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4. Screening and Treatment Outcomes in Adults and Children With Type 1 Diabetes and Asymptomatic Celiac Disease: The CD-DIET Study

Author

Mahmud, Farid H., primary, Clarke, Antoine B.M., additional, Joachim, Kariym C., additional, Assor, Esther, additional, McDonald, Charlotte, additional, Saibil, Fred, additional, Lochnan, Heather A., additional, Punthakee, Zubin, additional, Parikh, Amish, additional, Advani, Andrew, additional, Shah, Baiju R., additional, Perkins, Bruce A., additional, Zuijdwijk, Caroline S., additional, Mack, David R., additional, Koltin, Dror, additional, De Melo, Emilia N., additional, Hsieh, Eugene, additional, Mukerji, Geetha, additional, Gilbert, Jeremy, additional, Bax, Kevin, additional, Lawson, Margaret L., additional, Cino, Maria, additional, Beaton, Melanie D., additional, Saloojee, Navaaz A., additional, Lou, Olivia, additional, Gallego, Patricia H., additional, Bercik, Premysl, additional, Houlden, Robyn L., additional, Aronson, Ronnie, additional, Kirsch, Susan E., additional, Paterson, William G., additional, and Marcon, Margaret A., additional

Published
2020
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12. Impact of a Gluten-Free Diet on Quality of Life and Health Perception in Patients With Type 1 Diabetes and Asymptomatic Celiac Disease.

Author

Weiman, Daniel I., Mahmud, Farid H., Clarke, Antoine B. M., Assor, Esther, McDonald, Charlotte, Saibil, Fred, Lochnan, Heather A., Punthakee, Zubin, Marcon, Margaret A., and CD-DIET Study Group

Subjects
TYPE 1 diabetes, CELIAC disease, GLUTEN-free diet, KETOACIDOSIS, OVERWEIGHT children, QUALITY of life, MEDICAL research, NURSING home residents, BLOOD sugar analysis, RESEARCH, RESEARCH methodology, SENSORY perception, PROGNOSIS, MEDICAL cooperation, EVALUATION research, COMPARATIVE studies, PATIENT compliance, LONGITUDINAL method
Abstract

Context: Celiac disease (CD) is a common comorbidity seen in patients with type 1 diabetes (T1D) and is frequently asymptomatic. As chronic conditions requiring significant lifestyle changes, there are limited reports assessing changes in health-related quality of life (HRQoL) during transition to a gluten-free diet (GFD) in patients with T1D who are asymptomatic for CD.Objective: This work aims to prospectively assess HRQoL and health perception in children and adults with T1D and asymptomatic CD after random assignment to GFD vs usual diet.Methods: Patients with T1D aged 8 to 45 years without CD symptoms were serologically screened for CD, with positive results confirmed with intestinal biopsy. Participants were randomly assigned in an open-label fashion to a GFD or gluten-containing diet (GCD) for 12 months. Generic and diabetes-specific HRQoL and self-perceived wellness (SPW) were assessed longitudinally.Results: A total of 2387 T1D patients were serologically screened. CD was biopsy-confirmed in 82 patients and 51 participants were randomly assigned to a GFD (N = 27) or GCD (N = 24). Excellent adherence to the assigned diets was observed. Overall, no changes in generic (P = .73) or diabetes-specific HRQoL (P = .30), or SPW (P = .41) were observed between groups over 12 months. Hemoglobin A1c (HbA1c) and gastrointestinal symptoms were consistent predictors of HRQoL and SPW.Conclusion: HRQoL and SPW were not significantly affected by the adoption of a GFD over 12 months, but worsened with symptom onset and increased HbA1c. Our findings indicate that transition to a GFD can be made successfully in this population without adversely affecting quality of life. [ABSTRACT FROM AUTHOR]

Published
2021
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13. Diagnostic Accuracy of Serologic Screening Tests for Celiac Disease in Asymptomatic Adults and Children with Type 1 Diabetes

