicians believed that the decisions made by their colleagues would be similar to their own. The overall results of this study indicate that we as researchers must make scientific evidence comprehensible and communicate evidence so that clinicians are able to interpret and implement it in practice. Of particular significance is that scientific evidence leads to an evidence-based care which is effective clinical practice and to the promotion of health from the perspective of the patient, together with cost-effectiveness as a priority.

Significant association of the dupA gene of Helicobacter pylori with duodenal ulcer development in a South-east Indian population

OpenAIRE

Alam, Jawed; Maiti, Sankar; Ghosh, Prachetash; De, Ronita; Chowdhury, Abhijit; Das, Suryasnata; Macaden, Ragini; Devarbhavi, Harshad; Ramamurthy, T.; Mukhopadhyay, Asish K.

2012-01-01

A novel virulence factor, duodenal ulcer-promoting gene A (dupA), in Helicobacter pylori has been found to be associated with disease in certain populations but not in others. This study analysed a South-east Indian population as part of the debate about the relevance of dupA for the prediction of clinical outcomes. A total of 140 H. pylori strains isolated from duodenal ulcer (DU) (n=83) and non-ulcer dyspepsia (NUD) patients (n=57) were screened by PCR and dot-blot hybridization to determin...

Neutron activation analysis of chemical impurities in manipulated samples of omeprazole

International Nuclear Information System (INIS)

Sepe, Fernanda Peixoto; Leal, Alexandre Soares; Gomes, Tatiana Cristina Bomfim; Menezes, Maria Angela de Barros Correia; Silva, Maria Aparecida

2011-01-01

In this work, samples of Omeprazole (C 17 H 19 N 3 O 3 S), a largely used drug in the treatment of dyspepsia and peptic ulcer, were acquired from five different pharmacies of manipulation - or retail pharmacies which prepare personalized drugs under medical recommendation - in Belo Horizonte/Brazil and investigated using the k 0 - Neutron Activation Analysis (NAA). The preliminary results showed the presence of elements not foreseen in the original formula. It confirms the potential risk offered by medicines without suitable inspection. (author)

The prevention of gastropathy and upper abdominal symptoms caused by nonsteroidal anti-inflammatory drugs.

Science.gov (United States)

Vakil, Nimish

2006-01-01

The use of nonsteroidal anti-inflammatory drugs (NSAIDs) is increasing, primarily due to arthritis in the aging population. This article reviews current data on the risk of gastrointestinal complications related to NSAIDs and strategies to manage risk in patients taking these agents. Risks of NSAID use include gastrointestinal ulceration, hemorrhage, or perforation; renal dysfunction; death; and dyspepsia. Alternate therapies include use of non-NSAID analgesics; low-dose NSAIDs; and concurrent administration of cytoprotective agents with NSAIDs, acid inhibitors, proton pump inhibitors, and COX-2 agents.

Synthesis and application of a new fluorous-tagged ammonia equivalent

DEFF Research Database (Denmark)

Nielsen, Simon Dalsgaard; Smith, Garrick; Begtrup, Mikael

2010-01-01

A novel fluorous-tagged ammonia equivalent has been developed. It is based on a nitrogen-oxygen bond, which can be cleaved in a traceless manner by a molybdenum complex or samarium diiodide. The application in the synthesis of ureas, amides, sulfonamides, and carbamates is described. The scope of...... of the fluorous N--O linker is exemplified by the synthesis of itopride, a drug used for the treatment of functional dyspepsia. Itopride was synthesized with the aid of fluorous purification methods and the product was isolated in good overall yield, with high purity....

Neutron activation analysis of chemical impurities in manipulated samples of omeprazole

Energy Technology Data Exchange (ETDEWEB)

Sepe, Fernanda Peixoto; Leal, Alexandre Soares; Gomes, Tatiana Cristina Bomfim; Menezes, Maria Angela de Barros Correia; Silva, Maria Aparecida, E-mail: asleal@cdtn.br [Nuclear Technology Development Centre/Brazilian Commission for Nuclear Energy (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

2011-07-01

In this work, samples of Omeprazole (C{sub 17}H{sub 19}N{sub 3}O{sub 3}S), a largely used drug in the treatment of dyspepsia and peptic ulcer, were acquired from five different pharmacies of manipulation - or retail pharmacies which prepare personalized drugs under medical recommendation - in Belo Horizonte/Brazil and investigated using the k{sub 0} - Neutron Activation Analysis (NAA). The preliminary results showed the presence of elements not foreseen in the original formula. It confirms the potential risk offered by medicines without suitable inspection. (author)

[MODERN PROKINETICS AND THEIR ROLE IN THE TREATMENT OF GASTROENTEROLOGICAL PATHOLOGY].

Science.gov (United States)

Sheptulin, A A; Belousova, I B

2016-01-01

The importance of prokinetics (drugs stimulating motor function of the gastrointestinal tract) arises from the high prevalence of gastroenterological pathology associated with primary or secondary disturbances of this function in esophagus, stomach, and intestines. The main groups of prokinetics are beta-blockers of dopamine receptors, inhibitors of acetylcholine esterase (or their combination with dopamine receptor blockers), 5-HT4-receptor agonists. They find wide application for the treatment of gastroesophgeal reflux disease, functional dyspepsia and constipation, obstipational form of irritable bowel syndrome, and other conditions accompanied by motor function disorders of the gastrointestinal tract.

Radiotherapy for Stage I seminoma testis: results of treatment and complications

International Nuclear Information System (INIS)

Hamilton, C.; Horwich, A.; Easton, D.; Peckham, M.J.

1986-01-01

The results of treatment by infradiaphragmatic lymph node irradiation and orchiectomy in 232 patients with Stage I testicular seminoma are reported. Of this group, only five (2%) patients relapsed and none died from seminoma. Contralateral testicular tumours occurred in 12 patients and five developed second non-testicular malignancies. The acute and late morbidity of radiotherapy was low although 15 patients developed peptic ulceration. There was a significant association between prior abdominal surgery and a history of dyspepsia with ensuing peptic ulceration. Future management policy is discussed on the basis of these observations. (Auth.)

Oral sildenafil citrate (viagra) for erectile dysfunction: a systematic review and meta-analysis of harms.

Science.gov (United States)

Tsertsvadze, Alexander; Yazdi, Fatemeh; Fink, Howard A; MacDonald, Roderick; Wilt, Timothy J; Bella, Anthony J; Ansari, Mohammed T; Garritty, Chantelle; Soares-Weiser, Karla; Daniel, Raymond; Sampson, Margaret; Moher, David

2009-10-01

To summarize and compare evidence on harms in sildenafil- and placebo-treated men with erectile dysfunction (ED) in a systematic review and meta-analysis. Randomized placebo-controlled trials (RCTs) were identified using an electronic search in MEDLINE, EMBASE, PsycINFO, SCOPUS, and Cochrane CENTRAL. The rates of any adverse events (AEs), most commonly reported AEs, withdrawals because of adverse events, and serious adverse events were ascertained and compared between sildenafil and placebo groups. The results of men with ED were stratified by clinical condition(s). Statistical heterogeneity was explored. Meta-analyses based on random-effects model were also performed. A total of 49 RCTs were included. Sildenafil-treated men had a higher risk for all-cause AEs (RR = 1.56, 95% CI: 1.38, 1.76), headache, flushing, dyspepsia, and visual disturbances compared with placebo-treated men. The magnitude of excess risk was greater in fixed- than in flexible-dose trials. The rates of serious adverse events and withdrawals because of adverse events did not differ in sildenafil vs placebo groups. A higher dose of sildenafil corresponded to a greater risk of AEs. The increased risk of harms was observed within and across clinically defined specific groups of patients. There was a lack of RCTs reporting long-term (>6 months) harms data. In short-term trials, men with ED randomized to sildenafil had an increased risk of all-cause any AEs, headache, flushing, dyspepsia, and visual disturbances. The exploration of different modes of dose optimization of sildenafil may be warranted.

Acotiamide hydrochloride (Z-338), a new selective acetylcholinesterase inhibitor, enhances gastric motility without prolonging QT interval in dogs: comparison with cisapride, itopride, and mosapride.

Science.gov (United States)

Matsunaga, Yugo; Tanaka, Takao; Yoshinaga, Koji; Ueki, Shigeru; Hori, Yuko; Eta, Runa; Kawabata, Yoshihiro; Yoshii, Kazuyoshi; Yoshida, Kenji; Matsumura, Toshihiro; Furuta, Shigeru; Takei, Mineo; Tack, Jan; Itoh, Zen

2011-03-01

Acotiamide hydrochloride (acotiamide; N-[2-[bis(1-methylethyl) amino]ethyl]-2-[(2-hydroxy-4,5-dimethoxybenzoyl) amino] thiazole-4-carboxamide monohydrochloride trihydrate, Z-338) has been reported to improve meal-related symptoms of functional dyspepsia in clinical studies. Here, we examined the gastroprokinetic effects of acotiamide and its antiacetylcholinesterase activity as a possible mechanism of action in conscious dogs. Acotiamide increased postprandial gastric motor activity in conscious dogs with chronically implanted force transducers and, like itopride, mosapride, and cisapride, exhibited gastroprokinetic activity in these dogs. Furthermore, acotiamide improved clonidine-induced hypomotility and delayed gastric emptying. Acotiamide-enhanced postprandial gastroduodenal motility was suppressed completely by pretreatment with atropine, a muscarinic receptor antagonist. In in vitro studies, acotiamide enhanced acetylcholine- but not carbachol-induced contractile responses of guinea pig gastric antrum strips. Moreover, like itopride and neostigmine, acotiamide inhibited recombinant human and canine stomach-derived acetylcholinesterase (AChE) activity in vitro. The mode of the AChE inhibitory action of acotiamide was selective and reversible. Unlike itopride or mosapride, acotiamide showed no affinity for dopamine D(2) or serotonin 5-HT(4) receptors. With regard to cardiovascular side effects, unlike cisapride, acotiamide did not affect myocardial monophasic action potential duration, QT interval, or corrected QT interval in anesthetized dogs. These results suggest that acotiamide stimulates gastric motility in vivo by inhibiting AChE activity without affecting QT interval. Acotiamide thus represents a beneficial new drug for the treatment of functional dyspepsia involving gastric motility dysfunction, with differences from other prokinetic agents.

Abdominal pain-predominant functional gastrointestinal diseases in children and adolescents: prevalence, symptomatology, and association with emotional stress.

Science.gov (United States)

Devanarayana, Niranga Manjuri; Mettananda, Sachith; Liyanarachchi, Chathurangi; Nanayakkara, Navoda; Mendis, Niranjala; Perera, Nimnadi; Rajindrajith, Shaman

2011-12-01

Functional gastrointestinal disorders (FGD) are common among children, but little is known regarding their prevalence in developing countries. We assessed the prevalence of abdominal pain-predominant FGD, in addition to the predisposing factors and symptomatology, in Sri Lankan children. A cross-sectional survey was conducted among a randomly selected group of 10- to 16-year-olds in 8 randomly selected schools in 4 provinces in Sri Lanka. A validated, self-administered questionnaire was completed by children independently in an examination setting. FGD were diagnosed using Rome III criteria. A total of 2180 questionnaires were distributed and 2163 (99.2%) were included in the analysis (1189 [55%] boys, mean age 13.4 years, standard deviation 1.8 years). Of them, 270 (12.5%) had at least 1 abdominal pain-predominant FGD. Irritable bowel syndrome (IBS) was seen in 107 (4.9%), functional dyspepsia in 54 (2.5%), functional abdominal pain in 96 (4.4%), and abdominal migraine (AM) in 21 (1.0%) (2 had AM and functional dyspepsia, 6 had AM and IBS). Extraintestinal symptoms were more common among affected children (P Abdominal pain-predominant FGD were higher in girls and those exposed to stressful events (P Abdominal pain-predominant FGD affects 12.5% of children ages 10 to 16 years and constitutes a significant health problem in Sri Lanka. IBS is the most common FGD subtype present. Abdominal pain-predominant FGD are higher in girls and those exposed to emotional stress. Prevalence of FGD decreased with age. Extraintestinal symptoms are more frequent in affected children.

Helicobacter pylori: From Bench to Bedside

Directory of Open Access Journals (Sweden)

N Chiba

1997-01-01

Full Text Available With the exponential increase in research in the field of Helicobacter pylori a paradigm shift has occurred. It is now recognized that H pylori is a chronic infection of the stomach causing inflammation. Some patients remain asymptomatic, while others may develop dyspepsia, duodenal or gastric ulcer, gastric cancer or a mucosa-associated lymphoid tissue lymphoma. However, the role of H pylori in contributing to nonulcer dyspepsia or nonsteroidal anti-inflammatory drug gastropathy remains controversial. An effective vaccine against H pylori is years away. Major interest has focused on the questions "who should be investigated and therefore treated" and "what is the latest gold standard for eradication of H pylori"? In Europe, guidelines have been developed to help the practitioner answer these important questions. Canadian guidelines will soon be available. For persons with known peptic ulcer disease there should be unequivocal acceptance that the good clinical practice of eradicating H pylori will result in substantial savings in health care expenses. The original 'classical triple therapy' (bismuth, metronidazole and tetracycline [BMT] has now been surpassed by the combination of a proton pump inhibitor (PPI plus two antibiotics (metronidazole plus clarithromycin; amoxicillin plus clarithromycin; or amoxicillin plus metronidazole, each given twice a day for one week. In Canada, the regimen of omeprazole plus one antibiotic (amoxicillin or clarithromycin was approved recently but gives an eradication rate that is lower than the current target of 90%. According to the European (Mäastricht recommendations, if a single treatment attempt with PPI plus two antibiotics fails, PPI plus BMT is recommended.

Helicobacter pylori

DEFF Research Database (Denmark)

Leth, Peter Mygind

1992-01-01

Helicobacter pylori (HP) are Gram-negative spiral bacteria which occur in the human stomach. The bacteria were cultured in vitro for the first time in 1983. It is suspected that the bacteria may cause chronic gastritis of type B and may also be a contributory cause of chronic ulceration and cancer...... of the stomach. The bacteria are accompanied by characteristic inflammatory changes in the gastric mucosa. The significance for gastritis, chronic ulceration, non-ulcer dyspepsia and carcinoma of the stomach is discussed. HP occurs in a great proportion of the population of the world and the frequency increases...

The importance of serotonin in the gastrointestinal tract

Directory of Open Access Journals (Sweden)

Jarosław Koza

2017-12-01

Description of the current knowledge and conclusions. Serotonin is responsible for some symptoms of carcinoid syndrome. It is the result of higher 5-hydroxytryptamine content in the body. Moreover disrupted serotonin system is found in different gastrointestinal disorders e.g. in gastroesophageal reflux disease, functional heartburn, hypersensitive esophagus, functional dyspepsia, irritable bowel syndrome (both diarrhoea predominant and constipation predominant as well as in inflammatory bowel diseases. Knowledge of changed mechanisms in particular diseases facilitates the optimal choice of treatment. Drugs affecting the serotonin system in gastroenterological clinical practice are useful especially in the case of abnormalities in the brain - gut axis.

Synthesis and application of a new fluorous-tagged ammonia equivalent.

Science.gov (United States)

Nielsen, Simon D; Smith, Garrick; Begtrup, Mikael; Kristensen, Jesper L

2010-04-19

A novel fluorous-tagged ammonia equivalent has been developed. It is based on a nitrogen-oxygen bond, which can be cleaved in a traceless manner by a molybdenum complex or samarium diiodide. The application in the synthesis of ureas, amides, sulfonamides, and carbamates is described. The scope of the fluorous N-O linker is exemplified by the synthesis of itopride, a drug used for the treatment of functional dyspepsia. Itopride was synthesized with the aid of fluorous purification methods and the product was isolated in good overall yield, with high purity. Copyright © 2010 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Baking soda induced severe metabolic alkalosis in a haemodialysis patient.

Science.gov (United States)

Solak, Yalcin; Turkmen, Kultigin; Atalay, Huseyin; Turk, Suleyman

2009-08-01

Metabolic alkalosis is a rare occurence in hemodialysis population compared to metabolic acidosis unless some precipitating factors such as nasogastric suction, vomiting and alkali ingestion or infusion are present. When metabolic alkalosis develops, it may cause serious clinical consequences among them are sleep apnea, resistent hypertension, dysrhythmia and seizures. Here, we present a 54-year-old female hemodialysis patient who developed a severe metabolic alkalosis due to baking soda ingestion to relieve dyspepsia. She had sleep apnea, volume overload and uncontrolled hypertension due to metabolic alkalosis. Metabolic alkalosis was corrected and the patient's clinical condition was relieved with negative-bicarbonate hemodialysis.

[Efficiency of famotidin in prophylaxis of NSAIDs-induced gastropathy: result of multicenter research ZASLON-1 (protection of gastric mucosa from non-steroidal anti-inflammatory drugs].

Science.gov (United States)

Lazebnik, L B; Drozdov, V N; Kim, V A

2009-01-01

This article presents results of the first Russian randomized study of NSAID-gastropaty prevention at patients receiving NSAIDS. Results of clinical and endoscopic monitoring of two groups of patients: 1st - 108 patients with AA or RA treated with diclofenac and famotidin and 2nd--116 patients with AA or RA receiving diclofenac treatment only. It was shown that combined use of diclofenac and famotidin reduces to 2.6 times frequency and significantly reduces severity of painful dyspepsia symptoms and antipain manifestations reduces more than twice frequency of erosive-ulcerous lesions of gastric mucosa and duodenum.

Randomised clinical trial: relief of upper gastrointestinal symptoms by an acid pocket-targeting alginate-antacid (Gaviscon Double Action) - a double-blind, placebo-controlled, pilot study in gastro-oesophageal reflux disease.

Science.gov (United States)

Thomas, E; Wade, A; Crawford, G; Jenner, B; Levinson, N; Wilkinson, J

2014-03-01

The alginate-antacid, Gaviscon Double Action (Gaviscon DA; Reckitt Benckiser, Slough, UK) suppresses reflux after meals by creating a gel-like barrier that caps and displaces the acid pocket distal to the oesophago-gastric junction. The effect of Gaviscon DA on reflux and dyspepsia symptoms has not yet been demonstrated with a modern trial design. A pilot study to assess the efficacy and safety of Gaviscon DA compared with matched placebo for decreasing upper gastrointestinal symptoms in symptomatic gastro-oesophageal reflux disease (GERD) patients. A randomised, double-blind, parallel group study was performed in 110 patients with symptoms of GERD. Patients received Gaviscon DA or placebo tablets for 7 consecutive days. The primary endpoint compared the change in overall Reflux Disease Questionnaire (RDQ) symptom score (combined heartburn/regurgitation/dyspepsia). Secondary endpoints assessed individual dimensions, GERD dimension (heartburn and regurgitation) and overall treatment evaluation (OTE). There was a greater decrease in overall RDQ symptom score in the Gaviscon DA group compared with the placebo group (Least Squares Mean difference -0.55; P = 0.0033), and for each of the dimensions independently. Patients in the Gaviscon DA group evaluated their overall treatment response higher than patients in the placebo group [mean (standard deviation) OTE 4.1 (2.44) vs. 1.9 (3.34); P = 0.0005]. No differences in the incidence of adverse events were observed between treatment groups. Gaviscon DA decreases reflux and dyspeptic symptoms in GERD patients compared with matched placebo and has a favourable benefit-risk balance. Larger scale clinical investigations of medications targeting the acid pocket are warranted. (EudraCT, 2012-002188-84). © 2014 John Wiley & Sons Ltd.

Development and validation of a simple and multifaceted instrument, GERD-TEST, for the clinical evaluation of gastroesophageal reflux and dyspeptic symptoms.

