Indigestion - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

INDIGESTION A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

ii

ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright ©2004 by ICON Group International, Inc. Copyright ©2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Indigestion: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-84462-3 1. Indigestion-Popular works. I. Title.

iii

Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

iv

Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on indigestion. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

v

About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

vi

About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

vii

Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON INDIGESTION ............................................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Indigestion .................................................................................... 6 E-Journals: PubMed Central ......................................................................................................... 7 The National Library of Medicine: PubMed .................................................................................. 9 CHAPTER 2. NUTRITION AND INDIGESTION ................................................................................... 25 Overview...................................................................................................................................... 25 Finding Nutrition Studies on Indigestion ................................................................................... 25 Federal Resources on Nutrition ................................................................................................... 26 Additional Web Resources ........................................................................................................... 27 CHAPTER 3. CLINICAL TRIALS AND INDIGESTION ......................................................................... 29 Overview...................................................................................................................................... 29 Recent Trials on Indigestion ........................................................................................................ 29 Keeping Current on Clinical Trials ............................................................................................. 30 CHAPTER 4. PATENTS ON INDIGESTION ......................................................................................... 33 Overview...................................................................................................................................... 33 Patents on Indigestion ................................................................................................................. 33 Patent Applications on Indigestion.............................................................................................. 40 Keeping Current .......................................................................................................................... 43 CHAPTER 5. BOOKS ON INDIGESTION ............................................................................................. 45 Overview...................................................................................................................................... 45 Book Summaries: Federal Agencies.............................................................................................. 45 Book Summaries: Online Booksellers........................................................................................... 46 Chapters on Indigestion ............................................................................................................... 47 CHAPTER 6. MULTIMEDIA ON INDIGESTION .................................................................................. 51 Overview...................................................................................................................................... 51 Video Recordings ......................................................................................................................... 51 CHAPTER 7. PERIODICALS AND NEWS ON INDIGESTION ............................................................... 53 Overview...................................................................................................................................... 53 News Services and Press Releases................................................................................................ 53 Newsletter Articles ...................................................................................................................... 55 Academic Periodicals covering Indigestion.................................................................................. 56 CHAPTER 8. RESEARCHING MEDICATIONS .................................................................................... 59 Overview...................................................................................................................................... 59 U.S. Pharmacopeia....................................................................................................................... 59 Commercial Databases ................................................................................................................. 61 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 65 Overview...................................................................................................................................... 65 NIH Guidelines............................................................................................................................ 65 NIH Databases............................................................................................................................. 67 Other Commercial Databases....................................................................................................... 69 APPENDIX B. PATIENT RESOURCES ................................................................................................. 71 Overview...................................................................................................................................... 71 Patient Guideline Sources............................................................................................................ 71 Finding Associations.................................................................................................................... 77 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 81 Overview...................................................................................................................................... 81 Preparation................................................................................................................................... 81 Finding a Local Medical Library.................................................................................................. 81

viii Contents

Medical Libraries in the U.S. and Canada ................................................................................... 81 ONLINE GLOSSARIES.................................................................................................................. 87 Online Dictionary Directories ..................................................................................................... 89 INDIGESTION DICTIONARY..................................................................................................... 91 INDEX .............................................................................................................................................. 125

1

FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with indigestion is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about indigestion, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to indigestion, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on indigestion. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to indigestion, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on indigestion. The Editors

1

From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

3

CHAPTER 1. STUDIES ON INDIGESTION Overview In this chapter, we will show you how to locate peer-reviewed references and studies on indigestion.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and indigestion, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “indigestion” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Gut Sensitivity in Functional Dyspepsia Source: European Journal of Gastroenterology and Hepatology. 4(8): 622-625. August 1992. Summary: Dyspepsia is the term used to describe the upper abdominal symptoms associated with indigestion. This article, one of a group of five review articles about functional dyspepsia, or indigestion, discusses gut sensitivity in functional dyspepsia. Most of the symptoms of functional dyspepsia are based on uncomfortable sensations; these could be caused by an abnormal stimulus or by enhanced gastric or duodenal sensitivity. The authors discuss gastroduodenal sensitivity; factors that sensitize the gut; inflammation; post-traumatic or infective sensitization; sensitization by disease in other sites; and the role of stress. 2 tables. 17 annotated references. (AA-M).

4

•

Indigestion

Psychosocial Factors in Functional Dyspepsia Source: European Journal of Gastroenterology and Hepatology. 4(8): 602-607. August 1992. Summary: Functional dyspepsia is a gastrointestinal disorder associated with mealrelated upper abdominal discomfort and nausea. Despite a limited number of behavioral research studies in functional dyspepsia, there appears to be growing evidence that psychosocial factors modify how the symptoms are experienced and acted upon (illness behavior). This article, one of a group of five review articles about functional dyspepsia, or indigestion, discusses these psychosocial factors. The author presents biopsychosocial framework used to clarify the relationship of psychosocial factors with functional dyspepsia. Topics covered include stress and gastrointestinal physiology; visceral sensation; the brain-gut axis; life stress; psychological disturbances; environmental and sociodemographic factors; psychosocial modifiers; and psychosocial outcome. 2 figures. 25 annotated references. (AA-M).

•

Evaluation of a New Referral System for the Management of Dyspepsia in Hong Kong: Role of Open-Access Upper Endoscopy Source: Journal of Gastroenterology and Hepatology. 15(11): 1251-1256. November 2000. Contact: Available from Blackwell Science. 54 University Street, Carlton South 3053, Victoria, Australia. +61393470300. Fax +61393475001. E-mail: [email protected]. Website: www.blackwell-science.com. Summary: In the management of dyspepsia (heartburn, indigestion), upper endoscopy is an important component. This article reports on a study of the outcome of open access upper endoscopy in contrast with the conventional referral system. For patients presenting with dyspepsia, family physicians in the authors' region of Hong Kong were given the option to arrange upper endoscopy directly with the Medical Endoscopy Unit in addition to the conventional referral to specialist clinics. A detailed prospective followup was performed from June to September 1997 to evaluate the outcome and impact of open access upper endoscopy. From November 1996 to September 1999, 978 referrals for open access upper endoscopy were received. The service significantly reduced the waiting time for the procedure by 16 weeks. Open access upper endoscopy had similar detection rates for peptic ulcers and cancers compared with referrals from specialist clinics. Seventy-five percent of patients did not require further consultation with their family physicians within 2 months after endoscopy. It is a safe and effective procedure in establishing a definitive diagnosis. All family physicians were satisfied with the open access upper endoscopy service. Both types of referral system for endoscopy were similar in terms of the diagnostic yield. 2 tables. 31 references.

•

Dyspepsia Algorithm Source: Practical Gastroenterology. 22(6): 26-28, 34-36, 38. June 1998. Contact: Available from Shugar Publishing, Inc. 99B Main Street, Westhampton Beach, NY 11978. (631) 288-4404. Fax (631) 288-4435. E-Mail: [email protected]. Summary: This article discusses the evaluation and treatment of patients who present with nonulcer dyspepsia (indigestion). Although symptoms can overlap with those of gastroesophageal reflux disease (GERD), nonulcer dyspepsia is not necessarily acidmediated. The symptoms suggest an upper gastrointestinal tract (GI) problem and are largely postprandial (after meals). A typical patient may complain of decreased appetite and excessive fullness, sometimes nausea, after a meal, particularly a large meal at

Studies

5

night. An upper GI series typically reveals no structural abnormality to account for the symptoms, which can include heartburn and regurgitation, postprandial bloating and distention, abdominal discomfort, burning pain, satiety, nausea, and, rarely, vomiting, all generally provoked by eating. These problems with dyspepsia can be caused by endoscopy-negative GERD and irritable bowel syndrome. The author explores the role of Helicobacter pylori in nonulcer dyspepsia and the concept of nonulcer dyspepsia as a motility disorder. Patients who have the nocturnal symptom component indicative of peptic ulcer, should proceed immediately to H. pylori testing and eradicative therapy for those who test positive. For patients with classic heartburn and other reflux-related symptoms, the physician should begin with a prokinetic agent and go on to acidsuppressive therapy if symptoms persist. For those with the spectrum of upper GI symptoms marked by postprandial bloating and discomfort, a prokinetic drug can be used to promote gastric emptying. Finally, for patients whose symptoms persist in the absence of an identifiable motility disorder, therapy with amitryptiline or trazodone for visceral hypersensitivity can be tried. 5 figures. 2 tables. •

Continuing Dilemma of Dyspepsia Source: Alimentary Pharmacology and Therapeutics. 15(Supplement 1): 6-9. June 2001. Contact: Available from Alimentary Pharmacology and Therapeutics. Blackwell Science Ltd., Osney Mead, Oxford OX2 OEL, UK. +44(0)1865 206206. Fax +44(0)1865 721205. Email: [email protected]. Website: www.blackwell-science.com. Summary: This article reviews the issue of dyspepsia (indigestion, including heartburn) from various perspectives. First, the author discusses the current relevance of dyspepsia as a major health problem on account of its high prevalence and substantial morbidity (complications or illness). People's quality of life has generally improved and is now valued as an important asset. Consequently, nonlethal but annoying disorders like dyspepsia become ever more important. Some individuals even demand medical solutions for symptoms that manifest only when they overindulge in food and drink, and which do not bother them when they follow a sensible lifestyle. Second, the author reviews the various definitions of dyspepsia and the epidemiological and pathophysiological evidence that support them, as well as subclassifications. Third, the author considers the issue of dyspepsia as a clinical challenge, in the absence of well established and uniform management guidelines. Guidelines have been published to facilitate the task of prescribing the most balanced diagnostic to therapeutic approach in each patient. However, the task remains difficult because many variables are at play. 15 references.

•

Heartburn: When a Little Indigestion Becomes a Big Problem Source: Mayo Clinic Health Letter. 13: 1: 1-3. January 1995. Summary: This article reviews the problem of heartburn, the most common symptom of gastroesophageal reflux disease (GERD). The article summarizes lifestyle habits that may contribute to or cause GERD. The article also provides information about the physiology of the stomach and esophagus; factors that can relax the esophageal sphincter muscle, including obesity, certain foods and beverages, large meals, and lying down after meals; how to know when symptoms dictate a visit to one's health care provider; diagnostic tests; complications; and drug therapy, including H2 blockers, omeprazole, and cisapride. One sidebar briefly reports on surgical options for GERD. 1 figure.

6

•

Indigestion

Symptom Patterns in Functional Dyspepsia Source: European Journal of Gastroenterology and Hepatology. 4(8): 597-601. August 1992. Summary: This article, one of a group of five review articles about functional dyspepsia, or indigestion, discusses symptom patterns. The author notes that new consensus guidelines on how dyspepsia and functional dyspepsia should be defined are now available, but the practice of classifying patients into dyspepsia subgroups based on symptoms alone continues to be controversial. New data on the epidemiology of functional dyspepsia confirms that it is very common in the community, but the prognosis and the reasons why only a minority of these persons seek health care remain to be clarified. 2 figures. 24 annotated references. (AA-M).

Federally Funded Research on Indigestion The U.S. Government supports a variety of research studies relating to indigestion. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to indigestion. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore indigestion. The following is typical of the type of information found when searching the CRISP database for indigestion: •

Project Title: NONINVASIVE TEST FOR MANAGEMENT OF NONULCER DYSPEPSIA Principal Investigator & Institution: Craine, Brian L.; Western Research Company, Inc. 3275 W Ina Rd, Ste 215 Tucson, Az 85741 Timing: Fiscal Year 2002; Project Start 01-NOV-1999; Project End 31-JUL-2004 Summary: (Applicant's abstract): Nonulcer dyspepsia is a highly prevalent medical condition affecting up to 30 percent of the Western population, accounting for 2-5 percent of all visits to primary care physicians and leads to over one billion dollars worth of upper endoscopy procedures per year. In an attempt to lower this tremendous burden on the health care system the general practice currently is to attempt to avoid endoscopy in the majority of patients, which are low risk, by an initial empiric trial of medication. Endoscopy can then be performed on those that fail initial therapy. Unfortunately, empiric treatment is only effective in about 40-50 percent of cases since it is difficult to determine in advance the most effective treatment. Consequently the high cost of endoscopy continues to be a problem. The overall goal of this project is to

2 Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

Studies

7

develop an inexpensive, non-invasive test for the objective and quantitative categorization of nonulcer dyspepsia patients with the purpose of providing the most effective initial treatment. The effectiveness of objective patient categorization will be tested with respect to ability to predict which patients will be responders to acid suppression therapy and which will be responsive to prokinetic treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “indigestion” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for indigestion in the PubMed Central database: •

Analysis of vacA, cagA, and IS605 Genotypes and Those Determined by PCR Amplification of DNA between Repetitive Sequences of Helicobacter pylori Strains Isolated from Patients with Nonulcer Dyspepsia or Mucosa-Associated Lymphoid Tissue Lymphoma. by van Doorn NE, Namavar F, van Doorn LJ, Durrani Z, Kuipers EJ, Vandenbroucke-Grauls CM.; 1999 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=85157

•

cagA and vacA in strains of Helicobacter pylori from ulcer and non-ulcerative dyspepsia patients. by Faundez G, Troncoso M, Figueroa G.; 2002; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=128829

•

cagA Status and Eradication Treatment Outcome of Anti-Helicobacter pylori Triple Therapies in Patients with Nonulcer Dyspepsia. by Broutet N, Marais A, Lamouliatte H, de Mascarel A, Samoyeau R, Salamon R, Megraud F.; 2001 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=87932

•

Empirical prescribing for dyspepsia: randomised controlled trial of test and treat versus omeprazole treatment. by Manes G, Menchise A, de Nucci C, Balzano A.; 2003 May 24; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=156019

•

Equally high prevalences of infection with cagA-positive Helicobacter pylori in Chinese patients with peptic ulcer disease and those with chronic gastritis-associated dyspepsia. by Pan ZJ, van der Hulst RW, Feller M, Xiao SD, Tytgat GN, Dankert J, van der Ende A.; 1997 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=229746

3 4

Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.

8

Indigestion

•

Eradication of Helicobacter pylori in functional dyspepsia: randomised double blind placebo controlled trial with 12 months' follow up. by Talley NJ, Janssens J, Lauritsen K, Racz I, Bolling-Sternevald E.; 1999 Mar 27; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27795

•

Is Helicobacter pylori associated with non-ulcer dyspepsia and will eradication improve symptoms? A meta-analysis. by Jaakkimainen RL, Boyle E, Tudiver F.; 1999 Oct 16; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=28257

•

Management of patients with uninvestigated dyspepsia. by Zanten S, Flook N, Chiba N.; 2001 Jan 23; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=80668

•

Nervousness, Indigestion and Pain. by Ludlow AI.; 1944 Apr; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=194362

•

Psychometric validation of the German translation of the Gastrointestinal Symptom Rating Scale (GSRS) and Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire in patients with reflux disease. by Kulich KR, Malfertheiner P, Madisch A, Labenz J, Bayerdorffer E, Miehlke S, Carlsson J, Wiklund IK.; 2003; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=269999

•

Randomised controlled trial of Helicobacter pylori testing and endoscopy for dyspepsia in primary care. by Delaney BC, Wilson S, Roalfe A, Roberts L, Redman V, Wearn A, Hobbs FD.; 2001 Apr 14; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=30588

•

Randomised trial of endoscopy with testing for Helicobacter pylori compared with non-invasive H pylori testing alone in the management of dyspepsia. by McColl KE, Murray LS, Gillen D, Walker A, Wirz A, Fletcher J, Mowat C, Henry E, Kelman A, Dickson A.; 2002 Apr 27; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=102780

•

Serum response of Escherichia coli strains causing dyspepsia and urinary tract infection: relation to alpha-hemolysin production and O type. by Siegfried L, Kmetova M, Janigova V, Sasinka M, Takacova V.; 1995 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=173650

•

Systematic review and economic evaluation of Helicobacter pylori eradication treatment for non-ulcer dyspepsia. by Moayyedi P, Soo S, Deeks J, Forman D, Mason J, Innes M, Delaney B.; 2000 Sep 16; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27478

•

Treating Helicobacter pylori infection in primary care patients with uninvestigated dyspepsia: the Canadian adult dyspepsia empiric treatment ---Helicobacter pylori positive (CADET-Hp) randomised controlled trial. by Chiba N, van Zanten SJ, Sinclair P, Ferguson RA, Escobedo S, Grace E.; 2002 Apr 27; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=102778

•

Treatment failure of norfloxacin against Campylobacter pylori and chronic gastritis in patients with nonulcerative dyspepsia. by Mertens JC, Dekker W, Ligtvoet EE, Blok P.; 1989 Feb; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=171471

Studies

9

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with indigestion, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “indigestion” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for indigestion (hyperlinks lead to article summaries): •

“Alarm symptoms” in dyspepsia. How does the general practitioner investigate? Author(s): Meineche-Schmidt V, Jorgensen T. Source: Scandinavian Journal of Primary Health Care. 2003 December; 21(4): 224-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14695073

•

A discussion of the relationship between selenium, thyroxine, and indigestion. Author(s): Stockdale T. Source: Nutr Health. 1998; 12(2): 131-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9502238

•

A randomized, double-blind comparison of two different coffee-roasting processes on development of heartburn and dyspepsia in coffee-sensitive individuals. Author(s): DiBaise JK. Source: Digestive Diseases and Sciences. 2003 April; 48(4): 652-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12741451

•

ABC of the upper gastrointestinal tract: Indigestion and non-steroidal antiinflammatory drugs. Author(s): Seager JM, Hawkey CJ. Source: Bmj (Clinical Research Ed.). 2001 November 24; 323(7323): 1236-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11719417

•

ABC of the upper gastrointestingal tract: Indigestion: When is it functional? Author(s): Talley NJ, Phung N, Kalantar JS. Source: Bmj (Clinical Research Ed.). 2001 December 1; 323(7324): 1294-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11731396

6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

10

Indigestion

•

Absence of symptomatic benefit of lansoprazole, clarithromycin, and amoxicillin triple therapy in eradication of Helicobacter pylori positive, functional (nonulcer) dyspepsia. Author(s): Veldhuyzen van Zanten S, Fedorak RN, Lambert J, Cohen L, Vanjaka A. Source: The American Journal of Gastroenterology. 2003 September; 98(9): 1963-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14499772

•

Aggresomes and Russell bodies. Symptoms of cellular indigestion? Author(s): Kopito RR, Sitia R. Source: Embo Reports. 2000 September; 1(3): 225-31. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11256604

•

An update of the Cochrane systematic review of Helicobacter pylori eradication therapy in nonulcer dyspepsia: resolving the discrepancy between systematic reviews. Author(s): Moayyedi P, Deeks J, Talley NJ, Delaney B, Forman D. Source: The American Journal of Gastroenterology. 2003 December; 98(12): 2621-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14687807

•

Antro-fundic dysfunctions in functional dyspepsia. Author(s): Caldarella MP, Azpiroz F, Malagelada JR. Source: Gastroenterology. 2003 May; 124(5): 1220-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12730863

•

Approach to treatment of dyspepsia in primary care: a randomized trial comparing “test-and-treat” with prompt endoscopy. Author(s): Arents NL, Thijs JC, van Zwet AA, Oudkerk Pool M, Gotz JM, van de Werf GT, Reenders K, Sluiter WJ, Kleibeuker JH. Source: Archives of Internal Medicine. 2003 July 14; 163(13): 1606-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12860586

•

Assessment of meal induced gastric accommodation by a satiety drinking test in health and in severe functional dyspepsia. Author(s): Tack J, Caenepeel P, Piessevaux H, Cuomo R, Janssens J. Source: Gut. 2003 September; 52(9): 1271-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12912857

Studies

11

•

Association of CagA and VacA presence with ulcer and non-ulcer dyspepsia in a Turkish population. Author(s): Bulent K, Murat A, Esin A, Fatih K, MMMurat H, Hakan H, Melih K, Mehmet A, Bulent Y, Fatih H. Source: World Journal of Gastroenterology : Wjg. 2003 July; 9(7): 1580-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12854168

•

Belching: dyspepsia or gastroesophageal reflux disease? Author(s): Lin M, Triadafilopoulos G. Source: The American Journal of Gastroenterology. 2003 October; 98(10): 2139-45. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14572558

•

By the way, doctor. I am 59 years old, in good health, and have been on HRT (estrogen and progesterone) for about 10 years. I have tried several different preparations, but despite this, have developed a uterine fibroid, experienced indigestion, gained 20 pounds, and had one abnormal mammogram (with, thankfully, a negative biopsy). Because there is heart disease in my family, my doctor wants me to stay on HRT for the rest of my life. Can you suggest any alternatives? Author(s): Robb-Nicholson C. Source: Harvard Women's Health Watch. 2000 January; 7(5): 8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10594971

•

Cellular indigestion: chaperones head to the cytoskeleton. Author(s): Sussman MA. Source: Journal of Molecular and Cellular Cardiology. 2002 February; 34(2): 83-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11851348

