• Title/Summary/Keyword: gastrointestinal symptom & disease

Search Result 60, Processing Time 0.026 seconds

Change in the treatment strategy for pediatric Crohn's disease

  • Kim, Mi-Jin;Choe, Yon-Ho
    • Clinical and Experimental Pediatrics
    • /
    • v.53 no.9
    • /
    • pp.830-833
    • /
    • 2010
  • Crohn's disease is characterized by chronic inflammation involving any portion of the gastrointestinal tract. Treating Crohn's disease is a major challenge for clinicians, as no curative therapy currently exists. Pediatric Crohn's disease is characterized by frequent relapses, a wide extent of disease, a high prevalence of extraintestinal manifestations, and a severe clinical course. The classic therapeutic approach is known as the 'step-up' strategy, and follows a progressive course of treatment intensification as disease severity increases. Although this approach is usually effective for symptom control, many patients become either resistant to or dependent on corticosteroids. The efficacy of infliximab suggests that, rather than a progressive course of treatment, early intense induction may reduce complications associated with conventional treatment and improve quality of life. Intensive early therapy with infliximab is known as the 'top-down' strategy. Such therapy offers the potential for altering the natural history of Crohn's disease, and is changing treatment paradigms. However, the relatively new concept of an early aggressive or 'top-down' treatment approach is not yet widely accepted, especially in pediatric patients. The results of our current study demonstrate that early and intensive treatment of pediatric Crohn's disease patients with infliximab, at initial diagnosis, was more effective for maintaining remission and reducing flares.

Recent Advances in Diagnosis of Gastrointestinal Disease (소화기질환 진단의 최신지견)

  • Choi, Ho-Seung;Kim, Jae-Kwan;Choi, Seo-Hyung
    • The Journal of the Society of Korean Medicine Diagnostics
    • /
    • v.13 no.1
    • /
    • pp.1-9
    • /
    • 2009
  • Objectives : If patients notice a symptom indicating inveterate dyspepsia but they don't have any problem around gastroscope, they get diagnosed as a functional dyspepsia or an imaginary stomach disease, but to overcome the limitations of these diagnoses, we are analyzing them for the common feature and are looking for a new diagnostics for them. Methods : Based on our survey with 122 patients with inveterate dyspepsia, we analyzed the period of onset, eating habits, the main symptoms, and observations on the gastroscope. We also analyzed the function of the stomach and intestines by EAV examinations, and the outer walls of the stomach and intestines by subdividing the level of coagulation into six with abdominal palpation. Results : We figured out that people who appeals about inveterate dyspepsia have had long period of onset, and that they had bad eating habits, shoulder stiffness, neck stiffness, headache, dizziness, etc. These are all the similar symptoms beside dyspepsia, which indicates that it is a syndrome. From about 70%, they didn't had particular problem in gastroscope, and as to be seen from the result of EAV examination, their stomachs and intestines had become functionless. Also, we were able to feel a stiffened tissue through abdominal palpation. Conclusion : Through this investigation, we found out that what the gastroscope can not find so that gets diagnosed as a functional dyspepsia or an imaginary stomach disease can be diagnosed as a syndrome called damjeok by overcoming the limitation utilizing the survey, EAV examinations, and abdominal palpation. We can find a mighty significance from the fact that it can be diagnosed as a syndrome.

  • PDF

A Case of Pneumothorax after Phrenic Nerve Block with Guidance of a Nerve Stimulator

  • Beyaz, Serbulent Gokhan;Tufek, Adnan;Tokgoz, Orhan;Karaman, Haktan
    • The Korean Journal of Pain
    • /
    • v.24 no.2
    • /
    • pp.105-107
    • /
    • 2011
  • Hiccups have more than 100 etiologies. The most common etiology has gastrointestinal origins, related mainly to gastric distention and gastroesophageal reflux disease. Intractable hiccups are rare but may present as a severe symptom of various diseases. Hiccups are mostly treated with non-invasive or pharmacological therapies. If these therapies fail, invasive methods should be used. Here, we present a patient on whom we performed a blockage of the phrenic nerve with the guidance of a nerve stimulator. The patient also had pneumothorax as a complication. Three hours after intervention, a tube thoracostomy was performed. One week later, the patient was cured and discharged from the hospital. In conclusion, a stimulator provides the benefit of localizing the phrenic nerve, which leads to diaphragmatic contractions. Patients with thin necks have more risk of pneumothorax during phrenic nerve location.

