Abstract
This is one of the best organized and easiest to reference medicine books I have found. It covers biology, pathophysiology, diagnosis and treatment of diseases of the gastrointestinal system, including the pancreas and hepatobiliary system. The chapters are broken into six sections highlighting different aspects of the digestive system.
Section I: Biology of the gastrointestinal tract. The first section starts with the important basics about regulation of food intake, motility, secretion, digestion, absorption, blood flow and defecation. This is followed by chapters on the healthy digestive system contrasted with descriptions of inflammation and neoplasia.
Section II: Approach to clinical signs in gastrointestinal disease. Each chapter addresses a common presenting clinical sign of gastrointestinal disease, including anorexia, ascites, constipation, vomiting, diarrhea, hepatoencephalopathy and polyuria/polydipsia. In a logical manner, it flows from a detailed definition, pathophysiology, and mechanisms and differential diagnosis. The reader is walked through pertinent history, physical examination findings and directed to appropriate diagnostics. General principles, medical and surgical options for treatment of each clinical sign are discussed with in-depth comments on others — radiation, endoscopy, alternative and complementary options — where appropriate.
Section III: Diagnostic approach to gastrointestinal disease. There are five chapters covering different aspects regarding interpretation of diagnostic tests: laboratory testing, diagnostic imaging, endoscopy, laparoscopy and histopathology. Laboratory testing reviews the commonly performed tests, such as complete blood count, serum chemistries and fecal parasitology, as well as other commonly available tests, such as serology, polymerase chain reaction, fecal microbiology and cytology. It is organized by sections of the digestive system, so the reader can see what test is appropriate for where. Diagnostic imaging looks at both the techniques used in routine practice, such as survey or contrast radiography, and ultrasonography, and those techniques found in referral settings, such as nuclear scintigraphy, computed tomography and magnetic resonance imaging. Assessment of gastric motility is covered at length. The endoscopy and laparoscopy chapters are very basic, but are good introductions to these modalities, covering equipment, patient selection and preparation, specific procedures and guidelines, and complications. The histopathology chapter provides excellent verbal and visual detail of both normal and abnormal conditions of the digestive system.
Section IV: Nutritional approach to gastrointestinal disease. This section begins by addressing assessment of malnutrition and obesity: etiology, pathogenesis, pathologic consequences and management. The second chapter delves into diagnosis, pathophysiology and management of adverse food reactions. ‘Nutritional strategies in gastrointestinal disease’ addresses the roles of proteins, carbohydrates and fats in the diet, and disease management. Sections on specific organs and their nutritional management follow. The final chapter walks the reader through patient selection for enteral and parenteral nutrition, method, administration and management.
Section V: Pharmacologic approach to gastrointestinal disease. In this section, the authors chose to divide it by class of therapies for the treatment of specific disorders or address a specific concern in the treatment of gastrointestinal diseases. The chapters include antidiarrheal agents, antiemetic agents, anthelmintic agents, non-steroidal anti-inflammatory drugs, antimicrobial agents, antioxidant drugs, behavioral intervention, chemotherapy, cytoprotective agents and probiotic agents, to list a few. As applicable, pathogenesis mechanisms of action, rational approach to therapy in the undiagnosed patient are included; commonly used agents in each category of treatment, dosages, and side effects are provided. It is a very thorough and extensive section, covering all types of potential therapies and their proper usage.
Section VI: Diseases of the gastrointestinal tract. In the final part of the book, each chapter is dedicated to a specific area of the gastrointestinal tract or organ, first reviewing structure and function, followed by the diagnostic evaluation of the patient. Many common causes of disease, including inflammation, infection and neoplasia, are discussed in each chapter as it pertains to that region. Within each of these discussions, diagnosis, treatment and prognosis are addressed.
This is a very comprehensive and user-friendly textbook. The pages are packed with full color illustrations, photos, algorithms and reference tables. It is easy to find and utilize basic information, as well as delve into a deep understanding and comprehension of a specific piece of the digestive system. This book is an excellent reference for private practitioner, referral center and veterinary student.