299 e-Letters

  • Submucosal "dissection" in collagenous colitis
    Jonathan D Mitchell

    Dear Editor

    We were fascinated to read the paper by Cruz-Correa et al. [1] describing cases of mucosal tearing at colonoscopy in patients subsequently found to have collagenous colitis. We were particularly interested in their postulated mechanism for these tears being a disruption of colonic mural integrity by the sub-mucosal collagen layer. We would like to present two cases which add further weight to t...

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  • Collagenous colitis with mucosal tear on air installation
    Timothy Shanahan

    Dear Editor

    I was interested to read the paper by Cruz-Correa et al. [1] describing mucosal tears at colonoscopy in patients with collagenous colitis. I was then interested to read letters from Mitchell et al.[2] and Komuro et al.[3] describing their experience with mucosal tears in patients with collagenous colitis and diversion colitis, respectively. I would like to present a case of an elde...

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  • Mesalazine is safe for the treatment of IBD
    Geert R D'Haens

    Dear Editor

    The article by Ransford and Langman [1] on suspected serious adverse drug reactions for sulphasalazine and mesalazine reported in the UK from 1991 to 1998 revealed significant differences between both drugs. Pancreatitis and interstitial nephritis were reported more frequently for mesalazine in comparison with sulphasalazine. The authors’ conclusion that mesalazine would not offer a safety benefit over s...

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  • Antibiotics for Crohn's disease
    Warwick Selby
    Dear Editor,

    The Therapy Update in the May issue highlighted the potential role for antibiotic therapy in Crohn's disease [1]. Dr Colombel indicated the need for appropriate antibiotics that are based on current theories of pathogenesis, namely that they be effective against both extracellular and intracellular bacteria. The possible role of Mycobacterium paratuberculosis, although controversial, also should not be overl...

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  • Complete regression of advanced hepatocellular carcinoma under therapy with long-acting octreotide
    Jens T Siveke

    Dear Editor

    Various therapeutic approaches for unresectable hepatocellular carcinoma (HCC) have been suggested during recent years. However, major advances concerning tumor regression or patient survival were not achieved. Few trials assessed the effect of the somatostatin analogue octreotide in advanced HCC with divergent results.[1,2] The latter might be due to the expression of somatostatin receptor type 2 (SSTR...

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  • Another cause of chest pains
    Carlos A Selmonosky

    Thoracic outlet syndrome is frequently undiagnosed in patients with non-cardiac ,non-coronary chest pains. See www.tos-syndrome.com. Patients with depression or panic attacks can have associated Thoracic Outlet Syndrome. The diagnosis will remain ignored unless the symptoms and physical findings are elicited in these patients.

  • Authors' reply
    Chuka U Nwokolo

    Dear Editor

    We would like to draw the attention of Murray et al.[1] to the objectives set out clearly in the introductory section of our paper.

    Our study was not designed to address the question of whether ghrelin is involved in long-term regulation of body weight. Furthermore, the duration of the study was too short to see any change in BMI. More importantly, waist circumference would be a better...

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  • Terminal ileal biopsies should not be used to document extent of colonoscopic examination
    MD Rutter

    Dar Editor

    We commend the BSG and the authors for the excellent recent publication of guidelines for the management of inflammatory bowel disease in adults.[1] However we feel that their recommendation for routine terminal ileal biopsying is inappropriate. Although it is important to biopsy the terminal ileum if there is macroscopic evidence of an abnormality, their statement that “a terminal ileal biopsy perfor...

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  • Efficacy and strategy of pneumatic dilatation in achalasia
    Roberto Penagini

    Dear Editor

    We read with interest the article by Eckardt et al regarding long-term results of pneumatic dilatation in achalasia.[1] Fifty-four patients were followed up for a median of 14 years after a single pneumatic dilatation using the Browne-McHardy dilator. The 5- and 10-year remission rates were 40 and 36% respectively and repeated dilatations only mildly improved the clinical response. Most of the rela...

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  • High-magnification-chromoscopic-colonoscopy as a screening tool in acromegaly
    David P Hurlstone

    Dear Editor

    We read with great interest the paper by Jenkins et al.[1] regarding screening guidelines for colorectal cancer and polyps in patients with acromegaly and the subsequent discussion by Renehan addressing screening inconsistencies as compared to other high risk groups.[2,3]

    The optimal colorectal screening modality and frequency in this group however requires clarification. Colonoscopy...

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