[Rectal bleeding during pregnancy]. / Rectaal bloedverlies tijdens de zwangerschap.

BACKGROUND: Ischaemic colitis is a relatively rare disease that predominantly affects elderly patients. This disorder has varying underlying causes and diverse clinical symptoms. CASE DESCRIPTION: A 29-year-old primigravida was admitted to our hospital with rectal bleeding and diffuse abdominal pain. The number of leucocytes and the CRP were elevated. Because the patient was pregnant a sigmoidoscopy without sedation was performed. The endoscopic image and histopathology of the biopsies revealed ischaemic colitis. Our patient recovered quickly under conservative treatment. CONCLUSION: Ischaemic colitis is usually self-limiting and a conservative treatment will suffice. Ischaemic colitis during pregnancy has been reported extremely rarely and the aetiology is unknown.

[Calcium suppletion for patients who use gastric acid inhibitors: calcium citrate or calcium carbonate?]. / Calciumsuppletie bij patiënten met maagzuurremmers: calciumcitraat of calciumcarbonaat?

Various calcium supplements are available for patients who have an indication for calcium suppletion. American guidelines and UpToDate recommend prescribing calcium citrate to patients who use antacids The rationale for this advice is that water-insoluble calcium carbonate needs acid for adequate absorption. No convincing scientific evidence supporting the advice to prescribe calcium citrate instead of calcium carbonate to patients who also take antacids is available, and therefore deserves further investigation. On the contrary, the fact that calcium carbonate does not need acid in order to be absorbed, has also not been proven. In clinical practise, it appears important that calcium is taken with meals in order to improve its absorption.