Biomedical subjects

Kenneth L Koch

Publications and source records attributed to Kenneth L Koch.

5 recordsLinked to original sources

PubMed2003

Diagnosis and treatment of neuromuscular disorders of the stomach.

Gastric neuromuscular disorders encompass a spectrum of dysfunction in nerve and smooth muscle that includes gastric visceral hypersensitivity, gastric dysrhythmias, fundic dysfunction, antral hypomotility, and gastroparesis. Patients with each disorder may present with such vague dyspepsia symptoms as early satiety, upper abdominal discomfort, bloating, or nausea with or without vomiting. A careful history and physical examination may suggest a gastric neuromuscular disorder, but symptoms are nonspecific. Gastroparesis is the most severe form of neuromuscular dysfunction. Such reversible causes of gastroparesis as mechanical obstruction of the stomach and chronic mesenteric ischemia must be excluded. Gastroparesis, gastric dysrhythmias, and hypersensitivity may follow viral infection or be due to degenerative processes that affect the gastric enteric neurons, smooth muscle, or interstitial cells of Cajal. Commonly, the cause of these gastric neuromuscular disorders is unknown. An approach to the diagnosis and treatment of gastric neuromuscular disorders is reviewed, including dietary counseling, drugs, and medical devices.

Humans↗

PubMed2003

Nausea and vomiting during pregnancy.

The differential diagnosis of nausea and vomiting is extensive and the underlying cause can be difficult to diagnose. Treatment of nausea and vomiting also can be unsatisfactory because the available pharmacotherapy does not correct the fundamental underlying pathophysiologic abnormalities. In contrast, the diagnosis of nausea and vomiting of pregnancy generally is straightforward. Almost 80% of women have some degree of nausea in the first trimester of pregnancy, and the diagnosis of pregnancy is established easily by the patient or physician. The spectrum varies from mild nausea to hyperemesis gravidarum. Various treatment approaches are addressed.

Diagnosis, Differential↗

PubMed2003

EGG data.

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Artifacts↗

PubMed2003

An open-label trial of L-glucose as a colon-cleansing agent before colonoscopy.

BACKGROUND: The high volume and poor palatability of standard colon cleansers remain obstacles to colonoscopy for many patients. Significant electrolyte disturbances and fluid balance alterations may occur with available agents. L-glucose, the stereoisomer of D-glucose, has laxative effects that make it potentially useful as a colon-cleansing agent. This study evaluated the safety and efficacy of L-glucose as a bowel cleanser before colonoscopy. METHODS: Thirty healthy individuals (age range 34-70 years) scheduled to undergo outpatient colonoscopy were given 24 g of L-glucose in 8 ounces of water to cleanse the colon. Nonblinded endoscopists rated the quality of the preparation based on established criteria. Laboratory studies were monitored before and after administration of the L-glucose and on the day after colonoscopy; adverse clinical events were also monitored. RESULTS: L-glucose administration resulted in excellent or good preparations in 80% (24/30) of the patients and fair or poor preparations in 20%. Average water consumption was 48 ounces. No adverse event occurred, and no significant laboratory test abnormalities were identified. CONCLUSIONS: Eighty percent of patients who prepared for colonoscopy by ingestion of L-glucose had good or excellent preparations. The L-glucose preparation was palatable, and its efficacy and safety appear equivalent to currently available colon-cleansing agents.

Adult↗

PubMed2002

Gastrointestinal factors in nausea and vomiting of pregnancy.

The objective of this review is to outline gastrointestinal factors that may be relevant to nausea and vomiting of pregnancy. Gastric neuromuscular dysfunctions of the stomach include abnormalities in gastric myoelectrical activity, gastric tone, and contractility, all of which may result in gastroparesis. These abnormalities in gastric neural activity and smooth muscle function are associated with nausea and vomiting in nonpregnant patients. Gastric dysrhythmias are disturbances of gastric pacesetter potential patterns that are present during the nausea of motion sickness, drug-induced nausea, in patients with diabetic gastropathy, and women with nausea of pregnancy. In pregnant women with abdominal pain, nausea, and vomiting, standard gastrointestinal diseases such as gastroesophageal reflux, peptic ulcers, and cholecystitis must be considered. A diagnostic approach and therapeutic options for treating nausea and vomiting of pregnancy based on understanding of gastric neuromuscular dysfunction is outlined.

Female↗