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[PMID]:29190055
[Au] Autor:Punkkinen J; Haak R; Kaartinen M; Walamies M
[Ti] Título:Help from habit reversal for supragastric belching.
[So] Source:Duodecim;132(22):2073-9, 2016.
[Is] ISSN:0012-7183
[Cp] País de publicação:Finland
[La] Idioma:eng
[Ab] Resumo:Supragastric belching differs from common gastric belching. It can be detected by 24-hour intra-esophageal impedance monitoring. Belching is seldom the only symptom: reflux symptom is present in 95% and dysphagia in 65% of the patients. In supragastric belching, the air does not come from the stomach but instead from the esophagus. Belching is caused by the patient him/herself swallowing air into the esophagus. This voluntary but unconscious symptom is treated by therapy in which explaining the mechanism of belching for the patient and learning of correct diaphragmatic breathing technique play a central role. Habit reversal is utilized for teaching the patient to react correctly to preemptive symptoms.
[Mh] Termos MeSH primário: Aerofagia/prevenção & controle
Eructação/prevenção & controle
Hábitos
[Mh] Termos MeSH secundário: Aerofagia/complicações
Aerofagia/fisiopatologia
Impedância Elétrica
Eructação/etiologia
Eructação/fisiopatologia
Esôfago/fisiopatologia
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE


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[PMID]:28619729
[Au] Autor:Lang IM; Medda BK; Shaker R
[Ad] Endereço:Medical College of Wisconsin Dysphagia Institute, Division of Gastroenterology and Hepatology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin imlang@mcw.edu.
[Ti] Título:Characterization and mechanisms of the supragastric belch in the cat.
[So] Source:Am J Physiol Gastrointest Liver Physiol;313(3):G220-G229, 2017 Sep 01.
[Is] ISSN:1522-1547
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:A response in which a belch occurs without gastric involvement, i.e., the supragastric belch (SGB), has been characterized in humans. The aims of this study were to determine whether animals have an SGB and, if so, to determine its mechanisms. Studies were conducted in decerebrate cats ( = 30) with electromyographic electrodes on hyoid, pharyngeal, esophageal, and diaphragm muscles. The effects of distending different regions of the esophagus in different manners using a balloon were quantified to determine the most appropriate stimulus for activating the cat SGB. The effects of esophageal perfusion of lidocaine ( = 3), vagus nerve transection ( = 3), or esophageal acidification ( = 5) on activation of the SGB were determined. Rapid large distensions of the thoracic esophagus best activated responses similar to the human SGB, i.e., rapid inhalation followed by a belch. The rapid inhalation was associated with activation of hiatal fibers and the belch with activation of dome fibers of the diaphragm. The rapid inhalation response was independent of the belch response. Lidocaine perfusion of the esophagus blocked the belch response without blocking the rapid inhalation, HCl perfusion sensitized the esophagus to activation of both the rapid inhalation and the belch response, and vagotomy blocked both responses. We conclude that the cat has an SGB that is composed of two independent reflex responses, i.e., rapid inhalation and belch, that are mediated by the vagus nerves and tension/mucosal receptors of the esophagus and sensitized by esophageal acid exposure. We hypothesize that the SGB is a learned voluntarily activated reflex response. Rapid strong distension of the thoracic esophagus activates rapid inhalation followed by a belch, which is the sequence of responses that compose the human supragastric belch (SGB). The rapid inhalation and belch phases of the cat SGB are activated by hiatal and dome fibers of the diaphragm, respectively, and are mediated by the vagus nerves and tension/mucosal receptors of the esophagus and sensitized by esophageal acid exposure. There are many similarities between the cat and human SGB.
[Mh] Termos MeSH primário: Gatos/fisiologia
Eructação/veterinária
Esôfago/fisiologia
[Mh] Termos MeSH secundário: Anestésicos Locais/farmacologia
Animais
Eructação/fisiopatologia
Esôfago/efeitos dos fármacos
Ácido Clorídrico
Concentração de Íons de Hidrogênio
Lidocaína/farmacologia
Vagotomia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anesthetics, Local); 98PI200987 (Lidocaine); QTT17582CB (Hydrochloric Acid)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171005
[Lr] Data última revisão:
171005
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170617
[St] Status:MEDLINE
[do] DOI:10.1152/ajpgi.00142.2017


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[PMID]:28132542
[Au] Autor:Turi-Kováts N; Arabadzisz H; Zsoldos A; Tomcsányi J
[Ad] Endereço:Kardiológia, Budai Irgalmasrendi Kórház Budapest, Árpád fejedelem u. 7., 1023.
