A longitudinal perspective on disease trends is not only fascinating, but also essential to understanding aetiology and pathogenesis. The epidemiology of upper gastrointestinal disease in industrialised populations is evolving rapidly [1–3]. Falling rates of peptic ulceration [4] and gastric cancer [2] are attributed to declining prevalence of Helicobacter pylori infection [5, 6]. Oesophageal squamous cell carcinoma remains the most predominant worldwide, although in developed countries there is a shift to adenocarcinoma [3, 7–9]. Data from Asia are similar to those in Western countries with a gradual decrease in peptic ulceration and H. pylori infection [10–13]. There is also a reported reduction in peptic ulceration in Latin America [14].