Abdominal symptoms during Sjogren's syndrome: a pilot study

Abstract Background: Abdominal symptoms in patients with primary Sjögren syndrome (pSS) are poorly documented. The objective of the study was to describe the abdominal symptoms of patients with pSS and to assess their association with characteristics of the disease. Methods: One hundred and fifty patients with pSS were evaluated using a composite global symptom score for abdominal symptoms and their severity. Data concerning the clinical and biological characteristics of pSS and abdominal disorders were also collected. Results: Of the patients with pSS, 95% suffered from abdominal symptoms (median global symptom score 7.5 ±5.5 points out of 30). More than half of the patients experienced abdominal tension (68%), upper abdominal pain (54%), abdominal discomfort (58%) and/or constipation (54%). Regarding the pSS activity, in relation to European League Against Rheumatism (EULAR) Sjogren syndrome disease activity index score items, general and central nervous system involvement wereassociated with a high global symptom score. The EULAR Sjogren Syndrome Patient Reported Index (ESSPRI) symptom score was positively correlated with the global symptom score (p < 0.01). Multivariate analysis showed a significant association between a high global symptom score and SSA seronegativity, gastroparesis, and ESSPRI score (p < 0.01 for each). Conclusions: The majority of patients with pSS suffered abdominal symptoms. There is currently no therapeutic recommendation because of the lack of information on the underlying pathophysiological mechanisms. Trial registration: NCT03157011. Date of registration: July 17, 2017.(AU)

<b>Two Cases of Chest and Abdominal Pain in Elderly Persons </b><b>Successfully Treated with Daisaikoto</b> / 日本東洋医学雑誌

We report two cases of chest and abdominal symptoms, the causes of which can not be established in a medical sense, successfully treated with daisaikoto. The first case was an 81-year-old male. He complained of tightness in his chest. Since the frequency of his symptom was increasing, he underwent further evaluation in hospital, but no abnormalities were found. We administered daisaikoto with reference to his constipation and <i>kyo-kyo-kuman </i>(subchondrial resistance and discomfort), the tightness in his chest disappeared and three months later his qi stagnation score and SDS score had improved.<br>The second case was an 83-year-old male. He had been suffering epigastric pain, tightness of chest and abdomen and a feeling of fullness in the abdomen since two years previously, when he suffered multiple traumatic injuries. We administered daisaikoto in light of his epigastric pain, constipation and <i>kyo-kyo-kuman</i>.The epigastric pain and tightness of the chest and abdomen gradually disappeared, and the number of his unscheduled visits to the clinic decreased.<br>Thus, daisaikoto may be used to treat patients with chest or abdominal symptoms and depression, the cause of which can not be established in any medical sense.

Disappearance of Various Abdominal Symptoms with Kampo Treatment in a Postoperative Patient with Renal Cell Carcinoma / 日本東洋医学雑誌

We report a case with various postoperative abdominal symptoms that were successfully treated with Kampo medicine. A 58-year-old Japanese female had nausea, eructation, epigastric pain, lower abdominal pain and anorexia that appeared just after laparoscopic nephrectomy for renal cell carcinoma. No abnormal findings were discovered by gastroenterological examinations. Western medical therapy was not successful. We used bukuryoin under the interpretation that nausea and eructation represent phlegm-fluid retention in the chest. The bukuryoin therapy cleared up her nausea and eructation in about one week. Additionally, her epigastric pain, lower abdominal pain and anorexia were cured by use of anchusan.

A Trial Study of Kikyo-to on Abdominal Symptoms in Chronic Pancreatitis Patient / 日本東洋医学雑誌

The authors investigated the activity of Kikyo-to on the intestinal hormones, cholecystokinin (CCK) and secretin, released in healthy humans. The clinical efficacy of Kikyo-to on the abdominal symptoms associated with chronic pancreatitis was also investigated. In healthy volunteers, Kikyo-to (5g) significantly increased plasma CCK and secretin concentrations 30 minutes after treatment. In chronic pancreatitis patients, abdominal pain, abdominal tenderness, nausea and diarrhea were decreased by treatment with Kikyo-to (7.5g/day; divided into three doses). In conclusion, Kikyo-to improved the complaints of chronic pancreatitis, especially abdominal pain. The presumed mechanism was that Kikyo-to stimulated pancreatic exocrine secretion by the release of intestinal hormones, CCK and secretin.

Diagnostic Values of Abdominal Ultrasonograpy in Patients with Fever and Abdominal Symptoms / 영남의대학술지

PURPOSE: Acute febrile illness in children frequently accompanies with abdominal symptoms such as vomiting, diarrhea, and abdominal pain, even if its etiology is not occured from the gastrointestinal tract. If the etiology of fever was unknown and the fever was accompanied with abdominal symptoms, we should be concerned about whether the etiology of fever was originated from the gastrointestinal tract or interpretated from the abnormality in the gastrointestinal tract. This study was performed to evaluate the diagnostic value of abdominal ultrasonography in patients with fever and abdominal symptoms. METHODS: We reviewed retrospectively the medical records of abdominal ultrasonographic (US) findings of 60 cases of acute febrile illness with abdominal symptoms at department of Pediatrics, Ulsan Dongang General RESULTS: (100%), splenomegaly in 4 cases (66.7%), ileocecitis in 1 case (16.7%), enlarged mesenteric lymph nodes and splenomegaly in 4 cases (66.7%), enlarged mesenteric lymph nodes, splenomegaly and ileocecitis in 1 cases (16.7%). 6) The enlarged mesenteric lymph nodes and the abnormalities around the appendix were seen in 7 cases (11.7%), which were confirmed as appendicitis all. 7) The thickening of wall in urinary bladder was seen in 2 cases (3.3%) of acute cystitis and acute hemorrhagic cystitis. 8) The subtle thickening of wall in colon was seen in 1 cases (1.7%) of shigellosis. CONCLUSIONS: The enlarged mesenteric lymph nodes, splenomegaly and ileocolitis on the abdominal ultrasonography in patients with fever and abdominal symptoms aree suggestive findings of typhoid fever. The enlarged mesenteric lymph nodes and the abnormalities around the appendix on abdominal ultrasonography make the rapid diagnosis of acute appendicitis and its complications, when physical examination is difficult in small children and diagnosis of their illnesses is obscure in patients with fever and abdominal pain.