Coeliac disease: a biopsy is not always necessary for diagnosis.


BACKGROUND:In view of the high diagnostic accuracy of immunoglobulin-A-tissue transglutaminase antibodies for detecting coeliac disease, we have explored whether a small bowel biopsy is always required to establish the diagnosis. AIM:To define the transglutaminase antibody level giving a positive predictive value for coeliac disease of 100% and to subsequently assess the proportion of new diagnoses of coeliac disease having such a result. METHODS:The Celikey kit (Phadia GmbH, Frieburg, Germany) was used to measure transglutaminase antibody levels. RESULTS:All patients with transglutaminase antibody levels >30 U/mL, i.e. 10 x upper limit of normal in 2002/2003 had characteristic small bowel mucosal lesions. In a subsequent audit, 58% of 112 new diagnoses of coeliac disease in 2004/2005 had levels above this cut-off value. CONCLUSIONS:We have shown that a transglutaminase antibody level can be defined which gives a positive predictive value of 100% for coeliac disease. From published data, these observations can be extended to most second-generation transglutaminase antibody kits. Our data provide further evidence that diagnostic guidelines could be modified so that small bowel biopsy is no longer regarded as mandatory in patients with such high transglutaminase antibody levels. This will avoid an invasive procedure and lead to a more rapid diagnosis and earlier treatment for over half of the new patients with coeliac disease.


Aliment Pharmacol Ther


Hill PG,Holmes GK




Has Abstract


2008-04-01 00:00:00














  • Meta-analysis: adherence to colorectal cancer screening and the detection rate for advanced neoplasia, according to the type of screening test.

    abstract:BACKGROUND:A variety of tests have been proposed for colorectal cancer (CRC), giving rise to uncertainty regarding the optimal approach. The efficacy and effectiveness of different tests are related to both screened participation and the detection rate. AIM:To perform a meta-analysis on adherence and detection rates o...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,meta分析


    authors: Hassan C,Giorgi Rossi P,Camilloni L,Rex DK,Jimenez-Cendales B,Ferroni E,Borgia P,Zullo A,Guasticchi G,HTA Group.

    更新日期:2012-11-01 00:00:00

  • Barrett's oesophagus with predominant intestinal metaplasia correlates with superficial cyclo-oxygenase-2 expression, increased proliferation and reduced apoptosis: changes that are partially reversed by non-steroidal anti-inflammatory drugs usage.

    abstract:BACKGROUND:Cyclo-oxygenase-2 expression has been reported to play an important role in the metaplasia-dysplasia-carcinoma sequence in Barrett's oesophagus. However, the existence of cyclo-oxygenase-2 expressing cells in Barrett's epithelium is still uncertain. AIM:To identify the cells that express cyclo-oxygenase-2 p...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: Amano Y,Ishihara S,Kushiyama Y,Yuki T,Takahashi Y,Chinuki D,Miyake T,Miyaoka Y,Rumi MA,Ishimura N,Adachi K,Kinoshita Y

    更新日期:2004-10-01 00:00:00

  • Selective COX-2 inhibitors and human inflammatory bowel disease.

    abstract:BACKGROUND:Much recent effort has been made to produce selective inhibitors of cyclo-oxygenase-2 (COX-2) in the belief that these will lack the gastrointestinal damaging effects of traditional non-steroidal anti-inflammatory drugs (NSAIDs). Inflammatory bowel disease is associated with increased local production of pro...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: McCartney SA,Mitchell JA,Fairclough PD,Farthing MJ,Warner TD

    更新日期:1999-08-01 00:00:00

  • Comparison of one-day oral dosing with three bismuth compounds for the suppression of Helicobacter pylori assessed by the 13C-urea breath test.

    abstract::Assessment of intragastric urease activity by the 13C-urea breath test was performed before and after one day of dosing with either De-Noltabs (tripotassium dicitrato bismuthate, one tablet 1 q.d.s.), Pepto-Bismol liquid (bismuth salicylate 30 ml q.d.s.), or Roter tablets (bismuth subnitrate, one tablet q.d.s.) in twe...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: Prewett EJ,Luk YW,Fraser AG,Lam WM,Pounder RE

