Professor Paul Pavli is retiring after a 40-year career as a gastroenterologist and researcher. He discusses advancements in the treatment of peptic ulcer disease, gastric cancer, colon cancer, and pancreatitis, as well as concerns about long-term use of proton pump inhibitors and recommendations for colorectal cancer screening.

The discovery and treatment of Helicobacter pylori has greatly improved the management of peptic ulcer disease and gastric cancer.

Advances in genetic testing have revolutionized the understanding and treatment of colon cancer and pancreatitis.

Interventional endoscopy has significantly improved the treatment of gastrointestinal bleeding.

There are concerns about the risks associated with long-term PPI use, but observational studies may have biased results by attributing negative outcomes to the treatment rather than the underlying condition.

A large study showed a 10% increased risk of mortality in patients on PPI therapy, but this risk disappeared when considering only long-term users.

The gold standard for colorectal cancer screening on a population basis is fecal blood testing, but colonoscopy every 10 years is recommended for patients expressing concern about their risk.

Grand Rounds would like to honor and thank Paul for his 40 years of distinguished practice and his contributions to Grand Rounds at the Canberra Hospital.