eLetters

299 e-Letters

  • 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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  • 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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  • Remarkable resemblance in the mode of transmission of HCV among Hemodialysis patients and IVDAs
    Anil K Saxena, MD; MRCP (Dublin)

    Dear Editor

    Hepatitis C virus (HCV) infection is widespread among patients on long-term hemodialysis (HD) and the intravenous drug abusers (IVDAs). However, there seem to be striking similarities in the mode of transmission between the two groups since both form high-risk groups for the parenterally transmitted HCV infection.

    The indispensable requirement of having vascular access site possibly adds to the...

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  • Scintigraphic assessment of SO dysfunction
    Enrico Corazziari

    Dear Editor

    Since diagnosis of sphincter of Oddi (SO) dysfunction may require the perendoscopic manometric assessment of the sphincter that is an invasive technique carrying a significant risk of pancreatitis, non invasive scintigraphy has been proposed as an alternative diagnostic method. Craig et al. [1] have reported their experience to assess SO dysfunction in post-cholecystectomy patients.with scintigraphy...

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  • Of actors and theatrics …
    Maria A O'Sullivan

    Dear Editor

    We enjoyed reading the commentary by Cremonini & Camilleri,[1] discussing the role of serotonin in mediating postprandial symptoms in irritable bowel syndrome (IBS), as well as the paper by Houghton et al,[2] which inspired the commentary.

    On a more general note, work such as that by Houghton et al,[2] and others, continues to make an important contribution to a rapidly growing...

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  • Diversion colitis with a mucosal tear on endoscopic insufflation
    Yasuhiro Komuro

    Dear Editor

    I read with interest and appreciated the report of Cruz- Correa and colleagues.[1] They show three cases of collageous colitis with mucosal tears on endoscopic insufflation and discussed that there was no report in any other gastrointestinal disease. We would like to present similar mucosal tear on endoscopic insufflation in a patient with diversion colitis.

    A 46-year-old Japanese man presented a...

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  • High grade dysplasia in Barrett's oesophagus
    Mohammed Shamim Absar

    Dear Editor

    This a very interesting article. From the surgeon's point of view, this brings up the debate of which is the optimum form of treatment for dysplasia. Are we overtreating patients by putting them through such major surgery like oesophagectomy. The use of other modalities of treatment should be the way forward for such conditions. Endosurgery which has tried at few centre for the high grade dysplasia and eve...

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  • The effect of a rapid-access flexible sigmoidoscopy clinic on the yield of early stage rectal cancer
    Robert C Macadam

    Dear Editor

    We read with interest the debate on population based endoscopic screening for colorectal cancer.[1] Whilst we agree that the case for population screening is compelling, we believe that Macafee and Scholefield’s statement that ‘earlier diagnosis is unlikely to occur through increased awareness or patient education alone’ is unnecessarily pessimistic.

    We have recently had the opportunity to audit th...

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  • Detecting the risks of osteoporotic fractures in coeliac disease
    Julian RF Walters

    Dear Editor

    The recent report by Thomason et al.[1] which failed to detect a significant increase in fractures experienced by treated coeliacs might reassure many patients and physicians. However this study, and the accompanying commentary by Compston [2] need full and critical assessment before changes in practice are adopted and coeliacs are no longer targeted to be screened for osteoporosis.

    It is n...

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  • Collagenous colitis: Constipation or diarrhea?
    Zsolt Barta

    Dear Editor

    As an axiom, collagenous colitis is characterized by diarrhea, lymphocytic inflammation, and a thickened subepithelial collagen layer in the colorectal mucosa.[1] Various case presentations in the literature discussed that frequent watery diarrheas introduce the clinical picture of the collagenous colitis and intermittent or continuous diarrhea can remain.[2] On the other hand, numerous cases never suffe...

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