The British journal of surgery
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Randomized Controlled Trial Clinical Trial
Prospective randomized study of sulindac versus calcium and calciferol for upper gastrointestinal polyps in familial adenomatous polyposis.
Eighteen patients with familial adenomatous polyposis (FAP) who had previously undergone colectomy but had upper gastrointestinal polyps were studied in a double-blind randomized crossover trial comparing sulindac with calcium and calciferol. Sulindac produced a reduction in the crypt proliferation index in the gastric epithelium of patients but did not significantly affect duodenal mucosa. Calcium with calciferol did not have any effects on crypt proliferation index in patients with FAP.
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Despite the increasing emphasis that is placed on both pH measurement and oesophageal manometry, there is little consensus about their usefulness in the clinical setting. These tests are far from infallible and it is difficult to support their universal application in patients with gastrooesophageal reflux disease. Nevertheless, these imperfect tests are useful in certain situations and clinicians must strive to use them intelligently for those most likely to benefit.