render book rev.qxd 23/02/2007 10:04 am page 194 book ...194 can j gastroenterol vol 21 no 3 march...

Can J Gastroenterol Vol 21 No 3 March 2007194

Fast Facts: Inflammatory Bowel Disease, 2006. David Rampton,Fergus Shanahan. Health Press Ltd, Oxford, OX14 3LN, UnitedKingdom. ISBN 1-903734-55-X, 135 pages. UK £15.00, US $24.95

Has the therapeutic divide across the Atlantic disappeared? My first thought whenasked to review the book, Fast Facts: Inflammatory Bowel Disease, written by twowell known experts on inflammatory bowel disease (IBD), was that there would bemajor differences in approach to this group of patients particularly in the field oftherapeutics across the Atlantic. This had been my impression during my gastroen-terology training, oh too many years ago.

I have learned by reviewing this book that the approach in Ireland and theUnited Kingdom mirrors the practice in most of Canada. I can endorse this book fora large number of groups. It is an up-to-date synopsis suitable as a reference for fam-ily physicians, emergency room physicians, general internists and medical students.It also would serve well as the earliest reference for training residents in gastroen-terology and surgery before they expand their knowledge on this subject. It wouldbe a valuable resource for allied health professionals assisting in the care of thesepatients such as dieticians, social workers, nurses and enterostomal therapists. It isnot meant to be a reference for specialists in this field. Some patients might be com-fortable with this as a disease reference.

This small book (135 pages) covers the topic in surprising depth. It is a revisedand updated edition which is reflected in its polished presentation.

The topics are well separated into discussions of etiology and pathogenesis, clin-ical, presentation and complications, and diagnosis. This is followed by discussionson investigations and treatments, which has been wisely separated into Crohn’s dis-ease and ulcerative colitis. It then ends with chapters on surgery, IBD in pregnancyand children, prognosis and future trends.

The chapter on medications outlines all the current therapies, including theirsuspected mechanism of action, adverse events, formulations and indications, andcontraindications. As with most chapters, the information is presented in tabula-tion format and longer format, so each item is reviewed twice to assist in retentionof information. There is a brief discussion on future promising therapies and the useof alternative treatments.

The chapter on diagnosis separates out the differential diagnosis based on pre-senting symptoms such as bloody diarrhea, abdominal pain with diarrhea andweight loss, rectal bleeding, abdominal mass and pain. This approach will certainlybe helpful for the target audience.

All these areas are well covered, with strong use of pathology images and endo-scopic images, diagrams and tables. Each chapter ends with a list of suggested read-ings and a summary of the key points which help reinforce items learned for thosereading the entire chapter.

The book has been well indexed to allow for use as a reference book. It also providescontact information for Crohn’s and colitis foundations in many countries across theworld, including Web sites. Other informative Web site addresses are provided.

I was particularly impressed by the fact that this book, published in January2006, has remained current in the rapidly changing field of therapeutics. Of note isthe description of the use of infliximab in ulcerative colitis.

As expected there were a few cross-Atlantic differences, such as the spelling ofcyclosporine (ciclosprine) and the use of balsalazide and paracetamol. There arealso references to tests not routinely available in Canada such as SeCHAT scans,capsule endoscopy, serology testing (ANCA and ASCA) and stool calprotectin.

A major weakness for those wishing to expand their knowledge is that referencesin each chapter often do not refer to the original articles but often textbook chap-ters and review articles.

The bottom line without fistulas: A valuable resource for practioners (nongas-troenterologists) who are involved in the management of patients with IBD.

Craig Render MD

Assistant Clinical Professor, Division of Gastroenterology

University of Alberta

Edmonton, Alberta

BOOK REVIEW

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