Clinical Cases Uncovered Gastroenterology PDF

Clinical Cases Uncovered Gastroenterology PDF

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Clinical gastroenterology is both simple and complex. The simplicity comes from the finite number of diagnoses that are commonly encountered, and the relatively limited number of symptoms that typically indicate disease of the gastrointestinal system. However, there are hidden depths to the practice of the speciality. Gastroenterologists deal with disease affecting many separate organs that all form part of the same system – the liver, pancreas, stomach, etc. The clinical consequences of some diseases can be dramatic and complex, particularly, for instance, dysfunction of the liver. Symptoms such as abdominal pain, altered bowel function and changes in weight can be combined in myriad ways to pose true clinical puzzles. This book aims to guide the reader through this complexity by offering real case studies and showing how, in practice, clinicians can achieve some degree of clarity, and offer to patients a reasonable diagnostic and therapeutic plan.
In the first section, the book offers a basic and brief overview of anatomical, physiological and pharmacological facts that inform our thinking about gastroenterological problems, and suggests how best to approach the patient in the second chapter. Thereafter, in the second section, each chapter deals with presenting symptoms and signs and the subsequent chapters are arranged in six sections to cover disease processes affecting the upper gastrointestinal tract, lower gastrointestinal tract, liver, pancreas and biliary tract, nutrition, and so – called functional bowel disorders. These are important and often overlooked because there is a profound lack of understanding about their pathogenesis. However, there are many patients with irritable bowel syndrome and the like, and a robust and reliable clinical approach to treating them is essential.
In each of the symptom – or sign – based chapters, the emphasis is on clinical reasoning and strategy, and the reader will have an opportunity to examine how the many possible paths are in practice negotiated to reach a diagnosis and formulate a plan for managing the situation. Exact doses and tests are deemphasised, while strategies, categories and context are highlighted, all within the framework of dealing with the particular human patient whose predicament is being examined.
Boxes and lists are strategically placed to aid memory and recall, and to emphasise key facts. The last section, which comprises a set of questions to test understanding, is based on the contents of each chapter, and the emphasis in these is on core knowledge rather than the esoteric or arcane.
Writing this book has proved to be an education as well being hugely enjoyable, and our hope is that the reader too will gain knowledge and understanding of the complexity of gastroenterological medicine, whilst acquiring some practical understanding of how to approach the patient with gastrointestinal problems, and some sense of satisfaction and fun. The typical reader might be a medical or nursing student in their clinical years, or a doctor in training, either in their foundation years or in early speciality training. The book will be useful as preparatory reading before joining the gastroenterology firm in a clinical rotation, or as an aid to revision before written and clinical examinations.

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