[Ti] Título:[Atypical complaint in myocardial ischaemia: belching].
[Ti] Título:Atípusos panasz myocardialis ischaemiában: böfögés..
[So] Source:Orv Hetil;158(5):183-186, 2017 Feb.
[Is] ISSN:0030-6002
[Cp] País de publicação:Hungary
[La] Idioma:hun
[Ab] Resumo:While educating non-medical personnel on acute coronary syndrome we often emphasize the importance of early recognition and urgent transfer to acute cardiac center of patients with acute myocardial infarction. Aside from typical symptoms of chest tightness and pain radiating to shoulder, arm and jaw, angina often presents with atypical, non-cardiac complaints. These symptoms, often suggesting gastrointestinal problems, can sometimes mislead even the most experienced physicians. We would like to present the case of an 83-year-old woman with several decades long history of ischaemic heart disease, who recently developed a new anginal symptom: lound, uncontrollable belching. Within the past eight months she was admitted four times with complaints of belching followed by chest pain. Even though initially it was thought as an incidental finding, in all four cases she had proven coronary occlusion requiring cardiac intervention. Orv. Hetil., 2017, 158(5), 183-186.
[Mh] Termos MeSH primário: Oclusão Coronária/diagnóstico
Eructação/etiologia
[Mh] Termos MeSH secundário: Idoso de 80 Anos ou mais
Dor no Peito/etiologia
Oclusão Coronária/complicações
Feminino
Seres Humanos
Refluxo Laringofaríngeo/etiologia
Infarto do Miocárdio/diagnóstico
Fatores de Risco
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170803
[Lr] Data última revisão:
170803
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170131
[St] Status:MEDLINE
[do] DOI:10.1556/650.2017.30636


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Registro de Ensaios Clínicos
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[PMID]:28112426
[Au] Autor:Tan VP; Liu KS; Lam FY; Hung IF; Yuen MF; Leung WK
[Ad] Endereço:Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong.
[Ti] Título:Randomised clinical trial: rifaximin versus placebo for the treatment of functional dyspepsia.
[So] Source:Aliment Pharmacol Ther;45(6):767-776, 2017 Mar.
[Is] ISSN:1365-2036
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Gut dysbiosis may contribute to pain and bloating in patients with functional gastrointestinal disease. AIMS: To determine if treatment with rifaximin would improve the symptoms of functional dyspepsia in Chinese patients in a double-blinded, randomised, placebo-controlled trial. METHODS: Consecutive subjects with a diagnosis of functional dyspepsia as per the Rome III criteria were randomised to receive rifaximin 400 mg or placebo, all taken three times daily for 2 weeks. The investigators and study subjects were blinded to the treatment allocation. Subjects were followed up for 8 weeks. The primary end point was adequate relief of global dyspeptic symptoms (GDS). Secondary endpoints were relief of individual dyspeptic symptoms. RESULTS: Eighty-six subjects were recruited. At week 8, there were significantly more subjects in the rifaximin than in the placebo group who experienced adequate relief of GDS (78% vs. 52%, P = 0.02). A trend favouring rifaximin group was also noted in the preceding 4 weeks. Rifaximin was also superior to placebo in providing adequate relief of belching and post-prandial fullness/bloating (PPF) in subjects at week 4. Subgroup analysis revealed that female subjects had more significant response to rifaximin treatment (adequate relief of GDS at week 4: 76% vs. 42%, P = 0.006; week 8: 79% vs. 47%, P = 0.008), as well as improvements in their belching and PPF at week 4. The incidences of adverse effects were similar in both groups. CONCLUSIONS: Treatment with 2 weeks of rifaximin led to adequate relief of global dyspeptic symptoms, belching and post-prandial fullness/bloating in subjects with functional dyspepsia. The difference was more marked in females. (clinicaltrials.org NCT01643083).