    更新日期:1992-02-01 00:00:00

  • Rifabutin- and furazolidone-based Helicobacter pylori eradication therapies after failure of standard first- and second-line eradication attempts in dyspepsia patients.

    abstract:BACKGROUND:Optimal management approach is not well defined for subjects who fail initial first- and second-line Helicobacter pylori eradication attempts and are dealt on a case-by-case basis by the specialists. AIM:To evaluate the efficacy and safety of standard and 'rescue' eradication therapies at primary and second...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: Qasim A,Sebastian S,Thornton O,Dobson M,McLoughlin R,Buckley M,O'Connor H,O'Morain C

    更新日期:2005-01-01 00:00:00

  • The prevalence of Helicobacter pylori in peptic ulcer disease.

    abstract::Both duodenal and gastric ulcer disease are closely associated with Helicobacter pylori infection. An infected individual has an estimated lifetime risk of 10-20% for the development of peptic ulcer disease, which is at least 3-4 fold higher than in non-infected subjects. H. pylori infection can be diagnosed in 90-100...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,评审


    authors: Kuipers EJ,Thijs JC,Festen HP

    更新日期:1995-01-01 00:00:00

  • Symptomatic and endoscopic duodenal ulcer relapse rates 12 months following Helicobacter pylori eradication treatment with omeprazole and amoxycillin with or without metronidazole.

    abstract:AIM:To determine the effect of Helicobacter pylori eradication with omeprazole and amoxycillin, with or without metronidazole, on the 12-month course of duodenal ulcer disease. METHODS:In a randomized; double-blind study, conducted in 19 hospitals, 105 H. pylori positive duodenal ulcer patients were healed and symptom...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Bell GD,Bate CM,Axon AT,Tildesley G,Martin JL,Taylor MD,Richardson PD

    更新日期:1996-08-01 00:00:00

  • Systematic review: ibuprofen-induced liver injury.

    abstract:BACKGROUND:Nonsteroidal anti-inflammatory drugs (NSAIDs) are a leading cause of drug-induced liver injury (DILI) across the world. Ibuprofen is one of the most commonly used and safest NSAIDs, nevertheless reports on ibuprofen-induced hepatotoxicity are available. AIM:To analyse previously published information on ibu...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: Zoubek ME,Lucena MI,Andrade RJ,Stephens C

    更新日期:2020-03-01 00:00:00

  • Polymeric nutrition as the primary therapy in children with small bowel Crohn's disease.

    abstract:BACKGROUND:Recent studies in adults have shown that polymeric (whole protein) diets are as effective as semi-elemental and elemental formulae for the induction of remission in small bowel Crohn's disease. Whole protein diets are more palatable and cheaper. There have been no studies confirming efficacy in children. PA...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: Beattie RM,Schiffrin EJ,Donnet-Hughes A,Huggett AC,Domizio P,MacDonald TT,Walker-Smith JA

    更新日期:1994-12-01 00:00:00

  • Development and validation of the chronic hepatitis C virus treatment satisfaction (HCVTSat) instrument.

    abstract:BACKGROUND:While current medications used to treat patients with chronic hepatitis C virus (HCV) effectively produce sustained viral response (SVR), postponement of therapy is often times attributed to patient perceptions of unfavourable outcomes. However, an instrument to assess patient perceptions of therapy (i.e. tr...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: Szeinbach SL,Baran RW,Dietz B,Gazzouola Rocca L,Littlefield D,Yawn BP

    更新日期:2013-03-01 00:00:00

  • Lessons from prolonged gastric pH monitoring.

    abstract::Intragastric pH monitoring has shown that the distribution of acidity within the stomach is not homogeneous. Not only is it affected by meals but it also has a circadian rhythm in which nocturnal pH falls to very acid levels in normal subjects. Although results of pH monitoring are highly reproducible within individua...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,评审


    authors: Bumm R,Blum AL,Bauerfeind P,Emde C

    更新日期:1987-01-01 00:00:00

  • Injection of botulinum toxin before pneumatic dilatation in achalasia treatment: a randomized-controlled trial.

