• Title/Summary/Keyword: Functional Abdominal Pain

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Clinical Study for Objectification of Abdominal Examination with Functional Dyspepsia - Epigastric Diagnosis using Algometer (기능성 소화불량 환자의 복진진단 객관화를 위한 임상연구 - 알고미터를 이용한 심하비경 진단 -)

  • Choi, Gyu-Ho;Rho, Gi-Hwan;Choi, Seo-Hyung
    • The Journal of Korean Medicine
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    • v.43 no.1
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    • pp.1-5
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    • 2022
  • Objectives: Using algometer, measure the pressure pain threshold (PPT) of the epigastric pain(心下痞硬) and calculate the cut-off value, and this can serve as the basis for prognostic diagnosis of functional dyspepsia so we would like to evaluate its diagnostic value. Methods: We investigated 353 patients with functional dyspepsia symptoms who admitted Gangnam Weedahm Oriental Hospital from February 1, 2021 to February 27, 2021. At the time of the patient's visit, an oriental medical doctor measured the pressure at the first pain point on the Algometer of (CV14), twice each, at 1minute intervals. The ROC (receiver operating characteristic) curve and the optimal cut-off value derived through the diagnosis of the (CV14) PPT value for epigastric pain(心下痞硬) and the gold standard of oriental medical doctor, it was evaluated through. Results: In 353 patients, the area under the ROC curve (AUC) was 0.909 (p=0). In addition, the optimal cutting value was 10.05 (kg/cm2), which was statistically significant. Additionally, the sensitivity of the Algometer's PPT measurement was 0.704 and the specificity was 0.884. As a result, if the PPT value of the Algometer exceeds 10.05 (kg/cm2) in terms of the optimal cutting value, it can be seen that epigastric pain(心下痞硬) is lost. Conclusion: Algometer's PPT value measurement can be a reliable test method for quantification of epigastric pain(心下痞硬) diagnosis and can be useful as an objective indicator.

Spinal Cord Stimulation for Intractable Visceral Pain Due to Sphincter of Oddi Dysfunction

  • Lee, Kang Hun;Lee, Sang Eun;Jung, Jae Wook;Jeon, Sang Yoon
    • The Korean Journal of Pain
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    • v.28 no.1
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    • pp.57-60
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    • 2015
  • Sphincter of Oddi dysfunction (SOD) is a syndrome of chronic biliary pain or recurrent pancreatitis due to the functional obstruction of the pancreaticobiliary flow. We report a case of spinal cord stimulation (SCS) for chronic abdominal pain due to SOD. The patient had a history of cholecystectomy and had suffered from chronic right upper quadrant abdominal pain. The patient had been diagnosed as having SOD. The patient was treated with opioid analgesics and nerve blocks, including a splanchnic nerve block. However, two years later, the pain became intractable. We implanted percutaneous SCS at the T5-7 level for this patient. Visual analog scale (VAS) scores for pain and the amount of opioid intake decreased. The patient was tracked for more than six months without significant complications. From our clinical case, SCS is an effective and alternative treatment option for SOD. Further studies and long-term follow-up are necessary to understand the effectiveness and the limitations of SCS on SOD.

Effect of Naesowhajung-tang on Electrogastrography in children with functional dyspepsia (기능성 소화불량증 환아(患兒)의 위전도에 대한 내소화중탕(內消和中湯)의 효과(效果))

  • Kim, Jong-Yoon;Lee, Jin-Yong;Yoon, Sang-Hyub
    • The Journal of Pediatrics of Korean Medicine
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    • v.16 no.2
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    • pp.199-213
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    • 2002
  • We have surveyed the epidemiology of functional dyspepsia in 7 cases of Children and investigated the therapeutic effect on Functional Dyspepsia following 4 weeks medication of Naesowhajung-tang using Electrogastrogram. The Results were as followings: 1. Sex ratio are 6 males, 1 female; their mean ages, $9.0{\pm}1.41(7-11years)$; length, $137.2{\pm}13.86cm$; body weight, $35.3{\pm}l1.34kg$. 2. Most of subjects have a normal growth state. But one case have severe growth disturbance. Familial tendency for this disease is noted in 85.8%. 3. Abdominal pain was seen in 100% of subjects. The indicated symptom was lowed in order of abdominal pain(100%), nausea vomiting(71.43%), general fatigue(65.34%), vertigo headache(57.14%), belching(55.38%), etc. 4. The EGG finding after treatment was improved in 53%, aggrevated in 43. In cases, postprandial improvement was more remarkable than fasting improvement. Common cold and antibiotics seems to have functioned as an aggrevating factor on gastric motility. From the above results, Naesowhajung-tang seems to have been used in the treatment of functional dyspepsia for children.