[Mh] Termos MeSH primário: Dispepsia/tratamento farmacológico
Dispepsia/epidemiologia
Fármacos Gastrointestinais/uso terapêutico
Rifamicinas/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Idoso
Método Duplo-Cego
Dispepsia/diagnóstico
Eructação/diagnóstico
Eructação/tratamento farmacológico
Eructação/epidemiologia
Feminino
Fármacos Gastrointestinais/farmacologia
Hong Kong/epidemiologia
Seres Humanos
Masculino
Meia-Idade
Dor/diagnóstico
Dor/tratamento farmacológico
Dor/epidemiologia
Efeito Placebo
Período Pós-Prandial/efeitos dos fármacos
Período Pós-Prandial/fisiologia
Rifamicinas/farmacologia
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Gastrointestinal Agents); 0 (Rifamycins); L36O5T016N (rifaximin)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170612
[Lr] Data última revisão:
170612
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170124
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1111/apt.13945


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[PMID]:27852385
[Au] Autor:Cheng H; Hu FL; Sheng JQ; An HJ; Xu L; Liu FX; Li Y; Hao Q; Zheng PY; Lu GF; Cao ZQ; Wang YP
[Ad] Endereço:Department of Gastroenterology, Peking University First Hospital, Beijing 100034, China.
[Ti] Título:[Jinghuaweikang capsules combined with furazolidone-based triple or quadruple therapy as the rescue treatment for Helicobacter pylori infection: a multicenter randomized controlled clinical trial].
[So] Source:Zhonghua Yi Xue Za Zhi;96(40):3206-3212, 2016 Nov 01.
[Is] ISSN:0376-2491
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To explore the efficacy of Jinhuaweikang capsules plus furazolidone-based triple or quadruple therapy as the rescue treatment for ( . ) infection. This is a prospective randomized controlled multicenter clinical trial. Patients with chronic gastritis from . infection in whom eradication treatment failed were recruited from 6 hospitals. All patients were divided into 4 groups using stratified randomization: group A1 (PAFJ), receiving pantoprazole 40 mg+ amoxicillin 1 000 mg+ furazolidone 100 mg+ Jinghuaweikang 3 capsules, twice a day for 10 d (d1-10); group A2, PAFJ therapy as in group A1, followed by Jinghuaweikang 3 capsules twice a day for 18 d (d11-28); group B1 (PAFB), receiving pantoprazole 40 mg+ amoxicillin 1 000 mg+ furazolidone 100 mg+ bismuth potassium citrate 220 mg, twice a day for 10 d (d1-10); group B2, PAFB therapy as in group B1, followed by Jinghuaweikang 3 capsules twice a day for 18 d (d11-28). At least 28 days after the end of treatment, all patients underwent C urea breath test for assessment of . eradication. A total of 357 patients, 145 males and 212 females, were recruited, including 90 in group A1, 88 in group A2, 89 in group B1, and 90 in group B2. The eradication rates of . in groups A1 and A2 were 76.1%(67/88)and 79.6%(70/88) in per-protocol (PP) analysis, 74.4%(67/90) and 79.6%(70/88)in intention-to-treat (ITT) analysis; the rates in groups B1 and B2 were as 85.9%(73/85) and 92.1%(81/88) in PP analysis, 82.0%(73/89) and 90.0%(81/90)in ITT analysis. There were statistically significant differences in PP eradication rates among the 4 groups ( =0.020); there was statistically significant difference between groups A1 and B2, and also between groups A2 and B2 ( =0.003, 0.020), but not between groups A1/A2 and B1 ( >0.05), nor between groups B1 and B2 ( >0.05). No statistically significant differences in ITT eradication rates were found among the 4 groups ( >0.05). The improvement of belching and poor appetite for patients in groups A2 and B2 was better than those in groups A1 and B1. The efficacy of Jinghuaweikang capsules plus furazolidone-based quadruple therapy is superior to combination with furazolidone-based triple therapy as the rescue treatment of . and superior to bismuth-containing quadruple therapy. Extending administration of Jinghuaweikang capsules to 28 days may better improve symptoms of indigestion.
