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Dyspepsia (Indigestion)
Indigestion (dydpepsia). Indigestion information - Patient | Patient Page 1 of 5 View this article online at https://patient.info/health/dyspepsia-indigestion Dyspepsia (Indigestion) Dyspepsia (indigestion) is a term which describes pain and sometimes other symptoms which come from your upper gut (the stomach, oesophagus or duodenum). There are various causes (described below). Treatment depends on the likely cause. Understanding digestion Food passes down the gullet (oesophagus) into the stomach. The stomach makes acid which is not essential but helps to digest food. Food then passes gradually into the first part of the small intestine (the duodenum). In the duodenum and the rest of the small intestine, food mixes with chemicals called enzymes. The enzymes come from the pancreas and from cells lining the intestine. The enzymes break down (digest) the food. Digested food is then absorbed into the body from the small intestine. What is dyspepsia? Dyspepsia is a term which includes a group of symptoms that come from a problem in your upper gut. The gut (gastrointestinal tract) is the tube that starts at the mouth and ends at the anus. The upper gut includes the oesophagus, stomach and duodenum. Various conditions cause dyspepsia. The main symptom is usually pain or discomfort in the upper tummy (abdomen). In addition, other symptoms that may develop include: • Bloating. • Belching. • Quickly feeling full after eating. • Feeling sick (nausea). • Being sick (vomiting). Symptoms are often related to eating. Doctors used to include heartburn (a burning sensation felt in the lower chest area) and bitter-tasting liquid coming up into the back of the throat (sometimes called 'waterbrash') as symptoms of dyspepsia. -
Abdominal Pain - Gastroesophageal Reflux Disease
ACS/ASE Medical Student Core Curriculum Abdominal Pain - Gastroesophageal Reflux Disease ABDOMINAL PAIN - GASTROESOPHAGEAL REFLUX DISEASE Epidemiology and Pathophysiology Gastroesophageal reflux disease (GERD) is one of the most commonly encountered benign foregut disorders. Approximately 20-40% of adults in the United States experience chronic GERD symptoms, and these rates are rising rapidly. GERD is the most common gastrointestinal-related disorder that is managed in outpatient primary care clinics. GERD is defined as a condition which develops when stomach contents reflux into the esophagus causing bothersome symptoms and/or complications. Mechanical failure of the antireflux mechanism is considered the cause of GERD. Mechanical failure can be secondary to functional defects of the lower esophageal sphincter or anatomic defects that result from a hiatal or paraesophageal hernia. These defects can include widening of the diaphragmatic hiatus, disturbance of the angle of His, loss of the gastroesophageal flap valve, displacement of lower esophageal sphincter into the chest, and/or failure of the phrenoesophageal membrane. Symptoms, however, can be accentuated by a variety of factors including dietary habits, eating behaviors, obesity, pregnancy, medications, delayed gastric emptying, altered esophageal mucosal resistance, and/or impaired esophageal clearance. Signs and Symptoms Typical GERD symptoms include heartburn, regurgitation, dysphagia, excessive eructation, and epigastric pain. Patients can also present with extra-esophageal symptoms including cough, hoarse voice, sore throat, and/or globus. GERD can present with a wide spectrum of disease severity ranging from mild, intermittent symptoms to severe, daily symptoms with associated esophageal and/or airway damage. For example, severe GERD can contribute to shortness of breath, worsening asthma, and/or recurrent aspiration pneumonia. -
Gastritides: Diagnostic Evaluation of Multifaceted Conditions