Author

GOULD, MICHELLE, primary, MAHMUD, FARID H., additional, CLARKE, ANTOINE B., additional, ASSOR, ESTHER, additional, PARIKH, AMISH, additional, ADVANI, ANDREW, additional, PERKINS, BRUCE A., additional, SHAH, BAIJU R., additional, ZUIJDWIJK, CAROLINE S., additional, MCDONALD, CHARLOTTE, additional, MACK, DAVID, additional, KOLTIN, DROR, additional, HSIEH, EUGENE, additional, SZENTGYORGYI, EVA M., additional, SAIBIL, FRED, additional, MUKERJI, GEETHA, additional, LOCHNAN, HEATHER A., additional, GILBERT, JEREMY, additional, BAX, KEVIN, additional, LAWSON, MARGARET L., additional, BEATON, MELANIE D., additional, SALOOJEE, NAV A., additional, LOU, OLIVIA, additional, GALLEGO, PATRICIA H., additional, HOULDEN, ROBYN L., additional, ARONSON, RONNIE, additional, KIRSCH, SUSAN E., additional, PATERSON, WILLIAM G., additional, PUNTHAKEE, ZUBIN, additional, and MARCON, MARGARET A., additional

Published
2018
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14. Higher Rates of Celiac Disease Serology and Biopsy Positivity in Adults with Type 1 Diabetes

Author

MAHMUD, FARID H., primary, CLARKE, ANTOINE B., additional, JOACHIM, KARIYM C., additional, ASSOR, ESTHER, additional, PARIKH, AMISH, additional, ADVANI, ANDREW, additional, PERKINS, BRUCE A., additional, SHAH, BAIJU R., additional, ZUIJDWIJK, CAROLINE S., additional, MCDONALD, CHARLOTTE, additional, MACK, DAVID, additional, KOLTIN, DROR, additional, HSIEH, EUGENE, additional, SZENTGYORGYI, EVA M., additional, SAIBIL, FRED, additional, MUKERJI, GEETHA, additional, LOCHNAN, HEATHER A., additional, GILBERT, JEREMY, additional, BAX, KEVIN, additional, LAWSON, MARGARET L., additional, BEATON, MELANIE D., additional, SALOOJEE, NAV A., additional, LOU, OLIVIA, additional, GALLEGO, PATRICIA H., additional, HOULDEN, ROBYN L., additional, ARONSON, RONNIE, additional, KIRSCH, SUSAN E., additional, PATERSON, WILLIAM G., additional, PUNTHAKEE, ZUBIN, additional, and MARCON, MARGARET A., additional

Published
2018
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15. Frequency, Severity, and Associations of Gastrointestinal Symptoms in Adults and Children with Type 1 Diabetes

Author

MAHMUD, FARID H., primary, DE MELO, EMILIA NUNES, additional, CLARKE, ANTOINE B., additional, ASSOR, ESTHER, additional, PARIKH, AMISH, additional, ADVANI, ANDREW, additional, PERKINS, BRUCE A., additional, SHAH, BAIJU R., additional, ZUIJDWIJK, CAROLINE S., additional, MCDONALD, CHARLOTTE, additional, MACK, DAVID, additional, KOLTIN, DROR, additional, HSIEH, EUGENE, additional, SZENTGYORGYI, EVA M., additional, SAIBIL, FRED, additional, MUKERJI, GEETHA, additional, LOCHNAN, HEATHER A., additional, GILBERT, JEREMY, additional, BAX, KEVIN, additional, LAWSON, MARGARET L., additional, BEATON, MELANIE D., additional, SALOOJEE, NAV A., additional, LOU, OLIVIA, additional, GALLEGO, PATRICIA H., additional, HOULDEN, ROBYN L., additional, ARONSON, RONNIE, additional, KIRSCH, SUSAN E., additional, PATERSON, WILLIAM G., additional, PUNTHAKEE, ZUBIN, additional, and MARCON, MARGARET A., additional

Published
2018
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19. Methotrexate in Combination With Infliximab Is No More Effective Than Infliximab Alone in Patients With Crohn's Disease

Author

Feagan, Brian G., primary, McDonald, John W.D., additional, Panaccione, Remo, additional, Enns, Robert A., additional, Bernstein, Charles N., additional, Ponich, Terry P., additional, Bourdages, Raymond, additional, MacIntosh, Donald G., additional, Dallaire, Chrystian, additional, Cohen, Albert, additional, Fedorak, Richard N., additional, Paré, Pierre, additional, Bitton, Alain, additional, Saibil, Fred, additional, Anderson, Frank, additional, Donner, Allan, additional, Wong, Cindy J., additional, Zou, Guangyong, additional, Vandervoort, Margaret K., additional, Hopkins, Marybeth, additional, and Greenberg, Gordon R., additional

Published
2014
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22. How Well IsHelicobacter pyloriTreated in Usual Practice?

