Dyspeptic symptoms and gastric emptying of solids in patients with functional dyspepsia. Role of Helicobacter pylori infection.

BACKGROUND: Our aim was to investigate the relation between dyspeptic symptoms, gastric emptying of digestible and indigestible solids, and Helicobacter pylori infection in patients with functional dyspepsia. METHODS: We used isotopic labeling and radiologic techniques to study gastric emptying of a solid meal and of 10 radiopaque indigestible solids in 50 healthy volunteers and 50 patients with functional dyspepsia. In addition, we determined the presence of seven symptoms of dyspepsia and added the score for each symptom to obtain an index of dyspepsia for each patient. RESULTS: Seventy-eight per cent of our dyspeptic patients had gastroparesis to a solid meal, and 68% to indigestible solids. We found no apparent relation between gastroparesis or H. pylori infection and dyspeptic symptoms separately or as an index of dyspepsia. Moreover, the presence of the bacteria was not related to gastroparesis to a solid meal or to indigestible solids. CONCLUSIONS: We conclude that neither symptoms of dyspepsia nor H. pylori appears to be related to gastroparesis to solids. H. pylori infection is not related to dyspeptic symptoms.

Gastroparesis of digestible and indigestible solids in patients with insulin-dependent diabetes mellitus or functional dyspepsia.

Gastric emptying of a solid meal and of 10 indigestible radiopaque solids was measured with scintigraphic and radiological techniques in 50 healthy volunteers (controls), 41 patients with insulin-dependent diabetes mellitus, and 50 patients with functional dyspepsia. Gastroparesis was found in 51% of our diabetic patients and 74% of our patients with dyspepsia. The values of Tlag, T1/2 and the percentage of isotope remaining in the stomach at 105 min were 14.9 min, 59.4 min and 25.3% in control subjects; 21.4 min, 88.1 min, and 46.9% in diabetic patients (P < 0.05 vs the control group); and 23.2 min, 114.6 min, and 58.7% in dyspeptic patients (P < 0.05 vs the control group). Whereas all healthy volunteers emptied all 10 indigestible solids in less than 4 hr, only 51% and 32% of diabetics and dyspeptics, respectively, achieved this emptying time (P < 0.01). Their respective values of T1/2 were 81 min, 212 min, and 203 min (P < 0.01 for diabetics and dyspeptics vs controls). We found no correlation between the findings for gastric emptying of digestible and indigestible solids. We conclude that gastroparesis affecting digestive and interdigestive motility is present in a high percentage of diabetics and functional dyspeptics and that conscientious evaluation of gastroparesis in both groups requires studies designed specifically to characterize each type of motility.

[Epidemiology of primary biliary cirrhosis in the South area of Granada]. / Epidemiología de la cirrosis biliar primaria en el área sur de Granada.

BACKGROUND: The epidemiology of primary biliary cirrhosis (PBC) in Spain is still poorly known. In fact, remarkable differences between areas have been found. METHODS: The epidemiology of PBC was investigated in the South area of the city and the province of Granada from 1976 through 1989. Several clinical and epidemiological data were collected from 25 patients who met the criteria for PBC and the yearly incidence and prevalence were calculated. RESULTS: The ages of patients which PBC ranged from 31 to 74 years (mean age 50 +/- 10.5); 88% were females and 28% were diagnosed in the asymptomatic phase of the disease. The incidence for the study period was variable, with a maximum of 6.8 cases/million and an overall yearly incidence rate of 4.1 +/- 2.3 cases/million (7.1 +/- 4.3 cases/million for females). When the risk population was considered (people over 25 years) the respective values were 11.5 and 6.9 +/- 3.7 cases/million (12.1 +/- 7.2 cases/million for females). The prevalence showed a progressive increase, being 36.4 cases/million at the end of the study; for the "risk" population it was 61.5/million (100 cases/million for females). CONCLUSIONS: Incidence and prevalence of PBC in the area of study are within medium and medium-high values for Spain and Europe. As in other studies, personal environmental or social factors with epidemiological significance were not identified.

[Gastric emptying of solids in chronic alcoholic hepatopathy: role of autonomic insufficiency]. / Vaciamiento gástrico de sólidos en la hepatopatía etílica crónica: responsabilidad de la insuficiencia autonómica.

Thirty one subjects are studied, 15 healthy (controls) and 16 presenting chronic alcoholic hepatopathy, in whom the existence of an autonomic insufficiency syndrome (AIS) was evaluated measuring the variations in heart rate while breathing (R index) and after standing up [O(B) index]. Vagal functioning was also studied when evaluating gastric emptying of digestible solids (VGS) and non digestible (VGSND). VGS after 45, 75 and 105 minutes in alcoholic patients was slower than in healthy controls (p less than 0.05) and in 50% of them it was slow after 105 minutes. VGSND was similar in both groups. R and O(B) indexes in alcoholic patients was smaller than in the control group (p less than 0.001), presenting 94% of them some index altered. An elevated percentage of patients suffering chronic alcoholic hepatopathy present a AIS which involves several organs, being R and O(B) indexes a better diagnostic method than VGS study.

[Acute pseudo-obstruction of the colon, a problem of old age. A study of 5 cases treated medically]. / La pseudobstrucción aguda del colon, un problema de la tercera edad. Estudio de cinco casos tratados médicamente.

Acute partial obstruction of the colon is a frequent complaint among elderly patients, this being the reason for the increase in incidence. 5 cases which were medically treated successfully are presented. The proper terminology is briefly discussed, describing the typical clinical features and the associated diseases which appear in 80-90% of cases. The diagnosis is basically clinical and plain abdominal X-Ray, barium enema and/or colonoscopy are the most helpful tests to make a differential diagnosis between mechanical and nonmechanical obstruction. An in-depth view on colonoscopy as a diagnostic and therapeutic method is presented.