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Association Between Gastric Myoelectric Activity Disturbances and Dyspeptic T Symptoms in Gastrointestinal Cancer Patients ⁎ Aneta L
Advances in Medical Sciences 64 (2019) 44–53 Contents lists available at ScienceDirect Advances in Medical Sciences journal homepage: www.elsevier.com/locate/advms Original research article Association between gastric myoelectric activity disturbances and dyspeptic T symptoms in gastrointestinal cancer patients ⁎ Aneta L. Zygulskaa, , Agata Furgalab, Krzysztof Krzemienieckia,c,1, Beata Wlodarczykb, Piotr Thorb a Department of Oncology, University Hospital in Cracow, Cracow, Poland b Department of Pathophysiology, Jagiellonian University Medical College, Cracow, Poland c Department of Oncology, Jagiellonian University Medical College, Cracow, Poland ARTICLE INFO ABSTRACT Keywords: Purpose: Dyspeptic symptoms present a severe problem in gastrointestinal (GI) cancer patients. The aim of the Gastrointestinal carcinoma study was to analyze an association between gastric myoelectric activity changes and dyspeptic symptoms in Gastric motility gastrointestinal cancer patients. Gastric myoelectric activity Material and Methods: The study included 80 patients (37 men and 43 women, mean age 61.2 ± 7.8 years) Electrogastrography diagnosed with GI tract malignancies: colon (group A), rectal (group B) and gastric cancers (group C). Gastric Dyspeptic symptoms myoelectric activity in a preprandial and postprandial state was determined by means of a 4-channel electro- gastrography. Autonomic nervous system was studied based on heart rate variability analysis. The results were compared with the data from healthy asymptomatic controls. Results: In a fasted state, GI cancer patients presented with lesser percentages of normogastria time (A:44.23 vs. B:46.5 vs. C:47.10 vs. Control:78.2%) and average percentage slow wave coupling (ACSWC) (A:47.1 vs. B:50.8 vs. C:47.2 vs. Control:74.9%), and with higher values of dominant power (A:12.8 vs. -
Childhood Functional Gastrointestinal Disorders: Child/Adolescent
Gastroenterology 2016;150:1456–1468 Childhood Functional Gastrointestinal Disorders: Child/ Adolescent Jeffrey S. Hyams,1,* Carlo Di Lorenzo,2,* Miguel Saps,2 Robert J. Shulman,3 Annamaria Staiano,4 and Miranda van Tilburg5 1Division of Digestive Diseases, Hepatology, and Nutrition, Connecticut Children’sMedicalCenter,Hartford, Connecticut; 2Division of Digestive Diseases, Hepatology, and Nutrition, Nationwide Children’s Hospital, Columbus, Ohio; 3Baylor College of Medicine, Children’s Nutrition Research Center, Texas Children’s Hospital, Houston, Texas; 4Department of Translational Science, Section of Pediatrics, University of Naples, Federico II, Naples, Italy; and 5Department of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina Characterization of childhood and adolescent functional Rome III criteria emphasized that there should be “no evi- gastrointestinal disorders (FGIDs) has evolved during the 2- dence” for organic disease, which may have prompted a decade long Rome process now culminating in Rome IV. The focus on testing.1 In Rome IV, the phrase “no evidence of an era of diagnosing an FGID only when organic disease has inflammatory, anatomic, metabolic, or neoplastic process been excluded is waning, as we now have evidence to sup- that explain the subject’s symptoms” has been removed port symptom-based diagnosis. In child/adolescent Rome from diagnostic criteria. Instead, we include “after appro- IV, we extend this concept by removing the dictum that priate medical evaluation, the symptoms cannot be attrib- “ ” fi there was no evidence for organic disease in all de ni- uted to another medical condition.” This change permits “ tions and replacing it with after appropriate medical selective or no testing to support a positive diagnosis of an evaluation the symptoms cannot be attributed to another FGID. -
General Signs and Symptoms of Abdominal Diseases
