“We must go beyond textbooks, go out into the bypaths and untrodden depths of the wilderness and travel and explore and tell the world the glories of our journey” Professor John Hope Franklin.
However, textbooks are changing too. Electronic editions, online extensions, PDA downloadable versions, online updates, and enhancements such as video clips have created a fusion of textbooks and the worldwide web that is changing the experience and expectations of the readership. The emerging pressures of revalidation and recertification of doctors via formal testing is also creating a new demand for practical and concise textbooks. It is now possible to travel places with a textbook and a computer.
At over 1000 pages, this textbook can hardly be labelled concise although the layout is extremely well organised. It uses all of the electronic enhancements mentioned above and is profusely illustrated with highlighted tables and message boxes. There are four colour coded sections: symptoms, syndromes and scenarios, diseases of the gut and liver, primer of diagnostic methods, and primer of treatments.
The four sections create challenges in preventing overlap and repetitions. For example, heartburn is covered in symptoms section and oesophageal diseases section, with repetitions in diagnostic tests of motility and functional tests and the treatment sections. Overall, however, the structure works reasonably well and the first two sections are the strongest. There are superb chapters such as analysis of diarrhoea, but also chapters such as functional gastrointestinal disease which simply lists a succession of tables. Some of the chapters in the initial section also have useful internet sources of information for patients and doctors. The symptoms, syndromes, and scenarios ignore an increasingly large proportion of health care seekers who wish to avoid risks by screening, although asymptomatic.
Diseases of the gut and liver are organised roughly in anatomical and conventional order but cover the entire breadth of gastrointestinal and liver disorders with a superb collection of splendidly illustrated chapters. Some, but not all, of the chapters are state of the art, with particularly strong coverage of gastric malignancies and colorectal cancer. A chapter on other gastrointestinal tumours misses opportunities for illustrations and could have been easily merged with a previous chapter on gastrointestinal stromal tumours and carcinoid tumours. Motility disorders are well covered, including a very well balanced chapter on irritable bowel syndrome.
In the primer of diagnostic methods, there are some excellent chapters on endoscopic techniques, but given the profusion of endoscopy textbooks, it may be less useful to the readership. However, virtual endoscopy and the PET chapters are well written and illustrated. Novel endoscopic imaging modalities are covered somewhat too concisely. In the primer of treatments, the chapter on drugs used in gastrointestinal and liver diseases is mostly repetition and redundant, but the nutritional assessment and management sections are strong.
The authorship is international and a refreshing number of “rising stars” are represented. The index is comprehensive. Overall, this is a welcome addition to the wide selection of textbooks available to gastroenterologists and will be useful to both trainees and experienced clinicians. It fulfils the definition of a good book………
“That is a good book which is opened with expectation and closed in profit” Amos Bronson Alcott.