IntroductionIn 1995, Safe reviewed the major advances in the investigation and management of upper gastrointestinal tract (UGT) disorders over the previous 25 years. Further research over the past five years, particularly in the field of the ethics of nutrition in the elderly, has stimulated this review of the literature. Rather than attempt a comprehensive review, however, we focus on areas where the approach to the management of UGT disease has been significantly influenced. The following topics are covered: gastrooesophageal reflux disease (GORD); peptic ulcer disease (PUD); the management of non-steroidal drug-induced mucosal injury; UGT bleeding; UGT cancer and the ethics of artificial nutrition support.

Old people are a growing minority. They comprise approximately 12% of the UK population, but consume an increasing proportion of health care resources. Gastrointestinal (GI) disorders are the third most common reason why patients over 65 years seek primary care advice, and 40% of these consultations relate to the upper GI tract.