OBJECTIVETo investigate the correlation between the pathogeneses of diarrhea-pre- dominant irritable bowel syndrome (D-IBS) complicated functional dyspepsia (FD) patients of Gan-stagnation Pi-deficiency Syndrome (GSPDS) and symptoms, psychological states, and gastrointestinal hormones.

METHODSA total of 111 patients with confirmed D-IBS complicated FD of GSPDS were recruited as the treated group by using Rome III standard and Chinese medical syndrome standard. And 30 healthy volunteers were recruited as the control group. The general condition, scoring for digestive symptoms, and the distribution of GSPDS subtype of all subjects were recorded by a questionnaire, and assessed by Symptom Checklist (SCL-90; a software for psychological test developed by Beijing Huicheng Adult Cor- poration). Meanwhile, plasma levels of 5-hydroxytryptamine (5-HT), somatostatin (SS), vasoactive intestinal peptide (VIP), endothelin (ET), interleukin 10 (IL-10), and interleukin 12 (IL-12) were measured in all subjects.

RESULTS(1) The subtype of D-IBS complicated FD of GSPDS was dominant in Pi-qi deficiency type (51/111,45.9%),Pi yang deficiency type (34/111,30.6%), and GSPDS. There was no statistical difference in the scoring of digestive symptoms among the 3 subtypes (P >0.05). (2) Compared with the control group, the anxiety factor score and the total score significantly increased in all three subtypes of D-IBS complicated FD of GSPDS, and the depression score of Pi yang deficiency type and Gan-depression type also significantly increased (P <0.05, P <0.01); the depression score of Gan-depression type was significantly higher than that of the Pi-qi deficiency type (P <0.01). Plasma 5-HT levels were obviously lower in D-IBS complicated FD patients of GSPDS accompanied with anxiety or depression than in those with no obvious psychological abnormalities, and VIP and IL-10 levels were significantly lower than those in the control group (P <0.05). Plasma VIP levels were also obviously lower in D-IBS complicated FD patients of GSPDS accompanied with anxiety or depression than in those with no obvious psychological abnormalities (P <0.01), and SS levels were significantly lower than those in the control group (P <0.05). There was no statistical difference in plasma ET or IL-12 levels in each patient group, when compared with the control group (P >0.05). (3) Compared with the.control group, plasma 5-HT levels significantly increased, plasma VIP and IL-10 levels significantly decreased in ach subtype of D-IBS complicated FD patients of GSPDS (P <0.05, P <0.01), and no significant change of SS, ET, or IL-12 occurred (P >0.05). Besides, plasma 5-HT levels were significantly higher in Gan-depression type than in Pi yang deficiency type, VIP levels were lower in Gan-depression type than in Pi-qi deficiency type (all P <0.05).

CONCLUSIONSGan stagnation and Pi deficiency were dominant in D-IBS complicated FD patients of GSPDS. Psychological abnormalities, increased plasma 5-HT levels, and decreased plasma VIP levels were closely correlated with Gan stagnation subtype, which provided some reference for looking for objective indicators of Chinese medical syndromes in treating D-IBS complicated FD patients of GSPDS.

Adult ; Case-Control Studies ; Diarrhea ; etiology ; Dyspepsia ; blood ; complications ; psychology ; Gastrointestinal Hormones ; blood ; Humans ; Irritable Bowel Syndrome ; blood ; complications ; psychology ; Psychological Tests ; Qi ; Serotonin ; Surveys and Questionnaires ; Yang Deficiency

