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We are writing in relation to the study by Rutter et al with interest.1 The COVID-19 pandemic has resulted in major changes to healthcare delivery in many clinical areas including endoscopic services.1–3 The British Society of Gastroenterology (BSG) and Joint Advisory Group for Gastrointestinal Endoscopy (JAG) issued guidance for endoscopic services on 23 March 2020 recommending activities prioritising emergencies or essential procedures and postponement of non-emergency cases, bowel cancer screening and surveillance.4 The study by Rutter et al reported a substantial reduction to as low as 5% of normal endoscopic activity in the UK earlier on in the pandemic with only a 20% increase of pre-COVID-19 levels 10 weeks later. Endoscopic cancer detection rate reduced by 58% overall, with a worrying 72% reduction for colorectal cancer during the study period.1 A national survey of UK endoscopy leads in May 2020 showed a substantial number of endoscopy services stopped performing endoscopy with an anticipated slow recovery and trebling …

Ménétriers disease is a rare mucosal hyperproliferative disorder of the stomach, however, the evidence for long-term care remains limited, especially if a gastrectomy is declined. We present a case of 25-year-old Caucasian woman with a history of end-stage renal failure (ESRF) who experienced worsening symptoms of abdominal pain, haematemesis and abdominal swelling, with her serum albumin dropping to 20 g/L and haemoglobin to 4.9 g/dL. Endoscopy showed markedly hyperplastic gastric folds consistent with Ménétriers disease, confirmed histologically by gland dilation and gastric pit expansion. Intravenous cetuximab was prescribed for 12 months, with clinical, biochemical and endoscopic improvement. However, 5 weeks post cetuximab completion, there was relapse to 50% gastric coverage with Ménétriers. A discussion around gastrectomy was rejected by the patient. This is the first report of relapsing Ménétriers disease in a female patient with ESRF; we suggest that long-term cetuximab should be considered if a gastrectomy is declined.