Category: Medical

Do you have a two-bit pancreas? You well might…better read on.

About 8% of people, at least in Western countries, are born with the pancreas in two pieces, so called “pancreas divisum”. It is about as common as left-handedness, and ten times that of red hair. How come, and who cares? Some technical stuff to get started. The human pancreas is formed from two parts which…
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Do not miss Nagi Reddy this Wednesday

Nagi Reddy, superstar founder and chair of the Asian Institute of Gastroenterology in Hyderabad will zoom speak on ESWL of Biliary and Pancreatic stones at our weekly MUSC grand rounds this wednesday at 7 am EST. He has by far the greatest experience in the world. Not to be missed…. Access free at

My Favorite city (and International meeting)

I am fortunate that my career has taken me to more than 50 countries. I am often asked for my favorite city, which one I would most like to revisit. Leaving aside my home now in USA, and my roots in England, my choices are much influenced by where I have friends (especially those with…
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Have I GOTTEN all American now?

One of my readers (I hope that there may be more than one) chastised me recently for using the American word “gotten” in my latest blog. It is not in common usage in my native England, although some do refer to “ill-gotten gains”. Maybe “forgotten” and even “woe-begotten” are also somehow connected? Who said “two…
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What happened to the British Endoscopy Society 40 years ago?

Many gastroenterologists practicing today may not know that there was once a British Society for Digestive Endoscopy (BSDE). It folded in 1980. What was it, why, and what happened to it? The flexible endoscopy revolution started in the late 60s and blossomed in the 70s. Before that happened, the British Society of Gastroenterology (BSG) had…
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EPISOD revisited …..and validated, thank you Zach

My gastroenterologist readers, if any, (thank you) may recall that I led the team that developed a research study called EPISOD (Evaluating Predictors and Interventions in Sphincter of Oddi Dysfunction). The results were published in 2014 (Cotton PB, Durkalski V, Romagnuolo J, et al. A multicenter, randomized trial of endoscopic sphincterotomy for suspected sphincter of…
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A medicine called “worse than cats”

Some may remember that I posted a piece called “Thinking about placebos and healing”. I thought it was just a few months ago, but it was actually in November 2018. It was stimulated by my surprise and confusion about the fact that most patients undergoing sham procedures in my EPISOD research study did remarkably well,…
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The Middlesex Hospital – what sort of a name is that?

Some of the adventures I have recounted in recent months happened while I was on the Consultant staff of The Middlesex Hospital in London (1973-86). You may wonder about the name, which could be misunderstood. It was called The Middlesex because it was in the County of Middlesex, now part of the city of London.…
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Need some GI updates, with CME?

The Medical University of SC is now offering its weekly Gastroenterology/Hepatology grand rounds virtually at 7am on Wednesdays. Tomorrow, David Whitcomb of Pittsburg will speaks about “Early and effective management of pancreatitis”. Next week I will present “How flexible endoscopy began”. Anyone wishing to participate can contact me or Cindy Peeples at

So many royal connections!

I am running short on anecdotes about royal patients, but do have some other royal connections, about which you are no doubt curious, and maybe envious. Let’s start with Kings. I was born in the little village of Kingstone, near Hereford, in the west of England. Note “Cotton’s Meadow”, which was indeed a meadow across…
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