Chronic dyspepsia

Bjornsson ES, Abrahamsson H Contractile patterns in patients with severe chronic dyspepsia. Am J Gastroenterol 1999 94 54-64. 

Keywords Chemical sensors Point contact Exhaled air analysis Point-contact spectroscopy Organic conductors Noninvasive diagnostics Chronic dyspepsia... 

These agents lead to symptomatic improvement in a small number of patients with chronic dyspepsia. 

Calamus acts as a carminative, spasmolytic, and diaphoretic. Traditionally, it has been prescribed for acute and chronic dyspepsia, gastritis and gastric ulcer, intestinal colic, and anorexia. 

A 28-year-old man is admitted to hospital with a week-long history of severe vomiting. He confessed to self-medication of his chronic dyspepsia. He was clinically severely dehydrated and had shallow respiration. Initial biochemical results were ... 

In cases which recover from the pulmonary edema, there is usually no permanent disability, but pneumonia may develop later. Concns of 100—150ppm are dangerous for short exposures of 30 to 60 minutes. Concns of 200—700ppm may be fatal after even very short exposures Continued exposure to low concns of the fumes, insufficient to cause pulmonary edema, is said to result in chronic irritation of the respiratory tract, with cough, headache, loss of appetite, dyspepsia, corrosion of the teeth and gradual loss of strength... 

NSAIDs are one of the most widely used classes of medications in the United States, particularly in the elderly.4 More than 20,000 deaths occur in the United States per year as a direct result of adverse events related to NSAID use. Chronic NSAID ingestion leads to symptoms of nausea and dyspepsia in nearly half of patients. Peptic ulceration occurs in up to 30% of patients who use NSAIDs chronically, with gastrointestinal bleeding or perforation occurring in 1.5% of patients who develop an ulcer. NSAID-related peptic ulcers usually occur in the stomach duodenal ulcers are much less common. 

FGIDs present with variable combinations of chronic or recurring GI symptoms not explained by overt biochemical or structural abnormalities and encompass conditions like functional dyspepsia (FD), irritable bowel syndrome (IBS) and chronic idiopathic constipation [1], A variety of mechanisms that could explain the etiology of FGIDs are currently under investigation and include, but are not limited to altered GI motility, visceral hypersensitivity and post-infectious abnormalities [2],... 

Proton pump inhibitors (PPIs), such as omeprazole, esomeprazole, lansoprazole, pantoprazole, and rabeprazole, are commonly prescribed to treat symptoms of heartburn, acid reflux, chest pain, dyspepsia, and chronic cough. PPIs inhibit the transfer of protons into the stomach lumen. Pharmacological acid suppression is thus used to treat gastroesophageal reflux disease (GERD) and esophagitis, peptic ulcers, and Helicobacter pylori infection as well as to prevent ulcer development with concurrent nonsteroidal anti-inflammatory drug use. 

Peptic ulceration occurs as an acute or chronic non-traumatic epithelial breach typically in the gastric or duodenal mucosa, but also in the oesophagus (see above) and occasionally in the small intestine with the Zollinger-Ellison syndrome of gastrin overproduction or with an acid-secreting Meckel s diverticulum. Symptoms overlap with those of non-ulcer dyspepsia and cancer and the diagnostic cornerstone is endoscopy. Biopsy may be necessary to distinguish ulcer from cancer. 

Fenoprofen (Nalfon) is chemically and pharmacologically similar to ibuprofen and is used in the treatment of rheumatoid arthritis, osteoarthritis, and mild to moderate pain. GI effects such as dyspepsia and pain are most common, although dizziness, pruritus, and palpitations may occur. GI bleeding, sometimes severe, has been reported, and interstitial nephritis has been rarely associated with this drug. Concomitant administration of aspirin decreases the biological half-Ufe of fenoprofen by increasing the metabolic clearance of hydroxy-lated fenoprofen. Chronic administration of pheno-barbital also decreases the drug s half-life. 

Chronic phase (less than 2%) Diaphoresis, dyspepsia, tachycardia Serious Reactions... 

Alpinia ojjicinarum Hance Gao Liang Jiang (Lesser galangal) (rhizome) Galangol, essential oils, cineol, eugenol, pinene, cadinene, methyl cinnamate, sesquiterpene, dioxyflavonol.49 As stomachic in chronic enteritis, dyspepsia and gastralgia, carminative, antiperiodic, sialogogue. 

