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Small Bowel Disorders
  1. F BIAGO

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Small Bowel Disorders. Edited by R N Ratnaike (Pp 640; illustrated; £125.00). UK: Arnold, 2000. ISBN 0 340 76008 7.

This is a book that covers not only small intestinal disorders but also the anatomy and physiology of the normal small bowel. Absorption of nutrients is presented in a very detailed way. Although these aspects are very well dealt with, it is somewhat curious that in a book entitled Small Bowel Disorders almost 50% of the text is related to the anatomy and physiology of the small intestine. On the other hand, chapters on symptoms and signs of small intestinal diseases and those on the use of the most important diagnostic tests will be of great help for clinicians. I was favourably impressed by the quality of the very interesting figures.

The book is particularly aimed towards tropical conditions affecting the small bowel. Many pages are specifically dedicated to infectious diseases and these are always kept in mind in the chapters describing diagnostic tests. In contrast, some non-infectious conditions are less extensively described. Only a few pages are dedicated to small bowel bacterial overgrowth, vascular disorders, radiation enteritis, and graft versus host disease, conditions that are relevant in the practice of gastroenterology in the western world. Nevertheless, the chapter on coeliac disease provides some practical information on following a gluten free diet that will be very useful not only for gastroenterologists but also for general practitioners and dieticians dealing with patients affected by coeliac disease. Patients too may find this chapter of great use. The chapter on Crohn's disease is up to date and interesting. Disappointingly, the use of ultrasonography in both the diagnosis and follow up of this condition is only briefly described.

The references are somewhat disappointing. Although in some chapters they are up to date, in others most date back to the 80s.

In conclusion, this book will be useful for clinicians with a specific interest in the small intestine. Otherwise, however, gastroenterologists may not find this book much more useful than the chapters dedicated to the small bowel in the major gastroenterology textbooks. Moreover, gastroenterologists working in tertiary referral centres for the small bowel may find some chapters out of date and not of much use for the most difficult decisions. Hence clinicians practising in the tropics or dealing with patients travelling in less industrialised countries are those that will benefit most.