Gastritides: Diagnostic Evaluation of Multifaceted Conditions Gregory Y. Lauwers, MD Senior Member H. Lee Moffitt Cancer Center & Research Institute Tampa, FL [email protected] Changing epidemiology of gastritis (Autoimmune) (Chemical Reactive) Vieith M. Bayreuth Clinic data based on 1,333 389 cases Prevalence of Reactive Gastropathy and H. Pylori Gastritis H. Pylori Reactive Gastropathy Maguilnik I. AP&T 2012;36 • Urease activity: Biopsies (CLO-test) breath test • Serology • Stool antigen IF NEGATIVE • Sampling error -- Antibiotic monotherapy (e.g., other infections) • PPI (decreased # of bacteria; shift from antrum to prox. stomach) • Focally Enhanced Gastritis (IBD) Treated H. pylori gastritis H. Heilmannii • Low prevalence • (0.3-0.7% in devped countries) • Household pets • Mild inflammation • H. felis: • severe chronic active gastritis Autoimmune Atrophic Gastritis • Autosomal dominant inheritance • Confined to corpus and fundus • Immune – mediated injury (autoantibodies) – Loss of parietal cells – Gland atrophy – Metaplasia: pseudopyloric and intestinal types Autoimmune Gastritis SYN Treponema pallidum NK-Cell enteropathy NK-Cell enteropathy CD3 CD56 Granzyme EBV Gastritis EBV gastritis EBER Russell Body Gastritis IgG Lymphocytic gastritis •0.83% of unselected biopsies •1.7% to 4.5% of inflamed biopsies >25 IELs/ 100 epith cells (N:1-9) AJSP 1999;23. •Pan gastric:76% - Fundus:18% - Antrum:6% LYMPHOCYTIC GASTRITISCD3 • H. pylori: 30-40% [pan gastric or corpus predominant] • Celiac sprue: 26.4-38% [typically antral] • Crohn disease:1.5% • non GSE autoimmune disease: 4% • Neoplasia (gastric cancer; lymphoma):4% • Drugs (Ticlopidine, Ticlid®):1% • HIV • No clinical association in 20-28% of the cases… a seasonal tendency (fall) was noted AJSP 1999;23. Personal data: 346 cases (age range 1-87 years, mean age 51 years). -
Diagnostic Errors in Referrals To
DIAGNOSTIC ERRORS IN REFERRALS TO THE ZAGREB FEVER HOSPITAL VLADIMIR GRAHOVAC Dr med., Head, general practice unit, Gajevo-Jarun and BOZIDAR GAVAZZI Dr med., Head, general practice unit, Savska Cesta Health Centre "Tresnjevka", Zagreb Errare humanum, corrigere philosophicum est THE MOST sensitive indicators are those relating to the quality of work. There are many indices of various degrees of objec- tivity for the evaluation of the quality of the doctor's work. One of them concerning hospital physicians is the degree of agreement between clinical diagnosis and postmortem findings 1. A similar indicator for non-hospital doctors is the degree ofagreement between their referral diagnosis and hospital discharge diagnoses. Since in Yugoslavia there are a great many contradictory opinions of the quality of work of doctors in general, and general practitioners in particular, and since they are often based on impressions and emotions rather than on objective studies, we decided to analyse the degree of agreement between referral diagnoses of the cases sent to the Zagreb fever hospital (hospital for contagious diseases) and the discharge diagnoses of this hospital. Although aware of defi- ciencies of this kind of study which relates only to a single hospital, and a specialized one at that, we decided to use it for the following reasons: 1. The fever hospital is one of the hospitals in which most case histories, in addition to referral diagnoses, contain the name of the physician who referred the patient to the hospital. This makes the subsequent identification possible. 2. Patients are for the most part sent to the fever hospital directly, without any preceding consultation with another doctor specialist or laboratory analysis. -
Short Course 10 Metaplasia in The
0 3: 436-446 Rev Esp Patot 1999; Vol. 32, N © Prous Science, SA. © Sociedad Espajiola de Anatomia Patot6gica Short Course 10 © Sociedad Espafiola de Citologia Metaplasia in the gut Chairperson: NA. Wright, UK. Co-chairpersons: G. Coggi, Italy and C. Cuvelier, Belgium. Overview of gastrointestinal metaplasias only in esophagus but also in the duodenum, intestine, gallbladder and even in the pancreas. Well established is columnar metaplasia J. Stachura of esophageal squamous epithelium. Its association with increased risk of esophageal cancer is widely recognized. Recent develop- Dept. of Pathomorphology, Jagiellonian University ments have suggested, however, that only the intestinal type of Faculty of Medicine, Krakdw, Poland. metaplastic epithelium (classic Barrett’s esophagus) predisposes to cancer. Another field of studies is metaplasia in the short seg- ment at the esophago-cardiac junction, its association with Metaplasia is a reversible change in which one aduit cell type is Helicobacter pylon infection and/or reflux disease and intestinal replaced by another. It is always associated with some abnormal metaplasia in the cardiac and fundic areas. stimulation of tissue growth, tissue regeneration or excessive hor- Studies on gastric mucosa metaplasia could be divided into monal stimulation. Heterotopia, on the other hand, takes place dur- those concerned with pathogenesis and detailed structural/func- ing embryogenesis and is usually supposed not to be associated tional features and those concerned with clinical significance. with tissue damage. Pancreatic acinar cell clusters in pediatric gas- We know now that gastric mucosa may show not only complete tric mucosa form another example of aberrant cell differentiation. and incomplete intestinal metaplasia but also others such as ciliary Metaplasia is usually divided into epithelial and connective tis- and pancreatic metaplasia. -
