Article Text

Download PDFPDF

Inflammatory Bowel Disease: Diagnosis and Therapeutics
  1. S Ghosh

Statistics from

Edited by R D Cohen. Totowa, New Jersey: Humana Press, 2003, pp 364. ISBN 0-89603-909-9. E-ISBN 1-59259-311-9

Knowledge is of two kinds. We know a subject ourselves, or we know where we can find information on it”, Samuel Johnson (1709–1784).

In this era of IT explosion, a concise source of information is always welcome. Inflammatory bowel disease (IBD) can now boast of several large reference books with international contributors. Smaller texts tend to bring either a personal dimension, often entertaining, or a focus on controversial areas. The rather concise 350 page book edited by Dr Cohen however attempts to provide an overview of IBD within 17 chapters set out in a fairly conventional manner. It covers areas well beyond diagnosis and therapeutics. The contributors are all North American and the book therefore attempts to cater to a predominantly North American readership. When I received this lightweight but hardbound edition I immediately decided to put it to the “transatlantic flight test”—that is, whether the book would entertain and inform during a return flight to the USA, in between the inflight entertainment and an occasional champagne.

The book is organised in a conventional manner with historical facts, epidemiology, aetiopathogenesis, and genetics followed by presentation and diagnostics, medical and surgical management, paediatric issues, ostomy care, nutritional and extraintestinal manifestations, and cancer. Pathological features, for an obscure reason, come in as the last chapter. Two chapters towards the end cover very important gender issues and economic aspects. The chapter on economic aspects gives a wealth of information on medical care costs in IBD and almost anyone involved in caring for IBD patients will benefit from reading it. It is an ideal chapter on which to base a few slides whenever one is called upon to deliver a talk on some aspect of the management of IBD, which these days is incomplete unless a few economic issues are also addressed. Gender specific issues deals mainly with fertility and pregnancy in IBD patients, but does not address the issue of female fertility after ileal-pouch anal anastomosis, an increasingly important issue when counselling young women prior to a colectomy. In a book focusing on therapeutics, covering the entire medical management of both Crohn’s disease and ulcerative colitis within 22 pages was clearly challenging, but the chapter does provide some interesting management algorithms. Probiotics are referred to very briefly in the first chapter. The chapter on surgical management is longer and well illustrated. Indeed some of the illustrations can well be adopted for the purpose of counselling patients. The chapter on stoma care has a disproportionately short list of references compared with the other chapters, which are all well referenced. Radiological findings and imaging attract a whole chapter but not endoscopic findings, which is given a passing reference in the chapter on pathological features.

The main weakness of the book is that it tries to have something for everybody; but this is probably also its main strength. If I wanted a volume that I could give to my new research fellow about to start a career in research into IBD I could use this book as an introduction to IBD for at least the next three years. Best of all, I could give this book to such a research fellow, irrespective of whether he is a clinician, nurse, or a basic scientist. Patients, their friends, and families will however find most of the chapters rather dense and technical, even by North American “expert patient” standard and I do not think that it seriously tried to fulfil the role of educating patients, despite the claim in the preface. The book as a whole has a number of useful illustrations although some chapters are completely free of illustrations and hence somewhat less attractive in layout.

Overall, the book passed its “transatlantic flight test” and I felt I had read a robust overview of IBD. I will have my copy ready to pass on to my oncoming research fellows, but I will also continue to keep my larger reference books for more detailed information on specific therapeutic aspects.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.