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Inflammatory Bowel Diseases
  1. S Ghosh

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Edited by J Satsangi and L Sutherland. London: Elsevier, 2003, £99.99, pp 792. ISBN 0 443 07121 7

In pure quality of production terms, this is clearly the “Ferrari” among all multi-authored books on inflammatory bowel diseases (IBD). Lavishly illustrated in colour and printed on glossy pages, this is a beautiful book to thumb through. The authorship is very international and therefore somewhat variable in style. Some chapters unpredictably lack a useful “conclusion” section, not made up by the very brief bullet points at the beginning of each chapter. Following a brief historical perspective, the arrangement is traditional and comprehensive, dealing successively with pathogenesis, clinical presentation and diagnosis, medical and surgical treatments, and complications and clinical problems. The intestinal complications section deals only with abdominal fistulising Crohn’s disease and omits other intra-abdominal and intestinal complications dealt with in the surgical treatment section.

The pathogenesis section covers genetics, immunology, epithelial barrier, animal models, and implications of pathophysiology for clinical management. However, this section is roughly about one fifth of the book and for a basic scientist looking for an exhaustive reference source, somewhat limited in scope. The clinical section is however extensive and superbly illustrated. The chapter on endoscopy is especially pleasing with a wide range of photographs and a detailed treatise, but capsule endoscopy is missing. The two chapters on imaging are somewhat overlapping and repetitive and could have been separated along the lines of barium radiology, computed tomography, magnetic resonance imaging, and emerging techniques. Somewhat surprisingly, biological therapies come under selected topics in therapy. Given the importance of infliximab in current management, this might have been given a separate “anti-tumour necrosis factor” chapter, although there is some repetition, with infliximab also being discussed in the primer of current therapies chapter. The surgical treatment section is magnificent but spoiled by inappropriate headers in places, such as “Complications of port access” spilling over into later pages. Quality of life issues probably should have come earlier in the clinical section rather than as the last chapter, and are somewhat superficially dealt with. Pharmacoeconomic aspects are not extensively dealt with, given that these will become progressively important issues in the era of expensive therapies.

Overall, one cannot but marvel at the encyclopaedic breadth and scope of this book and this is a must have for all institutional libraries. The index is not particularly user friendly, and a search could not find “dendritic cells” or “bile acid malabsorption”. For a book dealing with inflammatory bowel diseases, the absence of a substantial chapter on microscopic colitis may be considered an omission although it is briefly covered in the differential diagnosis.

“Some books are to be tasted, others to be swallowed, and some few to be chewed and digested: that is, some books are to be read only in parts, others to be read, but not curiously, and some few to be read wholly, and with diligence and attention”, Sir Francis Bacon. It may be a daunting task to read this book wholly with diligence and attention but it is a marvellous advertisement for IBD. An individual gastroenterologist would probably like to refer to this book from the institutional library rather than own one. Like a Ferrari, owning one may not be the most practical way to travel every day.

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