General signs and symptoms of abdominal diseases Dr. Förhécz Zsolt Semmelweis University 3rd Department of Internal Medicine Faculty of Medicine, 3rd Year 2018/2019 1st Semester • For descriptive purposes, the abdomen is divided by imaginary lines crossing at the umbilicus, forming the right upper, right lower, left upper, and left lower quadrants. • Another system divides the abdomen into nine sections. Terms for three of them are commonly used: epigastric, umbilical, and hypogastric, or suprapubic Common or Concerning Symptoms • Indigestion or anorexia • Nausea, vomiting, or hematemesis • Abdominal pain • Dysphagia and/or odynophagia • Change in bowel function • Constipation or diarrhea • Jaundice “How is your appetite?” • Anorexia, nausea, vomiting in many gastrointestinal disorders; and – also in pregnancy, – diabetic ketoacidosis, – adrenal insufficiency, – hypercalcemia, – uremia, – liver disease, – emotional states, – adverse drug reactions – Induced but without nausea in anorexia/ bulimia. • Anorexia is a loss or lack of appetite. • Some patients may not actually vomit but raise esophageal or gastric contents in the absence of nausea or retching, called regurgitation. – in esophageal narrowing from stricture or cancer; also with incompetent gastroesophageal sphincter • Ask about any vomitus or regurgitated material and inspect it yourself if possible!!!! – What color is it? – What does the vomitus smell like? – How much has there been? – Ask specifically if it contains any blood and try to determine how much? • Fecal odor – in small bowel obstruction – or gastrocolic fistula • Gastric juice is clear or mucoid. Small amounts of yellowish or greenish bile are common and have no special significance. • Brownish or blackish vomitus with a “coffee- grounds” appearance suggests blood altered by gastric acid. -
Observational Study of Children with Aerophagia
Clinical Pediatrics http://cpj.sagepub.com Observational Study of Children With Aerophagia Vera Loening-Baucke and Alexander Swidsinski Clin Pediatr (Phila) 2008; 47; 664 originally published online Apr 29, 2008; DOI: 10.1177/0009922808315825 The online version of this article can be found at: http://cpj.sagepub.com/cgi/content/abstract/47/7/664 Published by: http://www.sagepublications.com Additional services and information for Clinical Pediatrics can be found at: Email Alerts: http://cpj.sagepub.com/cgi/alerts Subscriptions: http://cpj.sagepub.com/subscriptions Reprints: http://www.sagepub.com/journalsReprints.nav Permissions: http://www.sagepub.com/journalsPermissions.nav Citations (this article cites 18 articles hosted on the SAGE Journals Online and HighWire Press platforms): http://cpj.sagepub.com/cgi/content/refs/47/7/664 Downloaded from http://cpj.sagepub.com at Charite-Universitaet medizin on August 26, 2008 © 2008 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution. Clinical Pediatrics Volume 47 Number 7 September 2008 664-669 © 2008 Sage Publications Observational Study of Children 10.1177/0009922808315825 http://clp.sagepub.com hosted at With Aerophagia http://online.sagepub.com Vera Loening-Baucke, MD, and Alexander Swidsinski, MD, PhD Aerophagia is a rare disorder in children. The diagnosis is stool and gas. The abdominal X-ray showed gaseous dis- often delayed, especially when it occurs concomitantly tention of the colon in all and of the stomach and small with constipation. The aim of this report is to increase bowel in 8 children. Treatment consisted of educating awareness about aerophagia. This study describes 2 girls parents and children about air sucking and swallowing, and 7 boys, 2 to 10.4 years of age, with functional consti- encouraging the children to stop the excessive air swal- pation and gaseous abdominal distention. -
Gastroenterology and the Elderly
3 Gastroenterology and the Elderly Thomas W. Sheehy 3.1. Esophagus 3.1.1. Dysphagia Esophageal disorders, such as esophageal motility disorders, infections, tumors, and other diseases, are common in the elderly. In the elderly, dysphagia usually implies organic disease. There are two types: (1) pre-esophageal and (2) esophageal. Both are further subdivided into motor (neuromuscular) or structural (intrinsic and extrinsic) lesions.! 3.1.2. Pre-esophageal Dysphagia Pre-esophageal dysphagia (PED) usually implies neuromuscular disease and may be caused by pseudobular palsy, multiple sclerosis, amy trophic lateral scle rosis, Parkinson's disease, bulbar poliomyelitis, lesions of the glossopharyngeal nerve, myasthenia gravis, and muscular dystrophies. Since PED is due to inability to initiate the swallowing mechanism, food cannot escape from the oropharynx into the esophagus. Such patients usually have more difficulty swallowing liquid THOMAS W. SHEEHY • The University of Alabama in Birmingham, School of Medicine, Department of Medicine; and Medical Services, Veterans Administration Medical Center, Birming ham, Alabama 35233. 