ABSTRACT
Diseases of the gut, liver and pancreas are common. Some abdominal symptoms are so frequently experienced that they are regarded as normal, whereas similar symptoms can also represent serious disease. The challenge for all doctors in primary and specialist care is to sift the symptom pattern and manage each patient appropriately. The aim of this book is to suggest appropriate ways of using investigations, specialist clinics and drugs (or ‘resources’ in the current jargon) for patients with gastroenterological conditions in both primary and specialist care. The authors present the options that they consider to represent best management for common disorders, but are conscious that opinions and circumstances differ. Consequently these options (as opposed to rigid ‘protocols’) may simply act as a starting point for dialogue between doctors in primary care and specialist gastroenterology. To use a maritime analogy, for many gastroenterological disorders the specialist should be at hand for a light touch on the tiller, rather than acting as captain, first officer and bosun rolled into one. Indeed, the specialist’s main role is often as a navigator, trying to plot the best course in the management of chronic relapsing disorders.
