Trends and Controversies in Ibd: Evidence-Based Approach or Individual Management?

ISBN-13: 9780792387886 / Angielski / Twarda / 2004 / 252 str.

A. Dignass; H. Lochs; E. -F Stange

Opis

In spite of significant scientific progress in recent years, the aetiopathogenesis of chronic inflammatory bowel diseases (IBD) remains elusive. With a prevalence of 1:700 to 1:500 in central Europe, both diseases are not rare. However, most physicians will generally treat only a few patients with IBD in their clinical practice. Because of this limited experience and the variety of clinical IBD manifestations, IBD patients are frequently treated in specialized tertiary care centres. Nevertheless, IBD patients will also consult less specialized general practitioners, who will not be able to focus extensively on the management of IBD patients due to time constraints.
Physicians who take care of IBD patients have to select among an ever-increasing amount of new scientific information in order to provide optimal and up-to-date care to their patients. In the era of evidence-based medicine it is often under debate whether evidence-based medicine may really improve the management of IBD patients or whether the diversity and complexity of IBD needs an individual and patient-oriented approach.
This book, the proceedings of the Falk Symposium 134 on Trends and Controversies in IBD - Evidence-Based Approach or Individual Management', held in Berlin, Germany, on 12-13 June 2003, critically discusses established and emerging new concepts in the field of IBD. It critically analyzes evidence-based and individual approaches in the management of IBD and discusses these approaches with the help of selected case reports.

Spis treści

List of principal contributors

Preface

Section I: Novel aspects in the Aetiopathogenesis of IBD: Relevance for diagnosis and therapy.-Genetics of Inflammatory bowel disease.- Specific immunity in inflammatory bowel disease.- Inflammatory bowel diseases and innate immunity.- Bacterial biofilm in inflammatory bowel disease.- Dietary factors in the aetiopathogenesis of inflammatory bowel disease.- Section II: Classfication and natural history of disease.- Vienna and other classifications.- Steroid-dependent and –refractory Crohn’s disease: epidemiology and mechanisms.- Ulcerative pancolitis and ulcerative procitis – different expression of the same disease or different entities?.- Inderetiminate colitis: overlap diagnosis or own entity?.- Section III: Standards and controversies in the therapy of Crohn’s disease.- Therapy of chronic recurrent Chrohn’s disease.- Therapy of chronically active and/or steroid-resistant Crohn’s disease.- Is therapeutic response predictable?.- The therapy of Crohn’s disease should be guided clinically.- The primary therapeutic aim in Crohn’s disease should be mucosal healing.- Maintenance therapy is not cost-effective.- Maintenance therapy for Crohn’s disease.- Section IV: Standards and controversies in the management of ulcerative colitis.- Evidence-based therapy of uncomplicated ulcerative colitis.- Evidence-based therapy of chronically active and steroid-resistant ulcerative colitis.- Standards and controversies in the management of ulcerative colitis: immunosuppressive therapy is preferable to collectomy.- Early collectomy is preferable to immunosuppressive therapy.- Section V: Standards and controversies in the surgical management of IBD.- Conventional surgical procedures are still standard in Crohn’s desease.- Selection of patients with ulcerative colitis or indeterminate colitis for restorative proctocolectomy.- Ileal pouch-anal anastomosis: one- or two-stage procedure?.- Section VI: Therapy of special problems.- Perianal fistulizing Crohn’s disease: medical treatment.- Perianal Crohn’s disease – surgical therapy.- Pouchitis.- Therapy of inflammatory bowel diesease during pregancy and nursing.- Should current therapeutic concepts in Crohn’s disease and ulcerative colitis include prevention of dysplasia and carcinoma?.- Therapy of abdominal pain in inflammatory bowel disease.- Theapy of theumatoid extraintestinal manifestations of inflammatory bowel disease.- Treatment of skin manifestations (erythema nodosum pyoderma gangrenosum) in inflammatory bowel disease.-

Index.