•

Clinical and pathological implications of IgG antibody responses to Helicobacter pylori and its virulence factors in non-ulcer dyspepsia. Author(s): Xia HH, Talley NJ, Blum AL, O'Morain CA, Stolte M, Bolling-Sternevald E, Mitchell HM. Source: Alimentary Pharmacology & Therapeutics. 2003 April 1; 17(7): 935-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12656696

•

Comparative classification and grading of Helicobacter pylori gastritis in patients with gastric cancer and patients with functional dyspepsia. Author(s): Meining A, Kompisch A, Stolte M. Source: Scandinavian Journal of Gastroenterology. 2003 July; 38(7): 707-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12889555

12

Indigestion

•

Contribution of artificial neural networks to the classification and treatment of patients with uninvestigated dyspepsia. Author(s): Andriulli A, Grossi E, Buscema M, Festa V, Intraligi NM, Dominici P, Cerutti R, Perri F; NUD LOOK Study Group. Source: Dig Liver Dis. 2003 April; 35(4): 222-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12801032

•

Cost-effectiveness of alternative approaches in the management of dyspepsia. Author(s): Makris N, Barkun A, Crott R, Fallone CA. Source: International Journal of Technology Assessment in Health Care. 2003 Summer; 19(3): 446-64. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12962332

•

Cost-effectiveness of routine endoscopic biopsies for Helicobacter pylori detection in patients with non-ulcer dyspepsia. Author(s): Makris N, Crott R, Fallone CA, Bardou M, Barkun A. Source: Gastrointestinal Endoscopy. 2003 July; 58(1): 14-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12838214

•

Diet, food intake, and disturbed physiology in the pathogenesis of symptoms in functional dyspepsia. Author(s): Feinle-Bisset C, Vozzo R, Horowitz M, Talley NJ. Source: The American Journal of Gastroenterology. 2004 January; 99(1): 170-81. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14687160

•

Discussion on antro-fundic dysfunction in functional dyspepsia. Author(s): Boeckxstaens GE, Tytgat GN. Source: Gastroenterology. 2004 January; 126(1): 381-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14753223

•

Dyspepsia and Helicobacter pylori infection: a prospective multicentre observational study. Author(s): Perri F, Festa V, Grossi E, Garbagna N, Leandro G, Andriulli A; “NUDLOOK” Study Group. Source: Dig Liver Dis. 2003 March; 35(3): 157-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12779069

•

Dyspepsia results may not apply in primary care. Author(s): Delaney BC, Moayyedi P, Logan RF. Source: Bmj (Clinical Research Ed.). 2003 October 4; 327(7418): 811. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14525899

Studies

13

•

Dyspepsia symptoms and Helicobacter pylori infection, Nakuru, Kenya. Author(s): Shmuely H, Obure S, Passaro DJ, Abuksis G, Yahav J, Fraser G, Pitlik S, Niv Y. Source: Emerging Infectious Diseases. 2003 September; 9(9): 1103-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14519247

•

Dyspepsia. Author(s): Talley NJ. Source: Gastroenterology. 2003 October; 125(4): 1219-26. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14517803

•

Dyspepsia: endoscopy findings in Uganda. Author(s): Ogwang DM. Source: Trop Doct. 2003 July; 33(3): 175-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12870612

•

Effect of fluoxetine on symptoms and gastric dysrhythmia in patients with functional dyspepsia. Author(s): Wu CY, Chou LT, Chen HP, Chang CS, Wong PG, Chen GH. Source: Hepatogastroenterology. 2003 January-February; 50(49): 278-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12630041

•

Effectiveness of Gorei-san (TJ-17) for treatment of SSRI-induced nausea and dyspepsia: preliminary observations. Author(s): Yamada K, Yagi G, Kanba S. Source: Clinical Neuropharmacology. 2003 May-June; 26(3): 112-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12782911

•

Effects of a fixed combination of peppermint oil and caraway oil on symptoms and quality of life in patients suffering from functional dyspepsia. Author(s): Holtmann G, Haag S, Adam B, Funk P, Wieland V, Heydenreich CJ. Source: Phytomedicine : International Journal of Phytotherapy and Phytopharmacology. 2003; 10 Suppl 4: 56-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12807344

•

Effects of duodenal lipids on gastric sensitivity and relaxation in patients with ulcerlike and dysmotility-like dyspepsia. Author(s): Bjornsson E, Sjoberg J, Ringstrom G, Norstrom M, Simren M, Abrahamsson H. Source: Digestion. 2003; 67(4): 209-17. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12966228

14

Indigestion

•

Efficacy and tolerability of itopride hydrochloride in patients with non-ulcer dyspepsia. Author(s): Shenoy KT, Veenasree, Leena KB. Source: J Indian Med Assoc. 2003 June; 101(6): 387-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14579989

•

Efficacy of a herbal preparation in patients with functional dyspepsia: a metaanalysis of double-blind, randomized, clinical trials. Author(s): Gundermann KJ, Godehardt E, Ulbrich M. Source: Adv Ther. 2003 January-February; 20(1): 43-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12772817

•

Efficacy of artichoke leaf extract in the treatment of patients with functional dyspepsia: a six-week placebo-controlled, double-blind, multicentre trial. Author(s): Holtmann G, Adam B, Haag S, Collet W, Grunewald E, Windeck T. Source: Alimentary Pharmacology & Therapeutics. 2003 December; 18(11-12): 1099-105. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14653829

•

Electrogastrography as a diagnostic tool for delayed gastric emptying in functional dyspepsia and irritable bowel syndrome. Author(s): van der Voort IR, Osmanoglou E, Seybold M, Heymann-Monnikes I, Tebbe J, Wiedenmann B, Klapp BF, Monnikes H. Source: Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society. 2003 October; 15(5): 467-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14507348

•

Empirical prescribing for dyspepsia: randomised controlled trial of test and treat versus omeprazole treatment. Author(s): Manes G, Menchise A, de Nucci C, Balzano A. Source: Bmj (Clinical Research Ed.). 2003 May 24; 326(7399): 1118. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12763982

•

Endoscopic findings and the prevalence of Helicobacter pylori in chronic renal failure patients with dyspepsia. Author(s): Karari EM, Lule GN, McLigeyo SO, Amayo EO. Source: East Afr Med J. 2000 August; 77(8): 406-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12862061

•

Epigastric pain in dyspepsia and reflux disease. Author(s): Vakil N. Source: Reviews in Gastroenterological Disorders. 2003; 3 Suppl 4: S16-21. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14671510

Studies

15

•

Eradication of Helicobacter pylori in nonulcer dyspepsia: how much analysis do we need? Author(s): McQuaid KR. Source: Journal of Clinical Gastroenterology. 2003 April; 36(4): 291-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12642732

•

Evaluation of a model for counseling patients with dyspepsia in Swedish community pharmacies. Author(s): Westerlund T, Allebeck P, Marklund B, Andersson IL, Branstad JO, Sjoblom M. Source: American Journal of Health-System Pharmacy : Ajhp : Official Journal of the American Society of Health-System Pharmacists. 2003 July 1; 60(13): 1336-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12901035

•

Evaluation of epigastric discomfort and management of dyspepsia and GERD. Author(s): Schroeder BM. Source: American Family Physician. 2003 September 15; 68(6): 1215-6, 1219-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14524407

•

Factor structure of the Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire evaluated in patients with heartburn predominant reflux disease. Author(s): Kulich KR, Wiklund I, Junghard O. Source: Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation. 2003 September; 12(6): 699-708. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14516179

•

Functional dyspepsia, upper gastrointestinal symptoms, and transit in children. Author(s): Chitkara DK, Delgado-Aros S, Bredenoord AJ, Cremonini F, El-Youssef M, Freese D, Camilleri M. Source: The Journal of Pediatrics. 2003 November; 143(5): 609-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14615731

•

Functional dyspepsia. Author(s): Cash B. Source: Medgenmed [electronic Resource] : Medscape General Medicine. 2002 December 12; 4(4): 6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12817202

•

Functional dyspepsia: evaluation and treatment. Author(s): Simren M, Tack J. Source: Gastroenterology Clinics of North America. 2003 June; 32(2): 577-99. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12858607

16

Indigestion

•

Functional dyspepsia: relationship between clinical subgroups and Helicobacter pylori status in Western Turkey. Author(s): Saruc M, Ozden N, Turkel N, Ayhan S, Demir MA, Tuzcuoglu I, Akarca US, Yuceyar H. Source: Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Medicas E Biologicas / Sociedade Brasileira De Biofisica. [et Al.]. 2003 June; 36(6): 747-51. Epub 2003 June 03. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12792704

•

Gastric lipoma presenting with dyspepsia. Author(s): Amarapurkar D, Das HS, Gangwal S, Deasi PB. Source: J Assoc Physicians India. 2003 February; 51: 227-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12725277

•

Health-related anxiety and the effect of open-access endoscopy in US patients with dyspepsia. Author(s): Quadri A, Vakil N. Source: Alimentary Pharmacology & Therapeutics. 2003 March 15; 17(6): 835-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12641506

•

Health-related quality of life in functional dyspepsia. Author(s): El-Serag HB, Talley NJ. Source: Alimentary Pharmacology & Therapeutics. 2003 August 15; 18(4): 387-93. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12940923

•

Helicobacter pylori and dyspepsia management. Author(s): Shah MV. Source: East Afr Med J. 2000 August; 77(8): 405. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12862060

•

Helicobacter pylori eradication is beneficial in the treatment of functional dyspepsia. Author(s): Malfertheiner P, MOssner J, Fischbach W, Layer P, Leodolter A, Stolte M, Demleitner K, Fuchs W. Source: Alimentary Pharmacology & Therapeutics. 2003 September 15; 18(6): 615-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12969088

•

Helicobacter pylori infection and dyspepsia in pregnancy. Author(s): McKenna D, Watson P, Dornan J. Source: Obstetrics and Gynecology. 2003 October; 102(4): 845-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14551017

Studies

17

•

Helicobacter pylori infection treatment of nonulcer dyspepsia: an analysis of metaanalyses. Author(s): Laheij RJ, van Rossum LG, Verbeek AL, Jansen JB. Source: Journal of Clinical Gastroenterology. 2003 April; 36(4): 315-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12642737

•

Heterogeneity of symptom pattern, psychosocial factors, and pathophysiological mechanisms in severe functional dyspepsia. Author(s): Fischler B, Tack J, De Gucht V, Shkedy ZI, Persoons P, Broekaert D, Molenberghs G, Janssens J. Source: Gastroenterology. 2003 April; 124(4): 903-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12671886

•

Hospital admissions for peptic ulcer and indigestion in London and New York in the 19th and early 20th centuries. Author(s): Baron JH, Sonnenberg A. Source: Gut. 2002 April; 50(4): 568-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11889081

•

Hypnotherapy effective for functional dyspepsia. Author(s): Ebell M. Source: American Family Physician. 2003 May 15; 67(10): 2203-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12776973

•

Hypnotherapy for functional dyspepsia: do the results add up? Author(s): Chitkara D, Talley NJ. Source: Gastroenterology. 2003 August; 125(2): 636; Author Reply 637. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12891584

•

Impact of upper endoscopy on satisfaction in patients with previously uninvestigated dyspepsia. Author(s): Rabeneck L, Wristers K, Souchek J, Ambriz E. Source: Gastrointestinal Endoscopy. 2003 March; 57(3): 295-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12612505

•

Indigestion and coeliac disease. Author(s): Stockdale T. Source: Nutr Health. 2003; 17(3): 263-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14703158

18

Indigestion

•

Initial management strategies for dyspepsia. Author(s): Delaney BC, Moayyedi P, Forman D. Source: Cochrane Database Syst Rev. 2003; (2): Cd001961. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12804417

•

Intragastric distribution of a standardized meal in health and functional dyspepsia: correlation with specific symptoms. Author(s): Piessevaux H, Tack J, Walrand S, Pauwels S, Geubel A. Source: Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society. 2003 October; 15(5): 447-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14507346

•

Is it possible to predict treatment response to a proton pump inhibitor in functional dyspepsia? Author(s): Bolling-Sternevald E, Lauritsen K, Talley NJ, Junghard O, Glise H. Source: Alimentary Pharmacology & Therapeutics. 2003 July 1; 18(1): 117-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12848633

•

Looking back: the beginning of indigestion. Transactions of the MSMA, 1905, pages 125-128. Author(s): Folkes HM. Source: J Miss State Med Assoc. 2002 February; 43(2): 52-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11838364

•

Low yield of endoscopy in patients with persistent dyspepsia taking proton pump inhibitors. Author(s): Smith T, Verzola E, Mertz H. Source: Gastrointestinal Endoscopy. 2003 July; 58(1): 9-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12838213

•

Measuring dyspepsia-related health in randomized trials: the Severity of Dyspepsia Assessment (SODA) and its use in treatment with NSAIDs and COX-2-specific inhibitors. Author(s): Rabeneck L. Source: Rheumatology (Oxford, England). 2003 November; 42 Suppl 3: Iii32-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14585916

•

Meta-analysis of dyspepsia and nonsteroidal antiinflammatory drugs. Author(s): Ofman JJ, Maclean CH, Straus WL, Morton SC, Berger ML, Roth EA, Shekelle PG. Source: Arthritis and Rheumatism. 2003 August 15; 49(4): 508-18. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12910557

Studies

19

•

Metronidazole-resistant Helicobacter pylori is more prevalent in patients with nonulcer dyspepsia than in peptic ulcer patients in a multiethnic Asian population. Author(s): Lui SY, Yeoh KG, Ho B. Source: Journal of Clinical Microbiology. 2003 November; 41(11): 5011-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14605132

•

Modifying dyspepsia management in primary care: a cluster randomised controlled trial of educational outreach compared with passive guideline dissemination. Author(s): Banait G, Sibbald B, Thompson D, Summerton C, Hann M, Talbot S; Salford and Trafford Ulcer Research Network. Source: The British Journal of General Practice : the Journal of the Royal College of General Practitioners. 2003 February; 53(487): 94-100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12817353

•

Mutilation anxiety differs among females with fibromyalgia and functional dyspepsia and population controls. Author(s): Malt EA, Ursin H. Source: Journal of Psychosomatic Research. 2003 June; 54(6): 523-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12781306

•

New developments in the treatment of functional dyspepsia. Author(s): Stanghellini V, De Ponti F, De Giorgio R, Barbara G, Tosetti C, Corinaldesi R. Source: Drugs. 2003; 63(9): 869-92. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12678573

•

NICE issues guidance for heartburn and indigestion. Author(s): Ferriman A. Source: Bmj (Clinical Research Ed.). 2000 July 22; 321(7255): 197. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10903645

•

Non-endoscopic gastric mucosal biopsy in dyspepsia. Author(s): Lutfi A, Khan MA, Zuberi SJ. Source: J Pak Med Assoc. 2003 September; 53(9): 432-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14620321

•

Nurse-led dyspepsia clinic using the urea breath test for Helicobacter pylori. Author(s): Fraser A, Williamson S, Lane M, Hollis B. Source: N Z Med J. 2003 June 20; 116(1176): U479. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12835807

20

Indigestion

•

Patients with unstable angina pectoris present increased humoral response against Helicobacter pylori in comparison with patients with aggravated dyspepsia. Author(s): Rechcinski T, Kasprzak JD, Chmiela M, Krzeminska-Pakula M, Rudnicka W. Source: Acta Microbiol Pol. 2002; 51(4): 339-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12708822

•

Peppermint oil and caraway oil in functional dyspepsia--efficacy unaffected by H. pylori. Author(s): May B, Funk P, Schneider B. Source: Alimentary Pharmacology & Therapeutics. 2003 April 1; 17(7): 975-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12656700

•

Persistent dyspepsia after laparoscopic cholecystectomy. The influence of psychological factors. Author(s): Lorusso D, Porcelli P, Pezzolla F, Lantone G, Zivoli G, Guerra V, Misciagna G, Demma I. Source: Scandinavian Journal of Gastroenterology. 2003 June; 38(6): 653-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12825875

•

PPI therapy does not prevent endoscopy in dyspepsia. Author(s): Ebell M. Source: American Family Physician. 2003 May 15; 67(10): 2204, 2206. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12776974

•

Predictors of conventional and alternative health care seeking for irritable bowel syndrome and functional dyspepsia. Author(s): Koloski NA, Talley NJ, Huskic SS, Boyce PM. Source: Alimentary Pharmacology & Therapeutics. 2003 March 15; 17(6): 841-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12641507

•

Presence of H. pylori in the oral cavity of betel-quid ('Paan') chewers with dyspepsia: relationship with periodontal health. Author(s): Choudhury CR, Choudhury AD, Alam S, Markus AF, Tanaka A, Choudhury AD. Source: Public Health. 2003 September; 117(5): 346-7. Erratum In: Public Health. 2004 January; 118(1): 79. Choudhury Ashok D [corrected to Chourhury Ashoka D]. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12909425

•

Rates of dyspepsia one year after Helicobacter pylori screening and eradication in a Danish population. Author(s): Wildner-Christensen M, Moller Hansen J, Schaffalitzky De Muckadell OB. Source: Gastroenterology. 2003 August; 125(2): 372-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12891538

Studies

21

•

Reader's Digest or. reader's indigestion? Author(s): Okuda WH. Source: Hawaii Dent J. 1997 February; 28(2): 4, 11. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11851238

•

Role of cognitive factors in symptom induction following high and low fat meals in patients with functional dyspepsia. Author(s): Feinle-Bisset C, Meier B, Fried M, Beglinger C. Source: Gut. 2003 October; 52(10): 1414-8. Erratum In: Gut. 2004 February; 53(2): 316. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12970132

•

Serum positive cagA in patients with non-ulcer dyspepsia and peptic ulcer disease from two centers in different regions of Turkey. Author(s): Serin E, Yilmaz U, Kunefeci G, Ozer B, Gumurdulu Y, Guclu M, Kayaselcuk F, Boyacioglu S. Source: World Journal of Gastroenterology : Wjg. 2003 April; 9(4): 833-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12679943

•

Symptoms associated with impaired gastric emptying of solids and liquids in functional dyspepsia. Author(s): Sarnelli G, Caenepeel P, Geypens B, Janssens J, Tack J. Source: The American Journal of Gastroenterology. 2003 April; 98(4): 783-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12738456

•

Systematic review: Antacids, H2-receptor antagonists, prokinetics, bismuth and sucralfate therapy for non-ulcer dyspepsia. Author(s): Moayyedi P, Soo S, Deeks J, Forman D, Harris A, Innes M, Delaney B. Source: Alimentary Pharmacology & Therapeutics. 2003 May 15; 17(10): 1215-27. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12755835

•

The effect of a Helicobacter pylori treatment strategy on health care expenditures in patients with peptic ulcer disease and dyspepsia. Author(s): Kearney DJ, Liu CF, Crump C, Brousal A. Source: The American Journal of Gastroenterology. 2003 September; 98(9): 1952-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14499771

•

The impact of solid-phase gastric emptying studies in the management of children with dyspepsia. Author(s): Aktay AN, Werlin SL, Hellman RS. Source: Clinical Pediatrics. 2003 September; 42(7): 621-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14552521

22

Indigestion

•

The management of dyspepsia and reflux. Author(s): Delaney BC. Source: The Practitioner. 2003 May; 247(1646): 408-11. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12760129

•

The prevalence of clinically significant endoscopic findings in primary care patients with uninvestigated dyspepsia: the Canadian Adult Dyspepsia Empiric Treatment Prompt Endoscopy (CADET-PE) study. Author(s): Thomson AB, Barkun AN, Armstrong D, Chiba N, White RJ, Daniels S, Escobedo S, Chakraborty B, Sinclair P, Van Zanten SJ. Source: Alimentary Pharmacology & Therapeutics. 2003 June 15; 17(12): 1481-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12823150

•

The test-and-treat strategy for Helicobacter pylori in uninvestigated dyspepsia. Author(s): Thibodeau LR. Source: Jaapa. 2003 August; 16(8): 20-2, 25-8. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14968490

•

Too many cooks cause SNFs indigestion. Author(s): Burgess KL. Source: Provider. 2000 June; 26(6): 47-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11182955

•

Treating dyspepsia with acupuncture and homeopathy: reflections on a pilot study by researchers, practitioners and participants. Author(s): Paterson C, Ewings P, Brazier JE, Britten N. Source: Complementary Therapies in Medicine. 2003 June; 11(2): 78-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12801492

•

Trends and determinants of pharmacotherapy for dyspepsia: analysis of 3-year prescription data in The Netherlands. Author(s): Quartero AO, Smeets HM, de Wit NJ. Source: Scandinavian Journal of Gastroenterology. 2003 June; 38(6): 676-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12825878

•

Ultrastructural morphology of Helicobacter pylori in post vagotomy dyspepsia. Author(s): Ghosh TK, Ghoshal UC, Chakraborty S. Source: Indian J Pathol Microbiol. 2002 January; 45(1): 83-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12593571

Studies

23

•

Understanding indigestion and GORD. Author(s): Adams S. Source: Prof Care Mother Child. 1999; 9(6): 143, 146. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10855224

•

Unsuppressed postprandial phasic contractility in the proximal stomach in functional dyspepsia: relevance to symptoms. Author(s): Simren M, Vos R, Janssens J, Tack J. Source: The American Journal of Gastroenterology. 2003 October; 98(10): 2169-75. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14572563

•

Update on the role of drug therapy in non-ulcer dyspepsia. Author(s): Talley NJ. Source: Reviews in Gastroenterological Disorders. 2003 Winter; 3(1): 25-30. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12684590

•

Upper GI cancer in patients with uncomplicated dyspepsia. Author(s): McColl KE. Source: Scandinavian Journal of Gastroenterology. 2003 July; 38(7): 804; Author Reply 804. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12889572

•

What is the long-term outcome of the different subgroups of functional dyspepsia? Author(s): Heikkinen M, Farkkila M. Source: Alimentary Pharmacology & Therapeutics. 2003 July 15; 18(2): 223-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12869083

•

Yield of endoscopy in dyspepsia and concurrent treatment with proton pump inhibitors: the blind leading the blind? Author(s): Talley NJ. Source: Gastrointestinal Endoscopy. 2003 July; 58(1): 89-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12838227

25

CHAPTER 2. NUTRITION AND INDIGESTION Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and indigestion.