Science.gov (United States)

Nakada, Koji; Matsuhashi, Nobuyuki; Iwakiri, Katsuhiko; Oshio, Atsushi; Joh, Takashi; Higuchi, Kazuhide; Haruma, Ken

2017-07-28

To evaluate the psychometric properties of a newly developed questionnaire, known as the gastroesophageal reflux and dyspepsia therapeutic efficacy and satisfaction test (GERD-TEST), in patients with GERD. Japanese patients with predominant GERD symptoms recruited according to the Montreal definition were treated for 4 wk using a standard dose of proton pump inhibitor (PPI). The GERD-TEST and the Medical Outcome Study Short Form-8 Health Survey (SF-8) were administered at baseline and after 4 wk of treatment. The GERD-TEST contains three domains: the severity of GERD and functional dyspepsia (FD) symptoms (5 items), the level of dissatisfaction with daily life (DS) (4 items), and the therapeutic efficacy as assessed by the patients and medication compliance (4 items). A total of 290 patients were eligible at baseline; 198 of these patients completed 4 wk of PPI therapy. The internal consistency reliability as evaluated using the Cronbach's α values for the GERD, FD and DS subscales ranged from 0.75 to 0.82. The scores for the GERD, FD and DS items/subscales were significantly correlated with the physical and mental component summary scores of the SF-8. After 4 wk of PPI treatment, the scores for the GERD items/subscales were greatly reduced, ranging in value from 1.51 to 1.87 and with a large effect size ( P GERD items/subscales were observed between treatment responders and non-responders ( P GERD-TEST has a good reliability, a good convergent and concurrent validity, and is responsive to the effects of treatment. The GERD-TEST is a simple, easy to understand, and multifaceted PRO instrument applicable to both clinical trials and the primary care of GERD patients.

Association of Helicobacter pylori cagA Gene with Gastric Cancer and Peptic Ulcer in Saudi Patients.

Science.gov (United States)

Saber, Taisir; Ghonaim, Mabrouk M; Yousef, Amany R; Khalifa, Amany; Al Qurashi, Hesham; Shaqhan, Mohammad; Samaha, Mohammad

2015-07-01

This study was conducted to assess the relationship between occurrence of gastric cancer and peptic ulcer, and the presence of H. pylori cagA gene and anti-CagA IgG, and to estimate the value of these antibodies in detecting infection by cagA gene-positive H. pylori strains in Saudi patients. The study included 180 patients who were subjected to upper gastrointestinal endoscopy in Taif province and Western region of Saudi Arabia (60 gastric cancer, 60 peptic ulcer, and 60 with non-ulcer dyspepsia). Gastric biopsy specimens were obtained and tested for H. pylori infection by rapid urease test and culture. PCR was performed on the isolated strains and biopsy specimens for detection of the cagA gene. Blood samples were collected and tested for CagA IgG by ELISA. H. pylori infection was detected among 72.8% of patients. The cagA gene and anti-CagA IgG were found in 63.4% and 61.8% of H. pylori-infected patients, respectively. They were significantly (p peptic ulcer compared with those with non-ulcer dyspepsia. Detection of the CagA IgG was 91.6% sensitive, 89.6% specific, and 90.8% accurate compared with detection of the cagA gene. Its positive and negative predictive values were 93.8% and 86%, respectively. The study showed a significant association between the presence of the cagA gene and gastric cancer and peptic ulcer disease, and between anti-CagA IgG and the cagA gene in Saudi patients. However, a further larger study is required to confirm this finding.

Associations between Medication Use and Functional Gastrointestinal Disorders: A Population-Based Study

Science.gov (United States)

Choung, Rok Seon; Locke, G. Richard.; Schleck, Cathy D.; Zinsmeister, Alan R.; Talley, Nicholas J.

2013-01-01

Background Functional GI syndromes are known to be very prevalent but this may be associated with unrecognized medications use. We aimed to estimate the prevalence of PPI, antidepressant, and narcotic use in the general population, and evaluate the association between each medication and functional GI syndromes adjusting for potential confounders. Methods In 2008 and 2009, newly revised versions of a validated bowel disease questionnaire were mailed to a community based cohort (total mailed=8006) of Olmsted County, MN residents; 3831 returned the questionnaire (response rate=48.0%). Medication usage, specifically PPIs, narcotics, and antidepressants in the last year, was elicited via three separate questions on the questionnaire. The association between each medication and GI symptom complexes was assessed using multiple variable logistic regression models. Results A total of 3515 of the respondents (92%) had complete data (mean age: 61±15; 54% female). The overall proportion reporting PPI use was 20% (95% CI: 19, 22), narcotic use 12% (95% CI: 11, 13), and antidepressant use 15% (95% CI: 14, 16). PPI use was significantly associated with IBS status (OR=1.4, 95% CI 1.1, 1.7) as well as with GERD (OR=3.5, 95% CI 2.7, 4.4) and dyspepsia (OR=2.0, 95% CI 1.5, 2.7). The association of PPI use with IBS was not explained by coexistent GERD or dyspepsia. Antidepressant use was significantly associated only with bloating (OR=1.6, 1.1, 2.2). Conclusions Some medications that may alter intestinal transit or bowel flora are commonly utilized by the general population, and PPI use appears to be linked to IBS. PMID:23360217

The predictive value of mean platelet volume, plateletcrit and red cell distribution width in the differentiation of autoimmune gastritis patients with and without type I gastric carcinoid tumors.

Science.gov (United States)

Tüzün, Ali; Keskin, Onur; Yakut, Mustafa; Kalkan, Cagdas; Soykan, Irfan

2014-01-01

Autoimmune gastritis is an autoimmune and inflammatory condition that may predispose to gastric carcinoid tumors or adenocarcinomas. The early diagnosis of these tumors is important in order to decrease morbidity and mortality. Platelet indices such as mean platelet volume and plateletcrit levels increase in inflammatory, infectious and malign conditions. The primary aim of this study was to explore wheter platelet indices and red cell distribution width have any predictive role in the discrimination of autoimmune gastritis patients with and without gastric carcinoid tumors. Also secondary aim of this study was to investigate whether any changes exist betwenn autoimmune gastritis and functional dyspepsia patients by means of platelet indices. Plateletcrit (0.22 ± 0.06 vs. 0.20 ± 0.03%, p gastritis patients compared to control group. Receiver operating curve analysis suggested that optimum plateletcrit cut-off point was 0.20% (AUC: 0.646), and 13.95% as the cut off value for red cell distribution width (AUC: 0.860). Although plateletcrit (0.22 ± 0.06 vs. 0.21 ± 0.04%, p = 0.220) and mean platelet volume (8.94 ± 1.44 vs. 8.68 ± 0.89 fl, p = 0.265) were higher in autoimmune gastritis patients without carcinoid tumor compared to patients with carcinoid tumors, these parameters were not statistically significant. Changes in plateletcrit and red cell distribution width values may be used as a marker in the discrimination of autoimmune gastritis and fucntional dyspepsia patients but not useful in patients with gastric carcinoid tumor type I.

Surveillance of psychosomatic disorders in internal medicine in Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

Science.gov (United States)

Shatri, Hamzah; Mudjaddid, E; Lapau, Buchari

2004-01-01

to examine certain characteristics of patients who suffer from psychosomatic disorders. We called data through medical report outpatient clinic of the Psychosomatic Division, Department of internal medicine, Cipto Mangunkusumo Central General Hospital/Faculty of Medicine of the University of Indonesia (FKUI/RSUPN-CM), Jakarta, Indonesia, in 1996. The data was processed manually and by computer from which table and graphic were obtained. The descriptive analysis was performed to the objective the study. the FPD patients consisted of those with vegetative imbalance (multiple psychosomatic syndrome) (30.2%), dyspepsia (20.8%), functional heart disease (11.3%) and others 1%-6%. All of SPD consisted of chronic disease, such as hypertension (38.3%), diabetes mellitus (29.8%), bronchial asthma (10.6%), coronary artery disease (6.4%), and others 2%-5%. According to DSM IV, among the psychosomatic patients, 52.7% met the criteria for anxiety, 29.3% for depression, 14.2% for mixed anxiety and depression, and 3.8% unclear. The psychosocial stressor groups were family problems (38%), physical conditions (16%), work-related problems (13.4%), marriage problems (8.4%) and others (1%-4%). The most common physical symptoms of psychosomatic disorders were functional. Common functional psychosomatic disorders were multiple psychosomatic syndrome, dyspepsia and functional heart disease. Structural disorders found were chronic diseases. There was no difference in prevalence between males and females. The most frequent functional disorders were more commonly found among those under 40 years of age, while those with structural disorders were more common among patients 40 years of age or more. The psychological diagnoses were anxiety and depression. The most frequent psychological stressors were family problems, medical conditions, work-related problems and marriage problems.

Presentation and Epidemiology of Gastroesophageal Reflux Disease.

Science.gov (United States)

Richter, Joel E; Rubenstein, Joel H

2018-01-01

Gastroesophageal reflux disease (GERD) is the most prevalent gastrointestinal disorder in the United States, and leads to substantial morbidity, though associated mortality is rare. The prevalence of GERD symptoms appeared to increase until 1999. Risk factors for complications of GERD include advanced age, male sex, white race, abdominal obesity, and tobacco use. Most patients with GERD present with heartburn and effortless regurgitation. Coexistent dysphagia is considered an alarm symptom, prompting evaluation. There is substantial overlap between symptoms of GERD and those of eosinophilic esophagitis, functional dyspepsia, and gastroparesis, posing a challenge for patient management. Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.

First-in-Man Dose-Escalation Study of the Selective BRAF Inhibitor RG7256 in Patients with BRAF V600-Mutated Advanced Solid Tumors

DEFF Research Database (Denmark)

Dienstmann, Rodrigo; Lassen, Ulrik; Cebon, Jonathan

2016-01-01

V600-mutated advanced solid tumors. PATIENTS AND METHODS: Patients received RG7256 orally over 8 dose levels from 200 mg once a day (QD) to 2400 mg twice a day (BID) (50-, 100- and 150-mg tablets) using a classic 3 + 3 dose escalation design. RESULTS: In total, 45 patients were enrolled; most (87...... %) had advanced melanoma (94 % BRAF V600E). RG7256 was rapidly absorbed, with limited accumulation and dose-proportional increase in exposure up to 1950 mg BID. The maximal tolerated dose (MTD) was not reached. The most common drug-related adverse events (AEs) were dyspepsia (20 %), dry skin (18 %), rash...

Rare bile duct anomaly: B3 duct draining to gallbladder

Directory of Open Access Journals (Sweden)

Seung Eun Lee

2016-01-01

Full Text Available A 10-year-old girl presented with recurrent right upper abdominal pain and dyspepsia. Magnetic resonance cholangiopancreatography revealed a dilated common channel of intrahepatic bile duct of segment 3 (B3 and segment 4 (B4 drained into the gallbladder directly. The patient underwent laparoscopic cholecystectomy and Roux-en Y hepaticojejunostomy (B3-jejunostomy. Among the anatomical variability of the biliary system, the cholecystohepatic ducts are controversial in existence and incidence. We report a very rare variant of a cholecystohepatic duct in which the B3 duct drained into gallbladder directly and to the best of our knowledge this is the first report.

Clinical and radiologic review of uncommon cause of profound iron deficiency anemia: Median arcuate ligament syndrome

International Nuclear Information System (INIS)

Gunduz, Yasemin; Asil, Kiyasrttin; Aksoy, Yakup Ersel; Ayhan, Lacin Tatli

2014-01-01

Median arcuate ligament syndrome is an anatomic and clinical entity characterized by dynamic compression of the proximal celiac artery by the median arcuate ligament, which leads to postprandial epigastric pain, vomiting, and weight loss. These symptoms are usually nonspecific and are easily misdiagnosed as functional dyspepsia, peptic ulcer disease, or gastropathy. In this report, we presented a 72-year-old male patient with celiac artery compression syndrome causing recurrent abdominal pain associated with gastric ulcer and iron deficiency anemia. This association is relatively uncommon and therefore not well determined. In addition, we reported the CT angiography findings and three-dimensional reconstructions of this rare case.

Clinical and radiologic review of uncommon cause of profound iron deficiency anemia: Median arcuate ligament syndrome

Energy Technology Data Exchange (ETDEWEB)

Gunduz, Yasemin; Asil, Kiyasrttin; Aksoy, Yakup Ersel; Ayhan, Lacin Tatli [Dept. of Radiology, Sakarya University Medical Faculty, Sakarya (Turkmenistan)

2014-08-15

Median arcuate ligament syndrome is an anatomic and clinical entity characterized by dynamic compression of the proximal celiac artery by the median arcuate ligament, which leads to postprandial epigastric pain, vomiting, and weight loss. These symptoms are usually nonspecific and are easily misdiagnosed as functional dyspepsia, peptic ulcer disease, or gastropathy. In this report, we presented a 72-year-old male patient with celiac artery compression syndrome causing recurrent abdominal pain associated with gastric ulcer and iron deficiency anemia. This association is relatively uncommon and therefore not well determined. In addition, we reported the CT angiography findings and three-dimensional reconstructions of this rare case.

A one-year economic evaluation of six alternative strategies in the management of uninvestigated upper gastrointestinal symptoms in Canadian primary care.

Science.gov (United States)

Barkun, Alan N; Crott, Ralph; Fallone, Carlo A; Kennedy, Wendy A; Lachaine, Jean; Levinton, Carey; Armstrong, David; Chiba, Naoki; Thomson, Alan; Veldhuyzen van Zanten, Sander; Sinclair, Paul; Escobedo, Sergio; Chakraborty, Bijan; Smyth, Sandra; White, Robert; Kalra, Helen; Nevin, Krista

2010-08-01

The cost-effectiveness of initial strategies in managing Canadian patients with uninvestigated upper gastrointestinalsymptoms remains controversial. To assess the cost-effectiveness of six management approaches to uninvestigated upper gastrointestinal symptoms in the Canadian setting. The present study analyzed data from four randomized trials assessing homogeneous and complementary populations of Canadian patients with uninvestigated upper gastrointestinal symptoms with comparable outcomes. Symptom-free months, qualityadjusted life-years (QALYs) and direct costs in Canadian dollars of two management approaches based on the Canadian Dyspepsia Working Group (CanDys) Clinical Management Tool, and four additional strategies (two empirical antisecretory agents, and two prompt endoscopy) were examined and compared. Prevalence data, probabilities, utilities and costs were included in a Markov model, while sensitivity analysis used Monte Carlo simulations. Incremental cost-effectiveness ratios and cost-effectiveness acceptability curves were determined. Empirical omeprazole cost $226 per QALY ($49 per symptom-free month) per patient. CanDys omeprazole and endoscopy approaches were more effective than empirical omeprazole, but more costly. Alternatives using H2-receptor antagonists were less effective than those using a proton pump inhibitor. No significant differences were found for most incremental cost-effectiveness ratios. As willingness to pay (WTP) thresholds rose from $226 to $24,000 per QALY, empirical antisecretory approaches were less likely to be the most costeffective choice, with CanDys omeprazole progressively becoming a more likely option. For WTP values ranging from $24,000 to $70,000 per QALY, the most clinically relevant range, CanDys omeprazole was the most cost-effective strategy (32% to 46% of the time), with prompt endoscopy-proton pump inhibitor favoured at higher WTP values. Although no strategy was the indisputable cost effective option, Can

Acotiamide hydrochloride (Z-338) enhances gastric motility and emptying by inhibiting acetylcholinesterase activity in rats.

Science.gov (United States)

Kawachi, Masanao; Matsunaga, Yugo; Tanaka, Takao; Hori, Yuko; Ito, Katsunori; Nagahama, Kenji; Ozaki, Tomoko; Inoue, Naonori; Toda, Ryoko; Yoshii, Kazuyoshi; Hirayama, Masamichi; Kawabata, Yoshihiro; Takei, Mineo

2011-09-01

In clinical trials, acotiamide hydrochloride (acotiamide: Z-338) has been reported to be useful in the treatment of functional dyspepsia. Here, we investigated the effects of acotiamide on gastric contraction and emptying activities in rats in comparison with itopride hydrochloride (itopride) and mosapride citrate (mosapride). We also examined in vitro the compound's inhibitory effect on acetylcholinesterase (AChE) activity derived from rat stomach. In in vivo studies, acotiamide (30 and 100mg/kg s.c.) and itopride (100mg/kg s.c.) markedly enhanced normal gastric antral motility in rats. In gastric motility dysfunction models, acotiamide (100mg/kg s.c.) and itopride (100mg/kg s.c.) improved both gastric antral hypomotility and the delayed gastric emptying induced by clonidine, an α(2)-adrenoceptor agonist. In contrast, mosapride (10mg/kg s.c.) had no effect on these models. Like the AChE inhibitors itopride (30 mg/kg s.c.) and neostigmine (10 μg/kg s.c.), acotiamide (10mg/kg s.c.) also clearly enhanced gastric body contractions induced by electrical stimulation of the vagus, which were abolished by atropine and hexamethonium, whereas mosapride (3 and 10mg/kg s.c.) did not. In in vitro studies, acotiamide concentration-dependently inhibited rat stomach-derived AChE activity (IC(50)=2.3 μmol/l). In addition, stomach tissue concentrations of acotiamide after administration at 10mg/kg s.c. were sufficient to produce inhibition of AChE activity in rat stomach. These results suggest that acotiamide stimulates gastric motility and improves gastric motility dysfunction in rats by inhibiting AChE activity, and may suggest a role for acotiamide in improving gastric motility dysfunction in patients with functional dyspepsia. Copyright © 2011 Elsevier B.V. All rights reserved.

Clinical Evaluation of Commiphora Mukul, a Botanical resin, in the Management of Hemorrhoids: A randomized controlled trial

Science.gov (United States)

Yousefi, Mahdi; Mahdavi, Mohammad Reza Vaez; Hosseini, Seyed Mousalreza; Bahrami, Abdollah; Davati, Ali; Kamalinejad, Mohammad; Faghihzadeh, Sograt

2013-01-01

Background: Hemorrhoids complaint is one of the most common problems in most society, especially in Asian countries. Current drug treatment protocols cannot cure the disease, and they are palliative. According to Persian traditional medicine, Commiphora Mukul (CM) resin is a medication choice. Aim: This randomized study was undertaken to evaluate the efficacy and safety of crude CM resin compared to a combination of lactolose and anti-hemorrhoid (LandA) in patients with uncomplicated hemorrhoids grade 1 and 2. Materials and Methods: This trial was carried out on 99 patients with hemorrhoids, in Ghaem and Imam Reaza Hospitals of the Mashhad University of Medical Sciences, Iran. They randomly received CM 3 g/d for 4 weeks (as study group) or LandA (Lactolose syrup in laxative dose for 1 month and anti-hemorrhoid suppository daily for 10 days) as control group. Subjective and objectives variables including painful defecation, flatulence, constipation, gastro-esophageal reflux (GER), dyspepsia, proctorrhagia, anal protrusion, and colonoscopic grading were assessed before, immediately after, and 4 weeks after the treatment period. An intent-to-treat analysis was used. Safety was assessed with evaluation of clinical adverse effects by common toxicity criteria version 4.0. Forty-nine patients were assigned randomly to receive LandA and 50 to receive CM. After 4 weeks, flatulence, dyspepsia, GER, and colonoscopic grading scores significantly decreased in study group, whereas in control group constipation, painful defecation, and proctorrhagia showed better but not significant improvement. After 4-weak follow-up, the rate of constipation, and proctorrhagia also showed significantly improvement in study group. Constipation and proctorrhagia in control group recurred significantly in 4-week follow-up than after the treatment, whereas this recurrence in test group was not seen. Conclusion: CM was more effective than LandA in 4-week treatment of patients with uncomplicated

Review article: clinical implications of enteric and central D2 receptor blockade by antidopaminergic gastrointestinal prokinetics.

