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Reprinted with permission from the IFFGD. Originally printed in Participate -- Vol 7 No 1, Spring 1998. Go to the IFFGD website for Information on subscribing to Participate (and becoming an IFFGD member). People with functional gastrointestinal (GI) disorders can have a variety of symptoms that range from painless diarrhea or constipation, to pain associated with diarrhea and/or constipation (usually called irritable bowel syndrome). There is another, less common condition of abdominal pain that is chronic or frequently recurring; it is not associated with changes in bowel pattern. This condition is called chronic functional abdominal pain (CFAP). CFAP is a functional GI disorder. There are no abnormal x-rays or laboratory findings to explain the pain. It occurs because of altered sensitivity to nerve impulses in the gut and brain, and it is not associated with altered motility in the intestines. For people with CFAP, the pain can be so all-consuming that it becomes the main focus of their lives. Not only does it impact on quality of life, but it has a major economic impact as well. The US Householders Survey of Functional GI Disorders published in 1993 found that people with CFAP missed an average of 12 days of work annually due to illness compared to 4 missed days for people without gastrointestinal symptoms. Also, the number of doctor visits in a year averaged 11 for those with CFAP compared with only 2 for those without CFAP.
Campylobacter: bacteria that causes diarrhea, cramping, abdominal pain and fever. Symptoms can start 2 to 5 days after exposure and usually last about one week. It is one of the most common causes of diarrheal illness in the US, especially during the summer. Prevention: always cook meat thoroughly. Keep raw meat, especially poultry, separate from other foods. Do not use the same utensils and plates for cooked foods that were used for raw foods until thoroughly washed. Always wash hands after touching raw meat. Do not drink “raw milk” (unpasteurized). Common Foods: poultry; contaminated water Salmonella: a bacteria that causes diarrhea, fever, and abdominal cramps. Symptoms can start 12 to 72 hours after infection and last 4-7 days. Can be so severe that hospitalization is required, especially if the bacteria spread to the bloodstream. Prevention: avoid eating undercooked foods, such as poultry, ground beef and eggs. Do not drink “raw milk.” Do not use the same utensils and plates for cooked foods that were used for raw foods until thoroughly washed. Always wash hands after touching raw meat. Common Foods: poultry; eggs; dairy products; beef E-Coli 0157: a bacteria that can cause severe stomach cramps, bloody diarrhea, vomiting and fever. Some infections can be lifethreatening and can lead to kidney failure. Symptoms usually occur 3-4 days after exposure but can start as soon as 1 day after exposure up to10 days after exposure. Prevention: wash hands before preparing food, after using the bathroom or diapering infants, and after contact with livestock and/or their food. Avoid eating undercooked ground beef, alfalfa sprouts, “raw milk” or unpasteurized cheeses.
Pain that is in the stomach or belly area is called abdominal pain. Sometimes when it hurts in this area the problem may actually be in your chest or pelvic region. Abdominal pain is also called a belly ache, stomach ache, or abdominal cramps. SOME FACTS about Abdominal Pain Abdominal pain is a common problem. Most of the time it will go away without any medical care. Sometimes it is a sign of a very serious condition that can be life-threatening. It all depends upon the cause. How much it hurts is not always the most serious symptom. Pain that develops quickly and is localized (remains in the same place) in a small area requires immediate medical attention. People with mental retardation cannot always tell you what hurts. You need to look carefully for other signs (such as bending over and crying). Individuals with pain will often show changes in behavior. SIGNS & SYMPTOMS There are many different signs and symptoms for abdominal pain depending upon what the cause is. Some of the signs include: Pain in the area below the chest and above the groin (just below waist) Cramps in the belly area Crying and bending over, holding onto the belly area Burning feeling in the stomach or lower throat (esophagus) Lack of appetite and food avoidance ...
Emergency Department Visits for Chest Pain and Abdominal Pain: United States, 1999–2008 Farida A. Bhuiya, M.P.H.; Stephen R. Pitts, M.D., M.P.H., F.A.C.E.P.; and Linda F. McCaig, M.P.H., Division of Health Care Statistics Key findings Data from the National Hospital Ambulatory Medical Care Survey: 1999–2008 • The number of noninjury emergency department (ED) visits in which abdominal pain was the primary reason for the visit increased 31.8%. • The percentage of ED visits for which chest pain was the primary reason decreased 10.0%. • Use of advanced medical imaging increased strongly for ED visits related to abdominal pain (122.6%) and chest pain (367.6%). Chest and abdominal pain are the most common reasons that persons aged 15 years and over visit the emergency department (ED) (1). Because EDs provide both emergency and nonemergency care (2,3), visits for these symptoms may vary in their acuity. Advanced medical imaging is often ordered to assist in both diagnosing and ruling out serious illness associated with these symptoms (4,5). This report describes trends in visits for chest and abdominal pain in adults and the seriousness of illness and use of imaging in these visits. All data shown are for persons aged 18 and over whose visit was not injury related. Keywords: National Hospital Ambulatory Medical Care Survey • advanced medical imaging • reason for visit Are ED visits for chest or abdominal pain increasing?
