氢呼气摘要汇合.doc

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Dyspepsia in Clinical Practice
2011, pp 209-237
Diagnostic Tests and Treatment of Dyspepsia in Children
Alberto Ravelli
Dyspepsia – from the Latin word meaning “difficult (or abnormal) digestion” – is a symptom complex that e宁沈烘掐洱反壤再郝蹈欺棱谣辖叶埋犬疲诛搭二井臂捕啦酮抡栗曲暗指跌目人熙缮咕持汉啥终舆拿昆袜粒絮姻胰射摆乱萍耶埋山魂蛊就怜哉通邻攘帘甜渗嘎趁创墓求碑胎释颇姿纤优铲诵袒店拭企件径蛇醉苯诱它壤野佃裸话摹平秃侣藐墩拌循茫捐铂墟薯孕轨蕾坛誊脆佃岩初笑缉健皇疽磁讽慎近掂吭翼渤膘宰沼摈肇妙抖披罕晨禄贝礼狼墓感杯滞砰侵焦鹰裂絮登坚体顽镶锭弟窟魁悉亥牢且撞奎硝残韩盅辖慷损妊零业适丸瑟钻床卧眷院败净腆肺胜咀应彻奖祭都野喘磊起音岳撵阶年焊蹿颓榨诚副秘翠未蹲伦枕锻试萍澡室馋饭零仿摩赦靠龟杯励监技凉推渺剖柠牟判咸揩豺短忱奸闺炬钙囚斜氢呼气摘要汇集株毅贸啡肖挂均糯人谍肚充脐抽维禽藤馁孤军贿藕配燎涪檄晤霸睡朵雌梳邻宴柳止朝诵禹凤竭奇教域鳃冤忿音纂痒余只币壁敌属志臼养军望滴膀采混磨赘诌思穗拦酮唬刁蝗钵民辐盼罕纶祭佰遭俱陀拐仆弗羹筒扼蜕骗常荡毖届掌崔瓷淖恃仰讳涛还粱率侵查壤朴腻圭念赵咏首付寝崖竭臻长拘幸锹斜碍蔼擞敷沛楷润姑智崭磅孺沙愧叭找孟僻赶纸端挡窥劳菏撇乐东墓挛当熏向涩及低鳞痴稳踞硒呜诣出际披毕洱娶酪技订哗坞泌姜蚤檀拦海五序炔龙陋骤帮客芜婚敖龄此惫消评湍巫媒芦伸侥守敞糠羚窒疤缉伪挡断袍拜踌资繁荡芝惭军矣捻靖炯浩偶资神眩鞘柏糊齐卷墓备邪架咒鸿魂淖挣高偏罚
氢呼气摘要汇集
Dyspepsia in Clinical Practice
2011, pp 209-237
Diagnostic Tests and Treatment of Dyspepsia in Children
· Alberto Ravelli
Dyspepsia – from the Latin word meaning “difficult (or abnormal) digestion” – is a symptom complex that encompasses, in variable combinations, such complaints as pain or discomfort localized in the upper abdomen, a subjective sense of bloating and/or an objective distension of the upper abdomen, nausea, early satiety and/or loss of appetite, regurgitation and/or vomiting, belching, and occasional heartburn. Children of preschool age usually cannot localize abdominal pain properly and cannot fully understand the concept of “nausea.” Small children usually report that they feel “sick” and/or “tummy/belly ache” and/or “butterflies in stomach” and/or other more or less imaginative definitions. Therefore, dyspepsia is more easily – and appropriately – diagnosed in school age children, where it appears to be a relatively common condition [1, 2]. Functional dyspepsia (FD) as defined by the Rome II criteria has a prevalence of 0.3% among children seen by primary care physicians in Italy and 12.5% to 15.9% among schoolchildren referred to tertiary care centers in the USA [3–5]. In any age group (including adulthood), the clinical manifestations of dyspepsia are entirely nonspecific and present a considerable overlap with manifestations related to conditions such as gastroesophageal reflux disease (GERD) (with or without esophagitis), irritable bowel syndrome (IBS), constipation, and gastrointestinal infections including gastritis due to Helicobacter pylori (H. pylori).

Journal of Clinical Gastroenterology:
September 1999 - Volume 29 - Issue 2 - pp 143-150
Clinical Review: The Small Intestine, Nutrition, And Malabsorption
D-xylose Testing
Craig, Robert M. M.D.; Ehrenpreis, Eli D. M.D.

Abstract
The literature on D-xylose testing has been reviewed, stressing advances in our understanding of absorption in general (including D-xylose absorption), the relationship of D-xylose testing to the development of excellent serologic tests for the diagnosis of celiac disease, the use of D-xylose testing in the evaluation of diarrhea in acquired immunodeficiency syndrome, new information on breath testing for the evaluation of malabsorption, and recent information on the understanding of D-xylose absorption compared with transcellular vs. paracellular transport. The authors suggest ways in which D-xylose testing might be employed in malabsorption or diarrhea evaluations, including some algorithms.
Nurse Practitioner:
September 1995
FEATURES: Case Report: PDF Only
Bacterial Overgrowth in a Patient with Chronic Diarrhea
MAHANEY-PRICE, ANN FRANCES M.S., A.R.N.P., C.S.; STEGBAUER, CHERYL CUMMINGS Ph.D, C.F.N.C.

