ABSTRACT
To investigate the clinical characters and the possible pathogenesis of post infectious functional dyspepsia(PI-FD).Methods 550 patients suffered with acute gastrointestinal infection were followed-up for half year to evaluate the prevalence and symptoms of PI-FD.Meanwhile,thirty patients with non-special functional despepsra(NS-FD)and twenty healthy volunteers were enrolled.The number of mast cells,the total amount of tryptase and histamine released were determined.Furthermore,the ultra-structure of mast cells was observed by electron microscope,and the number of mast cells located within 5μm of nerve fibers was also countered.Results The prevalence of PI-FD is about 6.7%(35/522)after acute gastrointestinal infection in half year.The scores of epigastric pain,epigastric burning sensation and early satiety in patients with PI-FD were significantly higher than those in patients with NS-FD(P<0.05 for all),so did the scores of histological chronic inflammation in gastric mucusa(P<0.05).There is no significant difference in the number of mast cells between patients with PI-FD and NS-FD(P>0.05).However,the number of activated mast cells in patients with PI-FD is significantly higher than that in patients with NS-FD.The total amount of tryptase in gastric mucoss and the histamine released in patients with PI-FD is higher than that in patients with NS-FD and healthy volunteers(P<0.05 for all).Under the electron microscope,the number of mast cells located within 5μm of nerve fibers in PI-FD patients was significant higher than that in other two groups(P<0.05 forall).Conclusions PI-FD is probably a specific type of functional dyspepsia.Epigastric pain,epigastric burning sensation,and early satiety are the major symptoms in these patients.Mast cells maybe involved in the pathogenesis of PI-FD.
ABSTRACT
PURPOSE: This study was conducted to assess clinical practices related to the evaluation and treatment of patients with acute gastrointestinal infection(AGI) in infants and children. This survey also evaluated the current opinion regarding the use of rotavirus vaccine. METHODS: This survey was conducted using a self-administered questionnaire provided to 82 pediatricians in private clinics of Jeonbuk province. From April to June, 2002, 63 of 82 pediatricians(76.8 %) responded to the survey. RESULTS: The annual proportion of patients with AGI was 13%. The highest proportion of patients with diarrhea were reported for the months of October through December. For the treatment of diarrhea, pediatricians preferred to prescribe lactobacillus products, oral rehydration solution, enzyme products, anti-emetics, anti-diarrheal formula, nothing by mouth(NPO) and bowel movement inhibitors in descending order of frequency. Most pediatricians(79.4%) prescribed antibiotics in less than 20% of patients with AGI. Amoxicillin was the most commonly prescribed antibiotics followed by trimethoprim/sulfamethoxazole(TMP/SMX) and amoxicillin/clavulanate. Clinical manifestations that pediatricians considered as important factors in prescribing antibiotics were bloody diarrhea, mucoid diarrhea, high fever, persisting disease and abdominal pain. Diagnostic procedures that pediatricians preferred for AGI patients were stool examination(rotavirus antigen, RBC, WBC), abdominal X-ray, and serum electrolytes. Pediatricians had a strong interest in rotavirus vaccine(71.4%). CONCLUSIONS: Acute gastrointestinal illness remains a common problem, especially during the winter months in Korea. AGI manifesting as watery diarrhea is appropriately treated with commonly available agents but pediatricians appear ready to consider additional approaches to decrease the sizable disease burden of AGI among children in Korea.