Can NOW Supplements Vitamin D-3 Help with Gastritis?
Research Authors
Overview
SCIENTIFIC SCORE
Possibly Effective
Based on 7 Researches
7.8
USERS' SCORE
Good
Based on 5 Reviews
8.3
Supplement Facts
Serving Size: 1 Softgel
Amount Per Serving
%DV
Vitamin D3 (as Cholecalciferol) (from Lanolin)
125 mcg (5,000 IU)
625%
Top Medical Research Studies
8
Vitamin D3 benefits gastritis treatment
[Vitamin D3 alleviates the gastritis that associated with Helicobacter pylori infection in mice with hypercholesterolemia by enhancing the activity of vitamin D receptors in the liver tissue and blocking the signaling pathway of JAK/STAT3].
We investigated the impact of vitamin D3 (VD3) on gastritis, especially concerning Helicobacter pylori (Hp) infections and high cholesterol levels. Mice were used to establish conditions of hypercholesterolemia and Hp infection, allowing us to assess the effectiveness of VD3 over an eight-week treatment period.
Throughout the study, we observed significant improvements in the liver and gastric tissues of mice that received VD3. Specifically, levels of vitamin D receptors and Insig-2 increased in the liver, while serum gastrin levels decreased, indicating a positive response to the treatment. We also noted a reduction in inflammatory markers associated with the JAK/STAT3 signaling pathway, which suggests that VD3 plays a role in alleviating inflammation linked to gastritis.
Importantly, alongside these findings, we observed improvements in liver health, as the treatment reduced hepatic ballooning and gastric tissue inflammation in the high cholesterol and Hp infected groups. Overall, our results illustrate that VD3 is a promising aid in alleviating gastritis related to both high cholesterol and Hp, potentially through its mechanism of enhancing liver health and disrupting inflammatory pathways.
Read More
9.5
Vitamin D's role in gastritis recovery
A failing to thrive 18 month old with vitamin D deficiency rickets and Helicobacter pylori gastritis.
We observed an intriguing case involving an 18-month-old girl who struggled with vomiting, diarrhea, and failure to thrive. Initially, she was exclusively breastfed, and her blood tests revealed a vitamin D deficiency paired with low calcium and phosphorus levels. After regular vitamin D and calcium supplementation was initiated, her condition presented further challenges, including lower-limb bowing and irritability.
As time went on, despite an increase in her vitamin D dosage, her growth velocity stagnated, and gastrointestinal symptoms persisted. To deepen our understanding, an endoscopic examination was performed which identified Helicobacter pylori gastritis, a bacterial infection in the stomach lining. Following the eradication of H. pylori, we noted a significant improvement in her growth and overall activity levels.
Interestingly, after six months of follow-up, there were no signs of rickets, showcasing an impressive turnaround. While we recognize that vitamin D was part of her treatment regimen, it’s essential to note that the significant improvement can largely be attributed to addressing the H. pylori infection. This highlights the complex interplay between vitamin deficiencies and gastrointestinal health in children.
Read More
8
Vitamin D impacts gastritis treatment
The effect of vitamin D deficiency on eradication rates of infection.
We explored the effect of vitamin D levels on the success of treatment for gastritis, particularly focusing on the bacteria known as H. pylori. In our study, we included 150 patients diagnosed with gastritis, measuring their serum 25-hydroxy-vitamin D (25[OH]D) levels before starting a 14-day clarithromycin-based triple therapy.
After treatment, we assessed whether the bacteria were successfully eradicated using a stool antigen test. Our findings showed that a significant number of patients, specifically 70%, successfully eradicated the infection, while 30% did not.
Notably, we observed that those who had low vitamin D levels—defined as less than 20 ng/mL—had higher rates of treatment failure compared to those with sufficient vitamin D levels. This suggests that vitamin D deficiency could be a factor affecting the success of gastritis treatment.
Overall, our results highlight the potential importance of vitamin D in improving treatment outcomes for gastritis linked to H. pylori. We believe further research, particularly randomized trials assessing vitamin D supplementation in this context, is necessary to better understand its role.
Read More
Most Useful Reviews
9
Successful vitamin D boost
Excellent product! After battling a severe vitamin D deficiency, I began with 5,000 for a month, then 10,000 for two months. My vitamin D levels rose significantly, and I experienced no pain or heartburn, even with gastritis.
