Instant Natural Colic Relief
Pain due to spasm of visceral smooth muscle, e.g. biliary, renal colic, when severe, requires a substantial dose of morphine, pethidine or buprenorphine. These drugs themselves cause spasm of visceral smooth muscle and so have a simultaneous action tending to increase the pain. Phenazocine and buprenorphine are less liable to cause spasm. An antimuscarinic drug such as atropine or hyoscine may be given simultaneously to antagonise this effect. Prostaglandins are involved in control of smooth muscle and colic can be treated with NSAIDs, e.g. diclofenac, indometacin (i.m., suppository or oral).
Dyspepsia refers to upper abdominal pain or discomfort that can be caused by PUD. but it also can be produced by a number of other gastrointestinal disorders. Gastroesophageal reflux typically produces heartburn. or burning epigastric or midchest pain, usually occurring after meals and worsening with recumbency. Biliary colic caused by gallstones typically has acute onset of severe pain located in the right upper quadrant or epigastrium, usually is precipitated by meals, especially fatty foods, lasts 30-60 minutes with spontaneous resolution, and is more common in women. Irritable bowel syndrome is a diagnosis of exclusion but is suggested by chronic dysmotility symptoms, that is, bloating, cramping that is often relieved with defecation, without weight loss or bleeding. If these causes are excluded by history or other investigations. it is still difficult to clinically distinguish by symptoms those patients with PUD and those without ulcers, termed nonulcer dyspepsia. 4.1J A...
In the clinical context, it is common to observe that algogenic conditions may affect simultaneously more than one internal organ in the same patient. Especially when two viscera are involved, which share at least part of their central sensory projection, this circumstance gives rise to the so-called phenomenon of ''viscero-visceral hyperalgesia,'' due to which the patient experiences an enhancement of both spontaneous referred pain and referred hyperal-gesia (22). The concomitant presence of coronary heart disease and gallbladder calculosis, for instance, tends to produce more numerous anginal attacks and biliary colics in the patients than does one condition only (common sensory projection between heart and gallbladder T5) (24). The association of dysmenorrhea with IBS (common projection between uterus and colon T10-L1) (25) frequently produces more menstrual pain, intestinal pain, and somatic abdominal pelvic hyperalgesia (in the areas of referral from the uterus and from the...
Major indications for IVP include acute renal colic and nonglomerular hematuria. In these conditions, IVP is more sensitive than ultrasonography because it provides anatomic definition of the entire urinary tract as well as functional information. Other clinical indications for IVP include renal stone disease, voiding difficulties, neurogenic bladder, recurrent urinary tract infections (UTIs), sterile pyuria, congenital abnormalities (Figure 4), unexplained abdominal pain, and postoperative complications (Table 7). With the advent of ultrasonography, computed tomography (CT), and nuclear imaging, IVP is no longer the first-line diagnostic study in patients suspected of having renal neoplasias, obstructive uropathy, or renovascular hypertension or in the follow-up of renal allograft recipients.
Gut distension has been widely used to test sensitivity, both in experimental animals and in conscious man. Gastrointestinal distension in healthy subjects induces sensations such as abdominal pressure and fullness, referred to the epigastrium and the paraumbilical region. The type of sensations induced by distension is rather homogeneous from the stomach down to the mid small bowel (5-8), which indicates that the expression of the gut in response to stimuli, and the discriminative value of symptoms in relation to the site of origin in the gut are both relatively poor. A small proportion of distensions in the stomach and proximal duodenum induce nausea, which is rarely induced by jejunal distension. In contrast, jejunal distensions are frequently perceived as colicky or stinging sensation. To note, these sensations induced by experimental stimuli in healthy subjects are similar to the symptoms reported by patients with functional gut disorders in the clinic.
Intrabiliary pressure may rise substantially after morphine (as much as 10 times in 10 minutes), due to spasm of the sphincter of Oddi. Sometimes biliary colic is made worse by morphine, presumably in a patient in whom the dose happens to be adequate to increase intrabiliary pressure, but insufficient to produce more than slight analgesia. In patients who have had a cholecystectomy this can produce a syndrome sufficiently like a myocardial infarction to cause diagnostic confusion. Naloxone may give dramatic symptomatic relief, as may glyceryl trinitrate. Another result of this action of morphine is to dam back the pancreatic juice and so cause a rise in the serum amylase concentration. Morphine is therefore best avoided in pancreatitis but buprenorphine has less of this effect.