Finding Nutrition Studies on Indigestion The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “indigestion” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

7 Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

26

Indigestion

The following information is typical of that found when using the “Full IBIDS Database” to search for “indigestion” (or a synonym): •

Abdominal pain, indigestion, anorexia, nausea and vomiting. Source: Bruppacher, R Gyr, N Fisch, T Baillieres-Clin-Gastroenterol. 1988 April; 2(2): 275-92 0950-3528

•

Clinical efficacy of Herbal and other drugs in primary indigestion cases of lactating murrah buffaloes. Author(s): Ch. Charan Singh Haryana Agricultural University, Hisar (India). Dept. of Livestock Production and Management Source: Singh, N. Kumari, R. Akbar, M.A Indian-Journal-of-Dairy-Science (India). (September 1999). volume LIII(5) page 294-297. water buffaloes digestive disorders milk yielding animals phytotherapy 0019-5146

•

Clinical, haematological and biochemical findings in milk-fed calves with chronic indigestion. Author(s): Department of Reproduction, Clinic of Veterinary Internal Medicine, University of Zurich, Switzerland. Source: Stocker, H Lutz, H Rusch, P Vet-Rec. 1999 September 11; 145(11): 307-11 00424900

•

Indigestion: You can cure it. Source: Brown, Norman. Weight-Watchers. New York : W/W Twenty First Corp. November 1983. volume 16 (10) page 16, 47.

•

Powerful peppermint calms indigestion, sore throat, and nausea. Source: Ciesinski, T. Org-gard. [Emmaus, PA : Rodale Press, c1988-. May/June 2001. volume 48 (4) page 18. 0897-3792

•

Remedies for common family ailments: 1. Indigestion and heartburn. Source: Sinclair, A Prof-Care-Mother-Child. 1994 Jan-February; 4(1): 23-4 0964-4156

•

Treatment of ruminal indigestion according to popular belief in Sweden. Author(s): Department of Pathology, Swedish University of Agricultural Sciences, Uppsala. Source: Brag, S Hansen, H J Rev-Sci-Tech. 1994 June; 13(2): 529-35 0253-1933

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

•

The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

•

The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

•

The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

Nutrition

27

•

The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

•

Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

•

Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

•

Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

•

Google: http://directory.google.com/Top/Health/Nutrition/

•

Healthnotes: http://www.healthnotes.com/

•

Open Directory Project: http://dmoz.org/Health/Nutrition/

•

Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

•

WebMD®Health: http://my.webmd.com/nutrition

•

WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

The following is a specific Web list relating to indigestion; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

Vitamins Vitamin B3 Source: Healthnotes, Inc.; www.healthnotes.com

•

Minerals Betaine Hydrochloride Source: Healthnotes, Inc.; www.healthnotes.com Calcium Source: Healthnotes, Inc.; www.healthnotes.com Magnesium Hydroxide Source: Healthnotes, Inc.; www.healthnotes.com

28

Indigestion

Sulfur Source: Integrative Medicine Communications; www.drkoop.com •

Food and Diet Artichoke Alternative names: Cynara scolymus Source: Healthnotes, Inc.; www.healthnotes.com Cinnamon Alternative names: Cinnamomum zeylanicum Source: Healthnotes, Inc.; www.healthnotes.com Cinnamon Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,271,00.html Fructo-Oligosaccharides (FOS) and Other Oligosaccharides Source: Healthnotes, Inc.; www.healthnotes.com Garlic Alternative names: Allium sativum Source: Healthnotes, Inc.; www.healthnotes.com Gluten-Free Diet Source: Healthnotes, Inc.; www.healthnotes.com Quinoa Source: Healthnotes, Inc.; www.healthnotes.com Rhubarb Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Tea Source: Healthnotes, Inc.; www.healthnotes.com

29

CHAPTER 3. CLINICAL TRIALS AND INDIGESTION Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning indigestion.

Recent Trials on Indigestion The following is a list of recent trials dedicated to indigestion.8 Further information on a trial is available at the Web site indicated. •

A Study of IC351 (tadalafil) for the treatment of diabetic patients with symptoms of dyspepsia (upset stomach) and gastroparesis (delayed gastric emptying). Condition(s): Gastroparesis Study Status: This study is terminated. Sponsor(s): Eli Lilly and Company Purpose - Excerpt: The purposes of this study are to determine whether an experimental drug known as IC351 (tadalafil) can reduce symptoms of dyspepsia in diabetic patients (fullness after eating, inability to finish a regular meal, bloating, discomfort or pain in the upper abdomen, belching after meals, nausea, vomiting), and/or reduce the amount of time the stomach takes to empty the contents of a standard meal. The safety of IC351 given once daily for 8 weeks in this population will also be studied. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00050609

8

These are listed at www.ClinicalTrials.gov.

30

Indigestion

Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “indigestion” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •

For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/

•

For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html

•

For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/

•

For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm

•

For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm

•

For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm

•

For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp

•

For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm

•

For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/

•

For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm

•

For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm

•

For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm

•

For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm

Clinical Trials 31

•

For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm

•

For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials

33

CHAPTER 4. PATENTS ON INDIGESTION Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.9 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “indigestion” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on indigestion, we have not necessarily excluded nonmedical patents in this bibliography.

Patents on Indigestion By performing a patent search focusing on indigestion, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 9Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

34

Indigestion

example of the type of information that you can expect to obtain from a patent search on indigestion: •

Antacid pharmaceutical composition Inventor(s): Buch; R. Michael (Randolph, NJ), Engelman; E. Eric (Budd Lake, NJ), Georgiades; Constantine (East Brunswick, NJ), Volpe; Frank A. (Kinnelon, NJ) Assignee(s): Warner-lambert Company (morris Plains, Nj) Patent Number: 5,762,962 Date filed: October 5, 1994 Abstract: Antacid pharmaceutical compositions provide optimal buffering profiles of from 3.0 to 5.0 for immediate and long lasting relief from the symptoms of acid indigestion, sour stomach, heartburn and gas. The composition may comprise a dual or tripartite combination of the actives calcium carbonate, calcium or magnesium citrate and/or calcium phosphate which, as a result of their different activities, neutralize the excess stomach acid both immediately and continuously over time. The formulations also provide the individual with alternative dosage forms which may provide greater levels of calcium, less sodium and less production of gastrointestinal gas. Excerpt(s): The present invention relates generally to pharmaceutical compositions comprising active agents useful in the treatment of upper gastrointestinal disorders such as what is commonly referred to as sour stomach, upset stomach, heartburn, gas, acid indigestion and the like. Pharmaceutical compositions containing antacid agents useful for treating gastrointestinal problems are widely used and have been around for quite some time. They vary to some extent in the active ingredients and other excipients and increasingly vary with respect to the other ingredients used that are responsible for flavor, texture, mouthfeel and mechanisms of delivery. H.sup.+ (acid)+CaCO.sub.3.fwdarw.HCO.sub.3.sup.- +Ca.sup.++ 1. H.sup.+ +HCO.sub.3.sup..fwdarw.H.sub.2 O+CO.sub.2.uparw.2. Web site: http://www.delphion.com/details?pn=US05762962__

•

Cinnoline-3-carboxylic acid derivatives Inventor(s): Maruyama; Akira (Kashima, JP), Ogawa; Shigeru (Machida, JP), Tobe; Akihiro (Yokohama, JP), Yamazaki; Satoshi (Sagamihara, JP) Assignee(s): Mitsubishi Kasei Corporation (tokyo, Jp) Patent Number: 5,391,549 Date filed: March 10, 1993 Abstract: A novel cinnoline derivative having an antagonistic activity against serotonin 5-HT.sub.3 receptor, its pharmaceutically acceptable salts, its N-oxide derivatives or solvates thereof, and pharmaceutical formulations containing the same for the prevention and/or treatment of various disorders such as nausea and/or emesis caused by anticancer drugs or X-ray treatment, central nervous disorders such as anxiety and/or neuropathy, gastroenteric diseases such as indigestion, chronic gastritis, digestive ulcer, irritable bowel syndromes and the like, hemicrania, cluster headache, trigeminal neuralgia, arrhythmia and the like.

Patents 35

Excerpt(s): This invention relates to a cinnoline derivative which is pharmaceutically useful as an antagonist against serotonin 5-HT.sub.3 receptor, its pharmaceutically acceptable salts, its N-oxide derivatives or solvates thereof, and pharmaceutical compositions containing the same. Metoclopramide has generally been used to treat or control the emesis caused by anticancer agents such as cisplatin though it does not have sufficient antiemetic activity and, due to its dopamine-like effect, brings other side effects such as extrapyramidal disorders, central nervous actions or the like. Recently, it was reported that specific antagonists against serotonin 5-HT.sub.3 receptor have inhibitory effects on emesis induced by a carcinostatic agent at a small dosage. The Lancet, 1461-1463, 1987. Web site: http://www.delphion.com/details?pn=US05391549__ •

Compositions of and new uses for N-acylanilinobutyric acids Inventor(s): Riedel; Richard (Constance, DT), Schoetensack; Wolfgang (Hegne, DT) Assignee(s): Byk Gulden Lomberg Chemische Fabrik Gmbh (constance, Dt) Patent Number: 4,034,111 Date filed: April 25, 1975 Abstract: Pharmaceutically-acceptable compositions containing, as an active ingredient, at least one N-acylanilinobutyric acid have uses unrelated to the choleretic activity suggested in U.S. Pat. No. 3,780,095. Moreover, the further uses generally involve administration of smaller doses than would be required to obtain a choleretic effect.The new uses include: a) increasing the gastrointestinal enzyme secretion and b) tonicizing the cardiovascular system. The increase of the gastrointestinal enzyme secretion is applied in the treatment of different diseases such as treatment of sprue, treatment of indigestion, treatment of acute and chronic pancreatitis, therapy for degenerated intestine mucous membrane, treatment of stomach spasms, treatment of stomach ulcers, treatment of diseases where the application of an antigastrin is indicated. The tonicizing of the cardiovascular system is applied in, e.g., increasing the circulation of blood in internal organs, increasing the heart force, reating disturbances in the liver function. Excerpt(s): The active ingredient for novel medicaments and uses is a compound of the type disclosed in U.S. Pat. No. 3,780,095, which clearly explains the manner in which such compounds are made. Novel medicaments containing, as at least one active ingredient, a pharmaceutically-acceptable N-acylanilinobutyric acid or a pharmaceutically-acceptable salt thereof have a number of uses which are unrelated to and unexpected from the choleretic activity referred to in U.S. Pat. No. 3,780,095. These medicaments contain one such active ingredient, a combination of any two or more such active ingredients or a combination of one or more such active ingredients and one or more other therapeutically-active and physiologically-compatible ingredients in a chemically-compatible dosage form. The uses include, but are not limited to, those enumerated in the preceding Abstract of the Disclosure. Web site: http://www.delphion.com/details?pn=US04034111__

36

•

Indigestion

Ibuprofen antacid combinations Inventor(s): Gates; Thomas N. (Doylestown, PA), Sims; Robert T. (Holicong, PA), Slivka; William (Philadelphia, PA) Assignee(s): Mcneill-ppc, Inc. (fort Washington, Pa), Merck & Co., Inc. (rahway, Nj) Patent Number: 5,288,507 Date filed: July 29, 1992 Abstract: This invention relates to a pharmaceutical composition for use in the treatment of pain and inflammation and the treatment of acid indigestion, sour stomach, heartburn and symptoms of upset stomach associated with these conditions in a mammalian organism, said composition comprising:(i) an analgesically and antiinflammatory effective amount of (S)-ibuprofen, or a salt thereof, substantially free of (R)-ibuprofen;(ii) an amount effective in the treatment of acid indigestion, sour stomach and/or heartburn of at least one of the antacids; and(iii) optionally, an amount effective in treating excess gas and flatulence of an anti-gas agent. Excerpt(s): The non-steroidal anti-inflammatory drugs (NSAID) have been utilized in the treatment of pain/inflammation and have been disclosed as useful in the treatment, management and mitigation of cold symptoms and the pain associated therewith. Ibuprofen (2-(4-isobutylphenyl)propionic acid) is a well known and commonly employed NSAID. Recently, it has been found that a faster onset of pain relief and an enhanced analgesic response can be obtained by the utilization of the single enantiomer (S)-ibuprofen in comparison to racemic ibuprofen, (see for example U.S. Pat. No. 4,877,620). Antacids are useful for the treatment of acid indigestion, heartburn, sour stomach, and symptoms of upset stomach associated with these conditions. Antacids work by neutralizing the excess stomach acid, thereby preventing inflammation, relieving pain, and allowing the mucous layer and lining to mend. In optional combination with an anti-gas agent, such as simethicone, antacids may offer relief or reduction of flatuence. Anti-gas remedies have a defoaming action that relieves or reduces flatulence by dispersing and preventing the formation of mucous-surrounded gas pockets in the gastrointestinal tract. Additionally, products which are combined with alginates float on the contents of the stomach and produce a neutralizing layer to subdue acid that can rise into the esophagus, causing heartburn. Web site: http://www.delphion.com/details?pn=US05288507__

•

Matrix which contains nephrite jade powder as a main component Inventor(s): Kim; Jun-Han (#102-902 Hanjoo Apartment, Twaegye-dong 944, Choonchun-Shi, Kangwon-do, KR) Assignee(s): None Reported Patent Number: 5,879,797 Date filed: August 15, 1996 Abstract: The present invention relates to a novel matrix containing nephrite jade powder as a main component. By using the matrix, a variety of goods in the field of medical goods, utensil goods, equipments for leisure time, vessels, interior goods, agricultural goods, industrial goods, fishery goods, traffic goods, transportation goods, equipments for sports, electronic instruments, precision instrument, or the like can be prepared. The goods made of the matrix can show excellent effects of treating

Patents 37

pathological symptoms (headache, numb feeling, indigestion, insomnia, or the like), removing impurities (such as heavy metals), improving the quality of water, promoting the growth of plants by virtue of the inherent properties of nephrite jade. Excerpt(s): The present invention relates to a matrix containing fine powder of nephrite jade as a main component. More specifically, the present invention relates to the matrix containing fine powder of nephrite jade of very fine combination weave fibrous microstructure of cryptocrystalline tremolite type. By using the matrix, a variety of goods in the field of medical goods, utensil goods, equipments for leisure time, vessels, interior goods, agricultural goods, industrial goods, fishery goods, traffic goods, transportation goods, equipments for sports, electronic instruments, precision instrument, or the like can be prepared. The goods made of the matrix can show excellent effects of treating pathological symptoms (headache, numb feeling, indigestion, insomnia, or the like), removing impurities (such as heavy metals), improving the quality of water, promoting the growth of plants by virtue of the inherent properties of nephrite jade. As is generally known, jade is largely divided into jadeite and nephrite jade. Web site: http://www.delphion.com/details?pn=US05879797__ •

Method for treating gastrointestinal disorders Inventor(s): Wilkins, Jr.; Joe S. (7700 Seawall Blvd., Unit 403, Galveston, TX 77551) Assignee(s): None Reported Patent Number: 6,420,435 Date filed: October 12, 2000 Abstract: Methods of treating gastrointestinal disorders (e.g. heart bum, GERD, and gastric indigestion) comprising orally administering therapeutically effective amounts of limonene are described herein. Excerpt(s): The present invention is directed to a method for treating gastrointestinal disorders and in particular comprises the oral administration of a therapeutically effective amount of limonene, preferably a purified form of d-limonene, to a person in need of such treatment. The present invention is directed to a method for treating gastrointestinal disorders and comprises the oral administration of a therapeutically effective amount of limonene, preferably a purified form of d-limonene (i.e. at least 98%), to a person in need of such treatment. "Limonene" as used herein shall include both d-limonene and 1-limonene. While the mechanism of action is not certain at this time, in vitro studies suggest that this compound has a neutralizing effect on gastric acid by coating the stomach wall and thereby protecting the mucosal lining from gastric juices. The inventor has discovered that oral administration of a therapeutically effective amount of purified, food grade limonene (preferably at least 98% pure d-limonene), taken once daily or once every other day for 2 to 20 days, will alleviate or eliminate entirely the symptoms, both in terms of frequency and severity, of gastrointestinal disorders, such disorders ranging from mild/moderate heartburn and gastric indigestion to severe heartburn or gastro esophageal reflux disorder (GERD). The therapeutic regimen for treating gastrointestinal disorders, as defined further below, comprises the oral administration of a therapeutically effective amount of limonene, wherein the limonene is administered once a day or once every other day for a time sufficient to alleviate or eliminate entirely the severity and frequency of the gastrointestinal symptoms, such symptoms including stomach pain, burping, and

38

Indigestion

gastric acid reflux. As used herein, "treatment" shall mean temporary or permanent alleviation or elimination of gastrointestinal disorder symptoms. A preferred adult dose of limonene is about 500 to 1,000 milligrams administered once daily or once every other day for 7-20 days. It will be appreciated by those of ordinary skill in the art that the amount of limonene, dosing schedule, and duration of treatment may vary depending upon the individual's age, weight, and severity of the gastrointestinal disorder. Web site: http://www.delphion.com/details?pn=US06420435__ •

Pharmaceutical composition for the treatment of functional dyspepsia and/or irritable bowel syndrome and new use of substances therein Inventor(s): Efendic; Suad (Stjarnvagen 16B, 18134 Lidingo, SE), Hellstrom; Per (Svardsjovagen 1, 16775 Bromma, SE) Assignee(s): None Reported Patent Number: 6,348,447 Date filed: February 3, 2000 Abstract: The invention relates to the new use of gastrointestinal peptide hormones selected from the class consisting of glucagon-like peptide-1 (GLP-1) and derivatives thereof having anti-secretory effects and smooth muscle relaxatory properties in the gastrointestinal tract for the manufacture of a pharmaceutical composition for the treatment of functional dyspepsia and/or irritable bowel syndrome. The invention also relates to a pharmaceutical composition comprising a combination of at least one member selected from said class consisting of GLP-1 and derivatives thereof with one or more other gastrointestinal peptide hormone(s) or derivative(s) thereof together with pharmacologically acceptable additives and to a method of treating functional dyspepsia or irritable bowel syndrome or both by administering an effective amount of at least one member of said class consisting of GLP-1 and derivatives thereof having effects and properties as mentioned above. Excerpt(s): This application is a 371 of PCT/SE99/00997 filed Jun. 8, 1999 which claims priority to Swedish application 98 02080-3 filed Jun. 11, 1998. The present invention relates to a new use of a gastrointestinal peptide hormone or a derivative thereof, to a pharmaceutical composition for the treatment of functional dyspepsia and/or irritable bowel syndrome, and to a method for such treatment. Functional diseases are characterized by disordered function of the organ or organ system and no obvious structural pathology can be detected neither macroscopically nor microscopically. This should be differentiated from morphologic pathological diseases where the structure of the organ is changed from normality to abnormality. This type of disease can always be diagnosed either macro- or microscopically, and may be followed by functional aberration of the organ. Web site: http://www.delphion.com/details?pn=US06348447__