Science.gov (United States)

Tonini, M; Cipollina, L; Poluzzi, E; Crema, F; Corazza, G R; De Ponti, F

2004-02-15

Antidopaminergic gastrointestinal prokinetics (bromopride, clebopride, domperidone, levosulpiride and metoclopramide) have been exploited clinically for the management of motor disorders of the upper gastrointestinal tract, including functional dyspepsia, gastric stasis of various origins and emesis. The prokinetic effect of these drugs is mediated through the blockade of enteric (neuronal and muscular) inhibitory D2 receptors. The pharmacological profiles of the marketed compounds differ in terms of their molecular structure, affinity at D2 receptors, ability to interact with other receptor systems [5-hydroxytryptamine-3 (5-HT3) and 5-HT4 receptors for metoclopramide; 5-HT4 receptors for levosulpiride) and ability to permeate the blood-brain barrier (compared with the other compounds, domperidone does not easily cross the barrier). It has been suggested that the serotonergic (5-HT4) component of some antidopaminergic prokinetics may enhance their therapeutic efficacy in gastrointestinal disorders, such as functional dyspepsia and diabetic gastroparesis. The antagonism of central D2 receptors may lead to both therapeutic (e.g. anti-emetic effect due to D2 receptor blockade in the area postrema) and adverse (including hyperprolactinaemia and extrapyramidal dystonic reactions) effects. As the pituitary (as well as the area postrema) is outside the blood-brain barrier, hyperprolactinaemia is a side-effect occurring with all antidopaminergic prokinetics, although to different extents. Extrapyramidal reactions are most commonly observed with compounds crossing the blood-brain barrier, although with some differences amongst the various agents. Prokinetics with a high dissociation constant compared with that of dopamine at the D2 receptor (i.e. compounds that bind loosely to D2 receptors in the nigrostriatal pathway) elicit fewer extrapyramidal signs and symptoms. A knowledge of central and peripheral D2 receptor pharmacology can help the clinician to choose between the

Chronic fatigue in patients with unexplained self-reported food hypersensitivity and irritable bowel syndrome: validation of a Norwegian translation of the Fatigue Impact Scale

Directory of Open Access Journals (Sweden)

Lind R

2013-07-01

Full Text Available Ragna Lind,1 Arnold Berstad,2 Jan Hatlebakk,1,3 Jørgen Valeur21Department of Medicine, Haukeland University Hospital, Bergen, 2Unger-Vetlesen Institute, Department of Medicine, Lovisenberg Diakonale Hospital, Oslo, 3Department of Clinical Medicine, University of Bergen, Bergen, NorwayBackground: Patients with unexplained self-reported food hypersensitivity and irritable bowel syndrome (IBS suffer from several health complaints, including fatigue. The aim of the present study was to validate a Norwegian translation of the Fatigue Impact Scale (FIS, and to assess the impact of fatigue in patients with self-reported food hypersensitivity and IBS, as compared with healthy controls.Methods: Thirty-eight patients with unexplained self-reported food hypersensitivity and IBS, who participated in the validation of the FIS completed the following additional questionnaires: the Short Form of Nepean Dyspepsia Index for assessment of quality of life, the Subjective Health Complaint Inventory, and questionnaires for diagnosis and severity of IBS. Impact of fatigue was studied in 43 patients with unexplained self-reported food hypersensitivity, 70% diagnosed with IBS, and 42 healthy controls.Results: Cronbach's α for the FIS was 0.98, indicating excellent agreement between individual items. Scores on the FIS correlated with scores on the Short Form of Nepean Dyspepsia Index (r = 0.50, P = 0.001, indicating good convergent validity, and were higher in patients (median 85.0, interquartile range 36.8–105.3 than in controls (median 14.0, interquartile range 3.0–29.0, P ≤0.0001.Conclusion: The Norwegian translation of the FIS performed excellently in patients with unexplained self-reported food hypersensitivity and IBS, with patients reporting significantly more impact of chronic fatigue than healthy controls.Keywords: irritable bowel syndrome, fatigue, food hypersensitivity, quality of life

Gastrointestinal and non-gastrointestinal presentation in patients with celiac disease.

Science.gov (United States)

Ehsani-Ardakani, Mohammad Javad; Rostami Nejad, Mohammad; Villanacci, Vincenzo; Volta, Umberto; Manenti, Stefania; Caio, Giacomo; Giovenali, Paolo; Becheanu, Gabriel; Diculescu, Mircea; Pellegrino, Salvatore; Magazzù, Giuseppe; Casella, Giovanni; Di Bella, Camillo; Decarli, Nicola; Biancalani, Mauro; Bassotti, Gabrio; Hogg-Kollars, Sabine; Zali, Mohammad Reza; Rostami, Kamran

2013-02-01

Celiac disease (CD) may have a variety of different presentations. This study has aimed to explore the prevalence of gastrointestinal (GI) and non-GI symptoms in patients with CD according to data collected in Italy and Romania (Europe) and Iran (Middle East). This is a retrospective cross-sectional study conducted in Iran, Romania and Italy with data collection during the period from May 2009 - May 2011. For each center we included only patients with CD that was confirmed by endoscopy, small bowel biopsies and positive serology. GI symptoms such as abdominal pain, diarrhea, constipation, nausea and vomiting, weight loss and flatulence, as well as additional signs and symptoms of iron deficiency anemia (IDA), osteoporosis, hypertransaminasemia, and other related abnormalities were collected. Overall, 323 women and 127 men, whose mean age at diagnosis was 34.2 ± 16.47 years were included in this study. Of these, 157 subjects (34.9%) reported at least one GI symptom. The majority of cases had the following primary presenting GI symptoms: diarrhea (13.6%), dyspepsia and constipation (4.0%). Other disease symptoms were reported by 168 (37.3%) patients. The most presenting non-GI symptoms in the majority of cases were anemia (20.7%) and osteopenia (6%). There were statistically significant differences between the majority of symptoms when we compared the reported clinical symptoms from different countries. This study indicated that upper abdominal disorders such as abdominal pain and dyspepsia were the most common primary complaints among European patients, whereas Iranian patients had complaints of diarrhea and bloating as the classic presentations of CD. For non-GI symptoms, anemia was the most frequent complaint for both Iranian and Italian patients; however it was significantly higher in Iranians.

Epidemiology of Functional abdominal bloating and its impact on health related quality of life: male-female stratified propensity score analysis in a population based survey in mainland China.

Directory of Open Access Journals (Sweden)

Meijing Wu

Full Text Available BACKGROUND: The epidemiology of Functional abdominal bloating (FAB and its impact on health-related quality of life (HRQoL in Chinese people remains unclear. METHODS: Randomised, stratified, multi-stage sampling methodology was used to select a representative sample of the general population from five cities in China (n = 16,078. All respondents completed the modified Rome II questionnaire; 20% were asked to complete the 36-item Short Form (SF-36. The associated factors of FAB were analyzed. The effects of FAB on HRQoL were estimated with gender stratification using propensity score techniques in 20% subsample. RESULTS: Overall, 643 individuals (4.00% had FAB and it was more prevalent in males than in females (4.87% vs. 3.04%, P<0.001. For males, self-reported history of dyspepsia was most strongly associated with FAB (OR = 2.78; 95% CI: 1.59, 4.72. However, the most strongly associated factor was self-reported health status for females (moderate health vs. good health: OR = 2.06, 95% CI: 1.07, 3.96. P = 0.030; poor health vs. good health: OR = 5.71, 95% CI: 2.06, 15.09. Concerning HRQoL, FAB was found to be related to two domains: role limitation due to physical problems (P = 0.030 and bodily pain (P<0.001 in females. While, in males, there were significant differences in multiple domains between those with and without FAB. CONCLUSION: The prevalence of FAB in China was lower than previous reports. Males who had ever been diagnosed with dyspepsia and females who were in a poor self-reported health status were correlated with a higher prevalence of FAB. FAB affected only physical health in females, but impaired both physical and mental health in males.

Helicobacter pylori infection in patients with calcular cholecystitis: a hospital based study

International Nuclear Information System (INIS)

Hussain, A.; Haider, I.Z.; Ahmad, S.

2011-01-01

Background: Helicobacter pylori, a gram negative bacillus has been recognised as a public health problem and approximately half of the world population has H. pylori infection causes chronic gastritis, peptic ulcer disease and gastric malignancies. Objective of this study was to determine the frequency of H. pylori infection in patients of chronic calcular cholecystitis. Methods: This cross-sectional descriptive study was conducted at Liaquat University Hospital, Hyderabad, Pakistan from April 2010 to September 2010. All patients with history of gallstone presented with acute abdominal pain, dyspepsia, bloating and epigastric discomfort and diagnosed as calcular cholecystitis were further evaluated for the detection of H. pylori by serology and histopathology. Frequency and percentage of H. pylori infection in patients with calcular cholecystitis was calculated. Result: Total 100 patients of cholelithiasis underwent laparoscopic cholecystectomy were recruited. The pain in upper right part of the abdomen was observed in all 100 patients, fever in 75%, nausea and vomiting in 68%, loss of appetite in 45%, feeling of tiredness or weakness in 22%, headache in 38%, chills in 52%, backache in 58%, pain under the right shoulder in 45%, heartburn in 67%, belching in 54%, indigestion in 80%, dyspepsia in 90%, bloating in 88%, and epigastric discomfort in 85% patients. Eighty-two percent patients had family history of gallstones. The mean age of overall study population was 48.72 +- 8.78 years and mean age of H. pylori infected calcular cholecystitis patients was 47.98 +- 5.43 years in male and 48.76 +- 6.68 years in females. The H. pylori infection was identified in 55% patients with calcular cholecystitis, of which 32.7% were males and 67.3% were females (p=0.03, statistically significant). Majority of females (60%) had =40 U/ml antibody titre (p=0.917, non-significant). Conclusion: A possible relationship was identified between Helicobacter pylori and calcular

Manometric assessment of esophageal motor function in patients with primary biliary cirrhosis.

Science.gov (United States)

Bektas, Mehmet; Seven, Gulseren; Idilman, Ramazan; Yakut, Mustafa; Doğanay, Beyza; Kabacam, Gökhan; Ustun, Yusuf; Korkut, Esin; Kalkan, Çağdaş; Sahin, Günay; Cetinkaya, Hulya; Bozkaya, Hakan; Yurdaydin, Cihan; Bahar, Kadir; Cinar, Kubilay; Soykan, Irfan

2014-03-01

Primary biliary cirrhosis is associated with other autoimmune diseases including Sjögren's syndrome, and scleroderma. Esophageal dysmotility is well known in scleroderma, and Sjögren's syndrome. The aim of this study is to investigate whether any esophageal motor dysfunction exists in patients with primary biliary cirrhosis. The study was performed in 37 patients (36 women, mean age: 56.29 ± 10.01 years) who met diagnostic criteria for primary biliary cirrhosis. Thirty-seven functional dyspepsia patients, were also included as a control group. Patients entering the study were asked to complete a symptom questionnaire. Distal esophageal contraction amplitude, and lower esophageal sphincter resting pressure were assessed. Manometric findings in primary biliary cirrhosis patients vs. controls were as follows: Median lower esophageal sphincter resting pressure (mmHg): (24 vs 20, p=0.033); median esophageal contraction amplitude (mmHg): (71 vs 56, p=0.050); mean lower esophageal sphincter relaxation duration (sc, x ± SD): (6.10 ± 1.18 vs 8.29 ± 1.92, pesophageal sphincter relaxation (%) (96 vs 98, p=0.019); respectively. No significant differences were evident in median peak velocity (sc) (3.20 vs 3.02, p=0.778) between patients with primary biliary cirrhosis and the functional dyspepsia patients. Esophageal dysmotility was found in 17 (45.9%) primary biliary cirrhosis patients (non-specific esophageal motor disorder in ten patients, hypomotility of esophagus in five patients, nutcracker esophagus in one patient and hypertensive lower esophageal sphincter in one patient). Esophageal dysmotility was detected in 45.9% of patients. The study suggests that subclinic esophageal dysmotility is frequent in patients with primary biliary cirrhosis. Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.

Frequency of γδ T Cells and Invariant Natural Killer T Cells in Helicobacter Pylori-infected Patients with Peptic Ulcer and Gastric Cancer.

Science.gov (United States)

Shadman, Mojtaba; Rajabian, Zeinab; Ajami, Abolghasem; Hussein-Nattaj, Hadi; Rafiei, Alireza; Hosseini, Vahid; Taghvaei, Tarang; Abbasi, Ali; Tehrani, Mohsen

2015-10-01

To clarify the effect of γδ T cells and invariant Natural Killer T (iNKT) cells in pathophysiology of dyspeptic disorders, number of these two cells in patients with non-ulcer dyspepsia (NUD), peptic ulcer disease (PUD), and gastric cancer (GC) were compared.Patients with dyspepsia were divided into three groups of NUD, PUD, and GC according to their endoscopic and histopathological examinations. Helicobacter pylori infection was diagnosed by rapid urease test and histopathology. The number of peripheral blood CD3+TCRγδ(+) T cells and CD3+Va24Ja18+ iNKT cells were determined by flow cytometry. Immunohistochemistry (IHC) was also used for identifying the TCRγδ+ cells.Forty two patients with NUD (31.6%), 44 with PUD (33.1%), and 47 with GC (35.3%) were included in the study. The frequency of CD3+TCRγδ(+) T cells in peripheral blood of patients with GC (2.71±0.25) was significantly lower than that in NUD (3.97±0.32, p<0.05) and PUD groups (3.87±0.32, p<0.05). However, there was no significant difference in CD3+TCRγδ(+) T cell percentage between the NUD and PUD groups. The frequency of TCRγδ(+) lymphocytes was significantly lower in tissue samples from patients with GC (4.81±0.53) than in NUD (11.09±1.09, p<0.0001) and PUD groups (11.11±1.01, p<0.0001). Also, we could not find any significant difference in the percentage of mucosal TCRγδ+ cells between the NUD and PUD groups. The results showed no significant difference in iNKT cells percentage among the three groups of patients.The results suggest that decreasing number of γδ T cells may be related to development and progression of gastric cancer.

Gastric inflammatory markers and interleukins in patients with functional dyspepsia treated with astaxanthin

DEFF Research Database (Denmark)

Andersen, L.P.; Holck, Susanne; Kupcinskas, L.

2007-01-01

The chronic active inflammation caused by Helicobacter pylori is dominated by neutrophils, macrophages, lymphocytes and plasma cells. Several interleukins are involved in the inflammatory process. The aim of this study was to investigate the effect of astaxanthin on gastric inflammation in patien...

Gastric inflammatory markers and interleukins in patients with functional dyspepsia treated with astaxanthin

DEFF Research Database (Denmark)

Andersen, L.P.; Holck, Susanne; Kupcinskas, L.

2007-01-01

. There was a significant decrease in gastric inflammation in H. pylori-positive patients from both groups. There were no significant changes in the density of H. pylori or in any of the interleukins during or after treatment. There was a significant up-regulation of CD4 and down-regulation of CD8 in patients with H....... pylori treated with astaxanthin. Astaxanthin had an effect on the inflammation and on the density of H. pylori in mice in a study where the diet could be standardized without antioxidants (Bennedsen et al., 1999). These dietary conditions are impossible in studies involving humans, and may be due...

Ursodeoxycholic acid induced generalized fixed drug eruption.

Science.gov (United States)

Ozkol, Hatice Uce; Calka, Omer; Dulger, Ahmet Cumhur; Bulut, Gulay

2014-09-01

Fixed drug eruption (FDE) is a rare form of drug allergies that recur at the same cutaneous or mucosal site in every usage of drug. Single or multiple round, sharply demarcated and dusky red plaques appear soon after drug exposure. Ursodeoxycholic acid (UDCA: 3α,7β-dihydroxy-5β-cholanic acid) is used for the treatment of cholestatic liver diseases. Some side effects may be observed, such as diarrhea, dyspepsia, pruritus and headaches. We encountered only three cases of lichenoid reaction regarding the use of UDCA among previous studies. In this article, we reported a generalized FDE case related to UDCA intake in a 59-year-old male patient with cholestasis for the first time in the literature.

CURRENCY OF THE MICROFLORA CORRECTION WHEN BEGINNING FEEDING WITH ADDITIONAL FOOD AND ARTIFICIAL MILK FORMULAS

Directory of Open Access Journals (Sweden)

N. V. Toptchiy

2012-01-01

Full Text Available Children feeding with breast milk have significantly lower risk of gastrointestinal infectious diseases development, than children feeding with artificial milk formulas. At the beginning of feeding with additional food influence of allogenic antigens on child’s organism is increasing, which can lead to disturbances in microbiocoenosis of the gastro-intestinal tract. This causes stool disorders, intestinal colic, dyspepsia, dermatitis, allergic reactions, immunodeficiency with recurrent relapses of infections and development of non-infectious disease and their transition into chronic condition. Forming of the malabsorption syndrome at the background of such conditions leads to growth and mental development retardation of children. Numerous clinical trials proved the beneficial effects of the probiotic Hylak Forte on intestinal microflora in disbiosis.

Proton-pump inhibitor therapy induces acid-related symptoms in healthy volunteers after withdrawal of therapy

DEFF Research Database (Denmark)

Reimer, Christina; Søndergaard, Bo; Hilsted, Linda

2009-01-01

-controlled trial with 120 healthy volunteers was conducted. Participants were randomized to 12 weeks of placebo or 8 weeks of esomeprazole 40 mg/d followed by 4 weeks with placebo. The Gastrointestinal Symptom Rating Scale (GSRS) was filled out weekly. A score of >2 on 1 of the questions regarding heartburn, acid...... dyspepsia, heartburn, or acid regurgitation in the PPI group was 13 of 59 (22%) at week 10, 13 of 59 (22%) at week 11, and 12 of 58 (21%) at week 12. Corresponding figures in the placebo group were 7% at week 10 (P = .034), 5% at week 11 (P = .013), and 2% at week 12 (P = .001). CONCLUSIONS: PPI therapy...

Forty Years Abuse of Baking Soda, Rhabdomyolysis, Glomerulonephritis, Hypertension Leading to Renal Failure: A Case Report

Directory of Open Access Journals (Sweden)

Terje Forslund M.D., Ph.D.

2008-01-01

Full Text Available We present a patient who had ingested sodium bicarbonate for treatment of alcoholic dyspepsia during forty years at increasing doses. During the last year he had used more than 50 grams daily. He presented with metabolic alkalosis, epileptic convulsions, subdural hematoma, hypertension and rhabdomyolysis with end stage renal failure, for which he had to be given regular intermittent hemodialysis treatment. Untreated hypertension and glomerulonephritis was probably present prior to all these acute incidents. Examination of the kidney biopsy revealed mesangial proliferative glomerulonephritis and arterial wall thickening causing nephrosclerosis together with interstitial calcinosis. The combination of all these pathologic changes might be responsible for the development of progressive chronic renal failure ending up with the need for continuous intermittent hemodialysis treatment.

Radix Stellariae extract prevents high-fat-diet-induced obesity in C57BL/6 mice by accelerating energy metabolism

Directory of Open Access Journals (Sweden)

Yin Li

2017-05-01

Full Text Available Stellaria dichotoma L. is widely distributed in Ningxia and surrounding areas in northwestern China. Its root, Radix Stellariae (RS, has been used in herbal formulae for treating asthenic-fever, infection, malaria, dyspepsia in children and several other symptoms. This study investigated whether the RS extract (RSE alleviates metabolic disorders. The results indicated that RSE significantly inhibited body weight gain in high-fat (HF-diet-fed C57BL/6 mice, reduced fasting glucose levels, and improved insulin tolerance. Moreover, RSE increased the body temperature of the mice and the expression of uncoupling proteins and peroxisome proliferator-activated receptors in the white adipose tissue. Thus, RSE alleviated metabolic disorders in HF-diet-fed C57BL/6 mice by potentially activating UCP and PPAR signaling.

Effects of itopride hydrochloride on plasma gut-regulatory peptide and stress-related hormone levels in healthy human subjects.

Science.gov (United States)

Katagiri, Fumihiko; Shiga, Toru; Inoue, Shin; Sato, Yuhki; Itoh, Hiroki; Takeyama, Masaharu

2006-01-01

Itopride hydrochloride (itopride), a gastrokinetic drug, has recently been evaluated for its clinical usefulness in functional dyspepsia. We investigated effects of itopride on human plasma gastrin-, somatostatin-, motilin-, and cholecystokinin (CCK)-like immunoreactive substances (IS); adrenocorticotropic hormone (ACTH)-immunoreactive substances (IS), and cortisol under stress conditions in healthy subjects. A single administration of itopride caused significant increases in plasma somatostatin- and motilin-IS levels compared to placebo. Itopride significantly decreased plasma CCK-IS, and suppressed the ACTH-IS level compared to placebo. We hypothesize that itopride may have an accelerating gastric emptying effect, and a modulatory effect on the hypothalamo-pituitary-adrenal axis and autonomic nervous functions. These effects might be beneficial in stress-related diseases, suggesting that itopride has clinicopharmacological activities.