A Case of Metastatic Ampulla of Vater Cancer Achieving Cure (고형물 삼킴장애로 내원한 환자 1례)

  • Weon Jin Ko;Won Young Park;Jun-Hyung Cho;Joo Young Cho
    • Journal of Digestive Cancer Research
    • /
    • v.2 no.2
    • /
    • pp.82-84
    • /
    • 2014
  • We report a case with dysphagia for solids. A 51-year-old man with benign esophageal stricture was transferred for endoscopic treatment. He had lye ingestion history at 9 years old and underwent esophagectomy with right colonic interposition for the treatment of the benign esophageal stricture. But his symptom was acting up 2 years ago and lasted afterward even though he had underwent endoscopic treatments for dysphagia several times, including balloon dilation and stent insertion. He had polypoid enhancing wall thickening around anastomosis site of stomach with perigastric soft tissue density and suspicious nodular extension to omentum on the small bowel computed tomography. So he had a surgical resection of small bowel and jejunojejunostomy, and the pathological result was adenocarcinoma, intestinal type with soft tissue infiltration. Later he underwent total gastrectomy with segmental resection of interpositional colon and segmental resection of duodenum and ileo-colic anastomosis revision. And recently he has been on chemotherapy.

  • PDF

Clinical Case Report of PPI-refractory Gastro-Esophageal Reflux Disease (GERD) with Korean Medicine Treatment - A Focus on Evaluation of the Abdominal Examination (한의 복합치료로 호전된 불응성 위식도역류질환 (PPI-refractory GERD) 환자 1례 - 복진소견 평가를 중심으로 -)

  • Lee, Jae-hong;Cho, Soo-ho;Ko, Seok-jae;Park, Jae-woo
    • The Journal of Internal Korean Medicine
    • /
    • v.38 no.5
    • /
    • pp.727-735
    • /
    • 2017
  • This case report describes a 60-year-old man who had reflux symptoms despite treatment with proton pump inhibitors (PPIs). Korean traditional medicine, including a herbal prescription, acupuncture, and moxibustion was administered to the patient during his 19 days of hospitalization. The visual analogue scale (VAS), gastrointestinal scale (GIS), and gastrointestinal symptom rating scale (GSRS) scores were assessed on the dates of admission and discharge. An abdominal examination, which is one of the Korean medicine diagnostic tools, was performed every day to evaluate the treatment progress. During the treatment, the improvement of symptoms was clinically correlated with abdominal examination outcomes. We suggest that administration of traditional Korean Medicine on PPI-refractory GERD patients could be effective and we recommend utilization of the abdominal examination as an assessment tool for Korean Medicine treatment.

Case Series of Refractory Gastroesophageal Reflux Disease Treated with Lijin-tang-gamibang (이진탕가미방(二陳湯加味方)을 투여한 불응성 위식도역류질환의 증례군 연구)

