Abstract:
BACKGROUND:Uninvestigated dyspepsia is common in family practice. The prevalence of clinically significant upper gastrointestinal findings (CSFs) in adult uninvestigated dyspepsia patients, and their predictability based on history, is unknown. METHODS:Prompt endoscopy was performed within 10 days of referral, in 1040 adult patients presenting with uninvestigated dyspepsia at 49 Canadian family practitioner centres. Subsequent management strategies during a 6-month follow-up period were determined by the individual family practitioners. RESULTS:CSFs were identified in 58% (603/1040) of patients. Erosive oesophagitis was most common (43%; N = 451); peptic ulcer was uncommon (5.3%; N = 55). Alarm symptoms were uncommon (2.8%; N = 29). Most patients had at least three dyspepsia symptoms, more than 80% had at least six, and approximately half had eight or more. Based on the dominant symptom, 463 (45%) patients had ulcer-like, 393 (38%) had reflux-like and 184 (18%) had dysmotility-like dyspepsia. The patients' dominant symptom was not predictive of endoscopic findings. Oesophagitis was more common in those with dominant reflux-like symptoms and was the most common finding in all subgroups. The prevalence of gastroduodenal findings was similar in all symptom subgroups. Helicobacter pylori (H. pylori) infection (30%; 301/1013) was associated with gastroduodenal findings. CONCLUSIONS:Dyspepsia subclassifications, based on dominant symptom, are of limited value in predicting the presence and nature of CSFs. Oesophagitis was by far the most common diagnosis (43% of patients). CSFs were common in uninvestigated dyspepsia patients and their nature suggests patients could be initially treated effectively, without endoscopy, using empirical acid suppressive therapy.
journal_name
Aliment Pharmacol Therjournal_title
Alimentary pharmacology & therapeuticsauthors
Thomson AB,Barkun AN,Armstrong D,Chiba N,White RJ,Daniels S,Escobedo S,Chakraborty B,Sinclair P,Van Zanten SJdoi
10.1046/j.1365-2036.2003.01646.xsubject
Has Abstractpub_date
2003-06-15 00:00:00pages
1481-91issue
12eissn
0269-2813issn
1365-2036pii
1646journal_volume
17pub_type
杂志文章abstract:BACKGROUND:Spontaneous portosystemic shunt (SPSS) is a frequent cause of recurrent hepatic encephalopathy (HE) in patients with cirrhosis. AIM:To assess the effectiveness and optimal candidate selection for embolisation of SPSS, for the treatment of recurrent HE in patients with cirrhosis. METHODS:This retrospective ...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.12771
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Randomized, placebo controlled trials are used to assess the efficacy of therapies for Crohn's disease. The placebo response and remission rates vary among studies. AIM:To analyse how the placebo response and remission rates in Crohn's trials have changed over time in the era of parenteral biologic therapie...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2036.2009.04125.x
更新日期:2010-01-01 00:00:00
abstract::This review summarizes the clinical evidence to support current therapies in irritable bowel syndrome (IBS). Fibre is indicated at a dose of at least 12 g per day in patients with constipation-predominant IBS. Loperamide (and probably other opioid agonists) are of proven benefit in diarrhoea-predominant IBS; loperamid...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:
更新日期:1999-05-01 00:00:00
abstract:BACKGROUND:Approximately one third of patients with acute severe ulcerative colitis (ASUC) fail response to steroids. Ciclosporin and anti-TNFα are proven second-line therapies, but evidence of their efficacy has come mainly from tertiary centres and/or selective clinical trial recruitment. AIM:To assess ASUC outcomes...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.12473
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:Imbalance between apoptosis and proliferation may be one of the mechanisms underlying H. pylori associated gastric carcinogenesis. AIM:To examine the cell kinetics of gastric intestinal metaplasia and the effect of H. pylori eradication. METHODS:Endoscopic gastric biopsies were obtained from 100 H. pylori-...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1046/j.1365-2036.2001.01057.x
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND:Programmed cell death protein-1-targeted immunotherapy has shown promising results in phase II studies of hepatocellular carcinoma. AIM:To evaluate safety and efficacy of nivolumab and pembrolizumab in an international, multicentre, real-world cohort of patients with advanced hepatocellular carcinoma. METH...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,多中心研究
doi:10.1111/apt.15245
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:In Sweden, the most common causes of liver cirrhosis are alcohol overconsumption and hepatitis C. However, recent data on the clinical characteristics of Swedish patients with cirrhosis are scarce. AIMS:To determine the incidence, clinical presentation, aetiological spectrum and survival rates of liver cirr...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.13635
