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Inflammatory Bowel Diseases

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    Inflammatory Bowel Diseases. Third edition. Editors RN Allen, JM Rhodes, SB Hanauer, MRB Keighley, J Alexander-Williams, VW Fazio. (Pp 989; illustrated; £125.00.) Edinburgh: Churchill Livingstone, 1996. ISBN 0-443-05067-8.

    The time will come, one supposes, when all the brain’s mysteries will be disclosed. Then, the combined forces of information technology and neurosciences will come up with methods to introduce and store knowledge—conveniently when we are asleep—so that existing methods of learning will be so inefficient that the lecture, seminar and written word will become redundant.

    What will then become a blockbuster textbook such as the present offering? Is it to be replaced by a chip downloaded directly into our brains? Maybe so, but until that time we shall just have to make do with the good, old-fashioned read—and try and retain what we can.

    If we are to continue with books for the time being, then please let them be as agreeable as the latest edition of Inflammatory Bowel Diseases. The greatest care has gone into the choice of chapters (112) and authors (155) to produce a definitive text for our time.

    This third edition, appearing some seven years after its predecessor, reflects the steady progress that has been made in our knowledge of this most enigmatic of areas within clinical gastroenterology. The addition of three new editors has led to the production of a volume that is, in many ways, very much more than just an update of the previous version. There are nearly 200 pages on pathogenesis which at least enable the clinician to feel a little more confident about answering patients’ almost invariable question, at some time or other, as to the cause of their condition. Knowledge may provide comfort even if we all know the best short answer to that highly pertinent query! The clinical section offers comprehensive coverage of diagnosis (incorporating new imaging modalities), the treatment section has been updated and, in the case of surgery, the text has been more than minimally invaded by completely new material.

    This book is 1000 pages long, and one perhaps should be a little wary of highlighting omissions. The field is fairly fast-moving, but this reviewer would like to have seen a little more about host–bacterial interaction in the gut. Presumably, the deadline was a little too late to cover all of the important recent progress in genetics. Similarly, targeted therapy has not received the attention that it might do in, for example, an annual update.

    It is somewhat of an old canard to say that textbooks are out-of-date as soon as they hit the bookstalls. I certainly heard that said when I was a medical student some 25 years ago, but surely it must be ever-truer today and in the future as online journals become the norm.

    I think this book could have done with a little excision. There is relatively little repetition, but I really wondered whether we needed to have 100 pages on inflammation in the gut which is not inflammatory bowel disease. I was unconvinced that we needed a chapter on‘Incisions and surgical approaches in surgery for inflammatory bowel disease’.

    Any reader mulling over the contents list will have no doubt that he is in for a pretty authoritative and substantial work when he finds out that the titles of chapters 4, 5 and 6 respectively are:Epidemial overview of inflammatory bowel disease, Epidemiology of inflammatory bowel disease, and Epidemiology smoking and oral contraception. There is patchy imbalance elsewhere. The histopathology of ulcerative colitis gets 20 pages whereas that of Crohn’s disease gets just 6.

    Overall though this is a very considerable volume indeed. Most of the chapters on therapy just exude with the authority of their authors. The fact that one of the authors of both the medical and surgical sections comes from the USA may even mean that this book will sell a few copies in the New World. It certainly deserves to.

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