Clinical Dilemmas in Inflammatory Bowel Disease

by Editor: Peter Irving (Barts and the London, Queen Mary's School of Medicine and Dentistry, London); Editor: David Rampton (Barts and the London, Queen Mary's School of Medicine and Dentistry, London); Editor: Fergus Shanahan (National University o

• ISBN13: 9781405133777
• ISBN10: 1405133775
• Edition: 1st
• Format: Paperback
• Copyright: 2006-07-01
• Publisher: Wiley-Blackwell

Summary

This provides evidence-based guidance on topical clinical questions encountered by the medical team involved in the diagnosis, treatment and management of patients to help with the daily challenges in IBD. It discusses special management problems, novel treatments and optimising current management. Invaluable for the gastroenterologist/pediatric gastroenterologist, pathologist, radiologist, surgeon, dietician, stoma therapist, GI specialist nurse, pharmacist and counsellor in the medical team.

Author Biography

Peter Irving, Centre for Gastroenterology, Institute of Cell and Molecular Science, Barts and the London, Queen Mary School of Medicine and Dentistry, London, UK.

David Rampton, Professor of Clinical Gastroenterology at the Centre for Gastroenterology, Institute of Cell and Molecular Science, Barts and the London, Queen Mary School of Medicine and Dentistry, London, UK.

Fergus Shanahan, Professor and Chair of the Department of Medicine, National University of Ireland Cork, Cork University Hospital, Cork, Eire.