Efficacy of the Treatment for Anxiety-Depressive Disorders in Patients with Gastroenterological Diseases

Directory of Open Access Journals (Sweden)

S.V. Kosynska

2015-02-01

Full Text Available The article deals with problem of the treatment of anxiety-depressive disorders in patients with gastroenterological disease and persistent symptoms of abdominal pain and dyspepsia. For objectification of psychoemotional disorders and choice of their correction, we have applied HADS scale. We have detected a high incidence of anxiety — in 93.75 % of such patients, depression — in 81.25 %, their combination — in 78.1 %. Gidazepam efficacy was evaluated in anxiety disorders and escitalopram one — in depressive disorders. It is shown that the use of psychocorrection enables to reverse gastroenterological symptoms: abdominal pain has completely gone in 71.9 % of patients, dyspeptic complaints — in 86.9 %, as well as to reduce anxiety-depressive symptoms.

Forty years abuse of baking soda, rhabdomyolysis, glomerulonephritis, hypertension leading to renal failure: a case report.

Science.gov (United States)

Forslund, Terje; Koistinen, Arvo; Anttinen, Jorma; Wagner, Bodo; Miettinen, Marja

2008-01-01

We present a patient who had ingested sodium bicarbonate for treatment of alcoholic dyspepsia during forty years at increasing doses. During the last year he had used more than 50 grams daily. He presented with metabolic alkalosis, epileptic convulsions, subdural hematoma, hypertension and rhabdomyolysis with end stage renal failure, for which he had to be given regular intermittent hemodialysis treatment. Untreated hypertension and glomerulonephritis was probably present prior to all these acute incidents. Examination of the kidney biopsy revealed mesangial proliferative glomerulonephritis and arterial wall thickening causing nephrosclerosis together with interstitial calcinosis. The combination of all these pathologic changes might be responsible for the development of progressive chronic renal failure ending up with the need for continuous intermittent hemodialysis treatment.

Light-chain amyloidosis presenting with rapidly progressive submucosal hemorrhage of the stomach

Directory of Open Access Journals (Sweden)

Song-Yi Kim

2016-04-01

Full Text Available The gastrointestinal tract is frequently in involved light-chain (AL amyloidosis, but significant hemorrhagic complications are rare. A 71-year-old man presented to our hospital with dyspepsia and heartburn for 1 month. Gastroscopy revealed a large submucosal hematoma at the gastric fundus. Two days later, a follow-up gastroscopy indicated extensive expansion of the hematoma throughout the upper half of the stomach. The hematoma displayed ongoing expansion during the endoscopic examination, suggesting that rupture was imminent. Emergency total gastrectomy was performed, and amyloidosis was confirmed after examining the surgical specimen. Bone marrow examination revealed multiple myeloma, and serum immunoglobulin assay confirmed the diagnosis of myeloma-associated AL amyloidosis. At manuscript submission, the patient was doing well and was undergoing chemotherapy.

Scintigraphic study on the motility of stomach and gallbladder in non-ulceric dyspepsia patients

International Nuclear Information System (INIS)

Fu Min; Xu Guomin; Xu Denren

1992-01-01

Cholecystography with 99m Tc-EHIDA was performed to assess the preprandial empty function of gallbladder and then solid meal labelled with 99m Tc-DTPA was given to assess the postprandial empty function of stomach in 25 patients with NUD. The examinations were repeated in 15 patients with hypomotilitic stomach and gallbladder following administration of Domperidone 20 mg t.i.d for four weeks. The results showed that the empty function of stomach was closely related to the amplitude and frequency of antrum contractile peristaltic waves, all NUD patients who had delayed gastric empty also had hypomotilitic gallbladder. This may be one of the pathophysiologic bases of NUD. The movements of stomach and gallbladder both preprandial and postprandial were synchronous. Domperidone can restore hypomotility of stomach and gallbladder in NUD patients to normal, and the movements of stomach and gallbladder still remained synchronous

Does postprandial itopride intake affect the rate of gastric emptying? A crossover study using the continuous real time 13C breath test (BreathID system).

Science.gov (United States)

Nonaka, Takashi; Kessoku, Takaomi; Ogawa, Yuji; Yanagisawa, Shogo; Shiba, Tadahiko; Sahaguchi, Takashi; Atsukawa, Kazuhiro; Takahashi, Hisao; Sekino, Yusuke; Iida, Hiroshi; Hosono, Kunihiro; Endo, Hiroki; Sakamoto, Yasunari; Koide, Tomoko; Takahashi, Hirokazu; Tokoro, Chikako; Abe, Yasunobu; Maeda, Shin; Nakajima, Atsushi; Inamori, Masahiko

2011-01-01

The aim of this study was to determine whether oral Itopride hydrochloride (itopride) intake might have any effect on the rate of gastric emptying, using a novel non-invasive technique for measuring the rate of gastric emptying, namely, the continuous real time 13C breath test (BreathID system: Exalenz Bioscience Ltd., Israel). Eight healthy male volunteers participated in this randomized, two-way crossover study. The subjects fasted overnight and were randomly assigned to receive 50mg itopride following a test meal (200 kcal per 200mL, containing 100mg 13C acetate), or the test meal alone. Under both conditions, gastric emptying was monitored for 4 hours after administration of the test meal by the 13C-acetic acid breath test performed continually using the BreathID system. Using Oridion Research Software (beta version), the time required for emptying of 50% of the labeled meal (T 1/2), the analog to the scintigraphy lag time for 10% emptying of the labeled meal (T lag), the gastric emptying coefficient (GEC), and the regression-estimated constants (beta and kappa) were calculated. The parameters measured under the two conditions were compared using the Wilcoxon's signed-rank test. No significant differences in the calculated parameters, namely, the T 1/2, T lag, GEC, beta or kappa, were observed between the two test conditions, namely, administration of a test meal+itopride and administration of the test meal alone. The present study revealed that postprandial itopride intake had no significant influence on the rate of gastric emptying. Recently, several studies have shown that itopride may be effective in the treatment of patients with functional dyspepsia. Our results suggest that the efficacy of itopride in patients with functional dyspepsia may be based on its effect of improving functions other than the rate of gastric emptying, such as the activities at neuronal sites, brain-gut correlation, visceral hypersensitivity, gastric accommodation and distension

Association of presence/absence and on/off patterns of Helicobacter pylori oipA gene with peptic ulcer disease and gastric cancer risks: a meta-analysis.

Science.gov (United States)

Liu, Jingwei; He, Caiyun; Chen, Moye; Wang, Zhenning; Xing, Chengzhong; Yuan, Yuan

2013-11-20

There are increasing studies examining the relationship between the status of H. pylori oipA gene and peptic ulcer disease (PUD) and gastric cancer (GC) but the results turn out to be controversial. We attempted to clarify whether oipA gene status is linked with PUD and/or GC risks. A systematically literature search was performed through four electronic databases. According to the specific inclusion and exclusion criteria, seven articles were ultimately available for the meta-analysis of oipA presence/absence with PUD and GC, and eleven articles were included for the meta-analysis of oipA on/off status with PUD and GC. For the on/off functional status analysis of oipA gene, the "on" status showed significant associations with increased risks of PUD (OR = 3.97, 95% CI: 2.89, 5.45; P gastritis and functional dyspepsia controls. Results of the homogeneity test indicated different effects of oipA "on" status on PUD risk between children and adult subgroups and on GC risk between PCR-sequencing and immunoblot subgroups. For the presence/absence analysis of oipA gene, we found null association of the presence of oipA gene with the risks of PUD (OR = 1.93, 95% CI: 0.60, 6.25; P = 0.278) and GC (OR = 2.09, 95% CI: 0.51, 8.66; P = 0.308) compared with gastritis and functional dyspepsia controls. To be concluded, when oipA exists, the functional "on" status of this gene showed association with increased risks for PUD and GC compared with gastritis and FD controls. However, merely investigating the presence/absence of oipA would overlook the importance of its functional on/off status and would not be reliable to predict risks of PUD and GC. Further large-scale and well-designed studies concerning on/off status of oipA are required to confirm our meta-analysis results.

Assessment of the Prevalence of Diabetic Gastroparesis and Validation of Gastric Emptying Scintigraphy for Diagnosis

Directory of Open Access Journals (Sweden)

Zeinab Alipour

2017-02-01

Full Text Available Objective: Gastroparesis is defined as delayed gastric emptying and is a common medical condition in diabetic patients. Scintigraphy is commonly used as a standard diagnostic procedure for the quantitative assessment of gastroparesis. The aims of this study were to determine an optimum imaging time for the diagnosis of gastroparesis, to assess the prevalence of gastroparesis, to evaluate the correlation between endoscopy and scintigraphy findings as well as the correlation between gastric emptying with patient genders, blood glucose concentration, and functional dyspepsia. Methods: Gastric emptying was assessed in 50 diabetic patients with a mean age of 50.16 years. For evaluation of gastric emptying, a test meal containing 2 pieces of toast, 120 cc non-labeled water and fried egg labeled with 1 mCi of 99mTc was given to each patient. The scintigraphy was performed immediately after ingestion and was repeated at 1, 1.5, 2 and 4 hours after ingestion. In some patients, an additional 90-minute dynamic scan was also acquired. Results: The prevalence of gastroparesis in this study population was determined as 64%. Also, the results of this study revealed that a 4-hour scan after ingestion is more relevant than a 90-minute dynamic scan for the evaluation of delayed gastric emptying. There was no statistically significant difference between 1-hour and 2-hour scans, 1-hour and 90-minute scans, 2-hour and 90-minute scans, 2-hour and 4-hour scans. Likewise there was no significant correlation between blood glucose levels, gender and calculated values of gastric emptying time in all groups. Conclusion: According to our findings, it can be suggested that the prevalence of gastroparesis is higher than that mentioned in some previous studies. Also, this study indicates that a gastric emptying scintigraphy at 2 and 4 hours after meal ingestion might provide the anticipated clinical information in diabetic patients with dyspepsia without other evident reasons.

What to eat and drink in the festive season: a pan-European, observational, cross-sectional study.

Science.gov (United States)

Parker, Helen L; Curcic, Jelena; Heinrich, Henriette; Sauter, Matthias; Hollenstein, Michael; Schwizer, Werner; Savarino, Edoardo; Fox, Mark

2017-05-01

Digestive discomfort after meals is common in the community, especially during the festive season. It is uncertain whether this is related to intake of either high-calorie or high-fat foods or, alternatively, intake of specific foods. This prospective, cross-sectional study tested the hypothesis that the risk of reflux or dyspepsia is associated with the fat content of the meal independent of caloric load in a 'real-life' setting. Four festive meals were served to delegates attending a conference on four consecutive days. Test meals had the same volume, but varied in calorie and fat content. Study procedures and symptoms were monitored using a mobile application (SymTrack). The effect of alcoholic compared with nonalcoholic drinks was also assessed. Primary outcome was the occurrence of reflux or dyspeptic symptoms. Fullness was documented by a visual analogue scale. A total of 84/120 (70%) delegates aged 22-69 years consented to participate. At screening, 22 (31%) participants reported at least mild symptoms on the Leuven Dyspepsia Questionnaire. Specific ingredients did not appear to impact on postprandial symptoms. All high-calorie dinners [British, German, Italian (with alcohol)] induced more symptoms than the low-fat, low-calorie Czech dinner [odds ratio: 2.6, 95% confidence interval (CI): 0.97-6.9 (P=0.058), 1.5 (0.3-3.8), and 2.8 (0.7-10.5), respectively]. Self-reported fullness after the high-fat, high-calorie British dinner was higher by 23/100 (95% CI: 4-42, P=0.016) with respect to low-fat, low-calorie Czech and German dinners. Study participants tolerated a range of food and drink well. Reflux or dyspeptic symptoms were least likely after the low-fat, low-calorie meal. Fullness was increased after the high-fat, high-calorie dinner, but not low-fat meals. These results will help the public to make evidence-based dietary choices during the carnival season!

Comorbidities in adults with asthma: Population-based cross-sectional analysis of 1.4 million adults in Scotland.

Science.gov (United States)

Weatherburn, C J; Guthrie, B; Mercer, S W; Morales, D R

2017-10-01

Comorbidity in people with asthma can significantly increase asthma morbidity and lower adherence to asthma guidelines. The objective of this study was to comprehensively measure the prevalence of physical and mental health comorbidities in adults with asthma using a large nationally representative population. Cross-sectional analysis of routine primary care electronic medical records for 1 424 378 adults in the UK, examining the prevalence of 39 comorbidities in people with and without asthma, before and after adjustment for age, sex, social deprivation and smoking status using logistic regression. Of 39 comorbidities measured, 36 (92%) were significantly more common in adults with asthma; 62.6% of adults with asthma had ≥1 comorbidity vs 46.2% of those without, and 16.3% had ≥4 comorbidities vs 8.7% of those without. Comorbidities with the largest absolute increase in prevalence in adults with asthma were as follows: chronic obstructive pulmonary disease (COPD) (13.4% vs 3.1%), depression (17.3% vs 9.1%), painful conditions (15.4% vs 8.4%) and dyspepsia (10.9% vs 5.2%). Comorbidities with the largest relative difference in adults with asthma compared to those without were as follows: COPD (adjusted odds ratio [aOR] 5.65, 95% CI 5.52-5.79), bronchiectasis (aOR 4.65, 95% CI 4.26-5.08), eczema/psoriasis (aOR 3.30, 95% CI 3.14-3.48), dyspepsia (aOR 2.20, 95% CI 2.15-2.25) and chronic sinusitis (aOR 2.12, 95% CI 1.99-2.26). Depression and anxiety were more common in adults with asthma (aOR 1.60, 95% CI 1.57-1.63, and aOR 1.53, 95% CI 1.48-1.57, respectively). Physical and mental health comorbidities are the norm in adults with asthma. Appropriate recognition and management should form part of routine asthma care. © 2017 John Wiley & Sons Ltd.

Treatment of Infantile Diarrhea by Acupuncture and Laser Irradiation - A Report of 60 Cases

Institute of Scientific and Technical Information of China (English)

丁渡明

2004-01-01

@@ Infantile diarrhea is a common disease in babies of less than 2 years old in summer or autumn. It is due to acute dyspepsia mainly caused by improper feeding or attack of cold or damp pathogens.Clinically, it is characterized by increased times of defecation (5-6, or even dozens of times a day),yellow-green or blue-green thin feces intermingled with mucus, milk-mass and indigested food which have a sour and fetid odor, accompanied with loss of appetite, abdominal distending pain, nausea,vomiting, and even fever, irritability, dehydration and electrolyte disturbance in severe cases. The microscopy reveals that there are leukocytes and fat globules in feces. We have treated 60 cases of infantile diarrhea with acupuncture and He-Ne laser point irradiation and obtained satisfactory therapeutic results.

FUNCTIONAL DISORDERS OF THE BILIARY TRACT IN CHILDREN AS A MULTIDISCIPLINARY PROBLEM

Directory of Open Access Journals (Sweden)

N. I. Ursova

2014-01-01

Full Text Available Wide prevalence, multiplicity, great variety of etiological factors, diversity of clinical manifestations, and difficulties in registration of the gallbladder and bile ducts disorders and sphincter of Oddi dysfunction – all support the interest of internists to diagnosis and treatment of functional biliary disorders. Taking into account clinically relevant anatomical interrelations between the organs of the choledochopancreatoduodenal zone, a possibility to develop a great variety of systemic diseases and conditions with long-term asymptomatic course it is advisable to conduct complex examination of pediatric patients with abdominal pain and dyspepsia signs. Exact syndromal diagnosis is of great importance in pediatric practice for it determines the necessity of treatment and its strategy. The tactic physician’s task is a choice of a drug which provide therapeutic effect with minimum risk of toxicity.

C-4 Gem-Dimethylated Oleanes of Gymnema sylvestre and Their Pharmacological Activities

Directory of Open Access Journals (Sweden)

Giovanni Di Fabio

2013-12-01

Full Text Available Gymnema sylvestre R. Br., one of the most important medicinal plants of the Asclepiadaceae family, is a herb distributed throughout the World, predominantly in tropical countries. The plant, widely used for the treatment of diabetes and as a diuretic in Indian proprietary medicines, possesses beneficial digestive, anti-inflammatory, hypoglycemic and anti-helmentic effects. Furthermore, it is believed to be useful in the treatment of dyspepsia, constipation, jaundice, hemorrhoids, cardiopathy, asthma, bronchitis and leucoderma. A literature survey revealed that some other notable pharmacological activities of the plant such as anti-obesity, hypolipidemic, antimicrobial, free radical scavenging and anti-inflammatory properties have been proven too. This paper aims to summarize the chemical and pharmacological reports on a large group of C-4 gem-dimethylated pentacyclic triterpenoids from Gymnema sylvestre.

THE EVALUATION OF FREQUENCY AND SEASONAL VARIATIONS OF ACID PEPTIC DISEASE: A SEVEN YEARS STUDY

Directory of Open Access Journals (Sweden)

Syed Iftikhar Haider

2016-06-01

Full Text Available Acid peptic disease (APD is a worldwide health problem. It includes a variety of inflammatory and ulcerative lesions involving esophagus, stomach and duodenum. The disease condition may persist with multiple symptoms, one of them being dyspepsia. The object of the present study was to determine the frequency and seasonal variations of APD in patients presenting with dyspeptic symptoms. This observational study was carried out at the endoscopy unit in Baqai Medical University from December 2003 to December 2010, over a period of seven years. The evolution of APD frequency remained equivocal throughout the study period. However, a decline was noted in the frequency of peptic ulcer disease (PUD especially for gastric and duodenal ulcer cases but a rise during autumn and winter seasons was also noted in duodenal ulcer cases.

Burden of illness in functional gastrointestinal disorder--the consequences for the individual and society.

Science.gov (United States)

Glise, H; Wiklund, I; Hallerbäck, B

1998-01-01

To review the consequences of functional gastrointestinal disorders (FGD), i.e. heartburn without esophagitis, dyspepsia and IBS for the individual and society. Current publications indicate that functional gastrointestinal disorders are more prevalent than organic gastrointestinal disorders in the population. Symptoms, not the organic finding per se, are most important to the individual. Functional disorders are furthermore linked to somatic symptoms, from other parts of the body, as well as to mental health. Together they constitute a large medical burden on society in terms of consultations, drug consumption and surgery. Social costs are further increased by problems at work and a considerable increase in absenteeism. Functional gastrointestinal disorders should be taken more seriously by the medical community and society, since the burden of illness seems much larger than earlier anticipated.

LACTASE DEFICIENCY IN BABIES AND INFANTS

Directory of Open Access Journals (Sweden)

E.A. Kornienko

2006-01-01

Full Text Available Lactose, the constituent disaccharide of milk and other dairy products, is an important nutrient in early childhood. Lactase breaks down lactose in small intestine. In most people the activity of lactase reduces with age. In infancy lactase deficiency tends to be either transient, which is more often, or secondary to intestinal diseases. Abdominal cramps, anxiety and dyspepsia are the common symptoms of lactase deficiency. Tactics of treatment should take into account a cause and severity of the condition. A specialized milk formula «enfamil lactofree», distinguished for its' optimal formulation, high clinical effectiveness and good tolerance, could be recommended for use in children with primary, transient and secondary lactase deficiency who receive formula and mixed feeding.Key words: lactose, lactase deficiency, lactose-free formula.

Acute toxicity from baking soda ingestion.

