Showing papers on "Bloating published in 1996"
Journal Article•
TL;DR: Patients were enrolled in a double-blind multicentric study carried out in 45 Italian Gastroenterology Departments and levosulpiride was significantly superior to domperidone, metoclopramide and placebo both in the overall clinical improvement scale as well as in a subgroup of symptoms (postprandial bloating, epigastric pain, heartburn).
Abstract: Abnormalities in gastrointestinal motility have been reported in a substantial proportion of patients with functional dyspepsia, supporting the use of prokinetic drugs for treatment of dyspeptic symptoms. To evaluate efficacy and safety of levosulpiride in short-term treatment, 1298 patients were enrolled in a double-blind multicentric study carried out in 45 Italian Gastroenterology Departments. Patients were randomly assigned to either levosulpiride (25 mg tid), domperidone (10 mg tid), metoclopramide (10 mg tid) or placebo (1 tablet tid) for 4 weeks. Patients were selected on the basis of: a) occurrence in the last 4 weeks of at least 5/10 selected symptoms (anorexia, nausea, vomiting, upper abdominal pain, postprandial bloating, abdominal fullness, early satiety, belching, heartburn, regurgitation), severity of which should reach/exceed a total score of 8, as assessed by a specific scale ranging from 0 (absent) to 3 (severe); b) normal results of routine biochemical, ultrasound and endoscopic examinations. In addition, each patient subjectively evaluated efficacy of treatment by a visual analogue scale. Significant improvement was recorded for all symptoms at days 10 and 28 in all groups (p < 0.001), but levosulpiride was significantly (p < 0.01) superior to domperidone, metoclopramide and placebo both in the overall clinical improvement scale as well as in a subgroup of symptoms (postprandial bloating, epigastric pain, heartburn). Active treatments and placebo were comparable as far as concerns occurrence of side-effects (12-20%) including galactorrhoea, breast tenderness and menstrual changes.
55 citations
Journal Article•
TL;DR: A combination of bowel training, dietary management, and regular exercise is the first phase of treatment, followed by other laxatives if needed.
Abstract: Constipation is a common complaint in older patients. Contributing factors are impaired general health, use of medications, and decreased mobility and physical activity. Diet has an indeterminate effect. Many patients become gradually more constipated with age and self-treat with over-the-counter laxatives. Investigation is warranted if defecation is associated with pain or bloating and/or represents a recent change in bowel habit. Although constipation is usually just an annoyance, it can have more serious consequences, such as impaction and ulceration. A combination of bowel training, dietary management, and regular exercise is the first phase of treatment. Bulk laxatives are second-line treatment, followed by other laxatives if needed.
27 citations
Journal Article•
TL;DR: Colorectal motility disorders may present as abdominal pain, diarrhea, constipation and/or fecal incontinence, and if symptoms do not resolve with dietary changes and appropriate medications and the anatomy is normal on lower gastrointestinal studies, colorectAL motility studies may be indicated.
Abstract: A careful history can localize gastrointestinal motility disorders and suggest appropriate diagnostic tests. Dysphagia, odynophagia, heartburn and reflux have esophageal origins. The same symptoms occur in achalasia, a classic motor disorder of the lower esophageal sphincter, which can be diagnosed by barium swallow, endoscopy and esophageal motility studies. Nausea, vomiting, anorexia, bloating and abdominal pain are symptoms of motor disorders of the stomach and small intestine. When these symptoms are accompanied by unexplained right upper quadrant pain, elevated liver enzyme levels and unexplained recurrent pancreatitis, the diagnosis of impaired biliary motility is suggested. Colorectal motility disorders may present as abdominal pain, diarrhea, constipation and/or fecal incontinence. If symptoms do not resolve with dietary changes and appropriate medications and the anatomy is normal on lower gastrointestinal studies, colorectal motility studies may be indicated.
13 citations
TL;DR: When lactose intolerance is limited to the equivalent of 240 ml of milk or less a day, symptoms are likely to be negligible and the use of lactose digestive aids unnecessary.
10 citations
TL;DR: This article found that the severity of dieting was positively associated with frequency of abdominal pain, bloating, diarrhea, and constipation in young women, and the women who reported 3 or more symptoms regularly scored higher on a scale for dieting severity.
Abstract: Young women report symptoms associated with irritable bowel syndrome (IBS), such as pain, bloating, and changes in bowel movements, more often than young men. Young women with eating disorders also report these gastrointestinal symptoms frequently. We hypothesized that if dieting behaviors were associated with these symptoms, the prevalence and frequency of the symptoms would be positively related to dieting severity in young women. We interviewed 301 1st-year college women representing the continuum of dieting severity. We found that severity of dieting was positively related to frequency of abdominal pain, bloating, diarrhea, and constipation, and that the women who reported 3 or more symptoms regularly scored higher on a scale for dieting severity. Although this study did not examine the relationship between dieting severity and clinical IBS, the findings suggested that dieting is associated with gastrointestinal symptoms in young women.
8 citations
Journal Article•
TL;DR: After other disorders have been excluded, treatment should be directed at the predominant symptoms and gauged to their severity.
Abstract: Irritable bowel syndrome is a common disorder with symptom complexes that can include diarrhea, constipation, pain and bloating. After other disorders have been excluded, treatment should be directed at the predominant symptoms and gauged to their severity. A careful balance between a thoughtful investigation and the expense and dangers of overtesting must always be considered. Most patients continue to have persistent symptoms several years after the original diagnosis.
8 citations
TL;DR: On the basis of the clinical evidence, and with a good level of statistical confidence, THDCA can be considered useful in the treatment of dyspeptic disturbances associated with gallstones or other hepatic disorders.
Abstract: In a controlled, randomised, parallel-group, double-blind trial the efficacy and safety of taurohyodeoxycholic acid (THDCA) was compared with another commonly used biliary acid, ursodeoxycholic acid (UDCA), in 100 patients with pain or other dyspeptic disturbances associated with hepatic or biliary disorders. THDCA and the reference drug were administered at 250mg doses twice a day for 2 months. The disturbances evaluated were: right hypochondrium pain, epigastric pain, nausea or vomiting, belching, epigastric bloating, flatulence or meteorism, lipid intolerance, constipation or diarrhoea. The degree of severity of the disturbances was recorded using an arbitrary 4-point scale (0 = absent, 1 = mild, 2 = moderate, 3 = severe), and the total score was calculated as the sum. Dyspeptic symptoms were reduced or completely disappeared in 87.2% of patients treated with THDCA (80.4% in the UDCA-treated group). Statistical analysis (Wilcoxon’s test with a test power higher than 80%) revealed significant differences between the reduction of symptoms obtained in the 2 groups (total score from 8.38 to 2.74 in the THDCA group and from 7.83 to 4.09 in the UDCA group). Adverse effects were reported in only a few patients (4.3% in the THDCA group and 8.7% in the UDCA group), without any statistically significant difference between the 2 groups. On the basis of the clinical evidence, and with a good level of statistical confidence, THDCA can be considered useful in the treatment of dyspeptic disturbances associated with gallstones or other hepatic disorders.
1 citations