Patents 39

•

Pharmaceutical compositions for the prophylaxis and therapy of calculosis of biliary tract and of biliary dyspepsia Inventor(s): Angelico; Mario (Florence, IT), Contos; Simos (Florence, IT) Assignee(s): Pharmaricherche DI Allesandra Tonozzi E C. S.a.s. (milan, It) Patent Number: 4,917,898 Date filed: June 1, 1988 Abstract: Pharmaceutical compositions for the prophylaxis and therapy of biliary tract calculosis and of biliary dyspepsia, containing as the active principle taurohyodeoxycholic acid, are herein described. Excerpt(s): The present invention relates to pharmaceutical compositions for the prophylaxis and the therapy of calculosis of biliary tract and for the treatment of biliary dyspepsia, containing as the active principle taurohyodeoxycholic acid, a natural biliary acid which up to now was not used in therapy. Other biliary acids have been used for a long time as medicaments for the treatment of cholesterol biliary calculosis and of biliary dyspepsia, particularly ursodeoxycholic acid (UDCA) and the tauroconjugate thereof (TUDCA). Taurohyodeoxycholic acid (THDCA), or 3.alpha.,6.alpha.-dihydroxy5.beta.-cholanoyl-2-amino-ethyl-sulfonic acid, which is present as a minor component in pig bile (Biochem. J. 56.38-39, 1954), forms in intestine, following 7-alpha dehydroxylation of a primary biliary acid of the pig, i.e. hyodeoxycholic acid (HDCA) and subsequent hepatic conjugation with taurine. Web site: http://www.delphion.com/details?pn=US04917898__

•

Use of rifaximin and pharmaceutical formulations containing it in the treatment of gastric dyspepsia caused by helicobacter pylori Inventor(s): Ferrieri; Antonella (Tole, IT), Rotini; Leone G. (Bologna, IT) Assignee(s): Alfa Wassermann S.p.a. (alanno, It) Patent Number: 5,352,679 Date filed: June 28, 1993 Abstract: The antibiotic known by the name rifaximin (INN) is active orally in the treatment of gastric dyspepsia caused by bacteria known as Helicobacter pylori. Rifaximin may be administered in any oral pharmaceutical form, particularly tablets, capsules, sugar coated tablets, granules and syrups containing from 200 to 2000 mg of active principle, at a daily dosage of between 400 and 2000 mg. Excerpt(s): The present invention relates to the treatment of gastric dyspepsia by oral administration of rifaximin. Two Australian microbiologists, Warren J. R. and Marshall B., reported in Lancet, 1983, 1, 1273-1275, that they had identified in gastric biopsies from patients affected with gastric dyspepsia some curved and storiform bacilli which were initially erroneously believed to belong to the Campylobacter species. Later, Goodwin C. S. et al, Int. J. Syst. Bact. 39, 397-405, 1989, made a more precise classification of the micro-organism, which had no elements in common with the Campylobacter genus, and used the name of Helicobacter pylori, derived from the helical form of the bacterium and from its preferred location in the pylorus. Marshall B. et al., Med. J. Australia, 142, 436-439, 1985 and Morris A., Nicholson G., Am.J. Gastroenterol., 82, 192-199, 1987, demonstrated the pathogenic nature of this bacterium which causes gastritis in man. McNulty C. A. M. et al., Antimicrob. Agents Chemother.,

40

Indigestion

28, (6), 837-838, 1985 and Shungu D. L. et al., Antimicrob. Agents Chemother., 31, (6) 949-950, 1987, have demonstrated the in vitro activity of several antibiotics against this bacterium. In particular, they demonstrated the vigorous antibacterial in vitro activity of antibiotics containing a beta-bactam group, penicillin, ampicillin, cefoxttin and imipenem, quinolones: norfloxacin and cyprofloxacin, aminoglycosides: gentamicin and erythromycin, and also tetracycline and metronidazole and the lack of in vitro activity of other antibacterial agents like sulfa drugs, trimethoprim, nalidixic acid. Web site: http://www.delphion.com/details?pn=US05352679__

Patent Applications on Indigestion As of December 2000, U.S. patent applications are open to public viewing.10 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to indigestion: •

Diagnosis and treatment of non-ulcer dyspepsia based on hypothalamic-pituitaryadrenal axis abnormallity Inventor(s): Dinan, Timothy Garard; (Cobh, IE), Keeling, Paul William Napoleon; (Donnybrook, IE) Correspondence: Birch Stewart Kolasch & Birch; PO Box 747; Falls Church; VA; 220400747; US Patent Application Number: 20030170731 Date filed: March 17, 2003 Abstract: An in vitromethod and a kit for the diagnosis of non-ulcer dyspepsia (NUD) in a subject suspected of having NUD, comprises identifying in the subject a dysfunction of corticotropin releasing hormone (CRH) receptors characterised by the subject's response to CRH-induced adrenocorticotropic hormone (ACTH) production by estimating the level of ACTH in a sample of blood or a blood fraction obtained from said subject relative to a control. The method can be used to diagnose NUD in patients who are infected with Helicobacter pylori and those who are free of such infection. Excerpt(s): This invention relates to the diagnosis and therapy of non-ulcer dyspepsia (NUD), for patients who have Helicobacter pylori infection and those who do not. Symptoms of post prandial fullness or bloating, early satiety, excessive flatulence, upper abdominal pain and nausea are commonplace both in primary care and in gastroenterology clinics (Fisher, R. S. and Parkman, H. P. New England J Med (1998), 339, 1376-1381). These symptoms are sometimes attributable to H. pylori infection, however in many cases no organic disease is found. The substantial group of patients who have persistent and occasionally disabling gastric symptoms without organic disease are classified as having functional dyspepsia or NUD (Talley, N. J. et al, Gastroenterology (1992) 102, 1259-68. Non-ulcer dyspepsia is a heterogeneous condition and has been classified according to symptom clusters as dysmotility-like dyspepsia, gastrooesophageal reflux-like dyspepsia, aerophagia, and essential dyspepsia (Talley, N. J. and Philips, S. F., Ann. Inter. Med. (1988) 108, 865-9). NUD is the most common reason for referral to gastroenterology clinics. To date systematic efforts to determine its

10

This has been a common practice outside the United States prior to December 2000.

Patents 41

aetiology have failed. No consistent biochemical or physiological abnormalities have been demonstrated and many gastroenterologists describe this condition as a functional disorder without an organic basis. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Method for treating functional dyspepsia Inventor(s): Mangel, Allen Wayne; (Chapel Hill, NC) Correspondence: David J Levy, Corporate Intellectual Property; Glaxosmithkline; Five Moore DR., PO Box 13398; Research Triangle Park; NC; 27709-3398; US Patent Application Number: 20030187017 Date filed: November 14, 2002 Abstract: This invention relates to the use of alosetron in the treatment or functional dyspepsia. Excerpt(s): The invention relates to a new medical use for alosetron, a compound which act as an antagonist of 5-hydroxytryptaminie (5-HT) at 5-HT3 receptors. and pharmaceutically acceptable salts, solvates and pharmaceutically acceptable equivalents thereof; in particular its hydrochloride salt. Alosetron is known to be useful for the treatment of a variety of conditions, including irritable bowel syndrome. PCT Publication No. WO 99/17755, published Apr. 15, 1999, incorporated herein by reference, in particular discloses the use of alosetron and other 5-HT.sub.3 receptor antagonists for the treatment of irritable bowel syndrome in females. It has now been discovered that alosetron is useful for the treatment of functional (or "nonulcer") dyspepsia. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

•

PROKINETIC AGENTS FOR TREATING GASTRIC HYPOMOTILITY AND RELATED DISORDERS Inventor(s): ANDREWS, PAUL L. R.; (LONDON, GB), WATSON, JOHN W.; (LEDYARD, CT), WOODS, ANTHONY J.; (LONDON, GB) Correspondence: Pfizer Inc; 150 East 42nd Street; 5th Floor - Stop 49; New York; NY; 10017-5612; US Patent Application Number: 20030176421 Date filed: December 30, 1999 Abstract: Stasis is treated or prevented in all or any part or parts of the stomach of a patient, especially a human patient, in need of such treatment, where said stasis results from hypomotility in the stomach, particularly gastric hypomotility with delayed emptying of the liquid and/or solid contents of the stomach. Gastric or gastrointestinal disorders are also treated which are characterized by one or more symptoms selected from pain, nausea, vomiting, heartburn, postprandial discomfort, indigestion and gastroesophageal reflux. Such treatment or prevention is achieved by administering to the patient a therapeutically effective amount of an inhibitor of phosphodiesterase-4 (PDE4), including isozyme subtypes thereof, sufficient to treat or prevent such hypomotility or gastric or gastrointestinal disorder in said patient. The PDE4 inhibitor comprises a compound of Formula (IA) or (IB): 1where in a preferred embodiment, R is

42

Indigestion

cyclopentyl or cyclohexyl; R.sup.1 is (C.sub.1-C.sub.2) alkyl; one of R.sup.2.sub.a and R.sup.2.sub.b is hydrogen and the other is a substituent of partial Formula (1.0.0) above, where the dashed line represents a single bond, m is 0, R.sup.113 and R.sup.114 are in a cis relationship to each other, R.sup.113 is cyano, R.sup.115 is hydrogen, and R.sup.114 is carboxy, --CH.sub.2OH, or --CH.sub.2C(.dbd.O)NH.sub.2.Pharmaceutical compositions are also described which are useful for carrying out the above-mentioned methods of treatment and prevention, and which are also useful in the treatment of a gastric or gastrointestinal disorder in a patient which comprises with respect to said patient, (i) a sign or concomitant of diabetic neuropathy, anorexia nervosa, achlorhydria, gastrointestinal surgery, post-surgical recovery in the period of emergence from general anesthesia; or the administration of morphine and morphine-like opioids; (ii) a secondary aspect of a primary disease or disorder in said patient which is organic, wherein said disease or disorder involves particularly a gastroenteric or gastroesophageal organ or tissue, or an organ or tissue of the central nervous system of said patient; or (iii) an adverse side effect of a different therapeutic agent administered to said patient in the course of treating another unrelated disease or disorder in said patient. Excerpt(s): The method of treatment of the present invention involves a therapeutic agent having a prokinetic effect on, i.e., that promotes activity with regard to gastric motility. This type of drug is useful in treating gastric hypomotility with delayed gastric emptying of liquid and/or solid contents of the antrum (stomach), which is a component of a number of gastric or gastrointestinal disorders. The symptoms of such gastric or gastrointestinal disorders can be quite serious and include pain, nausea, vomiting, heartburn, postprandial discomfort, indigestion, and gastroesophageal reflux. In particular, the present invention relates to therapeutic agents which by various mechanisms are able to elevate cAMP in populations of neurons in the myenteric plexus, leading to release of excitatory transmitters, e.g., acetylcholine, and subsequent stimulation with resulting contraction of the smooth muscle of the antrum. The therapeutic compounds useful as active ingredients in the pharmaceutical compositions and methods of treatment of the present invention are closely related, in terms of their chemical structure and biological activity, to inhibitors of the phosphodiesterase-IV (PDE4) isoenzyme. However, to date the art has incorrectly taught that PDE4 inhibitors antagonize gastrointestinal contractile responses, suggesting their use as antikinetic agents for treating hypermotility disorders; rather than as prokinetic agents for treating gastric hypomotility, as surprisingly discovered in accordance with the present invention. The gastrointestinal system must preserve a proper balance between absorption and secretion of water and electrolytes in order to keep nutrients, wastes, electrolytes and water in a life-sustaining flux. Equally important to successful performance of this ongoing process is the maintenance along the gastrointestinal tract of the appropriate anterograde motility. Gastrointestinal motility is also known to be a key component of vomiting. This aspect of its role is important in light of the fact that some antiemetic agents have enhanced gastric emptying as a significant aspect of their actions. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Patents 43

•

Use of recombinant gastric lipase for treating functional dyspepsia Inventor(s): Berna, Patrick; (Palaiseau, FR), Milano, Stephane; (St. Nicier, FR) Correspondence: Palmer & Dodge, Llp; Kathleen M. Williams; 111 Huntington Avenue; Boston; MA; 02199; US Patent Application Number: 20030157087 Date filed: October 25, 2002 Abstract: The invention relates to a method for treating a functional dyspepsia by administering to a mammal in need thereof a preparation comprising a recombinant gastric lipase. The invention also relates to pharmaceutical compositions comprising a recombinant gastric lipase and methods of use. Excerpt(s): This application claims priority under 35 U.S.C.sctn.120 to International Application PCT/EPO1/04679, filed Apr. 25, 2001 which claims priority to 00401174.8, filed Apr. 27, 2000. The invention relates to the use of recombinant gastric lipase for the preparation of a drug for preventing and/or treating functional dyspepsia. The invention also concerns a method for treating functional dyspepsia comprising administering to a patient in need thereof an effective amount of the above compound. Dyspepsia is a very common syndrome that accounts for about 30% of cases seen by gastroenterologists. Functional dyspepsia (also known as non-ulcer dyspepsia or NUD, i.e. without any clear and obvious gastric lesion) is the most important etiologic category and represents about 60% of all dyspepsia cases. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with indigestion, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “indigestion” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on indigestion. You can also use this procedure to view pending patent applications concerning indigestion. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

45

CHAPTER 5. BOOKS ON INDIGESTION Overview This chapter provides bibliographic book references relating to indigestion. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on indigestion include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “indigestion” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on indigestion: •

Indigestion: Living Better with Upper Intestinal Problems from Heartburn to Ulcers and Gallstones Source: New York, NY: Oxford University Press. 1992. 227 p. Contact: Available from Oxford University Press. Order Department, 2001 Evans Road, Cary, NC 27513. (800) 451-7556. Fax (919) 677-1303. PRICE: $11.95 plus shipping and handling. ISBN: 019508554X. Summary: This book offers advice on how to take care of and avoid a whole complex of disturbances categorized as indigestion. The author begins with an overview of the anatomy and physiology of digestion, including a chapter on terminology and definitions. After an additional chapter on diagnostic testing, the author turns to specific problems, including acid related problems (heartburn, esophagitis, and hiatal hernia), peptic ulcers, nonulcer dyspepsia, chest pain, gallbladder problems and gallstones, pancreatic diseases, jaundice, malabsorption and maldigestion, food intolerance and

46

Indigestion

food allergies, the impact of aging on the upper digestive tract (including the role of medications and drug interactions), and the brain gut connection. The appendices of the book offer coverage of related problems, including belching, nausea and vomiting, dry mouth and bitter taste, difficulty in tasting, lump in the throat, butterflies, difficulties in swallowing, delayed stomach emptying, the effects of diabetes on the upper digestive system, and the controversy over yeast. The author hopes to foster a cooperative dialogue between patients and their physicians as they work together to diagnose and manage upper digestive tract problems. A subject index concludes the book. 8 figures. 6 tables. •

Understanding Indigestion and Other Tummy Troubles Source: Woollahra, New South Wales, Australia: Health Books, Gore and Osment Publications. 1993. 64 p. Contact: Available from Health Books, Gore and Osment Publications, Private Box 427, 150 Queen Street, Woollahra, NSW 2025, Australia. (02) 361-5244. Fax (02) 360-7558. PRICE: $9.95 (as of 1995). ISBN: 187553136X. Summary: This book presents basic information on the causes and treatments of common stomach and digestive tract ailments. After an introductory section that reviews the anatomy and physiology of the gastrointestinal (GI) tract, the book features nine chapters on the following topics: indigestion; ulcers; food poisoning and other causes of upset stomachs and diarrhea; irritable bowel syndrome (IBS); inflammatory bowel disease (IBD); dealing with diverticular disease; bowel cancer; other GI problems, including hiccups, gas, hepatitis, food allergies, appendicitis, and sexually transmitted diseases of the bowel; and children's GI problems, including colic, food intolerance, gastroenteritis, reflux, celiac disease, constipation, IBS, IBD, polyps, and phantom pains. The book is written in clear, easy-to-understand language and focuses on practical, selfcare tips for many of the disorders covered.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print®). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “indigestion” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “indigestion” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “indigestion” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Cure Indigestion, Heartburn, Cholesterol, Triglyceride & Liver Problems with Artichoke Extract by Gary Ross, et al; ISBN: 1893910016; http://www.amazon.com/exec/obidos/ASIN/1893910016/icongroupinterna

•

Dyspepsia by David A., MD Johnson (Editor), et al; ISBN: 0943126975; http://www.amazon.com/exec/obidos/ASIN/0943126975/icongroupinterna

•

Indigestion: Its Causes and Cure by John Henry Clarke (1928); ISBN: 8170213665; http://www.amazon.com/exec/obidos/ASIN/8170213665/icongroupinterna

Books

47

•

LA Cura Biblica - Acidez Y LA Indigestion by Don, M.D. Colbert (2001); ISBN: 0884198022; http://www.amazon.com/exec/obidos/ASIN/0884198022/icongroupinterna

•

Managing Acid Reflux: Complementary Treatments for Indigestion and Other Digestive Disorders by Kate Gilbert Udall (2001); ISBN: 1580543316; http://www.amazon.com/exec/obidos/ASIN/1580543316/icongroupinterna

•

Natural & Herbal Remedies for Indigestion (Storey Country Wisdom Bulletin, A-248) by Kathleen Brown (2004); ISBN: 1580173209; http://www.amazon.com/exec/obidos/ASIN/1580173209/icongroupinterna

•

Stop Belly-Aching: Banish Indigestion & Irritable Bowel Syndrome by Peter, Dr Mansfield, Dr. Peter Mansfield (2002); ISBN: 0285636189; http://www.amazon.com/exec/obidos/ASIN/0285636189/icongroupinterna

•

The 2002 Official Patient's Sourcebook on Indigestion: A Revised and Updated Directory for the Internet Age by Icon Health Publications (2002); ISBN: 0597833931; http://www.amazon.com/exec/obidos/ASIN/0597833931/icongroupinterna

•

The Bible Cure for Heartburn and Indigestion (Fitness and Health) by Donald, Md. Colbert, Don Colbert (1999); ISBN: 0884196518; http://www.amazon.com/exec/obidos/ASIN/0884196518/icongroupinterna

•

The Incredible Worlds Of Wally Mcdoogle: #20 My Life As Invisible Intestines (with Intense Indigestion) by Bill Myers (Author); ISBN: 0849959918; http://www.amazon.com/exec/obidos/ASIN/0849959918/icongroupinterna

•

Users Guide to Healthy Digestion: Learn How You Can Put an End to Heartburn, Indigestion, Constipation, and Other Digestive Problems by Victoria Toews Dolby, Victoria Dolby Toews (2003); ISBN: 1591200857; http://www.amazon.com/exec/obidos/ASIN/1591200857/icongroupinterna

Chapters on Indigestion In order to find chapters that specifically relate to indigestion, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and indigestion using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “indigestion” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on indigestion: •

Dyspepsia Source: in Feldman, M.; Friedman, L.S.; Sleisenger, M.H. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 7th ed. [2-volume set]. St. Louis, MO: Saunders. 2002. p. 102-118. Contact: Available from Elsevier. 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 545-2522. Fax (800) 568-5136. Website: www.us.elsevierhealth.com. PRICE: $229.00 plus shipping and handling. ISBN: 0721689736. Summary: Dyspepsia (indigestion) affects more than one fourth of the general population in all industrialized countries and is a frequent reason for medical

48

Indigestion

consultation. Dyspepsia appears to have a significant impact upon quality of life and it results in enormous societal costs: both direct medical costs of physician visits, diagnostic tests, and medications, and indirect costs of absenteeism from diminished productivity in the workplace. This chapter on dyspepsia is from a comprehensive and authoritative textbook that covers disorders of the gastrointestinal tract, biliary tree, pancreas, and liver, as well as the related topics of nutrition and peritoneal disorders. Topics include a definition; epidemiology; causes of organic dyspepsia, including food intolerance, medication intolerance, peptic ulcer disease (PUD), gastric or esophageal malignancy (cancer), pancreatic and biliary tract disorders, systemic disorders, and uncommon luminal gastrointestinal disorders; functional (nonulcer) dyspepsia; the approach to uninvestigated dyspepsia, including determination of the reason for presentation, age factors, alarm symptoms, evaluation for gastroesophageal reflux (return of stomach's gastric acid back to the esophagus) symptoms, irritable bowel syndrome, evaluation for use of offending medications, the physical examination, noninvasive testing for Helicobacter pylori infection, and laboratory and additional studies; empirical therapy versus early endoscopy for uncomplicated dyspepsia; and treatment of functional dyspepsia. The chapter includes a mini-outline with page citations, full-color illustrations, and extensive references. 3 figures. 3 tables. 140 references. •

Non-Ulcer Dyspepsia: Indigestion Without a Label Source: in Janowitz, H.D. Indigestion: Living Better with Upper Intestinal Problems from Heartburn to Ulcers and Gallstones. New York, NY: Oxford University Press. 1992. p. 96-106. Contact: Available from Oxford University Press. Order Department, 2001 Evans Road, Cary, NC 27513. (800) 451-7556. Fax (919) 677-1303. PRICE: $11.95 plus shipping and handling. ISBN: 019508554X. Summary: This chapter on nonulcer dyspepsia (indigestion) is from a book that offers advice on how to take care of and avoid the whole complex of disturbances categorized as indigestion. The author reviews the uncomfortable upper abdominal symptoms that are indicative of this problem, noting that the discomfort usually occurs after eating and may include a feeling of bloating or distention. The overlap of this form of indigestion with other upper intestinal diseases means that an important part of the diagnostic problem is to eliminate any serious organic possibilities. Also discussed are how the diagnosis is established, including the crucial role of a detailed patient history, and the diagnostic tests that may be utilized. The author then reviews the management of patients with nonulcer dyspepsia (NUD), focusing on the concept of NUD as a motility problem. Topics include drug therapy, chronic intestinal pseudoobstruction, the use of parenteral nutrition to avoid or treat malnutrition, and the importance of a close working relationship between patient and physician. Many individuals are relieved both mentally and physically by the assurance of the nonorganic nature of their complaints, while many others desire and want relief and help. If the NUD fits the acid reflux pattern in the esophagus or resembles ulcerlike symptoms, the patient should be treated to prevent the possible development of these conditions. If the symptoms and studies show a disturbance in the motility process, a trial of prokinetic drugs may be useful.