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Proton pump inhibitor (PPI) use is costly and about two-thirds of prescribing is long-term. Although 20-50% of patients may be infected with Helicobacter pylori, eradication is not normal clinical practice. AIM:To establish if H. pylori eradication in long-term PPI users is cost-effective. METHODS:Long-ter...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1365-2036.2008.03851.x
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:After ileocaecal resection for Crohn's disease (CD), inflammatory lesions frequently recur on the anastomosis and/or on the neo-terminal ileum. AIM:To identify predictors of early post-operative endoscopic recurrence. METHODS:From September 2010 to September 2017, the REMIND group conducted a prospective n...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,多中心研究
doi:10.1111/apt.14944
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:Many studies report a high prevalence of lactose intolerance in patients with functional, gastrointestinal disease. AIM:To evaluate the role of small intestinal bacterial overgrowth (SIBO) in condition of lactose intolerance and the mechanism by which SIBO may impact lactose tolerance in affected patients. ...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2036.2010.04252.x
更新日期:2010-04-01 00:00:00
abstract:BACKGROUND:Strong suppression of viral replication and normalization of alanine aminotransferase is feasible with nucleos(t)ide analogues. It is estimated viral replication and liver inflammation can be controlled in 90% of patients with chronic hepatitis B with the current available treatments. AIM:To review the stud...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2036.2007.03481.x
更新日期:2007-12-01 00:00:00
abstract::It is not known whether hypoxia, associated with upper gastrointestinal endoscopic procedures when midazolam sedation is used without narcotics, persists into the post-procedure recovery period. Thirty consecutive patients aged over 60 years, undergoing ERCP using midazolam sedation alone, were monitored clinically an...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1365-2036.1992.tb00739.x
更新日期:1992-12-01 00:00:00
abstract:BACKGROUND:Regulatory requirements for claims of mucosal healing in ulcerative colitis (UC) will require demonstration of both endoscopic and histologic healing. Quantifying these rates is essential for future drug development. AIMS:To meta-analyse endoscopic and histologic placebo response and remission rates in UC r...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,meta分析
doi:10.1111/apt.14672
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Irritable bowel syndrome is the most common diagnosis in gastroenterology. Trials suggest certain probiotics to be beneficial. AIM:To investigate the effects of multispecies probiotic supplementation (Lactobacillus rhamnosus GG, L. rhamnosus Lc705, Propionibacterium freudenreichii ssp. shermanii JS and Bifi...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1365-2036.2007.03542.x
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:The incidence of Barrett's oesophageal adenocarcinoma is increasing more rapidly than any other malignancy in industrialized countries. Cyclo-oxygenase-2 appears to play an important role in gastrointestinal carcinogenesis. Previous studies on cyclo-oxygenase-2 expression in Barrett's oesophageal carcinogene...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1046/j.1365-2036.2003.01432.x
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:Pregabalin has a broad spectrum of analgesic and antihyperalgesic activity in both basic and clinical studies. However, its mechanisms and sites of action have yet to be determined in humans. AIMS:To assess the antinociceptive effect of pregabalin on experimental gut pain in patients with visceral hyperalge...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1365-2036.2011.04802.x
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Liver cirrhosis is characterized by a silent phase until decompensation, which is defined by ascites, bleeding from esophageal varices or hepatic encephalopathy. AIM:To compare the clinical course, patterns of survival and causes of death by etiology during long-term follow-up in a large population-based co...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.15255
更新日期:2019-06-01 00:00:00
abstract::Haemochromatosis was first recognized as a disease entity over a century ago and its hereditary nature recognized over 60 years ago. However it was only in late 1996 that the haemochromatosis gene was cloned and a single C282Y mutation confirmed as being the cause of all HLA-linked iron overload in Caucasian populatio...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2036.1997.00197.x
更新日期:1997-08-01 00:00:00
