Sampling gastro-enterologists' opinions and attitudes at two world congresses

This paper reports the results of a survey of gastro-enterologists' opinions and attitudes at the Stockholm, Sweden, Seventh World Congress (June 1982), elicited via a standard questionnaire in three languages. Respondents' replies were compared with those from the previous (Sixth) World Congress (Madrid 1978) on a variety of topics. As regards peptic ulcer, little change has occurred in the last four years concerning surgery, though highly selective vagotomy has become more common for duodenal ulcer. As regards drugs in routine use, this survey confirms the considerable rise in the proportion of centres prescribing H2 receptor blockers (from 48% in 1978 to 81% in 1982). As regards inflammatory bowel disease, there has been little change overall in surgical procedures though 'small' procedures have grown in popularity (such as diverting ileostomy), largely at the expense of colectomy. Most physicians would now recommend some form of cancer surveillance both for ulcerative colitis and Crohn's disease, the most popular modality being clinical examination plus sigmoidoscopy at 6-12 month intervals, with colonoscopy or barium enema every two years. As regards GI cancer detection, endoscopy is now the modality of choice both for gastric cancer and colo-rectal cancer. Finally, the majority of respondents confirm that they frequently encounter ethical problems both in connection with routine practice and research. By and large ethical committees were felt to be ineffective, and guidance on ethical matters (absent in many centres!) rarely takes a structured form. This last finding possibly lends weight to the O.M.G.E.'s intention to provide such guidance via its newly founded Ethical Committee.