Inflammatory Bowel Diseases New Developments And Standards

Falk Symposium No. 82, held in Halle, Germany, November 1994, focuses on the advances made in understanding the aetiology and pathogenesis of inflammatory bowel disease (IBD). Sections of this book, the Proceedings of the conference, are devoted to extraintestinal manifestations, cancer development, IBD in the context of pregnancy, and the assessment of disease activity, prognosis and quality of life. The second half of the book is devoted to the discussion of standards and new developments in diagnosis, conservative management and surgery. Audience: All clinicians and basic scientists working in the field of IBD.

The aetiology of the chronic inflammatory bowel diseases - Crohn's disease and ulcerative colitis - is still enigmatic. The therapeutic approach has therefore traditionally focused on anti-inflammatory principles, including corticosteroids and aminosalicylates. Since a significant proportion of patients is steroid-dependent or refractory and because of the problematic side-effects of long-term systemic steroids, active immunosuppression has gained acceptance in the field. The classical immunosuppressants azathioprine and 6-mercaptopurine have long been evidence-based in IBD, but underused. Recently, methotrexate and cyclosporine have also been proven to be effective in certain situations. Newer drugs like tacrolimus, mycophenolate and others may be similarly useful but their potential is still unclear. Finally, the immune modifiers including IL-10 and TNF-antibodies have been successfully subjected to controlled trials. Other experimental drugs discussed in this book are on the horizon. This volume is the Proceedings of Falk Symposium 119 held in Freiburg-im-Breisgau, Germany, October 3-4, 2000, and covers systematically the field of immunosuppression in inflammatory bowel diseases. It is hoped that it will further the prudent use of these drugs in the proper clinical situations by increasing our understanding of both the mechanisms of action and the clinical benefit to the patient.

As in the first edition of Inflammatory Bowel Diseases this new edition continues to provide readers with a concise, yet in-depth review of many of the important areas in the history, epidemiology, pathogenesis, diagnosis, and treatment of the inflammatory bowel diseases (ulcerative colitis and Crohn's disease), as well as associated issues: extraintestinal manifestations, ostomy care, women's issues, economics, etc. This Second Edition provides the reders with up-to-date, state-of-the art approaches to these disease states, with expansion into the newer topics that have emerged in the past few years which include the expansion of biological agents for treatment, new studies in the epidemiology of IBD, the changing economics of IBD, breakthroughs in new endoscopic evaluations, major advances in novel radiographic techniques, the detection of colorectal cancer in patients with IBD and new findings in the genetics of IBD. New Trend / Developments (* These all emerged since our last edition) The most critical trend that has arisen over the past few years has been the introduction and expansion of biological agents in the treatment of inflammatory diseases worldwide. While only one agent, infliximab (Remicade), existed at the time of publication of my first edition, there have been multiple other agents either approved or pending approval for the treatments of these diseases, or in the upper-stages of development. The impact is not only upon the patients, but also on the health-care providers, policy makers, researchers, biotech and pharmacompanies, and the business community. Major changes worldwide in the epidemiology of IBD has spurred new studies in the demographics of who is getting these diseases and why. Previously characterized as diseases primarily affected Caucasians in industrialized countries, there has been an explosion of growth amongst the African American and Hispanic populations in the United States, and well as in pockets of these and other ethnic groups worldwide. The economics of IBD has been changing greatly, given the issues raised above, as well as major changes in the United States Medicare program, and other insurance changes. The growing proportion of the GNP that healthcare costs are consuming in the US and worldwide has shifted attention to decreasing utilization of health care services, and other cost-savings measures. Again, up to this point this has been an exclusive part of our IBD book. New findings in the genetics of IBD have been recently published. Our first edition had the finding of the first Crohn’s disease gene inserted just before going to press; so much has been published about the phenotypes and other genotypes that have emerged. Breakthroughs in new endoscopic evaluations of the bowel (ie. Capsule endoscopy, double-balloon enteroscopy, endoscopic ultrasound) and their use in the inflammatory bowel diseases will be a key highlight of this new book. Major advances in novel radiographic techniques employed in patients with inflammatory bowel disease (ie. CT enterography, MR enterography, advanced ultrasounds, etc.) will also an important component of our work. There have been numerous areas related to the development and detection of colorectal cancer in patients with IBD that have emerged in the past few years. Techniques of better detection (ie. Narrow band imaging; special mucosal staining; endoscopic histological evaluations) as well as research in the putative role of mesalamine and other agents for colorectal cancer prevention are all hot topics that will attract much interest from a variety of interest groups I described above. Identification of additional disease states that probably belong in the IBD family, such as microscopic colitis (including lymphocytic colitis), and collagenous colitis add to the diseases that will be discussed in this new edition.

