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Helicobacter Infection
  1. J J MISIEWICZ

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Helicobacter Infection. Edited by Farthing MJG, Patchett SE. (Pp 263; illustrated; £45.00.) London: Royal Society of Medicine Press, 1998. ISBN 1-85315-342-7.

Helicobacter pylori is my favourite animal, but even allowing for that I found this monograph (because that is what it really is) a real page turner. If one is honest about it, few medical texts are actually enjoyable to read and ploughing through the so called literature can be hard work. Many books contain a lot of useful facts, but the prose can be turgid and laden with clichés. This issue of the British Medical Bulletin is a shining exception to the rule. Attractively produced by the Royal Society of Medicine Press, it sits easily in the hand and for a paltry £45 the 28 authors will take you on a fascinating and enlightening tour of theH pylori scene. On the way you will visit basic science, epidemiology, the clinical conditions associated (or not, as the case may be) with H pyloriinfection, diagnosis, treatment and management strategies, paediatrics and non-gastrointestinal effects of H pyloriinfection, and the possible development of a vaccine. The tour ends with a debate on the important topic of cost effectiveness of eradication therapy.

The planning committee was chaired by the Editor ofGut (Professor Michael Farthing), assisted by Dr Duncan Bell, Dr Jean Crabtree, Professor David Forman and Dr Stephen Patchett, and they have done an excellent job. Remarkably, for a multi-author text, there are no overlaps between the chapters and the scientific editors (Farthing and Patchett) must have worked very hard to have achieved an impressive uniformity of style. All the contributions are of a high standard, all are written by internationally recognised experts in the respective fields and deal authoritatively with their topics. The bibliographies include papers published up to 1998.

Does the book contain everything one needs to know aboutH pylori in 1998? Pretty nearly, but not quite—no one is perfect. To allow myself a few minor quibbles: perhaps the relation of H pylori to gastro-oesophageal reflux disease and the posteradication symptoms in patients with duodenal ulcer, could have been discussed.

Who should read this volume? As everyone knows, there has been a veritable explosion of publications on the various aspects ofH pylori, but do we really need another monograph on it? If it reaches the standard achieved byHelicobacter Infection, the answer is a resounding yes. For the committed helicobacteritesHelicobacter Infection provides an excellent refresher course and will stimulate those who are casting about for interesting hypotheses to test and grant application to write. Clinical research workers and hospital clinicians will find helpful discussions and even some answers, to the many dilemmas and uncertainties that still bedevil the management of H pyloriinfection. One is tempted to say that this text is required reading for the gastroenterologist in training. As more and more treatment ofH pylori infection is done in general practice and as confusion still persists regarding the when and how ofH pylori therapy and diagnosis, many general practitioners will find it very instructive to pick up this book in the Postgraduate Centre library and if they embrace the ideas set out in the clinical sections, their management of the dyspeptic, or the ulcer patient, or the patient on non-steroidal anti-inflammatory drugs or those with a family history of gastric cancer will improve.

It is interesting to see that in the interval between submission of the manuscripts to the publication of Helicobacter Infection there has been progress in the basic science, but the treatment remains largely unchanged, perhaps indicating that the limits of therapeutic efficacy has now been reached with the existing antimicrobial agents. Diagnostic techniques have been fine-tuned a little bit, but without, so far, any major impact on the practicalities. Go and buy your copy now, or make sure your departmental library has one. Oh, and another thing. For anyone setting out to edit a multi-author monograph, this is the template to work from.

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