Read More
7.5
Mood improvement
1 people found this helpful
A good product; my husband and I have already consumed several packages. My mood is excellent, and my vitamin levels have increased, with no side effects despite my gastritis.
Read More
7.5
Stomach-friendly capsules
The capsules are a good size and do not negatively affect my chronic gastritis. They are easy to swallow, and I can adjust my daily dosage as needed.
We observed an intriguing case involving an 18-month-old girl who struggled with vomiting, diarrhea, and failure to thrive. Initially, she was exclusively breastfed, and her blood tests revealed a vitamin D deficiency paired with low calcium and phosphorus levels. After regular vitamin D and calcium supplementation was initiated, her condition presented further challenges, including lower-limb bowing and irritability.
As time went on, despite an increase in her vitamin D dosage, her growth velocity stagnated, and gastrointestinal symptoms persisted. To deepen our understanding, an endoscopic examination was performed which identified Helicobacter pylori gastritis, a bacterial infection in the stomach lining. Following the eradication of H. pylori, we noted a significant improvement in her growth and overall activity levels.
Interestingly, after six months of follow-up, there were no signs of rickets, showcasing an impressive turnaround. While we recognize that vitamin D was part of her treatment regimen, it’s essential to note that the significant improvement can largely be attributed to addressing the H. pylori infection. This highlights the complex interplay between vitamin deficiencies and gastrointestinal health in children.
Read More
8
Vitamin D3 benefits gastritis treatment
[Vitamin D3 alleviates the gastritis that associated with Helicobacter pylori infection in mice with hypercholesterolemia by enhancing the activity of vitamin D receptors in the liver tissue and blocking the signaling pathway of JAK/STAT3].
We investigated the impact of vitamin D3 (VD3) on gastritis, especially concerning Helicobacter pylori (Hp) infections and high cholesterol levels. Mice were used to establish conditions of hypercholesterolemia and Hp infection, allowing us to assess the effectiveness of VD3 over an eight-week treatment period.
Throughout the study, we observed significant improvements in the liver and gastric tissues of mice that received VD3. Specifically, levels of vitamin D receptors and Insig-2 increased in the liver, while serum gastrin levels decreased, indicating a positive response to the treatment. We also noted a reduction in inflammatory markers associated with the JAK/STAT3 signaling pathway, which suggests that VD3 plays a role in alleviating inflammation linked to gastritis.
Importantly, alongside these findings, we observed improvements in liver health, as the treatment reduced hepatic ballooning and gastric tissue inflammation in the high cholesterol and Hp infected groups. Overall, our results illustrate that VD3 is a promising aid in alleviating gastritis related to both high cholesterol and Hp, potentially through its mechanism of enhancing liver health and disrupting inflammatory pathways.
Read More
8
Vitamin D3 enhances treatment success
Influence of adding vitamin D3 to standard clarithromycin-based triple therapy on the eradication rates of Helicobacter pylori infection.
We explored whether adding vitamin D3 to standard treatment for Helicobacter pylori (H. pylori) could help improve eradication rates in patients with gastritis. In a recent study, 150 patients diagnosed with H. pylori gastritis were divided into two groups. One group received the standard clarithromycin-based treatment, while the other group was given vitamin D3 along with the same antibiotics.
After the treatment, we assessed the success of eradication using stool tests conducted four weeks later. Results indicated that adding vitamin D3 led to significantly higher eradication rates of H. pylori compared to the standard treatment alone. This suggests that vitamin D3 may play an additional role in enhancing treatment effectiveness.
However, it's important to note that by integrating vitamin D3 into a multi-faceted treatment plan, we cannot fully isolate its independent effects on gastritis. Still, the findings highlight the potential benefits of incorporating vitamin D3 in conventional therapy for better outcomes.
Read More
8
Vitamin D impacts gastritis treatment
The effect of vitamin D deficiency on eradication rates of infection.
We explored the effect of vitamin D levels on the success of treatment for gastritis, particularly focusing on the bacteria known as H. pylori. In our study, we included 150 patients diagnosed with gastritis, measuring their serum 25-hydroxy-vitamin D (25[OH]D) levels before starting a 14-day clarithromycin-based triple therapy.