    abstract:BACKGROUND:Pneumatic dilatation is the first line therapy in achalasia, but half of patients relapse within 5 years of therapy and require further dilatations. AIM:To assess whether botulinum toxin injection before pneumatic dilatation is superior to pneumatic dilatation alone in achalasia patients. METHODS:Newly dia...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,随机对照试验


    authors: Mikaeli J,Bishehsari F,Montazeri G,Mahdavinia M,Yaghoobi M,Darvish-Moghadam S,Farrokhi F,Shirani S,Estakhri A,Malekzadeh R

    更新日期:2006-09-15 00:00:00

  • Absolute and relative contraindications to pegylated-interferon or ribavirin in the US general patient population with chronic hepatitis C: results from a US database of over 45 000 HCV-infected, evaluated patients.

    abstract:BACKGROUND:Chronic hepatitis C (HCV) treatment with pegylated-interferon (PEG-IFN)/ribavirin (RBV) is often limited by preexisting medical, psychiatric and psychosocial contraindications. However, limited data exist in general patient populations. AIM:To evaluate the percentage of HCV-infected patients in the general ...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: Talal AH,LaFleur J,Hoop R,Pandya P,Martin P,Jacobson I,Han J,Korner EJ

    更新日期:2013-02-01 00:00:00

  • A comparison of the gut microbiome between long-term users and non-users of proton pump inhibitors.

    abstract:BACKGROUND:Proton pump inhibitor (PPI) use is associated with an increased risk of Clostridium difficile infection (CDI), though the mechanism is unclear. PPI induced alterations to the gut microbiome may facilitate the emergence of CDI, though the effects of PPIs on gut microbiota are not well characterised. [Correcti...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: Clooney AG,Bernstein CN,Leslie WD,Vagianos K,Sargent M,Laserna-Mendieta EJ,Claesson MJ,Targownik LE

    更新日期:2016-05-01 00:00:00

  • Review article: the treatment of genotype 1 chronic hepatitis C virus infection in liver transplant candidates and recipients.

    abstract:BACKGROUND:Recently, the therapeutic landscape with regard to anti-HCV therapy has changed dramatically. The new directly acting anti-virals (DAAs) have demonstrated improved sustained virological response (SVR) compared with pegylated-interferon and ribavirin. AIM:To examine and present the latest data with regard to...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,评审


    authors: Joshi D,Carey I,Agarwal K

    更新日期:2013-04-01 00:00:00

  • Randomised clinical trial: prevention of recurrence of peptic ulcers by rabeprazole in patients taking low-dose aspirin.

    abstract:BACKGROUND:Few studies have evaluated the effects of rabeprazole on low-dose aspirin (LDA)-induced gastroduodenal injuries. AIM:To conduct a randomised, double-blind, triple-dummy, active-controlled, multicentre trial, named the PLANETARIUM study, to assess the efficacy, dose-response relationship and safety of rabepr...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Iwakiri R,Higuchi K,Kato M,Fujishiro M,Kinoshita Y,Watanabe T,Takeuchi T,Yamauchi M,Sanomura M,Nakagawa H,Sugisaki N,Okada Y,Ogawa H,Arakawa T,Fujimoto K

    更新日期:2014-10-01 00:00:00

  • A controlled trial of ondansetron in the pruritus of cholestasis.

    abstract:BACKGROUND:In patients with pruritus of cholestasis, response to conventional drug treatment may be unsatisfactory. Activation of 5-hydroxytryptamine receptors on dermal sensory nerve-endings plays a role in the perception of pruritus. The 5-hydroxytryptamine(3) receptor antagonist, ondansetron, has been used in the tr...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: O'Donohue JW,Pereira SP,Ashdown AC,Haigh CG,Wilkinson JR,Williams R

    更新日期:2005-04-15 00:00:00

  • Pyloric gland metaplasia and pouchitis in patients with ileal pouch-anal anastomoses.