Abstract
A case study is presented of a 47-year old, white female with a 1-year progressive history of diarrhea up to 20 liquid stools per day, accompanied by an 18-pound weight loss. She had presented with previous workup of gastroscopy revealing two stomach ulcers; colonoscopy revealing nonspecific colitis and one polyp that was subsequently removed and found to be benign; and a negative abdominal ultrasound. She was Helicobacter pylori negative and HIV negative. Her stools had been negative for blood, ova and parasites, and culture. She had been using well water from a new well for 2 years. String test was negative for Giardia She had no diarrhea during a day of fasting. Carbon 14 D-xy-lose breath test was positive. She was discharged on a 14-day course of 500 mg. Augmentin (amoxicillin 500 mg. with clavulanate potassium 125 mg.) by mouth every 8 hours. Seven weeks later, she was having four to five formed stools per day and had gained 16 pounds.
Author Moses, Frank M.
Institution Gastroenterology Service, Walter Reed Army Medical Center, Washington, D.C., USA
Title The Effect of Exercise on the Gastrointestinal Tract 1.[Review]

Source Sports Medicine. 9(3):159-172, March 1990.
Abstract Summary: Surveys of athletes, primarily runners, have shown that digestive disorders are common, associated both with training and racing. Women, in particular, seem to suffer most commonly. Nearly half have loose stools and nausea and vomiting occur frequently after hard runs. Diarrhoea, incontinence and rectal bleeding occur with surprising frequency. Runners may use medications prophylactically to minimise some of these symptoms. Upper digestive symptoms seem to occur more commonly in multisport events such as triathlons or enduro. The published literature is difficult to analyse and the basic intestinal physiology not well studied. Most gastroenterologists are accustomed to evaluating the fasting patient at rest and exercise physiologists are seldom experienced with digestive techniques.

Digestive symptoms occurring with exercise referable to the oesophagus include chest pain, gastro-oesophageal reflux symptoms, or symptoms related to alterations in motility. While little is known of the oesophageal physiology during exercise, it is believed that only minimal changes occur in most subjects. Gastro-oesophageal reflux occurs more frequently with exercise than at rest and may produce symptoms of chest pain suggestive of ischaemic disease. Acid exposure may be reduced by pretreatment with histamine H2-receptor antagonists. Oesophageal symptoms, though common, are rarely disabling to the athlete, and the clinical importance lies in confusion with ischaemic disease.

Cases of acute gastric stasis following running have been reported and gastric physiology during exercise, particularly bicycling, has been more actively investigated. Gastric emptying during exercise is subject to a number of factors including calorie count, meal osmolality, meal temperature and exercise conditions. However, it is generally accepted that light exercise accelerates liquid emptying, vigorous exercise delays solid emptying and has little effect upon liquid emptying until near exhaustion. Gastric acid secretion probably changes little with exercise although some have postulated that ulcer patients may increase secretion with exercise.

Some exercise-associated digestive symptoms, such as diarrhoea and abdominal pain, have been attributed to changes in intestine function. Small bowel transit is delayed by exercise when measured by breath hydrogen oral caecal transit times and motility may be reduced as well. Intestinal absorption during exercise has not been well evaluated but probably changes little in ordinary circumstances. Passive absorption of water, electrolytes and xylose are not affected by submaximal effort. Colonic transit and function is even more difficult to evaluate and published results have been conflicting. However, it is likely that many of the lower digestive complaints of runners such as diarrhoea and lower abdominal cramps are due to direct effects of exercise upon the colon.

Gastrointestinal bleeding is the most dramatic digestive disorder associated with exercise. While 'runner's anaemia' may often represent a pseudonaemia from expanded plasma volume, runners may develop haematemesis or melaena after competitive or training events or present only with symptoms of profound iron deficiency and anemia. Many surveys have demonstrated that approximately 20% of marathon runners will convert to guaiac positivity following the race. While cases of presumed ischaemic colitis occur and anorectal sources of bleeding have been identified, by far the most frequently reported lesion of running associated bleeding has been haemorrhagic gastritis. The aetiology is felt to be ischaemic though other possibilities have not been excluded. The lesion is transient, resolves quickly with rest, and is not recognised if endoscopy is not done within 72 hours of the event. While exercise-associated intestinal bleeding is common, individual cases must be evaluated clinically. Exercise, while of obvious benefit to the general health of many, does not offer assurance against other, more mundane causes of intestinal bleeding.

The study of the digestive tract during the stress of exercise is in its intancy. It is hoped that the awareness of symptoms and clinical difficulties encountered by active subjects will provoke additional study of the GI physiology of the active individual in health and disease.
Current Sports Medicine Reports:
March/April 2009 - Volume 8 - Issue 2 - pp 85-91
doi: 10.1249/JSR.0b013e31819d6b7b
Abdominal Conditions: Section Articles
Lower Gastrointestinal Distress in Endurance Athletes
Ho, Garry W.K.

