Therapy of Digestive Disorders

Abstract

In the Preface, the authors make very clear his purpose for the work: “(R)ather than emphasizing specific classes of medication, endoscopic intervention, or surgical procedures, Therapy of Digestive Disorders was developed to provide practitioners with an authoritative and evidence-based yet practical approach to the optimal management of individuals with specific digestive disorders.” It is important to keep this in mind as one reads this book. The majority of contributors are gastroenterologists and are noted experts in their fields. The book is an excellent reference that completely discusses algorithms for disease treatment, differential diagnosis, and a thoughtful approach to patients with digestive disorders. The algorithms for treatment, specifically in the chapters on gastroesophageal reflux disease, Zollinger-Ellison syndrome, and primary sclerosing cholangitis are thoughtful and well done. Discussions include the use of modern technology such as laparoscopic interventions including cholecystectomy and Heller myotomy for achalasia, as well as laparoscopic evaluations of patients with carcinoma. The chapters on molecular targets in the therapy of acid-related disease and on Helicobacter pylori disorders are excellent. Additionally, the chapters on a variety of hepatic diseases in the section on liver problems are consistently outstanding. The weaknesses of this book are minor and don’t detract significantly from the overall value of the text; most of these criticisms are from the viewpoint of a practicing clinical gastrointestinal surgeon. In future editions, however, I would expect these weaknesses to be addressed. The chapters on pancreatic adenocarcinoma and cholangiocarcinoma are good, but could be expanded. There are two chapters on the work-up of jaundice in the pregnant patient and the neonatal patient, but a thoughtful defined discussion on obstructive jaundice in general would be nice. Additionally, the use of color, now appearing with increasing frequency in other texts, would have greatly enhanced some of the endoscopic pictures. The pictures of radiation proctitis and other pictures in the section on lower GI bleeding are of inferior quality. There is a wide variation of quality in the representation of CT and radionuclide scans throughout the text. Finally, the section on special situations in the treatment of gallstones was well conceived, but could have been expanded and been of more help to the practitioner. Overall, however, I am impressed with Dr. Wolfe’s efforts. The book’s price is more than reasonable for the broad array of information offered and the authoritative authorship. This work should be an important addition to the library of any practicing gastroenterologist or gastrointestinal surgeon.