    abstract:BACKGROUND:Diagnosis and management of chronic antibiotic-refractory pouchitis and Crohn's disease of the pouch can be challenging. Pyloric gland metaplasia is a histological feature indicative of chronic mucosal inflammation. Its value in diagnosis and prognosis of pouch disorders has not been investigated. AIM:To as...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: Kariv R,Plesec TP,Gaffney K,Lian L,Fazio VW,Remzi FH,Lopez R,Goldblum JR,Shen B

    更新日期:2010-04-01 00:00:00

  • Systematic review with network meta-analysis: pharmacological prophylaxis against post-ERCP pancreatitis.

    abstract:BACKGROUND:The efficacy of many pharmacological agents for preventing post-ERCP pancreatitis (PEP) has been evaluated in randomised controlled trials (RCTs), but it is unclear which agent(s) should be used in clinical practice. Network meta-analyses of RCTs are used to simultaneously compare several agents to determine...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,meta分析,评审


    authors: Akshintala VS,Hutfless SM,Colantuoni E,Kim KJ,Khashab MA,Li T,Elmunzer BJ,Puhan MA,Sinha A,Kamal A,Lennon AM,Okolo PI,Palakurthy MK,Kalloo AN,Singh VK

    更新日期:2013-12-01 00:00:00

  • Review article: in vivo imaging by endocytoscopy.

    abstract:BACKGROUND:Endocytoscopy (EC) enables in vivo microscopic imaging at 1400-fold magnification, thereby allowing the analysis of mucosal structures at the cellular level. In contrast to fluorescence imaging with confocal laser endomicroscopy which allows analysis of mucosal structures up to 250 μm in depth, EC is based o...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,评审


    authors: Neumann H,Fuchs FS,Vieth M,Atreya R,Siebler J,Kiesslich R,Neurath MF

    更新日期:2011-06-01 00:00:00

  • Smoking behaviour and knowledge of the health effects of smoking in patients with inflammatory bowel disease.

    abstract:BACKGROUND:The detrimental effect of smoking on development and progression of Crohn's disease (CD) is generally accepted. AIM:To evaluate the awareness of smoking risks in a Belgian inflammatory bowel disease (IBD) population. METHODS:In the out-patient clinic of a tertiary referral centre, 625 consecutive patients ...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: De Bie C,Ballet V,Hendriks N,Coenen S,Weyts E,Van Assche G,Vermeire S,Ferrante M

    更新日期:2015-12-01 00:00:00

  • Octreotide (a somatostatin analogue) improves the quality of life in some patients with a short intestine.

    abstract::Six patients with short intestine (jejunal length 25-70 cm) on long-term parenteral nutrition, needing 4-5 L of intravenous fluid daily, were given octreotide (a somatostatin analogue, SMS 201-995) to investigate whether it would reduce beneficially their secretory diarrhoea (3.6-6.9 kg/day). They consumed the same di...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: Nightingale JM,Walker ER,Burnham WR,Farthing MJ,Lennard-Jones JE

    更新日期:1989-08-01 00:00:00

  • Review article: gastric pH -- the most relevant predictor of benefit in reflux disease?

    abstract::Summary In patients with gastro-oesophageal reflux disease, the pH of refluxed gastric contents has a direct bearing on disease severity and oesophageal damage. A pH of 4 has been defined as a threshold below which refluxed gastric contents become injurious to the oesophagus. Studies in patients with erosive oesophagi...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,评审


    authors: Armstrong D

    更新日期:2004-10-01 00:00:00

  • Low-dose lansoprazole and clarithromycin plus metronidazole vs. full-dose lansoprazole and clarithromycin plus amoxicillin for eradication of Helicobacter pylori infection.

    abstract:AIM:To compare, in a randomized controlled trial, the efficacy and tolerability of two 1-week triple therapies for Helicobacter pylori eradication. METHODS:One hundred and thirty-four consecutive patients with non-ulcer dyspepsia and H. pylori infection were randomized to receive lansoprazole 30 mg once daily, clarith...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Bazzoli F,Zagari RM,Pozzato P,Fossi S,Ricciardiello L,Nicolini G,De Luca L,Berretti D,Alampi G,Di Pietro C,Morelli P,Roda E

