 - All patients were recruited from a single Consultants surgical clinic at the same District General Hospital between August 2010 and February 2012. This study was approved by the local ethics committee National Research Ethics Service REC ref: 09H040565 and informed consent was obtained from all patients after they had the opportunity to study information leaflets that were also given to them. The trial was designed as a prospectively randomized and double blind trial with a 1:1 control:intervention allocation. 