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Investigation of changes in abdominal cavity between dyspepsia patients and healthy participants when pressure pain occurs using an algometer combined with an ultrasound device: a non-randomized, controlled, pilot trial (초음파 결합형 압통계를 활용한 압통시 소화불량 환자와 건강인의 복강내 조직 변화 비교: 비무작위 대조군 예비 임상시험)

  • Jinwoong Lim;Taeseong Jeong;Hoseok Jung;Sunny Kang;Chang-Min Choi;Dong Woung Kim
    • Journal of Society of Preventive Korean Medicine
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    • v.27 no.1
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    • pp.43-52
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    • 2023
  • Objectives : The aim of this study was to evaluate the differences in the abdominal cavity between functional dyspepsia patients and healthy people using an algometer combined with an ultrasound device. Methods : A non-randomized, controlled, pilot trial was conducted. Thirty patients in the experimental group and fifteen participants in the control group were recruited. We collected demographical data, and measured abdominal circumference, height of the body cavity, subcutaneous fat thickness, visual analogue scale of dyspepsia symptoms in the experimental group, depth of algometer and pressure of algometer when pressure pain occurred, and the whole ultrasonic image from the beginning of pressurization to the time when pressure pain occurred. The measurements were carried out twice with the duration of 1 week. Generalized linear regression was conducted to adjust baseline characteristics. Results : A total of 45 participants (30 in experimental group, 15 in control group) were recruited and finished the trial. Females were recruited more in the experimental group than in the control group and it was statistically significant. The difference in thickness of abdominal cavity between a second before the pressure pain and at the time when pressure pain occurred was statistically significant on 1st visit, and other measurements were not statistically significant. From the results of the regression analysis, the difference between two groups was statistically significant in the differences in the thickness of stomach and up to abdominal aorta on 1st visit, and the thickness of stomach on 2nd visit, and other measurements were not statistically different. Conclusions : According to the results, there were not statistically significant differences in abdominal examination when pressure pain occurred between dyspepsia patients and healthy people. Further studies are warranted to assess the abdominal examination using devices including algometer and ultrasound devices, regarding the results of the present study.

Case Study of Application on ADIM of Patient With Chronic Low Back Pain for Contraction Training of Transversus Abdominis (만성요통환자의 복횡근 수축훈련을 위한 ADIM 적용사례)

  • Kim, Han-Il
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.17 no.2
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    • pp.49-55
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    • 2011
  • Background: The purpose of this study was to identify the effects of the abdominal drawing-in maneuver (ADIM) for contraction training of transversus abdominis (TrA) to the patient with chronic low back pain (CLBP). Methods: A 37-year female patient with CLBP participated in study. This study was fix to method of ADIM that maintain to draw in lower abdomen in sitting position on chair and fix 1 time protocol that perform rest for 1-min and ADIM for 1-min during 10-min. Hereunder the subject performed 2 times protocol during 30-min. Measurement method were visual analogue scale (VAS), Korean version of Oswestry disability index (KODI) and using ultrasound imaging. Results: VAS was decreased 5cm to 1cm after intervention 3 weeks, KODI was decreased 22% to 9% after intervention 3 weeks and changes in thickness of the TrA were increased 32% to 68% during ADIM. Conclusions: These findings suggest that performed the ADIM took effect for decreased pain and functional disability level with increased changes in thickness of the TrA. Therefore, patients with CLBP should be use for training of deep abdominal muscles apply to the ADIM.

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Diagnosis of Functional Gastrointestinal Disorders with Rome III Criteria in Korean Pediatric and Adolescent Patients: Clinical Usefulness of QPGS (한국 소아청소년에서 로마 III 기준을 이용한 기능성 위장관 질환의 진단: QPGS (Questionnaire on Pediatric Gastrointestinal Symptoms)의 유용성)

  • Kim, Dong-Soon;Nho, Han-Nae;Kim, Cu-Rie;Lee, Hee-Woo;Yoon, Ji-Hyun;Uhm, Ji-Hyun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.120-132
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    • 2009
  • Purpose: We diagnosed pediatric functional gastrointestinal disorders in Korean children and adolescents using Rome III criteria and investigated the clinical validity of QPGS-Rome III. Methods: Diagnosis based on QPGS was compared with the physician's diagnosis based on Rome III criteria. One hundred and thirty eight children and their parents completed the QPGS. Agreement rates were measured using Kappa method. Results: In physician's diagnoses, the most prevalent disorders were functional dyspepsia (39.1%), irritable bowel syndrome (38.4%), and functional abdominal pain (18.8%). Among QPGS based diagnoses, the most prevalent disorders were irritable bowel syndrome (39.1%), functional dyspepsia (29.7%), and functional abdominal pain (21.7%). The agreement rate was substantial (${\kappa}$=0.72, p=0.00). Diagnostic disagreements probably resulted from different patient responses to bowel movement form and bowel frequency. Conclusion: Functional dyspepsia, irritable bowel syndrome, and functional abdominal pain were the most common disorders by Rome III criteria in the Korean pediatric and adolescent patients. The agreement rate between physician's diagnoses and QPGS based diagnoses supported the validity of the QPGS-Rome III in Korean pediatric and adolescent patients. QPGS seems to be useful in diagnosis of patients with functional gastrointestinal disorders by Rome III criteria.