Science.gov (United States)

Thomas, S H; Stone, C K

1994-01-01

Sodium bicarbonate is an extremely well-known agent that historically has been used for a variety of medical conditions. Despite the widespread use of oral bicarbonate, little documented toxicity has occurred, and the emergency medicine literature contains no reports of toxicity caused by the ingestion of baking soda. Risks of acute and chronic oral bicarbonate ingestion include metabolic alkalosis, hypernatremia, hypertension, gastric rupture, hyporeninemia, hypokalemia, hypochloremia, intravascular volume depletion, and urinary alkalinization. Abrupt cessation of chronic excessive bicarbonate ingestion may result in hyperkalemia, hypoaldosteronism, volume contraction, and disruption of calcium and phosphorus metabolism. The case of a patient with three hospital admissions in 4 months, all the result of excessive oral intake of bicarbonate for symptomatic relief of dyspepsia is reported. Evaluation and treatment of patients with acute bicarbonate ingestion is discussed.

Burden of comorbidities among Japanese patients with atrial fibrillation: a case study of dyspepsia [Corrigendum

Directory of Open Access Journals (Sweden)

Kinoshita Y

2013-09-01

Full Text Available Kinoshita Y, DiBonaventura M, Rossi B, Iwamoto K, Wang ECY, Briere JB. Clin Exp Gastroenterol. 2013;6:51–59.On page 54, in the second paragraph, line 6, note that "26.65% versus 17.02%" should be "29.65% versus 17.02%".View original paper by Kinoshita Y, DiBonaventura M, Rossi B et al. 

A double-blind comparison of clebopride and placebo in dyspepsia secondary to delayed gastric emptying.

Science.gov (United States)

Bavestrello, L; Caimi, L; Barbera, A

1985-01-01

Seventy-six patients suffering from dyspeptic symptoms secondary to roentgenologically demonstrated delayed gastric emptying were treated with clebopride (0.5 mg TID) or with placebo during a three-month double-blind trial. Clebopride was more effective (P less than or equal to 0.001) than placebo in reducing or relieving symptoms and roentgenological findings associated with delayed gastric emptying. No interactions of clebopride with concomitant drugs or coexisting disorders were observed, and the incidence of side effects was low. We conclude that clebopride will be beneficial in the management of patients with delayed gastric emptying.

The validity of a symptom diary in ratings of dyspepsia measured against a detailed interview

DEFF Research Database (Denmark)

Madsen, L G; Hansen, Jane Møller; Grønvold, M

2007-01-01

of the patient's open-ended responses to the same questions administered by interview. Agreements were evaluated by estimation of the overall agreement and weighted kappa values (Kw). RESULTS: Forty-six patients were evaluated. The Kw between the two clinicians rating severity and duration of symptoms were 0...

Thiolated silicone oil: Synthesis, gelling and mucoadhesive properties

Science.gov (United States)

Partenhauser, Alexandra; Laffleur, Flavia; Rohrer, Julia; Bernkop-Schnürch, Andreas

2015-01-01

The aim of this study was the development of novel thiolated silicone oils and their evaluation with regard to gelling and mucoadhesive properties. A thiol coupling of 220 ± 14 and 127 ± 33 μmol/g polymer for 3-mercaptopropionic acid (MPA)- and cysteine-coupled silicone oil was determined, respectively. The dynamic viscosity of MPA–silicone raised significantly (p Thiolated silicone oils can be regarded superior in comparison to commonly used silicone oils due to a prolonged retention time in the small intestine as site of action. Gelling and mucoadhesive features are advantageous for antiflatulent as well as mucoprotective biomaterials. Thus, these novel thiomers seem promising for an upgrade of currently available products for the treatment of dyspepsia, reflux oesophagitis and even inflammatory bowel diseases such as ulcerative colitis or Crohn’s disease. PMID:25660565

Pigmented hepatocellular adenoma with complete CD34 immunostaining pattern: A diagnostic dilemma

Directory of Open Access Journals (Sweden)

Mukul Vij

2012-01-01

Full Text Available WHO defines hepatocellular adenoma (HCA as a benign tumor composed of cells closely resembling normal hepatocytes, which are arranged in plates separated by sinusoids. It is more common in women. The present concerns a 41 years female who was found to have a mass lesion in liver on ultrasound while undergoing routine evaluation for dyspepsia. Computed tomography scan of abdomen showed 10 × 8 cm lesion in liver. Extended left hepatectomy was performed. Grossly hepatic cut surface showed circumscribed tumor with dark gray or black color. Microscopy revealed hepatocellular adenoma with abundant Dubin Johnson like pigment deposition. CD34 immunostaining showed complete sinusoidal pattern. We labeled the tumor as pigmented hepatic adenoma with complete CD34 staining pattern. To the best of author′s knowledge only eight cases of pigmented hepatocellular adenoma are described in world literature.

Gastrointestinal Symptoms in Children and Adolescents With Neurofibromatosis Type 1

DEFF Research Database (Denmark)

Ejerskov, Cecilie; Krogh, Klaus; Ostergaard, John R

2017-01-01

siblings (median age 10 years). The overall likelihood of having gastrointestinal symptoms usually attributed to either functional dyspepsia, irritable bowel syndrome or constipation was 30.4% in patients vs. 10.9% in siblings, odds ratio 3.58 (95% CI: 1.30-9.79). The prevalence of constipation was 22......OBJECTIVES: Neurofibromatosis type 1 (NF1) is a complex genetic disorder characterized by symptoms of the skin and nervous system. A previous study indicated that constipation is common in children with NF1. The aim of the present study was to investigate the phenotype and prevalence...... of gastrointestinal symptoms in a population of 4-17-year-olds with NF1 compared to their unaffected siblings. METHODS: Gastrointestinal symptoms were assessed with a web-based, parent or self-administered, validated, Rome® III diagnostic questionnaire. Participants were recruited from one of two Danish National...

Navigating recurrent abdominal pain through clinical clues, red flags, and initial testing.

Science.gov (United States)

Noe, Joshua D; Li, B U K

2009-05-01

Recurrent abdominal pain is a common chronic complaint that presents to your office. The constant challenge is one of detecting those with organic disease from the majority who have a functional pain disorder including functional dyspepsia, irritable bowel syndrome, functional abdominal pain, and abdominal migraine. Beginning with a detailed history and physical exam, you can: 1) apply the symptom-based Rome III criteria to positively identify a functional disorder, and 2) filter these findings through the diagnostic clues and red flags that point toward specific organic disease and/or further testing. Once a functional diagnosis has been made or an organic disease is suspected, you can initiate a self-limited empiric therapeutic trial. With this diagnostic approach, you should feel confident navigating through the initial evaluation, management, and consultation referral for a child or adolescent with recurrent abdominal pain.

High prevalence of ulcer bleeding risk factors in dual antiplatelet-treated patients after percutaneous coronary intervention

DEFF Research Database (Denmark)

Jensen, Berit Elin S; Hansen, Jane M; Junker, Anders B

2015-01-01

INTRODUCTION: Dual antiplatelet therapy is standard treatment following percutaneous coronary intervention (PCI) and stenting. However, such therapy increases the risk of upper gastrointestinal bleeding (UGIB). The risk factors of UGIB are well-documented and proton pump inhibitor (PPI) treatment...... reduces the risk. The aim was to describe the prevalence of risk factors of UGIB in dual antiplatelet-treated patients. METHODS: A questionnaire was used to assess the prevalence of risk factors of upper gastrointestinal bleeding among dual antiplatelet-treated first-time PCI patients in Western Denmark......: A total of 1,358 patients with a mean age of 64.1 years (range: 33-92 years) were included. The distribution of risk factors was as follows: dyspepsia: 681 patients (50.1%); previous ulcer: 110 (8.1%; 2.3% with bleeding); use of NSAIDs: 214 (15.8%); corticosteroids (2.9%), SSRIs (5.8%) and anticoagulants...

Varioliform erosions in the stomach and duodenum

Energy Technology Data Exchange (ETDEWEB)

Lotz, W.; Schulz, D.; Munkel, G.

1984-04-01

One thousand five hundred and eighty-three patients who were x-rayed for dyspepsia showed varioliform erosions in 15.3%. Men had an incidence of 9.8%, almost twice as common as in women (5.5%). Mucosal polyps, usually of the hyperplastic type, occurred in 2.4%. 15% of patients with gastric ulcers and 16% of patients with duodenal ulcers had varioliform erosions. On the other hand, amongst patients with erosions, 11% had gastric ulcers and 8.3% duodenal ulcers. The definitions of erosion which have been given in the literature are partly contradictory, and are discussed. Varioliform erosions, also known as complete erosions, may be acute or chronic. They are the third most common cause of bleeding from the upper gastrointestinal tract. With modern radiological methods of examining the stomach, they are no longer a rare finding. 5 figs.

[The role of chronic gastritis in past medical history with NSAID administration in patients with osteoarthrosis].

Science.gov (United States)

Zak, M Iu

2014-11-01

122 patients with osteoarthrosis, who have in the past medical history verified chronic gastritis (50 males and 72 females) at the age from 42 to 64 have been examined. Control group was comprised of 40 patients with osteoarthrosis without gastroduodenal zone pathology in the past medical history. For arthralgia relief patients were prescribed meloxicam (average dose--12.5 - 1.39 mg daily) or nimesulide (average dose--150 ± 14.91 mg daily). As a result of this research it was determined that administration of selective NSAID (meloxicam and nimesulide) in patients with chronic gastritis in the past medical history raised the risk of NSAID gastropathy/dyspepsia 2.9 times (P 0.05) of erosive gastropathy. Patients with chronic gastritis in the past medical history when taking NSAID with the purpose of gastropathy prevention are recommended to undergo gastroprotective therapy.

Role of curcumin in health and disease.

Science.gov (United States)

Pari, Leelavinothan; Tewas, Daniel; Eckel, Juergen

2008-04-01

Curcumin (diferuloylmethane) is an orange-yellow component of turmeric (Curcuma longa), a spice often found in curry powder. In recent years, considerable interest has been focused on curcumin due to its use to treat a wide variety of disorders without any side effects. It is one of the major curcuminoids of turmeric, which impart its characteristic yellow colour. It was used in ancient times on the Indian subcontinent to treat various illnesses such as rheumatism, body ache, skin diseases, intestinal worms, diarrhoea, intermittent fevers, hepatic disorders, biliousness, urinary discharges, dyspepsia, inflammations, constipation, leukoderma, amenorrhea, and colic. Curcumin has the potential to treat a wide variety of inflammatory diseases including cancer, diabetes, cardiovascular diseases, arthritis, Alzheimer's disease, psoriasis, etc, through modulation of numerous molecular targets. This article reviews the use of curcumin for the chemoprevention and treatment of various diseases.

Varioliform erosions in the stomach and duodenum

International Nuclear Information System (INIS)

Lotz, W.; Schulz, D.; Munkel, G.

1984-01-01

One thousand five hundred and eighty-three patients who were x-rayed for dyspepsia showed varioliform erosions in 15.3%. Men had an incidence of 9.8%, almost twice as common as in women (5.5%). Mucosal polyps, usually of the hyperplastic type, occurred in 2.4%. 15% of patients with gastric ulcers and 16% of patients with duodenal ulcers had varioliform erosions. On the other hand, amongst patients with erosions, 11% had gastric ulcers and 8.3% duodenal ulcers. The definitions of erosion which have been given in the literature are partly contradictory, and are discussed. Varioliform erosions, also known as complete erosions, may be acute or chronic. They are the third most common cause of bleeding from the upper gastrointestinal tract. With modern radiological methods of examining the stomach, they are no longer a rare finding. (orig.) [de

Ewing's Sarcoma of the Peritoneum: a Rare Location for Extraskeletal Ewing's Sarcoma.

Science.gov (United States)

Saglam, Muzaffer; Ozdemir, Yavuz; Yigit, Taner; Kucukodaci, Zafer; Sonmez, Guner

2016-11-01

A 38-year-old male presented to the emergency department with abdominal pain and bulge. He had a history of irritable bowel syndrome for 1 year with complaint of dyspepsia. Physical examination revealed a distended abdomen with a huge palpable mass located in the paraumblical region. Laboratory findings revealed a high white blood cell count with neutrophil predominance. Contrast-enhanced computed tomography (CT) showed a 23-cm, oval-shaped, grossly necrotic, low-attenuation mass with peripherally located dominant vessels. Magnetic resonance imaging (MRI) with diffusion weighted imaging (DWI) suggested a highly malignant tumor with prominent diffusion restriction especially at the periphery of the mass. On surgery, macroscopic examination showed a macrolobulated, hypervascular, reddish brown mass attached to the parietal peritoneum with a stalk. Ewing's sarcoma (ES) was diagnosed on histopathological examination with small round cells.

Diagnostic value of symptoms of oesophagogastric cancers in primary care: a systematic review and meta-analysis

Science.gov (United States)

Astin, Margaret P; Martins, Tanimola; Welton, Nicky; Neal, Richard D; Rose, Peter W; Hamilton, William

2015-01-01

Background Selection of primary care patients for investigation of potential oesophagogastric cancer is difficult, as the symptoms may represent benign conditions, which are also more common. Aim To review systematically the presenting features of oesophagogastric cancers in primary care, including open-access endoscopy clinics. Design and setting Systematic review and meta-analysis. Method MEDLINE®, Embase, the Cochrane Library, and CINAHL were searched for studies of adults who were symptomatic and presented in primary care or open-access endoscopy clinics. Exclusions were being asymptomatic, screening, or recurrent cancers. Data were extracted to estimate the diagnostic performance of features of oesophagogastric cancers and summarised in a meta-analysis. Results Fourteen studies were identified. The strongest summary sensitivity and specificity estimates were for: dyspepsia 0.42 (95% confidence interval [CI] 0.29 to 0.56) and 0.48 (95% CI = 0.31 to 0.65); pain 0.41 (95% CI = 0.24 to 0.62) and 0.75 (95% CI = 0.51 to 0.89); and dysphagia 0.32 (95% CI = 0.17 to 0.52) and 0.92 (95% CI = 0.81 to 0.97). Summary positive likelihood ratios (LR+) and diagnostic odds ratios were: dyspepsia 0.79 (95% CI = 0.55 to 1.15) and 0.65 (95% CI = 0.32 to 1.33); pain 1.64 (95% CI = 1.20 to 2.24) and 2.09 (95% CI = 1.57 to 2.77); and dysphagia 4.32 (95% CI = 2.46 to 7.58) and 5.91 (95% CI = 3.56 to 9.82). Corresponding LR+ were: anaemia 4.32 (95% CI = 2.64 to 7.08); nausea/vomiting/bloating 1.07 (95% CI = 0.52 to 2.19); reflux 0.78 (95% CI = 0.47 to 1.78) and; weight loss 5.46 (95% CI = 3.47 to 8.60). Conclusion Dysphagia, weight loss, and anaemia show the strongest association but with relatively low sensitivity and high specificity. The findings support the value of investigation of these symptoms, but also suggest that, in a population of patients who are low risk but not no-risk, investigation is not currently recommended. PMID:26412845

Effects of long-term acid suppressants with ranitidine and omeprazole on gastric mucosa

Directory of Open Access Journals (Sweden)

P C Alexander

2013-01-01

Full Text Available Background and objectives: Proton pump inhibitors are used widely for gastroesophageal reflux disease and ulcer type dyspepsia. Majority of the patients require long term medication. H2 receptor antagonist are also used for relief of symptoms. Though tachyphylaxis has been reported, symptom response is seen with long term use. The aim of the present study was to study the effects of long-term acid suppressants on gastric antral histology. Methods: Patients who received long-term acid suppressants such as ranitidine and omeprazole for gastroesophageal reflux disease or dyspepsia were included. All of them had an antral biopsy for histology and H. pylori status at baseline, at 6 months and 12 months. Patients on acid suppressants for less than a year or on long-term non-steroidal anti inflammatory drugs were excluded from the study. The grading of gastritis was classified as chronic active gastritis, atrophic gastritis, intestinal metaplasia and dysplasia. Results: Thirty patients received ranitidine and 28 omeprazole. In H. pylori positive group, the median duration of ranitidine and omeprazole were 3 years (1.5 to 8 years and 4 years (1 to 10 years respectively. Two thirds of patients had chronic active gastritis (ranitidine: 35.5%; omeprazole:26.6%; 10 had gastric atrophy (ranitidine: 6.6%; omeprazole:15.5% and 7 had intestinal metaplasia (ranitidine4.4%; omeprazole11.1%. Four of the 10 patients on omeprazole showed progression of histology as against only one of the 13 patients on ranitidine at one year of follow up. In omeprazole pylori negative patients, the median duration of ranitidine and omeprazole was 2.5 years (range 1 to 6 years and 3 years (range 2 to 7 years respectively. Irrespective of the acid suppressants, the baseline histology was either chronic active gastritis (78.5% or gastric atrophy (21.5%. None had intestinal metaplasia. Also there was no progression in histology staging during the follow up. Conclusions: Long-term acid

Helicobacter pylori infection in patients with dyspeptic symptoms having normal endoscopy

International Nuclear Information System (INIS)

Malik, M.F.; Hussain, T.; Khan, M.N.; Mirza, S.A.

2010-01-01

To find out the frequency of Helicobacter pylori infection in the local population presenting with dyspeptic symptoms but having normal upper gastrointestinal endoscopic findings. Hundred cases of dyspepsia having normal upper gastrointestinal endoscopy were taken as study population. Although the gold standard for presence or absence of Helicobacter pylori infection is culture but in this study the diagnostic method used was histopathology of gastric antrum. The male and female ratio was 2:1. Majority of the patients were either 40 years of age or less, mean age being 40.52 (sd+-13.22). The chief symptoms were pain epigastrium (46%) and upper abdominal discomfort (27%). Helicobacter pylori gastritis was found in 51% of cases. We conclude that Helicobacter pylori infection is quite common in dyspeptic patients apparently having normal endoscopic gastric mucosal findings. Eradication therapy should be instituted in positive cases to avoid its long-term complications. (author)

Additive effect of rikkunshito, an herbal medicine, on chemotherapy-induced nausea, vomiting, and anorexia in uterine cervical or corpus cancer patients treated with cisplatin and paclitaxel: results of a randomized phase II study (JORTC KMP-02).

Science.gov (United States)

Ohnishi, Shunsuke; Watari, Hidemichi; Kanno, Maki; Ohba, Yoko; Takeuchi, Satoshi; Miyaji, Tempei; Oyamada, Shunsuke; Nomura, Eiji; Kato, Hidenori; Sugiyama, Toru; Asaka, Masahiro; Sakuragi, Noriaki; Yamaguchi, Takuhiro; Uezono, Yasuhito; Iwase, Satoru

2017-09-01

Rikkunshito, an herbal medicine, is widely prescribed in Japan for the treatment of anorexia and functional dyspepsia, and has been reported to recover reductions in food intake caused by cisplatin. We investigated whether rikkunshito could improve chemotherapy-induced nausea and vomiting (CINV) and anorexia in patients treated with cisplatin. Patients with uterine cervical or corpus cancer who were to receive cisplatin (50 mg/m² day 1) and paclitaxel (135 mg/m² day 0) as first-line chemotherapy were randomly assigned to the rikkunshito group receiving oral administration on days 0-13 with standard antiemetics, or the control group receiving antiemetics only. The primary endpoint was the rate of complete control (CC: no emesis, no rescue medication, and no significant nausea) in the overall phase (0-120 hours). Two-tailed panorexia. Copyright © 2017. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology

Gastrointestinal disorders in joint hypermobility syndrome/Ehlers-Danlos syndrome hypermobility type: A review for the gastroenterologist.

Science.gov (United States)

Beckers, A B; Keszthelyi, D; Fikree, A; Vork, L; Masclee, A; Farmer, A D; Aziz, Q

2017-08-01

Joint hypermobility syndrome (JHS)/Ehlers-Danlos syndrome hypermobility type (EDS-HT) is the most common hereditary non-inflammatory disorder of connective tissue, characterized by a wide range of symptoms, mainly joint hyperextensibility and musculoskeletal symptoms. A majority of patients also experiences gastrointestinal (GI) symptoms. Furthermore, JHS/EDS-HT has specifically been shown to be highly prevalent in patients with functional GI disorders, such as functional dyspepsia and irritable bowel syndrome. The aim of this review was to examine the nature of GI symptoms and their underlying pathophysiology in JHS/EDS-HT. In addition, we consider the clinical implications of the diagnosis and treatment of JHS/EDS-HT for practicing clinicians in gastroenterology. Observations summarized in this review may furthermore represent the first step toward the identification of a new pathophysiological basis for a substantial subgroup of patients with functional GI disorders. © 2017 John Wiley & Sons Ltd.