87 S. R. Gambert (ed.), Contemporary Geriatric Medicine © Plenum Publishing Corporation 1983 88 THOMAS W. SHEEHY than solids. They sputter or cough during attempts to swallow and often have nasal regurgitation or aspiration of food. 3.1.3. Dysfunction of the Cricopharyngeus Muscle In the elderly, this is one of the more common forms of PED.2 These patients have the sensation of an obstruction in their throat when they attempt to swallow. This is due to incoordination of the cricopharyngeus muscle. When this muscle fails to relax quickly enough during swallowing, food cannot pass freely into the esophagus. If the muscle relaxes promptly but closes too quickly, food is trapped as it attempts to enter the esophagus. -
Gastroenterostomy and Vagotomy for Chronic Duodenal Ulcer
Gut, 1969, 10, 366-374 Gut: first published as 10.1136/gut.10.5.366 on 1 May 1969. Downloaded from Gastroenterostomy and vagotomy for chronic duodenal ulcer A. W. DELLIPIANI, I. B. MACLEOD1, J. W. W. THOMSON, AND A. A. SHIVAS From the Departments of Therapeutics, Clinical Surgery, and Pathology, The University ofEdinburgh The number of operative procedures currently in Kingdom answered a postal questionnaire. Eight had vogue in the management of chronic duodenal ulcer died since operation, and three could not be traced. The indicates that none has yet achieved definitive status. patients were questioned particularly with regard to Until recent years, partial gastrectomy was the eating capacity, dumping symptoms, vomiting, ulcer-type dyspepsia, diarrhoea or other change in bowel habit, and favoured operation, but an increasing awareness of a clinical assessment was made based on a modified its significant operative mortality and its metabolic Visick scale. The mean time since operation was 6-9 consequences, along with Dragstedt and Owen's years. demonstration of the effectiveness of vagotomy in Thirty-five patients from this group were admitted to reducing acid secretion (1943), has resulted in the hospital for a full investigation of gastrointestinal and widespread use of vagotomy and gastric drainage. related function two to seven years following their The success of duodenal ulcer surgery cannot be operation. Most were volunteers, but some were selected judged only on low stomal (or recurrent) ulceration because of definite complaints. There were more females rates; the other sequelae of gastric operations must than males (21 females and 14 males). The following be considered. -
En 17-Chilaiditi™S Syndrome.P65
Nagem RG et al. SíndromeRELATO de Chilaiditi: DE CASO relato • CASE de caso REPORT Síndrome de Chilaiditi: relato de caso* Chilaiditi’s syndrome: a case report Rachid Guimarães Nagem1, Henrique Leite Freitas2 Resumo Os autores apresentam um caso de síndrome de Chilaiditi em uma mulher de 56 anos de idade. Mesmo tratando-se de condição benigna com rara indicação cirúrgica, reveste-se de grande importância pela implicação de urgência operatória que representa o diagnóstico equivocado de pneumoperitônio nesses pacientes. É realizada revisão da li- teratura, com ênfase na fisiopatologia, propedêutica e tratamento desta entidade. Unitermos: Síndrome de Chilaiditi; Sinal de Chilaiditi; Abdome agudo; Pneumoperitônio; Espaço hepatodiafragmático. Abstract The authors report a case of Chilaiditi’s syndrome in a 56-year-old woman. Although this is a benign condition with rare surgical indication, it has great importance for implying surgical emergency in cases where such condition is equivocally diagnosed as pneumoperitoneum. A literature review is performed with emphasis on pathophysiology, diagnostic work- up and treatment of this entity. Keywords: Chilaiditi’s syndrome; Chilaiditi’s sign; Acute abdomen; Pneumoperitoneum; Hepatodiaphragmatic space. Nagem RG, Freitas HL. Síndrome de Chilaiditi: relato de caso. Radiol Bras. 2011 Set/Out;44(5):333–335. INTRODUÇÃO RELATO DO CASO tricos, com pressão arterial de 130 × 90 mmHg. Abdome tenso, doloroso, sem irri- Denomina-se síndrome de Chilaiditi a Paciente do sexo feminino, 56 anos de tação peritoneal, com ruídos hidroaéreos interposição temporária ou permanente do idade, foi admitida na unidade de atendi- preservados. De imediato, foram solicita- cólon ou intestino delgado no espaço he- mento imediato com quadro de dor abdo- dos os seguintes exames: amilase: 94; PCR: patodiafragmático, causando sintomas. -
