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Muscular trigger points and heartburn

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  One cause of heartburn which is frequently overlooked is pain from muscle trigger points. These can mimic acid reflux and yet be entirely unresponsive to acid suppression drugs. When I suggest this to people, they are quite surprised that their ‘reflux’ or ‘hiatus hernia’ is actually nothing of the sort. I am able to Read More

Does Diagnosing Barrett’s Oesophagus Improve Cancer Outcome

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One of the most important questions in the whole field of Barrett’s oesophagus is whether diagnosing it makes any difference. For most people, Barrett’s is a curiosity – the lining of the gullet changes from the normal pale pink to a salmon red colour. It is thought that this decreases the sensitivity to acid and Read More

Should doctors go on strike?

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Doctors are taking industrial action for the first time in 40 years in the UK! I have found this a very difficult issue. We earn well compared to most people. The country is in the middle of an austerity drive unparalleled in our life times. And yet, doctors pensions were renegotiated only 4 years ago, Read More

An unpalatable but effective treatment for Clostridium difficile diarrhoea


One of the rather more unlikely treatments for the nasty diarrhoeal illness caused by Clostridium difficile is ‘faecal transplant’. I first read about the concept 20 years ago but it did not really take off. This month in the Archives of Internal Medicine, they have tried it again and discovered that nine out of ten Read More

When to do anti-reflux surgery


One of the contributors to the study day was Mr Abrie Botha. He is a very experienced upper GI surgeon. He pointed out that the key to success for anti-reflux surgery is to make sure it is only offered to the right people. If chosen correctly, a paper from 2009 (by Broeders et al) showed Read More