[Mh] Termos MeSH primário: Helicobacter pylori
[Mh] Termos MeSH secundário: 2-Piridinilmetilsulfinilbenzimidazóis
Amoxicilina
Antiácidos
Antibacterianos
Bismuto
Testes Respiratórios
Cápsulas
Quimioterapia Combinada
Eructação
Furazolidona
Gastrite
Infecções por Helicobacter
Seres Humanos
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (2-Pyridinylmethylsulfinylbenzimidazoles); 0 (Antacids); 0 (Anti-Bacterial Agents); 0 (Capsules); 5J9CPU3RE0 (Furazolidone); 804826J2HU (Amoxicillin); D8TST4O562 (pantoprazole); U015TT5I8H (Bismuth)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171011
[Lr] Data última revisão:
171011
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161118
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0376-2491.2016.40.002


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[PMID]:27782892
[Au] Autor:Bastürk A; Artan R; Yilmaz A
[Ad] Endereço:Department of Pediatric Gastroenterology, Akdeniz University School of Medicine, Antalya, Turkey. drahmetbasturk@hotmail.com.
[Ti] Título:Efficacy of synbiotic, probiotic, and prebiotic treatments for irritable bowel syndrome in children: A randomized controlled trial.
[So] Source:Turk J Gastroenterol;27(5):439-443, 2016 Sep.
[Is] ISSN:2148-5607
[Cp] País de publicação:Turkey
[La] Idioma:eng
[Ab] Resumo:BACKGROUND/AIMS: Irritable bowel syndrome (IBS) is an important health problem that presents serious social burdens and high costs. Our study investigated the efficacy of synbiotic (Bifidobacterium lactis B94 with inulin), probiotic (B. lactis B94), and prebiotic (inulin) treatment for IBS in a pediatric age group. MATERIAL AND METHODS: This study was randomized, double-blind, controlled, and prospective in design and included 71 children between the ages of 4 and 16 years who were diagnosed with IBS according to the Rome III criteria. The first group received synbiotic treatment [5×109 colony forming units (CFU) of B. lactis B94 and 900 mg inulin]; the second group received probiotic treatment (5×109 CFU B. lactis B94), and the third group received prebiotic treatment (900 mg inulin) twice daily for 4 weeks. RESULTS: Probiotic treatment improved belching-abdominal fullness (p<0.001), bloating after meals (p=0.016), and constipation (p=0.031), and synbiotic treatment improved belching-abdominal fullness (p=<0.001), bloating after meals (p=0.004), constipation (p=0.021), and mucus in the feces (p=0.021). The synbiotic group had a significantly higher percentage of patients with full recovery than the prebiotic group (39.1% vs. 12.5%, p=0.036). CONCLUSION: Administration of synbiotics and probiotics resulted in significant improvements in initial complaints when compared to prebiotics. Additionally, there was a significantly higher number of patients with full recovery from IBS symptoms in the synbiotic group than in the prebiotic group. Therefore, the twice daily administration of synbiotics is suggested for the treatment of children with IBS.
[Mh] Termos MeSH primário: Síndrome do Intestino Irritável/terapia
Prebióticos/administração & dosagem
Probióticos/administração & dosagem
Simbióticos/administração & dosagem
[Mh] Termos MeSH secundário: Adolescente
Bifidobacterium animalis
Criança
Pré-Escolar
Método Duplo-Cego
Eructação/etiologia
Eructação/terapia
Feminino
Flatulência/etiologia
Flatulência/terapia
Seres Humanos
Inulina/administração & dosagem
Síndrome do Intestino Irritável/complicações
Síndrome do Intestino Irritável/microbiologia
Masculino
Estudos Prospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Prebiotics); 9005-80-5 (Inulin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161027
[St] Status:MEDLINE
[do] DOI:10.5152/tjg.2016.16301


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[PMID]:27492915
[Au] Autor:Cotter TG; Gurney M; Loftus CG
[Ad] Endereço:Department of Internal Medicine, Mayo Clinic, Rochester, MN.
[Ti] Título:Gas and Bloating-Controlling Emissions: A Case-Based Review for the Primary Care Provider.
[So] Source:Mayo Clin Proc;91(8):1105-13, 2016 Aug.
[Is] ISSN:1942-5546
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The evaluation of the patient with gas and bloating can be complex and the treatment extremely challenging. In this article, a simplified approach to the history and relevant physical examination is presented and applied in a case-oriented manner, suitable for application in the primary care setting.
