Xem 1-17 trên 17 kết quả Indigestion
  • Harrison's Internal Medicine Chapter 39. Nausea, Vomiting, and Indigestion Nausea, Vomiting, and Indigestion: Introduction Nausea is the subjective feeling of a need to vomit. Vomiting (emesis) is the oral expulsion of gastrointestinal contents resulting from contractions of gut and thoracoabdominal wall musculature. Vomiting is contrasted with regurgitation, the effortless passage of gastric contents into the mouth. Rumination is the repeated regurgitation of stomach contents, which may be rechewed and reswallowed.

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  • Gastric Motor Dysfunction Disturbed gastric motility is purported to cause acid reflux in some cases of indigestion. Delayed gastric emptying is also found in 25–50% of functional dyspeptics. The relation of these defects to symptom induction is uncertain; many studies show poor correlation between symptom severity and the degree of motor dysfunction. Impaired gastric fundus relaxation after eating may underlie selected dyspeptic symptoms like bloating, nausea, and early satiety.

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  • Differential Diagnosis Nausea and vomiting are caused by conditions within and outside the gut as well as by drugs and circulating toxins (Table 39-1).

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  • Diagnostic Testing For intractable symptoms or an elusive diagnosis, selected diagnostic tests can direct clinical management. Electrolyte replenishment is indicated for hypokalemia or metabolic alkalosis. Detection of iron-deficiency anemia mandates a search for mucosal injury. Pancreaticobiliary disease is indicated by abnormal pancreatic enzymes or liver biochemistries, whereas endocrinologic, rheumatologic, or paraneoplastic etiologies are suggested by specific hormone or serologic testing.

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  • Table 39-3 Alarm Symptoms in GERD Odynophagia Unexplained weight loss Recurrent vomiting Occult or gross gastrointestinal bleeding Jaundice Palpable mass or adenopathy Family history of gastrointestinal malignancy Upper endoscopy is performed as the initial diagnostic test in patients with unexplained dyspepsia who are 55 years old or have alarm factors because of the elevated risks of malignancy and ulcer in these groups.

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  • Disordered gut sensorimotor function also commonly causes nausea and vomiting. Gastroparesis is defined as a delay in emptying of food from the stomach and occurs after vagotomy, with pancreatic adenocarcinoma, with mesenteric vascular insufficiency, or in systemic diseases such as diabetes, scleroderma, and amyloidosis. Idiopathic gastroparesis occurring in the absence of systemic illness may follow a viral prodrome, suggesting an infectious etiology.

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  • Gastrointestinal Motor Stimulants Drugs that stimulate gastric emptying are indicated for gastroparesis (Table 39-2). Metoclopramide, a combined 5-HT4 agonist and D2 antagonist, exhibits efficacy in gastroparesis, but antidopaminergic side effects limit its use in 25% of patients. Erythromycin, a macrolide antibiotic, increases gastroduodenal motility by action on receptors for motilin, an endogenous stimulant of fasting motor activity. Intravenous erythromycin is useful for inpatients with refractory gastroparesis; however, oral forms also have some utility.

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  • Other Causes Alkaline reflux esophagitis produces GERD-like symptoms in patients who have had surgery for peptic ulcer disease. Opportunistic fungal or viral esophageal infections may produce heartburn or chest discomfort but more often cause odynophagia. Other causes of esophageal inflammation include eosinophilic esophagitis and pill esophagitis. Biliary colic is in the differential diagnosis of dyspepsia, but most patients with true biliary colic report discrete episodes of right upper quadrant or epigastric pain rather than chronic burning discomfort, nausea, and bloating.

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  • Helicobacter pylori Eradication H. pylori eradication is clearly indicated only for peptic ulcer and mucosaassociated lymphoid tissue gastric lymphoma. The utility of eradication therapy in functional dyspepsia is less well established

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  • The following chapters were contributions to Health--a monthly magazine published in New York City. Certain peculiarities of form and considerable repetition of statement--both of which the reader cannot fail to notice--are owing to the fact that about two-thirds of the chapters were written under the caption "Auto-genetic Poisons in the Intestinal Canal and their Auto-infection.

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  • Many enzymes are added to grain feeds in order to convert some of the indigestible carbohydrates acting only as dietary fiber to accessible energy sources. AMYLASES and GLYCASES (i.e. xylanase, cellulase, galactanase, mannanase, pectinase).

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  • HAVE you been on many diets? No matter how hard you try, do you always regain the weight you take off? Do you regain even more weight after a diet? Have you tried again and again to lose weight yet can’t seem to achieve satisfying results? Are you puzzled about your extra weight, because you really don’t feel that you overeat? Is it always those last few pounds that cause you to become unbelievably frustrated? Do you have certain health conditions (such as migraines, indigestion, etc.

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  • Or consider what our great grandfathers thought about the mountains, which we now consider so scenic. 4 They were 'monstrous excrescences of nature'. 5 God originally made the world a smooth sphere happily habitable for the original humans; but, alas, humans sinned, and the earth was warped in punishment. Thomas Burnet is repelled by these 'ruines of a broken World', 'wild, vast and indigested heaps of Stones and Earth' that resulted when 'con- fusion came into Nature'. 6 John Donne called them 'warts, and pock-holes in the face of th'earth'. 7 Now we know better.

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  • Indigestionis a nonspecific term that encompasses a variety of upper abdominal complaints including nausea, vomiting, heartburn, regurgitation, and dyspepsia (the presence of symptoms thought to originate in the gastroduodenal region). Some individuals with dyspepsia report predominantly epigastric burning, gnawing discomfort, or pain. Others with dyspepsia experience a constellation of symptoms including postprandial fullness, early satiety (an inability to complete a meal due to premature fullness), bloating, eructation (belching), and anorexia. ...

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  • Catching cold"--Sitting on the floor--Kicking the bedclothes off--Inadequate head covering--Subjecting baby to different temperatures suddenly--Wearing rubbers--Direct infection--Acute nasal catarrh--Acute coryza--Acute rhinitis--"Cold in the head"--"Snuffles"--Treatment of acute nasal catarrh, or rhinitis, or coryza, or "cold in the head," or "snuffles"--Chronic nasal catarrh--Chronic rhinitis--Chronic discharge from the nose--Nervous or persistent cough--Adenoids as a cause of persistent cough--Croup--Acute catarrhal laryngitis--Spasmodic croup--False croup--Tonsilitis--Angina--Sore throa...

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  • A little over 50 years ago, my father had a heart attack. He was driven to the hospital by friends after having “indigestion” for 2 days. He spent 2 weeks as an inpatient on an unmonitored rehabilitation ward and was treated principally with warfarin and digitalis. He was lucky and survived, but in that era, more than 20% of patients with an acute myocardial infarction died.

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  • (BQ) Part 1 book "Gastrointestinal physiology" presents the following contents: Clinical gastrointestinal physiology a systems approach; form and function-the physiological implications of the anatomy of the gastrointestinal system; brain-gut axis and regional gastrointestinal tract motility; gastrointestinal secretion-aids indigestion and absorption.

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