Books

•

49

Indigestion and Dyspepsia, or the Stomach and Its Discontents: Getting the Words Right Source: in Janowitz, H.D. Indigestion: Living Better with Upper Intestinal Problems from Heartburn to Ulcers and Gallstones. New York, NY: Oxford University Press. 1992. p. 19-22. Contact: Available from Oxford University Press. Order Department, 2001 Evans Road, Cary, NC 27513. (800) 451-7556. Fax (919) 677-1303. PRICE: $11.95 plus shipping and handling. ISBN: 019508554X. Summary: This chapter on terminology is from a book that offers advice on how to take care of and avoid the whole complex of disturbances categorized as indigestion. The author reviews the different terms that patients and physicians use, including indigestion, dyspepsia, heartburn, belching (gas), and flatulence. These problems of indigestion (dyspepsia) are important because they are so common; perhaps as many as one quarter of the population will complain of some of these kinds of symptoms over a 6 month period. The author explores the different kinds of indigestion, including those related to organic disease (such as peptic ulcer, gallstones, or pancreatitis) and those that do not have an organic basis (functional disorders). In addition, the author emphasizes that functional disorders are very real, even if their diagnosis by classic measures such as x-rays is uncertain. Many functional disorders are due to problems in gastrointestinal motility, or the movement of the contents of the digestive tract. The author encourages readers to keep close track of their symptoms, as different symptoms point to different etiologies (causes) which can in turn be treated.

•

Indigestion Source: in Gerber, J.M. Handbook of Preventive and Therapeutic Nutrition. Frederick, MD: Aspen Publishers, Inc. 1993. p. 91-99. Contact: Available from Aspen Publishers, Inc. 7201 McKinney Circle, Frederick, MD 21701-9782. (800) 638-8437 or (301) 417-7500. PRICE: $34. ISBN: 0834203189. Summary: This chapter, from a handbook of preventive and therapeutic nutrition, provides an overview about indigestion. Topics covered include the incidence of indigestion; its clinical assessment; differential diagnosis; secondary effects of maldigestion; hypochlorhydria; pancreatic insufficiency; biliary insufficiency; and colonic bacterial flora disorders. For each of the disorders considered, information about the clinical features and nutrition therapies is presented in brief.

51

CHAPTER 6. MULTIMEDIA ON INDIGESTION Overview In this chapter, we show you how to keep current on multimedia sources of information on indigestion. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

Video Recordings An excellent source of multimedia information on indigestion is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “indigestion” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “indigestion” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on indigestion: •

Extinguishing Heartburn Source: Madison, WI: University of Wisconsin Hospitals and Clinics, Department of Outreach Education. 1995. (videocassette). Contact: Available from University of Wisconsin Hospital and Clinics. Picture of Health, 702 North Blackhawk Avenue, Suite 215, Madison, WI 53705-3357. (800) 757-4354 or (608) 263-6510. Fax (608) 262-7172. PRICE: $19.95 plus shipping and handling; bulk copies available. Order number 091395A. Summary: Heartburn, or acid indigestion, can limit daily activities and productivity. This videotape is one in a series of health promotion programs called 'Picture of Health,' produced by the University of Wisconsin. In this program, moderated by Mary Lee and featuring gastroenterologist John Wyman, the common symptoms, diagnosis, and management of heartburn are covered. Dr. Wyman stresses that any chest pain requires a medical evaluation to rule out other causes such as heart disease. Dr. Wyman defines heartburn as a symptom of gastroesophageal reflux disease (GERD), which is the reflux

52

Indigestion

or return of stomach contents into the esophagus. Dr. Wyman reviews the anatomy and physiology of the gastrointestinal (GI) tract, including the lower esophageal sphincter (LES) and LES pressures. Risk factors for GERD include certain diet and lifestyle choices, smoking, obesity, pregnancy, and the regular use of certain foods and beverages. The program then reviews tips to control heartburn, including elevate the head of the bed, lose any excess weight, do not lie down immediately following a meal, and decrease portion size at mealtimes. Dr. Wyman recommends that people coping with heartburn eliminate acidic foods and any other foods that cause individual symptoms from their diet. The program briefly covers the use of antacids and the role of hiatal hernia and reflux. The program concludes by referring viewers to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

53

CHAPTER 7. PERIODICALS AND NEWS ON INDIGESTION Overview In this chapter, we suggest a number of news sources and present various periodicals that cover indigestion.

News Services and Press Releases One of the simplest ways of tracking press releases on indigestion is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “indigestion” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to indigestion. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “indigestion” (or synonyms). The following was recently listed in this archive for indigestion: •

Dyspepsia does not predict delayed gastric emptying in diabetics Source: Reuters Medical News Date: November 04, 2003

•

Diabetics' dyspepsia not same as slow food transit Source: Reuters Health eLine Date: November 04, 2003

54

Indigestion

•

Hypnotherapy soothes recurrent indigestion Source: Reuters Health eLine Date: December 06, 2002

•

Sparkling water may help indigestion, constipation Source: Reuters Health eLine Date: November 28, 2002

•

Obesity linked to higher risk of acid indigestion Source: Reuters Health eLine Date: December 06, 2001

•

Chronic indigestion may be due to ulcers Source: Reuters Health eLine Date: May 25, 1999 The NIH

Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “indigestion” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “indigestion” (or synonyms). If you know the name of a company that is relevant to indigestion, you can go to any stock trading Web site (such as http://www.etrade.com/) and

Periodicals and News

55

search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “indigestion” (or synonyms).

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “indigestion” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on indigestion: •

Sjogren's Syndrome and the Gastrointestinal Tract Source: Moisture Seekers Newsletter. 17(2): 1, 4-5. March 1999. Contact: Available from Sjogren's Syndrome Foundation, Inc. 8120 Woodmont Avenue, Suite 530, Bethesda, MD 20814-1437. (301) 718-0300 or (800) 475-6473. Fax (301) 718-0322. Website: www.sjogrens.org. Summary: This article on Sjogren's syndrome (SS) and the gastrointestinal tract is from a patient education newsletter for people with SS. The author outlines the areas where the gastroenterologist may play a role in caring for the person with SS, such as dealing with swallowing difficulties, dyspepsia (indigestion), diarrhea, and jaundice (usually due to primary biliary cirrhosis, or scarring). Difficulty in swallowing is usually due to the lack of saliva associated with SS, but occasionally it may be due to a blockage (postcricoid web) or a weakness of the muscle contractions involved in swallowing. In addition, those patients with SS are vulnerable to acid reflux, which causes heartburn symptoms. Children with SS are prone to achalasia, a type of muscle problem involving the lower esophageal sphincter. Dyspepsia (indigestion) is relatively common in patients with SS, as is inflammation of the stomach (gastritis). The author briefly discusses the role of the bacterium Helicobacter pylori in gastritis. There are at least two diseases associated with SS and diarrhea: chronic pancreatitis and celiac disease (gluten intolerance). The author notes that the link between SS and gastroenterological conditions is often via abnormal autoantibodies.

•

Viagra: Why Aren't More Men Taking It? Source: Harvard Health Letter. 24(12): 6. October 1999. Contact: Available from Harvard Medical School Health Publications Group. Harvard Health Letter, P.O. Box 420300, Palm Coast, FL 32142-0300. (800) 829-9045. E-mail: [email protected].

56

Indigestion

Summary: This brief article explores the recent use of sildenafil (Viagra) for erectile dysfunction (the preferred term for impotence). A poll published in the summer of 1999 by the American Association of Retired Persons (AARP) showed that of men over age 45, only about 25 percent with some degree of erectile dysfunction took medication for the problem. The author reviews the potential reasons for these data. First, many men choose not to seek medical attention for their erectile dysfunction (ED); even though ED is more commonly talked about, many men continue to feel uncomfortable dealing with it even in a medical context. Second, the actual clinical experience with Viagra can be less than the effectiveness reported in the original research studies. For example, Viagra may not work very well for men with vascular problems (including that due to diabetes mellitus). In addition, Viagra has common side effects, including headache (16 percent of all patients), flushing (10 percent), and indigestion (7 percent), none of which contribute to the likelihood of sexual activity. Some men also avoid Viagra because of the well publicized dangers of its interaction with other drugs, notably nitrate (including nitroglycerin tablets and amyl nitrates, a recreational drug known as poppers). •

Heartburn: Nothing to Do with the Heart Source: Digestive Health Matters. 1(2): 1-2. Winter 1999. Contact: Available from International Foundation for Functional Gastrointestinal Disorders (IFFGD). P.O. Box 170864, Milwaukee, WI 53217. (888) 964-2001 or (414) 9641799. Fax (414) 964-7176. Website: www.iffgd.org. Summary: This health information article discusses simple heartburn and ways to prevent or treat it. Heartburn (indigestion) is a burning sensation in the chest behind the breastbone, but other than the location, heartburn has no relationship to heart disease. The author cautions that frequent or persistent heartburn may be a symptom of an underlying disorder such as gastroesophageal reflux disease (GERD). The author describes how heartburn can occur when strong stomach (gastric) acid escapes back into the esophagus (gastroesphageal reflux), irritating or damaging the esophagus. A valve between the stomach and the esophagus called the lower esophageal sphincter (LES) should prevent this reflux. If the sphincter is not working well, there are a number of things that the patient may be doing that promote gastroesophageal reflux and cause heartburn. The author discusses the role of position (gravity), food (the amount and types of food eaten), and the problem of being overweight as risk factors for heartburn. The author then explains that avoiding the risk factors is the best treatment option for simple heartburn. Avoidance of recumbency or straining (exercise) after meals, and elevation of the bed are important. Early dinners, smaller meals, and the avoidance of fat, chocolate, and onions also seem helpful. A review of diet, medications, and the stresses of life may help patients to manage their heartburn symptoms. When these measures fail, an antacid preparation may temporarily relieve the symptoms by neutralizing stomach acid. There are also over the counter (OTC) drugs that reduce acid production; these may be safely taken for a few days until the heartburn subsides. The article concludes with a brief reminder of the symptoms that indicate a visit to a health care provider is necessary. 3 figures.

Academic Periodicals covering Indigestion Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to indigestion. In addition to

Periodicals and News

57

these sources, you can search for articles covering indigestion that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

59

CHAPTER 8. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for indigestion. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a nonprofit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI® Advice for the Patient® can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with indigestion. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The

60

Indigestion

following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to indigestion: Acetaminophen, Sodium Bicarbonate, and Citric Acid •

Systemic - U.S. Brands: Bromo-Seltzer http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202005.html

Allopurinol •

Systemic - U.S. Brands: Aloprim; Zyloprim http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202021.html

Antacids •

Oral - U.S. Brands: Advanced Formula Di-Gel; Alamag; Alamag Plus; Alenic Alka; Alenic Alka Extra Strength; Alka-Mints; Alkets; Alkets Extra Strength; Almacone; Almacone II; AlternaGEL; Alu-Cap; Aludrox; Alu-Tab; Amitone; Amphojel; Antacid Gelcaps; Antacid Liquid http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202047.html

Anti-Inflammatory Drugs, Nonsteroidal •

Systemic - U.S. Brands: Actron; Advil; Advil Caplets; Advil, Children's; Aleve; Anaprox; Anaprox DS; Ansaid; Bayer Select Ibuprofen Pain Relief Formula Caplets; Cataflam; Clinoril; Cotylbutazone; Cramp End; Daypro; Dolgesic; Dolobid; EC-Naprosyn; Excedrin IB http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202743.html

Bismuth Subsalicylate •

Oral - U.S. Brands: Bismatrol; Pepto-Bismol http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202092.html

Histamine H 2 -Receptor Antagonists •

Systemic - U.S. Brands: Axid; Axid AR; Mylanta AR Acid Reducer; Pepcid; Pepcid AC Acid Controller; Pepcid I.V.; Pepcid RPD; Tagamet; Tagamet HB; Zantac; Zantac EFFERdose Granules; Zantac EFFERdose Tablets http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202283.html

Omeprazole •

Systemic - U.S. Brands: Prilosec http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202423.html

Pancrelipase •

Systemic - U.S. Brands: Cotazym; Cotazym-S; Enzymase-; Ilozyme; Pancoate; Pancrease; Panokase; Protilase; Viokase; Zymase http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202436.html

Sodium Bicarbonate •

Systemic - U.S. Brands: Bell/ans; Citrocarbonate http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202525.html

Researching Medications

61

Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.

Mosby’s Drug Consult™ Mosby’s Drug Consult™ database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/.

PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

63

APPENDICES

65

APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute11: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

•

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

•

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

•

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

•

National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

•

National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

•

National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

11

These publications are typically written by one or more of the various NIH Institutes.

66

Indigestion

•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

•

National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

•

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

•

National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

•

National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

•

National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

•

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

•

National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

•

National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

•

National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

•

National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

•

National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

•

National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

•

Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

•

National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

•

National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

•

Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

•

Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

Physician Resources

67

NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.12 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:13 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

•

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

•

Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

12

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 13 See http://www.nlm.nih.gov/databases/databases.html.

68

Indigestion

•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

The NLM Gateway14 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.15 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “indigestion” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 4815 215 972 26 32 6060

HSTAT16 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.17 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.18 Simply search by “indigestion” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

14

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

15

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 16 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 17 18

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

Physician Resources

69

Coffee Break: Tutorials for Biologists19 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.20 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.21 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

19 Adapted 20

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 21 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

71

APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on indigestion can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to indigestion. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to indigestion. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “indigestion”:

72

•

Indigestion

Other guides Digestive Diseases http://www.nlm.nih.gov/medlineplus/digestivediseases.html Diverticulosis and Diverticulitis http://www.nlm.nih.gov/medlineplus/diverticulosisanddiverticulitis.html Esophagus Disorders http://www.nlm.nih.gov/medlineplus/esophagusdisorders.html Gastroesophageal Reflux/Hiatal Hernia http://www.nlm.nih.gov/medlineplus/gastroesophagealrefluxhiatalhernia.html Peptic Ulcer http://www.nlm.nih.gov/medlineplus/pepticulcer.html Stomach Disorders http://www.nlm.nih.gov/medlineplus/stomachdisorders.html

Within the health topic page dedicated to indigestion, the following was listed: •

Diagnosis/Symptoms Abdominal Pain, Long-Term Source: American Academy of Family Physicians http://familydoctor.org/528.xml Abdominal Pain, Short-Term Source: American Academy of Family Physicians http://familydoctor.org/527.xml ERCP (Endoscopic Retrograde Cholangiopancreatography) Source: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/ercp/index.htm Flexible Sigmoidoscopy Source: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/sigmoidoscopy/index.htm Laparoscopy http://www.nlm.nih.gov/medlineplus/tutorials/diagnosticlaparoscopygeneralloa der.html Lower GI Series Source: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/lowergi/index.htm Stool Color: When to Worry Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00772 Stool Tests Source: Nemours Foundation http://kidshealth.org/parent/general/sick/labtest8.html Swallowing Test Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/procdiag/swallowing.pdf

Patient Resources 73 Upper Endoscopy Source: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/upperendoscopy/index.htm Upper GI Series Source: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/uppergi/index.htm •

Nutrition Digestive Diseases and Nutrition: Questions and Answers Source: Cleveland Clinic Foundation http://www.clevelandclinic.org/health/healthinfo/docs/2200/2217.asp?index=8962

•

Specific Conditions/Aspects Blind Loop Syndrome Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00735 Cyclic Vomiting Syndrome Source: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/cvs/index.htm Gas in the Digestive Tract Source: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/gas/index.htm Intestinal Obstruction Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00689 Short Bowel Syndrome Source: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/shortbowel/index.htm Smoking and Your Digestive System Source: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/smoking/index.htm What I Need to Know about Gas Source: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/gas_ez/index.htm Whipple's Disease Source: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/whipple/index.htm

•

Children Intestinal Malrotation Source: Nemours Foundation http://kidshealth.org/parent/medical/digestive/malrotation.html

74

Indigestion

Intussusception Source: American Academy of Family Physicians http://familydoctor.org/111.xml Real Deal on the Digestive System Source: Nemours Foundation http://kidshealth.org/kid/body/digest_noSW.html What Is a Pediatric Gastroenterologist? http://www.aap.org/family/WhatisPedGastroDoc.pdf What's a Fart? Source: Nemours Foundation http://kidshealth.org/kid/talk/yucky/fart.html Why Do I Burp? Source: Nemours Foundation http://kidshealth.org/kid/talk/yucky/burp.html •

From the National Institutes of Health Facts and Fallacies about Digestive Diseases Source: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/facts/index.htm

•

Lists of Print Publications Digestive Diseases Materials Source: National Institute of Diabetes and Digestive and Kidney Diseases http://catalog.niddk.nih.gov/cgi-bin/cp/cpapp.cgi?usr=2410795&rnd=2865140&pg=store&sub_pg=main_cat&ref=2

•

Organizations American College of Gastroenterology http://www.acg.gi.org/ American Gastroenterological Association http://www.gastro.org/ Cyclic Vomiting Syndrome Association http://www.cvsaonline.org National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov/

•

Prevention/Screening Digestive Health Tips Source: American College of Gastroenterology http://www.acg.gi.org/patientinfo/healthtips/index.html

Patient Resources 75 Healthy Digestion: Keeping On Track Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DG00012 •

Statistics FASTATS: Digestive Disorders Source: National Center for Health Statistics http://www.cdc.gov/nchs/fastats/digestiv.htm

•

Teenagers Digestive System Source: Nemours Foundation http://kidshealth.org/teen/your_body/body_basics/digestive_system.html

•

Women What Everyone Should Know about Gastrointestinal Disorders in Women Source: American College of Gastroenterology http://www.acg.gi.org/patientinfo/gihealth/women.html

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on indigestion. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

All About Indigestion Source: London, England: British Digestive Foundation. 1993. 5 p. Contact: Available from British Digestive Foundation. 7 Chandos Street, London W1A 2LN England. PRICE: Single copy free. Summary: This patient education brochure provides basic information about indigestion. Written in a question-and-answer format, it covers topics including definitions of dyspepsia and heartburn; the causes of indigestion; symptoms; avoiding indigestion and heartburn; why indigestion is often confused with heart disease; when to seek medical help for chest pain; diagnostic tests; and treatment options. The brochure also outlines the need for more research on this area and asks readers to

76

Indigestion

support this research with financial assistance. The brochure includes an insert summarizing guidelines for the early diagnosis of digestive disorders. This insert, entitled 'When Should I See My Doctor' lists symptoms that suggest a health care provider should be consulted. The brochure concludes with a brief description of the activities of the British Digestive Foundation. The National Guideline Clearinghouse™ The National Guideline Clearinghouse™ offers hundreds of evidence-based clinical practice guidelines published in the United States and other countries. You can search this site located at http://www.guideline.gov/ by using the keyword “indigestion” (or synonyms). The following was recently posted: •

Dyspepsia Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1998 October (revised 2003 Jan); 48 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3664&nbr=2890&a mp;string=indigestion

•

Dyspepsia. A national clinical guideline Source: Scottish Intercollegiate Guidelines Network - National Government Agency [Non-U.S.]; 2003 March; 27 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3723&nbr=2949&a mp;string=indigestion

•

Evaluation of dyspepsia Source: American Gastroenterological Association - Medical Specialty Society; 1997 November 8 (reviewed 2001); 17 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1295&nbr=529&am p;string=indigestion Healthfinder™

Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database: •

Chest Pain: Is It just indigestion or a heart attack? Source: New South Wales Multicultural Health Communication Service http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7526

Patient Resources 77 •

Gastroesophageal Reflux Disease (GERD) Summary: This consumer health information document provides basic information about Gastroesophageal Reflux Disease (GERD) -- commonly called acid indigestion. Source: American College of Gastroenterology http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=3886

•

Indigestion Summary: Basic consumer information about indigestion, also known as upset stomach or dyspepsia, including prevention, diagnosis and treatment. Source: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=4200 The NIH Search Utility

The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to indigestion. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMD®Health: http://my.webmd.com/health_topics

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to indigestion. By consulting all of associations listed in

78

Indigestion

this chapter, you will have nearly exhausted all sources for patient associations concerned with indigestion. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about indigestion. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “indigestion” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “indigestion”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “indigestion” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “indigestion” (or a synonym) into the search box, and click “Submit Query.”