ROTAVIRAL INFECTION Simple Choice Multiple Choice
ROTAVIRAL INFECTION Simple choice 1. Choose the most receptive age for rotavirus infection: A. Newborns B. Children after 5 years C. Children 6-36 months D. Adults E. Elderly people 2. Select the causative agent that commonly cause viral diarrhea in children: A. Enterovirus B. Herpesvirus C. Coronavirus D. Astrovirus E. Rotavirus 3. Specify the character of the stool in the case of rotavirus infection in children: A. Frequent, poor, with mucus and blood, false calls and tenesmus, B. Liquid, frequent, light, greenish, mucous C. Frequent, aqueous, light, undigested, golden yellow or whitish D. Sanguinolent (with liquid blood), hemolytic-uremic syndrome, toxic shock E. Liquid stools, abdominal pain, followed by asymmetric and hypotonic flaccid paralysis. 4. Choose the etiological diagnosis of rotavirus infection: A. Lumbar puncture B. Biochemical blood test C. Blood culture D. Detection of rotavirus antigen in faces by ELISA E. Collecting the anamnestic of the disease and the objective examination thoroughly 5. Choose the basic treatment of Rotavirus infection in children: A. Antibacterial drugs B. Oral Rehydration C. Probiotics with high content of lacto and bifidobacteria D. Spasmolytics E. Corticosteroids Multiple choice 1. Indicate the main pathogenic mechanisms for rotavirus infection: A. Ulcerative and fibrinous necrotic inflammation in the submucosal and muscular layers of the large intestine B. Disaccharides deficiency C. Disruption of ideal water transport, sodium, and absorption abatement D. Fibrous inflammation of the large intestine mucosa E. Destruction of small intestine epitheliocytes 2. Choose the clinical signs characteristic of rotavirus infection in children: A. Confluent macula-papular rash spread throughout the body B. Acute debut with fever, vomiting, moderate, permanent periumbilical abdominal pain C. -
Non-Hodgkin's Gastrointestinal Lymphoma Presenting As Acute
Cirujano CLINICAL CASE General July-September 2019 Vol. 41, no. 3 / p. 208-216 Non-Hodgkin’s gastrointestinal lymphoma presenting as acute abdomen Linfoma no Hodgkin gastrointestinal presentándose como abdomen agudo CLINICAL CASES Arcenio Luis Vargas-Ávila,* Alan Hernández-Rosas,** José Roldán-Tinoco,*** Levi Alan Guzmán-Peña,*** Julián Vargas-Flores,**** Julio Adán Campos-Badillo,*** CASOS CLÍNICOS Rubén Mena-Maldonado***** Keywords: Lymphoma, small ABSTRACT RESUMEN intestine, hemorrhage, acute abdomen. Non-Hodgkin lymphoma is an uncommon cancer, but El linfoma no Hodgkin es una neoplasia poco común, when it is a primary lymphoma, the gastrointestinal tract pero cuando se trata de un linfoma primario, el tracto Palabras clave: is the most commonly involved and one of the most gastrointestinal es el sitio más comúnmente implicado y Linfoma, intestino common extra-nodal sites. Multiple risk factors have una de las presentaciones extranodales más frecuentes. delgado, hemorragia, been associated. However, its etiology is still unknown. Se han asociado múltiples factores de riesgo; sin embar- abdomen agudo. Nowadays there exist histochemical markers to distinguish go, aún se desconoce su etiología. Actualmente existen different cell types, criteria, and scales to differentiate marcadores histoquímicos que permiten diferenciar los between primary and secondary intestinal lymphomas. distintos tipos celulares así como los criterios y escalas The definitive diagnosis is obtained with a histopathologic para distinguir entre linfomas intestinales primarios y and immunohistochemical study of the extracted surgical secundarios. El diagnóstico definitivo se logra con el piece. Some studies such as endoscopy, CAT scan or estudio histopatológico e inmunohistoquímico de la pieza capsule endoscopy and double balloon enteroscopy have extraída quirúrgica o endoscópicamente. -
Kaplan USMLE Step 2 CK Surgery Lecture Notes2018