Author

Yogeswaran, Kumaresan, primary, Chen, Grant, additional, Cohen, Lawrence, additional, Cooper, Mary Anne, additional, Yong, Elaine, additional, Hsieh, Eugene, additional, Rowsell, Corwyn, additional, Saibil, Fred, additional, and Tinmouth, Jill, additional

Published
2011
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23. S1051 Methotrexate for the Prevention of Antibodies to Infliximab in Patients With Crohn's Disease

Author

Feagan, Brian G., primary, McDonald, John W., additional, Panaccione, Remo, additional, Enns, Robert A., additional, Bernstein, Charles N., additional, Ponich, Terry P., additional, Bourdages, Raymond, additional, MacIntosh, Donald G., additional, Dallaire, Chrystian, additional, Cohen, Albert, additional, Fedorak, Richard N., additional, Pare, Pierre, additional, Bitton, Alain, additional, Saibil, Fred, additional, Anderson, Frank, additional, Donner, Allan, additional, Wong, Cindy J., additional, Zou, Guang Yong, additional, Vandervoort, Margaret K., additional, Hopkins, Marybeth, additional, and Greenberg, Gordon R., additional

Published
2010
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24. Cyclooxygenase-2 Polymorphisms, Aspirin Treatment, and Risk for Colorectal Adenoma Recurrence—Data from a Randomized Clinical Trial

Author

Barry, Elizabeth L., primary, Sansbury, Leah B., additional, Grau, Maria V., additional, Ali, Iqbal U., additional, Tsang, Shirley, additional, Munroe, David J., additional, Ahnen, Dennis J., additional, Sandler, Robert S., additional, Saibil, Fred, additional, Gui, Jiang, additional, Bresalier, Robert S., additional, McKeown-Eyssen, Gail E., additional, Burke, Carol, additional, and Baron, John A., additional

Published
2009
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25. MTHFR Genotype and Colorectal Adenoma Recurrence: Data from a Double-blind Placebo-controlled Clinical Trial

Author

Levine, A. Joan, primary, Wallace, Kristin, additional, Tsang, Shirley, additional, Haile, Robert W., additional, Saibil, Fred, additional, Ahnen, Dennis, additional, Cole, Bernard F., additional, Barry, Elizabeth L., additional, Munroe, David J., additional, Ali, Iqbal U., additional, Ueland, Per, additional, and Baron, John A., additional

Published
2008
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26. A Randomized Trial of Methotrexate in Combination With Infliximab for the Treatment of Crohn's Disease

Author

Feagan, Brian, primary, McDonald, John W., additional, Panaccione, Remo, additional, Enns, Robert A., additional, Bernstein, Charles N., additional, Ponich, Terry P., additional, Bourdages, Raymond, additional, MacIntosh, Donald G., additional, Dallaire, Chrystian, additional, Cohen, Albert, additional, Fedorak, Richard, additional, Pare, Pierre, additional, Bitton, Alain, additional, Saibil, Fred, additional, Anderson, Frank, additional, Donner, Allan, additional, Wong, Cindy J., additional, Zou, Guang Yong, additional, Vandervoort, Margaret, additional, Hopkins, Marybeth, additional, and Greenberg, Gordon R., additional

Published
2008
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29. The Celiac Disease and Diabetes- Dietary Intervention and Evaluation Trial (CD-DIET) protocol: a randomised controlled study to evaluate treatment of asymptomatic coeliac disease in type 1 diabetes.

Author

Mahmud, Farid H., De Melo, Emilia N., Noordin, Karima, Assor, Esther, Sahota, Kamaljeet, Davies-Shaw, Jolie, Cutz, Ernest, Somers, Gino, Lawson, Margaret, Mack, David R., Gallego, Patricia, McDonald, Charlotte, Beaton, Melanie D., Bax, Kevin, Saibil, Fred, Gilbert, Jeremy, Kirsch, Susan, Perkins, Bruce A., Cino, Maria, and Szentgyorgyi, Eva

