Gastrointestinal nutrition.

Gastrointestinal nutrition

Anderson A, Shepherd S, Monash Medical Centre, Melbourne, 2003, 103 pages, $60 (plus $5 postage and handling), ISBN 0-9750347-0-7

This book provides a guide to the practical application of gastrointestinal nutrition. Its purpose is stated to be 'a comprehensive guide to the nutritional management of disorders of the gastrointestinal tract'. The book is aimed at dietitians and other health professionals involved in the management of people with gastrointestinal disorders.

Gastrointestinal nutrition has evolved from a previous publication from Monash Medical Centre, 'Dietary management of diseases of the gastrointestinal tract', the second edition of which was published in 1996. This new book adds to the information in the past publication with a number of new sections, includes the management of a number of additional disorders not previously covered, and updates other previously covered sections.

The authors, Amanda Anderson and Sue Shepherd, are two Australian dietitians experienced in the management of gastrointestinal tract (GIT) disorders who actively contribute to professional organisations associated with gastrointestinal nutrition.

The book starts with four new sections. Firstly, 'Physiology' reviews the structure of the GIT and its role in digestion and absorption, including sites of nutrient absorption, gastric emptying and transit time. A second section 'Gastrointestinal tests and investigations' is a useful addition where relevant tests and procedures are explained in simple language. 'Therapeutic nutrition', the third section, examines the role of specific dietary components thought to be beneficial to the GIT--fibre, prebiotics, probiotics and synbiotics. Fourthly, the causes and possible treatment of symptoms including constipation, diarrhoea, vomiting, nausea, flatus and fat malabsorption are discussed in 'Gastrointestinal symptoms'.

The book then follows its predecessor with the next (major) section 'Gastrointestinal nutrition', systematically covering each anatomical area of the GIT starting with the mouth and ending with the large intestine--specifically exploring their function, relevant diseases and conditions, and the medical and nutritional management currently recommended. The scope is more comprehensive in this book and covers all areas of the GIT including those not addressed in the previous publication such as oral health and nutrition, surgical procedures for weight loss, bezoars, diseases of the liver, pancreas and biliary tract, intestinal pseudo-obstruction and colorectal cancer. The information throughout is up to date. Finally, the book provides the definitions of terminology used, and a list of relevant web site addresses.

Updated reference lists are included at the end of each section, or condition, to assist those readers who are new to gastrointestinal nutrition to gain further knowledge and understanding of each subject area.

Additional features that would be useful for the next edition are more details and examples of prebiotics and synbiotics, individually referencing the health effects attributed to the use of probiotics to facilitate further reading on the reader's specific areas of interest, and practical guidelines to help balance pancreatic enzyme replacement dose and dietary fat intake. As this book is now more comprehensive an index would be a useful feature for future editions, along with cross-referencing of relevant sections throughout the book. This book would best be read from beginning to end, at least initially, for readers to become familiar with finding all relevant information within its structure.

In summary, this book achieves its aims and provides an excellent, well informed, up-to-date, practical summary for dietitians and interested health professionals. Prior understanding of normal gastrointestinal physiology and function is assumed, and the authors clearly indicate this at the start. Dietitians at all levels of expertise, from students to practising dietitians, would find the book informative. Dietitians who specialise in working with those with gastrointestinal disorders would also find this book useful for its comprehensive and up-to-date overview of this subject area. It would also be a valuable addition to individual and departmental dietetic, medical and health libraries.

Marcelle Middleton

Dietitian 

Glebe, NSW