After treatment, we assessed whether the bacteria were successfully eradicated using a stool antigen test. Our findings showed that a significant number of patients, specifically 70%, successfully eradicated the infection, while 30% did not.
Notably, we observed that those who had low vitamin D levels—defined as less than 20 ng/mL—had higher rates of treatment failure compared to those with sufficient vitamin D levels. This suggests that vitamin D deficiency could be a factor affecting the success of gastritis treatment.
Overall, our results highlight the potential importance of vitamin D in improving treatment outcomes for gastritis linked to H. pylori. We believe further research, particularly randomized trials assessing vitamin D supplementation in this context, is necessary to better understand its role.
Read More
7
Vitamin D deficiency in CAAG
Relevance of vitamin D deficiency in patients with chronic autoimmune atrophic gastritis: a prospective study.
We examined the connection between vitamin D deficiency and chronic autoimmune atrophic gastritis (CAAG), a condition that hampers vitamin absorption due to changes in stomach function. In our study, we evaluated 87 patients diagnosed with CAAG, focusing on their vitamin D levels compared to a control group of 1,232 healthy individuals.
Our findings revealed a significant reduction in vitamin D, specifically the 25-OH-Vitamin D levels, among the CAAG patients. The average 25-OH-Vitamin D level was 18.8 ng/ml in CAAG patients, markedly lower than the 27.0 ng/ml found in healthy individuals. Moreover, we discovered that more than half of the patients had levels below the normal threshold, which might indicate an issue with vitamin absorption due to their condition.
Interestingly, this study also highlighted a possible correlation between lower vitamin D levels and the severity of gastric atrophy, as patients with moderate or severe atrophy had even lower vitamin D levels than those with milder forms. Additionally, patients with gastric carcinoids exhibited the lowest vitamin D levels, suggesting a potential relationship between vitamin D deficiency and certain complications of CAAG.
Despite our insights into vitamin D deficiency in CAAG, we didn't delve deeply into the effects of vitamin D treatment on gastritis specifically. Therefore, while there seems to be a notable deficit in vitamin D among these patients, the implications for treatment remain unclear, emphasizing an area for future exploration.
Excellent product! After battling a severe vitamin D deficiency, I began with 5,000 for a month, then 10,000 for two months. My vitamin D levels rose significantly, and I experienced no pain or heartburn, even with gastritis.
Read More
7.5
Mood improvement
1 people found this helpful
A good product; my husband and I have already consumed several packages. My mood is excellent, and my vitamin levels have increased, with no side effects despite my gastritis.
Read More
7.5
Stomach-friendly capsules
The capsules are a good size and do not negatively affect my chronic gastritis. They are easy to swallow, and I can adjust my daily dosage as needed.
Read More
7.5
No adverse reactions
Perfect! This vitamin works well with my gastritis. The small capsules are easy to swallow and cause no unpleasant aftertaste. My test results show they are effective, but remember that excess vitamin D can be dangerous.
Read More
7.5
Easily absorbed vitamins
Small capsules are easy to take, as advised by my gastroenterologist. They enhance absorption, especially beneficial for my gastritis. A jar lasts long, and I take 10,000 daily with omega-3 during breakfast.
Read More
Frequently Asked Questions
Gastritis is an inflammation of the stomach lining, which can lead to a range of symptoms including abdominal pain, nausea, vomiting, and indigestion. This condition can be acute, arising suddenly and lasting for a short period, or chronic, developing gradually and persisting over time. Various factors can contribute to gastritis, such as excessive alcohol consumption, prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs), bacterial infections (most notably Helicobacter pylori), and autoimmune disorders.
Treatment for gastritis often focuses on addressing the underlying cause and might include medications to reduce stomach acid, antibiotics for infections, and lifestyle modifications like avoiding irritating foods and beverages. While many people recover from gastritis with adequate care, it's important to consult a healthcare professional for a proper diagnosis and treatment plan. If left untreated, gastritis can lead to more serious complications, such as stomach ulcers or even an increased risk for gastric cancer.
Vitamin D is a fat-soluble vitamin that's essential for maintaining healthy bones and teeth, supporting immune system function, and facilitating normal cell growth and development. It plays a crucial role in calcium absorption in the gut, which is vital for bone health. Unlike most vitamins, our bodies can produce Vitamin D when exposed to sunlight, specifically UVB rays, which is why it’s often referred to as the "sunshine vitamin." However, depending on your geographical location, lifestyle, and skin type, getting sufficient Vitamin D from the sun alone can be challenging, particularly during the winter months.
