ULCERS

There are no simple muses of peptic ulcer, Dr. Eisenberg makes clear in this comprehensive review. Fortunately, there are a number of effective treatments for the condition--or rather, conditions. One of the revelations of the book is that gastric ulcer (affecting the stomach) and duodenal ulcer (affecting the first segment of the small intestine) seem to be two different disorders: they have different signs and symptoms, sex/racial/ethnic incidence, personality profiles, genetic factors (such as association with blood group types), and so on. Eisenberg's summary of predisposing factors for each type is backed up by a variety of case histories and research investigations. In some of these, investigators were able to predict which individuals of a selected group might develop ulcers when exposed to conditions of stress. Information like this serves to dispel cliche (about the ulcer-prone executive, for example) and offer a sane, moderate approach to living. Dr. Eisenberg does not proscribe alcohol, tobacco, coffee, or tea, for example, although he does state clearly that aspirin should be avoided as a known irritant of the G.I. tract. As a surgeon (Head of Gastrointestinal Surgery at the University of Minnesota), he writes with convincing authority about what happens under elective interventions for intractable or emergency ulcer operations in the case of perforations or hemorrhage. But he also describes current medical and dietary management, and speaks of the possibility of using drugs to block particular histamine receptors in the stomach which stimulate acid production. He is speaking to the intelligent layman (and an estimated 10 to 20 million ulcer sufferers in America), but there is enough research interest, documentation, and fascinating case study from all over the world to make the book useful for the more professional practitioner interested in keeping up.