Patient Resources 79

81

APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.22

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

22

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

82

Indigestion

libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)23: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

23

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

Finding Medical Libraries 83

•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

84

Indigestion

•

Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

Finding Medical Libraries 85

•

Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

•

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

•

Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

86

Indigestion

•

South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

•

Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

87

ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on indigestion: •

Basic Guidelines for Indigestion Indigestion Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003260.htm

•

Signs & Symptoms for Indigestion Abdominal pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003120.htm Anxiety Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm Back pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003108.htm Belching Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003080.htm

88

Indigestion

Bloating Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003123.htm Chest pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003079.htm Depression Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003213.htm Excitement Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003212.htm Jaundice Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003243.htm Nausea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Profuse sweating Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003218.htm Unexplained weight loss Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003107.htm Vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm •

Diagnostics and Tests for Indigestion Abdominal ultrasound Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003777.htm EGD Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003888.htm Endoscopy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003338.htm Upper GI and small bowel series Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003816.htm

•

Nutrition for Indigestion Caffeine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002445.htm High-fiber Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002470.htm

Online Glossaries 89 •

Background Topics for Indigestion Abdominal discomfort Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002228.htm Bleeding Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000045.htm Exercise Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001941.htm Physical examination Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002274.htm

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

91

INDIGESTION DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Absenteeism: Chronic absence from work or other duty. [NIH] Accommodation: Adjustment, especially that of the eye for various distances. [EU] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Achlorhydria: A lack of hydrochloric acid in gastric juice despite stimulation of gastric secretion. [NIH] Actin: Essential component of the cell skeleton. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Aerophagia: A condition that occurs when a person swallows too much air. Causes gas and frequent belching. [NIH] Aetiology: Study of the causes of disease. [EU] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Age Factors: Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from aging, a physiological process,

92

Indigestion

and time factors which refers only to the passage of time. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Alginates: Salts of alginic acid that are extracted from marine kelp and used to make dental impressions and as absorbent material for surgical dressings. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Aluminum: A metallic element that has the atomic number 13, atomic symbol Al, and atomic weight 26.98. [NIH] Amebiasis: Infection with any of various amebae. It is an asymptomatic carrier state in most individuals, but diseases ranging from chronic, mild diarrhea to fulminant dysentery may occur. [NIH] Amenorrhea: Absence of menstruation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Amoxicillin: A broad-spectrum semisynthetic antibiotic similar to ampicillin except that its resistance to gastric acid permits higher serum levels with oral administration. [NIH] Ampicillin: Semi-synthetic derivative of penicillin that functions as an orally active broadspectrum antibiotic. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Anaerobic: 1. Lacking molecular oxygen. 2. Growing, living, or occurring in the absence of molecular oxygen; pertaining to an anaerobe. [EU] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve

Dictionary 93

function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Angina: Chest pain that originates in the heart. [NIH] Angina Pectoris: The symptom of paroxysmal pain consequent to myocardial ischemia usually of distinctive character, location and radiation, and provoked by a transient stressful situation during which the oxygen requirements of the myocardium exceed the capacity of the coronary circulation to supply it. [NIH] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Anorexia Nervosa: The chief symptoms are inability to eat, weight loss, and amenorrhea. [NIH]

Anterograde: Moving or extending forward; called also antegrade. [EU] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antidepressant: A drug used to treat depression. [NIH] Antiemetic: An agent that prevents or alleviates nausea and vomiting. Also antinauseant. [EU]

Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Appendicitis: Acute inflammation of the vermiform appendix. [NIH] Arrhythmia: Any variation from the normal rhythm or rate of the heart beat. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atrial: Pertaining to an atrium. [EU]

94

Indigestion

Atrioventricular: Pertaining to an atrium of the heart and to a ventricle. [EU] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Autoantibodies: Antibodies that react with self-antigens (autoantigens) of the organism that produced them. [NIH] Autoantigens: Endogenous tissue constituents that have the ability to interact with autoantibodies and cause an immune response. [NIH] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacteriostatic: 1. Inhibiting the growth or multiplication of bacteria. 2. An agent that inhibits the growth or multiplication of bacteria. [EU] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Belching: Noisy release of gas from the stomach through the mouth. Also called burping. [NIH]

Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Benign tumor: A noncancerous growth that does not invade nearby tissue or spread to other parts of the body. [NIH] Beta-Lactamases: Enzymes found in many bacteria which catalyze the hydrolysis of the amide bond in the beta-lactam ring. Well known antibiotics destroyed by these enzymes are penicillins and cephalosporins. EC 3.5.2.6. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Bile Acids and Salts: Steroid acids and salts. The primary bile acids are derived from cholesterol in the liver and usually conjugated with glycine or taurine. The secondary bile acids are further modified by bacteria in the intestine. They play an important role in the digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones. [NIH] Bile Ducts: Tubes that carry bile from the liver to the gallbladder for storage and to the small intestine for use in digestion. [NIH] Bile Pigments: Pigments that give a characteristic color to bile including: bilirubin, biliverdine, and bilicyanin. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH]

Dictionary 95

Biliary Tract: The gallbladder and its ducts. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bismuth: A metallic element that has the atomic symbol Bi, atomic number 83 and atomic weight 208.98. [NIH] Bladder: The organ that stores urine. [NIH] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Body Regions: Anatomical areas of the body. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Broad-spectrum: Effective against a wide range of microorganisms; said of an antibiotic. [EU] Buffaloes: Ruminants of the family Bovidae consisting of Bubalus arnee and Syncerus caffer. This concept is differentiated from bison, which refers to Bison bison and Bison bonasus. [NIH] Butterflies: Slender-bodies diurnal insects having large, broad wings often strikingly colored and patterned. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with

96

Indigestion

phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium Carbonate: Carbonic acid calcium salt (CaCO3). An odorless, tasteless powder or crystal that occurs in nature. It is used therapeutically as a phosphate buffer in hemodialysis patients and as a calcium supplement. [NIH] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbohydrates: The largest class of organic compounds, including starches, glycogens, cellulose, gums, and simple sugars. Carbohydrates are composed of carbon, hydrogen, and oxygen in a ratio of Cn(H2O)n. [NIH] Carboxy: Cannabinoid. [NIH] Carcinogen: Any substance that causes cancer. [NIH] Carcinostatic: Pertaining to slowing or stopping the growth of cancer. [NIH] Cardiac: Having to do with the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular System: The heart and the blood vessels by which blood is pumped and circulated through the body. [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Celiac Disease: A disease characterized by intestinal malabsorption and precipitated by gluten-containing foods. The intestinal mucosa shows loss of villous structure. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Cycle: The complex series of phenomena, occurring between the end of one cell division and the end of the next, by which cellular material is divided between daughter cells. [NIH] Cell Division: The fission of a cell. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chenodeoxycholic Acid: A bile acid, usually conjugated with either glycine or taurine. It acts as a detergent to solubilize fats for intestinal absorption and is reabsorbed by the small intestine. It is used as cholagogue, a choleretic laxative, and to prevent or dissolve gallstones. [NIH] Chest Pain: Pressure, burning, or numbness in the chest. [NIH]

Dictionary 97

Cholecystectomy: Surgical removal of the gallbladder. [NIH] Choleretic: A choleretic agent. [EU] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Cilastatin: A renal dehydropeptidase-I and leukotriene D4 dipeptidase inhibitor. Since the antibiotic, imipenem, is hydrolyzed by dehydropeptidase-I, which resides in the brush border of the renal tubule, cilastatin is administered with imipenem to increase its effectiveness. The drug also inhibits the metabolism of leukotriene D4 to leukeotriene E4. [NIH]

CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Clarithromycin: A semisynthetic macrolide antibiotic derived from erythromycin that is active against a variety of microorganisms. It can inhibit protein synthesis in bacteria by reversibly binding to the 50S ribosomal subunits. This inhibits the translocation of aminoacyl transfer-RNA and prevents peptide chain elongation. [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Colic: Paroxysms of pain. This condition usually occurs in the abdominal region but may occur in other body regions as well. [NIH] Colitis: Inflammation of the colon. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix

98

Indigestion

'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Concomitant: Accompanying; accessory; joined with another. [EU] Conjugated: Acting or operating as if joined; simultaneous. [EU] Conjugation: 1. The act of joining together or the state of being conjugated. 2. A sexual process seen in bacteria, ciliate protozoa, and certain fungi in which nuclear material is exchanged during the temporary fusion of two cells (conjugants). In bacterial genetics a form of sexual reproduction in which a donor bacterium (male) contributes some, or all, of its DNA (in the form of a replicated set) to a recipient (female) which then incorporates differing genetic information into its own chromosome by recombination and passes the recombined set on to its progeny by replication. In ciliate protozoa, two conjugants of separate mating types exchange micronuclear material and then separate, each now being a fertilized cell. In certain fungi, the process involves fusion of two gametes, resulting in union of their nuclei and formation of a zygote. 3. In chemistry, the joining together of two compounds to produce another compound, such as the combination of a toxic product with some substance in the body to form a detoxified product, which is then eliminated. [EU] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Consultation: A deliberation between two or more physicians concerning the diagnosis and the proper method of treatment in a case. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contractility: Capacity for becoming short in response to a suitable stimulus. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Cor: The muscular organ that maintains the circulation of the blood. c. adiposum a heart that has undergone fatty degeneration or that has an accumulation of fat around it; called also fat or fatty, heart. c. arteriosum the left side of the heart, so called because it contains oxygenated (arterial) blood. c. biloculare a congenital anomaly characterized by failure of formation of the atrial and ventricular septums, the heart having only two chambers, a single atrium and a single ventricle, and a common atrioventricular valve. c. bovinum (L. 'ox heart') a greatly enlarged heart due to a hypertrophied left ventricle; called also c. taurinum and bucardia. c. dextrum (L. 'right heart') the right atrium and ventricle. c. hirsutum, c.

Dictionary 99

villosum. c. mobile (obs.) an abnormally movable heart. c. pendulum a heart so movable that it seems to be hanging by the great blood vessels. c. pseudotriloculare biatriatum a congenital cardiac anomaly in which the heart functions as a three-chambered heart because of tricuspid atresia, the right ventricle being extremely small or rudimentary and the right atrium greatly dilated. Blood passes from the right to the left atrium and thence disease due to pulmonary hypertension secondary to disease of the lung, or its blood vessels, with hypertrophy of the right ventricle. [EU] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Circulation: The circulation of blood through the coronary vessels of the heart. [NIH]

Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corpus: The body of the uterus. [NIH] Corpus Luteum: The yellow glandular mass formed in the ovary by an ovarian follicle that has ruptured and discharged its ovum. [NIH] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytoskeleton: The network of filaments, tubules, and interconnecting filamentous bridges which give shape, structure, and organization to the cytoplasm. [NIH] Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of special organs. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH]

100

Indigestion

Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diarrhoea: Abnormal frequency and liquidity of faecal discharges. [EU] Dietary Fats: Fats present in food, especially in animal products such as meat, meat products, butter, ghee. They are present in lower amounts in nuts, seeds, and avocados. [NIH]

Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Dihydroxy: AMPA/Kainate antagonist. [NIH] Dilator: A device used to stretch or enlarge an opening. [NIH] Dimethyl: A volatile metabolite of the amino acid methionine. [NIH] Diploid: Having two sets of chromosomes. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Distention: The state of being distended or enlarged; the act of distending. [EU] Diurnal: Occurring during the day. [EU] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dosage Forms: Completed forms of the pharmaceutical preparation in which prescribed doses of medication are included. They are designed to resist action by gastric fluids, prevent vomiting and nausea, reduce or alleviate the undesirable taste and smells associated with oral administration, achieve a high concentration of drug at target site, or produce a delayed or long-acting drug effect. They include capsules, liniments, ointments, pharmaceutical solutions, powders, tablets, etc. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duodenum: The first part of the small intestine. [NIH] Dyspepsia: Impaired digestion, especially after eating. [NIH]

Dictionary 101

Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Emesis: Vomiting; an act of vomiting. Also used as a word termination, as in haematemesis. [EU]

Empiric: Empirical; depending upon experience or observation alone, without using scientific method or theory. [EU] Empirical: A treatment based on an assumed diagnosis, prior to receiving confirmatory laboratory test results. [NIH] Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Epigastric: Having to do with the upper middle area of the abdomen. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] ERCP: Endoscopic retrograde cholangiopancreatography (en-do-SKAH-pik RET-ro-grade ko-LAN-jee-o-PAN-kree-a-TAW-gra-fee). A procedure to x-ray the bile and pancreatic ducts. In this procedure, a thin, lighted tube (endoscope) is passed through the mouth and down into the first part of the small intestine (duodenum). A smaller tube (catheter) is then inserted through the endoscope into the bile and pancreatic ducts. A dye is injected through the catheter into the ducts, and an x-ray is taken. [NIH] Erectile: The inability to get or maintain an erection for satisfactory sexual intercourse. Also called impotence. [NIH] Erection: The condition of being made rigid and elevated; as erectile tissue when filled with

102

Indigestion

blood. [EU] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Erythromycin: A bacteriostatic antibiotic substance produced by Streptomyces erythreus. Erythromycin A is considered its major active component. In sensitive organisms, it inhibits protein synthesis by binding to 50S ribosomal subunits. This binding process inhibits peptidyl transferase activity and interferes with translocation of amino acids during translation and assembly of proteins. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophagitis: Inflammation, acute or chronic, of the esophagus caused by bacteria, chemicals, or trauma. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Estrogen: One of the two female sex hormones. [NIH] Evacuation: An emptying, as of the bowels. [EU] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Excipients: Usually inert substances added to a prescription in order to provide suitable consistency to the dosage form; a binder, matrix, base or diluent in pills, tablets, creams, salves, etc. [NIH] Excitatory: When cortical neurons are excited, their output increases and each new input they receive while they are still excited raises their output markedly. [NIH] Exocrine: Secreting outwardly, via a duct. [EU] Extracellular: Outside a cell or cells. [EU] Extrapyramidal: Outside of the pyramidal tracts. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Febrile: Pertaining to or characterized by fever. [EU] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Fibroid: A benign smooth muscle tumor, usually in the uterus or gastrointestinal tract. Also called leiomyoma. [NIH] Fistula: Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body. [NIH] Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a

Dictionary 103

fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU] Flatulence: Production or presence of gas in the gastrointestinal tract which may be expelled through the anus. [NIH] Flatus: Gas passed through the rectum. [NIH] Fluoxetine: The first highly specific serotonin uptake inhibitor. It is used as an antidepressant and often has a more acceptable side-effects profile than traditional antidepressants. [NIH] Flushing: A transient reddening of the face that may be due to fever, certain drugs, exertion, stress, or a disease process. [NIH] Functional Disorders: Disorders such as irritable bowel syndrome. These conditions result from poor nerve and muscle function. Symptoms such as gas, pain, constipation, and diarrhea come back again and again, but there are no signs of disease or damage. Emotional stress can trigger symptoms. Also called motility disorders. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gallstones: The solid masses or stones made of cholesterol or bilirubin that form in the gallbladder or bile ducts. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Acid: Hydrochloric acid present in gastric juice. [NIH] Gastric Emptying: The evacuation of food from the stomach into the duodenum. [NIH] Gastric Juices: Liquids produced in the stomach to help break down food and kill bacteria. [NIH]

Gastric Mucosa: Surface epithelium in the stomach that invaginates into the lamina propria, forming gastric pits. Tubular glands, characteristic of each region of the stomach (cardiac, gastric, and pyloric), empty into the gastric pits. The gastric mucosa is made up of several different kinds of cells. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastritis: Inflammation of the stomach. [EU] Gastroduodenal: Pertaining to or communicating with the stomach and duodenum, as a gastroduodenal fistula. [EU] Gastroenteritis: An acute inflammation of the lining of the stomach and intestines, characterized by anorexia, nausea, diarrhoea, abdominal pain, and weakness, which has

104

Indigestion

various causes, including food poisoning due to infection with such organisms as Escherichia coli, Staphylococcus aureus, and Salmonella species; consumption of irritating food or drink; or psychological factors such as anger, stress, and fear. Called also enterogastritis. [EU] Gastroenterologist: A doctor who specializes in diagnosing and treating disorders of the digestive system. [NIH] Gastroenterology: A subspecialty of internal medicine concerned with the study of the physiology and diseases of the digestive system and related structures (esophagus, liver, gallbladder, and pancreas). [NIH] Gastroesophageal Reflux: Reflux of gastric juice and/or duodenal contents (bile acids, pancreatic juice) into the distal esophagus, commonly due to incompetence of the lower esophageal sphincter. Gastric regurgitation is an extension of this process with entry of fluid into the pharynx or mouth. [NIH] Gastroesophageal Reflux Disease: Flow of the stomach's contents back up into the esophagus. Happens when the muscle between the esophagus and the stomach (the lower esophageal sphincter) is weak or relaxes when it shouldn't. May cause esophagitis. Also called esophageal reflux or reflux esophagitis. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gastrooesophageal: Pertaining to the stomach and oesophagus, as the gastrooesophageal junction. [EU] Gastroparesis: Nerve or muscle damage in the stomach. Causes slow digestion and emptying, vomiting, nausea, or bloating. Also called delayed gastric emptying. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

General practitioner: A medical practitioner who does not specialize in a particular branch of medicine or limit his practice to a specific class of diseases. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Giardiasis: An infection of the small intestine caused by the flagellated protozoan Giardia lamblia. It is spread via contaminated food and water and by direct person-to-person contact. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glutathione Peroxidase: An enzyme catalyzing the oxidation of 2 moles of glutathione in the presence of hydrogen peroxide to yield oxidized glutathione and water. EC 1.11.1.9. [NIH]

Gluten: The protein of wheat and other grains which gives to the dough its tough elastic

Dictionary 105

character. [EU] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Grading: A system for classifying cancer cells in terms of how abnormal they appear when examined under a microscope. The objective of a grading system is to provide information about the probable growth rate of the tumor and its tendency to spread. The systems used to grade tumors vary with each type of cancer. Grading plays a role in treatment decisions. [NIH]

Gram-negative: Losing the stain or decolorized by alcohol in Gram's method of staining, a primary characteristic of bacteria having a cell wall composed of a thin layer of peptidoglycan covered by an outer membrane of lipoprotein and lipopolysaccharide. [EU] Gram-Negative Bacteria: Bacteria which lose crystal violet stain but are stained pink when treated by Gram's method. [NIH] Gram-positive: Retaining the stain or resisting decolorization by alcohol in Gram's method of staining, a primary characteristic of bacteria whose cell wall is composed of a thick layer of peptidologlycan with attached teichoic acids. [EU] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Gyrase: An enzyme that causes negative supercoiling of E. coli DNA during replication. [NIH]

Haematemesis: The vomiting of blood. [EU] Haematological: Relating to haematology, that is that branch of medical science which treats of the morphology of the blood and blood-forming tissues. [EU] Haematology: The science of the blood, its nature, functions, and diseases. [NIH] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Health Promotion: Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH] Helicobacter: A genus of gram-negative, spiral-shaped bacteria that is pathogenic and has been isolated from the intestinal tract of mammals, including humans. [NIH]

106

Indigestion

Helicobacter pylori: A spiral bacterium active as a human gastric pathogen. It is a gramnegative, urease-positive, curved or slightly spiral organism initially isolated in 1982 from patients with lesions of gastritis or peptic ulcers in Western Australia. Helicobacter pylori was originally classified in the genus Campylobacter, but RNA sequencing, cellular fatty acid profiles, growth patterns, and other taxonomic characteristics indicate that the microorganism should be included in the genus Helicobacter. It has been officially transferred to Helicobacter gen. nov. (see Int J Syst Bacteriol 1989 Oct;39(4):297-405). [NIH] Hemicrania: An ache or a pain in one side of the head, as in migraine. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]

Hepatic: Refers to the liver. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Hiatal Hernia: A small opening in the diaphragm that allows the upper part of the stomach to move up into the chest. Causes heartburn from stomach acid flowing back up through the opening. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used of endocrine factors as opposed to neural or somatic. [EU] Humour: 1. A normal functioning fluid or semifluid of the body (as the blood, lymph or bile) especially of vertebrates. 2. A secretion that is itself an excitant of activity (as certain hormones). [EU] Hydrochloric Acid: A strong corrosive acid that is commonly used as a laboratory reagent. It is formed by dissolving hydrogen chloride in water. Gastric acid is the hydrochloric acid component of gastric juice. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hyperbilirubinemia: Pathologic process consisting of an abnormal increase in the amount

