Clin Med
-
Gastro-oesophageal reflux disease results from impaired function of the LOS and acid clearance of the distal oesophagus. Most patients do not require investigation and respond either to lifestyle changes, antacid/alginates, H2A, PPI or a combination of these treatments. Surgery is only rarely indicated.
-
Endoscopic ultrasound (EUS) is an increasingly available diagnostic and therapeutic tool used within the U. K. it has wide applications both in the gastrointestinal tract and mediastinum with its current main uses being in the staging of luminal malignancies and assessment of pancreatic and subepithelial lesions. The emergence of linear EUS has opened up new therapeutic avenues with fine needle aspiration, trucut biopsies, coeliac plexus blocks and transmural pseudocyst drainage all now possible. Future developments include localised brachytherapy/chemotherapy and alcohol ablation of unresectable pancreatic malignancies and EUS-guided endoscopic surgery.