Abstract

Introduction: Coeliac disease (CD) is an autoimmune condition characterised by gluten-induced intestinal inflammation, and observed at a 5-10 fold greater prevalence in type 1 diabetes. While universal screening for CD in patients with diabetes is frequently advocated, objective data is limited as to benefits on diabetes control, bone health or quality of life related to the adoption of a gluten-free diet (GFD) in the large proportion of patients with diabetes with asymptomatic CD. The Celiac Disease and Diabetes-Dietary Intervention and Evaluation Trial (CD-DIET) study is a multicenter, randomised controlled trial to evaluate the efficacy and safety of a GFD in patients with type 1 diabetes with asymptomatic CD. Methods and analysis: Children and adults (8-45 years) with type 1 diabetes will be screened for asymptomatic CD. Eligible patients with biopsy-proven CD will be randomly assigned in a 1:1 ratio to treatment with a GFD for 1 year, or continue with a gluten-containing diet. The primary outcome will evaluate the impact of the GFD on change in glycated haemoglobin. Secondary outcomes will evaluate changes in bone mineral density, blood glucose variability and health-related quality of life between GFD-treated and the regular diet group over a 1-year period. The study was initiated in 2012 and has subsequently expanded to multiple paediatric and adult centres in Ontario, Canada. Ethics and dissemination: The findings from this study will provide high-quality evidence as to the impact of GFD treatment on glycaemic control and complications in asymptomatic children and adults with CD and type 1 diabetes. [ABSTRACT FROM AUTHOR]

Published
2015
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34. Omeprazole (20 mg daily) versus cimetidine (1200 mg daily) in duodenal ulcer healing and pain relief

Author

Archambault, Andre P., Pare, Pierre, Bailey, Robert J., Navert, Henri, Williams, C.Noel, Freeman, Hugh J., Baker, Selwyn J., Marcon, Norman E., Hunt, Richard H., Sutherland, Lloyd, Kepkay, David L., Saibil, Fred G., Hawken, Katherine, Farley, Alain, Levesque, Denis, Ferguson, James, and Westin, Jan-Ake

Abstract

We conducted a double-blind, randomized, parallel group study in 169 patients with acute duodenal ulcers to compare omeprazole, 20 mg daily, with cimetidine, 600 mg twice daily. After 2 wk, 58% of the omeprazole-treated patients and 46% of the cimetidine-treated patients were completely healed (p = 0.056). After 4 and 6 wk 84% and 88% healed with omeprazole, and 80% and 89% healed with cimetidine (p = NS). After 2 wk, pain was completely gone in 62% of the omeprazole-treated patients versus 46% of the cimetidine-treated patients (p = 0.04). Clinical or laboratory adverse events were reported in 6 (7%) of the omeprazole-treated patients and 11 (13%) of the cimetidine-treated patients (p = NS). An adverse event caused withdrawal of 1 patient on omeprazole (anxiety and depression) and 2 patients on cimetidine (diarrhea and fall in hemoglobin). We conclude that omeprazole (20 mg daily) resulted in a trend toward more rapid ulcer healing compared with a relatively high dose of cimetidine (600 mg b.i.d.), and was preferred by patients for relief of ulcer pain.

Published
1988
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35. 5-Aminosalicylic acid enema in the treatment of distal ulcerative colitis, proctosigmoiditis, and proctitis

Author

Sutherland, Lloyd R., Martin, Francois, Greer, Scott, Robinson, Malcolm, Greenberger, Norton, Saibil, Fred, Martin, Thomas, Sparr, Joseph, Prokipchuk, Ed, and Borgen, Lowell

Abstract

The efficacy and safety of 4-g 5-aminosalicylic acid enemas were assessed in 153 patients with ulcerative colitis involving up to 50 cm of distal colon. Seventy-six patients received active medication and 77 received a placebo. There were 20 dropouts (6 in the active group and 14 in the placebo group) during the study because of insufficient efficacy. After 6 wk of therapy, 48 of the 76 patients (63%) receiving 5-aminosalicylic acid were considered to be “much improved” by the study physician compared to 22 of the 77 patients (29%) on placebo (p = 0.001). A disease activity index based on patient symptoms and sigmoidoscopic appearance was used to assess efficacy. Mean disease activity index declined 55% for patients on 5-aminosalicylic acid and 24% for patients on placebo (p = 0.0001). Analysis of subgroups indicated that patients most likely to respond were those with disease confined to the 20–40 cm from the anus. Response was not affected by concurrent sulfasalazine, but patients requiring concurrent oral steroids had a diminished response. Rapid onset of efficacy was shown by a significant reduction in rectal bleeding within 3 days of treatment initiation. 5-Aminosalicylic acid enemas are well tolerated and are of benefit in the treatment of ulcerative colitis confined to the distal colon.

Published
1987
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37. How Well Is Helicobacter pylori Treated in Usual Practice?

