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Medication Causes of Dyspepsia

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881. Gastrointestinal Considerations in Patients with Cardiovascular Disease Using Nonopioid Analgesics for Mild-to-Moderate Pain or Cardioprotection. (PubMed)

Gastrointestinal Considerations in Patients with Cardiovascular Disease Using Nonopioid Analgesics for Mild-to-Moderate Pain or Cardioprotection. Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most widely used classes of medications worldwide, available both through prescription and over the counter (OTC). Although these drugs are highly effective for pain, gastrointestinal (GI) complications may occur. Risk factors for GI complications from NSAIDs have been well studied (...) , and the highest risk exists among the elderly and patients with a history of GI bleeding or complications. The increasingly widespread use of aspirin for both primary and secondary cardiovascular prophylaxis has also drawn attention to the potential increase in GI complications. Several strategies may minimize NSAID-mediated GI complications, including the use of drugs that do not injure the gut, such as acetaminophen or a low-dose opiate. The cyclooxygenase-2 (COX-2) inhibitors, which cause approximately 50

2006 American Journal of Cardiology

882. Diagnostic value of the Manning criteria in irritable bowel syndrome. (Full text)

Diagnostic value of the Manning criteria in irritable bowel syndrome. Because unexplained 'functional symptoms' are a major cause of referral to gastroenterologists, the efficiency of the medical history to lead to a positive diagnosis of irritable bowel syndrome, without resorting to the use of expensive tests, remains a key question. Whilst the six criteria of Manning et al are widely used, data on their validity in discriminating irritable bowel syndrome from healthy controls, irritable (...) bowel syndrome from non-ulcer dyspepsia and especially among irritable bowel syndrome subgroups, are not available. To evaluate this, we studied 361 outpatients who completed a bowel disease questionnaire, which objectively measured Manning's (and other) criteria. The group included 82 patients with irritable bowel syndrome, 33 with non-ulcer dyspepsia, 101 with organic gastrointestinal disease, and 145 healthy controls. Diagnoses were based on a full and independent clinical evaluation

1990 Gut PubMed

883. The risks and benefits of an Rx-to-OTC switch. The case of over-the-counter H2-blockers. (PubMed)

quarter, but cause the overall rate of side effects among persons who self-medicate to decline; 4) cause an additional 300 persons per quarter with gastric cancer to self-medicate before seeking professional care, but cause no change in the median time between onset of symptoms and the decision to seek such care; and 5) decrease by 277,000 the number of persons per quarter who seek professional care for dyspepsia. On balance, results suggest that OTC H2-blockers may be a relatively safe and effective (...) given quarter, of whom 3.5 million self-medicate with antacids. Study results indicate that OTC availability of H2-blockers would: 1) increase the proportion of persons with dyspepsia who self-medicate from 61.8% currently to 64.1%; 2) increase the proportion of persons who experience complete relief of their symptoms while self-medicating from 37.9% currently to 43.2%; 3) result in 14 additional cases of serious hematologic disorders and an additional 22,000 instances of minor side effects per

1990 Medical Care

884. Helicobacter pylori and upper gastrointestinal disease: a survey of gastroenterologists in the United Kingdom. (Full text)

of non-ulcer dyspepsia, 69% used anti-H pylori therapy to treat a patient with this condition. At the time of the survey, 69% of those who used anti-H pylori therapy adopted some variant of standard triple therapy. Only 7% routinely tested for bacterial sensitivity to antibiotics and only 22% assessed their patients for eradication after treatment. There was a lack of consensus about whether H pylori was a cause of gastric ulcer or gastric cancer with only 47% and 17% respectively believing (...) Helicobacter pylori and upper gastrointestinal disease: a survey of gastroenterologists in the United Kingdom. The objective of this study was to conduct a survey of the opinions and practices of gastroenterologists in the United Kingdom concerning the impact of Helicobacter pylori infection on the management of upper gastrointestinal diseases. A postal questionnaire was sent to all medically qualified members of the British Society of Gastroenterology working in the UK. Replies were received

1995 Gut PubMed

885. The role of screening for Helicobacter pylori in patients with duodenal ulceration in the primary health care setting. (Full text)

recurrent dyspepsia had known gastro-oesophageal reflux and their ongoing symptoms after eradication therapy seemed, on close questioning, to be more attributable to this than to duodenal ulcer disease.Testing for and eradication of H pylori is worthwhile in general practice in those patients with previous proven duodenal ulceration who need long-term ulcer-healing medication. The high rate of eradication of H pylori achieved with the regimen used in this study compares very favourably (...) The role of screening for Helicobacter pylori in patients with duodenal ulceration in the primary health care setting. It is known that at least 90% of duodenal ulcers are caused by infection with the bacterium Helicobacter pylori. Eradicating this organism usually results in complete resolution of the disease. Testing for H pylori was introduced relatively recently, and thus, many patients known to have uncomplicated peptic ulcer disease who continue to need long-term treatment with ulcer