Belching Or Eructation
www.AuroraBayCare.com Belching or Eructation Why do I belch excessively? • Avoid carbonated beverages, such as soda, Eructation, or “belching,” is considered “the sparkling juice or water, and beer. voiding of gas or small quantity of acid fluid from • Avoid chewing gum – it increases the amount of the stomach through the mouth.” Aerophagia is the air you swallow. act of swallowing air, which can cause you to • Avoid smoking – this also increases air swallowed. belch. You may swallow large amounts of air with • Talk to your doctor about nonprescription your food, especially if you eat or drink quickly. medicines, such as antacids with simethicone and Some people have a nervous habit of swallowing activated charcoal, which may help to reduce air all day, especially in times of stress. Swallowing your symptoms. air significantly increases with anxiety. Often, • Ask your doctor about trying digestive enzymes, aerophagia is a learned process of sucking air into such as lactase supplements, which can help the esophagus (foodpipe) while breathing, but is digest carbohydrates and may allow you to eat done subconsciously. If you are in an upright foods that normally cause gas. position, swallowed air may pass back up from your stomach and be released through your mouth Foods that may cause excessive gas in a belch. However, each time you belch, you • Dairy products (except yogurt) swallow more air, so the belching is likely to • Vegetables, such as brown beans, cauliflower, continue. When you lie down, the air may instead peas, Brussels sprouts, cabbage, mushrooms, pass through the intestines and rectum, and out tomatoes and onions the anus. -
Association of Oral Anticoagulants and Proton Pump Inhibitor Cotherapy with Hospitalization for Upper Gastrointestinal Tract Bleeding
Supplementary Online Content Ray WA, Chung CP, Murray KT, et al. Association of oral anticoagulants and proton pump inhibitor cotherapy with hospitalization for upper gastrointestinal tract bleeding. JAMA. doi:10.1001/jama.2018.17242 eAppendix. PPI Co-therapy and Anticoagulant-Related UGI Bleeds This supplementary material has been provided by the authors to give readers additional information about their work. Downloaded From: https://jamanetwork.com/ on 10/02/2021 Appendix: PPI Co-therapy and Anticoagulant-Related UGI Bleeds Table 1A Exclusions: end-stage renal disease Diagnosis or procedure code for dialysis or end-stage renal disease outside of the hospital 28521 – anemia in ckd 5855 – Stage V , ckd 5856 – end stage renal disease V451 – Renal dialysis status V560 – Extracorporeal dialysis V561 – fitting & adjustment of extracorporeal dialysis catheter 99673 – complications due to renal dialysis CPT-4 Procedure Codes 36825 arteriovenous fistula autogenous gr 36830 creation of arteriovenous fistula; 36831 thrombectomy, arteriovenous fistula without revision, autogenous or 36832 revision of an arteriovenous fistula, with or without thrombectomy, 36833 revision, arteriovenous fistula; with thrombectomy, autogenous or nonaut 36834 plastic repair of arteriovenous aneurysm (separate procedure) 36835 insertion of thomas shunt 36838 distal revascularization & interval ligation, upper extremity 36840 insertion mandril 36845 anastomosis mandril 36860 cannula declotting; 36861 cannula declotting; 36870 thrombectomy, percutaneous, arteriovenous -
374 Part 876—Gastroenterology
§ 874.5550 21 CFR Ch. I (4–1–08 Edition) Drug Administration on or before July subpart E of part 807 of this chapter 13, 1999 for any tongs antichoke device subject to § 874.9. that was in commercial distribution [51 FR 40389, Nov. 6, 1986, as amended at 65 before May 28, 1976, or that has, on or FR 2316, Jan. 14, 2000] before July 13, 1999, been found to be substantially equivalent to a tongs antichoke device that was in commer- PART 876—GASTROENTEROLOGY- cial distribution before May 28, 1976. UROLOGY DEVICES Any other tongs antichoke device shall have an approved PMA or declared Subpart A—General Provisions completed PDP in effect before being Sec. placed in commercial distribution. 876.1 Scope. 876.3 Effective dates of requirement for pre- [51 FR 40389, Nov. 6, 1986, as amended at 64 market approval. FR 18329, Apr. 14, 1999] 876.9 Limitations of exemptions from sec- tion 510(k) of the Federal Food, Drug, § 874.5550 Powered nasal irrigator. and Cosmetic Act (the act). (a) Identification. A powered nasal irrigator is an AC-powered device in- Subpart B—Diagnostic Devices tended to wash the nasal cavity by 876.1075 Gastroenterology-urology biopsy means of a pressure-controlled pul- instrument. sating stream of water. The device con- 876.1300 Ingestible telemetric gastro- sists of a control unit and pump con- intestinal capsule imaging system. nected to a spray tube and nozzle. 876.1400 Stomach pH electrode. (b) Classification. Class I (general con- 876.1500 Endoscope and accessories. trols). The device is exempt from the 876.1620 Urodynamics measurement system. -