[Clinical symptoms of erosive and ulcerous lesions of gastroduodenal zone in patients with unstable ischemic heart disease and the significance of endoscopy in diagnosis].

Science.gov (United States)

Osadchiĭ, V A; Chernin, V V; Barashkov, A P

2003-01-01

We studied 103 patients with unstable ischemic heart disease and clinical signs of gastroduodenal injury. Among them 62 (60.2%) patients had moderate gastric dyspepsia and abdominal pain during first 1-5 days of hospitalization. In 17 (16.5%) cases these clinical symptoms were accompanied with symptoms of gastroduodenal hemorrhage. Twenty four patients (23.3%) with history of ulcer disease or chronic gastritis, were asymptomatic. In 96 (93.2%) patients endoscopy performed mainly on days 20-24 of hospital stay detected gastroduodenal erosions and ulcers: acute ulcers were found in 19.4, acute erosions - in 40.8, exacerbations of peptic ulcer - in 33.0% of patients. Clinical symptoms of gastroduodenal ulcers and erosions often did not reflect character, severity and dynamics of pathological process. Therefore gastro- duodenoscopy had decisive importance for diagnosis and assessment of effect of treatment. Endoscopy should be carried out with due consideration of concomitant coronary pathology.

Plexiform angiomyxoid myofibeoblastic tumor of the stomach: Report of a case and review of the literature

Energy Technology Data Exchange (ETDEWEB)

Baek, Soo Heui; Yoon, Jung Hee; Kim, Ji Yeon [Haeundae Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

2014-01-15

We report a case of a plexiform angiomyxoid myofibroblastic tumor of the stomach that developed in a 38-year-old woman who underwent gastrofiberscopy and multi-detector computed tomography scans due to dyspepsia for 3 months. There was a subepithelial protruding mass with a small central mucosal ulceration and heterogeneous prominent enhancement in the gastric upper body along the greater curvature. The tumor measured 3.5 x 2.3 cm in size and showed a multinodular plexiform growth pattern of bland spindle cells in the myxoid stroma with abundant small blood vessels. The tumor cells were negative for CD117 (c-KIT), CD34, and S-100 protein but diffusely positive for smooth muscle actin and Alcian blue. The pathologic examination demonstrated that the lesion was a plexiform angiomyxoid myofibroblastic tumor. The patient is doing well and has had no recurrence or metastasis for 6 months after the wedge resection.

Psychometric evaluation of a daily gastro-oesophageal reflux disease symptom measure

DEFF Research Database (Denmark)

Bytzer, Peter; Reimer, Christina; Smith, Gary

2017-01-01

was demonstrated by moderate to high correlations with ReQuest™ change scores and time with symptoms. An HRDQ cut-off value of 0.70 for definition of ‘bad day’ was also evaluated. Conclusions: Based on existing evidence, the HRDQ is a valid and reliable measure of GORD symptoms that can be used as a study outcome...... (Cronbach’s alpha range.83–.88) and test–retest reliability (intraclass correlation coefficient range.71–.90). Convergent and discriminant validity were supported by high correlations with ReQuest™ and ability to differentiate between groups based on ReQuest™ cut-off values. Responsiveness of HRDQ......Objective: The objective of this study was to evaluate the validity of the Heartburn Reflux Dyspepsia Questionnaire (HRDQ), a newly developed measure of gastro-oesophageal reflux disease (GORD) symptoms. Specifically, the HRDQ was developed for patients, who still experience symptoms with proton...

Abnormal duodenal loop demonstrated by X-ray

International Nuclear Information System (INIS)

Thommesen, P.; Funch-Jensen, P.

1986-01-01

The occurrence of dyspeptic symptoms has previously been correlated with the shape of the duodenal loop in patients with X-ray-negative dyspepsia. An abnormal duodenal loop was associated with a significantly higher incidence of symtoms provoked by meals, vomiting, regurgitations, heartburn, and the irritable bowel syndrome. 89% of these patients (26 patients with a normal duodenal loop and 39 patients with abnormal duodenal loop) were available for a 5-year follow-up study of symptomatic outcome. The incidence of symptoms provoked by meals was still significantly higher in patients with an abnormal duodenal loop, and there was also a significant difference concerning symptomatic outcome. Approximately 75% of the patients with a normal duodenal loop had improved, and 25% had unchanged clinical conditions. Approximately 50% of the patients with an abnormal duodenal loop had improved, and 50% had an unchanged or even deteriorated clinical condition

Metastatic Renal Cell Carcinoma Presenting as Gastric Ulcer: Case Report and Literature Review

Directory of Open Access Journals (Sweden)

Alhareth Al Juboori

2017-01-01

Full Text Available Renal cell carcinoma (RCC accounts for approximately 3% of all adult malignancies. True gastrointestinal metastases, specifically to gastric wall, have been rarely observed. Herein we describe a case of delayed metastasis to gastric wall occurring more than a decade after previously curative nephrectomy for RCC. A 67-year-old male with history of right radical nephrectomy in 2001 for RCC was found to have an asymptomatic right lower lobe solitary lung mass upon routine follow-up in 2011, with final biopsy results showing metastatic RCC for which he was treated accordingly. In 2014, patient was evaluated for dyspepsia with microcytic anemia and underwent an esophagogastroduodenoscopy and colonoscopy. EGD revealed a solitary one-centimeter atypical ulcer in the posterior mid gastric body with biopsy results being consistent with metastatic RCC. Our literature review has yielded thirty-six reported cases of RCC in association with gastric wall metastases.

[Experience of treatment of patients with gastropathy induced by non-steroid anti-inflammatory drugs].

Science.gov (United States)

Vakhrushev, Ia M; Loshchakova, O Iu

2007-01-01

A complex study of 147 patients who were taking non-steroid anti-inflammatory drugs (NSAIDs) revealed gastric lesions in 120 patients (81.6%). H2 blocker (ranitidine) was used for treating 40 patients with NSAID-induced gastropathy, proton pump inhibitor (omeprazole) was used for 40 patients, and Gastrozepin combined with Misoprostol--for 40 patients. Pain syndrome and dyspepsia were eliminated in most of the patients as a result of the treatment. Using Gastrozepin and Misoprostol produced an active effect on the trophic processes in the gastric mucous coat and caused erosion and ulcer healing. As compared to ranitidine and omeprazole, Gastrozepin used in combination with Cytotec produces a lower effect on the reduction of the acid-producing stomach function, yet it has a considerably greater effect on the normalization of the gastric mucus structure and restoration of metabolism of the gastric mucous coat collagen.

Clinical utility of curcumin extract.

Science.gov (United States)

Asher, Gary N; Spelman, Kevin

2013-01-01

Turmeric root has been used medicinally in China and India for thousands of years. The active components are thought to be the curcuminoids, primarily curcumin, which is commonly available worldwide as a standardized extract. This article reviews the pharmacology of curcuminoids, their use and efficacy, potential adverse effects, and dosage and standardization. Preclinical studies point to mechanisms of action that are predominantly anti-inflammatory and antineoplastic, while early human clinical trials suggest beneficial effects for dyspepsia, peptic ulcer, inflammatory bowel disease, rheumatoid arthritis, osteoarthritis, uveitis, orbital pseudotumor, and pancreatic cancer. Curcumin is well-tolerated; the most common side effects are nausea and diarrhea. Theoretical interactions exist due to purported effects on metabolic enzymes and transport proteins, but clinical reports do not support any meaningful interactions. Nonetheless, caution, especially with chemotherapy agents, is advised. Late-phase clinical trials are still needed to confirm most beneficial effects.

New fatty acid and acyl glycoside from the aerial parts of Phyllanthus fraternus Webster.

Science.gov (United States)

Ali, Abuzer; Jameel, Mohammad; Ali, Mohammed

2016-01-01

Phyllanthus fraternus Webster (Euphorbiaceae) is used to treat dyspepsia, indigestion, jaundice, dysentery, diabetes, influenza, kidney stones, urinary tract diseases, vaginitis, and skin eruptions in traditional systems of medicine. The methanol extract of aerial parts of P. fraternus was obtained by soxhlation method. Isolation of compounds was done by silica gel column chromatography. Analytical thin layer chromatography was used to check the homogeneity of eluted fractions. The structures of isolated compounds were established on the basis of spectral studies and chemical reactions. Phytochemical investigation of a methanolic extract of the aerial parts yielded a new fatty acid characterized as cis-n-octacos-17-enoic acid (5) and a new acyl tetraglycoside formulated as n-dodecanoyl-O-β-D-glucopyranosyl-(2'→1'')-O-β-D-glucopyranosyl-(2''→1''')-O-β-D-glucopyranosyl-(2'''→1'''')-O-β-D-glucopyranoside (7) along with known compounds 1-pentacosanol (1), β-sitosteryl oleate (2), β-sitosteryl linoleate (3), stigmasterol (4) and palmityl glucuronoside (6).

Ayurvedic preparation of Zingiber officinale Roscoe: effects on cardiac and on smooth muscle parameters.

Science.gov (United States)

Leoni, Alberto; Budriesi, Roberta; Poli, Ferruccio; Lianza, Mariacaterina; Graziadio, Alessandra; Venturini, Alice; Broccoli, Massimiliano; Micucci, Matteo

2017-08-28

The rhizome of the Zingiber officinale Roscoe, a biennial herb growing in South Asia, is commonly known as ginger. Ginger is used in clinical disorders, such as constipation, dyspepsia, diarrhoea, nausea and vomiting and its use is also recommended by the traditional medicine for cardiopathy, high blood pressure, palpitations and as a vasodilator to improve the circulation. The decoction of ginger rhizome is widely used in Ayurvedic medicine. In this papery by high-performance liquid chromatography, we have seen that its main phytomarkers were 6-gingerol, 8-gingerol and 6-shogaol and we report the effects of the decoction of ginger rhizome on cardiovascular parameters and on vascular and intestinal smooth muscle. In our experimental models, the decoction of ginger shows weak negative inotropic and chronotropic intrinsic activities but a significant intrinsic activity on smooth muscle with a potency on ileum is greater than on aorta: EC 50  = 0.66 mg/mL versus EC 50  = 1.45 mg/mL.

Utilization of C-14 settled urease for diagnosing Campylobacter Pylori in the stomach

International Nuclear Information System (INIS)

Chausson, Y.; Coelho, L.G.V.

1990-01-01

A new method for diagnosing the Campylobacter Pylori in the stomach is described, using C-14 settled urease. Campylobacter Pylori is now being considered the most probable causative agent of antral chronic gastritis, pepitic ulcer and non-ulcerous dyspepsia. The technique is based on ingestion of the tracer, its recovery by exhalation in etanol hyamine solution, followed by counting and dates evaluation. The test was applied to forty two voluntary male and female patients, after their written acquiescence. Their ages varied from 19 to 62 years old. Thirty of the results were positive and twelve negative. All of them were comproved by microbiological (cultura) and hystologycal studies of gastric biopsy gotten by gastroscopy. They were performed at the Gastroentherology Departament of the 'Hospital das Clinicas' that belongs to the Federal University of Minas Gerais. Repetitivity of the breath test was confirmed by repetition of the results in five positive patients and five negative ones. (author) [pt

Association of Helicobacter pylori infection with nodular antritis and follicular gastritis

Directory of Open Access Journals (Sweden)

Tomašević Ratko

2006-01-01

Full Text Available Introduction. Helicobacter pylori (H. pylori infection is known to be the must common cause of chronic gastritis having some endoscopic and pathologic characteristies as determinated by the Sydney System for Gastritis Classification. The aim of our case report was to point out the relationship between an endoscopic finding of nodular antritis and the presence of H. pylori infection and active chronic gastritis. Case report. Our patient underwent upper gastrointestinal endoscopy for dyspeptic complaints and was diagnosed as having nodular antritis, but also underwent urease test and hystopathologic examination of antral mucosa, to determine the presence and density of H. pylori infection and the presence and severity of gastritis. After a course of anti H. pylori treatment, dyspepsia improved and new biopsy specimens obtained two months and six months afterwards revealed no pathological findings. Conclusion. The case report supported the association of H. pylori infection of lymphoid follicles with nodular gastric mucosis.

Utilization of C-14 settled urease for diagnosing Campylobacter Pylori in the stomach. Utilizacao de ureia marcada com carbono quatorze para diagnostico da presenca do Campylobacter Pylori no estomago

Energy Technology Data Exchange (ETDEWEB)

Chausson, Y; Coelho, L G.V. [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN), Belo Horizonte, MG (Brazil)

1990-01-01

A new method for diagnosing the Campylobacter Pylori in the stomach is described, using C-14 settled urease. Campylobacter Pylori is now being considered the most probable causative agent of antral chronic gastritis, pepitic ulcer and non-ulcerous dyspepsia. The technique is based on ingestion of the tracer, its recovery by exhalation in etanol hyamine solution, followed by counting and dates evaluation. The test was applied to forty two voluntary male and female patients, after their written acquiescence. Their ages varied from 19 to 62 years old. Thirty of the results were positive and twelve negative. All of them were comproved by microbiological (cultura) and hystologycal studies of gastric biopsy gotten by gastroscopy. They were performed at the Gastroentherology Departament of the 'Hospital das Clinicas' that belongs to the Federal University of Minas Gerais. Repetitivity of the breath test was confirmed by repetition of the results in five positive patients and five negative ones. (author).

[A remembrance of Clarín's illnesses in his centenary].

Science.gov (United States)

Izquierdo Rojo, José María

2002-01-01

The Spanish famous writer Leopoldo Alas, also known by the pseudonymous of "Clarín" suffered from two main kind of illnesses: nervous and digestives. Both began early, when he was only thirty two. At that moment, and during all his thirties, nervous ailments were conspicuous, but digestive problems were growing up slow but steadily and became the most serious and even menacing during his forties. Nervous pathology was double: on the one hand, some attacks of migraine with visual disturbances (scotoma), dysphasia and other "indescribable nervous oddities", which happened about 4-5 times per year; on the other, several emotional and vague symptoms, such as melancholia, dejected mood, anxiety, nervousness, etc. Digestive symptomatology, consisting of atonic constipation, intestinal dyspepsia, febricula, and a feeling of being "as a blocked drain", is due--no doubt--to tuberculous peritonitis diagnosed by his young nephew Dr. Martínez. This serious illness was the cause of his death on the 13th June 1901, when he was only 49.

Endocrine carcinoma of the pancreatic tail exhibiting gastric variceal bleeding

Directory of Open Access Journals (Sweden)

Si-Yuan Wu

2014-01-01

Full Text Available Nonfunctional endocrine carcinoma of the pancreas is uncommon. Without excess hormone secretion, it is clinically silent until the enlarging or metastatic tumor causes compressive symptoms. Epigastric pain, dyspepsia, jaundice, and abdominal mass are the usual symptoms, whereas upper gastrointestinal (GI bleeding is rare. Here, we describe the case of a 24-year-old man with the chief complaint of hematemesis. Upper GI panendoscopy revealed isolated gastric varices at the fundus and upper body. Ultrasonography and computed tomography showed a tumor mass at the pancreatic tail causing a splenic vein obstruction, engorged vessels near the fundus of the stomach, and splenomegaly. After distal pancreatectomy and splenectomy, the bleeding did not recur. The final pathologic diagnosis was endocrine carcinoma of the pancreas. Gastric variceal bleeding is a possible manifestation of nonfunctional endocrine carcinoma of the pancreas if the splenic vein is affected by a tumor. In non-cirrhotic patients with isolated gastric variceal bleeding, the differential diagnosis should include pancreatic disorders.

Role of Medium Chain Triglycerides (Axona®) in the Treatment of Mild to Moderate Alzheimer's Disease.

Science.gov (United States)

Sharma, Alok; Bemis, Marc; Desilets, Alicia R

2014-08-01

Treatment of Alzheimer's disease (AD) with acetylcholinesterase inhibitors or N-methyl-D-aspartate (NMDA) receptor antagonists provides symptomatic relief but do not prevent its progression. Thus, additional approaches aimed at slowing the progression of the disease have been investigated. Reports detailing reduced brain glucose metabolism in the early stages of AD led to the hypothesis that alternate energy sources aimed at increasing neuronal metabolism may protect neurons and thus benefit patients with AD. Medium-chain triglycerides (MCTs) are metabolized to ketone bodies that serve as an alternative source of energy for neurons. Data from clinical trials suggest that MCTs improve cognition in patients with mild to moderate AD in apolipoprotein E4-negative patients. Adverse events observed were mild and included minor gastrointestinal problems such as diarrhea, dyspepsia, and flatulence. However, since genomic profiles are not routinely conducted in patients with AD in a clinical setting, the role of MCTs in clinical practice seems to be minimal. © The Author(s) 2014.

Real-Life and RCT Participants

DEFF Research Database (Denmark)

Reyes, Carlen; Pottegård, Anton; Schwarz, Peter

2016-01-01

We aimed to characterize incident users of alendronate from Denmark and Spain, and investigate their eligibility for participation in the pivotal Fracture Intervention Trial (FIT). This is an international cross-sectional study, where the data were obtained from the SIDIAP database (Sistema d...... of alendronate who were not eligible to participate in FIT. 14,316 and 21,221 subjects initiated alendronate in 2006-2007 (SIDIAP) and 2005-2006 (DHR), respectively. SIDIAP and DHR alendronate user cohorts had 2347 (16.4 %) and 5275 (24.9 %) subjects aged >80 years old, reported 9 (0.1 %) and 91 (0.......4 %) diagnoses of myocardial infarction, 423 (3 %) and 368 (1.7 %) of erosive gastro-intestinal disease, 200 (1.4 %) and 1109 (5.2 %) of dyspepsia, and 349 (2.4 %) and 149 (0.7 %) of metabolic bone disease, all of which were exclusion criteria in FIT. Men [3818 (26.7 %) in SIDIAP and 3885 (18.3 %) in DHR...

"Shell Shock": An Entity that Predated Combat-related Posttraumatic Stress Disorder

Directory of Open Access Journals (Sweden)

Ragul Ganesh

2015-01-01

Full Text Available In the last century, numerous soldiers had been diagnosed with various post combat disorders. The terminology that has been utilized to describe such patients include combat fatigue, combat stress reaction, soldier′s heart, effort syndrome, non-ulcer dyspepsia, effects of agent orange and gulf war syndrome. The initial description of such post combat disorder was probably ′shell shock′ which came into vogue during the World War I. The soldiers, undergoing unyielding artillery bombardment, in the trenches suffered persistent symptoms of headache, behavioural changes and memory impairment, and was designated at the time as ′shell shock′. Myers and Mott, independently studied numerous soldiers to elucidate the features and aetiology of the entity. An attempt was made to restrict the usage of the term, but the psychological distress of the soldiers persisted to be addressed in some manner or the other, culminating in the genesis of Post Traumatic Stress Disorder.

Breast cancer metastasizing to the stomach mimicking primary gastric cancer: A case report.

Science.gov (United States)

Yim, Kwangil; Ro, Sang Mi; Lee, Jieun

2017-03-28

Breast cancer with stomach metastasis rare with an incidence of 1% or less among metastatic breast cancer patients. We experienced a case of breast cancer metastasizing to the stomach in 65-year-old female patient. She experienced dyspepsia and poor oral intake before visiting the clinic. Diffuse infiltration with nodular mucosal thickening of the stomach wall was observed, suggesting advanced gastric cancer based on gross endoscopic finding. Spread of poorly cohesive tumor cells in the gastric mucosa observed upon hematoxylin and eosin stain resembled signet ring cell carcinoma, but diffuse positive staining for GATA3 in immunohistochemical stain allowed for a conclusive diagnosis of breast cancer metastasizing to the stomach. Based on the final diagnosis, systemic chemotherapy was administered instead of primary surgical resection. After 2 cycles of docetaxel administration, she showed a partial response based on abdominal computed tomography scan. This case is an unusual presentation of breast cancer metastasizing to the gastrointestinal tract.