Author

Yogeswaran, Kumaresan, Chen, Grant, Cohen, Lawrence, Anne Cooper, Mary, Yong, Elaine, Hsieh, Eugene, Rowsell, Corwyn, Saibil, Fred, and Tinmouth, Jill

Abstract

BACKGROUND: Helicobacter pylori is a WHO class I carcinogen also associated with nonmalignant gastrointestinal diseases. Effective treatment exists, and all persons infected with H pylori should receive treatment. However, data regarding the rates of treatment prescription in clinical practice are lacking.OBJECTIVE: To determine the rates of H pylori treatment in usual practice.METHODS: Patients with histological evidence of H pylori infection between January 1, 2007, and December 31, 2007, at Sunnybrook Health Sciences Centre (Toronto, Ontario) were identified. Charts were reviewed to determine the rates of H pylori treatment and confirmation of eradication, when indicated. Questionnaires were subsequently sent to endoscopists of patients identified as not having received treatment to determine the reasons for lack of treatment.RESULTS: A total of 102 patients were H pylori positive and were appropriate candidates for treatment, of whom 58 (57%) were male and 78 (76%) were outpatients, with 92 (90%) receiving eradication therapy. When indicated, 15 of 22 (68%) patients received confirmation of eradication, 13 of 18 (72%) patients underwent repeat endoscopy and 86% received complete therapy. Outpatients were more likely to receive eradication therapy (OR 10.3 [95% CI 2.6 to 40.4]; P=0.001) and complete therapy (OR 13.2 [95% CI 3.8 to 45.7]; P=0.0001) compared with inpatients. Having a follow-up appointment resulted in higher treatment rates (OR 12.0 [95% CI 3.0 to 47.5]; P=0.001).CONCLUSION: During the time period studied, adequate rates of H pylori treatment were achieved in outpatients and patients who had formal follow-up at Sunnybrook Health Sciences Centre. However, some aspects of care remain suboptimal including treatment of inpatients and care following treatment. Additional studies are required to identify strategies to improve the care of patients infected with H pylori.

Published
2011
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38. Two for One: Coexisting Ulcerative Colitis and Crohn’s Disease

Author

I Chen, Grant, Saibil, Fred, and Morava-Protzner, Izabella

Abstract

Three cases of coexisting ulcerative colitis and Crohn’s disease are presented. In the first case, the patient had a long-standing history of ulcerative proctitis before developing Crohn’s colitis. In the two remaining cases, the patients presented initially with Crohn’s disease of the ileum and, subsequent to resection, developed ulcerative colitis. Well-documented cases of patients diagnosed with both ulcerative colitis and Crohn’s disease are rare. The literature on such cases is reviewed, and the controversy over whether ulcerative colitis and Crohn’s disease are two distinct diseases is explored.

Published
2002
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39. Sorbitol: Often forgotten cause of osmotic diarrhea.

Author

Liauw S and Saibil F

Subjects
Chronic Disease, Female, Humans, Middle Aged, Osmolar Concentration, Sorbitol administration & dosage, Chewing Gum adverse effects, Diarrhea chemically induced, Sorbitol adverse effects
Published
2019

41. Inflammatory pouch disease: The spectrum of pouchitis.

Author

Zezos P and Saibil F

Subjects
Humans, Pouchitis classification, Pouchitis diagnosis, Pouchitis therapy, Predictive Value of Tests, Prognosis, Risk Factors, Terminology as Topic, Pouchitis etiology, Proctocolectomy, Restorative adverse effects
Abstract

Restorative proctocolectomy with ileal-pouch anal anastomosis (IPAA) is the operation of choice for medically refractory ulcerative colitis (UC), for UC with dysplasia, and for familial adenomatous polyposis (FAP). IPAA can be a treatment option for selected patients with Crohn's colitis without perianal and/or small bowel disease. The term "pouchitis" refers to nonspecific inflammation of the pouch and is a common complication in patients with IPAA; it occurs more often in UC patients than in FAP patients. This suggests that the pathogenetic background of UC may contribute significantly to the development of pouchitis. The symptoms of pouchitis are many, and can include increased bowel frequency, urgency, tenesmus, incontinence, nocturnal seepage, rectal bleeding, abdominal cramps, and pelvic discomfort. The diagnosis of pouchitis is based on the presence of symptoms together with endoscopic and histological evidence of inflammation of the pouch. However, "pouchitis" is a general term representing a wide spectrum of diseases and conditions, which can emerge in the pouch. Based on the etiology we can sub-divide pouchitis into 2 groups: idiopathic and secondary. In idiopathic pouchitis the etiology and pathogenesis are still unclear, while in secondary pouchitis there is an association with a specific causative or pathogenetic factor. Secondary pouchitis can occur in up to 30% of cases and can be classified as infectious, ischemic, non-steroidal anti-inflammatory drugs-induced, collagenous, autoimmune-associated, or Crohn's disease. Sometimes, cuffitis or irritable pouch syndrome can be misdiagnosed as pouchitis. Furthermore, idiopathic pouchitis itself can be sub-classified into types based on the clinical pattern, presentation, and responsiveness to antibiotic treatment. Treatment differs among the various forms of pouchitis. Therefore, it is important to establish the correct diagnosis in order to select the appropriate treatment and further management. In this editorial, we present the spectrum of pouchitis and the specific features related to the diagnosis and treatment of the various forms.

