A meta-analysis of 31 studies involving more than 120,000 subjects showed that fecal immunochemical testing (FIT test) was accurate in screening for colon cancer, but not in finding advanced pre-malignant polyps. If your goal is to find the pre-cancerous polyp before it transforms into a malignancy, than colonoscopy is still the best choice. Annals of Internal Medicine March 2019. MS
It is well established that the risk of colorectal cancer (CRC) is increased if a first degree relative (parent, brother, sister) has had CRC. What is the risk if CRC was found in a second degree relative (grandparent, aunt, uncle)? A huge study in Sweden looked at 16 million individuals over more than 50 years. There was only a minor, insignificant increased risk if a second degree relative was affected. Interestingly, the risk if a half-sibling had CRC was the same as if a full sibling did. British Medical Journal March 2019. MS
Harvard Medical Center randomized more than 25,000 men and women to take either Vitamin D supplementation or placebo for more than 5 years. There were no differences in the chance of strokes, heart attacks, or cancer and this finding was true for both those who started with normal Vitamin D levels, or with low levels. This was a high quality, low risk of bias study, so the conclusions are valid. New England Journal of Medicine, Jan 2019.
Fish oil (also called N-3 or omega-3 fatty acids) have been recommended in the past to decrease the chance of heart attacks and strokes. Harvard Medical Center sponsored a huge study involving more than 25,000 adults. The study included men and women, and all racial groups. These were individuals who did not have risk factors for cardiovascular disease, such as Diabetes, Hypertension, or elevated cholesterol. After more than 5 years, there was no difference between the fish oil and the placebo groups with regard to heart attacks, strokes, cancer, or all cause mortality. This was a high quality study with a low risk of bias, so its conclusion, that fish oil supplement is not worthwhile, is valid. New England Journal of Medicine, Jan 2019.
Patients with microscopic/lymphocytic colitis were randomized to treatment with mesalamine, budesonide, or placebo. The mesalamine group did no better than placebo, but the budesonide patients improved nicely. Gastroenterology, December 2018.
It is well established that FMT is highly effective in recurrent C diff infections. FMT has been tried in many other illnesses, including obesity, autism, schizophrenia, irritable bowel syndrome, ulcerative colitis, Crohn’ Disease, and many others. British investigators surveyed all the relevant studies that looked at other illnesses, and there was no compelling evidence that favored the use of FMT in any situation other than recurrent C diff. Digestive Diseases and Sciences, November 2018.
866 Canadian children with severe gastroenteritis were randomized to a different probiotic than the one used in the US study, brand name Lacidophil Strong, or placebo. As in the US study, there was no difference in time to illness resolution or spread to family members. Again, this was a high quality, low risk of bias study. New England Journal of Medicine, November 2018.
In a US study, 971 children with severe gastroenteritis were randomized to a probiotic (Culturelle) or placebo. There was no difference in length of illness, spread to family members, or days missed from Daycare/Preschool. This is a high quality, low risk of bias, which is unusual in the probiotic literature. New England Journal of Medicine, November 2018.
A study from the UK and Canada followed more than 2500 patients with Barrett’s Esophagus for an average of 9 years, and divided them into two groups: Nexium 20 mg a day and Nexium 40 mg twice a day. The high dose group had fewer numbers of esophageal cancer or High Grade Dysplasia (a precursor of cancer) than the low dose group. There were no adverse effects from either dose of long term Nexium. Lancet, Aug 2018.
It is well established that Irritable Bowel Syndrome (IBS) can develop following a gastrointestinal infection. In Bergen, Norway, in 2004, there was an outbreak of Giardia from a contaminated water source. Researchers followed 1252 laboratory confirmed cases of Giardia for 6 years and also 2500 age-matched individuals from Bergen who did not contract Giardia. Of the group who had (and cleared) Giardia, 43 % developed IBS over 6 years compared to 14% of the group who did not get Giardia. In the four subsequent years, almost no new cases of IBS arose. From Clinical Gastroenterology and Hepatology July 2018.