This is one of the latest additions to the Oxford handbook series, which now comprises over 30 titles covering the entirety of medical practice. It is aimed at medical students, doctors in training, nurses and general practitioners. It is also designed to be a useful aide memoire for senior gastroenterologists. Now that the days of doctors wearing white coats with capacious pockets are over, at least in the UK, it is intended to be carried in rucksacks or handbags. It weighs in at 402 g so is practical to be carried around hospital wards and outpatient departments.
It is divided into four sections, which have colour‐coded pages to aid navigation through the book. The first section covers approaches to 28 common clinical problems. This is an excellent section. Each of the four sections starts with the differential diagnosis, and for conditions with a large differential diagnosis, such as chronic diarrhoea, a pathophysiological framework is given to aid both understanding and memory. I was delighted to see that the old‐fashioned prohibitions on the use of antimotility drugs and antibiotics in acute diarrhoea are abandoned but instead wisely discussed. I was rather less convinced that a change in diet has much effect on excessive wind—if only it was that easy! In some areas, this section overlaps with the British National Formulary (BNF). For example, the different treatment protocols for Helicobacter pylori are documented far more comprehensively in the BNF.
The second section is an A to Z of all gastroenterological and hepatological conditions, tests and treatments. It is pretty comprehensive, although it took me some time to work out how to follow‐up a patient with a colonic adenoma, my problem being the use of the word “adenoma” instead of “polyp”. Detailed recommendations on follow‐up protocols for polyps are not provided, but, given the proliferation of guidelines from numerous national gastroenterology societies and bodies, this is inevitable. I looked up some small print problems I have had in my own clinical practice recently. The chapters on solitary rectal ulcers and gastrointestinal stromal tumours are well done. The association of microscopic colitis with proton‐pump inhibitors was not mentioned in an otherwise good summary. Gastroparesis does not seem to be covered in this book at all. Coverage of rare diseases is important in books such as this because it is exactly these conditions that catch young clinicians out and such patients often turn up on hospital wards and have lengthy inpatient stays.
There is a short section on drugs used in gastroenterological and hepatological practice. This is brief and punchy, giving the indications, mode of action, dosing regimens, contraindications, side effects and clinical practice points. This duplicates almost exactly information in the BNF, but is much more user friendly and it is easier to find the drug of interest.
The last section deals with gastroenterological and hepatological emergencies. It covers the acute abdomen, diarrhoea, liver failure, gastrointestinal haemorrhage, swallowed foreign bodies, oesophageal obstruction and rupture. There is certainly more than enough information to get a sick patient through the night and a sensible management plan established, which is exactly what the junior doctor wants. The section is also useful for senior clinicians as it includes prognostic scoring systems such as the Rockall Scoring system for upper gastrointestinal bleeding, which can be difficult to remember if one is not using them all the time.
Overall, this is an excellent book taking a no‐nonsense and sensible approach. Most topics are easily found and short enough to be read in less than 10 min. I shall certainly be recommending it to my own junior staff, both for their own benefit and also to remind myself of that annoying fact I've just forgotten!