Upper abdominal pain

Most patients have a history of heavy ethanol use and attacks of recurrent upper abdominal pain. The classic triad of pancreatic calcification, steatorrhea, and diabetes usually confirms the diagnosis. 

Localised upper abdominal pain is the most common symptom of peptic ulcer disease. The pain is relieved by antacids, proton pump inhibitors and H2 antagonists. The pain may or may not be relieved by food and is often v/orse during the night. Peptic ulceration may be accompanied by occasional vomiting, anorexia and weight loss. Diffuse abdominal pain is not a characteristic symptom of peptic ulcer disease. 

Hepatic - Pretreatment serum transaminase (ALT and AST) tests are advised for all patients before taking terbinafine. Warn patients to immediately report to their physician any symptoms of persistent nausea, anorexia, fatigue, vomiting, right upper abdominal pain or jaundice, dark urine, or pale stools. Discontinue treatment in patients with these symptoms taking oral terbinafine, and immediately evaluate the patient s liver function. 

Adverse reactions occurring in at least 3% of patients included the following Upper abdominal pain, anxiety, appetite decrease, asthenia, constipation, cough, depression, herpes simplex, influenza, insomnia, myalgia, peripheral neuropathy, pruritus (not otherwise specified), sinusitis, skin papilloma, weight decreased. 

Toxicity—Initial hematocrit, fecal occult blood, then q6-l 2 mo electrolytes and renal function tests q6-12 mo LFTs q6-12 mo in high-risk patients query patient for dyspepsia, nausea, vomiting, right upper abdominal pain, anorexia, fatigue, jaundice, edema, weight gain, decreased urine output... 

Constipation, influenza, upper abdominal pain, anorexia, conjunctivitis Serious Reactions... 

Dizziness, dry eyes, fatigue, depression, edema, hypertension, upper abdominal pain, vomiting, urine retention, delirium... 

This patient was the first case in our series in which ALPE was detected with acute renal failure due to unknown etiology. On September 19,1976, he ran two 100-m races at an athletics meeting. On September 20, vomiting, diarrhea, and upper abdominal pain developed, and the patient attended our department. His serum creatinine and uric acid levels were 5.0 mg/dl and 17.0 mg/dl, respectively. The pain persisted for 1... 

There are usually no subjective complaints - except when there are large space-occupying lesions which cause anorexia, weight loss, upper abdominal pain upon pressure, haemorrhaging in the tumour or tumour rupture. Febrile conditions and pain may point to infection, liver abscess or echinococcosis. 

Clinical features Acute liver congestion results in upper abdominal pain due to stretching of the capsule caused by liver enlargement this might even mimic an acute... 

A 20-year-old woman, who had previously taken paracetamol without adverse effects, took paracetamol 1 g and codeine 60 mg for a headache. After 3 hours she developed severe upper abdominal pain radiating to the back. The abdominal pain resolved within 24 hours of the administration of phloroglucinol and tiemonium. Her serum amylase activity was raised 3-fold and the serum lipase 15-fold. Other biochemical parameters, abdominal ultrasound, and an MRI scan were normal. Contrast-enhanced computed tomography showed pancreatic edema. 

Pirazolac, a pyrazoloacetic acid derivative, caused heartburn, upper abdominal pain, cutaneous adverse effects (rashes, exacerbation of pre-existing eczema), and eosi-nophilia in early clinical studies (1). In two comparative studies it was withdrawn in 15-20% of patients, that is more often than the comparator NSAIDs (indometacin, sulindac) (SEDA-16, 111). 

Several reports have suggested that triclabendazole may be of use in the treatment of Fasciola hepatica infection. In 20 patients with fascioliasis treated with two single doses of triclabendazole 10 mg/kg, the plasma concentrations of triclabendazole, its active metabolite triclabendazole-SO, and its sulfone metabolite were doubled by food (1). There were no serious adverse effects, except for some right-sided upper abdominal pain in several patients, which was relieved by oral spasmolytics. Triclabendazole should be administered with food. 

A 27-year-old Hispanic man presented with nausea and vomiting, diarrhea, and upper abdominal pain 12 months after starting to take chaparral capsules. A liver biopsy showed hepatocellular injury with necrosis and periportal inflammation. His liver function stabilized after withdrawal of chaparral. 

Esophagogastroduodenoscopy (EGD) is used to examine the esophagus, stomach, and duodenum. Patient preparation for EGD includes fasting for 6 to 8 hours prior to the procedure and the administration of sedatives and topical anesthetics. Common indications may be either diagnostic or therapeutic in nature, and include evaluating suspected upper GI bleeding, obstructions, upper abdominal pain. 

For upper abdominal pain with acid regurgitation, also add Zuo Jin Wan (Left Metal Pills). 

For vague upper abdominal pain which gets better with warmth or pressure and vomiting of clear fluids, add Fructus Evodiae Rutecarpae (Wu Zhu Yu), Fructus Citri Sacrodactylis (Fo Shou), and Radix Codonopsis Pilosulae (Dang Shen). 

A 22-year-old Korean male has recently moved to Minnesota. He has symptoms of clonorchia-sis (anorexia, upper abdominal pain, eosinophilia), presumably contracted in his homeland where the Oriental fiver fluke is endemic. He also has symptoms of diphyllobothriasis (abdominal discomfort, diarrhea, megaloblastic anemia), probably due to consumption of raw fish from lakes near the Canadian border. Which one of the following drugs is most likely to be effective in the treatment of both clonorchiasis and diphyllobothriasis in this patient ... 

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