Summer 2010 - The British Pain Society

BOOK REVIEW
Oral feeding difficulties
and dilemmas
Dr Fiona Ring, Dr Emily Collis
Imperial College Healthcare NHS Trust
Joint publication between RCP and the
British Society of Gastroenterologists
Jan 2010 ISBN: 9781860163715
At first look this publication may
seem a daunting eighty page read.
With a little perseverance though,
you begin to appreciate what the
authors are trying to achieve and
realise it is well worth the time
and effort.
Divided into five chapters, the
book does not provide a definitive
management plan for patients
with oral feeding difficulties. It
does however equip you with
the knowledge, and thus the
confidence, to approach this
increasingly common and always
difficult issue pragmatically.
The book starts off with the
basics, looking at the mechanism
of swallowing, how different
diseases impact on this and how
swallowing is assessed, before
LETTERS
considering the principles of
managing it when it is impaired.
Pertinent paragraphs discuss
the metabolic consequences of
withholding nutrition and what
happens at the end of life. You
then move on to a concise,
evidence-based review of the
techniques of artificial nutrition,
including their indications,
complications and consideration
of the alternatives. This is followed
by particularly useful chapters
which outline the ethical principles
applied to oral feeding difficulties
and the relevant law. The final
chapter serves to draw everything
together and apply it to clinical
practice. Disappointingly, the case
studies do not cover the most
taxing of clinical situations that
may be encountered, but they are
a good place to start.
The report is undoubtedly a
useful resource and having read
it, can instantly be translated into
practice. It gives a structure
within which to consider a patient
with oral feeding difficulties and
highlights the key questions
that should be addressed. It is a
reassuring reference in times of
uncertainty and is an invaluable
source of relevant information and
evidence, facilitating discussion
with patients and their relatives.
All of these points can only serve
to help us to arrive at the best
decision and outcome. It is an
insightful book you’ll be glad to
have on the shelf!
Letters to the Editor
Dear Editor
I read with interest article written
by Dr. Thanthullu Vasu on pain
research- ethics committee.
The article is well constructed
answering most of the doubts
trainees have regarding ethics
committee. It clearly explains the
steps taken by the committee.
I look forward for more such
informative articles.
Dr.Ravi Srinivasagopalan
St.Georges School of anaesthesia
London
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Breathworks CIC is a not-for-profit social enterprise offering courses, training
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placing an insert in Pain News
contact Rikke Susgaard-Vigon on
020 7269 7840 or email
newsletter@britishpainsociety.org
PAI N N E W S S U M M E R 2010 5 9