Inflammatory Bowel Disease: Experience and ControversyB.I. Korelitz Grouping ulcerative colitis with Crohn's disease (Inflammatory Bowel Disease) in a teaching seminar has historical support. The medical literature includes descriptions of both diseases in the latter half of the 19th century; they share many symptoms; in some instances, differentiating them may be very difficult; and the cause of each remains unknown. Furthermore, one member of a family may suffer with Crohn's disease while another has ulcerative colitis. And both processes are prone to the late complications of carcinoma at a site of previous involvement. Finally, the investigators and students of one disease have usually also contributed to the understanding of the other disease. The incidence of Crohn's disease seems to be increasing rapidly. This has been sug gested by reports from Sweden, the Netherlands, England, Scotland, and South Africa as well as the United States. Though methods of recording data vary, the increase is further supported by cases of greater virulence, still younger ages of onset, and more cases in the elderly. This is remarkable when we consider that fifty years ago, when the classic description from Mt. Sinai Hospital was being prepared, the disease was rare. Since the cause remains elusive, we must try to cope with this entity as skillfully as we can, with consideration of indications, and timing of drug and surgical intervention. The choice of forms of management has been controversial, even among the most experi enced physicians. |
Contents
ix | |
Evidence for Crohns Disease as an Extensive Process | 9 |
Environment vs Heredity in Inflammatory Bowel Disease | 21 |
Is Investigation Headed in the Right Direction? | 29 |
The Role of Hyperalimentation in the Treatment | 55 |
Special Problems of Adolescents with Inflammatory | 63 |
Burton I Korelitz MD | 77 |
Where Has Colonoscopy Had Its Greatest Value in | 87 |
Felicien M Steichen MD | 125 |
Indications for Surgery in Crohns Disease As Seen by | 133 |
Why Do Results of Management of Toxic Megacolon | 153 |
The Problems Arising in Diagnosis of Dysplasia | 161 |
A Program for Management of Ulcerative Colitis | 175 |
SPECIAL PRESENTATION | 185 |
Experience and Late Results with the Continent Ileostomy | 207 |
An Appraisal of the Results of the Continent Ileostomy | 221 |
Has There Been Any Progress in the Xray Diagnosis | 107 |
When in the Course of Crohns Disease Should Xray Studies | 117 |
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Common terms and phrases
abdominal abscess active alternate-day anastomosis anemia aphthoid azathioprine barium enema biopsy cancer carcinoma catheter cells chronic clinical colectomy colon colonoscopy complications continent ileostomy conventional ileostomy Crohn's disease crypt cytotoxicity diagnosis Dr Korelitz drug dysplasia endoscopy epithelium extraintestinal factors Figure fistula Gastroenterology gastrointestinal granuloma granulomatous colitis hyperalimentation ileal ileitis ileocolitis immunosuppressive improvement incidence increased indications inflammation inflammatory bowel disease intestinal involvement Kock Lenox Hill Hospital lesions lymphocytes lymphoid medical therapy mercaptopurine microgranuloma mucosa nipple valve normal nutritional obstruction occur onset operation parenteral patients with Crohn's patients with inflammatory patients with ulcerative performed physician postoperative pouch prednisone present problems procedure proctocolectomy proximal pseudopolyps Question rectal biopsy rectum recurrence rate regional enteritis resection reservoir response risk seen segment sigmoidoscopy small bowel steroids stoma stricture sulfasalazine surgeon surgery surgical surveillance suture symptoms tion tissue toxic dilatation toxic megacolon tract treatment ulcerative colitis usually x-ray York