This is the first national audit of colonoscopy that has successfully captured the majority of adult colonoscopies performed across an entire nation during a defined time period. The data confirm that there has been a significant improvement in the performance of colonoscopy in the UK since the last study reported seven years ago (CIR 76.9%) and that performance is above the required national standards.

This study indicates that early gastrostomy tube feeding is greatly superior to nasogastric tube feeding and should be the nutritional treatment of choice for patients with acute dysphagic stroke.

A hundred years after the introduction of aspirin as the first effective anti‐inflammatory drug, problems of tolerability still beset this class of drugs, in particular, gastrointestinal toxicity. Despite this, NSAIDs are among the most widely used and prescribed drugs world‐wide. Many agents have been used to counteract these side‐effects with varying degrees of success and acceptance. Although the central mechanism of NSAID action, reduced prostaglandin production by cyclooxygenase (COX) inhibition, was first described 25 years ago, the recent discovery of a second, inducible form of cyclo‐oxygenase, COX‐2, has stimulated research and interest in producing NSAIDs that are inherently safer whilst maintaining efficacy. Specific COX‐2 inhibitors, the first of which has recently been marketed in the UK, offer real hope as safer NSAIDs and this may be realised when drugs with even greater specificity become available. However, long‐term safety and efficacy need to be demonstrated in clinical practice, and questions remain unanswered about possible physiological roles for COX‐2. Other approaches to improving the safety of NSAIDs, including profound acid suppression and nitric oxide donation, may prove to be as successful in this rapidly changing field.

SUMMARY BackgroundPatients with coeliac disease may have diarrhoea despite being on a gluten-free diet.