Editor V Balakrishnan MD, DM, FACG, FAMS
Professor of Gastroenterology Amrita Institute of Medical Sciences and Research Centre,
Cochin, Kerala India
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
B-3 EMCA House, 23/23B Ansari Road, Daryaganj
New Delhi 110 002, India
Phones: +91-11-23272143, +91-11-23272703, +91-11-23282021, +91-11-23245672, Rel: 32558559 Fax: +91-11-23276490, +91-11-23245683
e-mail: jaypee@jaypeebrothers.com Visit our website: www.jaypeebrothers.com
Branches
- 2/B, Akruti Society, Jodhpur Gam Road SatelliteAhmedabad 380 015Phones: +91-079-26926233, Rel: +91-079-32988717, Fax: +91-079-26927094e-mail: jpamdvd@rediffmail.com
- 202 Batavia Chambers, 8 Kumara Krupa Road, Kumara Park East, Bangalore 560 001Phones: +91-80-22285971, +91-80-22382956, Rel: +91-80-32714073, Fax: +91-80-22281761 e-mail: jaypeemedpubbgl@eth.net
- 282 IIIrd Floor, Khaleel Shirazi Estate, Fountain Plaza Pantheon Road, Chennai 600 008 Phones: +91-44-28193265, +91-44-28194897, Rel: +91-44-32972089, Fax: +91-44-28193231 e-mail: jpchen@eth.net
- 4-2-1067/1-3, 1st Floor, Balaji Building, Ramkote Cross RoadHyderabad 500 095, Phones: +91-40-66610020, +91-40-24758498, Rel:+91-40-32940929, Fax:+91-40-24758499, e-mail: jpmedpub@rediffmail.com
- No. 41/3098, B & B1, Kuruvi Building, St. Vincent RoadKochi 682 018, Kerala, Phones: 0484-4036109
- 1-A Indian Mirror Street, Wellington SquareKolkata 700 013, Phones: +91-33-22451926, +91-33-22276404, +91-33-22276415, Rel: +91-33-32901926 Fax: +91-33-22456075, e-mail: jpbcal@dataone.in
- 106 Amit Industrial Estate, 61 Dr SS Rao Road, Near MGM Hospital, Parel, Mumbai 400 012 Phones: +91-22-24124863, +91-22-24104532, Rel: +91-22-32926896 Fax: +91-22-24160828, e-mail: pmedpub@bom7.vsnl.net.in
- “KAMALPUSHPA” 38, Reshimbag, Opp. Mohota Science College, Umred RoadNagpur 440 009 (MS) Phones: Rel: 3245220, Fax: 0712-2704275e-mail: jaypeenagpur@dataone.in
Practical Gastroenterology
© 2007, V Balakrishnan
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the editor and the publisher.
First Edition: 2007
9788180619083
Typeset at JPBMP typesetting unit
5Contributors
- Anil John, md, dm (gastro), dnb (gastro)
- Associate Professor of Gastroenterology
- Amrita Institute of Medical Sciences,
- Cochin, Kerala, India
- Balakrishnan V, md, dm, facg, fams
- Professor of Gastroenterology
- Amrita Institute of Medical Sciences,
- Cochin, Kerala, India
- Deepak Suvarna, md
- DNB Trainee in Gastroenterology
- Amrita Institute of Medical Sciences,
- Cochin, Kerala, India
- Elango EM, msc, phd
- HOD, Department of Molecular Biology
- Amrita Institute of Medical Sciences,
- Cochin, Kerala, India
- George Thomas, md, dm
- Consultant Gastroenterologist
- Pushpagiri Medical College & Hospital
- Thiruvalla, Kerala, India
- Jose V Francis, md, dm
- Consultant Gastroenterologist
- Lakeshore Hospital, Cochin, Kerala
- India
- Madhu S Menon, mbbs
- Resident in Gastroenterology
- Amrita Institute of Medical Sciences,
- Cochin, Kerala, India
- Mathew Philip, md, dm (gastro), dnb (med), dnb (gastro)
- Senior Consultant Gastroenterologist
- Lakeshore Hospital, Cochin, Kerala, India
- Musthafa CP, md, mrcp
- Assistant Professor in Gastroenterology
- Amrita Institute of Medical Sciences,
- Cochin, Kerala, India
- Nandakumar R, md, dm (gastro), dnb (med), dnb (gastro)
- Assistant Professor in Gastroenterology
- Amrita Institute of Medical Sciences,
- Cochin, Kerala, India
- Narayanan VA, md, dm Professor and HOD of Gastroenterology
- Amrita Institute of Medical Sciences,
- Cochin, Kerala, India
- Narendranathan M, md, dm, mph
- Senior Consultant Gastroenterologist
- KIMS and Cosmopolitan Hospitals
- Thiruvananthapuram, Kerala, India
- Padmanabhan TK, md
- Professor and HOD of Radiation Oncology
- Amrita Institute of Medical Sciences,
- Cochin, Kerala, India
- Padma S Sundaram, mbbs, drm
- Consultant, Dept of Nuclear Medicine
- Amrita Institute of Medical Sciences,
- Cochin, Kerala, India
- Pavithran K, md, dm (med oncology)
- Consultant, Department of Medical
- Oncology, Amrita Institute of Medical Sciences,
- Cochin, Kerala, India
- Philip Augustine, md, dm
- HOD of Gastroenterology and Medical Director
- Lakeshore Hospital, Cochin, Kerala, India
- Prakash Zacharias, md, dm
- HOD of Gastroenterology
- Malabar Institute of Medical Sciences,
- Calicut, Kerala, India
- Prem Nair md, dip ab (med), dip ab (gastro)
- Gastroenterologist and Medical Director
- Amrita Institute of Medical Sciences,
- Cochin, Kerala, India
- Raj VV, md, dm
- Consultant Gastroenterologist
- Manipal Hospital, Bangalore
- Karnataka, India
- Rajeendranath T, md, dm