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A Case Report of Symptom Improvement in Stage IV Metastatic Colorectal Cancer Treated with a Korean Medicine-based Integrative Cancer Treatment (전이성 4기 대장암 환자의 한의기반 통합암치료를 통한 증상 호전 증례보고)

  • Kim, Jong-hee;Park, Ji-hye;Oh, Hyeon-muk;Park, So-jung;Yoo, Hwa-seung
    • The Journal of Internal Korean Medicine
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    • v.41 no.6
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    • pp.1274-1281
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    • 2020
  • Objective: This case report shows symptom improvements in stage IV metastatic colorectal cancer treated with a Korean medicine-based integrative cancer treatment (ICT). Methods: A 61-year-old male patient diagnosed with colorectal cancer in November 2017 and metastasis to the lung, peritoneum, and liver in September 2020 was treated with Integrative Cancer Treatment (ICT) for abdominal pain, abdominal discomfort, and anorexia for 1 month. Clinical outcomes were measured with the National Cancer Institute Common Terminology Criteria for Adverse Event (NCI-CTCAE), a numeral rating (NRS), the Eastern Cooperative Oncology Group (ECOG), and the Functional Assessment of Cancer Therapy-General (FACT-G) scales. Results: After treatment, the patient's abdominal pain was improved from NRS 8 to 1, and the ECOG score of the patient was improved from grade 3 to 2. Integrative Cancer Treatment. Also the score improved on the FACT-G test, and there were no serious side effects of grade 3 or higher according to the NCI-CTCAE. Conclusion: This case study suggests that Korean medicine-based ICT may help to improve abdominal pain and quality of life in patients with metastatic colorectal cancer.

Clinical Characteristics of Pediatric Constipation in South Jordan

  • Altamimi, Eyad
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.17 no.3
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    • pp.155-161
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    • 2014
  • Purpose: Constipation is a common pediatric problem worldwide. This study aims to describe the clinical characteristics of pediatric constipation in south Jordan according to gender and age group. Methods: All patients with constipation managed at our pediatric gastroenterology service between September 2009 and December 2012 were included. Hospital charts were reviewed. Demographic data, clinical characteristics, and final diagnosis were recorded. Data were analyzed according to gender and the following age groups: infants, pre-school, school age, and adolescents. Results: During the study period, 126 patients were enrolled. The number (percentage) of patients according to age were the following infants: 43 (34.1%), pre-school: 55 (43.7%), school age: 25 (19.8%), and adolescents: 3 (2.4%). Males made up 54.8% of the study population. There were no statistical gender differences in any age group. The most common symptom in all age groups was dry, hard stool. Infrequent defecation was found in almost one-half of the patients. Fecal incontinence was more common in school-aged children compared to pre-school-aged children and adolescents. Abdominal pain was seen in almost 40% of the constipated children. Abdominal pain was more prevalent in girls and older children. Fecal mass in the rectum was the most common physical finding, with constipated boys exhibiting higher rates. Functional constipation was the most common etiology. Conclusion: Clinical characteristics of constipation in children vary according to age group and gender. Older children had less frequent bowel motions, a longer duration of symptoms, and a higher prevalence of long-standing constipation compilations (fecal incontinence and abdominal pain).

Core Stabilization With the Lumbar Extension Exercise in Low Back Pain

  • Noh, Dong-koog;Cha, Young-joo;Kim, Dae-hun;You, Joshua (Sung) H.
    • Physical Therapy Korea
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    • v.25 no.4
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    • pp.27-36
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    • 2018
  • Background: We developed a novel integrative lumbar stabilization technique that combines lumbar extension (LE) exercise with abdominal drawing-in maneuver (ADIM) to ameliorate low back pain (LBP) associated with neuromuscular imbalance and instability, based on the collective evidence of contemporary spinal rehabilitation. Objects: The specific aim of the present study was to investigate the effects of LE exercise with and without ADIM on core muscle strength, lumbar spinal instability, and pain, as well as functional characteristics in individuals with LBP using advanced radiographic imaging techniques. Methods: patients with mechanical LBP (N = 40, 6 males; $35.1{\pm}7.6years$) were recruited and randomly assigned either to the combined LE and ADIM (experimental group) or the LE alone (control group). Outcome measures included the visual analog scale, the modified Oswestry Disability Index, muscle strength imbalance (MSI), and radiographic imaging. The lumbar intervertebral displacement (LID), intervertebral (IV) and total lumbar extension (TLE) angles were calculated to evaluate the lumbar segmental instability. Results: The experimental group showed significant differences in the L3-L4, L5-S1 LIDs, L4-L5 and L5-S1 IV angles, and TLE angle as compared to the controls (p<.05). Immediate pain reduction and muscle strength imbalance ratio were significantly different between the groups (p<.05). Conclusion: These results suggest that the addition of ADIM significantly increased lumbar spinal stabilization in individuals with LBP, thereby reducing pain associated with functional lumbar flexion during daily activities.