Table of Contents

List of Contributors	viii
Preface	xiii
Part 1 Investigating IBD in the 21st Century
Capsule endoscopy: do we need it?	1	(4)
Joel E D Mawdsley
Mark Appleyard
Pathology reports -- pitfalls for the unwary	5	(3)
Wilfred Weinstein
Non-invasive diagnosis and assessment	8	(3)
Alex J Di Mambro
Ana Terlevich
Chris Probert
What is the best way to image perianal Crohn's disease?	11	(4)
Vikram A Sahni
Alison McLean
Surveillance colonoscopy in UC: alternatives and ways to improve outcome	15	(3)
Mark Lust
William Connell
Abnormal liver tests -- what should we do about them?	18	(3)
Richard Marley
Abid Suddle
Part 2 Medical Treatment: Making the Most of What We've Got
5-ASA drugs
Is monitoring necessary?	21	(4)
Rakesh Shah
Alastair Forbes
Do they have a role in Crohn's disease?	25	(3)
Vikrant Sibartie
Brian Feagan
Steroids
Steroids in Crohn's: are they obsolete?	28	(4)
David Rampton
Antibiotics for Crohn's disease
Antibiotics: which, when and for how long?	32	(4)
Alex Kent
Jean-Frederic Colombel
Mycobacterium avium paratuberculosis in Crohn's disease: player or spectator?	36	(4)
Geoff Smith
Fergus Shanahan
Immunomodulators
TPMT testing: is it essential?	40	(5)
Azhar Ansari
Jeremy D Sanderson
6-Mercaptopurine or azathioprine?	45	(3)
Dermot McGovern
Simon Travis
Thiopurines: how long should we use them for?	48	(3)
Alexandra Daley
Marc Lemann
Making the most of methotrexate	51	(4)
Emma Greig
John Keohane
Brian Feagan
Cyclosporine: balancing risk and benefit	55	(4)
Helena Deeney
Barney Hawthorne
Infliximab
Contraindications -- absolute or relative?	59	(4)
Rakesh Chaudhary
Subrata Ghosh
How can we prevent tuberculosis?	63	(4)
Sasha Beresford
David Rampton
Dealing with infusion reactions	67	(3)
Geri Van Assche
Severine Vermeire
Paul Rutgeerts
Use in ulcerative colitis	70	(4)
Sreedhar Subramanian
Jonathan Rhodes
Infliximab and surgery: health or hazard?	74	(3)
David Rampton
Nutritional therapy for Crohn's disease
Nutritional therapy for Crohn's disease: is it for adults?	77	(4)
Donald R Duerksen
Charles N Bernstein
Part 3 Medical Treatment: What's Round the Corner?
Trials and tribulations -- interpreting clinical trials in IBD	81	(4)
Elizabeth Carty
David Rampton
Genetics -- clinical and therapeutic applications	85	(4)
Mark Tremelling
Miles Parkes
Probiotics -- separating science from snakeoil	89	(4)
Fergus Shanahan
John Keohane
Worms	93	(3)
David Grunkemeier
R Balfour Sartor
Smoking and nicotine - poison for Crohn's, potion for colitis?	96	(4)
Brian Bressler
A Hillary Steinhart
Heparin	100	(5)
Ailsa Hart
Stuart Bloom
Leukocytapheresis: filtering out the facts	105	(3)
Peter Irving
David Rampton
Appendectomy for ulcerative colitis -- a therapeutic option?	108	(3)
Richard Makins
Graham Radford-Smith
Biologic treatments in IBD	111	(5)
Raymond D'Souza
James Lindsay
Stem cell transplantation for IBD	116	(5)
Paul Fortun
Christopher Hawkey
Complementary and alternative therapy -- the way forward or a step back?	121	(4)
Louise Langmead
David Rampton
Part 4 Common Clinical Challenges: Beyond the Text Book
Functional problems	125	(4)
Eamonn Quigley
Psychological stress: something to worry about?	129	(4)
Joel E D Mawdsley
David Rampton
Drugs to avoid	133	(3)
Paul Collins
Jonathan Rhodes
NSAIDs and COX-2 selective agents: cause or cure of pain in IBD?	136	(3)
Ingvar Bjarnason
David Scott
Iron replacement -- is it safe and effective?	139	(3)
Stefanie Kulnigg
Christoph Gasche
Hepatitis B and C viruses -- how do they affect management of IBD?	142	(4)
Graham R Foster
Alick N S Nkhoma
Pregnancy: what drugs can we use?	146	(4)
Thea Thomas
Elspeth Alstead
How to prevent growth failure in children	150	(3)
Jutta Koglmeier
Nick Croft
Predicting outcomes in severe UC	153	(3)
Simon Travis
Refractory proctitis	156	(3)
Anne Ballinger
Richard Makins
CMV co-infection -- does it matter?	159	(5)
Daan Hommes
Treatment of oral Crohn's disease	164	(4)
Carlo Nunes
Michael Escudier
Jeremy D Sanderson
Pathophysiologic approach to treatment of diarrhea in Crohn's disease	168	(3)
Henry J Binder
Short bowel	171	(4)
Jeremy Nightingale
Management of internal fistulae	175	(4)
David Rampton
What is indeterminate colitis?	179	(3)
Garret Cullen
Diarmuid O'Donoghue
Pouches for indeterminate colitis?	182	(3)
Laura Hancock
Neil Mortensen
Colitis-associated cancer: what's the risk to your patients?	185	(4)
Jayne Eaden
What to do with dysplasia, DALMs, and adenomas	189	(4)
Matt Rutter
Part 5 Managing IBD Outside the Gut
Pyoderma gangrenosum	193	(4)
Ana Paula Cunha
Fernando Tavarela Veloso
Arthritides -- helping the joints without harming the gut	197	(4)
Horace Williams
Tim Orchard
Prevention and treatment of osteoporosis	201	(4)
Richard Makins
Juliet Compston
Sclerosing cholangitis -- what to do?	205	(4)
Sue Cullen
Roger Chapman
Thromboembolic disease: an under-recognized complication?	209	(4)
Peter Irving
Fergus Shanahan
Pulmonary manifestations: rare but real	213	(4)
Peter Irving
Part 6 Are You Sure it's IBD?
Intestinal infections: mimics and precipitants of relapse	217	(5)
Sunil Samuel
Yashwant Mahida
Microscopic colitis	222	(4)
Debbie Nathan
Peter Gibson
Diverticular colitis	226	(3)
Linmarie Ludeman
Neil A Shepherd
Part 7 The IBD Service: Time for a Rethink?
Outpatient services -- do doctors still have a role?	229	(4)
Mark Kelly
Andrew Robinson
Shared care: tactical team selection	233	(4)
Reshma C Rakshit
John Mayberry
Databases -- are they worth the bother?	237	(4)
Stephen L Grainger
Index	241