Book Review

Textbook of Pediatric Gastroenterology and Nutrition

N Engl J Med 2005; 352:2033-2034May 12, 2005

Article

Textbook of Pediatric Gastroenterology and Nutrition
Edited by Stefano Guandalini. 804 pp., illustrated. London, Taylor & Francis, 2004. $299.95. ISBN: 1-84184-315-6

Two events in 2004 helped to underscore the rapid growth and increasingly international flavor of the young field of pediatric gastroenterology and nutrition. The first was the convening of the Second World Congress of Pediatric Gastroenterology and Nutrition in Paris, which was attended by more than 3100 delegates representing 107 countries. The second was the publication of this textbook, whose stated goal is the creation of a “global flavor,” one that will reflect “the different realities that gastroenterological and nutritional problems take on in different parts of the world.” Since nearly two thirds of the 64 contributors are from Europe, the book succeeds, at least, in having a continental flavor.

Cross Section of a Normal Colonic Crypt in a Child.

The book is a comprehensive survey of clinical gastroenterology and nutrition but does not cover hepatology. The editor has organized the book into major categories covering congenital disorders; diseases of the esophagus and stomach; infectious, functional, and inflammatory and immune-mediated disorders; general and neonatal nutritional problems; selected disorders; and surgical and neoplastic disorders.

Among the book's important strengths are well-written chapters by a number of internationally recognized experts. Most of the chapters follow a standard organizational style covering epidemiology, etiology, pathophysiology, clinical signs and symptoms, investigational studies, differential diagnosis, and treatment. Most of the discussions are thoroughly referenced. Clinicians will appreciate the practical approach to diagnosis and treatment, and all readers will appreciate the high quality of the technical aspects, including many of the color reproductions. Differences in diagnostic and therapeutic approaches between European and North American perspectives are generally handled well, since most of the authors have included a discussion of recent studies to support their recommendations.

The inclusion of some “how to” sections, such as a discussion of endoscopic procedures and techniques, would strengthen future editions of the book. Some readers might also appreciate a more thorough approach to issues such as the mechanisms of disease, especially in regard to the rapidly expanding field of autoimmune disorders. A section on the approach to specialized problems, such as diseases in immunocompromised children, would also be helpful. In addition, the section on congenital disorders could be expanded with a discussion of such conditions as deficiencies in brush-border enzymes and the gastrointestinal manifestations of cystic fibrosis. Future editions might become even more global by including an expanded representation of authors from Asia, Australia, Africa, and Latin America.

Despite these minor criticisms, this textbook — a positive addition to the field of pediatric gastroenterology and nutrition — serves to emphasize the growth and international diversity of the subspecialty. It should be a practical and helpful resource to the global community of physicians, students, nurses, and other professionals who care for children with gastroenterological and nutritional disorders.

John Snyder, M.D.
University of California, San Francisco, San Francisco, CA 94127