In addition to sunlight, Vitamin D can be obtained from certain foods such as fatty fish (like salmon and mackerel), fish liver oils, and fortified foods like milk and cereals. Some individuals may also consider supplements, especially if they're at risk for deficiency. Insufficient vitamin D levels are linked to various health issues, including rickets in children, osteomalacia in adults, and even an increased risk of chronic diseases. Regularly checking your vitamin D levels and consulting with a healthcare professional can help ensure you're meeting your needs for optimal health.
Based on user reviews, the timeline for seeing results when taking vitamin D supplements for gastritis appears to vary among individuals. Some users report that they began noticing improvements after only a few weeks. For example, one user highlighted that after battling a severe vitamin D deficiency, they began their regimen at a lower dose and increased it after a month, leading to significant improvements without experiencing pain or heartburn related to gastritis Read Review.
Others point out their vitamin levels increased in a relatively short period, suggesting that consistent use can lead to gradual improvements. Many reviews mention ease of swallowing the capsules and an absence of adverse effects, which can also play a role in user compliance and thus enhance the effectiveness of the supplement Read Review. Ultimately, while some users noticed results within a month, it is crucial to consult with a healthcare provider for personalized timelines and recommendations.
Recent research suggests that vitamin D may hold promise in alleviating gastritis, particularly when caused by Helicobacter pylori (H. pylori). In a study involving 150 patients, those who received vitamin D3 alongside standard antibiotic treatment for H. pylori experienced significantly higher eradication rates compared to those on antibiotics alone. This indicates that vitamin D3 could enhance the effectiveness of conventional therapies for gastritis related to H. pylori [2]. Further investigations have shown that vitamin D3 treatment led to improvements in inflammatory markers in gastric tissues, supporting its potential role in reducing gastritis symptoms [6].
Additionally, vitamin D deficiency has been linked to higher treatment failure rates in gastritis patients, underscoring the nutrient's importance in healing. Patients with low vitamin D levels before treatment had poorer outcomes, suggesting that monitoring and correcting vitamin D levels may be beneficial for those suffering from gastritis [3]. While findings from animal studies also point towards a gastroprotective role of vitamin D3 in managing gastritis, more extensive clinical trials are needed to solidify these conclusions and fully elucidate the mechanisms behind vitamin D's effects. Overall, the current evidence presents a compelling case for considering vitamin D as part of a comprehensive treatment approach for gastritis, especially associated with H. pylori infections [1].
Users have reported a variety of symptomatic improvements after taking vitamin D supplements, particularly in managing their gastritis. Many individuals have highlighted significant enhancements in their overall well-being, including a reduction in pain and heartburn symptoms. For example, one user noted that their vitamin D levels rose significantly after increasing their dosage, which also correlated with the resolution of pain and heartburn associated with gastritis Read Review. Another reviewer shared that both they and their partner experienced mood elevation and improvements in vitamin levels without adverse effects, supporting the idea that vitamin D can positively impact both physical and mental health while managing gastritis symptoms Read Review.
Additional anecdotal feedback emphasizes the ease of ingestion, with many users praising the capsule size and absence of unpleasant aftertaste, which encourages consistent use despite gastritis issues Read Review. Several reviewers mentioned being able to adjust their dosage comfortably and effectively without experiencing negative side effects, reinforcing the potential of vitamin D supplementation as a supportive treatment option for those with gastritis Read Review. However, individual results may vary, and it's always advisable to consult a healthcare professional for tailored advice.
Users have reported varying experiences when combining this vitamin D supplement with other supplements for managing gastritis. Many individuals praised the product's compatibility with their existing regimens, such as omega-3 supplementation. One user specifically mentioned that taking 10,000 IU daily alongside omega-3 not only enhanced absorption but also improved their overall condition related to gastritis Read Review. This highlights the potential for synergistic effects when combining vitamin D with other supplements aimed at alleviating symptoms.
Additionally, several users expressed satisfaction with the supplement's ease of use and digestion, which seemed to complement their treatment for gastritis. For instance, one user pointed out the small capsule size as a significant advantage, allowing for easy swallowing without exacerbating their gastritis symptoms Read Review. However, it's important for users to consult with healthcare professionals when adjusting or combining supplements, as individual responses can vary greatly and the potential for excess vitamin D should be taken into consideration Read Review.
