RAPID RESPONSES FROM BMJ.COM

doi:10.1136/bmjusa.01050004

BMJ, doi: 10.1136/bmjusa.01050004, (Published 5 September 2002)

Letters

RAPID RESPONSES FROM BMJ.COM

As of April 13th, three e-letters had been posted on bmj.com in response to the paper by Delaney. They are reproduced below in abbreviated form. $---$ Editor

What about dysphagia as an "alarm symptom"?

Don't forget about lactose intolerance

Dyspepsia: a missed opportunity in detecting early-stage cancer

What about dysphagia as an "alarm symptom"?

The first 150 words of the full text of this article appear below.

This article originally appeared in BMJ USA

EDITOR $---$ I think the "10-minute consultation" series is an excellent addition to the BMJ. Why was dysphagia not included inthe list of "alarm symptoms"?

Ross Upshur, assistant professor.
Sunnybrook and Women's College Health Sciences Centre,Toronto, Canada rupshur@idirect.com

Don't forget about lactose intolerance

EDITOR $---$ Lactose intolerance is one of the most common etiologies within all communities. In a selected population presentingwith gastrointestinal problems or to gastroenterologists for endoscopy/consultation,about two in five patients will have coexistent lactoseintolerance.

Biopsies taken for small bowel histology and enzymes/disacharridases in all patients with non-ulcer dyspepsia will identifyconcomitant lactose intolerance and, occasionally, gluten sensitivity.Lactase levels will identify mild, moderate, or severe degreesof lactose in- tolerance and will generally correlate with symptomseverity.

Ric Reiner, gastroenterologist.
Mackay Hospital, Queensland 4740, Australia rereiner@ozemail.com.au

Dyspepsia: a missed opportunity in detecting early-stage cancer

EDITOR $---$ What a shame that Delaney missed an opportunity to educate primary health care physicians about common misconceptionsconcerningdyspepsia.

The greatest pitfall for any doctor seeing patients with this common symptom is to incorrectly . . . [Full text of this article]