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Colonic Diseases
  1. S Ghosh

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Edited by T R Koch. Totowa New Jersey: Humana Press, 2003, pp 553. ISBN 0-89603-961-7

Colorectal diseases are common, and interest in coloproctology continues to increase among surgeons, physicians, and scientists. A recent attendance at a surgical coloproctology meeting confirmed the very multidisciplinary nature of the specialty. The focus on coloproctology justified the publication of a well organised book edited by Dr Timothy Koch. The book has a distinguished panel of North American authors.

Part I deals with basic science in 11 excellent chapters and the book is worth having simply to marvel at the progress in our understanding of colonic physiology and immunology over the past decade. Colonic motility and its neural regulation, as well as colorectal sensation, are covered in depth in three chapters. The integration of colonic function is vividly described and understanding is then translated to relevance in continence and defecation. The exciting possibilities of pharmacological interventions to modulate colonic function are entering an era reminiscent of the understanding of vascular control that led to a plethora of agonists and antagonists. Excellent chapters on mucin and goblet cell function, aging, micronutrients, and colonic endocrine cells follow, and these chapters integrate knowledge in an authoritative manner in areas not often appreciated by those not directly involved in relevant active research. The chapter on probiotics is more translational but nevertheless comprehensive. Even those with deep subspecialty interest in colorectal problems will come away with new information after reading this section of the book.

Part II covers investigations relevant to colonic diseases. Some of the chapters in this section probably are more relevant as research methodology tools, such as inflammation, oxidative stress, and epidemiological/outcome research. The chapter on inflammation could have contained some references to imaging in inflammatory diseases, especially with radionuclides, in order to justify sitting comfortably in this part of the book. The rest are more clinically inclined and comprehensively cover the entire spectrum of investigations in colonic diseases, including colonic physiology and function, radiology, colonoscopy, and histology.

Part III details specific diseases in a further 11 chapters. This is certainly not a book to have for its coverage of colon cancer, and given the importance of this disease, more information on the basic science of colorectal neoplasia as well as clinical aspects could have been provided, preferably in additional chapters. A number of more unusual conditions are not covered, such as pneumatosis cystoides intestinalis and melanosis coli, and there is little on colonic vascular disorders, including angiodysplasia. Radiation colopathy is mentioned only in the section on colonoscopy. Microscopic colitis and infectious colitis surely deserved full chapters, rather than passing mentions. The vast majority of references are from year 2000 or before.

The colour plates are superb, but lack of a full caption prevents their enjoyment in isolation without referring to the text. Overall, this is a superb volume with a wealth of information, especially in basic science and translational aspects. I would recommend this book to anyone interested in colorectal diseases, but perhaps not to those interested in colorectal cancer alone. All gastroenterologists, most colorectal surgeons, and some colorectal nurse specialists would benefit from having access to this book, which is compact enough to slip into a briefcase.