Most patients with nonspecific gastrointestinal symptoms have no serious underlying condition, but they are a considerable health-care burden. Health-related anxiety and health-care use decrease in patients with dyspepsia after they receive a normal upper endoscopy result; therefore, Esfandyari and Harewood examined whether similar benefits would result after patients received a negative colonoscopy result. This prospective cohort study included consecutive patients (aged 18–49 years) referred for first colonoscopy for nonspecific gastro intestinal symptoms (constipation, diarrhea, abdominal pain). Only patients who subsequently had a negative result on colonoscopy were included (59 of the 67 patients originally approached to participate). These patients completed a 21-item health anxiety questionnaire immediately before colonoscopy, after they were told of their negative result, and (by telephone) 1, 2 and 6 months after colonoscopy. Health resource use and symp tom score were also assessed at 2 and 4 months after colonoscopy. Postcolonoscopy, the mean health anxiety score of the cohort decreased, and further reductions occurred at 1, 2 and 6 months; reductions in health anxiety score were most pronounced for patients with a high health-related anxiety level at baseline. Symptoms, especially abdominal pain and diarrhea, also improved in a sustained manner up to the final follow-up at 6 months. All four measures of health resource use (emergency room visits, physician visits, hospitalizations, work days lost) decreased significantly over the study period. The authors suggest that the reassurance benefit of colonoscopy for this patient population, which translates to reduced use of health-care resources, could justify its use.