  • Ha, Na-yeon;Han, Ga-jin;Kim, Dae-jun;Ko, Seok-jae;Park, Jae-woo;Kim, Jin-sung
    • The Journal of Internal Korean Medicine
    • /
    • v.38 no.6
    • /
    • pp.1085-1095
    • /
    • 2017
  • Objectives: The purpose of this study was to investigate the efficacy of Lijin-tang-gamibang on refractory gastroesophageal reflux disease (GERD). Methods: This before-and-after study compared the first medical examination and examination at the end of medical treatment. Twelve refractory GERD patients who visited the Department of Digestive Diseases of Kyung Hee University Korean Medicine Hospital from August 14th, 2017 to October 14th, 2017, were treated with Lijin-tang-gamibang for four consecutive weeks. The clinical characteristics of refractory GERD and the efficacy of herbal medical treatment was assessed by questionnaires, the Nepean Dyspepsia Index-Korean version (NDI-K), the Korean Gastrointestinal Symptom Rating Scale (KGSRS), the Numerical Rating Scale (NRS), the Korean version of the Perceived Stress Scale (KPSS-10), the Qi Stagnation Questionnaire (QSQ), the Spleen Qi Deficiency Questionnaire (SQDQ), and the Patient Global Impression of Change (PGIC). Prolonged effects were reported upon the follow-up telephone survey two weeks after treatment. Results: After treatment with the herbal medicine Lijin-tang-gamibang, the clinical characteristics of 12 refractory GERD patients were improved, especially in terms of the most common symptoms of acid regurgitation and heartburn. Each symptom score of NDI-K, KGSRS, NRS, SQDQ, and PGIC showed significant advances. Prolonged effects were reported in NDI-K, NRS and PGIC questionnaires two weeks after treatment. Conclusions: These results suggest that Lijin-tang-gamibang is an effective treatment for refractory GERD.

The health lifestyle of adults related to smoking, drinking and exercise (흡연, 음주, 운동과 건강생활양식)

  • So Hee Young;Lee Mi Ra;Cheong Mee Sook
    • Journal of Korean Public Health Nursing
    • /
    • v.12 no.2
    • /
    • pp.221-235
    • /
    • 1998
  • This study is a descriptive survey to explore the health lifestyle of adults. The study subjects are teachers of elementary. middle and high school. and staffs of research institutes located in Chungchung Province and Daejon city. The data was collected from Jan. to march 1997 through self reporte for structured questionnaire. Fantastic check list of Wilson and Ciliska for Health Lifestyle Assessment and DSM-III-R for somatic symptom were used as tools. Data was analysed by frequency, $X^2_test$, t-test and Anova using SAS program. The results are as follows: 1. There were statistically significant differences In drinking(t=7.75, P=.000), exercise(t=-2.99, P=.003)and interpersonal relationship(t=2.22, P=.027) among 10 health lifestyle between smoking group and non-smoking group, in drinking(t=17.98, P=.000), exercise(-4.71. P=.000), and job satisfaction(t=2.22, P=.027) between drinking group and non-drinking group, and in eating habit(t=-2.00, P=.045), drinking (t=4.47, P=000), exercise (t= -16.49, P=000), keeping traffic law(t= -2.68, P=.007), personality (t= -2.05, P=.040) and anxiety/depression(t=-3.47, P=.000) between exercise group and non-exercise group. 2. There was statistically significant difference in cardiovascular symptom(F=4.22, P=.0l) among somatic symptoms of subjects according to exercise level. 3. There was statistically significance difference in lifestyle according to smoking level(F=, 3.33, P=.011), drinking level(F=9.17, P=.0001) and exercise level(F=11.93, P=.000l), and in somatic symptom according to sex(t=-3.93, P=.0001), weight(F=3.83, P=.022), exercise level (F=3.29, P=.03) among general characteristics. 4. There was statistically significant difference between sex in general (t= -3.64, P=.0001), gastrointestinal(t=-2.21, P=.02), musculoskeletal(t=-3.92, P=.001), and total symptom (t= -3.92, P=.0001). 5. There was statistically very highly signigicant difference In weight according to smoking($x^2=25.18,\; P=.001)$ and exercise$(x^2=16.46,\; P=001)$. 6. There was statistically significant difference in frequency between smoking group, drinking group and exercise group$(x^2=24.52,\;P=.001)$. Among a number of habit, smoking, drinking and exercise are important factors of human health to prevent related disease morbidity and death. It is essential for industrial health nurse to committ in this subject considering the influence of those factors and lifestyle on health. There is also a relationship of weight with smoking and exercise, the frequency of overweight/obesiy in smoking/ no-exercise group were high. It is quite necessary for the people having cardiovascular symptom to exercise to lower morbidity and mortality. The industrial health nurse has to keep In mind on this point and consider of time and facilities of fitness of employee. It needs to explore the cause by further research on somatic symptom of women. This research shows that concerning the relationship between smoking, drinking, and exercise, health care provider must take not only management of disease, but health behaviors and lifestyle into consideration.