- Senior Consultant Gastroenterologist
- Baby Memorial Hospital, Calicut,
- Kerala, India
- Rajesh G, md
- DNB Trainee in Gastroenterology
- Amrita Institute of Medical Sciences,
- Cochin, Kerala, India
- Rajiv Mehta, md, dnb (gastro)
- Assistant Professor in Gastroenterology
- Amrita Institute of Medical Sciences,
- Cochin, Kerala, India
- Ramachandran TM, md, dm
- Assistant Professor in Gastroenterology
- Medical College Hospital, Calicut,
- Kerala, India
- Ramesh GN, md, dm
- Senior Consultant in Gastroenterology
- Lakeshore Hospital, Cochin, Kerala, India
- Ramesh H, ms, mch, facs
- HOD, Surgical Gastroenterology
- Lakeshore Hospital, Cochin, Kerala, India
- Saju Xavier, md, dm
- Consultant Gastroenterologist Al-Shifa Hospital, Perinthalmanna,
- Kerala, India
- Shanmuga Sundaram P, mbbs, drm, dnb (nuclear med) mnams
- HOD, Department of Nuclear Medicine
- Amrita Institute of Medical Sciences
- Cochin, Kerala, India
- Shine Sadasivan, md, dnb (gastro)
- Assistant Professor in Gastroenterology
- Amrita Institute of Medical Sciences,
- Cochin, Kerala, India
- Sobhana Devi R, md, dm
- Professor and HOD of Gastroenterology
- Medical College Hospital, Kottayam,
- Kerala, India
- Srikanth Moorthy, md, pddc
- HOD, Department of Radiology and Imaging Services
- Amrita Institute of Medical Sciences,
- Cochin, Kerala, India
- Sreekumar KP, md
- Consultant, Department of Radiology and Imaging Services
- Amrita Institute of Medical Sciences,
- Cochin, Kerala, India
- Subhalal N, ms, mch, facs
- Professor of Surgical Gastroenterology
- Medical College Hospital
- Thiruvananthapuram, Kerala, India
- Sudhindran S, ms, frcs,
- HOD, Department of Gastrointestinal Surgery
- Amrita Institute of Medical Sciences,
- Cochin, Kerala, India
- Sudheer K, md
- Professor of Radiology
- Pushpagiri Medical College & Hospital,
- Thiruvalla, Kerala, India
- Sudheer OV, ms, mch
- Consultant GI Surgeon
- Amrita Institute of Medical Sciences,
- Cochin, Kerala, India
- Sunil Mathai, md, dm
- Senior Consultant Gastroenterologist
- Medical Trust Hospital, Cochin, Kerala, India
- Thankappan KR, md, dm,
- (Presently Consultant Gastroenterologist, Kingdom of Saudi Arabia)
- Professor of Gastroenterology (Retd)
- Medical College Hospital,
- Thiruvananthapuram, Kerala, India
- Thomas Alexander md, dm, dnb (gastro)
- HOD, Department of Gastroenterology
- VSM Hospital, Mavelikkara, Kerala, India
- Varghese Thomas, md, dm
- HOD, Department of Gastroenterology
- Medical College Hospital, Calicut,
- Kerala, India
- Vinayakumar KR, md, dm
- Professor of Gastroenterology Medical College Hospital,
- Thiruvananthapuram, Kerala, India
- Vinod Kumar V, md, dm
- HOD, Department of Gastroenterology
- Ernakulam Medial Centre, Cochin, Kerala, India
- Viswanath N, md, dm
- HOD, Department of Gastroenterology
- Mother Hospital, Thrissur, Kerala, India
Long before, we were conducting continuing medical education programmes for practitioners regularly in the Gastroenterology Department at Medical College, Trivandrum. After a few years, we compiled the entire course material prepared by the faculty of our department and M/s Jaypee Brothers Medical Publishers (P) Ltd. New Delhi published this as a book Common Problems in Gastroenterology. This book was warmly welcomed by doctors and it soon went into a second edition. There must have been a continuing demand for such a book as evidenced by an enquiry recently made by the publishers whether I could bring out a revised edition of this book.
Gastroenterology, like the rest of medicine, has made phenomenal advances in the past few years in theory and practice. Keeping in tune with this, the book has been totally re-written by an entirely new panel of authors, and several newer chapters included. Reflecting the emphasis the book lays on a practical approach to day-to-day gastroenterology care, so the book is entitled Practical Gastroenterology. This is a collective effort where an array of eminent gastroenterologists including a few from allied specialties from across the state, have contributed their valuable time and effort. I am deeply indebted to all of them. It is hoped this book will be a handy, comparatively inexpensive, ready reference in gastroenterology for practitioners and doctors in training all over India. My special thanks are due to Mr N Sudhakaran who has rendered invaluable help to me with secretarial assistance in the preparation of the manuscript. I should express my sincere gratitude to M/s Jaypee Brothers Medical Publishers (P) Ltd. New Delhi for the excellent support they have extended in publishing this book.
V Balakrishnan