USMLE ® • UP-TO-DATE ® STEP 2 CK STEP Updated annually by Kaplan’s all-star faculty STEP2 CK • INTEGRATED Lecture Notes 2018 Notes Lecture Packed with bridges between specialties and basic science Lecture Notes 2018 • TRUSTED Used by thousands of students each year to ace the exam USMLE Surgery Surgery Tell us what you think! Visit kaptest.com/booksfeedback and let us know about your book experience. ISBN: 978-1-5062-2822-8 kaplanmedical.com 9 7 8 1 5 0 6 2 2 8 2 2 8 USMLE® is a joint program of The Federation of State Medical Boards of the United States, Inc. and the National Board of Medical Examiners. USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME), neither of which sponsors or endorses this product. 978-1-5062-2822-8_USMLE_Step2_CK_Surgery_Course_CVR.indd 1 6/21/17 10:58 AM ® STEP 2 CK Lecture Notes 2018 USMLE Surgery USMLE® is a joint program of The Federation of State Medical Boards of the United States, Inc. and the National Board of Medical Examiners. S2 Surgery.indb 1 6/20/17 9:15 AM USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME), neither of which sponsors or endorses this product. This publication is designed to provide accurate information in regard to the subject matter covered as of its publication date, with the understanding that knowledge and best practice constantly evolve. The publisher is not engaged in rendering medical, legal, accounting, or other professional service. -
Gastritis - Symptoms and Causes - Mayo Clinic Visited 11/22/2019
Gastritis - Symptoms and causes - Mayo Clinic Visited 11/22/2019 Request an Appointment Find a Doctor MENU Find a Job Give Now Log in to Patient Account English Patient Care & Health Information Diseases & Conditions Request an Gastritis Appointment Symptoms & causes Diagnosis & treatment Doctors & departments Overview Print Advertisement Gastritis is a general term for a group Mayo Clinic does not endorse companies or of conditions with one thing in common: products. Advertising revenue supports our not- inflammation of the lining of the for-profit mission. stomach. The inflammation of gastritis Advertising & Sponsorship is most often the result of infection with Policy Opportunities Ad Choices the same bacterium that causes most stomach ulcers. Regular use of certain Stomach and pain relievers and drinking too much pyloric valve Mayo Clinic Marketplace alcohol also can contribute to gastritis. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic. Gastritis may occur suddenly (acute gastritis), or appear slowly over time (chronic gastritis). In some cases, gastritis NEW – Guide to Fibromyalgia can lead to ulcers and an increased risk of stomach cancer. Instant access – Mayo Clinic Health Letter For most people, however, gastritis isn't serious and improves quickly with treatment. Diabetes? This diet works … Stop osteoporosis in its tracks The Mayo Clinic Diet Online Products & Services Book: Mayo Clinic on Digestive Health https://www.mayoclinic.org/diseases-conditions/gastritis/symptoms-causes/syc-20355807[11/22/2019 4:16:25 PM] Gastritis - Symptoms and causes - Mayo Clinic Visited 11/22/2019 Symptoms The signs and symptoms of gastritis include: Gnawing or burning ache or pain (indigestion) in your upper abdomen that may become either worse or better with eating Nausea Vomiting A feeling of fullness in your upper abdomen after eating Gastritis doesn't always cause signs and symptoms. -
A 51-Year-Old Man with Gastric Cancer and Lung Nodules
T h e new england journal o f medicine case records of the massachusetts general hospital Founded by Richard C. Cabot Nancy Lee Harris, m.d., Editor Eric S. Rosenberg, m.d., Associate Editor Jo-Anne O. Shepard, m.d., Associate Editor Alice M. Cort, m.d., Associate Editor Sally H. Ebeling, Assistant Editor Christine C. Peters, Assistant Editor Case 29-2007: A 51-Year-Old Man with Gastric Cancer and Lung Nodules Edward T. Ryan, M.D., Suzanne L. Aquino, M.D., and Richard L. Kradin, M.D. Presentation of Case Dr. Allison L. McDonough (Internal Medicine): A 51-year-old man with a history of From the Division of Infectious Disease gastric cancer was admitted to the hospital because of a new pulmonary lesion. (E.T.R.) and the Departments of Radiology (S.L.A.) and Pathology (R.L.K.), Massa- The patient had been in good health until approximately 5 years before admis- chusetts General Hospital; and the De- sion, when he had a decreased appetite and epigastric discomfort; evaluation at partments of Medicine (E.T.R.), Radiology another facility revealed a hiatal hernia, gastroesophageal reflux, and a duodenal (S.L.A.), and Pathology (R.L.K.), Harvard Medical School. ulcer. Testing for Helicobacter pylori was positive. Omeprazole and metoclopramide were administered, and the hiatal hernia was surgically repaired. Pain, persistent N Engl J Med 2007;357:1239-46. gastroesophageal reflux, and weight loss developed approximately 2.5 years before Copyright © 2007 Massachusetts Medical Society. admission. A primary care physician at this hospital prescribed combination therapy (lansoprazole, amoxicillin, and clarithromycin) for 2 weeks to treat the H. -