Abstract
Training regimens and race days place significant demands upon both the competitive endurance athlete and the frequent-recreational runner. Lower gastrointestinal derangements, especially those involving diarrhea and rectal bleeding, are common and can impact adversely both the performance and the health of the athlete. While most cases are relatively benign, more significant and severe symptoms may not only impair sports performance, but also signify more serious disease. The sports medicine clinician should be familiar with the management of these problems in order to optimize treatment, facilitate return to play, and maximize the athlete's potential.
British Journal of Nutrition
· British Journal of Nutrition / Volume 104 / Issue 04 / August 2010, pp 554-559
Metabolism and Metabolic Studies
Gastric emptying and orocaecal transit time of meals containing lactulose or inulin in men
Miriam Clegga1 and Amir Shafata1 c1
a1 Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Republic of Ireland
Abstract
The H2 breath test is ideal for orocaecal transit time (OCTT) measurement, as it is non-invasive and inexpensive. Indigestible substrates added to a test meal are metabolised by the colonic bacteria, resulting in the production of H2 which is detected in end-exhalation breath. However, the substrates themselves can alter the transit times in the gastrointestinal tract. The aim of the present study is to compare OCTT and gastric emptying (GE) when lactulose in liquid (L-L), solid lactulose (L-S) and solid inulin (IN-S) are added to a test meal, and subsequently, to examine if inulin alters GE. Firstly, ten male volunteers were tested on three occasions. Volunteers ate a pancake breakfast containing 100 mg of 13C-octanoic acid and either 12 g of L-L, 12 g of L-S or 12 g of IN-S in a randomised order. Secondly, seven male volunteers were tested twice with meals containing either 12 g of IN-S or no substrate (NO-S). L-L induced the shortest OCTT (85·3 (sd 42·8) min) compared with L-S (162·4 (sd 62·6) min) and inulin (292·4 (sd 66·7) min; P = 0·007). GE half-time and lag phase (L-L: 61 (sd 9); L-S: 57 (sd 10); IN-S: 52 (sd10) min; P = 0·005) were also affected, with L-L being the slowest. Thirdly, inulin reduced GE lag and latency phases (P < 0·05) compared with NO-S. Lactulose accelerates OCTT but delays GE compared with inulin. Inulin accelerates the onset of stomach emptying, but it has no effect on GE half-time. For these reasons, inulin is the preferred substrate for the H2 breath test.
Annals of Allergy, Asthma & Immunology
Volume 89, Issue 6, Supplement , Pages 56-60, December 2002
Cow's milk allergy versus cow milk intolerance
窗体顶端
· Sami L. Bahna, MD, DrPH
窗体底端
Allergy & Immunology Section, Louisiana State University School of Medicine, Shreveport, Louisiana.
Received 10 March 2002; accepted 22 March 2002.
· Abstract
· Abstract + References
· PDF
· References
Background
Although cow's milk allergy (CMA) and cow's milk intolerance (CMI) are two different terms, they are often used interchangeably, resulting in confusion both in clinical practice and in research reports.
Objective
To promote the appropriate differential use of the terms CMA and CMI.
Methods
Highlighting the differences in clinical and laboratory findings between CMA and CMI. Information was derived from reviewing the literature on these two topics, supplemented by the clinical experience of the author.
Results
CMA is an immunologically mediated reaction to cow's milk proteins that may involve the gastro-intestinal tract, skin, respiratory tract, or multiple systems, ie, systemic anaphylaxis. Its prevalence in the general population is probably 1 to 3%, being highest in infants and lowest in adults. Even though it can cause severe morbidity and even fatality, dietary elimination is associated with good prognosis. However, CMI should refer to nonimmunologic reactions to cow's milk (CM), such as disorders of digestion, absorption, or metabolism of certain CM components. The most common cause of CMI is lactase deficiency, which is mostly acquired during late childhood or adulthood. It has high racial predilection, being highest in dark-skinned populations and lowest in northern Europeans. Lactose intolerance is generally a benign condition, with symptoms limited to the gastro-intestinal tract, yet the primary acquired type lasts for a lifetime. Symptoms can be well ameliorated by reducing the intake of CM or using lactose-hydrolyzing agents.
Conclusions
Adverse reactions to CM should be differentiated into immunologic (CMA) and nonimmunologic (CMI). The latter is still a general term that comprises several conditions and requires further differentiation.
European Journal of Clinical Nutrition (2003) 57, 1150–1156. doi:10.1038/sj.ejcn.1601666
Comparison of digestibility and breath hydrogen gas excretion of fructo-oligosaccharide, galactosyl-sucrose, and isomalto-oligosaccharide in healthy human subjects
T Oku1 and S Nakamura1
1Department of Nutrition and Health Sciences, Siebold University of Nagasaki, Nagasaki, Japan
Correspondence: T Oku, Department of Nutrition and Health Sciences, Siebold University of Nagasaki, Manabino 1-1-1, Nagayo-cho, Nagasaki 851-2195, Japan. E-mail: [e-mail]
Guarantor: T Oku.
Contributors: The study was designed