Because it provides a direct view of superficial lesions in the small bowel, capsule endoscopy is a promising diagnostic tool for studying patients with suspected Crohn's disease undetected by ...conventional modalities.
To assess the role of capsule endoscopy in the diagnosis of patients with suspected Crohn's disease.
Thirty-eight patients (16 males, mean age 46.2 years) with suspected Crohn's disease but negative at conventional imaging were examined using capsule endoscopy. They were divided into 2 groups: 12 patients with ongoing symptoms (Group 1), and 26 with ongoing symptoms and biochemical markers of inflammation (Group 2). Capsule endoscopy findings were classified as diagnostic (multiple erosions/ulcerations), suspicious (≤3 erosions/ulcerations), non-specific and normal.
Capsule endoscopy findings were diagnostic for Crohn's disease in 13 (34.2%) patients, suspicious in 2 (5.3%), non-specific in 4 (10.5%) and normal in 19 (50%), with an overall detection rate of 39.5%. The yield of positive findings was 8.3% in Group 1 and 46.2% in Group 2 (
p
=
0.022). Capsule endoscopy findings prompted specific measures or patient management changes in 39.5% of patients.
Capsule endoscopy has a high diagnostic yield in patients with suspected Crohn's disease and both clinical and biochemical markers of inflammation.
Summary
Background Cure rates for eradication of Helicobacter pylori appear to be decreasing, thus more effective therapies must be identified.
Aim To evaluate the efficacy of bovine lactoferrin in ...the treatment of H. pylori infection.
Methods In a multicentred prospective study, 402 (mean age 52.4, range 19–84 years) H. pylori‐positive patients were assigned to one of three regimens: group A – esomeprazole 20 mg b.d., clarithromycin 500 mg b.d. and tinidazole 500 mg b.d. for 7 days; group B – lactoferrin 200 mg b.d. for 7 days followed by the same schedule of group A; group C – esomeprazole 20 mg b.d., clarithromycin 500 mg b.d. and tinidazole 500 mg b.d. plus lactoferrin 200 mg b.d. for 7 days.
Results Of the 402 patients, 389 completed the study. Six patients were discontinued due to side effects, one patient in group B died and six patients were lost to follow up. The eradication rate (intention‐to‐treat analysis) was 77% in group A (105/136), 73% in group B (97/132) and 90% in group C (120/134) (χ2‐test P < 0.01). The incidence of side effects was 9.5% in group A, 9% in group B and 8.2% in group C (χ2‐test P = 0.1).
Conclusion This study demonstrates that bovine lactoferrin is an effective adjuvant to 7‐day triple therapy for eradication of H. pylori infection.
