A great article by Dr William Wildgoose regarding the perennial problem of upside down goldfish.
For the short version, excerpts from the abstract is pasted below:
There were almost equal numbers of short-bodied and long-bodied goldfish. In many cases, there were no external lesions and no consistent environmental factors could be identified… Several radiographic abnormalities were found in goldfish including over-inflation (44%), displacement (22%), fluid accumulation (12%) and rupture (2%) of the swim bladder and intestinal tympany (6%)… There was a very poor response to treatment and several environmental, medical and surgical approaches are discussed.
For the long version, click on this link.