Published
2015
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42. Inflammatory bowel disease and thromboembolism.

Author

Zezos P, Kouklakis G, and Saibil F

Subjects
Blood Coagulation, Humans, Inflammation Mediators blood, Inflammatory Bowel Diseases blood, Inflammatory Bowel Diseases physiopathology, Inflammatory Bowel Diseases therapy, Prognosis, Risk Assessment, Risk Factors, Thromboembolism blood, Thromboembolism physiopathology, Thromboembolism prevention & control, Inflammatory Bowel Diseases epidemiology, Thromboembolism epidemiology
Abstract

Patients with inflammatory bowel disease (IBD) have an increased risk of vascular complications. Thromboembolic complications, both venous and arterial, are serious extraintestinal manifestations complicating the course of IBD and can lead to significant morbidity and mortality. Patients with IBD are more prone to thromboembolic complications and IBD per se is a risk factor for thromboembolic disease. Data suggest that thrombosis is a specific feature of IBD that can be involved in both the occurrence of thromboembolic events and the pathogenesis of the disease. The exact etiology for this special association between IBD and thromboembolism is as yet unknown, but it is thought that multiple acquired and inherited factors are interacting and producing the increased tendency for thrombosis in the local intestinal microvasculature, as well as in the systemic circulation. Clinicians' awareness of the risks, and their ability to promptly diagnose and manage tromboembolic complications are of vital importance. In this review we discuss how thromboembolic disease is related to IBD, specifically focusing on: (1) the epidemiology and clinical features of thromboembolic complications in IBD; (2) the pathophysiology of thrombosis in IBD; and (3) strategies for the prevention and management of thromboembolic complications in IBD patients.

Published
2014
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43. How well is Helicobacter pylori treated in usual practice?

Author

Yogeswaran K, Chen G, Cohen L, Cooper MA, Yong E, Hsieh E, Rowsell C, Saibil F, and Tinmouth J

Subjects
Aged, Ambulatory Care standards, Endoscopy, Gastrointestinal, Female, Helicobacter Infections diagnosis, Humans, Male, Middle Aged, Helicobacter Infections drug therapy, Helicobacter pylori, Practice Patterns, Physicians' standards
Abstract

Background: Helicobacter pylori is a WHO class I carcinogen also associated with nonmalignant gastrointestinal diseases. Effective treatment exists, and all persons infected with H pylori should receive treatment. However, data regarding the rates of treatment prescription in clinical practice are lacking., Objective: To determine the rates of H pylori treatment in usual practice., Methods: Patients with histological evidence of H pylori infection between January 1, 2007, and December 31, 2007, at Sunnybrook Health Sciences Centre (Toronto, Ontario) were identified. Charts were reviewed to determine the rates of H pylori treatment and confirmation of eradication, when indicated. Questionnaires were subsequently sent to endoscopists of patients identified as not having received treatment to determine the reasons for lack of treatment., Results: A total of 102 patients were H pylori positive and were appropriate candidates for treatment, of whom 58 (57%) were male and 78 (76%) were outpatients, with 92 (90%) receiving eradication therapy. When indicated, 15 of 22 (68%) patients received confirmation of eradication, 13 of 18 (72%) patients underwent repeat endoscopy and 86% received complete therapy. Outpatients were more likely to receive eradication therapy (OR 10.3 [95% CI 2.6 to 40.4]; P=0.001) and complete therapy (OR 13.2 [95% CI 3.8 to 45.7]; P=0.0001) compared with inpatients. Having a follow-up appointment resulted in higher treatment rates (OR 12.0 [95% CI 3.0 to 47.5]; P=0.001)., Conclusion: During the time period studied, adequate rates of H pylori treatment were achieved in outpatients and patients who had formal follow-up at Sunnybrook Health Sciences Centre. However, some aspects of care remain suboptimal including treatment of inpatients and care following treatment. Additional studies are required to identify strategies to improve the care of patients infected with H pylori.

Published
2011
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