Bailliere's clinical gastroenterology最新文献_第3页

2 Prevalence, incidence and natural history of dyspepsia and functional dyspepsia 2消化不良和功能性消化不良的患病率、发病率及自然病史

Bailliere's clinical gastroenterology Pub Date : 1998-09-01 DOI: 10.1016/S0950-3528(98)90016-1

G. Richard Locke III MD (Consultant in Gastroenterology Health)

引用次数: 66

6 Role of gastric acid in the aetiology of dyspeptic disease and dyspepsia 胃酸在消化不良疾病和消化不良病因学中的作用

Bailliere's clinical gastroenterology Pub Date : 1998-09-01 DOI: 10.1016/S0950-3528(98)90020-3

Kenneth E.L. McColl MD, FRCP (Professor of Gastroenterology)

引用次数: 13

10 Are psychosocial factors of aetiological importance in functional dyspepsia? 社会心理因素在功能性消化不良的病因学上重要吗?

Bailliere's clinical gastroenterology Pub Date : 1998-09-01 DOI: 10.1016/S0950-3528(98)90024-0

Kevin W. Olden MD (Assistant Professor of Medicine Psychiatry)

引用次数: 12

12 How should new-onset dyspepsia be managed in general and specialist practice? 在一般和专科实践中如何管理新发消化不良?

Bailliere's clinical gastroenterology Pub Date : 1998-09-01 DOI: 10.1016/S0950-3528(98)90026-4

Peter Bytzer MD, PhD (Consultant)

引用次数: 4

1 Nomenclature of dyspepsia, dyspepsia subgroups and functional dyspepsia: Clarifying the concepts 1消化不良、消化不良亚群和功能性消化不良的命名:澄清概念

Bailliere's clinical gastroenterology Pub Date : 1998-09-01 DOI: 10.1016/S0950-3528(98)90015-X

Gerald Holtmann MD (Consultant in Internal Medicine Gastroenterology), Vincenzo Stanghellini MD, Nicholas J. Talley MD, PhD (Professor of Medicine)

{"title":"1 Nomenclature of dyspepsia, dyspepsia subgroups and functional dyspepsia: Clarifying the concepts","authors":"Gerald Holtmann MD (Consultant in Internal Medicine Gastroenterology), Vincenzo Stanghellini MD, Nicholas J. Talley MD, PhD (Professor of Medicine)","doi":"10.1016/S0950-3528(98)90015-X","DOIUrl":"10.1016/S0950-3528(98)90015-X","url":null,"abstract":"<div><p>There is international agreement that dyspepsia refers to pain or discomfort centred in the upper abdomen. However, the term ‘discomfort’ has been variably defined. While other symptoms may often be simultaneously present, gastro-oesophageal reflux disease can usually be clearly distinguished by the presence of predominant heartburn. Dyspepsia is a frequent reason for consultation in primary care and in gastrointestinal practice. With the widespread availability and utilization of endoscopy, it has become evident that a structural (or organic) explanation is found in only a minority of patients presenting with dyspepsia. Operationally, functional dyspepsia is defined as persistent or recurrent dyspepsia for 3 or more months in the absence of a clinically identifiable structural disease causing the symptoms. It has been proposed, based on symptoms, that functional dyspepsia be subdivided into symptom subgroups to promote patient homogeneity. The initially proposed ‘clustering’ of symptoms into ulcer-like and dysmotility-like functional dyspepsia has proved a dismal failure because of the considerable overlap observed, the lack of stability over time and the failure to identify robust pathophysiological abnormalities or responses to therapy. A subcategorization based upon the most bothersome symptom is theoretically more attractive but needs to be prospectively and rigorously tested.</p></div>","PeriodicalId":77028,"journal":{"name":"Bailliere's clinical gastroenterology","volume":"12 3","pages":"Pages 417-433"},"PeriodicalIF":0.0,"publicationDate":"1998-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0950-3528(98)90015-X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20797109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 46

8 Relevance of gastrointestinal motor disturbances in functional dyspepsia 胃肠运动障碍与功能性消化不良的相关性

Bailliere's clinical gastroenterology Pub Date : 1998-09-01 DOI: 10.1016/S0950-3528(98)90022-7

Vincenzo Stanghellini MD, Roberto Corinaldesi MD, Cesare Tosetti MD (General Practitioner)

引用次数: 1

9 Gastrointestinal sensory abnormalities in functional dyspepsia 功能性消化不良的胃肠道感觉异常

Bailliere's clinical gastroenterology Pub Date : 1998-09-01 DOI: 10.1016/S0950-3528(98)90023-9

Max J. Schmulson MD (Gastroenterologist), Emeran A. Mayer MD (Professor of Medicine Physiology Head)

{"title":"9 Gastrointestinal sensory abnormalities in functional dyspepsia","authors":"Max J. Schmulson MD (Gastroenterologist), Emeran A. Mayer MD (Professor of Medicine Physiology Head)","doi":"10.1016/S0950-3528(98)90023-9","DOIUrl":"10.1016/S0950-3528(98)90023-9","url":null,"abstract":"<div><p>Symptoms of functional dyspepsia, such as epigastric pain, bloating or early satiety and nausea, are non-specific and are likely to arise from different mechanisms. Current evidence suggests the presence of at least two subgroups: patients who respond to a prolonged course of acid suppression and patients who show a significant overlap of symptoms with other functional gastrointestinal disorders such as irritable bowel syndrome. An enhanced sensitivity of visceral afferent pathways with or without associated autonomic dysregulation appears to play an important role in the aetiology of symptoms in the second group. In the absence of visceral hypersensitivity, neither the slowing of gastric emptying nor the presence of chronic gastritis appears to be sufficient to cause symptoms of functional dyspepsia. The mechanisms and aetiology of visceral hypersensitivity are incompletely understood. An alteration in the interplay between vagal and spinal afferents, and the inadequate activation of antinociceptive systems in response to tissue irritation, may play a role in symptom generation.</p></div>","PeriodicalId":77028,"journal":{"name":"Bailliere's clinical gastroenterology","volume":"12 3","pages":"Pages 545-556"},"PeriodicalIF":0.0,"publicationDate":"1998-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0950-3528(98)90023-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20796383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 18

