Clinical Dilemmas in Inflammatory Bowel Disease by Peter Irving MD MRCP, Corey A. Siegel, David Rampton,

By Peter Irving MD MRCP, Corey A. Siegel, David Rampton, Fergus Shanahan

Evidence-based information to respond to greater than 60 debatable medical questions about inflammatory bowel diseaseClinical Dilemmas in Inflammatory Bowel disorder is a realistic guide delivering fast yet particular solutions to the questions and demanding situations that you're confronted with day-by-day within the scientific setting.Each brief bankruptcy addresses a special subject and offers evidence-based advice on topics starting from optimising present administration via to big administration difficulties and novel remedies. This ebook is appropriate for all doctors concerned with the care of sufferers with IBD: validated and trainee gastroenterologists, colorectal surgeons, pathologists, radiologists, professional nurses, pharmacists, dieticians and counsellors

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References 1 Sands BE. Therapy of inflammatory bowel disease. Gastroenterology 2000; 118: S68–82. 2 Azad Khan AK, Piris J, Truelove SC. An experiment to determine the active therapeutic moiety of sulfasalazine. Lancet 1977; 2: 892–5. 3 Cunliffe RN, Scott BB. Review article: monitoring for drug side effects in inflammatory bowel disease. Aliment Pharmacol Ther 2001; 16: 647–62. 4 Capell HA, Maiden N, Madhok R, et al. Intention-to-treat analysis of 200 patients with rheumatoid arthritis 12 years after random allocation to either sulfasalazine or penicillamine.

A subsequent trial performed by the same investigator did not replicate these results, with no significant difference between mesalazine and placebo groups [4]. More recently, a meta-analysis by Hanauer and Stromberg [5] showed that 4 g/day mesalazine reduced the Crohn’s Disease Activity Index (CDAI) by 18 points compared with placebo. However, such a small reduction does not translate into any significant improvement in clinical practice [6]. The overall data with mesalazine in active Crohn’s disease remain, at best, dubious.

BMJ 1989; 298: 82– 6. 12 Lapidus A, Bangstad M, Astrom M, et al. The prevalence of gallstone disease in a defined cohort of patients with Crohn’s disease. Am J Gastroenterol 1999; 94: 1261– 6. 13 Cucion C, Sonnenberg A. The comorbid occurrence of other diagnoses in patients with ulcerative colitis and Crohn’s disease. Am J Gastroenterol 2001; 96: 2107–12. Clinical Dilemmas in Inflammatory Bowel Disease Edited by Peter Irving, David Rampton, Fergus Shanahan Copyright © 2006 by Blackwell Publishing Ltd Part 2 Medical Treatment: Making the Most of What We’ve Got – 5-ASA drugs 7 Is monitoring necessary?

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