GP’s guide to dyspepsia | |
Rapid reference to dyspepsia. Emad El-Omar, Michael M Peek. London: Mosby, 2003 (vi + 128 pp). ISBN 0 7234 3326 7. |
DYSPEPSIA AFFECTS
up to 36% of the NSW population and one person in three will have consulted a doctor in the past three months. Strategies for management of dyspepsia have changed with the discovery of Helicobacter pylori’s association with upper-gastrointestinal disease and the continuing fall in the incidence of gastric cancer. This book is an excellent reference for the busy general practitioner confronted with the question of how to manage the patient with dyspepsia in the light of these changes. The book is a handy pocket size, with a little over 100 pages of colour-coded chapters. It is well indexed and referenced, making it easy for the busy clinician to look up issues relevant to the patient as they arise. The authors have taken a commonsense, practical approach to the management of dyspepsia, debunking a lot of the theories about dyspepsia classifications, diagnosis and management. It is appropriately pitched for the busy general practitioner, with some sound take-home messages, including “there are no data to show which strategy (step-up or step-down) is better… Common sense is often the best strategy.” The only shortcoming is the limited focus of the “frequently asked questions” section, which tends to be oriented towards Helicobacter pylori-related questions rather than dyspepsia more generally. This focus is probably somewhat outdated now that patients have forgotten about Helicobacter pylori and are more interested in the benefits and risks of endoscopy, long term medication and antireflux surgery. The book has an occasional British focus — one certainly would not have 50% of people having gastroscopy without sedation in this country! Overall, however, this is a welcome, handy rapid reference and should be recommended not only to general practitioners, but also to non-gastroenterologists who find themselves confronted with a patient with dyspepsia and the question “What should I do?”. Anne E Duggan
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