Are clinical features able to predict Helicobacter pylori gastritis patterns? Evidence from tertiary centers.

Science.gov (United States)

Carabotti, Marilia; Lahner, Edith; Porowska, Barbara; Colacci, Enzo; Trentino, Paolo; Annibale, Bruno; Severi, Carola

2014-12-01

Outcome of Helicobacter pylori infection is different according to gastritis extension (i.e. antrum-restricted gastritis or pangastritis). The aim of this study is to evaluate whether different gastritis patterns are associated with specific gastrointestinal symptoms or clinical signs that could be suggestive of the topography of gastritis. 236 consecutive symptomatic outpatients were recruited in two tertiary centers. They filled in a validated and self-administered Rome III modular symptomatic questionnaire, and underwent gastroscopy with histological sampling. 154 patients with Helicobacter pylori infection were included. Clinical presentation did not differ between antrum-restricted gastritis and pangastritis, gastro-esophageal reflux disease being present in 48.2 and 54.1 % of patients and dyspepsia in 51.8 and 45.9 %, respectively. However, pangastritis statistically differed from antrum-restricted gastritis in that the presence of clinical signs (p gastritis pattern whereas their association with signs, accurately detected, is indicative for the presence of pangastritis.

Investigation of the Quality of Life Indicators According to SF-8 in Patients with Functional Gastrointestinal Disorders

Directory of Open Access Journals (Sweden)

A.E. Dorofeiev

2015-04-01

Full Text Available Quality of life (QOL — a very important method which can improve the communication between a doctor and a patient, identifying the impact of the disease on the physical, mental and social well-being of a patient, the effectiveness of the therapy and the development of rehabilitation programs. The objective of the study was to investigate the psychosomatic characteristics and QOL of patients with irritable bowel syndrome (IBS and functional dyspepsia (FD. This study was cross-sectional. It included 80 patients with FD and 93 patients with IBS according to the Rome criteria III, as well as a control group of 30 healthy volunteers. We assessed health-related QOL by the standard 4-week form of SF-8 questionnaire. When comparing the level of QOL in patients with FD and IBS, we revealed significant deterioration compared with the control group, but there were no statistically significant differences between them (p < 0.05.

Helicobacter pylori Infection in the general population: A Middle Eastern perspective.

Science.gov (United States)

Khedmat, Hossein; Karbasi-Afshar, Reza; Agah, Shahram; Taheri, Saeed

2013-01-01

Helicobacter pylori (H.pylori) infection is probably the most important factor that has been associated with the development of gastric cancers in human populations. However, there are no reliable data on the prevalence of this infection in the Middle East. In this article, based on a comprehensive literature review, we aimed to evaluate the situation in this region. The literature has been searched for the incidence and prevalence of H.pylori infection by Pubmed and Google Scholar. Search was repeated for each of the Middle Eastern countries, and to empower the method, citations of each found article were searched for the related studies. Seventy seven reports from the countries of the Middle East region had been reviewed and they all indicated a high rate of infection either in the general population or in the dyspeptic patients, the rate seemed to be higher in patients with dyspepsia, in patients with histologically confirmed gastritis and in patients of older age groups.

Pain Management in Functional Gastrointestinal Disorders

Directory of Open Access Journals (Sweden)

Antonio Vigano

1995-01-01

Full Text Available Pain is a common feature in functional gastrointestinal disorders (FGID. An abnormally low visceral sensory threshold, as well as a number of central, spinal and peripheral pain-modulating abnormalities, have been proposed for this syndrome. Clinical aspects of pain associated with irritable esophagus, functional dyspepsia, biliary dysmotility, inflammatory bowel syndrome and proctalgia fugax are reviewed. Because of its unclear pathophysiology, pain expression is the main target for the successful assessment and management of symptomatic FGID. The sensory, cognitive and affective components of pain intensity expression need to be addressed in the context of a good physician-patient rapport. A multidisciplinary team approach is ideal for the smaller subset of patients with severe and disabling symptoms. Although pharmacotherapy may target specific functional disorders, the role of behavioural techniques and psychotherapy appears much more important for pain management in FGID. Functional performance and quality of life improvement, rather than pain intensity, are the main therapeutic goals in these patients.

Maastricht consensus-5: analytical review of statements

Directory of Open Access Journals (Sweden)

Yu.M. Stepanov

2017-02-01

Full Text Available This article analyzes the statements of Maastricht consensus-5 on H. pylori infection studying. There was shown the changes in approaches to diagnostics and treatment of H. pylori infection in previous Maastricht consensuses. H. pylori associated gastritis was considered to be an infection disease. There was also analyzed the relation between this infection and gatroduodenal pathology including functional dyspepsia, NSAID-gastropathy and others. The paper deals with up-to-date approaches to diagnostics of H. pylori infection with determination of the most optimal diagnostic method in different situations. The approaches to antihelicobacter therapy were analyzed. The special attention was paid to dependence of modern therapeutic schemes of helicobacteriosis therapy on H. pylori resistance to key antibiotics. There was confirmed the importance of H. pylori eradication for prevention of precancerous changes in the stomach. The increased interest of researchers to non-helicobacter flora in the stomach was shown. There was regarded an important role of probiotics in antihelicobacter therapy.

Inhibition of Helicobacter pylori and Associated Urease by Oregano and Cranberry Phytochemical Synergies

Science.gov (United States)

Lin, Y. T.; Kwon, Y. I.; Labbe, R. G.; Shetty, K.

2005-01-01

Ulcer-associated dyspepsia is caused by infection with Helicobacter pylori. H. pylori is linked to a majority of peptic ulcers. Antibiotic treatment does not always inhibit or kill H. pylori with potential for antibiotic resistance. The objective of this study was to determine the potential for using phenolic phytochemical extracts to inhibit H. pylori in a laboratory medium. Our approach involved the development of a specific phenolic profile with optimization of different ratios of extract mixtures from oregano and cranberry. Subsequently, antimicrobial activity and antimicrobial-linked urease inhibition ability were evaluated. The results indicated that the antimicrobial activity was greater in extract mixtures than in individual extracts of each species. The results also indicate that the synergistic contribution of oregano and cranberry phenolics may be more important for inhibition than any species-specific phenolic concentration. Further, based on plate assay, the likely mode of action may be through urease inhibition and disruption of energy production by inhibition of proline dehydrogenase at the plasma membrane. PMID:16332847

LBP based detection of intestinal motility in WCE images

Science.gov (United States)

Gallo, Giovanni; Granata, Eliana

2011-03-01

In this research study, a system to support medical analysis of intestinal contractions by processing WCE images is presented. Small intestine contractions are among the motility patterns which reveal many gastrointestinal disorders, such as functional dyspepsia, paralytic ileus, irritable bowel syndrome, bacterial overgrowth. The images have been obtained using the Wireless Capsule Endoscopy (WCE) technique, a patented, video colorimaging disposable capsule. Manual annotation of contractions is an elaborating task, since the recording device of the capsule stores about 50,000 images and contractions might represent only the 1% of the whole video. In this paper we propose the use of Local Binary Pattern (LBP) combined with the powerful textons statistics to find the frames of the video related to contractions. We achieve a sensitivity of about 80% and a specificity of about 99%. The achieved high detection accuracy of the proposed system has provided thus an indication that such intelligent schemes could be used as a supplementary diagnostic tool in endoscopy.

Upper functional gastrointestinal disorders in young adults.

Science.gov (United States)

Adibi, Peyman; Behzad, Ebrahim; Shafieeyan, Mohammad; Toghiani, Ali

2012-01-01

Functional Gastrointestinal disorders (FGID) are common disorders in gastroenterology which are common in young adults. The aim of this study is evaluating the prevalence of upper FGID in iranian young adults. This was a cross-sectional study which was on 995 persons who were going to marry. A ROME III based questionnaire was used to determine the frequency of upper GI Syndromes among the sample population. Our results determined 74 subjects had functional dyspepsia (36 subjects diagnosed as postprandial distress syndrome patient and Epigastric pain syndrome was seen in 38 subjects). Functional heartburn was diagnosed in 52 participants. Globus was seen in 35 subjects and 41 had unspecified excessive belching. Many epidemiologic studies were done all around the world but there are different reports about prevalence and incidence of FGIDs. Our results were agreed with reported prevalence of FGIDs in Iran in adults. And our findings were agreed with some other Asian studies.

Percutaneous peritoneovenous shunt positioning: technique and preliminary results

International Nuclear Information System (INIS)

Orsi, Franco; Grasso, Rosario Francesco; Bonomo, Guido; Marinucci, Irene; Monti, Cinzia; Bellomi, Massimo

2002-01-01

Nine peritoneovenous shunts were positioned by percutaneous technique in seven patients with advanced malignancy causing severe refractory ascites, and in two patients with hepatic cirrhosis (one with hepatocarcinoma). In all patients the shunts were percutaneously placed through the subclavian vein in the angiographic suite under digital fluoroscopic guide. No complications directly related to the procedure occurred. The shunt was successfully positioned in all patients in 60 min average time. No patient showed symptoms related to pulmonary overload or to disseminated intravascular coagulation. All patients had a significant improvement of the objective symptoms related to ascites such as respiratory symptoms, dyspepsia, and functional impairment to evacuation describing an improvement of their quality of life. Maximum shunt patency was 273 days. Percutaneous placement of peritoneovenous shunt is a safe, fast, and inexpensive procedure, extremely useful in resolution of refractory ascites, reducing symptoms, and allowing effective palliation, with a great improvement in quality of life. (orig.)

Percutaneous peritoneovenous shunt positioning: technique and preliminary results

Energy Technology Data Exchange (ETDEWEB)

Orsi, Franco; Grasso, Rosario Francesco; Bonomo, Guido; Marinucci, Irene [Division of Radiology, European Institute of Oncology, Milan (Italy); Monti, Cinzia [Institute of Radiology, University of Milan (Italy); Bellomi, Massimo [Division of Radiology, European Institute of Oncology, Milan (Italy); Institute of Radiology, University of Milan (Italy)

2002-05-01

Nine peritoneovenous shunts were positioned by percutaneous technique in seven patients with advanced malignancy causing severe refractory ascites, and in two patients with hepatic cirrhosis (one with hepatocarcinoma). In all patients the shunts were percutaneously placed through the subclavian vein in the angiographic suite under digital fluoroscopic guide. No complications directly related to the procedure occurred. The shunt was successfully positioned in all patients in 60 min average time. No patient showed symptoms related to pulmonary overload or to disseminated intravascular coagulation. All patients had a significant improvement of the objective symptoms related to ascites such as respiratory symptoms, dyspepsia, and functional impairment to evacuation describing an improvement of their quality of life. Maximum shunt patency was 273 days. Percutaneous placement of peritoneovenous shunt is a safe, fast, and inexpensive procedure, extremely useful in resolution of refractory ascites, reducing symptoms, and allowing effective palliation, with a great improvement in quality of life. (orig.)

Is this a reflux patient or is it a patient with functional dyspepsia with additional reflux symptoms?

DEFF Research Database (Denmark)

Funch-Jensen, Peter

1995-01-01

Patients with pyrosis or regurgitation as the dominating symptoms have gastro-oesophageal reflux disease (GORD). However, patients with more atypical symptoms may also suffer from it. The disease is usually chronic and patients who have additional oesophagitis are at risk of developing complicati......Patients with pyrosis or regurgitation as the dominating symptoms have gastro-oesophageal reflux disease (GORD). However, patients with more atypical symptoms may also suffer from it. The disease is usually chronic and patients who have additional oesophagitis are at risk of developing...

A clinicopathological study of dyspeptic subjects in Lagos, Nigeria

Directory of Open Access Journals (Sweden)

Ladi Hameed

2012-05-01

Full Text Available The clinicopathological and endoscopic features of dyspepsia have not been well studied in Nigeria due to the high cost of gastroscopes and lack of the relevant expertise. This study was designed to highlight these features and possible risk factors. This prospective study was conducted on adult dyspeptic patients who fulfilled the study criteria from November 2007 to December 2008 at a University hospital in Lagos, Nigeria. Demographic and clinical presentation including possible risk factors were obtained through a questionnaire administered by an interviewer followed by an upper gastrointestinal endoscopy and gastric biopsy. Of the 123 subjects who took part in the study, 100 gave their consent to an upper gastrointestinal endoscopy and biopsy. The male:female ratio was 1:1, mean age was 44.98 (SD 15.4 years and the modal age group was 38-47years. The prevalence of dyspepsia was 29% and epigastric pain was the most common presentation. Endoscopic findings were superficial mucosal lesion (21%, peptic ulcer (16%, features of gastroesophageal reflux disease (10%, and gastric cancer (2%, as well normal findings (44%. Non-steroidal antiinflammatory drug (NSAID use as a risk factor had a significant association with positive endoscopic findings; relative risk for development of positive endoscopic findings was 1.5% (P =0.03. Histology showed rates of chronic gastritis to be 91% and normal values 9%. The most common type of gastritis was the non-specific form (59.3%, followed by H. Pylori-associated gastritis (36.3%. The topography of gastritis was mainly pangastritis (68.1% and antral predominant in 23.1%. The prevalence of H. pylori by histology was 41%. The presence of H. pylori was not associated with severity, location or duration of symptoms. H. pylori was, however, found to be a significant contributor to the development of positive endoscopic findings (P=0.01; OR 2.92 95% CI 1.50-3.17. Alarm symptoms were found to be important markers of

On the importance of developing a new generation of breath tests for Helicobacter pylori detection.

Science.gov (United States)

Kushch, Ievgeniia; Korenev, Nikolai; Kamarchuk, Lyudmila; Pospelov, Alexander; Kravchenko, Andrey; Bajenov, Leonid; Kabulov, Mels; Amann, Anton; Kamarchuk, Gennadii

2015-12-15

State-of-the-art methods for non-invasive detection of the Helicobacter pylori (H. pylori) infection have been considered. A reported global tendency towards a non-decreasing prevalence of H. pylori worldwide could be co-influenced by the functional limitations of urea breath tests (UBTs), currently preferred for the non-invasive recognition of H. pylori in a clinical setting. Namely, the UBTs can demonstrate false-positive or false-negative results. Within this context, limitations of conventional clinically exploited H. pylori tests have been discussed to justify the existing need for the development of a new generation of breath tests for the detection of H. pylori and the differentiation of pathogenic and non-pathogenic strains of the bacterium. This paper presents the results of a pilot clinical study aimed at evaluating the development and diagnostic potential of a new method based on the detection of the non-urease products of H. pylori vital activity in exhaled gas. The characteristics of breath of adolescents with H. pylori-positive and H. pylori-negative functional dyspepsia, together with a consideration of the cytotoxin-associated gene A (CagA) status of H. pylori-positive subjects, have been determined for the first time using innovative point-contact nanosensor devices based on salts of the organic conductor tetracyanoquinodimethane (TCNQ). The clinical and diagnostic relevance of the response curves of the point-contact sensors was assessed. It was found that the recovery time of the point-contact sensors has a diagnostic value for differentiation of the H. pylori-associated peptic ulcer disease. The diagnostically significant elongation of the recovery time was even more pronounced in patients infected with CagA-positive H. pylori strains compared to the CagA-negative patients. Taking into account the operation of the point-contact sensors in the real-time mode, the obtained results are essential prerequisites for the development of a fast and

IgG immune responses to different proteins of Helicobacter Pylori as defined by immunoblot assay

Directory of Open Access Journals (Sweden)

Raeiszadeh M

2000-09-01

Full Text Available Helicobacter pylori (H.pylori is an etiologic factor for chronic gastritis and peptic ulcers. Serological testing of H.pylori infection is common in Iran, as other parts of the world. There are geographical variations in the humoral immune response to various H. pylori strains in different parts of the worl. We studied the immunogenic proteins of H.pylori by means of an Immunoblot assay with antigens of H.pylori strains isolated in Iran. Sera of 64 patients suffering from dyspepsia were analyzed to determine antibodlies which were good marker of infection and the antibody patterns associated with peptic ulcer.54 out of 64 dyspeptic patients were infected by H. pylori based on positive culture or positive results of both rapid urease test and direct examination. 14 out of fity-four had peptic ulcers and the rest were catagoriied as patients with non-ulcer dyspepsia. Some of them had multiple erosions in the gut or deodenum. Tweny –two major bands were identified by immunoblot. Of these, IgG antibodies against 10 protients, and they produced immunoreative bands at 14, 16, 22, 26, 32 , 32, 44, 87, 92, 120 Kda. Antibody patterns were not identical in the patients. The presence of at least one band at 14, 16, 22, 26, 32, 35Kda was the best marker of infection(sensitivity, 90% and specificity, 80% Major serological cross reactions were found at moderate molecular weight bands (50, 52, 54, 60, 66 KDa. The presence of at least one band at 14, 16, 22, 26, 32, 35Kda was the best marker of infection (sensitivity, 90% and specificity, 80%. Major serological crossreactions were found at moderate molerate molecular weight bands (50, 52, 54, 60, 66 KDa. The presence of antibodies to 120 Kda protein (Cag A and 87 Kda Protein (Vac A were not associated with the presence of peptic ulcers. These were in contradiction to results obtained across Europe and U.S but in agreement with Asian studies. However the presence of at least one band at either 32 or 35 Kda was

cagA Status and Eradication Treatment Outcome of Anti-Helicobacter pylori Triple Therapies in Patients with Nonulcer Dyspepsia

Science.gov (United States)

Broutet, Nathalie; Marais, Armelle; Lamouliatte, Hervé; de Mascarel, Antoine; Samoyeau, Roland; Salamon, Roger; Mégraud, Francis

2001-01-01

The differences in eradication rates reported in clinical trials aiming to cure Helicobacter pylori infection cannot be entirely explained by the type of regimen, bacterial resistance, or lack of compliance. Using data from a clinical trial, a logistic regression model was constructed to determine whether cagA status, assessed by PCR, affects the outcome of eradication. Resistance to clarithromycin (10% of the strains) predicted failure perfectly. In the model (n = 156), a cagA-lacking strain (odds ratio [OR] = 2.2; 95% confidence interval [CI], (1.1 to 4.7), tobacco smoking OR = 3.1; 95% CI, 1.3 to 7.0), and a double dose of proton pump inhibitor in the treatment regimen (OR = 0.3; 95% CI, 0.2 to 0.7) were associated with the treatment outcome. The exact role of cagA in the outcome of H. pylori eradication therapy has not been explored. However, the type of histological lesions which it causes in the gastric mucosa may be implicated. Regardless of the mechanism involved, cagA status is a good predictive marker of eradication outcome. PMID:11283049

A comparative study of stool antigen Immunocard STAT HpSA test with biopsy in diagnosis of H Pylori Infection

Directory of Open Access Journals (Sweden)

Munish Rastogi

2015-12-01

Full Text Available The present study was conducted on 78 cases in the Department of Medicine at G.S.V.M Medical College, Kanpur who reported with various gastrointestinal symptoms such as dyspepsia, heartburns, nausea, vomiting and loss of appetite. They all were advised for biopsy by the physician. Patients treated with antibiotics, bismuth or proton pump inhibitors within 4 weeks preceding the study were excluded. Invasive tests using mucosal biopsies including histology and rapid urease test (RUT were used to establish the gold standard in order to evaluate the accuracy of Immunocard STAT HpSA. Sensitivity, Specificity, Positive Predictive Value and Negative Predictive Value of Immunocard STAT HpSA as compared to gold standard were 95.5%, 81.8%, 96.9% and 75.0% respectively. It is thus concluded that the Immunocard STAT HpSA test has a diagnostic value comparable to the gold standard in detecting H Pylori. The sensitivity and specificity of the test is fair enough to be used as a test for screening purpose and also for diagnosis and treatment of H.Pylori infection in clinical practice

Virulence Factors of Helicobacter pylori

Directory of Open Access Journals (Sweden)

Paul Sinclair

1991-01-01

environment with respect to pH. The spiral shape of the cells and their flagellar motility allow them to wind themselves into the mucous layer of the stomach. Some evidence exists for the production of strong proteolytic activity, hence degrading the mucous barrier and increasing permeability for the organism. Cyroroxin excreted by the bacteria may have some effect on the surrounding cells, with the possible lysis and release of bacterial growth factors. There is evidence that a chemotactic response is present due to these growth factors and their higher concentration in the intracellular spaces. The presence of specific and nonspecific adhesion has also been demonstrated, thus allowing the bacterium, once at the epithelial cell surface, to attach and avoid being washed off by movement within the stomach. Although treatment with antimicrobials eradicates the organism and improves symptoms of peptic ulcer patients, there is no indication that the same occurs in nonulcer dyspepsia patients. Further work is essential to describe the virulence mechanisms of H pylori and the possible pathogenic role of the organism.