Association of Helicobacter Pylori Infection and Chronic Atrophic
www.impactjournals.com/oncotarget/ Oncotarget, Vol. 7, No. 13 Association of helicobacter pylori infection and chronic atrophic gastritis with risk of colonic, pancreatic and gastric cancer: A ten-year follow-up of the ESTHER cohort study Xin-Zu Chen1,2,*, Ben Schöttker2,*, Felipe Andres Castro2, Hongda Chen2, Yan Zhang2, Bernd Holleczek2,3, Hermann Brenner2,4 1Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China 2Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany 3Saarland Cancer Registry, Saarbrücken, Germany 4German Cancer Consortium (DKTK), Heidelberg, Germany *These authors contributed equally to this work Correspondence to: Hermann Brenner, e-mail: [email protected] Keywords: helicobacter pylori, chronic atrophic gastritis, colon cancer, pancreatic cancer, gastric cancer Received: November 21, 2015 Accepted: February 09, 2016 Published: March 06, 2016 ABSTRACT Objectives: To assess the association of H. pylori and chronic atrophic gastritis (AG) with colonic, pancreatic and gastric cancer in a population-based prospective cohort. Methods: Serum antibodies against H. pylori in general and specific to cytotoxin- associated gene A (CagA), as well as serum pepsinogen I and II were analyzed in 9,506 men and women, aged 50–75 years in a cohort study from Saarland, Germany. Incident cases of colonic, pancreatic and gastric cancer were ascertained by record linkage with data from the Saarland Cancer Registry. Results: During an average follow-up of 10.6 years, 108 colonic, 46 pancreatic and 27 gastric incident cancers were recorded. There was no association between H. pylori infection and colonic cancer (HR = 1.07; 95% CI 0.73–1.56) or pancreatic cancer (HR = 1.32; 0.73–2.39), regardless of either CagA seropositivity or AG status. -
Tumours of the Stomach Seen in Distal Disease, Whereas Diffuse Cancers Are Poorly Differentiated and Seen in Cardia Cancers
OESOPHAGUS AND STOMACH Intestinal cancers are usually well differentiated and more often Tumours of the stomach seen in distal disease, whereas diffuse cancers are poorly differentiated and seen in cardia cancers. Metastatic spread is by William H Allum direct infiltration, via lymphatics to regional and distant lymph nodes, haematogenous and transcoelomic, spreading throughout body cavities. Nodal status is based on the Japanese classification Abstract of lymph node drainage, which is divided into three tiers that are e Gastric tumours are either epithelial or stromal in origin. Benign tumours related to the principal arterial supply to the stomach (N1 3, are rare with the majority being malignant and mostly adenocarcinomas. Table 2). Classification of nodal stage has been modified Gastric lymphomas, gastrointestinal stromal tumours (GISTs) and gastric according to the number of nodes involved in relation to the carcinoid are less common and have variable cancer biology. Gastric number of nodes resected. The TNM classification has recently e adenocarcinoma is the eighth-commonest cancer in the UK. Proximally been revised TNM 7. In the revision oesophageal cancer situated cancers are most frequent. It is characterized by late presentation includes all cancers within 5 cm of the squamo-columnar junc- with 80% of patients presenting with locally advanced or distant meta- tion. All other cancers are classified as gastric. This is a pathological static disease. Recognition of early gastric cancer remains a challenge classification which has been recommended for implementation by in low-incidence areas. Improvements in imaging techniques have allowed more individualized, tailored and stage-related treatments. Outcome in localized cancers has improved with multi-modality therapies yet overall survival remains poor.