EDITORIAL

This month in Scandinavian Journal of Gastroenterology

The review in the present issue of Scandinavian

Journal of Gastroenterology discusses capsule reten-

tion following the use of wireless capsule endoscopy.

Karagiannis et al. [1] state that wireless capsule

endoscopy is to be considered as a method of choice

when investigating small bowel pathology. Capsule

retention occurs with an overall incidence of 1-2%,

occurring at any level of the gastrointestinal tract and

in most cases does not cause symptoms, though

rarely signs of intestinal obstruction or even intest-

inal perforation have been described. There is no

safe way of predicting capsule retention as of today

beyond obtaining a careful history.

In a model of experimental colitis induced by

dextran sulphate sodium in rats, Hakansson et al. [2]

reports that a combination of probiotics (three

strains) and blueberry husks or rye bran enhanced

the anti-inflammatory effects evaluated as compared

with probiotics or dietary fibers alone. The uses of

dietary supplements for the modulation of intestinal

inflammatory conditions are interesting as an alter-

native to pharmaceutical intervention.

Olen and co-workers [3] through two Swedish

general population-based registers report that under-

weight individuals are at increased risk of having an

undiagnosed coeliac disease, though overweight does

not rule out the condition, and the vast majority of

individuals with undiagnosed disease are of normal

weight.

In a prospective, case-controlled study on 210

patients with Crohn’s disease it could be demon-

strated that non-synonymous SNP (single nucleotide

polymorphism) of the histamine-degrading enzyme

diamin oxidase (DAO) is not of use in assessing

susceptibility to Crohn’s disease, either as a marker

of disease activity or of the clinical behaviour as

reported by Palacios et al. [4].

Simonsen and co-workers [5] demonstrate that

gastrointestinal protein loss may be quantified with

the indium-111-transferrin method with values ap-

pearing to be similar with those obtained with the

more cumbersome 51CrCl3 technique and that the

indium-111-transferrin method has the advantage of

being independent of faeces collection. More reliable

visualization of the site of protein loss requires

optimizined scintigraphic localization.

Quality assurance in colonoscopy with data ob-

tained from the Norwegian Gastronet Quality assur-

ance program is addressed by Hoff et al. [6]. A

quality-assurance-profiled electronic medical record

for colonoscopy was developed (ColoReg), support-

ing continuous quality improvement and giving

warnings when illogical registrations are entered.

Haenni et al. [7] describe the delay in intestinal

transit following the oral intake of a stable fat

emulsion (Fabuless), with known effects like re-

duced food intake and enhanced satiety. The de-

crease in gastrointestinal transit time in these healthy

subjects is suggested to explain the weight control

and appetite suppression provided by the studied fat

emulsion. Three years following an acute salmonella

enteridis infection, Mearin et al. [8] reported that

patients that developed post-infectious functional

gastrointestinal disorders demonstrated an increased

visceral sensitivity, and higher levels of anxiety and

somatization, but there were no evidence on inflam-

matory changes in the gastric or colonic mucosa.

Amasheh et al. [9] present a novel experimental

model of inflammatory bowel disease in which rat

colon was exposed to tumor necrosis factor alpha

and interferon gamma in Ussing chambers. The in

vitro model goes with altered mucosal morphology

and impaired epithelial function following one day

exposure of TNF-alpha and interferon gamma,

alterations resembling changes in IBD. In an in vitro

study, human gastric epithelial AGS cells Lim et al.

[10] imply that aPix is required for H.pylori-

mediated proinflammatory signalling.

Riphaus and co-workers [11] randomized 60

patients with liver cirrhosis subjected to upper

gastrointestinal endoscopy to either Midazolam

sedation or propofol and found that propofol seda-

tion did not cause acute deterioration of minimal

hepatic encephalopathy and was associated with a

significant improved recovery. In a long-term follow-

up (about 20 years) of patients with biopsy-

confirmed fatty liver, alcoholic and non-alcoholic

fatty liver disease, follow-up demonstrated that

patients with alcoholic fatty liver disease primarily

died from cirrhosis and other alcohol-related dis-

orders, whereas in patients with non-alcoholic fatty

liver disease survival was good and deaths mainly

Scandinavian Journal of Gastroenterology, 2009; 44: 1156�1157

ISSN 0036-5521 print/ISSN 1502-7708 online # 2009 Informa UK Ltd.

