At a glance 

• Proton pump inhibitor (PPI) medicines are used to reduce stomach acid production and are effective in managing gastro-oesophageal reflux disease
• They are commonly used in older people, often for periods longer than they are actually needed

At a glance 

• Medication management reviews (MMRs) aim to help people to get the most benefit from their medicines and minimise their risk of medicines-related harm

At a glance

• Polypharmacy is the concurrent use of multiple medicines. It is common in older people because they often have several chronic diseases that require management with medicines

At a glance

• Few people who have an initial gastroscopy require another within 3 years
• Repeat gastroscopy is used mainly to monitor conditions that can increase the risk of upper gastrointestinal (GI) cancer or bleeding in high risk groups

At a glance

• Repeat colonoscopy is used mainly to check for polyps and bowel cancer in people with a higher risk of bowel cancer
• There are limited reasons why a colonoscopy would be repeated within 3 years

At a glance

• Gastroscopy is used to investigate, treat or monitor conditions of the upper part of the gastrointestinal (GI) tract
• Most conditions that affect the upper GI tract and require gastroscopy are uncommon in people aged under 55 years

At at glance

• When planning for birth by caesarean section or induction of labour, waiting until at least 39 weeks gestation results in better outcomes for the baby, unless there are medical or obstetric reasons for earlier birth

Polypharmacy is when people are using five or more medicines at the same time. Medication management reviews (MMRs) aim to help people to get the most benefit from their medicines and minimise their risk of medicines-related harm.

In 2017–18, more than 330,000 potentially preventable hospitalisations were due to the five conditions in this chapter.

Gastroscopy is used to investigate, treat or monitor conditions of the upper part of the gastrointestinal (GI) tract. These conditions mostly affect people aged 55 or over. Few people who have a gastroscopy need another one within three years.