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Gut. 2007 October; 56(10): 1486–1487.
PMCID: PMC2000272

Clinical gastroenterology and hepatology

Reviewed by John de Caestecker

Edited by Weinstein, Hawkey, Bosch. St Louis: Elsevier Mosby, 2005, £117, pp 1191. ISBN 0-323-02751-2.

Gastrointestinal (GI) textbooks come in varied shapes and sizes: the “handbook”, often pocket‐sized, providing concise practical clinical information, is aimed principally at the early trainee, whereas the “specialist” treatise, an in‐depth review of a specific organ or disease, is aimed at research or clinical subspecialists. Finally, there is the general textbook, exemplified by the text reviewed here. This is usually aimed at senior/committed GI trainees and established gastroenterologists with a general GI and hepatology practice. This review aims to establish what the current book offers such a readership and why they might choose it in preference to other established texts.

A major disadvantage of printed text is that within 2–3 years of publication, revision is required to incorporate new advances, with the potential for further outlay by the consumer. Many textbooks overcome this by having updatable online or electronic versions; this book is no exception and has both available (details at The latest update is dated February 2007; these versions include additional video footage (presumably mainly endoscopic but I was unable to view these).

It is the authorship and layout of the book that is different and attractive: the editors are from both sides of the Atlantic and the 250‐odd authors are truly international and multidisciplinary, including a beautifully illustrated section on endoscopic mucosal resection of the GI tract by a Japanese author and lavishly illustrated radiological and surgical contributions. In addition to the expected systematic chapters on GI and liver diseases, there are colour‐coded sections dealing with common clinical scenarios/symptoms, a diagnostic methods “primer” (endoscopic, radiological, histopathological and functional), including a forward‐looking chapter on virtual colonoscopy, and treatment overviews (including drugs, radiological, endoscopic and surgical treatments, but also nutrition and, unusually, complementary therapies).

There are some helpful features to the book in general: most chapters are short and broken up into sections, with a similar (though not identical) layout to most, making them easy to read. Key points at the beginning of each section are not terribly informative but do give a flavour of the section; however, summary tables throughout the text give useful “at a glance” overviews, albeit some are over‐inclusive (such as lists of differential diagnoses in some of the clinical scenario sections). I liked the table in the chapter on chronic pancreatitis showing the evidence base from randomised controlled trials for surgical treatment: more chapters on common diseases (eg, irritable bowel disease) might benefit from a similar approach. For those who like algorithms, there are plenty in the “scenario” chapters, though some are unhelpfully complex. A nice touch is the inclusion of online sources of advice and information for patients given with many chapters (some of the detailed links have presumably expired as one is directed instead to the relevant “home” page) as well as short paragraphs on current controversies.

There were good chapters on irritable bowel syndrome and upper GI functional diseases by acknowledged experts, but I found the sections on motility testing and other functional tests rather cursory (eg, no mention of impedence pH/motility monitoring, high‐resolution manometry or ambulatory 24‐hour small bowel monitoring), in contradistinction to up‐to‐date sections on other diagnostic methods (eg, capsule endoscopy, positron emission scanning). When I looked up glucose hydrogen breath tests, there were three descriptions in different chapters, each with slightly differing methods and interpretation; perhaps there are other examples! As there is a section on diagnostic methods, one would hope that future editions will ensure that a single description of each method appears here, appropriately referenced from other chapters where the technique is mentioned.

Overall, I found this an engaging text, easy to dip into because the sections were in the main concise and well illustrated. The clinical scenario sections and those on diagnostic and treatment methodologies should be of particular value to those searching for clinical tips. Online or updatable e‐versions may be particularly attractive, especially if illustrations/videos can be exported into PowerPoint presentations. Those looking for a pocketable handbook may be tempted by the availability of a downloadable abbreviated version for PDAs.

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