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The aim of this review is to describe these changes, and the important role <jats:italic>H.\u2009pylori<\/jats:italic> infection has played in their evolution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>References were identified through searches of PubMed using the search terms\u2014endoscopy time trends, peptic ulcer disease, gastroesophageal reflux disease, upper gastrointestinal cancer, gastric polyps, <jats:italic>H.\u2009pylori<\/jats:italic>, eosinophilic gastrointestinal disorders, and celiac disease, from 1970 through December 2021.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The prevalence of <jats:italic>H.\u2009pylori<\/jats:italic> infection has fallen and consequently, <jats:italic>H.\u2009pylori<\/jats:italic>\u2010positive peptic ulcer disease has become rare. Gastroesophageal reflux disease is now the commonest disorder diagnosed at EGD, and Barrett's esophagus has increased in parallel. Cancer of the distal stomach has fallen while esophageal adenocarcinoma and reflux\u2010related cardia cancer have risen. Gastric polyps have changed from hyperplastic and adenomas to sporadic fundic gland polyps. Antimicrobial resistance has made <jats:italic>H.\u2009pylori<\/jats:italic> infection more difficult to eradicate. Eosinophilic gastrointestinal disorders, particularly eosinophilic esophagitis, have emerged as important new allergic disorders. Celiac disease has changed and increased.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>EGD findings appear to have changed from features suggesting a <jats:italic>H.\u2009pylori<\/jats:italic>\u2010positive \u201cphenotype\u201d 40\u2009years ago to a <jats:italic>H.\u2009pylori<\/jats:italic>\u2010negative \u201cphenotype\u201d today. These changes have major implications for the management of gastrointestinal disorders.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hel.13026","type":"journal-article","created":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T05:09:54Z","timestamp":1697087394000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Forty years of <i>Helicobacter pylori<\/i> infection and changes in findings at esophagogastroduodenoscopy"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0619-4577","authenticated-orcid":false,"given":"Humphrey J.","family":"O'Connor","sequence":"first","affiliation":[{"name":"Trinity Academic Gastroenterology Group, Trinity Centre for Health Sciences The University of Dublin, Tallaght University Hospital  Dublin 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