Pediatric Inflammatory Bowel Disease, Second Edition provides an essential reference with an emphasis on the unique pediatric issues of IBD. Chapters focus on complications of IBD specific to children and adolescents. Treatment recommendations are based on the latest clinical research available. The textbook also presents sections dedicated to the aspects of participation in clinical research unique to children and adolescents and the complicated yet vital process of successfully transitioning a patient from a pediatric to adult specialist. Controversies in pediatric IBD care such as the off-label use of medications are also covered. The format incorporates multiple tables, graphs, and figures to improve readability and make for an efficient reference for clinicians to use. Thoroughly revised and updated from the first edition, the volumes includes new therapies that are currently being used or tested for treatment of IBD, important areas regarding incidence and prevalence, immunization and response to vaccine administration as well as advancements in our understanding of growth and development with particular to the use of growth hormone therapy. Other new areas covered include important topics of complementary and alternative medicine use in IBD, immunization, and liver disease in IBD. Pediatric Inflammatory Bowel Disease, Second Edition is a valuable resource for pediatric gastroenterologists as well as adult gastroenterologists.

Ulcerative colitis and Crohn's disease remain a great therapeutic challenge to the medical community. In recent years knowledge about the pathogenesis of these diseases has progressed rapidly but the cause of the diseases remains completely unknown. It has become clear that dysregulation of the mucosal immune system is the basis for the chronic evolution of the diseases in a genetically susceptible population. Exciting new therapeutic approaches have been attempted in the last couple of years and cytokine and anti-cytokine treatments in particular seem very promising, especially in intractable disease. The format of the Falk Symposium 106 on `Advances in Inflammatory Bowel Diseases', held in Brussels, Belgium, June 18-20, 1998, was somewhat innovative as each session attempted to link the new insights into pathogenetic mechanisms with new therapeutic approaches, resulting in optimal information transfer. The classic therapeutic schemes were updated with a special focus on step-wise build-up of therapy.

Most symposia on chronic inflammatory bowel disease during the last few years have focused on new aspects of aetiology and pathophysiology. However, based on such new aspects, changes in diagnosis and treatment have been developed over the last few years and some others are currently under investigation. This book, the proceedings of Falk Symposium 97, `Clinical Challenges in Inflammatory Bowel Diseases - Diagnosis, Prognosis and Treatment', held in Lugano, Switzerland, 18-19 April 1997, summarizes these changes and new developments, discusses their value and defines further new approaches. The topics include primary diagnosis, definition of different patient groups, special problems of these patients in daily life and very new therapeutic principles. This volume opens new possibilities of diagnosis and treatment of inflammatory bowel disease to physicians and provides stimulation for further development.

The amount of information on the pathogenesis of inflammatory bowel disease is growing rapidly. This is reflected by a continuous increase in the number of papers presented at international GI meetings. To make things more difficult for practicing physicians, there is also a large number of new clinical trials being published which require periodical critical reviews and recommendations. Faced with these issues, the scientific commitee of the Falk Symposium No. 140 decided to take a different approach and to apply a novel format that is reflected in the title of the Symposium: "Translation from basic research to clinical practice". This book contains the proceedings of that Symposium, held in Dubrovnik, Croatia, on May 7–8, 2004. The sections are designed so that they start with the information from basic sciences on different aspects of these complex diseases and further lead to their clinical implications. Special attention is paid to the mechanisms of actions of established drugs. The last two sections are clinically oriented and focus on the most difficult aspects of both Crohn's disease and ulcerative colitis. This format provides state-of-the-art chapters by leading experts in the field and at the same time up-to-date information on the clinical application of the new knowledge.