Abdominal pain is the most common complaint seen in emergency departments in the United States and one of the 10 most common complaints in family medicine outpatient settings. The most common causes of abdominal pain are discussed here, with special attention given to the acute abdomen and recurrent abdominal pain. The term acute abdomen is medical jargon that refers to any acute condition within the abdomen that requires immediate medical or surgical attention. Acute abdominal pain may be of nonabdominal origin and does not always require surgery. The majority of patients who consult a physician about abdominal pain do not have an acute abdomen, although the chief complaint may have a sudden onset. In studies involving analysis of large series of patients presenting to emergency departments with acute abdominal pain, nonspecific abdominal pain (NSAP) was the most common diagnosis. Most patients with this symptom probably have gastroenteritis. The common causes of abdominal pain are gastroenteritis, gastritis, peptic ulcer disease, gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS), dysmenorrhea, salpingitis, appendicitis, cholecystitis, cholelithiasis, intestinal obstruction, mesenteric adenitis, diverticulitis, pancreatitis, ureterolithiasis, incarcerated hernias, gas entrapment syndromes, and ischemic bowel disease (particularly in the elderly). All of these conditions can manifest as an acute or sudden onset of abdominal pain, many can cause recurrent abdominal pain, and a few require surgical intervention. Any acute abdominal condition requires the physician to make an early, precise diagnosis, because prognosis often depends on prompt initiation of therapy, particularly surgical treatment. The more serious the problem, the more urgent the need for an accurate diagnosis.
Abdominal Complaints in School Age Children Michael A. D’Amico, MD Pediatric Gastroenterology and Nutrition May 16, 2012 Objectives • Become familiar with common causes of abdominal complaints in school age children • Understand the therapeutic approach to these conditions • Know when to make appropriate referrals • Explore presentation content further with Q & A’s Statements • No financial disclosures • I may be discussing off-label use of some medications Common Abdominal Complaints • Developmental level of child – introspection • Comfort level • Social context Often difficult to express or verbalize precise sensation Common Complaints (symptoms) • Pain – Most common – Vague • Don’t feel well, My tummy hurts, Hunger, Nausea • Upset stomach • Constipation – Hard to go, takes a long time going • Diarrhea
Diagnostic Laparoscopy for Chronic Abdominal Pain Richmond University Hospital, July 2012 David A Vivas, MD www.downstatesurgery.org Case Presentation HPI • 25 y/o female with no significant PMH who was seen in clinic c/o intermittent, moderate to severe, dull abdominal pain, located in epigastric area and right abdomen for the last 3 years. Patient denied any other symptoms (N/V, weight loss) • PMH: None • PSH: None www.downstatesurgery.org Case Presentation • Work up: • EGD: No pathologic findings • RUQ US: No gallstones or other biliary or liver pathology • Pelvic US: No GYN pathology www.downstatesurgery.org Case Presentation • Work up: • CT scan abdomen and pelvis with PO/IV contrast: • Probable diverticulum in the ascending colon • Otherwise unremarkable www.downstatesurgery.org Case Presentation • Work up: • Colonoscopy: • 0.5 cm sessile, friable mass in the distal ascending colon • Mass was removed with cold technique • Area was tattooed with India ink and sent to pathology • Rest of the study was unremarkable for any pathology
PostgreSQL as a Schemaless Database. Christophe Pettus PostgreSQL Experts, Inc. OSCON 2013 Welcome! • I’m Christophe. • PostgreSQL person since 1997. • Consultant with PostgreSQL Experts, Inc. • email@example.com • thebuild.com • @xof on Twitter. What’s on the menu? • What is a schemaless database? • How can you use PostgreSQL to store schemaless data? • How does do the various schemaless options perform? A note on NoSQL. • Worst. Term. Ever. • It’s true that all modern schemaless databases do not use SQL, but… • Neither did Postgres before it became PostgreSQL. (Remember QUEL?) • The deﬁning characteristic is the lack of a ﬁxed schema. Schematic. • A schema is a ﬁxed (although mutable over time) deﬁnition of the data. • Database to schema (unfortunate term) to table to ﬁeld/column/attribute. • Individual ﬁelds can be optional (NULL). • Adding new columns requires a schema change.
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