Abdominal Pain
10 Abdominal Pain Adrian Miranda Acute abdominal pain is usually a self-limiting, benign condition that irritation, and lateralizes to one of four quadrants. Because of the is commonly caused by gastroenteritis, constipation, or a viral illness. relative localization of the noxious stimulation to the underlying The challenge is to identify children who require immediate evaluation peritoneum and the more anatomically specific and unilateral inner- for potentially life-threatening conditions. Chronic abdominal pain is vation (peripheral-nonautonomic nerves) of the peritoneum, it is also a common complaint in pediatric practices, as it comprises 2-4% usually easier to identify the precise anatomic location that is produc- of pediatric visits. At least 20% of children seek attention for chronic ing parietal pain (Fig. 10.2). abdominal pain by the age of 15 years. Up to 28% of children complain of abdominal pain at least once per week and only 2% seek medical ACUTE ABDOMINAL PAIN attention. The primary care physician, pediatrician, emergency physi- cian, and surgeon must be able to distinguish serious and potentially The clinician evaluating the child with abdominal pain of acute onset life-threatening diseases from more benign problems (Table 10.1). must decide quickly whether the child has a “surgical abdomen” (a Abdominal pain may be a single acute event (Tables 10.2 and 10.3), a serious medical problem necessitating treatment and admission to the recurring acute problem (as in abdominal migraine), or a chronic hospital) or a process that can be managed on an outpatient basis. problem (Table 10.4). The differential diagnosis is lengthy, differs from Even though surgical diagnoses are fewer than 10% of all causes of that in adults, and varies by age group. -
Massive Pneumoperitoneum Presenting As an Incidental Finding
Open Access Case Report DOI: 10.7759/cureus.2787 Massive Pneumoperitoneum Presenting as an Incidental Finding Harry Wang 1 , Vivek Batra 2 1. Internal Medicine, Thomas Jefferson University Hospitals, Philadelphia, USA 2. Medical Oncology, Thomas Jefferson University Hospital, Philadelphia, USA Corresponding author: Harry Wang, [email protected] Abstract Pneumoperitoneum is often associated with surgical complications or intra-abdominal sepsis. While commonly deemed a surgical emergency, pneumoperitoneum in a minority of cases does not involve a viscus perforation or require urgent surgical management; these cases of “spontaneous pneumoperitoneum” can stem from a variety of etiologies. We report a case of a 72-year-old African American male with a history of metastatic pancreatic adenocarcinoma who presented with new-onset abdominal distention and an incidentally discovered massive pneumoperitoneum with no clear source of perforation on surveillance imaging. His exam was non-peritonitic, so no surgical intervention was recommended. He was treated with bowel rest, intravenous antibiotics, and hydration. He had a relatively benign clinical course with preserved gastrointestinal function and had complete resolution of his pneumoperitoneum on imaging two months after discharge. This case highlights the importance of considering non-surgical causes of pneumoperitoneum, as well as conservative management, when approaching patients with otherwise benign abdominal exams. Categories: Internal Medicine, Gastroenterology, Oncology Keywords: spontaneous pneumoperitoneum, pneumoperitoneum, pancreatic cancer, incidental finding Introduction Pneumoperitoneum is defined as the presence of free air within the peritoneal cavity. In the vast majority of cases (approximately 90%), this is a result of an intra-abdominal viscus perforation, often requiring intravenous antibiotics and acute surgical intervention [1].