Dedication |
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v | |
Acknowledgments |
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xi | |
About the Editors |
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xiii | |
Contributing Authors |
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xv | |
Preface |
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xxi | |
Foreword |
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xxiii | |
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Introduction |
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xxv | |
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1 | (54) |
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Question 1 How Can We Assess Prognosis in Crohn's Disease? |
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3 | (4) |
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Question 2 How Can I Clarify the Diagnosis in My Patient With Indeterminate Colitis? |
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7 | (4) |
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Question 3 How Do You Evaluate Small Bowel Crohn's Disease? How Do You Assess Response to Therapy? |
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11 | (6) |
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Question 4 How Do I Choose Between Computed Tomography and Magnetic Resonance Imaging for My Crohn's Disease Patients? Is There Still a Role for Barium? |
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17 | (4) |
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Question 5 What Is the Updated Role of Capsule Endoscopy in Crohn's Disease? |
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21 | (4) |
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Question 6 What Necessary Testing Should Be Performed Before Initiating Biologic Therapy? |
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25 | (4) |
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Question 7 How Should We Be Using C-Reactive Protein and Fecal Markers, Such as Lactoferrin or Calprotectin, in Our Patients? |
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29 | (4) |
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Question 8 My Patient on Tumor Necrosis Factor Alpha Therapy Has a Rash. What Should I Do? |
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33 | (6) |
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Question 9 My Crohn's Disease Patient Is Complaining of Joint Pain. What Should I Do? |
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39 | (4) |
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Question 10 My Patient With an Ileo Pouch-Anal Anastomosis Has Developed Diarrhea and Urgency. What Is the Differential Diagnosis, and How Should I Evaluate Him? What Is the Significance of Pre-pouch Ileitis? |
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43 | (6) |
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Question 11 How Often Does Celiac Disease Coexist With Inflammatory Bowel Disease? |
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49 | (6) |
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Section II Medical Treatment |
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55 | (98) |
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Question 12 What Endpoints Should We Aim for in Inflammatory Bowel Disease Medical Therapy? |
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57 | (4) |
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Question 13 Is There Ever a Time to Switch to 5-Aminosalicylic Acids in Ulcerative Colitis? |
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61 | (2) |
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Question 14 Which Therapies Are Steroid Sparing in Crohn's Disease and Ulcerative Colitis? How Should I Manage a Steroid Dependent Patient? |
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63 | (4) |
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Question 15 What Is the Role of Concomitant Immunomodulators With Biologic Use in Inflammatory Bowel Disease? |
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67 | (6) |
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Question 16 How Do You Optimize Therapy With Thiopurines? |
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73 | (6) |
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Question 17 How Long Do You Wait Before Declaring Treatment Failure With Azathioprine/6-Mercaptopurine, and Do You Ever Consider Stopping Therapy With These Agents After a Period of Time? |
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79 | (4) |
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Question 18 Which Patients Might Be Better for a "Top-Down" Approach (Using Anti-Tumor Necrosis Factor Therapy Before Steroids or Proven Failure of Oral Thiopurines)? Which Patients Should Be Started on Dual Therapy (Immunomodulator and Anti-Tumor Necrosis Factor)? |
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83 | (4) |
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Question 19 When Is It Appropriate to Switch to Another Biologic Therapy? |
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87 | (6) |
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Question 20 What Are the Risks of Biologic Therapies, and How Do You Communicate Them to Patients? |
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93 | (6) |
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Question 21 When Should I Consider Anti-Integrin Therapy for My Patient With Inflammatory Bowel Disease? What Is the Updated Understanding of Progressive Multifocal Leukoencephalopathy and John Cunningham Virus Testing? |
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99 | (6) |
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Question 22 Is It Ever Appropriate to Stop Anti-Tumor Necrosis Factor in a Stable Patient? |
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105 | (4) |
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Question 23 When in the Treatment Algorithm Should Methotrexate Be Considered for Treatment of Crohn's Disease? Is There a Role for Low-Dose Methotrexate for Immunogenicity Purposes? |
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109 | (4) |
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Question 24 What Are the Relative Benefits of Cyclosporine or Infliximab in Severe Ulcerative Colitis? How Do You Choose Between the Two Options? |
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113 | (4) |
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Question 25 How Do You Treat Pouchitis? What Do You Do for Recurrent or Refractory Pouchitis? |