  • PDF

Is This Symptom Even a Food Allergy?: Clinical Types of Food Protein-induced Enterocolitis Syndrome

  • Hwang, Jin-Bok
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • v.17 no.2
    • /
    • pp.74-79
    • /
    • 2014
  • Food protein-induced enterocolitis syndrome (FPIES) is an under-recognized non-IgE-mediated gastrointestinal food allergy. The diagnosis of FPIES is based on clinical history, sequential symptoms and the timing, after excluding other possible causes. It is definitively diagnosed by an oral food challenge test. Unfortunately, the diagnosis of FPIES is frequently delayed because of non-specific symptoms and insufficient definitive diagnostic biomarkers. FPIES is not well recognized by clinicians; the affected infants are often mismanaged as having viral gastroenteritis, food poisoning, sepsis, or a surgical disease. Familiarity with the clinical features of FPIES and awareness of the indexes of suspicion for FPIES are important to diagnose FPIES. Understanding the recently defined clinical terms and types of FPIES is mandatory to suspect and correctly diagnose FPIES. The aim of this review is to provide a case-driven presentation as a guide of how to recognize the clinical features of FPIES to improve diagnosis and management of patients with FPIES.

A Case Report of Seborrheic Dermatitis With a Gastrointestinal Symptom Treated by Jeokseokji-uyeoryang-tang Based on Shanghanlun (상한론에 근거하여 소화기 이상을 동반한 지루성 피부염 환자에 대한 적석지우여량탕 치험 1례)

  • Lee, Sung-Jun;Yoon, Hye-ji;Lee, Soong-In
    • Herbal Formula Science
    • /
    • v.24 no.1
    • /
    • pp.45-52
    • /
    • 2016
  • objective The purpose of this case report is to review the possibility of utilizing Jeokseokji-uyeoryang-tang as a therapy of seborrheic dermatitis, and to consider clinical using possibility of Shanghanlun.method Patient's Diagnosis and progress of seborrheic dermatitis was evaluated based on the patient's chart and picture. And diagnosis based on Shanghanlun was organized by table.results When analyzing the patient's history and symptoms, it can be found in article No. 159 in Shanghanlun. The area and intentsiy of erythema were reduced when viewed photos findings, so diagnosis and therapies used in this case showed valid results in seborrheic dermatitis.conclusion Jeokseokji-uyeoryang-tang is efficient to patient of this case report as a treatment.

A Clinical Case Report of Soyangin Patients with Functional Dyspepsia (기능성 소화불량증이 호전된 소양인 비수한표한병 환자 3례 보고)

  • Oh, Hyun-Joo;Hong, Seung-Min;Hwang, Min-Woo
    • Journal of Sasang Constitutional Medicine
    • /
    • v.28 no.3
    • /
    • pp.286-299
    • /
    • 2016
  • Objectives The purpose of this study was to report significant improvement of functional dyspepsia in 3 patients, who were diagnosed with 'Soyangin Spleen Cold-based Exterior Cold disease' and applied medication based on Sasang Constitutonal medicine.Methods The patients were treated with herbal medications, according to their own constitution. The objective outcome was measured by body composition analyzer and Gastrointestinal Symptom Rating Scale (GSRS), and the subjective sensation was assessed by using Visual Analogue Scale (VAS).Results The symptoms of functional dyspepsia improved remarkedly in all respects, without any side effects. Original symptoms also changed for the better.Conclusions This results show that it is available that functional dyspepsia is treated with medicines according to Sasang Constitutional medicine.