Gastric polyps are usually asymptomatic, with more than 90% found incidentally and a prevalence of up to 6% at upper endoscopy. Fundic gland polyps (FGPs) are the gastric polyps most frequently seen in the Western world, largely due to their long-established association with proton pump inhibitor (PPI) usage. In countries where Helicobacter pylori infection is prevalent an endoscopist is more likely to encounter hyperplastic polyps and adenomas, which are known to be associated with a higher malignant potential. Gastric polyps are often regarded as the ‘poor relation’ to their colonic counterparts and as such clinicians often feel unsure how to identify, assess and appropriately manage these lesions. Endoscopists often lack confidence in the endoscopic characterisation of gastric polyps, feel unsure when to biopsy polyps and, if they are biopsying polyps, how many they should sample, and finally they are not always certain what the longer-term management is. The British Society of Gastroenterology (BSG) guidelines provide a useful flowchart and overview of the management of gastric polyps, and the discussion here is based on those guidelines, guidelines from the European Society of Gastrointestinal Endoscopy (ESGE) and 12 years of clinical experience.

Barrett’s oesophagus is the precursor to oesophageal adenocarcinoma, which carries a poor prognosis, and it is likely that all endoscopists and gastroenterologists will encounter Barrett’s oesophagus in their clinical practice. Careful assessment and management of patients who have Barrett’s oesophagus with endoscopic surveillance and endoscopic endotherapy aim to reduce the risk of progression to invasive adenocarcinoma. Advances in endoscopic diagnosis and therapy should, therefore, help to reduce the risk of progression. As with all premalignant conditions and surveillance programmes, careful multidisciplinary management of the patient is important to reduce the risk of causing them to become unduly concerned. Here, we present some mistakes that in our experience are commonly made in the endoscopic diagnosis and management of Barrett’s oesophagus and give advice on how to avoid them. 

Colonoscopy is a complex procedure requiring both technical and non-technical skills. Performing colonoscopy also requires manual and visuospatial skills, interpretation of pathology, patient communication and a wide range of advanced therapeutic technologies. The clinical intention of colonoscopy must be individualised, and diagnostic and/or therapeutic intent rationalised, given the procedures invasive nature and associated risks. Furthermore, each colonoscopy differs due to patient factors, sedation strategy, anatomical configuration, technical challenges and endoscopist skills. Endoscopists must, therefore, demonstrate a wide range of expertise whilst working effectively in a team to manage the patient safely. It is not, therefore, surprising that mistakes in colonoscopy can occur. This article focuses on six common mistakes in colonoscopy that can be avoided to improve the procedure's safety and deliver a high-quality procedure. This, in turn, can reduce the rates of post-colonoscopy colorectal cancer (PCCRC) and improve patient experience and adherence to colonoscopy surveillance programmes. This article is based on evidence in conjunction with our collective clinical and research experience of errors in endoscopy and patient safety.

Long-term enteral nutrition via gastrostomy is a relatively common medical intervention for patients at risk of malnutrition who have an accessible and functioning gastrointestinal tract. There are clear clinical guidelines describing the principles of practice as well as numerous retrospective and non-randomised controlled studies and case series. However, fewer publications impart advice and guidance regarding the management and ‘patient selection’ for these interventions. The following article provides a combination of the author’s views and the evidence base.

Tissue sampling during endoscopic procedures is a fundamental aspect of investigating digestive diseases, with histological examination playing a crucial role in almost every case. Given its prevalence, the potential for mistakes is significant. Therefore, understanding the appropriate indications, techniques, and consequences of tissue sampling is essential for gastroenterologists. Key questions to consider before taking a biopsy or acquiring tissue include: Why? What for? How? How many?

This manuscript addresses these critical questions by detailing the eight most frequent and correctable mistakes in tissue acquisition during endoscopy. The recommendations provided are largely supported by existing guidelines and evidence, with some insights drawn from the authors' professional experience.

Colorectal cancer (CRC) is a common and deadly disease. Advances in understanding the disease have improved diagnosis, prevention, and treatment. Genetic factors play a role in some cases of CRC, and identifying hereditary disorders has helped reduce morbidity and mortality. Serrated polyps are also precursors of CRC, and colonoscopy is crucial for screening and prevention. However, colonoscopy is not perfect, and some lesions may be missed. Here we discuss common mistakes in CRC diagnosis, prevention, and treatment, and how to avoid them.