Functional dyspepsia is one of the most common gastrointestinal disorders encountered in clinical practice. Functional dyspepsia is currently defined by Rome III criteria as the chronic dyspeptic symptoms (postprandial fullness, early satiety, epigastric pain or burning) in the absence of underling structural or metabolic disease that readily explain the symptoms. According to the Rome III consensus, functional dyspepsia can be subdivided into postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS). Although the Rome III criteria have been published more than 8 years ago, not much effort has been put into validating these criteria and direct scientific evidence supporting the validity of the subdividing functional dyspepsia into PDS and EPS are lacking. This article is intended to review the validity of the Rome III criteria on the subdivisions of functional dyspepsia, i.e. PDS and EPS. The impact of sleep disorder, Helicobacter pylori-associated dyspepsia, and the emerging drug therapies in functional dyspepsia will also be discussed in this article.
Anti-Anxiety Agents/therapeutic use ; Diagnosis, Differential ; Dyspepsia/complications/*diagnosis/drug therapy ; Gastrointestinal Agents/therapeutic use ; Helicobacter Infections/complications/diagnosis ; Humans ; Serotonin Receptor Agonists/therapeutic use ; Severity of Illness Index ; Sleep Wake Disorders/etiology

BACKGROUND/AIMS: Gastroesophageal reflux disease (GERD), functional dyspepsia (FD), and peptic ulcer disease (PUD) impact the daily lives of affected individuals. The aim of this study was to compare the risk factors and impacts on life quality of overlapping FD or PUD in patients with GERD. METHODS: Data from patients diagnosed with GERD were collected between January and November 2009. FD was defined using the Rome III diagnostic criteria. The overlapping GERD-FD or GERD-PUD groups were classified as concomitant GERD and FD or peptic ulcers. The characteristics of these individuals were analyzed. RESULTS: There were 63, 48, and 60 patients in the GERD only, overlapping GERD-FD, and overlapping GERD-PUD groups, respectively. Significantly younger age, female gender, lower body weight and body mass index, and higher rates of tea consumption were noted in the GERD-FD group. Patients in the GERD-FD group exhibited the lowest quality of life scores, both with respect to physical and mental health, on the Short Form 36 domains. CONCLUSIONS: Patients with concomitant GERD and FD were more likely to be younger and female. Overlapping GERD and FD had the worst impact on the quality of life of the affected individuals.
Adult ; Age Factors ; Dyspepsia/*complications ; Female ; Gastroesophageal Reflux/*complications ; Humans ; Life Style ; Male ; Middle Aged ; Peptic Ulcer/*complications ; Quality of Life ; Questionnaires ; Risk Factors

OBJECTIVETo observe the therapeutic effect of Modified Banxia Houpo Decoction (MBHD) in treating patients with functional dyspepsia (FD) accompanied with psychological factors, and to compare it with Domperidone, Neurostan, and Domperidone + Neurostan.

METHODSRecruited were 89 FD patients accompanied with anxiety and/or depression, who were randomly assigned to four groups, i.e., the MBHD group (23 cases), the Domperidone group (22 cases), the Neurostan group (22 cases), and the Domperidone + Neurostan group (22 cases). Corresponding medication lasted for4 weeks. The psychological scoring was performed using Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA). The improvement rate of FD symptoms, the ratios of FD symptoms scoring <2, and the improvement rate of FD symptoms >50% were calculated by the scoring of FD symptoms. The gastric emptying rates of patients in each group were compared using the examinations of gastric emptying.

RESULTSThere was no statistical difference in pre-treatment HAMD, HAMA, FD symptoms scoring, and the gastric emptying rate among the 4 groups (P >0.05). The psychological scoring and FD symptoms scoring significantly decreased in the 4 groups except the Domperidone group after 4-week treatment (P<0.01, P <0.05). The psychological scoring and FD symptoms scoring were obviously lower in the MBHD group than in the Domperidone group (P <0.05). The improvement rate of FD symptoms, the ratios of FD symptoms scoring <2, and the improvement rate of FD symptoms >50% were the highest in the Domperidone + Neurostan group, followed by the MBHD group, and then the Domperidone group. After treatment the gastric emptying rate obviously increased in each treatment group when compared with before treatment in the same group (P <0. 01), and there was no statistical difference among these groups after treatment.