[Mh] Termos MeSH primário: Dieta
Eructação
Flatulência
Dilatação Gástrica
Síndrome do Intestino Irritável/complicações
[Mh] Termos MeSH secundário: Dor Abdominal/etiologia
Dor Abdominal/fisiopatologia
Adulto
Aerofagia/complicações
Aerofagia/etiologia
Comorbidade
Constipação Intestinal/complicações
Diagnóstico Diferencial
Dieta/efeitos adversos
Dieta/normas
Endoscopia do Sistema Digestório
Eructação/diagnóstico
Eructação/etiologia
Eructação/terapia
Feminino
Flatulência/diagnóstico
Flatulência/etiologia
Flatulência/terapia
Dilatação Gástrica/diagnóstico
Dilatação Gástrica/etiologia
Dilatação Gástrica/terapia
Gastroparesia/complicações
Gastroparesia/fisiopatologia
Seres Humanos
Síndrome do Intestino Irritável/diagnóstico
Masculino
Anamnese/métodos
Anamnese/normas
Meia-Idade
Distúrbios do Assoalho Pélvico/complicações
Período Pós-Prandial/fisiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170526
[Lr] Data última revisão:
170526
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160806
[St] Status:MEDLINE


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[PMID]:27325223
[Au] Autor:Ravi K; Katzka DA
[Ad] Endereço:Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
[Ti] Título:Esophageal Impedance Monitoring: Clinical Pearls and Pitfalls.
[So] Source:Am J Gastroenterol;111(9):1245-56, 2016 Sep.
[Is] ISSN:1572-0241
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The development of intraluminal esophageal impedance monitoring has improved our ability to detect and measure gastroesophageal reflux without dependence on acid content. This ability to detect previously unrecognized weak or nonacid reflux episodes has had important clinical implications in the diagnosis and management of gastroesophageal reflux disease (GERD). In addition, with the ability to assess bolus transit within the esophageal lumen, impedance monitoring has enhanced the recognition and characterization of esophageal motility disorders in patients with nonobstructive dysphagia. The assessment of the intraluminal movement of gas and liquid has also been proven to be of diagnostic value in conditions such as rumination syndrome and excessive belching. Further, alternative applications of impedance monitoring, such as the measurement of mucosal impedance, have provided novel insights into assessing esophageal mucosal integrity changes as a consequence of inflammatory change. Future applications for esophageal impedance monitoring also hold promise in esophageal conditions other than GERD. However, despite all of the clinical benefits afforded by esophageal impedance monitoring, important clinical and technical shortcomings limit its diagnostic value and must be considered when interpreting study results. Overinterpretation of studies or application of impedance monitoring in patients can have deleterious clinical implications. This review will highlight the clinical benefits and limitations of esophageal impedance monitoring and provide clinical pearls and pitfalls associated with this technology.
[Mh] Termos MeSH primário: Impedância Elétrica
Transtornos da Motilidade Esofágica/diagnóstico
Refluxo Gastroesofágico/diagnóstico
[Mh] Termos MeSH secundário: Transtornos de Deglutição/diagnóstico
Transtornos de Deglutição/fisiopatologia
Eructação/diagnóstico
Eructação/fisiopatologia
Transtornos da Motilidade Esofágica/fisiopatologia
Esôfago/fisiopatologia
Refluxo Gastroesofágico/fisiopatologia
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170620
[Lr] Data última revisão:
170620
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160622
[St] Status:MEDLINE
[do] DOI:10.1038/ajg.2016.256


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[PMID]:27266352
[Au] Autor:Liu ZJ; Wang K; Duan LP; Xia ZW; Xu ZJ; Ge Y; Bao WH
[Ad] Endereço:Department of Gastroenterology, Peking University Third Hospital, Beijing 100191, China.
[Ti] Título:[Comparison of clinical features and high-resolution esophageal motility characteristics between esophagogastric junction outflow obstruction and type â…¡ achalasia patients].
[So] Source:Zhonghua Yi Xue Za Zhi;96(18):1435-40, 2016 May 17.
