“Facts are stubborn things; and whatever may be our wishes, our inclinations, or the dictates of our passions, they cannot alter the state of facts and evidence”, John Adams
We owe it to our patients to know the facts and implement them accurately for improving their quality of lives. This obligation imposes formidable challenges to a modern practicing physician often struggling with information overload, demands of revalidation, and a maze of regulatory requirements. The second edition of this very successful and well known volume is a superb way of updating gastroenterology and hepatology evidence and facts encapsulated within one manageable volume. The “Introduction” is a concise assembly of the science behind collating, dissecting, and interpreting evidence, itself now a major medical specialty. The second edition has gained important chapters such as microscopic and collagenous colitis, antibiotic associated diarrhoea, oesophageal motility disorders, Barrett's oesophagus, non‐alcoholic steatohepatitis, management of obesity, management of viral hepatitis after liver transplantation, and acute colonic pseudo‐obstruction. The volume admirably covers all priority areas within gastroenterology and hepatology, perhaps with the exception of constipation, hidden in the chapter on irritable bowel syndrome. The volume can be used both as a reference textbook and as a real confidence boosting update to be read from cover to cover. The contents will cover 95% of patients an average general gastroenterologist would expect to care for, both in acute wards and in outpatient clinics. Coverage of infectious gastroenteritis, including that in the immunocompromised host, may make subsequent editions more appealing to a wider readership worldwide. Authorship across the Atlantic divide gives a rare balance to the volume and should appeal to all English‐reading physicians.
The chapters are conventionally arranged and are rigorously evidence based, with evidence grades prominently shaded. Some recommendations, such as lifestyle changes in alleviating gastro‐oesophageal reflux, refer to studies of variable robustness without evidence grades. Most chapters are extensively referenced, some with over 300 references, a notable exception being functional dyspepsia with 58 references, clearly missing some pivotal works. Coverage of hepatology is extensive and superb, with a rich list of topics related to liver transplantation. This is especially welcome “bucking the trend” as most textbooks now separate into gastroenterology and hepatology, while most gastroenterologists continue to manage a wide spectrum of liver disorders. Oesophageal diseases, ulcer disease, and Helicobacter, inflammatory bowel diseases, including microscopic colitis, irritable bowel syndrome, and acute pancreatitis are very well covered. Colon cancer is perhaps less well covered and topics on nutritional support are scant.
The textbook comes bundled with a convenient CD‐ROM which should be an essential travel companion in every gastroenterologist's laptop carry case. What about a PDA version in the future? Evidence ages rapidly, and a very welcome feature is the update section available from a designated website. Each of the chapters present comprehensive evidence as well as expert interpretation. Most chapters clearly delineate where evidence is lacking and further research is required. I have no doubt that this is an essential acquisition for all practising gastroenterologists, including gastrointestinal surgeons and gastroenterology departments. Trainees too should familiarise themselves with the CD‐ROM as a convenient way of knowing evidence filtered through experts. A list of trials, systematic reviews, and meta‐analysis can be daunting but there is no better user friendly access to evidence for gastroenterologists. I foresee the volume going through many editions and becoming a classic.
“The facts are always friendly, every bit of evidence one can acquire, in any area, leads one that much closer to what is true” Carl Rogers