1996 The British Journal of General Practice PubMed

886. Randomized controlled trial of Cassia alata Linn. for constipation. (PubMed)

Randomized controlled trial of Cassia alata Linn. for constipation. Cassia alata Linn. is a medical plant. Its leaves have been claimed to be effective as a laxative. The studies done so far have shown no toxicity as a result of consuming Cassia alata Linn. leaves. The plant has been found to contain anthraquinones, presumed to be the active ingredient causing the laxative effect. The objective of the study was to test efficacy of Cassia alata Linn. leaves for treatment of constipation compared (...) and clinically important. Minimal self-limited side effects, i.e., nausea, dyspepsia, abdominal pain and diarrhea were noted in 16-25 per cent of the patients.(ABSTRACT TRUNCATED AT 250 WORDS)

1990 Journal of the Medical Association of Thailand = Chotmaihet thangphaet

887. Gastrointestinal safety profile of meloxicam: a meta-analysis and systematic review of randomized controlled trials. (PubMed)

of proceedings from international gastroenterology meetings were conducted. Randomized clinical trials comparing the frequency of GI adverse events for meloxicam versus non-COX-2-selective NSAIDs were selected. Specific data about the frequency of dyspepsia; perforations, ulcers, and bleeds (PUBs); and withdrawal of medication because of adverse GI events was also extracted. From a pool of 62 potentially relevant citations, 12 randomized trials were identified. All trials concerning symptomatic GI adverse (...) events used the World Health Organization's Adverse Reaction Terminology List (WHO-ARTL) to code adverse events. Patients using meloxicam had fewer GI adverse events compared with non-COX-2-selective NSAIDs (odds ratio = 0.64; 95% confidence interval [CI], 0.59-0.69). Patients using meloxicam experienced less dyspepsia (odds ratio = 0.73; 95% CI, 0.64-0.84), fewer PUBs (odds ratio = 0.52; 95% CI, 0.28-0.96), and less frequent discontinuation of NSAID because of adverse GI events (odds ratio = 0.59

1999 The American journal of medicine

888. [Effectiveness of the treatment of systemic lupus erythematosus with methotrexate]. (PubMed)

results or prednisone requirements. During treatment six patients had oral aphthae and five had dyspepsia; three had an increase in transaminase levels, which in one caused the treatment to be stopped. There were two urinary infections, one community acquired pneumonia and one upper airway symptoms requiring antibiotic treatment; one female patient had acute cholecystitis with cholelithiasis necessitating surgical intervention.Weekly low doses of methotrexate may prevent flares of activity of SLE (...) in this type of patients, but it does not reduce the requirements of prednisone, nor modify analytical data. Toxic effects are rare and reversible upon interrupting medication.

1993 Medicina clinica

889. Safety and efficacy of sildenafil citrate in the treatment of male erectile dysfunction. (PubMed)

the relaxant effect of nitric oxide (NO) on the corpus cavernosum by inhibiting PDE5, which is responsible for degradation of cGMP in this tissue. When sexual stimulation causes local release of NO, inhibition of PDE5 by sildenafil increases concentrations of cGMP in the corpus cavernosum, causing smooth muscle relaxation and blood flow into the penis, resulting in an erection. Sildenafil at recommended doses has no effect in the absence of sexual stimulation. The drug is rapidly absorbed after oral (...) effects reported at a rate of >2% were headache, flushing, dyspepsia, nasal congestion, urinary tract infection, abnormal vision, diarrhea, dizziness, and rash. No cases of priapism were reported. The use of sildenafil is contraindicated in men who are taking organic nitrates, because of the potential for a precipitous decrease in blood pressure. Postmarketing reports and surveillance have revealed at least 39 deaths with sildenafil use in men having a history of heart disease, men taking nitrate