CONCLUSIONSMBHD had certain therapeutic effects on FD patients accompanied with psychological factors. Its effect was associated with gastric emptying. Besides, its improvement of the psychological state and symptoms was superior to that of Domperidone.

Adolescent ; Adult ; Anxiety Disorders ; complications ; Depression ; complications ; Domperidone ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Dyspepsia ; complications ; drug therapy ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Treatment Outcome ; Young Adult

PURPOSE: The aim of this study is to evaluate the feasibility and safety of cardia preserving proximal gastrectomy, in early gastric cancer of the upper third. MATERIALS AND METHODS: A total of 10 patients were diagnosed with early gastric cancer of the upper third through endoscopic biopsy. The operation time, length of resection free margin, number of resected lymph nodes and postoperative complications, gastrointestinal symptoms, nutritional status, anastomotic stricture, and recurrence were examined. RESULTS: There were 5 males and 5 females. The mean age was 56.5+/-0.5 years. The mean operation time was 188.5+/-0.5 minutes (laparoscopic operation was 270 minutes). Nine patients were T1 stage (T2 : 1), and N stage was all N0. The mean number of resected lymph nodes was 25.2+/-0.5. The length of proximal resection free margin was 3.1+/-0.1 cm and distal was 3.7+/-0.1 cm. Early complications were surgical site infection (1), bleeding (1), and gastro-esophageal reflux disease (1) (this symptom was improved with medication). Late complications were dyspepsia (3) (this symptom was improved without any treatment), and others were nonspecific results of endoscopy or symptom. CONCLUSIONS: Cardia preserving proximal gastrectomy was feasible for early gastric cancer of the upper third. Further evaluation and prospective research will be required.
Biopsy ; Cardia ; Constriction, Pathologic ; Dyspepsia ; Endoscopy ; Female ; Gastrectomy ; Gastroesophageal Reflux ; Hemorrhage ; Humans ; Lymph Nodes ; Male ; Nutritional Status ; Postoperative Complications ; Recurrence ; Stomach Neoplasms

No abstract available.
Adult ; Cough/etiology ; Diagnosis, Differential ; Dyspepsia/etiology ; Female ; Humans ; Lung/radiography/surgery ; Sarcoidosis, Pulmonary/complications/*radiography/surgery ; Tomography, X-Ray Computed/methods

Follicular dendritic cell sarcoma is a rare neoplasm that originates from follicular dendritic cells in lymphoid follicles. This disease usually involves the lymph nodes, and especially the head and neck area. Rarely, extranodal sites may be affected, including tonsil, the oral cavity, liver, spleen and the gastrointestinal tract. We report here on the imaging findings of follicular dendritic cell sarcoma of the abdomen that involved the retroperitoneal lymph nodes and colon. It shows as a well-defined, enhancing homogenous mass with internal necrosis and regional lymphadenopathy.
Abdomen/ultrasonography ; Abdominal Neoplasms/complications/*radiography/*ultrasonography ; Abdominal Pain/etiology ; Aged ; Colon/radiography/ultrasonography ; Colonic Neoplasms/complications/*radiography/*ultrasonography ; Dendritic Cell Sarcoma, Follicular/complications/*radiography/*ultrasonography ; Dendritic Cells, Follicular/radiography/ultrasonography ; Diagnosis, Differential ; Dyspepsia/etiology ; Female ; Gastrointestinal Hemorrhage/etiology ; Humans ; Lymph Nodes ; Male ; Middle Aged ; Radiography, Abdominal/methods ; Retroperitoneal Space/radiography/ultrasonography ; Tomography, X-Ray Computed/methods