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117 | (4) |
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Question 26 What Is the Role of Probiotics in My Patients With Inflammatory Bowel Disease? |
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121 | (4) |
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Question 27 What Is Your First-Line Approach to the Diagnosis and Treatment of Patients With Perianal Crohn's Disease? |
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125 | (4) |
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Question 28 How Do You Handle an Inflammatory Bowel Disease Patient With Clostridium difficile Infection? |
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129 | (4) |
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Question 29 My Patient Has Primary Sclerosing Cholangitis and Ulcerative Colitis. Is There a Role for Ursodeoxycholic Acid Anymore? |
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133 | (4) |
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Question 30 What Is the Optimal Management of Ulcerative Proctosigmoiditis? |
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137 | (4) |
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Question 31 My Patient Has a History of Breast Cancer and Is in Remission From That Condition. She Also Has Crohn's Disease. Can I Use Azathioprine or Infliximab to Treat Her? What if There Is a Family History of Lymphoma or Leukemia? Should That Influence Management? |
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141 | (4) |
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Question 32 My Patient Recently Had a Sigmoid Colon Resection for Diverticulitis. The Pathology Report Read "Chronic Colitis." Is Diverticular-Associated Colitis a Subset of Inflammatory Bowel Disease, and Does My Patient Need Any Medical Therapy to Prevent Recurrence of Colitis? |
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145 | (4) |
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Question 33 What Is the Best Medical Therapy for Inflammatory Bowel Disease in Elderly Patients? Are Anti-Tumor Necrosis Factors Safe in This Patient Population? |
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149 | (4) |
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Section III Surgical Treatment |
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153 | (20) |
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Question 34 My Patient With Crohn's Disease Has an Ileal Abscess. What Is the Appropriate Management and Timing of Medical and Surgical Therapies? |
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155 | (4) |
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Question 35 What Are the Latest Robotic and Laparoscopic Approaches for Inflammatory Bowel Disease Surgery? |
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159 | (4) |
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Question 36 How Should I Treat My Crohn's Disease Patient After an Ileocecectomy and Primary Anastomosis? |
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163 | (6) |
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Question 37 How Does Perioperative Immune Suppression Affect Surgical Outcomes in Inflammatory Bowel Disease? |
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169 | (4) |
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Section IV Cancer/Infection Prevention |
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173 | (62) |
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Question 38 Should I Use Chromoendoscopy in My Surveillance Colonoscopy in Inflammatory Bowel Disease? How and Which Agent? Would Narrow-band Imaging Be an Alternative for This? |
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175 | (4) |
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Question 39 Can We Follow Flat Low-Grade Dysplasia? Is Any Dysplasia Really Flat or Just a Spectrum of Depth and Size? |
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179 | (4) |
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Question 40 How Do You Screen and Survey for Dysplasia in Crohn's Disease Patients? Can You Perform Segmental Resection in Crohn's Disease Patients With Dysplasia? |
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183 | (4) |
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Question 41 What Is the Risk of Skin Cancer in Inflammatory Bowel Disease? What Should We Recommend to Our Patients? |
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187 | (4) |
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Question 42 How Do You Approach Polypoid Lesions in Patients With Inflammatory Bowel Disease? |
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191 | (6) |
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Question 43 What Is the Most Effective Strategy to Promote Smoking Cessation in Patients With Crohn's Disease? |
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197 | (6) |
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Question 44 What Is the Risk of Lymphoma With Antimetabolites and Anti-Tumor Necrosis Factor Agents? |
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203 | (6) |
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Question 45 What Is the Updated Approach to Antimetabolites and Biologic Therapy in Inflammatory Bowel Disease and Pregnancy? |
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209 | (4) |
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Question 46 Which Vaccines Should I Recommend for My Inflammatory Bowel Disease Patients, and When Should I Give Them? |
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213 | (4) |
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Question 47 Which Inflammatory Bowel Disease Patients Should I Screen for Osteoporosis? Should I Also Screen for Vitamin D Deficiency? |
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217 | (4) |
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Question 48 What Is the Role of Diet in the Treatment of Inflammatory Bowel Disease? How Do I Discuss This With My Patients? |
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221 | (8) |
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Question 49 What Advice Should I Give the Inflammatory Bowel Disease Patient Who Is Traveling? |
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229 | (6) |
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Financial Disclosures |
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235 | (4) |
Index |
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239 | |