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Book review
The changing world of inflammatory bowel disease: impact of generation, gender and global trends
  1. David S Rampton
  1. Correspondence to Professor David S Rampton, Barts and the London School of Medicine and Dentistry, Endoscopy Unit, Royal London Hospital, London E1 1BB, UK; d.rampton{at}

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Edited by EJ Scherl, MC Dubinski, Published by Slack Inc, Thorofare, New Jersey, USA, 2009, pp 267, £70 (Hardback). ISBN-978-1-55642-841-8

How the expression of chronic diseases differs in people of varying ages, sex and ethnicity may tell us something about their cause: it certainly influences their management. I saw this intriguing title on the Amazon website a few weeks ago, and was delighted to be spared the decision as to whether or not to buy it by being sent a free copy for review.

The Changing World of Inflammatory Bowel Disease’ is medium sized, concise and selective in its coverage. Most of its chapters are written by well-known inflammatory bowel disease (IBD) specialists. The first section provides overviews of the epidemiology of IBD in the west and developing world and an interesting and unusual chapter on immune development as it influences the expression of IBD in different age groups. Section two offers an eclectic mix of topics relating to IBD in children and adolescents: these include aetiopathogenesis, with an emphasis on genetics, natural history, medication responsiveness, bone disease, psychosocial issues in adolescents and transitional care. The third section concentrates on IBD in young adults. It starts and ends with fascinating (not least because they are so rarely covered in standard texts) summaries of the psychosocial impact of IBD on relationships and sexual health, and of the effect of surgery on femininity; in between, there are more conventional reviews of fertility and pregnancy in women with IBD. The penultimate section again covers an area rarely addressed, that of IBD in older people, while the last contains chapters on chronic care, surgery, management controversies and, slightly bizarrely, a final one juxtaposing a brief history of IBD with a review of the impact of new treatments.

Almost all the chapters are well laid out, with clear subheadings, tables and diagrams. Most are short: indeed, a few are too short and therefore superficial in their coverage. It is ironic that in a book which contains the words ‘world’ and ‘global’ in its title, all except one of the authors is from the USA or Canada. The book suffers from repetition in places: genetic aspects, for example, are covered in three of the chapters in the second section. It is also already slightly out of date, having been published in 2009, with references in most chapters no more recent than 2007. Lastly, while accepting that this is not meant to be a comprehensive text, there are a few relevant topics of which it makes little or no mention and which could perhaps be considered for a future edition. These include the evolution of Crohn's disease as children grow into adulthood (specifically, why don't we see, in adults, oral Crohn's or the extensive small bowel disease so common in children?), enteral nutrition (and why children and adolescents are so much better at taking it than adults) and the psychosocial impact of IBD on people from different cultural and ethnic groups.

Who should read this book? Paediatric and adult gastroenterologists with an interest in IBD and IBD specialist nurses will find plenty to interest them, although inevitably some chapters will cover topics outside their own line of practice. Perhaps this is one therefore to recommend to your library rather than to buy yourself, especially as it costs about £70.


  • Competing interests None.

  • Provenance and peer review Commissioned; not externally peer reviewed.