BACKGROUND/AIMS: Gastrointestinal (GI) symptoms are common among patients with non-insulin dependent diabetes mellitus (NIDDM). Our aim was to investigate the frequency of chronic GI symptoms in Korean patients with NIDDM. METHODS: A cross-sectional survey, using a reliable and valid questionnaire, was performed in diabetes clinics from seven hospitals of the Catholic University of Korea. RESULTS: A total of 608 patients (249 males and 359 females, mean age 53.7+/-10.9 years) were investigated. The frequencies of weekly heartburn and acid regurgitation (esophageal symptoms) were 7.1% (95% confidence interval [CI], 5.0 to 9.2) and 4.4% (95% CI, 2.8 to 6.1), respectively. The frequency of dyspepsia was 13.2% (95% CI, 10.5 to 15.8). The frequencies of constipation and diarrhea were 15.0% (95% CI, 12.2 to 18.0) and 5.3% (95% CI, 3.5 to 7.1), respectively. Nausea and the use of manual maneuvers to facilitate defecation were more prevalent in women than in men. Constipation and fecal incontinence were more common in diabetes patients with long duration (>10 years). Fecal incontinence and using laxatives were more frequent in the complicated diabetes group. Using laxatives was more frequent in the uncontrolled diabetes group. CONCLUSIONS: Two-thirds of diabetic patients experienced GI symptoms. The prevalence of GI symptoms was more common in patients who had diabetic complications and a long duration of diabetes.
Adult ; Aged ; Constipation/epidemiology ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/*complications ; Dyspepsia/epidemiology ; Female ; Gastrointestinal Diseases/*epidemiology ; Humans ; Male ; Middle Aged ; Nausea/epidemiology ; Prevalence ; Sex Characteristics ; Vomiting/epidemiology

BACKGROUND/AIMS: Conflicting results have been reported whether patients with non-ulcer dyspepsia (NUD) respond differently to Helicobacter pylori (H. pylori) eradication treatment compared with patients with peptic ulcer diseases (PUD). The aim of this study was to evaluate any difference in H. pylori eradication rates between patients with NUD and PUD according to each proton pump inhibitor (PPI). METHODS: From September, 2004 to April, 2007, we retrospectively reviewed 2,297 patients with NUD (1,050 patients) or PUD (1,247 patients) infected with H. pylori. All patients received a standard 1 week triple therapy comprising of one of the five PPIs (pantoprazole, esomeprazole, omeprazole, lansoprazole, rabeprazole), clarithromycin and amoxicillin. The follow-up H. pylori test was performed 4 weeks after the completion of therapy. RESULTS: There was no significant difference in the eradication rates between the two groups. In comparison of eradication rates according to PPI, omeprazole- based triple therapy group showed higher eradication rate than other groups in patients with NUD, but not in patients with PUD. CONCLUSIONS: This study failed to show any difference in H. pylori eradication rate between patients with NUD and PUD. There is no convincing evidence that the eradication rate may be affected by different PPI.
2-Pyridinylmethylsulfinylbenzimidazoles/therapeutic use ; Adult ; Amoxicillin/administration & dosage ; Anti-Bacterial Agents/administration & dosage ; Anti-Ulcer Agents/administration & dosage ; Clarithromycin/administration & dosage ; Data Interpretation, Statistical ; Drug Therapy, Combination ; Dyspepsia/*drug therapy/etiology/microbiology ; Enzyme Inhibitors/therapeutic use ; Female ; Helicobacter Infections/complications/*drug therapy/microbiology ; *Helicobacter pylori ; Humans ; Male ; Middle Aged ; Omeprazole/analogs & derivatives/therapeutic use ; Peptic Ulcer/*drug therapy/etiology/microbiology ; Proton Pump Inhibitors/therapeutic use

Adult ; Antidepressive Agents ; therapeutic use ; Depression ; complications ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Dyspepsia ; drug therapy ; psychology ; Female ; Gastric Emptying ; drug effects ; Gastrointestinal Agents ; therapeutic use ; Gastrointestinal Motility ; drug effects ; Humans ; Male ; Middle Aged ; Phytotherapy ; Powders