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Fibre supplementation increased the risk for recurrent adenomas, and calcium supplementation did not prevent recurrence
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 QUESTION: In patients with colorectal adenomas, does supplementation with ispaghula husk or calcium prevent adenoma recurrence?

Design

Randomised (allocation concealed*), blinded (patients, clinical staff, and investigators),* placebo controlled trial with 3 years follow up.

Setting

21 centres in 10 countries (Belgium, Denmark, France, Germany, Ireland, Israel, Italy, Portugal, Spain, and the UK).

Patients

665 patients who were 35–75 years of age, had a complete index colonoscopy showing ≥2 adenomas or 1 adenoma of >5 mm in diameter, and did not have a debilitating or life threatening disease. Exclusion criteria were history of large bowel disease, contraindications to calcium or fibre, or inability or unwillingness to stop current fibre or calcium supplementation. 552 patients (83%, mean age 59 y, 64% men) …

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