Lack of efficacy of a reduced microparticle diet in a multi-centred trial of patients with active Crohn's disease.

Background And Aims: Dietary microparticles, which are bacteria-sized and non-biological, found in the modern Western diet, have been implicated in both the aetiology and pathogenesis of Crohn's disease. Following on from the findings of a previous pilot study, we aimed to confirm whether a reduction in the amount of dietary microparticles facilitates induction of remission in patients with active Crohn's disease, in a single-blind, randomized, multi-centre, placebo controlled trial.

Methods: Eighty-three patients with active Crohn's disease were randomly allocated in a 2 x 2 factorial design to a diet low or normal in microparticles and/or calcium for 16 weeks.

What proportion of dyspeptic patients having H. pylori breath test subsequently undergo endoscopy?

Background: Helicobacter pylori (HP) testing in young patients with uncomplicated dyspepsia has been recommended. A test and treat strategy for dyspeptics positive for HP is recommended by the European H. pylori Study Group and the American Gastroenterology Association.

Barium enema or colonoscopy for the investigation of iron deficiency anaemia?

Objective: To determine whether double contrast barium enema is adequate for excluding carcinoma of the colon in patients with iron deficiency anaemia.

Design: Prospective audit.

Subjects: One hundred and twenty-three patients with iron deficiency anaemia.

Drinking before endoscopy: milk or water?

Background: The traditional fluid fast prior to endoscopy is unnecessary. We have previously shown that drinking water prior to endoscopy does not affect either the quality of mucosal views or residual gastric fluid volumes when compared to patients undergoing endoscopy after a standard fast. The present study was designed to establish whether milk, which may delay gastric emptying, could also be drunk prior to endoscopy without adverse effect.