Natural Remedies For Abdominal Distension
A-Glucosidase inhibitors should be taken with the first bite of food. Gastrointestinal effects of bloating, flatulence, diarrhea, and stomach pain can occur early in therapy and diminish with time. These agents are ideally suited for those patients who ingest significant amounts of complex carbohydrates as adjunctive therapy to sulfonylureas and insulin sensitizers. Although they work on two different mechanisms in controlling postprandial sugar, sufficient data does not yet exist to give a formal recommendation on concomitant use of a-glucosidase inhibitors and glinides (5).
A limited number of medications are currently available in the pediatric age group for use as adjuncts to behavioral management. Sibutramine (Meridia) is currently available for the treatment of adolescents 16 yr of age or older. Sibutramine is a norepinephrine and serotonin reuptake inhibiter and has side effects that include hypertension, tachycardia, dry mouth, headache, constipation, and insomnia. When used in conjunction with a group-based behavioral therapy, sibutramine plus behavioral therapy led to a more rapid decline in BMI than behavioral therapy alone (91). Sibutramine should not be administered in conjunction with monoamine oxidase inhibitors or other serotonin reuptake inhibitors. Another pharmaceutical alternative is orlistat (Xenical). Orlistat binds gut lipase and prevents hydrolysis of dietary fats into free fatty acids and monoacylglycerols. Its side effects, which often lead to discontinuation of the medication, include flatulence, diarrhea, steatorrrhea, and...
Vitamin E is one of the least toxic vitamins (50), and there is no evidence of side effects of consumption of vitamin E that occurs naturally in foods. Studies on toxicity are, therefore, limited to supplemental sources of vitamin E (1). Kappus and Diplock (51) reviewed the literature on vitamin E toxicity and concluded that humans show few side effects after supplemental doses below 2100mg per day of tocopherol. Animal studies show that vitamin E is not mutagenic, carcinogenic, or teratogenic (5254). Adults tolerate relatively high doses without significant toxicity however, muscle weakness, fatigue, double vision, emotional disturbance, breast soreness, thrombophlebitis, nausea, diarrhea, and flatulence have been reported at tocopherol intakes at 1600-3000mg day (1, 55-58).
The answer is c Seidel 4e pp 532533 Normal liver span is 612 cm in the MCL and 48 cm in the midsternal line MSL Micro
The answer is c. (Fauci, 14 e, pp 1626-1629. Sapira, p 273.) Diabetic patients, especially those with poor control, may develop delayed gastric emptying (autonomic dysfunction). Often patients will have a succussion splash (a splash is heard with the stethoscope when shaking the patient due to air-fluid level). Diagnosis is made by a gastric emptying study. Patients with celiac sprue (also called gluten-sensitive enteropathy) present with bloating, diarrhea, and excessive flatus. They typically have signs of malabsorption, such as hypoalbuminemia, iron-deficiency anemia, hypocholesterolemia, and decreased carotene level. The diagnosis is made by small bowel biopsy and the treatment is a wheat-free diet. Whipple's disease is a multisystemic disorder characterized by arthralgias, abdominal pain, fever, weight loss, lymphadenopathy, heart disease, and neurologic disease. Finding periodic acid-Schiff (PAS) positive-staining foamy macrophages in tissues makes the diagnosis, and...
The answer is d. (Behrman, 16 e, pp 2156-2159.) Lead poisoning produces a motor neuropathy and is associated with anemia, a gingival lead line, colicky abdominal pain, and basophilic stippling of red blood cells. Patients with acute intermittent porphyria (AIP) present with recurrent bouts of abdominal pain, confusion, and peripheral and cranial neuropathies. Kernicterus is accumulation of bilirubin in the newborn that may cause neuronal death and scarring. Children with fragile X syndrome present with mental retardation, large ears, and a prominent jaw. The triad of macroglossia, abdominal distension, and constipation is consistent with cretinism. 498. The answer is c. (Behrman, 16 e, pp 1554-1556. Hay, 14 e, pp 782-792.) The most common renal tumor in children is Wilms tumor or nephroblastoma (an embryonal tumor of renal origin). Children present with a painful abdominal mass, dysuria, polyuria, hematuria, weight loss, nausea, and vomiting. Physical examination typically...
Discussion Obesity contributes to atherosclerosis, CAD, hyperlipidemia, hypertension, and type II diabetes. Anti-obesity drugs currently on the market include orlistat and sibutramine. They are indicated lor weight loss and maintenance in conjunction with a calorie-reduced diet in patients with a body mass index 30. Orlistat is a lipase inhibitor that acts in the GI tract and blocks the absorption of dietary fat. The most common adverse effects are GI-related and include spotting, flatus, and fatty stools. Absorption of lipid-soluble vitamins (e.g., vitamin K) or medications (e.g., griseofulvin) may be decreased. Sibutramine treats obesity through appetite suppression it acts centrally by blocking serotonin and norepinephrine reuptake. Adverse effects include headache, dry mouth, constipation, insomnia, and a substantial increase in blood pressure and heart rate in some patients. Unlike the discontinued drug fenfluramine, sibutramine does not cause pulmonary hypertension or cardiac...
