Omega-3 fatty acids did not show an effect on extending the remission in Crohn's disease. For the diet patients the question remains whether the noncompliant patients dropped out early because they sensed a relapse approaching or whether their condition deteriorated because they failed to comply with the diet.
It is known that only a minority of patients with faecal incontinence report these symptoms to their physicians. Epidemiological estimates based on medical chart data, therefore, may contain a detection bias. To evaluate such bias in epidemiological data, we evaluated prospectively the presence of faecal incontinence in selected patient groups with a proven high incidence of such symptoms and compared it to the incidence in a group of healthy controls. If the patient acknowledged faecal incontinence in the questionnaire, the medical chart was checked to see if these symptoms had been noted during previous work-up; this was used to estimate the number of unregistered cases if the epidemiological estimate is based on medical chart data. The incidence of incontinence was significantly elevated in all patient groups as compared to the controls, but only up to 5% of patients with faecal incontinence, regardless of the underlying mechanism, had these incontinence symptoms noted in the medical charts. We conclude that for the estimation of the prevalence and incidence of faecal incontinence, data from medical charts contain a detection bias which systematically underestimates the real presence of faecal incontinence.
We have analysed the pedigrees of 265 probands with Crohn disease, collected from a specialty clinic at the University of Düsseldorf. Complex segregation analysis suggests the presence of a recessive gene with incomplete penetrance for susceptibility to the disease with no residual causes of family resemblance. However, a proportion of the isolated cases are probably due to phenocopies, this proportion being greatest among cases with an advanced age of onset.
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