Peritonitis in Geriatric Inpatients

Wroblewski, M; Mikulowski, Pawel

doi:10.1093/ageing/20.2.90

Cited by 37 publications

(11 citation statements)

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“…Older patients with functional dyspepsia have higher pain, discomfort and fullness thresholds than do younger patients in response to gastric balloon distension 29 . In addition, our findings may explain why peritonitis and abdominal complaints are more occult in older persons 30 . A study from Japan showed that only 46.5% of older patients (60–69 years old) with gastric cancer who initially presented with symptoms had epigastric pain compared with 71.6% of young patients (<40 years old) 31 .…”

Section: Discussionmentioning

confidence: 68%

The ageing gut: diminished symptom response to a standardized nutrient stimulus

Gururatsakul

Holloway

Adam

et al. 2010

Neurogastroenterology &Amp; Motility

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BACKGROUND The prevalence of dyspepsia and the severity of reflux symptoms decreases with advancing age. We postulate that advancing age influences sensory function and this will be associated with a diminished symptom response to a standardized meal stimulus.Our aim was to assess the influence of age on visceral sensory function. METHODS Baseline gastrointestinal symptoms and anxiety and depression were assessed in 53 healthy volunteers using validated questionnaires. After an 8-h fast, subjects received 200 mL of a standardized enteral feeding solution every 5 min up to a cumulative volume of 800 mL. After each 200 mL drink, five key symptoms were assessed (fullness, abdominal pain, retrosternal/abdominal burning, nausea and regurgitation) using a standardized instrument on visual analogue scales (0-100). The cumulative symptom score across all symptoms was calculated. KEY RESULTS Fullness was the most prominent symptom reported (79.8 +/- 9.5) followed by nausea (14.9 +/- 4.9) and pain (9.8 +/- 4.5); these three items accounted for more than 90% of the overall symptom load. The cumulative pain and nausea scores during a standardized nutrient challenge were significantly and inversely correlated with age (r = -0.43, P = 0.002 and r = -0.28, P = 0.045). Subjects >60 years of age reported significantly lower pain and nausea scores (0.9 +/- 0.9, 4.5 +/- 3.9) than did subjects <40 years (22 +/- 11.9, P = 0.002; 29.3 +/- 12, P = 0.043). CONCLUSIONS & INFERENCES Symptom responses to a standardized nutrient challenge, in particular pain and nausea, are inversely correlated with age.

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Section: Discussionmentioning

confidence: 68%

The ageing gut: diminished symptom response to a standardized nutrient stimulus

Gururatsakul

Holloway

Adam

et al. 2010

Neurogastroenterology &Amp; Motility

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“…Particular care is needed when examining older or obese patients, as the physical examination may be unreliable 626364. The identification of patients with a small bowel obstruction who have strangulated bowel and the identification of patients with mesenteric ischemia require a high index of suspicion, as the clinical presentation and examination have low sensitivity 52…”

Section: Initial Examinationmentioning

confidence: 99%

Secondary peritonitis: principles of diagnosis and intervention

Ross

Matthay

Harris

2018

BMJ

119

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Secondary peritonitis accounts for 1% of urgent or emergent hospital admissions and is the second leading cause of sepsis in patients in intensive care units globally. Overall mortality is 6%, but mortality rises to 35% in patients who develop severe sepsis. Despite the dramatic growth in the availability and use of imaging and laboratory tests, the rapid diagnosis and early management of peritonitis remains a challenge for physicians in emergency medicine, surgery, and critical care. In this article, we review the pathophysiology of peritonitis and its potential progression to sepsis, discuss the utility and limitations of the physical examination and laboratory and radiographic tests, and present a paradigm for the management of secondary peritonitis.

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“…37,38 Peptic ulcers, intestinal obstruction, and peritonitis are other visceral conditions, often with reduced or absent abdominal complaints, 29 and about 45% of older persons with appendicitis do not have typical lower-right quadrant pain as a presenting symptom, compared with 5% of younger adults. 39 Living in a nursing home, 53% of the patients are at risk of developing a pressure ulcer, 40 and skin diseases found in 95% of the patients were described as one of the most prevalent health problems. 41 Pain in connection with genito-urinary infections is quite often described.…”

Section: Pain Prevalence In Nursing Home Patientsmentioning

confidence: 99%

Pain in patients with dementia: A review of pain assessment and treatment challenges

Husebø¹,

Achterberg²,

Lobbezoo³

et al. 2012

Nor J Epidemiol

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Pain represents a major treatment challenge in older people with dementia. The majority of healthy older people experience regular pain and around 50% take regular analgesics. Pain is likely to be equally prevalent in people with dementia, yet only a small minority are prescribed regular analgesics. This is a key issue since recent work has provided evidence that untreated pain may be a major contributor to reduced quality of life and increases the likelihood of emergence of behavioural and psychological symptoms such as agitation. Better assessment and treatment of pain may therefore substantially improve outcomes for people with dementia. In this context, we reviewed the literature and summarised the best available evidence regarding the frequency of pain and pain diagnosis in patients with dementia based on pain assessment and treatment recommendations for these individuals. Hardly any randomized, controlled studies of pain treatment efficacy in patients with dementia are available, with the consequence that most pain treatment recommendations are not based on the highest level of evidence.

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Peritonitis in Geriatric Inpatients

Cited by 37 publications

References 0 publications

The ageing gut: diminished symptom response to a standardized nutrient stimulus

The ageing gut: diminished symptom response to a standardized nutrient stimulus

Secondary peritonitis: principles of diagnosis and intervention

Pain in patients with dementia: A review of pain assessment and treatment challenges

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