abstract:BACKGROUND:Peginterferon-alpha-based therapy frequently leads to neutropenia. It remains unclear whether neutropenia is associated with bacterial infection in chronic hepatitis C (CHC). AIM:To evaluate the risk of bacterial infection and neutropenia in patients with CHC treated with peginterferon-alpha/ribavirin. MET...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2036.2009.03957.x
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:Patients with chronic liver disease and components of metabolic syndrome may be at higher risk for fibrosis. AIM:To assess the impact of clinicodemographic factors on hepatic fibrosis in CLD. METHODS:Of 1028 chronic liver disease patients, 964 were included in the analysis. Extensive clinico-demographic an...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2036.2010.04266.x
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:Sulfasalazine is accepted therapy for active ulcerative colitis, but side-effects and intolerance are common. Balsalazide is an azo-bonded pro-drug which also releases 5-aminosalicylic acid into the colon, but uses an inert carrier molecule. AIM:To compare the safety and efficacy of sul- fasalazine, 3 g, wi...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1046/j.1365-2036.2002.01151.x
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:In cirrhosis, portal hypertension is associated with a spectrum of renal dysfunction that has significant implications for morbidity and mortality. AIM:To discuss recent progress in the patho-physiological mechanisms and therapeutic options for portal hypertension-related renal dysfunction. METHODS:A liter...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1111/apt.12653
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:The effects of proton pump inhibitors and Helicobacter pylori infection on the distribution of drugs used for the eradication of the bacteria are poorly understood. AIM:The aim of this study was to investigate the effects of a 7-day administration of 20 mg of omeprazole on the pharmacokinetics of amoxicilli...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2036.2002.01262.x
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND:Ingestion of capsaicin reduces symptoms in functional dyspepsia but induces upper abdominal symptoms initially. AIMS:To evaluate the effects of one week of oral dosing with capsaicin on mechanonociception and chemonociception. METHODS:Healthy subjects ingested capsules containing 0.5 mg capsaicin t.d.s (n ...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2036.2006.03022.x
更新日期:2006-08-15 00:00:00
abstract::Helicobacter pylori produces a 550 kDa, multimeric, nickel-containing urease that catalyses the hydrolysis of urea to yield ammonia and carbonic acid. The ure gene cluster, comprised of seven genes, encodes the two structural subunits UreA (26.5 kDa) and UreB (60.3 kDa), and five accessory proteins: UreI, UreE, UreF, ...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1046/j.1365-2036.1996.22164006.x
更新日期:1996-04-01 00:00:00
abstract:BACKGROUND:The widespread use of eradication therapy for Helicobacter pylori in Japan has led to an increase in antibiotic-resistant strains and the problem of re-treatment in cases of eradication failure. AIM:To perform drug sensitivity testing for metronidazole in 92 H. pylori-positive patients who had failed eradic...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2036.2003.01401.x
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:A-gliadin residues 31-49 (peptide A) binds to HLA-DQ2 and is toxic to coeliac small bowel. Analogues of this peptide, which bind to DQ2 molecules but are non-toxic, may be a potential route to inducing tolerance to gliadin in patients with coeliac disease. METHODS:Toxicity was investigated with small bowel ...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1046/j.1365-2036.1999.00512.x
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND:In spite of its frequent use in the treatment of irritable bowel disease little is known about mebeverine's mode of action in man. AIM:To examine mebeverine's effect on transit though the gut during lactulose-induced diarrhoea. METHODS:Nine healthy volunteers undertook a two-way randomized crossover study....
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2036.1998.00340.x
更新日期:1998-06-01 00:00:00
abstract:BACKGROUND:With the global efforts to eradicate hepatitis C virus (HCV), treatment during pregnancy is becoming a priority for research as this, and maternal cure should reduce vertical transmission. However, as information on the efficacy and safety of direct-acting antivirals (DAAs) in pregnancy is generally lacking,...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1111/apt.15476
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Although the use of tumour necrosis factor (TNF) antagonists is increasingly codified, several unresolved issues remain. AIM:To conduct a French national survey on TNF antagonists use in inflammatory bowel disease (IBD). METHODS:A postal questionnaire was sent to all French gastroenterologists among whom 4...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1365-2036.2009.04097.x
更新日期:2009-10-15 00:00:00