L.G.M. van Rossum

Evaluation of treatment regimens to cure Helicobacter pylori infection - a meta-analysis.

: To assess effectiveness of treatment to cure Helicobacter pylori infection.

Cutoff value determines the performance of a semi-quantitative immunochemical faecal occult blood test in a colorectal cancer screening programme

Background:The cutoff of semi-quantitative immunochemical faecal occult blood tests (iFOBTs) influences colonoscopy referrals and detection rates. We studied the performance of an iFOBT (OC-Sensor) in colorectal cancer (CRC) screening at different cutoffs.Methods:Dutch screening participants, 50–75 years of age, with average CRC risk and an iFOBT value ⩾50 ng ml−1 were offered colonoscopy. The detection rate was the percentage of participants with CRC or advanced adenomas (⩾10 mm, ⩾20% villous, high-grade dysplasia). The number needed to scope (NNTScope) was the number of colonoscopies to be carried out to find one person with CRC or advanced adenomas.Results:iFOBT values ⩾50 ng ml−1 were detected in 526 of 6157 participants (8.5%) and 428 (81%) underwent colonoscopy. The detection rate for advanced lesions (28 CRC and 161 with advanced adenomas) was 3.1% (95% confidence interval: 2.6–3.5%) and the NNTScope was 2.3. At 75 ng ml−1, the detection rate was 2.7%, the NNTScope was 2.0 and the CRC miss rate compared with 50 ng ml−1 was <5% (N=1). At 100 ng ml−1, the detection rate was 2.4% and the NNTScope was <2. Compared with 50 ng ml−1, up to 200 ng ml−1 CRC miss rates remained at 16% (N=4).Conclusions:Cutoffs below the standard 100 ng ml−1 resulted in not only higher detection rates of advanced lesions but also more colonoscopies. With sufficient capacity, 75 ng ml−1 might be advised; if not, up to 200 ng ml−1 CRC miss rates are acceptable compared with the decrease in performed colonoscopies.

Proton-pump inhibitor therapy for acetylsalicylic acid associated upper gastrointestinal symptoms: a randomized placebo-controlled trial.

Objective : Patients using acetylsalicylic acid (aspirin) have an increased risk of upper gastrointestinal discomfort. The aim of this study was to assess whether gastric acid suppression improves upper gastrointestinal symptoms in patients using low‐dose aspirin for cardiovascular disease.

Corpus gastritis in patients with endoscopic diagnosis of reflux oesophagitis and Barrett's oesophagus.

A high level of gastric acid secretion is considered to be a risk factor for reflux oesophagitis or Barretts oesophagus. Corpus gastritis may have a protective effect on the oesophagus, because of decreased gastric acid output.

The impact of gastrointestinal symptoms on health status in patients with cardiovascular disease

Background : Drugs for the management of cardiovascular disease may provoke gastrointestinal discomfort and complications.

Getting adequate information across to colorectal cancer screening subjects can be difficult.

Objectives Participation in screening should be the outcome of an informed decision. We evaluated whether invitees in the first Dutch colorectal cancer (CRC) screening programme were adequately informed after having received a detailed information leaflet. Methods A total of 20,623 subjects aged 50–75 years were invited to the fecal occult blood test (FOBT) screening programme. All received a detailed information leaflet by mail between May 2006 and January 2007. After two weeks, a reminder letter was sent to all invitees, accompanied by a survey on CRC and screening. Results The survey was completed by 9594 invitees (47%). Almost all responders (99%) found the leaflet clear and readable. Almost all indicated that CRC can be treated better if found early (99%). Only 20% of the responders answered all knowledge-related answers correctly. Almost half of the responders (47%) believed that a negative FOBT excludes the presence of CRC. Older age and having a positive family member for CRC were correctly identified as risk factors by 80%. Conclusion This study demonstrates that although an information leaflet was reported as being clear and readable, the information provided in it was not always understood well. This suggests that other educational options should be investigated in order to improve general knowledge of CRC in screening invitees.

Health-related quality of life of patients with gastrointestinal symptoms.

Background : Little is known about the variation in health‐related quality of life among patients with different presentations of gastrointestinal symptoms.

Anxiety, depression and psychotropic medication use in patients with persistent upper and lower gastrointestinal symptoms

Background:  Limited information is available about anxiety, depression and psychotropic medication use in patients referred for gastrointestinal endoscopy.

Health-related quality of life in patients with cardiovascular disease – the effect of upper gastrointestinal symptom treatment

Background : Upper gastrointestinal discomfort decreases the already impaired health status of patients with cardiovascular disease.

Gastrointestinal symptoms in NSAID users in an 'average risk population': results of a large population-based study in randomly selected Dutch inhabitants

Non‐steroidal anti‐inflammatory drug (NSAID) use is widespread and associated with gastrointestinal symptoms and complications. The aims of this study were to assess (i) gastrointestinal symptoms in users of prescribed and over‐the‐counter (OTC) NSAIDs and (ii) proton pump inhibitor (PPI) co‐prescription rates in NSAID users at increased risk for gastrointestinal complications.