Description
Gastroenterological practice in Singapore varies in many ways fromthat in Western countries and it is timely that a book on the
management of gastroenterological problems commonly encountered
locally be produced. This book is aimed at the general practitioner and
physicians whose special interest is not gastroenterology.
The pattern of gastroenterological disorders Mais vsierand sed by the
improved socio-economic circumstances in Malaysia and Singapore.
The pace of work and living is responsible for the increase in functional
disorders. As a general physician with a special interest in
gastroenterology, I have noticed a drastic turnabout in peptic ulcer
disease. The prevalence of duodenal ulcers has completely overtaken
that of gastric ulcers.
Acute haemorrhage from duodenal ulcers is also more common than
previously. Gall bladder afflictions have shown a similar trend. The
incidence of chronic inflammatory diseases of the bowel is increasing.
Bacterial infections of the large bowel are not uncommon, and
tuberculosis of the gut is now becoming a rarity. The increase in
colorectal cancers has been tremendous over the past decade, and
measures to counteract this increase will pose a major challenge to
both gastroenterologists and general physicians.
The progress in gastrointestinal endoscopy is note worthy. In 1966, 1
brought home from Tokyo an early model of a fibreoptic gastroscope
with a tiny camera at the tip of the instrument. With innovations almost
every other year, there are now a host of models for different purposes.
Today, every advance in this field has become available including
endoscopic removal of gallstones, endoscopic drainage of malignant
obstruction of the biliary tree and ultrasonic endoscopy. To keep up with
the pace of instrumental development, practising gastroenterologists
have been sent abroad regularly for training.
In the solid organs of the abdomen, again the classical infectious
diseases are less frequently seen nowadays. There is a high
prevalence of viral hepatitis and liver cancer. As previously, the
challenge here is early diagnosis. Amoebic liver abscess is
documented in only a handful of patients yearly, and has been
overtaken in prevalence by pyogenic liver abscesses.
All in all, a lot of progress has been made and it gives me great
pleasure to launch this textbook which I hope will not be the last local
production.