Users report a variety of experiences regarding the appropriate dose of Vitamin D for managing symptoms related to gastritis. A number of users, including one who started at 5,000 IU and then increased to 10,000 IU, found significant improvement in their vitamin D levels and experienced no gastritis-related pain or heartburn during this regimen Read Review. Others also reported positive outcomes, noting that their vitamin levels increased without side effects despite pre-existing gastritis Read Review.
One user mentioned that their gastroenterologist recommended taking 10,000 IU daily, which they combined with omega-3 during breakfast, enhancing vitamin D absorption Read Review. Additionally, consumers appreciated the small capsule size, which made it easier for those with gastritis to swallow without discomfort Read Review. While users reported benefits at these dosages, it’s crucial to remember that excessive vitamin D can be harmful, and individual responses may vary.
9
Successful vitamin D boost
Excellent product! After battling a severe vitamin D deficiency, I began with 5,000 for a month, then 10,000 for two months. My vitamin D levels rose significantly, and I experienced no pain or heartburn, even with gastritis.
7.5
Mood improvement
1 people found this helpful
A good product; my husband and I have already consumed several packages. My mood is excellent, and my vitamin levels have increased, with no side effects despite my gastritis.
7.5
Stomach-friendly capsules
The capsules are a good size and do not negatively affect my chronic gastritis. They are easy to swallow, and I can adjust my daily dosage as needed.
7.5
Easily absorbed vitamins
Small capsules are easy to take, as advised by my gastroenterologist. They enhance absorption, especially beneficial for my gastritis. A jar lasts long, and I take 10,000 daily with omega-3 during breakfast.
7.5
No adverse reactions
Perfect! This vitamin works well with my gastritis. The small capsules are easy to swallow and cause no unpleasant aftertaste. My test results show they are effective, but remember that excess vitamin D can be dangerous.
8
Vitamin D3 enhances treatment success
Influence of adding vitamin D3 to standard clarithromycin-based triple therapy on the eradication rates of Helicobacter pylori infection.
We explored whether adding vitamin D3 to standard treatment for Helicobacter pylori (H. pylori) could help improve eradication rates in patients with gastritis. In a recent study, 150 patients diagnosed with H. pylori gastritis were divided into two groups. One group received the standard clarithromycin-based treatment, while the other group was given vitamin D3 along with the same antibiotics.
After the treatment, we assessed the success of eradication using stool tests conducted four weeks later. Results indicated that adding vitamin D3 led to significantly higher eradication rates of H. pylori compared to the standard treatment alone. This suggests that vitamin D3 may play an additional role in enhancing treatment effectiveness.
However, it's important to note that by integrating vitamin D3 into a multi-faceted treatment plan, we cannot fully isolate its independent effects on gastritis. Still, the findings highlight the potential benefits of incorporating vitamin D3 in conventional therapy for better outcomes.
7
Vitamin D supports gastric health
Helicobacter pylori induces increased expression of the vitamin d receptor in immune responses.
We explored how Vitamin D might interact with gastritis, especially when caused by the gastric pathogen Helicobacter pylori. In a detailed study involving 17 patients infected with H. pylori and 16 control participants, we looked at the expression of the vitamin D receptor (VDR) within the gastric mucosa.
Our focus was on understanding if increased levels of VDR could play a role in combating gastritis linked to H. pylori infection. We gathered data by measuring various immune response markers in both infected and healthy gastric tissues. Notably, we discovered that VDR expression and the cathelicidin antimicrobial protein (CAMP) were significantly elevated in those with H. pylori infection, revealing a potential defensive mechanism at play.
Additionally, treatment with 1α,25(OH)2 D3, an active form of vitamin D, boosted CAMP expression while reducing certain inflammatory cytokines in gastric cells. This suggests that vitamin D may enhance the body's ability to fend off the bacteria. However, it's important to note that while VDR has been shown to support the immune response, more research is needed to fully understand its therapeutic potential.
In summary, our findings indicate that vitamin D could play a significant role in managing inflammation and supporting gastric health in those affected by H. pylori, offering promising insight into possible preventative strategies.
