John Gordon Williams CBE is a British health services researcher and clinical academic gastroenterologist. He led the establishment of the Postgraduate Medical School in Swansea, created and developed the Health Informatics Unit at the Royal College of Physicians, and was the founding president of WAGE, the Welsh Association for Gastroenterology and Endoscopy [1] Williams was appointed a CBE for services to medicine in 2014. [2]
He trained in medicine at Cambridge University and St Thomas' Hospital in London, qualifying in 1970. His early career was spent in the Royal Navy, where he trained as a gastroenterologist in naval hospitals in Plymouth and Portsmouth, and in London. With Sir Godfrey Milton-Thompson, Roy Pounder and George Misiewicz he evaluated the first H2-receptor antagonists to be given to man, [3] refining new techniques to assess acid secretion, [4] [5] and demonstrating efficacy in duodenal ulcer disease, a common cause of significant morbidity in sailors. [6] In 1982, he led a Surgical Support Team in the campaign to retake the Falklands Islands, overseeing the conversion of SS Canberra to take casualties, and driving the development and implementation of a simple resuscitation regime for mass casualties that was used successfully ashore. [7] As Professor of Naval Medicine from 1984 to 1988 he oversaw the postgraduate training of naval physicians and research in the medical specialties.
He retired from the Royal Navy in 1988 and was appointed to Swansea University, as the founding director of the School of Postgraduate Studies in Medical and Healthcare, the precursor of Swansea University Medical School. [1] He pioneered the development of health services and informatics research, leading to the recognition of Swansea as a founding Centre of Excellence in the Farr Institute. [8] From 2002 to 2007 he was Director of the Wales Office of Research and Development, a post in which he created the Clinical Research Collaboration Cymru. [9] As a clinical and health services researcher he has led major trials of treatment [10] and service delivery, [11] [12] and developed patient focused approaches to the measurement of quality of life and outcome, [13] [14] [15] and the use of routine data for research. [16] These studies have informed developments in service delivery in gastroenterology and in 2009 he was invited to deliver the Endoscopy Foundation Lecture at the Annual Meeting of the British Society of Gastroenterology. [17] As Director of the Health Informatics Unit at the Royal College of Physicians he has led the development of national standards for the structure and content of patient records and communications, [18] to improve the quality of record keeping and data returns. [19] These standards are now embodied in national policy, and will be fundamental to the success a paperless NHS, [20] and the introduction of precision medicine, by ensuring that sufficiently detailed data can be recorded in structured form in patient records.
Commander of the Order of the British Empire (CBE) – for services to Medicine (2014)
Proton-pump inhibitors (PPIs) are a class of medications that cause a profound and prolonged reduction of stomach acid production. They do so by irreversibly inhibiting the stomach's H+/K+ ATPase proton pump.
Peptic ulcer disease (PUD) is a break in the inner lining of the stomach, the first part of the small intestine, or sometimes the lower esophagus. An ulcer in the stomach is called a gastric ulcer, while one in the first part of the intestines is a duodenal ulcer. The most common symptoms of a duodenal ulcer are waking at night with upper abdominal pain, and upper abdominal pain that improves with eating. With a gastric ulcer, the pain may worsen with eating. The pain is often described as a burning or dull ache. Other symptoms include belching, vomiting, weight loss, or poor appetite. About a third of older people have no symptoms. Complications may include bleeding, perforation, and blockage of the stomach. Bleeding occurs in as many as 15% of cases.
A randomized controlled trial is a form of scientific experiment used to control factors not under direct experimental control. Examples of RCTs are clinical trials that compare the effects of drugs, surgical techniques, medical devices, diagnostic procedures or other medical treatments.
Gastroesophageal reflux disease (GERD) or gastro-oesophageal reflux disease (GORD) is one of the upper gastrointestinal chronic diseases in which stomach content persistently and regularly flows up into the esophagus, resulting in symptoms and/or complications. Symptoms include dental corrosion, dysphagia, heartburn, odynophagia, regurgitation, non-cardiac chest pain, extraesophageal symptoms such as chronic cough, hoarseness, reflux-induced laryngitis, or asthma. In the long term, and when not treated, complications such as esophagitis, esophageal stricture, and Barrett's esophagus may arise.