Daucus carota L. subsp. sative Hoffm. Nan He Chi (Carrot) (whole plant) Carotenes, lycopene, phytofluere, umbelliferone, alpha-pinene, camphene, myrcene, daucol, alpha-phellandrene, bisabolene, luteolin-7-glucoside, daucine, pyrrolidine, geraniol, citronellol, carotol, citral, caryophyllene, p-cymene, asarone, daucosterol, petroselinic acid.48 For chronic dysentery, worms, carminative, diuretic, emmenagogue, lower blood sugar, prevent cancer, diabetes, dyspepsia and gout. 

Capsicum has stimulant, antispasmodic, carminative, diaphoretic, counterirritant, antiseptic, and rubefacient properties. Traditionally, it has been used for colic, flatulent dyspepsia without inflammation, chronic laryngitis (as a gargle), insufficiency of peripheral circulation, and externally for neuralgia, including rheumatic pains and unbroken chilblains. 

Pokeweed has various traditional uses, from medicinal to industrial processes. It is used as a cathartic, emetic, narcotic, and gargle. Additional medicinal uses include treatment of various skin diseases, conjunctivitis, syphilis, cancer, parasitic infestations of the scalp, chronic rheumatism, ringworm, dyspepsia, swollen glands, scabies, ulcers, edema, dysmenorrhea, mumps, and tonsillitis. It is currently popular for its antimicrobial and antineoplastic activity. 

Thyme is reputed to possess carminative, antispasmodic, antitussive, expectorant, secretomotor, bactericidal, anthelmintic, and astringent properties. Traditionally, it is used for dyspepsia, chronic gastritis, asthma, diarrhea and enuresis in children, laryngitis, tonsillitis (as a gargle), and specifically for pertussis and bronchitis. 

Chronic rheumatism and skin diseases. Of some use in dyspepsia. Action of root stronger than berries. For rheumatism the root is often compounded with Black Cohosh and Wintergreen. 

For occasional and chronic constipation, dyspepsia, and disordered stomach. Two ounces of the leaves may be infused in 1 pint of boiling water and allowed to stand for an hour before use in wineglass doses. Any possibility of griping will be avoided if 1 drachm of Ginger is added to the Senna leaves before infusing. 

Continued exposure to low concentrations of the fiimes, insufficient to cause pulmonary edema, is said to result in chronic irritation of the respirator tract, with cough, headache, loss of appetite, dyspepsia, corrosion of the teeth, and gradual loss of strength. 

Ferri et Quinis Citras (citrate of iron and quinine) A specific tonic that supposedly combined the virtues of iron (a tonic used in chronic diarrhea and dysentery, enlargement of the liver and spleen, anemia, and dyspepsia) and quinine (a tonic febrifuge and antiperiodic). 

There has been a systematic review of published randomized studies of the use of iV-acetylcysteine in chronic bronchitis (2). A total of 39 trials were considered, of which only nine were included in the meta-analysis. In all cases, oral A -acetylcysteine had been used in a dosage of 200-300 mg bd for 4-32 weeks. There were gastrointestinal adverse effects (dyspepsia, diarrhea, and heartburn) in 10% of 2011 patients, and 6.5% withdrew because of their symptoms. However, the rate of gastrointestinal adverse effects was higher in the placebo group (11% with a withdrawal rate of 7.1%). There was no exacerbation of chronic bronchitis in 49% of patients treated with acetylcysteine compared with 31% of placebo-treated patients, a relative benefit of 1.56 (95% Cl = 1.37, 1.77). There was also symptom improvement with treatment 61 % reported improvement in symptoms with acetylcysteine compared with 35% with placebo. 

Two cases of severe vomiting, dyspepsia, and headache, with falls in body weight and plasma albumin, have been reported in patients on chronic peritoneal dialysis (2). Both occurred a few days after they started to take ramipril (dose not reported) and totally resolved after withdrawal. Both patients subsequently took losartan, which was well tolerated. This led the authors to suggest that the mechanism was mediated by bradykinin and/or prostaglandins, through an interaction with gastrointestinal motility, which may also be affected by peritoneal dialysis. 

Omeprazole is indicated for patients with chronic or intermittent dyspepsia, so long as there is no underlying pathology. Patients should be referred to a doctor if relief is not obtained after treatment for 2 weeks. 

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