    更新日期:2002-01-01 00:00:00

  • Mebeverine decreases mass movements and stool frequency in lactulose-induced diarrhoea.

    abstract:BACKGROUND:In spite of its frequent use in the treatment of irritable bowel disease little is known about mebeverine's mode of action in man. AIM:To examine mebeverine's effect on transit though the gut during lactulose-induced diarrhoea. METHODS:Nine healthy volunteers undertook a two-way randomized crossover study....

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Washington N,Ridley P,Thomas C,Spiller RC,Watts PJ,Wilson CG

    更新日期:1998-06-01 00:00:00

  • Review article: anti-inflammatory mechanisms of action of Saccharomyces boulardii.

    abstract:BACKGROUND:Saccharomyces boulardii, a well-studied probiotic, can be effective in inflammatory gastrointestinal diseases with diverse pathophysiology, such as inflammatory bowel disease (IBD), and bacterially mediated or enterotoxin-mediated diarrhoea and inflammation. AIM:To discuss the mechanisms of action involved ...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,评审


    authors: Pothoulakis C

    更新日期:2009-10-15 00:00:00

  • Pregnancy outcome in inflammatory bowel disease: prospective European case-control ECCO-EpiCom study, 2003-2006.

    abstract:BACKGROUND:Inflammatory bowel disease (IBD) frequently affects women during their reproductive years. Pregnancy outcome in women with IBD is well described, particularly in retrospective studies. AIM:To evaluate the pregnancy outcome in patients with IBD in a prospective European multicentre case-control study. METHO...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章,多中心研究


    authors: Bortoli A,Pedersen N,Duricova D,D'Inca R,Gionchetti P,Panelli MR,Ardizzone S,Sanroman AL,Gisbert JP,Arena I,Riegler G,Marrollo M,Valpiani D,Corbellini A,Segato S,Castiglione F,Munkholm P,European Crohn-Colitis Organisat

    更新日期:2011-10-01 00:00:00

  • Use of proton pump inhibitors and the risk of cholangitis: a nationwide cohort study.

    abstract:BACKGROUND:Proton pump inhibitor (PPI) use may alter the gut microbiome and increase the risk of cholangitis. However, the association of PPI use with the risk of incident cholangitis has not been evaluated. AIM:To evaluate whether PPI use was associated with a higher risk of cholangitis. METHODS:This cohort study in...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: Min YW,Kang D,Shin JY,Kang M,Park JK,Lee KH,Lee JK,Lee KT,Rhee PL,Kim JJ,Guallar E,Cho J,Lee H

    更新日期:2019-10-01 00:00:00

  • Stepwise diagnosis in covert hepatic encephalopathy: critical flicker frequency and MELD-score as a first-step approach.

    abstract:BACKGROUND:The diagnosis of covert hepatic encephalopathy (CHE) by means of portosystemic encephalopathy syndrome (PSE) test is costly and therefore infrequently performed. AIM:To determine the ability of critical flicker frequency (CFF) alone or in combination with laboratory findings, as an initial test to pre-selec...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 杂志文章


    authors: Greinert R,Ripoll C,Hollenbach M,Zipprich A

    更新日期:2016-09-01 00:00:00

  • Effect of propranolol and depot lanreotide SR on postprandial and circadian portal haemodynamics in cirrhosis.

    abstract:BACKGROUND:Long-acting somatostatin analogues have been suggested as an alternative to propranolol for the prevention of variceal rebleeding. AIM:To compare the effectiveness of lanreotide SR, a new depot formulation injected once-weekly, and propranolol in reducing circadian portal blood flow (PVF) and meal-stimulate...

    journal_title:Alimentary pharmacology & therapeutics

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Schiedermaier P,Koch L,Stoffel-Wagner B,Layer G,Sauerbruch T

    更新日期:2003-10-15 00:00:00