D S Sanders

..The changes which the authors have implemented and described (including audit data), may be something which any practising healthcare professional in this field may choose to incorporate into their own clinical practice...

..The clinical strategy described in this paper can be applied to other neurodegenerative diseases and provides a framework for improving a PEG service...

..Targeting patients who have non-specific abdominal pain or coeliac-associated symptoms/diseases may improve diagnosis...

..OBJECTIVE: This review provides an update of the published data on case finding for coeliac disease, with the aim of improving the recognition of this disease in clinical practice...

..To assess the effectiveness of a centralised upper-gastrointestinal haemorrhage (UGIH) unit...

..This review provides an update of the published data on coeliac disease. We discuss the relationship between coeliac disease and abdominal pain and ways in which this may change emergency physicians practice...

..Nonspecific abdominal pain (NSAP) may account for up to 40% of cases. There has been no published prospective study in which adult patients presenting with acute abdominal pain are investigated for celiac disease...

..To establish the prevalence of coeliac disease in the general population and in specific conditions, such as irritable bowel syndrome, iron deficiency anaemia, fatigue and other coeliac-related conditions...

..However, a targeted case-finding approach may be more valid and cost-effective with the initial selection of patients who should be investigated for CD based on questioning about gastrointestinal symptoms or anemia...

..To determine the incidence and presenting features of adult coeliac disease in a single university hospital in South Yorkshire...

..We aimed to assess the association of coeliac disease with irritable bowel syndrome in patients fulfilling ROME II criteria...

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..The commonest type of neuropathy seen in the context of gluten sensitivity is sensorimotor axonal. We report 17 patients with sensory ganglionopathy associated with gluten sensitivity...

..The aim of this study was to evaluate the relationship between the invasive type V pit pattern using high-magnification-chromoscopic-colonoscopy (HMCC) and submucosal invasive depth for flat and depressed colorectal lesions...

..The aim of the present study was to assess the efficacy and safety of en-bloc endoscopic mucosal resection with high-magnification chromoendoscopy in the management of sessile and flat colorectal lesions </= 20 mm...

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..Myopathy may be another manifestation of gluten sensitivity and is likely to have an immune-mediated pathogenesis. A gluten-free diet may be a useful therapeutic intervention...

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..We hypothesized that the novel technique of high-magnification chromoscopic pouchoscopy (HMCP) may permit accurate anatomical localization of this high risk zone in vivo and permit improved biopsy accuracy...

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..New mini probe ultrasound "through the scope" imaging permits staging of lesions proximal to the rectum using direct endoscopic visualisation...

..The aim of this study was to examine the accuracy of miniprobe ultrasound imaging in the preoperative staging of colorectal cancer and to examine the value of the technique for management decisions...

..No studies have addressed the technical feasibility of retroflexion endoscopic dissection methods for luminal "salvage" therapy in patients considered unresectable using conventional forward-viewing resection...

..However, endoscopic biopsy may cause morbidity and discomfort. Our aim was to evaluate wireless capsule endoscopy as an alternative test for the recognition of villous atrophy...

..This article discusses the use of antibodies and duodenal biopsy within this context. Finally, we propose a pragmatic diagnostic algorithm for clinicians to use when investigating patients for coeliac disease...

..Our aim was to assess whether there is an optimal duodenal biopsy strategy for detecting villous atrophy in adult patients with suspected gluten-sensitive enteropathy...

..Patients with coeliac disease may have diarrhoea despite being on a gluten-free diet...

..We conducted a prospective clinicopathological evaluation of an extended endoscopic mucosal resection technique for highly selected lesions of the rectum and assessed outcome data over a maximal 24-month period...

..Distinguishing between inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) can be challenging...

..The high prevalence of gluten sensitivity in patients with stiff-person syndrome (SPS) lead us to investigate the relationship between gluten sensitivity and GAD-antibody-associated diseases...

..A UK-based prospective feasibility study of ESD for colorectal tumours was undertaken; primary endpoints were R0 resection, safety and recurrence...

..Knowledge of the diverse manifestations of gluten sensitivity is essential in avoiding such misdiagnosis...

..Our unit previously reported a readmission rate of 23% in 6 months. There is a paucity of data evaluating community gastrostomy management. We therefore aimed to evaluate the benefits of a dedicated dietetic home enteral feed (HEF) team...

..Little is known about the infrastructure to train gastroenterologists in capsule endoscopy. The level of capsule endoscopy exposure among trainees in the United Kingdom or Europe has also not been quantified...

..The process may be improved by providing procedure-specific information leaflets that offer information regarding common and serious complications...

..This review appraises the current literature to define the clinical indications and practical aspects of capsule endoscopy and enteroscopy that are of interest to the clinician...

..Percutaneous endoscopic gastrostomy (PEG) is the commonest method of long-term enteral nutrition. In the UK there is no nationally funded framework to provide community support for patients with gastrostomies...

..Furthermore, we explored to what extent vague abdominal symptoms consistent with both disorders were attributed to irritable bowel syndrome (IBS) and if the presence of prodromal IBS (P-IBS) had an impact on prodrome duration...

..No systematic study of the effect of gluten-free diet on gluten ataxia has ever been undertaken...

..Previous data have suggested that pan-chromoscopy may improve detection rates. No randomised control trial has been performed examining detection rates of such lesions while controlling for extubation time and lavage effect...