Barrett's esophagus is a condition in which there is an abnormal (metaplastic) change in the mucosal cells lining the lower portion of the esophagus, from stratified squamous epithelium to simple columnar epithelium with interspersed goblet cells that are normally present only in the small intestine and large intestine. This change is considered to be a premalignant condition because it is associated with a high incidence of further transition to esophageal adenocarcinoma, an often-deadly cancer.
Helicobacter pylori, previously known as Campylobacter pylori, is a gram-negative, flagellated, helical bacterium. Mutants can have a rod or curved rod shape, and are less effective. Its helical or spiral body is thought to have evolved in order to penetrate the mucous lining of the stomach, helped by its flagella, and thereby establish infection. The bacterium was first identified as the causal agent of gastric ulcers in 1983 by the Australian doctors Barry Marshall and Robin Warren.
An upper gastrointestinal series, also called a barium swallow, barium study, or barium meal, is a series of radiographs used to examine the gastrointestinal tract for abnormalities. A contrast medium, usually a radiocontrast agent such as barium sulfate mixed with water, is ingested or instilled into the gastrointestinal tract, and X-rays are used to create radiographs of the regions of interest. The barium enhances the visibility of the relevant parts of the gastrointestinal tract by coating the inside wall of the tract and appearing white on the film. This in combination with other plain radiographs allows for the imaging of parts of the upper gastrointestinal tract such as the pharynx, larynx, esophagus, stomach, and small intestine such that the inside wall lining, size, shape, contour, and patency are visible to the examiner. With fluoroscopy, it is also possible to visualize the functional movement of examined organs such as swallowing, peristalsis, or sphincter closure. Depending on the organs to be examined, barium radiographs can be classified into "barium swallow", "barium meal", "barium follow-through", and "enteroclysis". To further enhance the quality of images, air or gas is sometimes introduced into the gastrointestinal tract in addition to barium, and this procedure is called double-contrast imaging. In this case the gas is referred to as the negative contrast medium. Traditionally the images produced with barium contrast are made with plain-film radiography, but computed tomography is also used in combination with barium contrast, in which case the procedure is called "CT enterography".
Gastrointestinal bleeding, also called gastrointestinal hemorrhage (GIB), is all forms of bleeding in the gastrointestinal tract, from the mouth to the rectum. When there is significant blood loss over a short time, symptoms may include vomiting red blood, vomiting black blood, bloody stool, or black stool. Small amounts of bleeding over a long time may cause iron-deficiency anemia resulting in feeling tired or heart-related chest pain. Other symptoms may include abdominal pain, shortness of breath, pale skin, or passing out. Sometimes in those with small amounts of bleeding no symptoms may be present.
A Cushing ulcer, named after Harvey Cushing, is a gastric ulcer associated with elevated intracranial pressure. It is also called von Rokitansky–Cushing syndrome. Apart from the stomach, ulcers may also develop in the proximal duodenum and distal esophagus.
Indigestion, also known as dyspepsia or upset stomach, is a condition of impaired digestion. Symptoms may include upper abdominal fullness, heartburn, nausea, belching, or upper abdominal pain. People may also experience feeling full earlier than expected when eating. Indigestion is relatively common, affecting 20% of people at some point during their life, and is frequently caused by gastroesophageal reflux disease (GERD) or gastritis.
Gastrointestinal perforation, also known as ruptured bowel, is a hole in the wall of part of the gastrointestinal tract. The gastrointestinal tract includes the esophagus, stomach, small intestine, and large intestine. Symptoms include severe abdominal pain and tenderness. The pain is typically sudden when the hole is in the stomach or duodenum, whereas the pain may occur more gradually when the hole in the large intestine. The pain is usually constant in nature. Sepsis, with an increased heart rate, increased breathing rate, fever, and confusion may occur.