Dictionary 107

of bilirubin in the circulating blood, which may result in jaundice. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Ibuprofen: A nonsteroidal anti-inflammatory agent with analgesic properties used in the therapy of rheumatism and arthritis. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Imipenem: Semisynthetic thienamycin that has a wide spectrum of antibacterial activity against gram-negative and gram-positive aerobic and anaerobic bacteria, including many multiresistant strains. It is stable to beta-lactamases. Clinical studies have demonstrated high efficacy in the treatment of infections of various body systems. Its effectiveness is enhanced when it is administered in combination with cilastatin, a renal dipeptidase inhibitor. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Impotence: The inability to perform sexual intercourse. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incompetence: Physical or mental inadequacy or insufficiency. [EU] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Indigestion: Poor digestion. Symptoms include heartburn, nausea, bloating, and gas. Also called dyspepsia. [NIH] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be

108

Indigestion

clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]

Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Inorganic: Pertaining to substances not of organic origin. [EU] Inotropic: Affecting the force or energy of muscular contractions. [EU] Insomnia: Difficulty in going to sleep or getting enough sleep. [NIH] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intracellular: Inside a cell. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intravenous: IV. Into a vein. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Irritable Bowel Syndrome: A disorder that comes and goes. Nerves that control the muscles in the GI tract are too active. The GI tract becomes sensitive to food, stool, gas, and stress. Causes abdominal pain, bloating, and constipation or diarrhea. Also called spastic colon or mucous colitis. [NIH] Isoenzyme: Different forms of an enzyme, usually occurring in different tissues. The isoenzymes of a particular enzyme catalyze the same reaction but they differ in some of their properties. [NIH] Jaundice: A clinical manifestation of hyperbilirubinemia, consisting of deposition of bile pigments in the skin, resulting in a yellowish staining of the skin and mucous membranes. [NIH]

Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large

Dictionary 109

intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Leiomyoma: A benign tumor derived from smooth muscle tissue, also known as a fibroid tumor. They rarely occur outside of the uterus and the gastrointestinal tract but can occur in the skin and subcutaneous tissues, probably arising from the smooth muscle of small blood vessels in these tissues. [NIH] Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Lesion: An area of abnormal tissue change. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Lipase: An enzyme of the hydrolase class that catalyzes the reaction of triacylglycerol and water to yield diacylglycerol and a fatty acid anion. It is produced by glands on the tongue and by the pancreas and initiates the digestion of dietary fats. (From Dorland, 27th ed) EC 3.1.1.3. [NIH] Lipodystrophy: A collection of rare conditions resulting from defective fat metabolism and characterized by atrophy of the subcutaneous fat. They include total, congenital or acquired, partial, abdominal infantile, and localized lipodystrophy. [NIH] Lipoma: A benign tumor composed of fat cells. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Lower Esophageal Sphincter: The muscle between the esophagus and stomach. When a person swallows, this muscle relaxes to let food pass from the esophagus to the stomach. It stays closed at other times to keep stomach contents from flowing back into the esophagus. [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mammogram: An x-ray of the breast. [NIH] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Mastication: The act and process of chewing and grinding food in the mouth. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU]

110

Indigestion

MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Proteins: Proteins which are found in membranes including cellular and intracellular membranes. They consist of two types, peripheral and integral proteins. They include most membrane-associated enzymes, antigenic proteins, transport proteins, and drug, hormone, and lectin receptors. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] Metronidazole: Antiprotozoal used in amebiasis, trichomoniasis, giardiasis, and as treponemacide in livestock. It has also been proposed as a radiation sensitizer for hypoxic cells. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985, p133), this substance may reasonably be anticipated to be a carcinogen (Merck, 11th ed). [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Micro-organism: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness,

Dictionary 111

and air sickness. [NIH] Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucosal Lining: The lining of GI tract organs that makes mucus. [NIH] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Muscle Contraction: A process leading to shortening and/or development of tension in muscle tissue. Muscle contraction occurs by a sliding filament mechanism whereby actin filaments slide inward among the myosin filaments. [NIH] Myenteric: On stimulation of an intestinal segment, the segment above contracts and that below relaxes. [NIH] Myocardial Ischemia: A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (coronary arteriosclerosis), to obstruction by a thrombus (coronary thrombosis), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (myocardial infarction). [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myosin: Chief protein in muscle and the main constituent of the thick filaments of muscle fibers. In conjunction with actin, it is responsible for the contraction and relaxation of muscles. [NIH] Nalidixic Acid: Synthetic antimicrobial agent used in urinary tract infections. It is active against gram-negative bacteria but has little activity against gram-positive organisms or Pseudomonas. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH]

112

Indigestion

Networks: Pertaining to a nerve or to the nerves, a meshlike structure of interlocking fibers or strands. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuralgia: Intense or aching pain that occurs along the course or distribution of a peripheral or cranial nerve. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Nitrates: Inorganic or organic salts and esters of nitric acid. These compounds contain the NO3- radical. [NIH] Nitric acid: A toxic, corrosive, colorless liquid used to make fertilizers, dyes, explosives, and other chemicals. [NIH] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nitroglycerin: A highly volatile organic nitrate that acts as a dilator of arterial and venous smooth muscle and is used in the treatment of angina. It provides relief through improvement of the balance between myocardial oxygen supply and demand. Although total coronary blood flow is not increased, there is redistribution of blood flow in the heart when partial occlusion of coronary circulation is effected. [NIH] Nonulcer Dyspepsia: Constant pain or discomfort in the upper GI tract. Symptoms include burning, nausea, and bloating, but no ulcer. Possibly caused by muscle spasms. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Norfloxacin: Quinoline-derived synthetic antibacterial agent with a very broad spectrum of action. Oral administration yields highly bactericidal plasma, tissue, and urine levels. Norfloxacin inhibits bacterial DNA-gyrase and is used in gastrointestinal, eye, and urinary infections. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Observational study: An epidemiologic study that does not involve any intervention, experimental or otherwise. Such a study may be one in which nature is allowed to take its course, with changes in one characteristic being studied in relation to changes in other characteristics. Analytical epidemiologic methods, such as case-control and cohort study designs, are properly called observational epidemiology because the investigator is

Dictionary 113

observing without intervention other than to record, classify, count, and statistically analyze results. [NIH] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few morphine, codeine, and papaverine - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic. [NIH] Overweight: An excess of body weight but not necessarily body fat; a body mass index of 25 to 29.9 kg/m2. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic Ducts: Ducts that collect pancreatic juice from the pancreas and supply it to the duodenum. [NIH] Pancreatic Insufficiency: Absence of or reduced pancreatic exocrine secretion into the duodenum and resultant poor digestion of lipids, vitamins, nitrogen, and carbohydrates. [NIH]

Pancreatic Juice: The fluid containing digestive enzymes secreted by the pancreas in response to food in the duodenum. [NIH] Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Parenteral Nutrition: The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously). [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Pathogen: Any disease-producing microorganism. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

114

Indigestion

Penicillin: An antibiotic drug used to treat infection. [NIH] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptic Ulcer: An ulceration of the mucous membrane of the esophagus, stomach or duodenum, caused by the action of the acid gastric juice. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Peptide Chain Elongation: The process whereby an amino acid is joined through a substituted amide linkage to a chain of peptides. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Pharmaceutical Solutions: Homogeneous liquid preparations that contain one or more chemical substances dissolved, i.e., molecularly dispersed, in a suitable solvent or mixture of mutually miscible solvents. For reasons of their ingredients, method of preparation, or use, they do not fall into another group of products. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharmacotherapy: A regimen of using appetite suppressant medications to manage obesity by decreasing appetite or increasing the feeling of satiety. These medications decrease appetite by increasing serotonin or catecholamine—two brain chemicals that affect mood and appetite. [NIH] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phosphodiesterase: Effector enzyme that regulates the levels of a second messenger, the cyclic GMP. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth

Dictionary 115

day of gestation when the blastocyst adheres to the decidua. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]

Plexus: A network or tangle; a general term for a network of lymphatic vessels, nerves, or veins. [EU] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Population Control: Includes mechanisms or programs which control the numbers of individuals in a population of humans or animals. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postprandial: Occurring after dinner, or after a meal; postcibal. [EU] Post-traumatic: Occurring as a result of or after injury. [EU] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Primary Biliary Cirrhosis: A chronic liver disease. Slowly destroys the bile ducts in the liver. This prevents release of bile. Long-term irritation of the liver may cause scarring and cirrhosis in later stages of the disease. [NIH] Progeny: The offspring produced in any generation. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH]

116

Indigestion

Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Prokinetic Drugs: Medicines that cause muscles in the GI tract to move food. An example is cisapride (SIS-uh-pryd) (Propulsid). [NIH] Prone: Having the front portion of the body downwards. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proton Pump: Integral membrane proteins that transport protons across a membrane against a concentration gradient. This transport is driven by hydrolysis of ATP by H(+)transporting ATP synthase. [NIH] Proton Pump Inhibitors: Medicines that stop the stomach's acid pump. Examples are omeprazole (oh-MEH-prah-zol) (Prilosec) and lansoprazole (lan-SOH-prah-zol) (Prevacid). [NIH]

Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

Pulmonary: Relating to the lungs. [NIH] Pulmonary hypertension: Abnormally high blood pressure in the arteries of the lungs. [NIH] Pylorus: The opening in a vertebrate from the stomach into the intestine. [EU] Pyramidal Tracts: Fibers that arise from cells within the cerebral cortex, pass through the medullary pyramid, and descend in the spinal cord. Many authorities say the pyramidal tracts include both the corticospinal and corticobulbar tracts. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Quinolones: Quinolines which are substituted in any position by one or more oxo groups. These compounds can have any degree of hydrogenation, any substituents, and fused ring systems. [NIH] Race: A population within a species which exhibits general similarities within itself, but is

Dictionary 117

both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radioactive: Giving off radiation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Resolving: The ability of the eye or of a lens to make small objects that are close together, separately visible; thus revealing the structure of an object. [NIH] Retrograde: 1. Moving backward or against the usual direction of flow. 2. Degenerating, deteriorating, or catabolic. [EU] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rod: A reception for vision, located in the retina. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH]

118

Indigestion

Salivary glands: Glands in the mouth that produce saliva. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Selenium: An element with the atomic symbol Se, atomic number 34, and atomic weight 78.96. It is an essential micronutrient for mammals and other animals but is toxic in large amounts. Selenium protects intracellular structures against oxidative damage. It is an essential component of glutathione peroxidase. [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Sensitization: 1. Administration of antigen to induce a primary immune response; priming; immunization. 2. Exposure to allergen that results in the development of hypersensitivity. 3. The coating of erythrocytes with antibody so that they are subject to lysis by complement in the presence of homologous antigen, the first stage of a complement fixation test. [EU] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sexually Transmitted Diseases: Diseases due to or propagated by sexual contact. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Sigmoid: 1. Shaped like the letter S or the letter C. 2. The sigmoid colon. [EU] Sigmoidoscopy: Endoscopic examination, therapy or surgery of the sigmoid flexure. [NIH] Simethicone: A mixture of dimethyl polysiloxanes and silica gel used as an antiflatulent. Without the addition of silica gel (dimethicone), it is used as an ointment base ingredient and skin protectant. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Smooth Muscle Tumor: A tumor composed of smooth muscle tissue, as opposed to leiomyoma, a tumor derived from smooth muscle. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation,

Dictionary 119

maintenance of fluid volume, and electrolyte balance. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Spastic: 1. Of the nature of or characterized by spasms. 2. Hypertonic, so that the muscles are stiff and the movements awkward. 3. A person exhibiting spasticity, such as occurs in spastic paralysis or in cerebral palsy. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Sprue: A non febrile tropical disease of uncertain origin. [NIH] Stasis: A word termination indicating the maintenance of (or maintaining) a constant level; preventing increase or multiplication. [EU] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stomach Ulcer: An open sore in the lining of the stomach. Also called gastric ulcer. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions

120

Indigestion

of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Sucralfate: A basic aluminum complex of sulfated sucrose. It is advocated in the therapy of peptic, duodenal, and prepyloric ulcers, gastritis, reflux esophagitis, and other gastrointestinal irritations. It acts primarily at the ulcer site, where it has cytoprotective, pepsinostatic, antacid, and bile acid-binding properties. The drug is only slightly absorbed by the digestive mucosa, which explains the absence of systemic effects and toxicity. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Suppressive: Tending to suppress : effecting suppression; specifically : serving to suppress activity, function, symptoms. [EU] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Systemic: Affecting the entire body. [NIH] Taurine: 2-Aminoethanesulfonic acid. A conditionally essential nutrient, important during mammalian development. It is present in milk but is isolated mostly from ox bile and strongly conjugates bile acids. [NIH] Tetracycline: An antibiotic originally produced by Streptomyces viridifaciens, but used mostly in synthetic form. It is an inhibitor of aminoacyl-tRNA binding during protein synthesis. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Time Factors: Elements of limited time intervals, contributing to particular results or situations. [NIH] Tips to control heartburn: Avoid lying down 2 to 3 hours after eating. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of

Dictionary 121

toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translocation: The movement of material in solution inside the body of the plant. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Trichomoniasis: An infection with the protozoan parasite Trichomonas vaginalis. [NIH] Tricuspid Atresia: Absence of the orifice between the right atrium and ventricle, with the presence of an atrial defect through which all the systemic venous return reaches the left heart. As a result, there is left ventricular hypertrophy because the right ventricle is absent or not functional. [NIH] Trigeminal: Cranial nerve V. It is sensory for the eyeball, the conjunctiva, the eyebrow, the skin of face and scalp, the teeth, the mucous membranes in the mouth and nose, and is motor to the muscles of mastication. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulceration: 1. The formation or development of an ulcer. 2. An ulcer. [EU] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]

Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Urea Breath Test: A test used to detect Helicobacter pylori infection. The test measures breath samples for urease, an enzyme H. pylori makes. [NIH] Ureters: Tubes that carry urine from the kidneys to the bladder. [NIH]

122

Indigestion

Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urinary tract infection: An illness caused by harmful bacteria growing in the urinary tract. [NIH]

Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Ursodeoxycholic Acid: An epimer of chenodeoxycholic acid. It is a mammalian bile acid found first in the bear and is apparently either a precursor or a product of chenodeoxycholate. Its administration changes the composition of bile and may dissolve gallstones. It is used as a cholagogue and choleretic. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vagotomy: The interruption or removal of any part of the vagus (10th cranial) nerve. Vagotomy may be performed for research or for therapeutic purposes. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] Veins: The vessels carrying blood toward the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Villous: Of a surface, covered with villi. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Viruses: Minute infectious agents whose genomes are composed of DNA or RNA, but not both. They are characterized by a lack of independent metabolism and the inability to replicate outside living host cells. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Whipple: An intestinal lipodystrophy; occurs in men and usually is associated with arthritis, diarrhea, and fat malabsorption. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others.

Dictionary 123

[NIH]

X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Zygote: The fertilized ovum. [NIH]

125

INDEX A Abdomen, 29, 91, 95, 101, 108, 109, 114, 119, 120 Abdominal, 3, 4, 5, 26, 40, 48, 72, 87, 88, 89, 91, 97, 100, 103, 108, 109, 113, 114 Abdominal Pain, 40, 72, 91, 103, 108 Absenteeism, 48, 91 Accommodation, 10, 91 Acetylcholine, 42, 91 Achlorhydria, 42, 91 Actin, 91, 111 Adrenal Cortex, 91, 115 Adrenergic, 91, 100, 101, 120 Adverse Effect, 91, 118 Aerobic, 91, 107 Aerophagia, 40, 91 Aetiology, 41, 91 Affinity, 91, 92, 118 Age Factors, 48, 91 Agonist, 92, 100 Alginates, 36, 92 Algorithms, 92, 95 Alimentary, 5, 11, 14, 16, 18, 20, 21, 22, 23, 92, 113 Alkaline, 92, 95 Alkaloid, 92, 110 Allergen, 92, 118 Alternative medicine, 54, 92 Aluminum, 92, 120 Amebiasis, 92, 110 Amenorrhea, 92, 93 Amino Acids, 92, 102, 114, 116, 117, 121 Ammonia, 92, 121 Amoxicillin, 10, 92 Ampicillin, 40, 92 Ampulla, 92, 101 Anaerobic, 92, 107 Anaesthesia, 92, 107 Analgesic, 36, 92, 107, 110, 113 Anesthesia, 42, 92 Angina, 20, 93, 112 Angina Pectoris, 20, 93 Anorexia, 26, 42, 93, 103, 121 Anorexia Nervosa, 42, 93 Anterograde, 42, 93 Antibacterial, 40, 93, 107, 112, 119 Antibiotic, 39, 92, 93, 95, 97, 102, 114, 119, 120

Antibodies, 93, 94 Antibody, 11, 91, 93, 97, 106, 108, 109, 118 Antidepressant, 93, 103 Antiemetic, 35, 42, 93 Antigen, 91, 93, 98, 106, 107, 108, 109, 118 Anti-inflammatory, 9, 36, 93, 107 Antimicrobial, 93, 111 Anus, 93, 95, 103 Anxiety, 16, 19, 34, 87, 93 Appendicitis, 46, 93 Arrhythmia, 34, 93 Arterial, 93, 98, 107, 112, 116 Arteries, 93, 95, 99, 110, 111, 116 Asymptomatic, 92, 93, 113 Atrial, 93, 98, 121 Atrioventricular, 94, 98 Atrium, 93, 94, 98, 121, 122 Autoantibodies, 55, 94 Autoantigens, 94 Autodigestion, 94, 113 Autonomic, 91, 94, 112 B Bacteria, 39, 93, 94, 97, 98, 102, 103, 105, 107, 110, 119, 122 Bactericidal, 94, 112 Bacteriostatic, 94, 102 Bacterium, 39, 55, 94, 98, 106 Base, 94, 102, 108, 118, 121 Belching, 11, 29, 46, 49, 87, 91, 94 Benign, 94, 102, 105, 109 Benign tumor, 94, 109 Beta-Lactamases, 94, 107 Bile, 39, 94, 95, 96, 101, 103, 104, 106, 108, 109, 115, 120, 122 Bile Acids, 94, 104, 120 Bile Acids and Salts, 94 Bile Ducts, 94, 103, 115 Bile Pigments, 94, 108 Biliary, 39, 48, 49, 94, 95, 113 Biliary Tract, 39, 48, 95, 113 Bilirubin, 94, 95, 103, 107 Biochemical, 26, 41, 95, 118 Biopsy, 11, 19, 95 Biotechnology, 7, 9, 54, 67, 95 Bismuth, 21, 60, 95 Bladder, 95, 121, 122 Bloating, 5, 29, 40, 48, 88, 95, 104, 107, 108, 112

126

Indigestion

Blood Coagulation, 95, 96 Blood Platelets, 95, 118 Blood pressure, 95, 107, 116, 118 Blood vessel, 95, 96, 99, 109, 118, 119, 120, 122 Body Fluids, 95, 118 Body Mass Index, 95, 113 Body Regions, 95, 97 Bowel, 38, 41, 46, 73, 88, 95, 100, 108, 114, 119 Bowel Movement, 95, 100, 119 Branch, 85, 95, 104, 105, 113, 119, 120 Breakdown, 95, 100, 103 Broad-spectrum, 92, 95 Buffaloes, 26, 95 Butterflies, 46, 95 C Calcium, 27, 34, 95, 96, 97 Calcium Carbonate, 34, 96 Capsules, 39, 96, 100 Carbohydrates, 96, 113 Carboxy, 42, 96 Carcinogen, 96, 110 Carcinostatic, 35, 96 Cardiac, 96, 99, 101, 103, 111 Cardiovascular, 35, 96, 118 Cardiovascular System, 35, 96 Catecholamine, 96, 100, 114 Celiac Disease, 46, 55, 96 Cell, 91, 92, 94, 95, 96, 97, 98, 99, 102, 105, 107, 108, 111, 113, 114, 115, 117, 121, 122 Cell Cycle, 96, 97 Cell Division, 94, 96, 115 Cellulose, 96, 115 Central Nervous System, 42, 91, 96, 103, 105, 110, 118 Central Nervous System Infections, 96, 105 Character, 93, 96, 99, 105 Chenodeoxycholic Acid, 96, 122 Chest Pain, 45, 51, 75, 76, 96 Cholecystectomy, 20, 97 Choleretic, 35, 96, 97, 122 Cholesterol, 39, 46, 94, 97, 103 Chromosome, 97, 98, 105 Chronic, 7, 8, 14, 26, 34, 35, 48, 54, 55, 91, 92, 97, 101, 102, 108, 113, 115, 119, 121 Chronic renal, 14, 97, 121 Cilastatin, 97, 107 CIS, 42, 97 Cisplatin, 35, 97 Clarithromycin, 10, 97

