eLetters

299 e-Letters

  • Yield of capsule endocopy in Crohn's disease may depend on the quality of prior ileo-colonoscopy
    Karsten Schulmann

    Dear Editor

    We read the article by Fireman et al. [1] with great interest. We agree that full visualisation and imaging of the entire length of the small bowel is unsatisfactory at present and that capsule endoscopy (CE) is a novel technique and can be considered as promising new approach for the diagnosis of obscure disease located in the small bowel.

    The authors diagnosed Crohn’s di...

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  • Author's reply
    Alessio Fasano

    Dear Editor

    If I interpret correctly Dr Sanders' position, he favors population screening, provided that a case-finding approach is applied. His letter is giving me the opportunity to further expand on my opinion on the appropriateness for coeliac disease (CD) population screening. As I mentioned in my final remarks and in the summary of my debate, while CD fulfill the criteria for mass screening, currently we la...

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  • Coeliac disease: is case-finding the correct ethical and logistical approach?
    David S Sanders

    Dear Editor

    I read with interest the debate pertaining to screening for coeliac disease (CD). Although one can argue that CD fulfils the tenets of any screening programme, however, we do not know the natural history of screen -detected patients with CD.

    Logistically when would we decide to screen – at what age and how often thereafter? Serological markers may be highly sensitive and specific but the value o...

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  • Transient ischaemic colitis due to reserpine
    Oya Uygur-Bayramiçli

    Dear Editor

    I read with interest the article by Butcher et al. [1] regarding transient ischaemic colitis following aeroplane flight. In this article among other predisposing factors leading to ischaemic colitis drugs are also mentioned and cocaine is given as an example.I think that reserpine, a rauwolfia alkaloid is another drug which can cause ischaemic colitis.

    A 74 year old female patient was h...

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  • TIPS for gastric varices
    Barbara M Ryan

    Dear Editor

    We recently read with interest the study by Tripathi and colleagues[1] investigating the outcome of TIPS in patients with gastric (GV) compared to oesophageal varices (OV). This study confirmed the previous finding of lower mean portosystemic pressure gradient (PPG) in patients with GV bleeding relative to those with a history of OV bleeding.[2] Indeed in this study 35% (14/40) of GV patients compare...

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  • Caution with the use of cyclosporin in pregnancy
    Riaz Dor

    Dear Editor

    We read the article by Alstead and Nelson-Piercy with great interest.[1]

    We report a case (submitted for publication) of a woman with fulminant ulcerative colitis in the 29th week of pregnancy. Her disease was refractory to steroids, but she refused to have cyclosporin whilst pregnant. She therefore underwent an emergency Caesarean section and was given intravenous cyclosporin post-operatively....

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  • Which 5ASA?
    Simon Travis

    Dear Editor

    I am delighted that the Therapy Update on 5-ASA has generated discussion – which is as intended for the series. Articles constrained to 600 words and a dozen references must necessarily be concise, but it would be a colourless author who stayed on the therapeutic fence.

    Pace, Dr Mansfield, the article did not (and I do not) advise exclusive use of Pentasa, nor indeed any mesalazine derivative....

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  • Response to Dr A R Weale et al
    Cosimo Prantera

    Dear Editor

    the critical letter of Drs Weale and Rees merits some comments:

    Multicenter clinical studies on probiotics are just starting up. As is normal practise, they have been preceded by some pilot studies. It is obvious that before investing a large amount of money in a multicenter study, pharmaceutical companies need to know that the effectiveness of the drug under examination is supported by bo...

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  • Management of acute upper gastrointestinal bleeding
    Achuth H Shenoy

    Dear Editor

    Your publication of evidence-based guidelines by KR Palmer (Gut 2002; 51(Suppl IV):iv1-iv6] on the management of non-variceal bleeding is comprehensive, timely and is useful to the gastroenterologist as well as non-gastroenterologist alike. The mortality due to acute upper gastrointestinal (UGI) bleeding has not changed over last 5 decades.[1] This may be due to increasing elderly populati...

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  • Evidence based transfusion strategies
    Alan W Steel

    Dear Editor

    These well informed guidelines [1] are largely accurate, however, section 3.3, dealing with resuscitation in the critically ill does need some correction. The implication is that transfusion in critically ill patients with evidence of gastrointestinal haemorrhage is indicated to maintain Hb > 10 g/dl. This cannot be demonstrated by the quoted study.[2] In this randomised controlled study of alternati...

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