Blood in stool or rectal bleeding looks different depending on how early it enters the digestive tract—and thus how much digestive action it has been exposed to—and how much there is. The term can refer either to melena, with a black appearance, typically originating from upper gastrointestinal bleeding; or to hematochezia, with a red color, typically originating from lower gastrointestinal bleeding. Evaluation of the blood found in stool depends on its characteristics, in terms of color, quantity and other features, which can point to its source, however, more serious conditions can present with a mixed picture, or with the form of bleeding that is found in another section of the tract. The term "blood in stool" is usually only used to describe visible blood, and not fecal occult blood, which is found only after physical examination and chemical laboratory testing.
The ampulla of Vater, hepatopancreatic ampulla or hepatopancreatic duct is the common duct that is usually formed by a union of the common bile duct and the pancreatic duct within the wall of the duodenum. This common duct usually features a dilation ("ampulla"). The common duct then opens medially into the descending part of the duodenum at the major duodenal papilla. The common duct usually measures 2-10mm in length.
The British Society of Gastroenterology (BSG) is a British professional organisation of gastroenterologists, surgeons, pathologists, radiologists, scientists, nurses, dietitians and others amongst its members, which number over 3,000. It was founded in 1937, and is a registered charity. Its offices are in Regent's Park, London.
A stress ulcer is a single or multiple mucosal defect usually caused by physiological stress which can become complicated by upper gastrointestinal bleeding. These ulcers can be caused by shock, sepsis, trauma or other conditions and are found in patients with chronic illnesses. These ulcers are a significant issue in patients in critical and intensive care.
Helicobacter pylori eradication protocols is a standard name for all treatment protocols for peptic ulcers and gastritis in the presence of Helicobacter pylori infection. The primary goal of the treatment is not only temporary relief of symptoms but also total elimination of H. pylori infection. Patients with active duodenal or gastric ulcers and those with a prior ulcer history should be tested for H. pylori. Appropriate therapy should be given for eradication. Patients with MALT lymphoma should also be tested and treated for H. pylori since eradication of this infection can induce remission in many patients when the tumor is limited to the stomach. Several consensus conferences, including the Maastricht Consensus Report, recommend testing and treating several other groups of patients but there is limited evidence of benefit. This includes patients diagnosed with gastric adenocarcinoma, patients found to have atrophic gastritis or intestinal metaplasia, as well as first-degree relatives of patients with gastric adenocarcinoma since the relatives themselves are at increased risk of gastric cancer partly due to the intrafamilial transmission of H. pylori. To date, it remains controversial whether to test and treat all patients with functional dyspepsia, gastroesophageal reflux disease, or other non-GI disorders as well as asymptomatic individuals.
Megaduodenum is a congenital or acquired dilation and elongation of the duodenum with hypertrophy of all layers that presents as a feeling of gastric fullness, abdominal pain, belching, heartburn, and nausea with vomiting sometimes of food eaten 24 hours prior.
Clifford Frank Hawkins (1915–1991) was a British gastroenterologist and rheumatologist.
Melissa Anne Wake MBChB MD FRACP FAHMS is a New Zealand paediatrician and Scientific Director of the Generation Victoria initiative, aiming to create very large, parallel whole-of-state birth and parent cohorts in Victoria, Australia, for Open Science discovery and interventional research. She is Group Leader of the Murdoch Children's Research Institute’s Prevention Innovation Research Group and holds Professorial positions with the University of Melbourne and the University of Auckland.
Sir Andrew Watt Kay FRSE, FRCPSG, FRCSEd was a Scottish academic surgeon who was Regius Professor of Surgery at the University of Glasgow from 1964 to 1981. He developed the augmented histamine test, which bore his name, and was widely used in the investigation and treatment of peptic ulcer disease. He was knighted for services to surgery. From 1972 to 1974 he served as president of the Royal College of Physicians and Surgeons of Glasgow.
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