Book Review

Pediatric Inflammatory Bowel Disease

N Engl J Med 2008; 359:1299September 18, 2008

Article

Pediatric Inflammatory Bowel Disease
Edited by Petar Mamula, Jonathan E. Markowitz, and Robert N. Baldassano. 686 pp., illustrated. New York, Springer, 2008. $179. ISBN: 978-0-387-73480-4

Gastrointestinal disease in children is often the orphan of clinical inquiry and scientific investigation. This book provides a thorough update of the pathophysiology and clinical features of gastrointestinal disease in children and describes therapeutic approaches to the management of the disease in children, particularly as it differs from the treatment of adults. In addition, it asks the pediatric gastroenterology community to collectively address the mechanistic and therapeutic challenges of the disorder that are unique to the practice of pediatrics through basic and clinical research.

Pediatric Inflammatory Bowel Disease is divided into seven major sections that incorporate the collective knowledge about this disease in children: its cause and pathogenesis, epidemiology and clinical features, diagnosis, medical and surgical therapies, guidelines for conducting clinical research, and special considerations that have unique applications for children and adolescents. A striking feature of the book is its comprehensive coverage of the scientific investigation and clinical inquiry that have been directed at one of the most common gastrointestinal disorders of childhood. Throughout, the contributors provide examples of the differences between pediatric and adult disease and clarify the differences that characterize the various conditions that fall under the umbrella of this one clinical entity. The intensity of ongoing research is reflected in the book's coverage of the molecular intricacies of the disorder. The nuances of diagnosis, as revealed in the medical history, in the physical examination, and in laboratory, radiologic, and endoscopic studies, are presented from a practical viewpoint based on extensive clinical experience. The differential diagnosis, although broad in scope, is simplified into a common theme to facilitate the resolution of diagnostic dilemmas. Medical and surgical treatments are discussed in the context of evidence-based strategies where possible. Each chapter is well referenced, with few omissions. One of the most interesting aspects of the book is the information it provides on what is involved in participation in clinical trials, which are presented as a means of improving the health and well-being of children with inflammatory bowel disease.

Key strengths of the book are its descriptions of the undercurrents of discussion and debate inside the pediatric gastroenterology community and its suggested framework (through clinical research trials) for increasing the knowledge on which the clinical care of children with inflammatory bowel disease will be based. Pediatric Inflammatory Bowel Disease will be an important resource primarily for pediatric gastroenterologists. However, all physicians who care for children with inflammatory bowel disease will find that it serves as a model for organizing clinicians to collectively advance the knowledge of the disorder through common clinical practice and participation in future research protocols.

Kathleen J. Motil, M.D., Ph.D.
Baylor College of Medicine, Houston, TX 77030
kmotil@bcm.edu