8
Vitamin D impacts gastritis treatment
The effect of vitamin D deficiency on eradication rates of infection.
We explored the effect of vitamin D levels on the success of treatment for gastritis, particularly focusing on the bacteria known as H. pylori. In our study, we included 150 patients diagnosed with gastritis, measuring their serum 25-hydroxy-vitamin D (25[OH]D) levels before starting a 14-day clarithromycin-based triple therapy.
After treatment, we assessed whether the bacteria were successfully eradicated using a stool antigen test. Our findings showed that a significant number of patients, specifically 70%, successfully eradicated the infection, while 30% did not.
Notably, we observed that those who had low vitamin D levels—defined as less than 20 ng/mL—had higher rates of treatment failure compared to those with sufficient vitamin D levels. This suggests that vitamin D deficiency could be a factor affecting the success of gastritis treatment.
Overall, our results highlight the potential importance of vitamin D in improving treatment outcomes for gastritis linked to H. pylori. We believe further research, particularly randomized trials assessing vitamin D supplementation in this context, is necessary to better understand its role.
8
Vitamin D3 benefits gastritis treatment
[Vitamin D3 alleviates the gastritis that associated with Helicobacter pylori infection in mice with hypercholesterolemia by enhancing the activity of vitamin D receptors in the liver tissue and blocking the signaling pathway of JAK/STAT3].
We investigated the impact of vitamin D3 (VD3) on gastritis, especially concerning Helicobacter pylori (Hp) infections and high cholesterol levels. Mice were used to establish conditions of hypercholesterolemia and Hp infection, allowing us to assess the effectiveness of VD3 over an eight-week treatment period.
Throughout the study, we observed significant improvements in the liver and gastric tissues of mice that received VD3. Specifically, levels of vitamin D receptors and Insig-2 increased in the liver, while serum gastrin levels decreased, indicating a positive response to the treatment. We also noted a reduction in inflammatory markers associated with the JAK/STAT3 signaling pathway, which suggests that VD3 plays a role in alleviating inflammation linked to gastritis.
Importantly, alongside these findings, we observed improvements in liver health, as the treatment reduced hepatic ballooning and gastric tissue inflammation in the high cholesterol and Hp infected groups. Overall, our results illustrate that VD3 is a promising aid in alleviating gastritis related to both high cholesterol and Hp, potentially through its mechanism of enhancing liver health and disrupting inflammatory pathways.
References
Xu W, Wang L, Yang L, Li X, Li C, et al. [Vitamin D3 alleviates the gastritis that associated with Helicobacter pylori infection in mice with hypercholesterolemia by enhancing the activity of vitamin D receptors in the liver tissue and blocking the signaling pathway of JAK/STAT3]. Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi. 2024;40:520.
El Shahawy MS, Shady ZM, Gaafar A. Influence of adding vitamin D3 to standard clarithromycin-based triple therapy on the eradication rates of Helicobacter pylori infection. Arab J Gastroenterol. 2021;22:209. doi:10.1016/j.ajg.2021.08.002
El Shahawy MS, Hemida MH, El Metwaly I, Shady ZM. The effect of vitamin D deficiency on eradication rates of infection. JGH Open. 2018;2:270. doi:10.1002/jgh3.12081
Massironi S, Cavalcoli F, Zilli A, Del Gobbo A, Ciafardini C, et al. Relevance of vitamin D deficiency in patients with chronic autoimmune atrophic gastritis: a prospective study. BMC Gastroenterol. 2018;18:172. doi:10.1186/s12876-018-0901-0
Yildirim O, Yildirim T, Seckin Y, Osanmaz P, Bilgic Y, et al. The influence of vitamin D deficiency on eradication rates of Helicobacter pylori. Adv Clin Exp Med. 2017;26:1377. doi:10.17219/acem/65430
Guo L, Chen W, Zhu H, Chen Y, Wan X, et al. Helicobacter pylori induces increased expression of the vitamin d receptor in immune responses. Helicobacter. 2014;19:37. doi:10.1111/hel.12102
Bharwani SS, Shaukat Q, Balhaj G, Ashari M. A failing to thrive 18 month old with vitamin D deficiency rickets and Helicobacter pylori gastritis. BMJ Case Rep. 2011;2011. doi:10.1136/bcr.04.2011.4160