1999 Clinical therapeutics

890. Management of dyspepsia in adults in primary care

for Clinical Excellence (NICE) 2004: 45 Authors' objectives This report provides guidelines on the management of dyspepsia in adults in primary care. Authors' conclusions The following have been identified as priorities for implementation. Referral for endoscopy - Review medications for possible causes of dyspepsia (for example, calcium antagonists, nitrates, theophyllines, bisphosphonates, corticosteroids and non-steroidal anti-inflammatory drugs [NSAIDs]). In patients requiring referral, suspend NSAID (...) Management of dyspepsia in adults in primary care Management of dyspepsia in adults in primary care Management of dyspepsia in adults in primary care National Institute for Clinical Excellence Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation National Institute for Clinical Excellence. Management of dyspepsia in adults in primary care. London: National Institute

2004 Health Technology Assessment (HTA) Database.

891. What is the evidence for the use of warfarin or antiplatelet medication in patients with atrial fibrillation?

What is the evidence for the use of warfarin or antiplatelet medication in patients with atrial fibrillation? What is the evidence for the use of warfarin or antiplatelet medication in patients with atrial fibrillation? - Trip Database or use your Google+ account Find evidence fast ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere (...) clinicians to search across other content types including images, videos, patient information leaflets, educational courses and news. For further information on Trip click on any of the questions/sections on the left-hand side of this page. But if you still have questions please contact us via jon.brassey@tripdatabase.com What is the evidence for the use of warfarin or antiplatelet medication in patients with atrial fibrillation? Clinical Evidence has a number of pages detailing the evidence

2004 TRIP Answers

892. Stomach pain - evidence-based methods in the diagnosis and treatment of dyspepsia</a>

for approximately 3% of all physician visits. Dyspepsia is a general term to describe prolonged (weeks to months) pain or discomfort localized to the upper abdomen. The word dyspepsia originates from the Greek and means poor (dys) digestion (pepsia). Peptic ulcers, eg, ulcers located in the stomach or the duodenum, are one of the many causes behind dyspepsia. The discovery that peptic ulcers are related to a bacterial infection (Helicobacter pylori or H. pylori) and the development of effective drugs (...) for treating peptic ulcers has substantially changed treatment strategies and improved the outcomes. This has generated expectations that other causes of dyspepsia can be successfully treated in similar ways. Controversial opinions along these lines and the substantial increase in prescription of potent antacids are among the reasons for this report. What causes dyspepsia? Dyspepsia has many causes that are either organically or functionally related. Organic dyspepsia includes mainly peptic ulcers, ie

2000 Swedish Council on Technology Assessement

893. Review: herbal medicinal products seem to be effective and safe in nonulcer dyspepsia (Full text)

with the herbal medicinal products, apart from reports of hepatotoxicity with greater celandine; however, comprehensive safety data are lacking. Conclusion In patients with non-ulcer dyspepsia, treatment with herbal medicinal products seems to be effective and safe for improving dyspeptic symptoms. Commentary Many people have symptoms of pain or discomfort in the upper abdomen. About half of these people seek medical care, and many are investigated with endoscopy or barium radiography. Two thirds of those who (...) are tested have no findings to explain the symptoms and are given a diagnosis of non-ulcer dyspepsia. The exact cause of the symptoms is not yet clear, and a clearly effective treatment has not been identified. Given this situation, it is not surprising that many patients seek relief from alternative, non-prescription remedies. Whether such self management can be helpful is an important question. In this systematic review, Thompson Coon and Ernst summarise the literature addressing the safety

2004 Evidence-Based Medicine (Requires free registration) PubMed

894. An evidence-based approach to the management of uninvestigated dyspepsia in the era of Helicobacter pylori

, hepatobiliary and other nongastrointestinal origins of the presenting dyspeptic symptoms, including possible medication-induced dyspepsia, lifestyle or dietary indiscretions. Although it may be difficult to exclude all of these causes on history-taking, it is important to know when to investigate further. Box B: Older patients and patients with alarm features Although cancer is a rare cause of dyspeptic symptoms (accounting for less than 2% of cases), it is an important consideration. Alarm features (...) the medical literature and clinical expertise to aid decision-making in patient care. The Canadian Dyspepsia (CanDys) Working Group was convened with the mandate to develop an evidence-based management tool for uninvestigated dyspepsia that would be practical and would reflect the realities of the primary care setting. The aim was to provide primary care physicians with recommendations and guidance concerning appropriate investigations, treatments and indications for referral for patients

2000 CPG Infobase

895. Outcomes After Medical and Surgical Treatment of Gastroesophageal Reflux Disease

Outcomes After Medical and Surgical Treatment of Gastroesophageal Reflux Disease Outcomes After Medical and Surgical Treatment of Gastroesophageal Reflux Disease - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding (...) more. Outcomes After Medical and Surgical Treatment of Gastroesophageal Reflux Disease The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT00260572 Recruitment Status : Active, not recruiting First Posted : December 1, 2005 Last Update Posted : August 21, 2018 Sponsor: University of Pittsburgh