Pain intensity is easily quantified by using unidimensional pain scales such as the visual analogue scale, the numerical scale, and the category scale.911 Older patients are usually able to complete a category scale by rating pain as none, mild, moderate, or severe. Either the category scale or even a pictorial face scale can be used by those with moderate cognitive impairment.9 Pain intensity is influenced by mood, perceived meaning of pain, and psychological state (depression, delirium, or anxiety), and is not the same as nociception. Pain syndromes that are resistant to opioids include neuropathic pain, cutaneous pain, incident flares of pain, and colic.912
The diagnosis of acute salpingitis is made clinically by abdominal tenderness, cervical motion tenderness, and adnexal tenderness (Table 21-1). Confirmatory tests may include a positive gonorrhea or Chlamydia culture or an ultrasound suggesting a TOA. Other diseases that must be considered are acute appendicitis, especially if the patient has right-sided abdominal pain and ovarian torsion, which usually presents as colicky pain and is associated with an ovarian cyst on ultrasound. Renal disorders, such as pyelonephritis or nephrolithiasis, also must be considered. Right upper quadrant pain may be seen with salpingitis when perihepatic adhesions are present, the so-called Fitz-Hugh-Curtis syndrome. When the diagnosis is in doubt, the best method for confirmation is laparoscopy. The surgeon would look for purulent discharge exuding from the fimbria of the tubes.
The colon bypass will now be explained in detail. The patient is supine and an upper midline incision performed. The omentum is detached from the transverse colon. The peritoneal reflection on the left is taken down. The middle colic artery and vein are ligated near the origin at the superior mesenteric vessels. The transverse colon is transected proximally using the GIA stapler. The mesentery of the sigmoid is transilluminated to identify the left colic artery, which will be included with the replaced colonic segment. The colon segment to be used is transsected at the sigmoid region and this segment is now attached only to its supplying artery and vein. It is passed posterior to the stomach through a rent in the gastrohepatic omentum and this allows the most direct alignment of the artery and vein. The esophagus is bluntly removed through the abdominal approach as well as the cervical approach as described previously. The esophagus is removed and the colonic segment brought up...
In the patient with no gross evidence of extra-ovarian disease, a full staging procedure should be performed. This consists of cytology of each hemi-diaphragm, infra-colic omentectomy, and peritoneal biopsy specimens from each paracolic gutter, the vesico-uterine fold, and the pouch of Douglas. In addition, any suspicious areas should be sampled. Pelvic and para-aortic lymph node sampling are recommended for full staging, as a small percentage of patients will have apparent early-stage disease but have positive lymph nodes on final review, thereby changing the stage, recommended treatment, and prognosis. The bowel should be inspected from the ileocecal valve to the ligament of Treitz, specifically evaluating for tumor implants and sites of obstruction. Approximately 30 of patients with apparent limited disease are upstaged at the time of staging. This significantly impacts treatment recommendations and prognosis.
The lymphatic drainage field of each segment of bowel corresponds fairly accurately to its blood supply. High ligation of the vessels to the involved segment of bowel with removal of a wide surrounding segment of mesocolon will, therefore, remove the lymph nodes draining the area. Division of the middle colic vessels and a resection of a generous wedge of transverse mesocolon, for example, would be performed for a growth of transverse colon.
In large nonphysiological doses (pharmacotherapy) vasopressin causes contraction of all smooth muscle, raising the blood pressure and causing intestinal colic. The smooth-muscle stimulant effect provides an example of tachyphylaxis (frequently repeated doses give progressively less effect). It is not only inefficient when used to raise the blood pressure, but is also dangerous, since it causes constriction of the coronary arteries and sudden death has occurred following its use.
Some pains associated with disease can be very intense, and cause a shock reaction, so that the person is quite severely incapacitated. For example, that associated with cholecystitis, or with renal colic. Here the pain seems to be caused by muscular spasm as the ducts or ureters involved try to force the respective fluid (bile or urine) past a blockage. Also intense pain can be caused by ischaemia to muscles as in thrombosis in the leg or in the heart for example.
Right upper abdominal pain of acute onset that occurs after ingestion of a fatty meal and is associated with nausea and vomiting is most suggestive of biliary colic as a result of gallstones. Duodenal ulcer pain is likely to be diminished with food, and gastric ulcer pain is not likely to have acute severe onset. Acute hepatitis is more likely to produce dull ache and tenderness.
The abdominal ureter lies on the medial edge of psoas major (which separates it from the tips of the transverse processes of L2-L5) and then crosses into the pelvis at the bifurcation of the common iliac artery in front of the sacroiliac joint. Anteriorly, the right ureter is covered at its origin by the second part of the duodenum and then lies lateral to the inferior vena cava and behind the posterior peritoneum. It is crossed by the testicular (or ovarian), right colic, and ileocolic vessels. The left ureter is crossed by the testicular (or ovarian) and left colic vessels and then passes above the pelvic brim, behind the mesosigmoid and sigmoid colon to cross the common iliac artery immediately above its bifurcation.