Unusual presentations of eosinophilic gastroenteritis: Case series and review of literature

Institute of Scientific and Technical Information of China (English)

Rafiq A Sheikh; Thomas P Prindiville; R Erick Pecha; Boris H Ruebner

2009-01-01

Eosinophilic gastroenteritis (EG) is an uncommon disease characterized by focal or diffuse eosinophilic infiltration of the gastrointestinal tract, and is usually associated with dyspepsia, diarrhea and peripheral eosinophilia. Diffuse gastrointestinal tract and colonic involvement are uncommon. The endoscopic appearance may vary from normal to mucosal nodularity and ulceration. Gastrointestinal obstruction is unusual and is associated with predominantly muscular disease. We present five unusual cases of EG associated with gastric outlet and duodenal obstruction. Two cases presented with acute pancreatitis and one had a history of pancreatitis. Four cases responded well to medical therapy and one had recurrent gastric outlet obstruction that required surgery. Four out of the five cases had endoscopic and histological evidence of esophagitis and two had colitis. Two patients had ascites. These cases reaffirm that EG is a disorder with protean manifestations and may involve the entire gastrointestinal tract. Gastric outlet and/or small bowel obstruction is an important though uncommon presentation of EG. It may also present as esophagitis, gastritis with polypoid lesions, ulcers or erosions, colitis and pancreatitis and may mimic malignancy.

Stem and leaf anatomy of Plectranthus neochilus Schltr., Lamiaceae

Directory of Open Access Journals (Sweden)

Márcia do Rocio Duarte

Full Text Available Plectranthus neochilus Schltr. is an aromatic herb named " boldo" or " boldo-gambá" and employed for treating hepatic insufficiency and dyspepsia in folk medicine. This paper has investigated its stem and leaf anatomy, in order to contribute for the medicinal plant identification. The botanical material was prepared according to standard microtechniques. The stem has quadrangular transection and, in secondary growth at the level analyzed, shows uniseriate epidermis and numerous trichomes. The glandular ones are capitate and peltate. The former has short unicellular or long multicellular stalk and uni- or bicellular head. The latter presents short stalk and eight-celled ovoid head. The non-glandular trichomes are multicellular, uniseriate and coated with granular cuticle. It is observed angular collenchyma, cambia forming phloem outward and xylem inward, and perivascular fiber caps next to the phloem. The blade has uniseriate epidermis coated with striate cuticle, diacytic stomata on both surfaces, numerous trichomes similar to the stem ones, and homogeneous mesophyll. The midrib shows one or two collateral bundles and the petiole has many of them distributed as an open arc.

Modern strategy of diagnostics and treatment of NSAID-induced enteropathy in elderly

Directory of Open Access Journals (Sweden)

Lipatova Т.Е.

2015-03-01

Full Text Available The aim of the research is to improve the efficiency of diagnosis and treatment of NSAID-induced enteropathy at elderly patients with chronic pain (osteoarthritis, dorsopathy. Material and Methods. 300 elderly with osteoarthritis or dorsopathies regularly (8 weeks or more receiving diclofenac at 75 mg per day were inspected. Clinical features, morphology, components of the diffuse endocrine system of the small intestine were studied. Results. It is defined, that at elderly patients with regular use of NSAIDs in 25% of cases postbulbar erosive duodenitis, in 75% of cases inflammatory and atrophic changes of the distal duodenum were diagnosed. Diagnosis of NSAID-induced enteropathy at elderly should include faecal calprotectin and morphology analysis of postbulbar area of the duodenum. Use meloxicam and sulfasalazine at older patients helps to eliminate or reduce intestinal dyspepsia, malabsorption, and intestinal inflammation on the results of faecal calprotectin and of histology of the small intestine. Conclusion. Elderly patients are at high-risk group for NSAID-induced enteropathy due to functional disturbances in the neuroendocrine system of the small intestine.

Polymorphisms at Locus 4p14 of Toll-Like Receptors TLR-1 and TLR-10 Confer Susceptibility to Gastric Carcinoma in Helicobacter pylori Infection.

Directory of Open Access Journals (Sweden)

M Ravishankar Ram

Full Text Available Helicobacter pylori (H. pylori -induced gastric inflammation impacts the functions of leptin- and ghrelin-producing cells in the gastroduodenum. Inflammation resulting from H. pylori sensing via Toll-like receptors (TLRs and the associated downstream signaling largely remain ambiguous. Here, we investigated the role of gut hormones, pro-inflammatory cytokines and single nucleotide polymorphisms (SNPs associated with TLR 4p14 in H. pylori disease in 30 subjects with non-ulcer dyspepsia (NUD, 40 with peptic ulcer disease (PUD and 15 with gastric cancer (GC subjects positive and negative for H. pylori infection. The level of pro-inflammatory cytokines was directly proportional to the severity of gastritis, and disease status influenced the levels of gut hormones and pro-inflammatory cytokines. TLR-1 SNPs rs4833095 and TLR-10 SNPs rs10004195 and were directly associated with H. pylori disease, and were up-regulated in the presence of H. pylori in a genotype-independent manner. We concluded that TLR-1 rs4833095 and TLR10 rs10004195 confer susceptibility to development of gastroduodenal disease, especially GC in H.pylori disease.

Radiotherapy for testicular seminoma stage I: treatment results and long-term post-irradiation morbidity in 365 patients

International Nuclear Information System (INIS)

Fossa, S.D.A.; Aass, N.; Kaalhus, O.

1989-01-01

After infradiaphragmatic radiotherapy the cancer-related 10 year survival was 99% in 365 patients with seminoma Stage I referred to the Norwegian Radium Hospital between 1970 and 1982. Thirteen patients relapsed, 11 of them within the first 3 years after treatment. Nine of the recurrent patients were cured by radiotherapy alone (4) or in combination with chemotherapy (5). There is no need to include the inguinal lymph nodes into the irradiation field or to give scrotal irradiation, not even to patients with tumor infiltration beyond the testicular tissue, or to those with prior scrotal or inguinal surgery. At least 1 year after radiotherapy moderate or more severe dyspepsia was observed in 16 patients. Nine patients developed a peptic ulcer. In general, there was no increased risk for development of a second non-germ cell cancer after radiotherapy. However, 4 patients developed a pulmonary cancer indicating a border-line significance of increased risk for this type of malignancy. (p:0.05). In conclusion, infradiaphragmatic radiotherapy remains the optimal routine treatment in seminoma patients with Stage I

Additional corpus biopsy enhances the detection of Helicobacter pylori infection in a background of gastritis with atrophy

Directory of Open Access Journals (Sweden)

Lan Hung-Chieh

2012-12-01

Full Text Available Abstract Background The best sites for biopsy-based tests to evaluate H. pylori infection in gastritis with atrophy are not well known. This study aimed to evaluate the site and sensitivity of biopsy-based tests in terms of degree of gastritis with atrophy. Methods One hundred and sixty-four (164 uninvestigated dyspepsia patients were enrolled. Biopsy-based tests (i.e., culture, histology Giemsa stain and rapid urease test and non-invasive tests (anti-H. pylori IgG were performed. The gold standard of H. pylori infection was defined according to previous criteria. The sensitivity, specificity, positive predictive rate and negative predictive rate of biopsy-based tests at the gastric antrum and body were calculated in terms of degree of gastritis with atrophy. Results The prevalence rate of H. pylori infection in the 164 patients was 63.4%. Gastritis with atrophy was significantly higher at the antrum than at the body (76% vs. 31%; p Conclusions In moderate to severe gastritis with atrophy, biopsy-based test should include the corpus for avoiding false negative results.

Dyspeptic symptoms and delayed gastric emptying of solids in patients with inactive Crohn’s disease

Directory of Open Access Journals (Sweden)

Nóbrega Ana Carolina Mello

2012-12-01

Full Text Available Abstract Background Patients with Crohn’s disease (CD have been shown to present dyspeptic symptoms more frequently than the general population. Some of these symptoms could be related to motility disorders to some degree. Then, we propose to investigate whether gastric emptying of solids in patients with inactive CD is delayed and to determine the relationships between gastric emptying and dyspeptic symptoms in inactive CD. Methods Twenty-six patients with inactive Crohn’s disease, as defined by a Crohn’s Disease Activity Index (CDAI 13C octanoic acid coupled to a solid meal and answered a validated questionnaire (The Porto Alegre Dyspeptic Symptoms Questionnaire to assess dyspeptic symptoms. Patients with scores ≥ 6 were considered to have dyspepsia. The control group was composed by 19 age- and sex-matched healthy volunteers. Results Patients with CD had a significantly longer t 1/2 and t lag (p Conclusion Delayed gastric emptying in inactive Crohn’s disease patients seems to be associated with dyspeptic symptoms, particularly vomiting, even without any evidence of gastrointestinal obstruction.

Epidemiology of Functional abdominal bloating and its impact on health related quality of life: male-female stratified propensity score analysis in a population based survey in mainland China.

Science.gov (United States)

Wu, Meijing; Zhao, Yanfang; Wang, Rui; Zheng, Wenxin; Guo, Xiaojing; Wu, Shunquan; Ma, Xiuqiang; He, Jia

2014-01-01

The epidemiology of Functional abdominal bloating (FAB) and its impact on health-related quality of life (HRQoL) in Chinese people remains unclear. Randomised, stratified, multi-stage sampling methodology was used to select a representative sample of the general population from five cities in China (n = 16,078). All respondents completed the modified Rome II questionnaire; 20% were asked to complete the 36-item Short Form (SF-36). The associated factors of FAB were analyzed. The effects of FAB on HRQoL were estimated with gender stratification using propensity score techniques in 20% subsample. Overall, 643 individuals (4.00%) had FAB and it was more prevalent in males than in females (4.87% vs. 3.04%, Pproblems (P = 0.030) and bodily pain (PChina was lower than previous reports. Males who had ever been diagnosed with dyspepsia and females who were in a poor self-reported health status were correlated with a higher prevalence of FAB. FAB affected only physical health in females, but impaired both physical and mental health in males.

An 11-Year-Old Male Patient with Refractory Asthma and Heartburn

Directory of Open Access Journals (Sweden)

Tareq Al-Abdoulsalam

2011-01-01

Full Text Available Achalasia is characterized by obstruction of the distal esophagus and subsequent dilation of the proximal esophagus, and is considered to be a rare disorder in children. Patients commonly present with gastrointestinal (GI symptoms such as dysphagia; however, pulmonary symptoms may also occur. Rare pulmonary symptoms due to achalasia are dyspnea and wheeze due to tracheal compression. The authors describe an 11-year-old boy who was referred to a pediatric respiratory clinic for asthma that was not responsive to inhaled medications. The child presented with a one-year history of dyspnea on exertion, cough and wheeze. He also complained of chronic dyspepsia. The presence of GI symptoms, in addition to abnormalities on chest radiograph and spirometry, suggested the presence of achalasia. The diagnosis was confirmed and the patient subsequently underwent surgical myotomy that relieved his GI and pulmonary symptoms, and normalized spirometry. The present article is an illustrative case report to remind pediatricians to consider other diagnoses when a patient does not respond to asthma medications.

Correlation between duodenogastric reflux and symptoms of digestive system diseases

International Nuclear Information System (INIS)

Leja, M.; Reinholds, E.; Brezinskis, G.; Aboltins, A.; Lejnieks, A.

2004-01-01

The symptoms of digestive origin potentially indicative for duodenogastric reflux (DGR) have been compared to the results obtained by scintigraphic method, elaborated by the group of authors. The symptoms were registred bu using a specially elaborated questionnaire according to preliminary determined intervals of time with respect to the scintigraphic investigation. No correlation was found between DGR and the following symptoms: nausea, vomiting, regurgitation with sour and bitter content, belching, heartburn, burning sensation in the epigastric area, early satiety, flatulence, constipation, dyspepsia and abdominal pain. Diarrhoea in the morning of the investigation and month prior to the investigation was statistically significantly correlating to DGR, while no correlation was confirmed to the symptom a day and a week prior to the investigation. Bittertaste in the mouth had the best correlation to DGR in all the analysed intervals. The conclusion is made that bitter taste in the mouth is the best correlating symptom for DGR, still the low sensitivity and low positive and negative predictive values of the symptom does not make it a useful guide for symptom-based diagnosis of DGR

The Prevalence of Helicobacter Pylori in Dyspeptic Patients and the Relationship with Endoscopic Diagnosis

Directory of Open Access Journals (Sweden)

Ozgur Turk

2016-07-01

Full Text Available Aim: One of the most common reasons of the chronic gastritis is Helicobacter pylori (Hp infection. Recent studies reported that Hp gastritis is involved with the duodenal ulcer, atrophic gastritis, dyspepsia, gastric cancer and MALT lymphoma. The prevalence of Hp infection has regional differences. We aimed to determine the frequency of Hp infection in our region and introduce the relationship between results of endoscopy with Hp infection. Material and Method: In this study we analyzed retrospectively 412 patients%u2019 endoscopy results and histopathological results between 2013 January-2014 February.Total 246 patients who have underwent endoscopic biopsy and Hphistopathologically investigated. Results: Male and female ratio was 1.8:1. There were 77 male patients and 139 female patients. Mean age of patients was 46.50±15.05 and range of age was 15 to 82.There was not any statically meaningful association between Hp and patients ages and gender (p>0.05.47.7% of patients were diagnosed as Hp positive, There was a meaningful relationship between Hp ( and chronic gastritis ( groups (p

Cataplexy as a side effect of modafinil in a patient without narcolepsy☆

Science.gov (United States)

Lopes, Eduardo; Pereira, Danielle; da Silva Behrens, Nilce Sanny Costa; de Almeida Fonseca, Hassana; Calvancanti, Paola Oliveira; de Araújo Lima, Taís Figueiredo; Pradella-Hallinan, Marcia; Castro, Juliana; Tufik, Sergio; Coelho, Fernando Morgadinho Santos

2014-01-01

Narcolepsy is a disease in which there is diurnal excessive sleepiness with sleep attacks and a prevalence in the general population of 1/4000 individuals. Classically, it is characterized by cataplexy, sleep paralysis, hypnagogic hallucinations and fragmented sleep. The use of modafinil in the treatment of narcolepsy is the first option of treatment for diurnal excessive sleepiness. Although considered a safe drug for use in patients with narcolepsy, being utilized for more than 20 years, modafinil possesses a series of side effects, some of them still not fully researched or described. Side effects such as headache, nausea, anxiety, insomnia, lumbago, diarrhea, dyspepsia, rhinitis and vertigo are the most frequent. However, the clinical follow-up of patients under treatment with modafinil must be intensive and the side effects ought to be noted and evaluated. The under-response to treatment or the unexpected side effects must always be directed to differential diagnostics. The objective of this article is to describe an unexpected side effect of the use of modafinil in a patient with incorrect diagnosis of narcolepsy. PMID:26483900

[Functional and motor gastrointestinal disorders].

Science.gov (United States)

Mearin, Fermín; Rey, Enrique; Balboa, Agustín

2015-09-01

This article discusses the most interesting studies on functional and motor gastrointestinal disorders presented at Digestive Diseases Week (DDW), 2015. Researchers are still seeking biomarkers for irritable bowel syndrome and have presented new data. One study confirmed that the use of low-dose antidepressants has an antinociceptive effect without altering the psychological features of patients with functional dyspepsia. A contribution that could have immediate application is the use of transcutaneous electroacupuncture, which has demonstrated effectiveness in controlling nausea in patients with gastroparesis. New data have come to light on the importance of diet in irritable bowel syndrome, although the effectiveness of a low-FODMAP diet seems to be losing momentum with time. Multiple data were presented on the long-term efficacy of rifaximin therapy in patients with irritable bowel syndrome and diarrhoea. In addition, among other contributions, and more as a curiosity, a study evaluated the effect of histamine in the diet of patients with irritable bowel syndrome. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Epidemiology, Clinical Characteristics, and Associations for Rome IV Functional Nausea and Vomiting Disorders in Adults.

Science.gov (United States)

Aziz, Imran; Palsson, Olafur S; Whitehead, William E; Sperber, Ami D; Simrén, Magnus; Törnblom, Hans

2018-05-29

Functional nausea and vomiting disorders (FNVDs) are classified as chronic nausea and vomiting syndrome (CNVS) or cyclic vomiting syndrome (CVS) - CVS includes cannabinoid hyperemesis syndrome. We investigated the population prevalence of FNVDs, their characteristics, and associated factors. In the year 2015, an Internet cross-sectional health survey was completed by 5931 adults in the general populations of 3 English-speaking countries; 2100 participants were in the United States, Canada, or the United Kingdom. Quota-based sampling was used to generate demographically balanced and population-representative samples. The survey collected data on demographics, healthcare visits, medications, somatic symptom severity, quality of life, and symptom-based diagnostic criteria for Rome IV FNVDs as well as for irritable bowel syndrome and functional dyspepsia. Subsequent comparisons were made between Rome IV FNVD subjects and individuals without FNVDs (controls). Overall, 2.2% of the population (n=131) fulfilled symptom-based diagnostic criteria for Rome IV FNVDs - the United States (3%) had a greater prevalence than Canada (1.9%) or the United Kingdom (1.8%) (P=.02). The prevalence of CNVS was similar among the countries, ranging from 0.8% to 1.2%. However, the prevalence of CVS was higher in the United States (2%) than in Canada (0.7%) or the United Kingdom (1%) (P=.03). The proportion of subjects with CVS taking cannabis did not differ significantly among countries (P=.31), although the 7 cases of cannabinoid hyperemesis syndrome were in the United States. A significantly higher proportion of subjects with CVS reported a compulsive need for hot water bathing to alleviate emetic symptoms than subjects with CNVS (44% vs. 19%, P=.03); this behaviour was independent of cannabis but augmented by its use. Subjects with FNVDs had significantly greater health impairment and health care utilization than controls. On multivariate analysis, independent factors associated with FNVDs

An Extremely Rare and Unusual Case of Retroperitoneal and Pelvic Metastasis from Squamous Cell Carcinoma of Vallecula

Directory of Open Access Journals (Sweden)

Abhishek Purkayastha

2016-06-01

Full Text Available We report an extremely rare and unusual case of retroperitoneal and pelvic metastasis from primary squamous cell carcinoma of vallecula. Generally carcinoma oropharynx metastasizes to lungs, liver and bone while retroperitoneal and pelvic metastasis is rarely heard of. To the best of our knowledge this case is one of the scantly reported cases ever of this kind in the world.  A 60-year-old male presented with dysphagia and hoarseness of voice of four month duration.  Computed tomography (CT scan face and neck showed growth right vallecula. Biopsy of lesion showed squamous cell carcinoma. Metastatic work up was negative. He received definitive chemo-radiation. Patient during follow up presented with dyspepsia, abdominal discomfort and weight loss. Whole body positron emission tomography (WB PET scan revealed retroperitoneal and pelvic lymph node deposits which were confirmed as metastasis of squamous cell carcinoma by CT guided fine needle aspiration cytology (FNAC. Patient was exhibited palliative chemotherapy but his general condition deteriorated and he finally succumbed to his metastatic illness. This case is being reported to highlight its extreme rarity, the diagnostic and therapeutic challenges it presented and its overall dismal prognosis.