[Is] ISSN:0376-2491
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:OBJECTIVES: To compare the clinical features and high-resolution esophageal motility-impedance characteristics among esophagogastric junction outflow obstruction (Eoo) patients, type â…¡ achalasia (Ach) patients and healthy controls (Con), in order to explore the values of esophageal high-resolution manometry (HRM) in diagnosis and treatment of Eoo patients. METHODS: Patients with dysphagia were enrolled from December 2011 to December 2014 at the outpatient department of Peking University Third Hospital, so were age-matched healthy volunteers. All the patients with organic obstruction were excluded. All the participants were tested with high-resolution esophageal motility-impedance measurement, the patients were diagnosed as Eoo or Ach according to the Chicago classification criteria. Clinical features and esophageal motility characteristics of Eoo, Ach and Con were analyzed. RESULTS: A total of 23 Eoo, 24 Ach and 20 Con were enrolled, whose gender ratios, average ages and body mass indexes were of no significant differences(all P>0.05). (1) The Eoo group had higher percentage of food reflux[21.7% (5/23) vs 0(0/24), P=0.005]and belching[17.4% (4/23) vs 0 (0/24), P=0.013], but lower percentage of dysphagia[47.8% (11/23) vs 79.2% (19/24), P=0.025]and vomiting[0(0/23) vs 12.5%(3/24), P=0.040]compared with the Ach group, with no significant differences in other symptoms(all P>0.05). Besides, the Eoo group had lower Eckardt scores than the Ach group[1(1, 2) vs 3 (2, 5), P<0.001]. (2) The lower esophageal sphincter (LES) basal pressure-minimum in the Eoo was higher than the Con[(26.73±2.77) vs (17.16±1.76) mmHg, P<0.05]. The mean LES basal pressure; and the LES integrated relaxation pressure (IRP), IRP-maximum, and LES relaxation percentage were significantly different among Eoo, Ach and Con[(19.80±1.25) vs (35.95±2.36), (8.43±0.72) mmHg, both P<0.05; (23.22±2.02) vs (48.37±3.71), (12.32±1.29) mmHg, bothP<0.05; 38.61%±3.10% vs 12.42%±5.66%, 64.00%±3.85%, both P<0.05]. (3) There were significant differences in velocity, amplitude, and duration of esophageal peristaltic wave and intrabolus pressure (all P<0.05) among Eoo, Ach and Con; and failed contraction percentage, panesophageal pressurization percentage, premature contraction percentage, and rapid contraction percentage of Eoo were lower than Ach (all P<0.05) while complete contraction percentage of Eoo was high compared with Ach (P<0.001), but no significant differences between Eoo and Con. (4) The Eoo had significantly less incomplete bolus clearance[0.00% (0.00%, 20.00%) vs 100.00% (90.00%, 100.00%), P<0.001]and shorter bolus transit time[(5.44±0.29) s vs (24.13±1.69) s, P<0.001]than Ach, but there were no significant differences between Eoo and Con in these two indexes[0.00% (0.00%, 20.00%) vs 0.00% (0.00%, 9.75%); (5.44±0.29) s vs (5.30±0.19) s; both P>0.05]. CONCLUSIONS: The clinical manifestations and esophageal HRM characteristics of Eoo appear to be between Ach and Con, which suggests that Eoo may be an early-stage of Ach. Further study of the pathophysiological characteristics of Eoo patients may provide more evidence to elucidate the pathogenesis of achalasia.
[Mh] Termos MeSH primário: Acalasia Esofágica/diagnóstico
Acalasia Esofágica/fisiopatologia
Transtornos da Motilidade Esofágica/diagnóstico
Transtornos da Motilidade Esofágica/fisiopatologia
Junção Esofagogástrica/fisiopatologia
[Mh] Termos MeSH secundário: Índice de Massa Corporal
Eructação
Refluxo Gastroesofágico
Seres Humanos
Manometria
Pacientes Ambulatoriais
Pressão
Vômito
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1610
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160609
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0376-2491.2016.18.010


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[PMID]:27182168
[Au] Autor:Zhang CL; Geng CH; Yang ZW; Li YL; Tong LQ; Gao P; Gao YQ
[Ad] Endereço:Chun-Ling Zhang, Zhi-Wei Yang, Department of Ultrasound, Daqing Oilfield General Hospital, Daqing 163001, Heilongjiang Province, China.
[Ti] Título:Changes in patients' symptoms and gastric emptying after Helicobacter pylori treatment.
[So] Source:World J Gastroenterol;22(18):4585-93, 2016 May 14.
