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Inflammatory Bowel Disease: A Guide For Patients And Their Families.
1. J F MAYBERRY

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Inflammatory Bowel Disease: A Guide For Patients And Their Families. 2nd edition. Edited by Stein SH, Rood RP. (Pp 256; illustrated; $22.00/£13.75, Int.$25.00/£15.63.) Lippincott Williams and Wilkins, 1998. ISBN 0-397-51771-8.

This is without question an excellent book. It attempts with considerable success to provide a “textbook” for the patient with inflammatory bowel disease (IBD). As with most textbooks, it is not an easy read but sets out to give an exhaustive account of the cause, symptoms, investigation, and management of patients with ulcerative colitis and Crohn’s disease. As a result it does not score well on readability, but this should not seriously detract from its value as a patient education tool. Clearly the book will need to be used with discrimination but should be available to all patients who want to do advanced reading on their disease.

Patients with IBD are concerned about the management of their condition. Most studies have shown that their anxieties and interests focus around treatment and cancer risk. Although the book uses American drug nomenclature, the chapter dealing with medical therapy should be readily understood by an English patient although the interchangeability of names such as mesalamine and mesalazine may need explanation. The role of diet therapy in the management of acute exacerbations is given rather short shrift, although its value in the treatment of children is clearly recognised in the chapter by Susan Peck and David Piccoli.

I was particularly impressed by Samuel Benjamin’s refreshing chapter on alternative medicine. He recognises the fact that at some time most patients with IBD will consider an alternative approach and that a substantial number will try at least one of these treatments. He therefore counsels patients to seek a gastroenterologist and an alternative practitioner who are open to each form of treatment. His three red flags about comments that should alert patients to dangerous alternative practitioners are worthy of repetition:

• “We need to cleanse your body of toxins from standard medical care.”

• “We need to free your body of all present treatments in order for our treatment to work.”

• “It is impossible to have a mind, body and spiritual healing as long as your are on these medications.”

However, he also cautions patients about the “rationale of gastroenterologists” who consider integrative treatments “inappropriate”.

This book is for patients. It ends with a chapter on self help groups and details some of the work of the Patient Education Committee, a division of the National Scientific Advisory Committee. This close link between scientific research and patient education is something that should be emulated throughout patient groups. There is a range of useful suggestions for patient meetings and programmes for local support groups. This is a wonderful resource for the hard pressed local medical advisor. If only I had had a copy last year!

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