Gallstones usually form as a consequence of precipitation of cholesterol microcrystals in bile. They are very common, occurring in 10-20 of patients older than 65 years. Patients often are asymptomatic. When discovered incidentally, they can be followed without intervention, as only 10 of patients will develop any symptoms related to their stones within 10 years. When patients do develop symptoms because of a stone in the cystic duct or Hartmann pouch, the typical attack of biliary colic usually has a sudden onset, often precipitated by a large or fatty meal, with severe steady pain in the right upper quadrant or epigastrium, lasting between I and 4 hours. They may have mild elevations of the alkaline phosphatase level and slight hyperbilirubinemia. but elevations of the bilirubin level over 3g dL suggest a common duct stone. The first diagnostic test in a patient with suspected gallstones usually is an ultrasonogram. The test is noninvasive and very sensitive for detecting stones in...
Which may become lodged in the common bile duct. However, obstructing stones causing jaundice usually are associated with epigastric or right upper quadrant colicky pain. Extrahepatic dilatation without evidence of stones warrants further study with CT or endoscopic retrograde cholangiopancreatography (ERCP) to detect stones and exclude malignant causes of common bile duct and pancreatic duct obstruction including cholangiocarcinoma, pancreatic cancer, and ampullary cancer (ampulla of Vater).
O.basilicum (Albahaca) is one of many plants used in Guatemala to treat gastrointestinal disorders such as colic, stomach pains, intestinal parasites, flatulence, and loss of appetite. It is also used as an anti-emetic agent (Caceres et al., 1990). Among the Caribs, a small ethnic group of Afro-Caribbean origin, in Guatemala a decoction of O.micranthum (Albahaca) leaves is used orally for coughs and phlegm, stomach pains, intestinal parasites and skin diseases (locally). The juice is used directly for ear pain (Gir n et al., 1991).
Disorders of the urinary tract may also cause kidney pain, often reported as flank pain at or below the posterior costal margin near the costovertebral angle. It may radiate anteriorly toward the umbilicus. Kidney pain is a visceral pain usually produced by distention of the renal capsule and typically dull, aching, and steady. Ureteral pain is dramatically different. It is usually severe and colicky, originating at the costovertebral angle and radiating around the trunk into the lower quadrant of the abdomen, or possibly into the upper thigh and testicle or labium. Ureteral pain results from sudden distention of the ureter and associated distention of the renal pelvis. Ask about any associated fever or chills, or hematuria. Renal or ureteral colic is caused by sudden obstruction of a ureter, as by urinary stones or blood clots.
The afferent fibres ascend centrally to the hypothalamus and thence to the orbital and frontal gyri of the cerebral cortex along as yet indeterminate pathways. Normally, we are unaware of the afferent impulses from the viscera unless they become sufficiently great to exceed the pain threshold when they are perceived as visceral pain, e.g. the pain of coronary ischaemia or intestinal colic.
C1 esterase inhibitor (C1 INH) deficiency is an inherited autosomal and recessive complement disorder associated with the disease hereditary angioedema (HAE). HAE may result from the synthesis of a mutated C1 INH protein or insufficient production of a normal protein. Clinical manifestations are recurrent episodes of facial tongue and laryngeal edema that may cause obstruction of the upper airways. C1 INH deficiency may lead to edema of the gastrointestinal tract which presents as colic or diarrhea. These clinical manifestations occur following
Food sensitivity can develop at any age but is particularly common in infants and young children. About 7-10 of children exhibit food allergies during their growing years.1 Colic in babies may be caused by sensitivity to a food -a common allergen is the protein in cow's milk. Adults can also develop sensitivity reactions, particularly when the immune system is knocked off-balance by stress, illness, food additives, and poor nutrition.
Besides flavouring, tejpat is used as a clarifier along with the products of Emblica officinalis fruits, and for tanning and dyeing leather (Anon, 1950). It is reported to have hypoglycemic, stimulant and carminative effects, and is used in Indian systems of traditional medicines to treat colic, coughs, diarrhoea, gonorrhoea, rheumatism, irritation, boils, conjunctivitis and itching (Chopra etal., 1956 Chatterjee and Prakashi, 1991 Hussain etal., 1992). In Kashmir, the leaves are used as a substitute for pan or betel leaves. The strong flavour of tejpat is due to an alcohol soluble essential oil Indian Cassia Lignea oil (Anon, 1950), which is rich in eugenol, widely used in pharmaceutical preparations, perfumes for soap, cosmetics and as a flavouring agent in many kinds of foods, meats and sauces (Zutshi, 1982).
Everything You Need To Know About Baby Sleeping. Your baby is going to be sleeping a lot. During the first few months, your baby will sleep for most of theday. You may not get any real interaction, or reactions other than sleep and crying.