DOI: 10.1080/00365520903264550

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caused by cardiovascular disease and cancer, as

reported by Dam-Larsen and co-workers [12].

In a Swedish survey on the management of

pancreatic pseudocysts as reported by Andersson

et al. [13], the response rate on the questionnaire

was 88% among treating hospitals and a hetero-

geneity was found in treatment strategies, reflecting

lack of protocols and management strategies for

patients with pancreatic pseudocysts, implying the

risk of patients potentially obtaining suboptimal

treatment. Multidisciplinary teams and ‘‘a tailored

therapeutic approach’’ was suggested and evidence-

based recommendations are awaited in e.g. the

coming Scandinavian guidelines on the management

of acute pancreatitis.

Roland Andersson

Associate Editor

References

[1] Karagiannis S, Faiss S, Mavrogiannis C. Capsule retention:

A feared complication of wireless capsule endoscopy. Scand J

Gastroenterol 2009;/44:/1158�65.

[2] Hakansson A, Branning C, Adawi D, Molin G, Nyman M,

Jeppsson B, et al. Blueberry husks, rye bran and multi-strain

probiotics affect the severity of colitis induced by dextran

sulphate sodium. Scand J Gastroenterol 2009;/44:/1213�25.

[3] Olen O, Montgomery SM, Marcus C, Ekbom A, Ludvigsson

JF. Coeliac disease and body mass index: A study of two

Swedish general population-based registers. Scand J Gastro-

enterol 2009;/44:/1198�1206.

[4] Lopez Palacios N, Agundez JAG, Mendoza JL, Garcıa-

Martın E, Martınez C, Enrique Fuentes Ferrer M, et al.

Analysis of a non-synonymous single nucleotide polymorph-

ism of the human diamine oxidase gene (ref. SNP ID:

rs1049793) in patients with Crohn’s disease. Scand J

Gastroenterol 2009;/44:/1207�12.

[5] Simonsen JA, Braad P-E, Veje A, Gerke O, Schaffalitzky de

Muckadell OB, Høilund-Carlsen PF. 111Indium-transferrin

for localization and quantification of gastrointestinal protein

loss. Scand J Gastroenterol 2009;44:1191�97.

[6] Hoff G, Ottestad PM, Skafløtten SR, Bretthauer M, Moritz

V. Quality assurance as an integrated part of the electronic

medical record � a prototype applied for colonoscopy. Scand

J Gastroenterol 2009;/44:/1259�65.

[7] Haenni A, Sundberg B, Yazdanpandah N, Viberg A, Olsson

J. Effect of fat emulsion (Fabuless) on orocecal transit time in

healthy men. Scand J Gastroenterol 2009;/44:/1186�90.

[8] Mearin F, Perello A, Balboa A, Perona M, Sans M, Salas A,

et al. Pathogenic mechanisms of postinfectious functional

gastrointestinal disorders: Results 3 years after gastroenter-

itis. Scand J Gastroenterol 2009;/44:/1173�85.

[9] Amasheh M, Grotjohann I, Amasheh S, Fromm A, Soder-

holm JD, Zeitz M, et al. Regulation of mucosal structure and

barrier function in rat colon exposed to TNFa and IFNg in

vitro: a novel model for studying pathomechanisms of IBD-

cytokines. Scand J Gastroenterol 2009;/44:/1226�35.

[10] Lim JW, Kim KH, Kim H. aPix interacts with Helicobacter

pylori CagA to induce IL-8 expression in gastric epithelial

cells. Scand J Gastroenterol 2009;/44:/1166�72.

[11] Riphaus A, Lechowicz I, Frenz MB, Wehrmann T. Propofol

sedation for upper GI endoscopy in patients with liver

cirrhosis as alternative to midazolam to avoid acute dete-

rioration of minimal encephalopathy: A randomized, con-

trolled study. Scand J Gastroenterol 2009;/44:/1244�51.

[12] Dam-Larsen S, Becker U, Franzmann M-B, Larsen K,

Christoffersen P, Bendtsen F. Final results of a long-term,

clinical follow-up in fatty liver patients. Scand J Gastro-

enterol 2009;/44:/1236�43.

[13] Andersson B, Andren-Sandberg A, Andersson R. Survey of

the management of pancreatic pseudocysts in Sweden.

Scand J Gastroenterol 2009;/44:/1252�8.

Editorial 1157

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