Clinical trial, 6, 14, 29, 30, 67, 97, 117 Cloning, 95, 97 Colic, 46, 97 Colitis, 97, 108 Complement, 97, 118 Computational Biology, 67, 98 Concomitant, 42, 98 Conjugated, 94, 96, 98 Conjugation, 39, 98 Conjunctiva, 98, 121 Consciousness, 92, 98 Constipation, 46, 47, 54, 98, 103, 108 Consultation, 4, 48, 98 Consumption, 98, 104 Contractility, 23, 98 Contraindications, ii, 98 Cor, 40, 98 Coronary, 93, 99, 110, 111, 112 Coronary Circulation, 93, 99, 112 Coronary Thrombosis, 99, 110, 111 Corpus, 99, 115 Corpus Luteum, 99, 115 Cortical, 99, 102 Cranial, 99, 105, 112, 121, 122 Craniocerebral Trauma, 99, 105 Curative, 99, 120 Cyclic, 73, 74, 99, 114 Cytoplasm, 99, 117 Cytoskeleton, 11, 99 Cytotoxicity, 97, 99 D Databases, Bibliographic, 67, 99 Deamination, 99, 121 Degenerative, 99, 106 Dendrites, 99, 112 Deuterium, 99, 106 Diabetes Mellitus, 56, 100, 104 Diagnostic procedure, 33, 54, 100 Diaphragm, 100, 106 Diarrhea, 46, 55, 92, 100, 103, 108, 122 Diarrhoea, 100, 103 Dietary Fats, 100, 109 Digestion, 13, 45, 47, 75, 92, 94, 95, 100, 104, 107, 108, 109, 113, 114, 119 Digestive system, 30, 46, 100, 104 Digestive tract, 46, 49, 100, 118 Dihydroxy, 39, 100 Dilator, 100, 112 Dimethyl, 100, 118 Diploid, 100, 115 Direct, iii, 48, 59, 100, 104, 117 Distal, 100, 104, 116

Index 127

Distention, 5, 48, 100 Diurnal, 95, 100 Dopamine, 35, 100 Dosage Forms, 34, 100 Drug Interactions, 46, 61, 100 Duodenum, 94, 100, 101, 103, 113, 114, 119 Dyspepsia, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 29, 38, 39, 40, 41, 43, 46, 47, 48, 49, 53, 55, 75, 76, 77, 100, 107 E Effector, 91, 97, 101, 114 Efficacy, 14, 20, 26, 101, 107 Electrolyte, 101, 115, 119, 121 Embryo, 101, 107 Emesis, 34, 35, 101 Empiric, 6, 8, 22, 101 Empirical, 7, 14, 48, 101 Endoscope, 101 Endoscopic, 12, 14, 19, 22, 72, 101, 118 Endoscopy, 4, 5, 6, 8, 10, 12, 13, 16, 17, 18, 20, 22, 23, 48, 73, 88, 101 End-stage renal, 97, 101 Environmental Health, 66, 68, 101 Enzymatic, 96, 98, 101 Enzyme, 35, 101, 104, 105, 108, 109, 114, 121, 122 Epidemiological, 5, 101 Epigastric, 14, 15, 101, 113 Epinephrine, 91, 100, 101, 112, 121 Epithelium, 101, 103 ERCP, 72, 101 Erectile, 56, 101 Erection, 101 Erythrocytes, 102, 118 Erythromycin, 40, 97, 102 Esophageal, 5, 37, 48, 102, 104 Esophagitis, 45, 102, 104, 120 Esophagus, 5, 36, 48, 52, 56, 72, 100, 102, 104, 105, 109, 114, 117, 119 Estrogen, 11, 102 Evacuation, 98, 102, 103 Evoke, 102, 119 Excipients, 34, 102 Excitatory, 42, 102 Exocrine, 102, 113 Extracellular, 102, 118 Extrapyramidal, 35, 100, 102 F Family Planning, 67, 102 Fat, 21, 56, 94, 98, 102, 109, 113, 117, 122 Febrile, 102, 119

Feces, 98, 102, 119 Fibroid, 11, 102, 109 Fistula, 102, 103 Fixation, 102, 118 Flatulence, 36, 40, 49, 103 Flatus, 103 Fluoxetine, 13, 103 Flushing, 56, 103 Functional Disorders, 49, 103 Fungi, 98, 103, 110 G Gallbladder, 45, 91, 94, 95, 97, 100, 103, 104 Gallstones, 45, 48, 49, 94, 96, 103, 122 Ganglia, 91, 103, 111 Gas, 34, 36, 46, 49, 73, 91, 92, 94, 103, 106, 107, 108, 112 Gastric Acid, 37, 48, 92, 103 Gastric Emptying, 5, 14, 21, 29, 42, 53, 103, 104 Gastric Juices, 37, 103, 114 Gastric Mucosa, 19, 103 Gastrin, 103, 106 Gastritis, 7, 8, 11, 34, 39, 55, 103, 106, 120 Gastroduodenal, 3, 103 Gastroenteritis, 46, 103 Gastroenterologist, 51, 55, 74, 104 Gastroenterology, 3, 4, 6, 10, 11, 12, 13, 15, 17, 20, 21, 22, 23, 40, 74, 75, 77, 104 Gastroesophageal Reflux, 4, 5, 11, 41, 42, 48, 51, 56, 72, 77, 104 Gastroesophageal Reflux Disease, 4, 5, 11, 51, 56, 77, 104 Gastrointestinal tract, 4, 9, 36, 38, 42, 48, 55, 102, 103, 104, 109, 118 Gastrooesophageal, 40, 104 Gastroparesis, 29, 104 Gene, 95, 104 General practitioner, 9, 104 Genetics, 98, 104 Giardiasis, 104, 110 Gland, 91, 104, 113, 118, 119, 120 Glucose, 96, 100, 104 Glucose Intolerance, 100, 104 Glutathione Peroxidase, 104, 118 Gluten, 28, 55, 96, 104 Governing Board, 105, 115 Grade, 37, 101, 105 Grading, 11, 105 Gram-negative, 105, 106, 107, 111 Gram-Negative Bacteria, 105, 111 Gram-positive, 105, 107, 111

128

Indigestion

Growth, 37, 93, 94, 96, 105, 106, 115, 120, 121 Gyrase, 105, 112 H Haematemesis, 101, 105 Haematological, 26, 105 Haematology, 105 Haploid, 105, 115 Headache, 34, 37, 56, 105 Headache Disorders, 105 Health Promotion, 51, 105 Heart attack, 76, 105 Heartburn, 4, 5, 9, 15, 19, 26, 34, 36, 37, 41, 42, 45, 46, 47, 48, 49, 51, 55, 56, 75, 105, 106, 107 Helicobacter, 5, 7, 8, 10, 11, 12, 13, 14, 15, 16, 17, 19, 20, 21, 22, 39, 40, 48, 55, 105, 106, 121 Helicobacter pylori, 5, 7, 8, 10, 11, 12, 13, 14, 15, 16, 17, 19, 20, 21, 22, 39, 40, 48, 55, 106, 121 Hemicrania, 34, 105, 106 Hemodialysis, 96, 106 Hemorrhage, 99, 105, 106, 119 Hemostasis, 106, 118 Hepatic, 39, 106 Hepatitis, 46, 106 Hepatocytes, 106 Hiatal Hernia, 45, 52, 72, 106 Homologous, 106, 118 Hormone, 38, 40, 101, 103, 106, 110, 115, 120 Host, 106, 107, 122 Humoral, 20, 106 Humour, 106 Hydrochloric Acid, 91, 106 Hydrogen, 42, 94, 96, 99, 104, 106, 110, 116 Hydrolysis, 94, 97, 106, 116 Hyperbilirubinemia, 106, 108 Hypersensitivity, 5, 92, 107, 118 Hypertension, 105, 107, 121 Hypertrophy, 99, 107, 121 Hypothalamic, 40, 107 Hypothalamus, 107 I Ibuprofen, 36, 60, 107 Id, 27, 72, 73, 75, 76, 77, 84, 86, 107 Imipenem, 40, 97, 107 Immune response, 93, 94, 107, 118, 120 Immunization, 107, 118 Impairment, 107, 110 Impotence, 56, 101, 107

In vitro, 37, 40, 107 In vivo, 107 Incision, 107, 108 Incompetence, 104, 107 Indicative, 5, 46, 48, 107, 113, 122 Induction, 21, 107 Infarction, 99, 107, 110, 111 Infection, 7, 8, 12, 13, 16, 17, 40, 48, 92, 104, 107, 109, 112, 114, 119, 121, 122 Inflammation, 3, 36, 55, 93, 97, 102, 103, 106, 108, 113, 117, 122 Inflammatory bowel disease, 46, 108 Ingestion, 108, 115 Inhalation, 108, 115 Inorganic, 97, 108, 111, 112 Inotropic, 100, 108 Insomnia, 37, 108 Internal Medicine, 10, 26, 104, 108 Intestinal, 45, 48, 49, 73, 96, 105, 108, 109, 111, 122 Intestine, 35, 39, 94, 95, 108, 116 Intracellular, 108, 110, 115, 117, 118 Intramuscular, 108, 113 Intravenous, 108, 113 Invasive, 7, 8, 108 Ions, 94, 101, 106, 108 Irritable Bowel Syndrome, 5, 14, 20, 34, 38, 41, 46, 47, 48, 103, 108 Isoenzyme, 42, 108 J Jaundice, 45, 55, 88, 107, 108 K Kb, 66, 108 L Large Intestine, 100, 108, 117, 118 Leiomyoma, 102, 109, 118 Lens, 109, 117 Lesion, 43, 109, 121 Library Services, 84, 109 Lipase, 43, 109 Lipodystrophy, 109, 122 Lipoma, 16, 109 Liver, 12, 35, 46, 47, 48, 91, 94, 100, 102, 103, 104, 106, 109, 115, 121 Localized, 103, 108, 109, 115, 121 Locomotion, 109, 115 Lower Esophageal Sphincter, 52, 55, 56, 104, 109 Lymphatic, 108, 109, 115 M Malabsorption, 45, 96, 109, 122 Malignancy, 48, 109

Index 129

Malnutrition, 48, 109 Mammogram, 11, 109 Manifest, 5, 109 Mastication, 109, 121 Mediate, 100, 109 Mediator, 109, 118 MEDLINE, 67, 110 Membrane, 35, 98, 105, 110, 111, 114, 116 Membrane Proteins, 110, 116 Memory, 93, 110 Meninges, 96, 99, 110 Menstrual Cycle, 110, 115 Mental Disorders, 31, 110 Meta-Analysis, 8, 14, 110 Metronidazole, 19, 40, 110 MI, 89, 110 Microorganism, 110, 113, 122 Micro-organism, 39, 106, 110 Modification, 110, 116 Molecular, 11, 67, 69, 92, 95, 98, 110, 117 Molecule, 93, 94, 98, 101, 106, 110, 117 Morphine, 42, 110, 111, 113 Morphology, 22, 105, 110 Motility, 5, 14, 18, 42, 48, 49, 103, 110, 118 Motion Sickness, 110, 111 Mucins, 111, 117 Mucosa, 7, 96, 103, 111, 120 Mucosal Lining, 37, 111 Mucus, 111 Muscle Contraction, 55, 111 Myenteric, 42, 111 Myocardial Ischemia, 93, 111 Myocardium, 93, 110, 111 Myosin, 111 N Nalidixic Acid, 40, 111 Narcotic, 110, 111 Nausea, 4, 13, 26, 29, 34, 40, 41, 42, 46, 88, 93, 100, 103, 104, 107, 111, 112, 121 NCI, 1, 30, 65, 97, 111 Necrosis, 107, 110, 111 Need, 3, 15, 37, 41, 43, 45, 47, 51, 55, 73, 75, 78, 91, 97, 111 Nerve, 91, 92, 99, 103, 104, 109, 111, 112, 119, 121, 122 Nervous System, 96, 109, 111, 112, 119, 120 Networks, 12, 112 Neural, 12, 106, 112 Neuralgia, 34, 112 Neuromuscular, 91, 112, 121 Neuromuscular Junction, 91, 112

Neurons, 42, 99, 102, 103, 112 Neuropathy, 34, 42, 112 Nitrates, 56, 112 Nitric acid, 112 Nitrogen, 92, 103, 112, 113, 121 Nitroglycerin, 56, 112 Nonulcer Dyspepsia, 4, 7, 10, 15, 17, 19, 45, 48, 112 Norepinephrine, 91, 100, 112 Norfloxacin, 8, 40, 112 Nuclear, 98, 111, 112 Nuclei, 98, 112, 116 O Observational study, 12, 112 Ointments, 100, 113 Opium, 110, 113 Overweight, 26, 56, 113 Ovum, 99, 113, 115, 123 P Palliative, 113, 120 Pancreas, 48, 91, 100, 104, 109, 113 Pancreatic, 45, 48, 49, 101, 104, 113 Pancreatic Ducts, 101, 113 Pancreatic Insufficiency, 49, 113 Pancreatic Juice, 104, 113 Pancreatitis, 35, 49, 55, 113 Parenteral, 48, 113 Parenteral Nutrition, 48, 113 Paroxysmal, 93, 105, 113 Pathogen, 106, 113 Pathogenesis, 12, 113 Pathologic, 95, 99, 106, 107, 113 Patient Education, 55, 75, 82, 84, 89, 113 Penicillin, 40, 92, 114 Pepsin, 114 Peptic, 4, 5, 7, 17, 19, 21, 45, 48, 49, 72, 106, 114, 120 Peptic Ulcer, 4, 5, 7, 17, 19, 21, 45, 48, 49, 72, 106, 114 Peptide, 38, 97, 114, 116 Peptide Chain Elongation, 97, 114 Peritoneal, 48, 114 Peritoneum, 114 Pharmaceutical Solutions, 100, 114 Pharmacologic, 93, 114, 120 Pharmacotherapy, 22, 114 Pharynx, 104, 114 Phosphodiesterase, 41, 42, 114 Phospholipids, 102, 114 Phosphorus, 96, 114 Physical Examination, 48, 114 Physiologic, 92, 110, 114, 117

130

Indigestion

Physiology, 4, 5, 12, 45, 46, 52, 104, 114 Pilot study, 22, 114 Placenta, 114, 115 Plants, 37, 92, 104, 110, 112, 115, 121 Plasma, 93, 104, 106, 112, 115 Platinum, 97, 115 Plexus, 42, 115 Poisoning, 46, 104, 111, 115 Population Control, 19, 115 Posterior, 113, 115 Postprandial, 4, 23, 41, 42, 115 Post-traumatic, 3, 105, 115 Potassium, 115 Practice Guidelines, 68, 76, 115 Precursor, 100, 101, 112, 115, 121, 122 Prevalence, 5, 14, 22, 115 Primary Biliary Cirrhosis, 55, 115 Progeny, 98, 115 Progesterone, 11, 115 Progressive, 97, 105, 111, 116 Prokinetic Drugs, 48, 116 Prone, 55, 116 Prophylaxis, 39, 116 Protein C, 116, 121 Protein S, 95, 97, 102, 116, 117, 120 Proteins, 92, 93, 97, 102, 110, 112, 114, 115, 116, 117, 118, 121 Proton Pump, 18, 23, 116 Proton Pump Inhibitors, 18, 23, 116 Protons, 106, 116, 117 Protozoa, 98, 110, 116 Proximal, 23, 100, 116 Public Policy, 67, 116 Publishing, 4, 7, 116 Pulmonary, 95, 98, 99, 116, 122 Pulmonary hypertension, 99, 116 Pylorus, 39, 116 Pyramidal Tracts, 102, 116 Q Quality of Life, 5, 8, 13, 15, 16, 48, 116 Quinolones, 40, 116 R Race, 36, 116 Radiation, 93, 110, 117, 123 Radioactive, 106, 112, 117 Randomized, 9, 10, 14, 18, 101, 117 Receptor, 21, 34, 35, 41, 60, 93, 100, 117, 118 Receptors, Serotonin, 117, 118 Recombinant, 43, 117 Recombination, 98, 117 Rectum, 93, 95, 100, 103, 108, 117

Refer, 1, 97, 102, 103, 109, 117 Reflux, 5, 8, 14, 15, 22, 37, 40, 46, 47, 48, 51, 55, 56, 104, 117, 120 Refraction, 117, 119 Regimen, 37, 101, 114, 117 Regurgitation, 5, 104, 105, 117 Resolving, 10, 117 Retrograde, 72, 101, 117 Rheumatism, 18, 107, 117 Ribosome, 117, 121 Rigidity, 115, 117 Risk factor, 52, 56, 117 Rod, 94, 117 S Saliva, 55, 117, 118 Salivary, 100, 117, 118 Salivary glands, 100, 117, 118 Screening, 20, 74, 97, 118 Secretion, 35, 42, 91, 106, 111, 113, 118 Secretory, 38, 118 Selenium, 9, 118 Semisynthetic, 92, 97, 107, 118 Sensitization, 3, 118 Sequencing, 106, 118 Serotonin, 34, 35, 103, 114, 117, 118, 121 Serum, 8, 21, 92, 97, 118 Sexually Transmitted Diseases, 46, 118 Side effect, 35, 42, 56, 59, 91, 118, 120 Sigmoid, 118 Sigmoidoscopy, 72, 118 Simethicone, 36, 118 Small intestine, 94, 96, 100, 101, 104, 106, 108, 118 Smooth muscle, 38, 42, 102, 109, 110, 112, 118, 120 Smooth Muscle Tumor, 102, 118 Social Environment, 116, 118 Sodium, 34, 60, 118 Somatic, 106, 119 Spastic, 108, 119 Specialist, 4, 78, 119 Species, 39, 101, 104, 116, 119, 121, 122 Spectrum, 5, 107, 112, 119 Sphincter, 5, 56, 119 Spinal cord, 96, 97, 110, 111, 112, 116, 119 Sprue, 35, 119 Stasis, 41, 119 Stimulus, 3, 98, 119 Stomach Ulcer, 35, 119 Stool, 72, 108, 119 Stress, 3, 4, 96, 103, 104, 108, 111, 119 Stroke, 31, 66, 119

Index 131

Subacute, 108, 119 Subarachnoid, 105, 119 Subclinical, 108, 119 Subcutaneous, 109, 113, 119 Subspecies, 119 Substance P, 102, 118, 119 Sucralfate, 21, 120 Suppression, 7, 120 Suppressive, 5, 120 Sympathomimetic, 100, 101, 112, 120 Symptomatic, 10, 113, 120 Systemic, 48, 60, 95, 101, 108, 120, 121 T Taurine, 39, 94, 96, 120 Tetracycline, 40, 120 Therapeutics, 5, 11, 14, 16, 18, 20, 21, 22, 23, 61, 120 Thorax, 91, 120 Thrombosis, 116, 119, 120 Thyroid, 120, 121 Thyroid Gland, 120 Thyroxine, 9, 120 Time Factors, 92, 120 Tips to control heartburn, 52, 120 Tissue, 7, 42, 93, 94, 95, 101, 103, 107, 109, 110, 111, 112, 113, 114, 117, 118, 120, 121 Toxic, iv, 98, 99, 112, 118, 120 Toxicity, 100, 120 Toxicology, 68, 120 Toxins, 93, 108, 121 Transfection, 95, 121 Translation, 8, 102, 121 Translocation, 97, 102, 121 Transmitter, 91, 100, 109, 112, 121 Transplantation, 97, 107, 121 Trauma, 102, 111, 113, 121 Trichomoniasis, 110, 121 Tricuspid Atresia, 99, 121 Trigeminal, 34, 121 Tryptophan, 118, 121

Tyrosine, 100, 121 U Ulcer, 7, 8, 11, 12, 13, 14, 19, 21, 23, 34, 40, 43, 48, 112, 119, 120, 121 Ulceration, 114, 121 Unconscious, 107, 121 Uraemia, 113, 121 Urea, 19, 121 Urea Breath Test, 19, 121 Ureters, 121, 122 Urethra, 122 Urinary, 8, 111, 112, 121, 122 Urinary tract, 8, 111, 122 Urinary tract infection, 8, 111, 122 Urine, 95, 112, 121, 122 Ursodeoxycholic Acid, 39, 122 Uterus, 99, 102, 109, 115, 122 V Vagotomy, 22, 122 Vascular, 56, 105, 107, 108, 114, 120, 122 Vasculitis, 113, 122 Vasodilator, 100, 122 Veins, 95, 115, 122 Venous, 112, 116, 121, 122 Ventricle, 94, 98, 107, 121, 122 Ventricular, 98, 121, 122 Veterinary Medicine, 67, 122 Villous, 96, 122 Virulence, 11, 120, 122 Viruses, 110, 122 Visceral, 4, 5, 114, 122 Vitro, 40, 122 W Whipple, 73, 122 White blood cell, 93, 111, 122 X X-ray, 34, 49, 101, 109, 112, 123 Z Zygote, 98, 123

132

Indigestion