..03, odds ratio 2.14, 95% CI: 1.07-4.28). CONCLUSIONS: Metronidazole resistance in H. pylori is highly prevalent and more common in women and the young, but does not appear to be related to socio-economic status...

..Methods Patients with Type 1 diabetes mellitus were prospectively recruited and ALT, glycated haemoglobin and lipid profile were measured. Patients with Type 2 diabetes mellitus were recruited as a comparison group...

..Push enteroscopy is used in the assessment of refractory coeliac disease. However, its value in making the diagnosis of coeliac disease is still not defined...

..Conflicting data exist concerning the accuracy of this technique when discriminating neoplastic from non-neoplastic lesions, particularly when flat and depressed...

..The use of abdominal ultrasound may provide an adjuvant tool for percutaneous endoscopic gastrostomy insertion. This novel technique may minimise the risk of complications in selected patients...

..To evaluate the diagnostic yield of push enteroscopy in relation to indication and compare the yield in patients who had capsule endoscopy followed by push enteroscopy against capsule endoscopy naive patients...

..Such patients should not be diagnosed with coeliac disease, solely by histology, as previous retrospective studies have suggested other associations with lymphocytic duodenosis...

..0001). The complication rate was low (0.2 % per group). CONCLUSIONS: Colonoscopy in the elderly is safe and effective with a high diagnostic yield. Colonoscopy may now be the imaging modality of choice in the elderly population...

..In view of the high intrapatient variability in TGN production over time, TGN measurements may not be currently advocated for routine clinical use...

..Patients were subsequently classed as 'accepted' or 'declined' for surgery and SAPS II scores were compared between these two groups...

..Compliance with a strict, lifelong gluten-free diet is the cornerstone of management, improving symptoms and reducing complications of the disease...

..We also assessed whether tissue transglutaminase (tTG) antibody is a quantitative marker for histologic severity...

..To determine an effective diagnostic method of detecting all cases of coeliac disease in patients referred for gastroscopy without performing routine duodenal biopsy...

..Capsule endoscopy is an area in which nurses could develop as physician extenders...

..We have identified a novel neuronal transglutaminase isozyme and investigated whether this enzyme is the target of the immune response in patients with neurological dysfunction...

..The relationship between coeliac disease and inflammatory bowel disease (IBD) is controversial. The aim of this study was to determine the prevalence of coeliac disease in IBD and the prevalence of IBD in coeliac disease...

..Upper gastrointestinal haemorrhage (UGIH) is a common emergency, however, dedicated bleed units only exist in selected hospitals in the UK...

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..Mucosal T-cell activity plays a pivotal role in coeliac disease pathogenesis. We aimed to determine if the development of adult coeliac disease is influenced by appendectomy or tonsillectomy...

..To characterize humoral response to cerebellum in patients with gluten ataxia...

..The recognition of markedly deranged transaminases allows the clinician to differentiate the two diagnoses and potentially avoid the risks incurred with laparotomy...

..Diagnosis requires the demonstration of villous atrophy in the small bowel which improves when gluten is withdrawn...

..Patients with symptoms caused by giardiasis typically present with diarrhea, the absence of which may result in a low clinical index of suspicion for the diagnosis...

..We evaluated the prevalence of exocrine pancreatic insufficiency in diarrhea-predominant IBS (D-IBS) and assessed the effects of pancreatic enzyme supplementation...

..Our aim was to ascertain the prevalence of elevated CgA in diarrhoea predominant Rome II IBS (D-IBS) patients and investigate if this could be a marker for octreotide therapy...

..Total colonoscopy is required to detect such lesions, as only 18% of flat lesions would be in reach of the flexible sigmoidoscope...

..Increasing numbers of IBD patients are using CAM in addition to conventional therapy. Awareness of this may prevent adverse CAM and conventional drug interactions...

..As there are no large studies comparing PEG against PIG, we wished to analyse mortality after endoscopic or radiological gastrostomy insertion...

..However, there are limited data to support this approach...

..IgA deposits against TG2 in the small bowel and at extraintestinal sites are proving to be additional reliable and perhaps more specific markers of the whole spectrum of gluten sensitivity. They may also hold the key to its pathogenesis...

..This study shows that capsule endoscopy has both a high diagnostic yield and an impact on subsequent patient management. These data further support the role of capsule endoscopy in routine clinical practice...

..The aim of the present article is to provide clinicians with an up-to-date review of the literature in this clinical field and allow them to determine the most appropriate management strategy...

..This observation could be taken as an indicator that there is a decline in research activity within the UK gastroenterology community...

..However, there is paucity of data on which clinical factors predict the ability of CE to detect pathology and alter management...

..The purpose of this study was to investigate whether a policy of routine duodenal biopsies increased the yield of diagnosing Giardia and whether treatment improved the patient's presenting symptoms...

..Of these 20 patients, 19 initially improved on pancreatic supplementation. To date, there are no published longitudinal studies...

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..Gluten-free diet may thus be a useful therapeutic intervention for patients with gluten neuropathy...

..Signs and symptoms of bacterial overgrowth, differential diagnosis, investigation, and current treatment options are discussed...

..Furthermore, predicting relapse of disease using conventional endoscopic, histopathological and clinical criteria has not proven reliable...

..Patients with CD feel justifiably cautious when eating food not prepared at home. Educating chefs about a gluten-free diet may alleviate the social restrictions on coeliac patients...