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NIHR Signal MRI and ultrasound scans are both helpful in assessing Crohn’s disease; MRI is slightly more accurate
Two types of scan, MRI and ultrasound, work well when used for staging and monitoring Crohn’s disease. MRI is more accurate. Researchers compared a form of magnetic resonance (MR) imaging that includes an oral contrast agent, with ultrasound scans. They aimed to see which was better able to detect the presence and extent of active disease in the small bowel. The trial, carried out in eight NHS hospitals, involved 284 participants who had both MR and ultrasonography. While both tests perfo...
NIHR Signal Stopping smoking is unlikely to worsen symptoms of ulcerative colitis
Non-smokers and people who stop smoking after being diagnosed with ulcerative colitis are unlikely to have more flare-ups or other signs of worsening disease, compared with those who continue to smoke. Smoking is linked to reduced rates of developing ulcerative colitis in some studies. Some patients also believe that smoking can also lessen the symptoms of the disease, although previous research about this has had conflicting results. This study indicates that smoking does not have a significan...
NIHR Signal Robotic surgery for rectal cancer produces similar results to keyhole surgery
Robotic rectal cancer surgery does not appear technically easier than standard keyhole surgery. The researchers, in this trial, judged this by measuring the need to ‘convert’ a keyhole procedure to open surgery when operating. This NIHR-funded trial also found that robotic surgery produced similar clinical results to standard laparoscopic (keyhole) surgery in treating rectal cancer. In the trial, 28 out of 230 patients (12%) who received keyhole surgery were converted to open surger...
NIHR Signal Telephone-delivered CBT can provide lasting benefits for people with IBS
People with irritable bowel syndrome (IBS) who receive cognitive behavioural therapy (CBT) continue to have lower levels of symptoms over the following two years. Telephone-delivered CBT is particularly effective, with 71% of study participants experiencing a clinically significant improvement in their IBS symptoms. This NIHR-funded study is the 24-month follow-up to an earlier publication of 12-month outcomes for 558 people with IBS receiving usual care alone or additional telephone or web-bas...
NIHR Signal Whole-body MRI is effective for identifying metastatic disease in colorectal cancer patients
Initial investigation which includes whole-body magnetic resonance imaging (MRI) is as good as standard pathways for detecting metastatic disease in adults with newly diagnosed colorectal cancer. This NIHR-funded study also found that whole-body MRI reduces the number of investigations needed, the length of the staging process, and costs less than standard pathways. The treatment options for colorectal cancer depend on the stage of the cancer. For example, if a patient has metastatic disease (s...
NIHR Signal Transvaginal ultrasound and MRI achieve similar accuracy for diagnosing lower bowel endometriosis
Transvaginal ultrasound and magnetic resonance imaging (MRI) scans are both accurate ways to diagnose the most severe form of deep endometriosis affecting the bowel. By using both transvaginal ultrasound and MRI, the chance of non-invasively and accurately diagnosing endometriosis of the lower bowel rises to nearly 100%. This review and meta-analysis looked at eight studies where both transvaginal ultrasound and MRI had been used to diagnose endometriosis in a total of 1,132 women. In each indi...
NIHR Signal Telephone or internet delivered talking therapy can alleviate irritable bowel symptoms
People with irritable bowel syndrome may find cognitive behavioural therapy (a talking therapy) delivered via telephone or internet improves their symptoms. Compared with usual care alone, both interventions were shown to be more effective, with telephone delivery resulting in greater symptom reduction and web-based therapy being more cost-effective. Irritable bowel symptoms can persist long-term and have a major impact on the quality of life. Stress is one of the known triggers. Cognitive beha...
NIHR Signal Medication to reduce stomach acid may increase risk of hip fractures
People who take proton pump inhibitors for digestive disorders such as stomach ulcers and acid reflux may be up to 24% more likely to experience hip fractures. Nevertheless, the benefits of treatment in an individual may outweigh this effect unless the risk of osteoporosis or fracture is high. A conversation between the prescriber and the individual patient on relative risks should help in a treatment decision. The link may be important for people taking these drugs, especially if they have ot...
NIHR Signal Prolonging anticoagulant treatment after abdominal cancer surgery reduces clot risk
People who have low molecular weight heparin (LMWH) for between two to four weeks after abdominal or pelvic surgery, especially for cancer, have fewer blood clots in their large veins or lungs. In this review of seven trials, five per cent of people receiving extended treatment experienced a clot compared with 13% who received LMWH only while in hospital. There was no difference in bleeding complications. The optimal duration of treatment following abdominal surgery is uncertain, balancing blee...
NIHR Signal Treatments for depression may help irritable bowel symptoms
Antidepressants are likely to provide more than a placebo effect for those with symptoms of irritable bowel syndrome. Antidepressants improve symptoms in about 60% of those taking them, but two-thirds of that effect may be due to placebo. Psychological therapies, such as talking therapies also appear effective in about half of those offered them but may be partly due to expectations because it is not possible to provide a placebo control. Irritable bowel syndrome is a chronic disorder of the gu...
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