Bøger af J. Schölmerich

There is no single truth regarding the recognition and management of IBD. In this regards the old dictum ¿there is no disease but the patient¿ should be the golden rule. Nowadays, more complicated Crohn's disease cases at relatively young ages are not unusual. Various clinical and extraintestinal manifestations have been seen rarely until now. The evolution of the therapeutic armamentarium is now a double-edged sword since ¿more drugs¿ may mean ¿more side-effects, less compliance and a more critical attitude of health authorities towards the cost of treatment¿. Education of the patient and the family, creation of empathy and a positive rapport with the patient and a careful analysis of confounding/contributing factors to the disease behaviour are essential elements of optimal therapy of IBD patients.This book contains the proceedings of Falk Symposium 159, entitled IBD 2007 -- Achievements in Research and Clinical Practice, held in Istanbul, Turkey, on May 4--5, 2007, where opinion leaders with worldwide reputations discuss IBD and related issues in a less well-known part of the world with respect to prevalence, disease behaviour and patient characteristics, as well as the difficulties faced in differential diagnosis and management.

Between the 1950s and 1980s, Europe and North America saw an increase in the incidence of Crohn¿s disease in adults. The incidence of paediatric Crohn¿s disease has grown and we are now entering a new era, in which inflammatory bowel disease (IBD), is emerging in the Asia-Pacific nations. This book presents the first major text where "East meets West" in IBD. The issues in the regions where IBD is a relatively common disease include the role of genetic and environmental factors in pathogenesis and disease expression, the application of diagnostic tools, and the use of biological agents in therapy. In contrast, key issues in the nations where IBD is at present relatively rare include characterising the nature and behaviour of IBD in those populations, developing ways of differentiating IBD from infective bowel conditions, eg. tuberculosis, how to apply standard treatment regimens, and the role of traditional therapies, such as Traditional Chinese Medicine, in the management of IBD.

The first gene responsible for Crohn's disease has now been identified and the pathophysiological understanding of inflammatory bowel disease as well as its practical treatment have made much progress in recent years. Thus it is obviously important to consider the targets and the aims of treatment in context. The Falk Symposium No. 131 (Part II of the Gastroenterology Week Freiburg 2002), held in October 2002 in Freiburg, Germany, in its first part was dedicated to newly defined and partly alternative therapeutic targets. In addition, an attempt was made to learn from experts from other fields such as pneumology or dermatology. The second part was dedicated to the aims of treatment in daily practice. Aside from general treatment, aims such as amelioration of symptoms, pre-conditions of treatment, the view of the patients, and aspects of life quality were dealt with. This volume is the proceedings of the symposium and is important reading for both clinicians and basic scientists.

Portal hypertension is causally related to major complications of chronic liver disease like upper GI tract bleeding, ascites formation, portosystemic encephalopathy and bacterial infections. In recent years, new approaches have increased our knowledge of the underlying pathobiological events of these complications. Accordingly, new promising treatment modalities have been developed and introduced into clinical trials. This book, the proceedings of the 79th Falk Symposium in Freiburg-im-Breisgau, Germany, 17--19 June 1994, presents the latest developments in the field, including a section which describes the role of portal hypertension in the pathogenesis of complications of chronic liver disease. Also covered is the therapeutic management of portal hypertension and its consequences as well as the latest endoscopic, interventional and surgical treatment options. This book is essential reading for those whose interests range from anatomy and pathobiology through to practical recommendations for treatment of portal hypertension.

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.

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.

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.