The answer is c. (Rock, 8le, pp 1211-1213.) The most common cause of fecal incontinence is obstetric trauma with inadequate repair. The rectal sphincter can be completely lacerated, but as long as the patient retains a functional puborectalis sling, a high degree of continence will be maintained. Generally the patient is continent of formed stool but not of flatus. Other causes of fecal incontinence include senility, central nervous system (CNS) disease, rectal prolapse, diabetes, chronic diarrhea, and inflammatory bowel disease. While rectal prolapse, CNS disease, and senility are thus potential causes of this condition, they can be excluded by the
A 60-year-old man with a history of appendectomy 30 years ago presents to the emergency room complaining of abdominal pain. He describes the pain as colicky and crampy and feels it builds up and then improves on its own. He has vomited at least 10 times since the pain started this morning. He states that he has not had a bowel movement for 2 days and cannot recall the last time he passed flatus. The abdomen is slightly distended. Abdominal auscultation reveals high-pitched bowel sounds and peristaltic rushes. Percussion reveals a tympanic abdomen. The patient is diffusely tender on palpation but has no rebound tenderness. Rectal examination reveals the absence of stool. Which of the following is the most likely diagnosis
The answer is c. (Guyton, pp 769-770.) Gas within the colon is derived primarily from fermentation of undigested material by intestinal bacteria to produce CO2, H2, and methane. The digestive tract normally contains about 150 to 200 mL of gas, most of which is in the colon (100-150 mL). Most of the gas in the stomach is derived from air swallowed during eating or in periods of anxiety. Gas is produced in the small intestine by interaction of gastric acid and bicarbonate in the intestinal and pancreatic secretions but does not accumulate because it is either reabsorbed or quickly passed into the colon. The amount of gas varies markedly from one person to another and is influenced by diet for example, ingestion of large amounts of beans, which contain indigestible carbohydrates in their hulls, will increase gas formation by intestinal bacteria. Diffusion of gas from the blood to the intestinal lumen is responsible for the N2 present in intestinal gas and is influenced by the...
A-Glucosidase inhibitors are modestly effective in treating diabetes with hemoglobin A1-C reductions of 0.5-1 and can be particularly effective in patients who consume high-carbohydrate diets. Adverse effects of a-glucosidase inhibitors are gastrointestinal and include abdominal bloating, pain, diarrhea, and flatulence, occurring in up to 70 of patients. Although these adverse effects tend to dissipate in 4-6 weeks, they are to be a major reason for discontinuation of medications.
The jaundice appears and lasts for about 2 weeks. The body temperature often returns to normal but anorexia and nausea remain. There is usually dark urine and grayish stools. The liver remains tender and perhaps enlarged. The patient experiences flatulence and may have mild pruritis.
Examples of prescriptions include one where animal parts were mixed in wine to procure an abortion rub a mixture of lizard's liver, skin of the cicada locust and wine on to the navel. Or the flesh of a pit viper was prepared by placing the snake in a gallon of wine then burying the sealed jar under a horse's stall for one year. The resultant liquid was a cure for apoplexy, fistula, stomach pain, heart pain, colic, haemorrhoids, worms, flatulence and bleeding from the bowel. Alcoholism could be cured by donkey's placenta mixed in wine, the liver of a black cat in wine for malaria, and to cure a bad cold an owl was smothered to death, plucked and boiled, its bones charred and taken with wine (Read 1931-7).
The easiest and cheapest method for distending the colon is to use room air, insufflated via a hand held plastic bulb. Typically patients lie on the CT scanner table in a left lateral position facing away from the operator. A lubricated rectal catheter attached to an insufflator bulb via a connecting tube is then inserted into the rectum and taped to the patient's buttocks. The patient is encouraged to retain any gas and avoid passing flatus by clenching the anal sphincter. Colonic insufflation is then performed by gently and intermittently squeezing the plastic bulb typically over a period of 1-2 min. In contrast, rapid successive squeezes can cause discomfort and may precipitate rectosigmoid spasm (Rubesin et al. 2000)
The answer is e. (Tintinalli, 5 e, pp 539-541.) The patient has a past medical history of appendectomy, which predisposes him to adhesions and small bowel obstruction (SBO). Other etiologies for SBO include incarcerated hernia, stricture, and malignancy. The high-pitched bowel sounds, the peristaltic rushes, and the tympany with percussion are physical findings when air is under pressure in viscera and intestinal fluid is present (i.e., obstruction). The hallmarks of intestinal obstruction are abdominal pain, distension, vomiting, and obstipation. Abdominal radiographs may reveal dilated loops of bowel in a ladderlike pattern and air-fluid levels. Large bowel obstruction (LBO) is due to malignancy, diverticulitis, and volvulus. A mnemonic for abdominal distension is the 6 Fs Fat, Fluid, Food, Fetus, Feces, and Flatus.
It also induced a reduction of testosterone levels, which is consistent with the reduction of testosterone levels in overweight women with PCOS after weight loss by dietary changes and exercise (139). However, it is difficult to assess the long-term clinical efficiency of the medications because the literature is rather inconclusive (small number of patients and short-term studies). Common side effects (headache, insomnia) and potentially serious cardiovascular effects (hypertension, arrythmias, etc.) limit the widespread use of sibutramine, and although orlistat generally has a safer side-effect profile, the frequent adverse effects on bowel habits (flatulence, steatorrhea, GI discomfort) are also significant hurdles to its use.
Hard stools are passed infrequently, sometimes after several days and with difficulty. Occasionally, liquid stool can pass around the obstruction and give the false impression of diarrhea and encopresis. Constipation in the neonate should be considered Hirschsprung until proven otherwise. The aganglionic segment is in the colon, usually rectosigmoid. Infants may have failure to thrive and abdominal distension. In older children with Hirschsprung, the rectal vault is empty of stool. Abdominal distension
Stool culture, also known as fecal culture, is an examination of the waste or excrement expelled from the digestive tract. Stool cultures are done to evaluate diarrhea of unknown etiology, to identify the presence of parasites in the lower gastrointestinal tract, and to identify organisms that cause damage to intestinal tissue. Excessive flatus and abdominal discomfort are additional indications for stool culture. It must be noted that feces of a healthy individual contains a significant number and variety of organisms that are not always pathogenic.