Field of medicine: Gastroenterology and hepatology.

Format: Hardcover book.

Audience: Medical students, trainees, internists, and surgeons.

Purpose: To serve as a comprehensive, authoritative text on the pathophysiology, diagnosis, and management of gastrointestinal and liver diseases.

Content: This new edition incorporates significant changes. Most important, it contains 22 new chapters on the liver. A section on the approach to clinical problems includes good chapters on the problem-oriented evaluation of nausea and diarrhea and is designed to appeal mostly to clinicians in training. The presentation of organ pathophysiology differs from that in previous editions. This edition presents organs in order from cephalad to caudad rather than beginning with hollow organs.

Highlights: The book contains excellent sections on autoimmune hepatitis, ascites and spontaneous bacterial peritonitis, viral hepatitis A through G, and drug-induced liver diseases. Other additions include new chapters on nonsteroidal anti-inflammatory drugs and gastrointestinal disease, Helicobacter pylori, and the gastrointestinal complications of organ and bone marrow transplantation.

Limitations: Although the section on the liver serves as an update for practicing gastroenterologists and will be useful for clinicians in training, hepatologists and hepatology fellows may not find enough specific or detailed information.

Related reading: In a comparison with two other well-recognized gastroenterology textbooks, Textbook of Gastroenterology, 2nd edition, by Yamada and colleagues (JB Lippincott, 1995), and Bockus' Gastroenterology, 5th edition, by Haubrich and coworkers (WB Saunders, 1995), this book fares well despite its shorter length. Bockus' Gastroenterology, which first appeared in 1945, emphasizes physical diagnosis and the historical aspects of gastrointestinal disease. Textbook of Gastroenterology, which debuted in 1991, is known for its thorough treatment of the pathophysiology of peptic ulcer disease and other digestive disorders. Sleisenger and Fordtran's Gastrointestinal and Liver Disease contains a hepatology section, which the other two works lack. Like Textbook of Gastroenterology, it contains useful algorithms for diagnosing and treating gastrointestinal disease, but it is less comprehensive in several other areas, such as biochemistry, molecular genetics, and nutrition.

Reviewer: Diana L. Rowell, MD, Ochsner Clinic, New Orleans, Louisiana.