Familial aggregation of inflammatory bowel disease: a population-based study in South Limburg, The Netherlands. The South Limburg IBD Study Group.

BACKGROUND: The aim of our study was to investigate the prevalence of Crohn's disease (CD) and ulcerative colitis (UC) in first-degree relatives of IBD patients living in a well-defined area. METHODS: IBD patients known at the IBD Registration South Limburg as well as population controls were asked about the occurrence of IBD in their first-degree relatives. RESULTS: IBD was reported and confirmed in 16 (out of 1554) relatives by 11 (out of 245) patients. Prevalence of IBD was highest for siblings (1.5%) and children (1.3%), while only 0.2% of the parents were affected with IBD. Among relatives of the control subjects, IBD was observed in 0.8% (versus 4.5% in IBD patients), resulting in an odds ratio of 5.7 (95% CI: 2.0-16.7). CONCLUSIONS: The observed risk of IBD for first-degree relatives of IBD patients was higher than in controls. However, the risk in our population is lower than has been reported by other centres, possibly because of the population-based character of our study.

[Transanal resection of large sessile rectal polyps]. / Transanale resectie van grote sessiele poliepen van het rectum.

OBJECTIVE: To assess the safety and effectiveness of transanal resection of large rectal adenomas. DESIGN: Retrospective. SETTING: Department of Surgery, University Hospital Maastricht, the Netherlands. METHOD: 35 patients underwent transanal resection of large rectal polyps. These cases were analysed as to the accuracy of preoperative biopsies, complication rate, recurrence rate and value of endoscopic follow-up. RESULTS: Preoperative biopsies proved to be unreliable: in 49% of the cases histology of the whole specimen matched with the result of the biopsy. Five patients showed adenocarcinoma in the definite specimen, they were treated successfully by low anterior resection or rectum extirpation following the transanal resection. Six patients developed complications. In 1 patient this resulted in a colostomy. The average follow-up was 45 months. Sixty per cent of the patients in whom an adenoma or a carcinoma in situ was removed developed a recurrent adenoma. Recurrent adenomas were all treated by endoscopic polypectomy. CONCLUSION: Transanal resection of large rectal adenomas is a safe and effective method of treatment. However, the high recurrence requires frequent endoscopy.