Effectiveness of high-dose barium enema filling for colonic diverticular bleeding.

AIM: Therapeutic barium enema was first reported in 1970. The long-term recurrence rate of colonic diverticular bleeding after therapeutic barium enema was compared with that of endoscopic haemostasis. METHOD: This study included 57 consecutive patients admitted between 2003 and 2008 with colonic diverticular bleeding in whom conservative treatment failed to stop bleeding within 3 h of hospital admission. Lower gastrointestinal endoscopy was performed immediately after admission. In 75% of patients, bleeding was from the right colon, and any identifiable source of bleeding was treated by endoscopic haemostasis. Cases with an undetectable source received high-dose barium impaction therapy. RESULTS: Treatment was as follows: Group A (n = 37) solely by endoscopic haemostasis; Group B (n = 11) solely by therapeutic barium enema group, and Group C (n = 9) by endoscopic haemostasis and therapeutic barium enema. At a follow up of seven (median; range: 1-56) months, recurrent bleeding rates were 18/37 (48.6%), 6/11 (54.5%) and 2/9 (22.2%) (P = 0.3930). CONCLUSION: High-dose barium enema is as effective as endoscopic haemostasis for the prevention of recurrent diverticular bleeding.

Breath sample collection through the nostril reduces false-positive results of 13C-urea breath test for the diagnosis of helicobacter pylori infection.

BACKGROUND: One of the disadvantages of '3C-urea breath test is possible interference by urease activity not related to Helicobacterpylori. AIMS: We design the simple and non-invasive modification to avoid the contamination of 13CO(2) produced in the mouth. PATIENTS AND METHODS: One hundred and twenty-nine patients who underwent diagnostic upper endoscopy were enrolled. Within 1 week of the endoscopic procedure, each patient received the modified 13C-urea breath test. Breath samples were collected at baseline and at 1, 3, 5, 10, 15, 20 and 30 min after ingestion of 100 mg 13C-urea solution through the mouth and the nostril at each time point. RESULTS: The breath delta13CO2 value through the nostril at 1 min was already higher in H. pylori-positive patients than in H. pylori-negative patients. Using 2.5% as the cut-off value, the sensitivity and specificity of the modified 13C-urea breath test at 20 min were both 100%, whereas the sensitivity and specificity of the standard 13C-urea breath test were 97.7 and 94%, respectively, using 3% as the cut-off value. CONCLUSIONS: The modified 13C-urea breath test in which breath samples are collected through the nostril provides an easy way of avoiding false-positive results for the detection of H. pylori infection.