Our comprehension of upper gastrointestinal disease has been extended in the past three decades by the introduction of endoscopy, ultrasonography, computed tomography scanning, pH monitoring, and manometry. This burgeoning of investigational modalities coincided with the development of acid suppressing drugs that for the first time enabled the control of peptic ulcer and gastro-oesophageal reflux disease. However, by the 1990s, long term acid suppression for the majority of patients with peptic …