2005 Clinical Trials

896. Dyspepsia management in primary care: a decision analysis of competing strategies

of effectiveness data The evidence was derived from a systematic review of published studies, and from authors' assumptions. Modelling A decision tree was designed to compute the cost-effectiveness of the four strategies for the treatment of uninvestigated dyspepsia. The time horizon considered was 1 year. Outcomes assessed in the review The following clinical and effectiveness data were obtained from the literature review and included as inputs in the model: the probability that the cause of dyspepsia (...) is nonulcer dyspepsia (NUD); the probability that NUD is H. pylori positive; the probability that the cause of dyspepsia is peptic ulcer disease (PUD); the probability that PUD is H. pylori positive; the probability that the cause of dyspepsia is oesophagitis; the probability that oesophagitis is H. pylori positive; the probability that the cause of dyspepsia is gastric cancer; the probability that gastric cancer is H. pylori positive; the probability that H. pylori is successfully eradicated by the first

2002 NHS Economic Evaluation Database.

897. The Omega-Project: a comparison of two diagnostic strategies for risk- and cost-oriented management of dyspepsia

The Omega-Project: a comparison of two diagnostic strategies for risk- and cost-oriented management of dyspepsia The Omega-Project: a comparison of two diagnostic strategies for risk- and cost-oriented management of dyspepsia The Omega-Project: a comparison of two diagnostic strategies for risk- and cost-oriented management of dyspepsia Brignoli R, Watkins P, Halter F Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each (...) abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Diagnostic strategies (mandatory versus selective endoscopy) for risk- and cost-oriented management of dyspepsia. Type of intervention Diagnosis. Economic study type Cost-effectiveness analysis. Study population Adult (male and female) patients with dyspeptic disorders (for at least one month) who were

1997 NHS Economic Evaluation Database.

898. Therapy for Helicobacter pylori in patients with nonulcer dyspepsia: a meta-analysis of randomised controlled trials

of nonulcer dyspepsia. Searching MEDLINE and HealthSTAR were searched from 1984 to 1999 with no language restrictions; the search terms were reported. Proceedings from the annual meetings of the American College of Gastroenterology, American Gastroenterological Association, and European H. pylori Study Groups (1995 to 1999), and reference lists of retrieved articles and reviews that met the inclusion criteria, were also searched. Manufacturers of H. pylori medications and experts in the field were (...) suggested continued evaluation of the causes of nonulcer dyspepsia is needed. Bibliographic details Laine L, Schoenfeld P, Fennerty M B. Therapy for Helicobacter pylori in patients with nonulcer dyspepsia: a meta-analysis of randomised controlled trials. Annals of Internal Medicine 2001; 134(5): 361-369 PubMedID Original Paper URL Other publications of related interest Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical

2001 DARE.

899. In a person presenting with symptoms of dyspepsia, what is the appropriate management plan?

if the person has any ALARM symptoms (see Refer?). Address anxieties about the significance of symptoms. Stop nonsteroidal anti-inflammatory drugs (NSAIDs) where possible. If this is not possible, see Scenario: Dyspepsia while taking NSAID. Review other medication that may be causing dyspepsia: corticosteroids; bisphosphonates; medication that may lower oesophageal sphincter pressure (e.g. theophylline, nitrates, and calcium-channel blockers). Choose a first-line treatment strategy. Either: - Test (...) In a person presenting with symptoms of dyspepsia, what is the appropriate management plan? In a person presenting with symptoms of dyspepsia, what is the appropriate management plan? - Trip Database or use your Google+ account Find evidence fast ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches

2007 TRIP Answers

900. Evaluation of Food Hypersensitivity in Children/Adolescents With Functional Dyspepsia

Information provided by: Children's Mercy Hospital Kansas City Study Details Study Description Go to Brief Summary: The main purpose of this study is to determine if standard and investigational tests used to help diagnose and treat food allergies can provide information that will be useful in determining the cause of dyspepsia and helpful in designing a treatment plan. The study will also determine if there is a connection between positive allergy tests and inflammation in the upper abdomen. Condition (...) Evaluation of Food Hypersensitivity in Children/Adolescents With Functional Dyspepsia Evaluation of Food Hypersensitivity in Children/Adolescents With Functional Dyspepsia - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before

2006 Clinical Trials

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