3 Is functional dyspepsia just a subset of the irritable bowel syndrome? 功能性消化不良只是肠易激综合征的一个子集吗?

Bailliere's clinical gastroenterology Pub Date : 1998-09-01 DOI: 10.1016/S0950-3528(98)90017-3

William E. Whitehead PhD (Chief Gastrointestinal Motility Laboratory), Natalie A. Gibbs PhD (Postdoctoral Research Fellow), Zhiming Li MD, PhD (Research Associate) , Douglas A. Drossman MD (Professor of Medicine Psychiatry)

{"title":"3 Is functional dyspepsia just a subset of the irritable bowel syndrome?","authors":"William E. Whitehead PhD (Chief Gastrointestinal Motility Laboratory), Natalie A. Gibbs PhD (Postdoctoral Research Fellow), Zhiming Li MD, PhD (Research Associate) , Douglas A. Drossman MD (Professor of Medicine Psychiatry)","doi":"10.1016/S0950-3528(98)90017-3","DOIUrl":"10.1016/S0950-3528(98)90017-3","url":null,"abstract":"<div><p>To determine whether functional dyspepsia and irritable bowel syndrome are different entities, epidemiological data, factor analysis studies, physiological data and associated psychological symptoms were reviewed. Between 30% and 60% of patients with either diagnosis also meet the criteria for the other diagnosis, a level greater than expected to occur by chance but not sufficient to infer an identity. Most factor analysis studies identify independent clusters of symptoms corresponding to functional dyspepsia and irritable bowel syndrome. Visceral hypersensitivity is seen throughout the gastrointestinal tract in both disorders, but the motility patterns seen in association with functional dyspepsia (principally antral hypomotility and delayed gastric emptying) differ from the motility patterns seen in irritable bowel syndrome. Psychological symptoms are similar in these two disorders but are not believed to be aetiological for either of them. Thus, based on a factor analysis of gastrointestinal symptoms and differences in intestinal motility, functional dyspepsia and irritable bowel syndrome appear to be different entities.</p></div>","PeriodicalId":77028,"journal":{"name":"Bailliere's clinical gastroenterology","volume":"12 3","pages":"Pages 443-461"},"PeriodicalIF":0.0,"publicationDate":"1998-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0950-3528(98)90017-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20797111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 33

4 Is functional dyspepsia largely explained by gastro-oesophageal reflux disease? 功能性消化不良在很大程度上可以用胃食管反流病来解释吗?

Bailliere's clinical gastroenterology Pub Date : 1998-09-01 DOI: 10.1016/S0950-3528(98)90018-5

John Wayman FRCS (Research Fellow) , S.M. Griffin MD FRCS (Consultant Surgeon Senior Lecturer) , Frederick C. Campbell MD(Hons) FRCS (Professor of Gastroenterological Surgery)

{"title":"4 Is functional dyspepsia largely explained by gastro-oesophageal reflux disease?","authors":"John Wayman FRCS (Research Fellow) , S.M. Griffin MD FRCS (Consultant Surgeon Senior Lecturer) , Frederick C. Campbell MD(Hons) FRCS (Professor of Gastroenterological Surgery)","doi":"10.1016/S0950-3528(98)90018-5","DOIUrl":"10.1016/S0950-3528(98)90018-5","url":null,"abstract":"<div><p>Functional dyspepsia is a chronic disorder of unknown aetiology. The lack of endoscopic abnormalities in patients with this disorder has led many physicians to believe that gastrooesophageal reflux disease may be responsible for most symptoms. Our group has addressed this issue, by pathophysiological studies in a large cohort of Dundee patients with persistent dyspeptic symptoms. Peptic ulcer and gallstones were excluded in all patients by appropriate tests. Ambulatory pH monitoring showed oesophageal acid reflux that lay above the conventional diagnostic threshold in approximately 20% of patients. This subset was diagnosed as having gastro-oesophageal reflux disease.</p><p>In the remainder, moderate or severe reflux-like symptoms were reported by approximately 44% patients, who were categorized as reflux-like functional dyspepsia. Reflux symptoms were mild or absent in 36% patients, who were categorized as non-reflux-like dyspepsia. While oesophageal pH profiles lay within the conventional normal range in both of these functional dyspepsia subgroups, patients with reflux-like functional dyspepsia had significantly greater acid exposure values, including total oesophageal acid exposure time, percentage time at a pH of less than 4.0, DeMeester scores and pain reflux event correlation. Hence patients with reflux-like functional dyspepsia have oesophageal acid exposure that lies below the diagnostic threshold for gastro-oesophageal reflux disease but exceeds that of patients with non-reflux dyspepsia. The high pain/reflux event correlation in reflux-like functional dyspepsia suggests that subthreshold oesophageal acid exposure may be associated with troublesome reflux symptoms.</p></div>","PeriodicalId":77028,"journal":{"name":"Bailliere's clinical gastroenterology","volume":"12 3","pages":"Pages 463-476"},"PeriodicalIF":0.0,"publicationDate":"1998-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0950-3528(98)90018-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20797112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Index 指数

Bailliere's clinical gastroenterology Pub Date : 1998-09-01 DOI: 10.1016/S0950-3528(98)90028-8

引用次数: 0