[Is] ISSN:2219-2840
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:AIM: To investigate the changes in clinical symptoms and gastric emptying and their association in functional dyspepsia (FD) patients. METHODS: Seventy FD patients were enrolled and divided into 2 groups Helicobacter pylori (H. pylori)-negative group (28 patients), and H. pylori-positive group (42 patients). Patients in the H. pylori-positive group were further randomly divided into groups: H. pylori-treatment group (21 patients) and conventional treatment group (21 patients). Seventy two healthy subjects were selected as the control group. The proximal and distal stomach area was measured by ultrasound immediately after patients took the test meal, and at 20, 40, 60 and 90 min; then, gastric half-emptying time was calculated. The incidence of symptoms and gastric half-emptying time between the FD and control groups were compared. The H. pylori-negative and conventional treatment groups were given conventional treatment: domperidone 0.6 mg/(kg/d) for 1 mo. The H. pylori-treatment group was given H. pylori eradication treatment + conventional treatment: lansoprazole 30 mg once daily, clarithromycin 0.5 g twice daily and amoxicillin 1.0 g twice daily for 1 wk, then domperidone 0.6 mg/(kg/d) for 1 mo. The incidence of symptoms and gastric emptying were compared between the FD and control groups. The relationship between dyspeptic symptoms and gastric half-emptying time in the FD and control groups were analyzed. Then total symptom scores before and after treatment and gastric half-emptying time were compared among the 3 groups. RESULTS: The incidence of abdominal pain, epigastric burning sensation, abdominal distension, nausea, belching, and early satiety symptoms in the FD group were significantly higher than in the control group (50.0% vs 20.8%; 37.1% vs 12.5%; 78.6% vs 44.4%; 45.7% vs 22.2%; 52.9% vs 15.3%; 57.1% vs 19.4%; all P < 0.05). The gastric half-emptying times of the proximal end, distal end, and the whole stomach in the FD group were slower than in the control group (93.7 ± 26.2 vs 72.0 ± 14.3; 102.2 ± 26.4 vs 87.5 ± 18.2; 102.1 ± 28.6 vs 78.3 ± 14.1; all P < 0.05). Abdominal distension, belching and early satiety had an effect on distal gastric half-emptying time (P < 0.05). Abdominal distension and abdominal pain had an effect on the gastric half-emptying time of the whole stomach (P < 0.05). All were risk factors (odds ratio > 1). The total symptom score of the 3 groups after treatment was lower than before treatment (P < 0.05). Total symptom scores after treatment in the H. pylori-treatment group and H. pylori-negative group were lower than in the conventional treatment group (5.15 ± 2.27 vs 7.02 ± 3.04, 4.93 ± 3.22 vs 7.02 ± 3.04, All P < 0.05). The gastric half-emptying times of the proximal end, distal end, and the whole stomach in the H. pylori-negative and H. pylori-treatment groups were shorter than in the conventional treatment group (P < 0.05). CONCLUSION: FD patients have delayed gastric emptying. H. pylori infection treatment helps to improve symptoms of dyspepsia and is a reasonable choice for treatment in clinical practice.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Antagonistas de Dopamina/uso terapêutico
Dispepsia/tratamento farmacológico
Esvaziamento Gástrico/efeitos dos fármacos
Gastroparesia/tratamento farmacológico
Infecções por Helicobacter/tratamento farmacológico
Helicobacter pylori/efeitos dos fármacos
Inibidores da Bomba de Prótons/uso terapêutico
[Mh] Termos MeSH secundário: Dor Abdominal/tratamento farmacológico
Dor Abdominal/microbiologia
Dor Abdominal/fisiopatologia
Adulto
Distribuição de Qui-Quadrado
Dispepsia/diagnóstico
Dispepsia/microbiologia
Dispepsia/fisiopatologia
Eructação/tratamento farmacológico
Eructação/microbiologia
Eructação/fisiopatologia
Feminino
Gastroparesia/diagnóstico
Gastroparesia/microbiologia
Gastroparesia/fisiopatologia
Infecções por Helicobacter/diagnóstico
Infecções por Helicobacter/microbiologia
Infecções por Helicobacter/fisiopatologia
Helicobacter pylori/patogenicidade
Seres Humanos
Modelos Logísticos
Masculino
Meia-Idade
Náusea/tratamento farmacológico
Náusea/microbiologia
Náusea/fisiopatologia
Razão de Chances
Fatores de Risco
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Dopamine Antagonists); 0 (Proton Pump Inhibitors)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170411
[Lr] Data última revisão:
170411
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160517
[St] Status:MEDLINE
[do] DOI:10.3748/wjg.v22.i18.4585



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