Table of Contents
Preface 8
Part 1 Understanding Crohn's Disease and Ulcerative Colitis
1 What Is This Disease? 10
What Is Inflammatory Bowel Disease? 10
Glossary of Inflammatory Bowel Disease 12
Who Gets Inflammatory Bowel Disease? 14
Where in the Body Does IBD Occur? 15
What Goes Wrong in IBD? 21
What Are the Possible Complications of IBD? 23
2 How Do I Know I Have IBD? 34
Recognizing Symptoms 34
Common Symptoms 35
Diagnostic Methods 44
Prognosis 55
3 What Can I Expect Now That I Have IBD? 56
Frequently Asked Questions 56
Can I Die from This Disease? 58
Will the Disease Get Worse? 58
Can My Condition Improve? 60
Can I Still Go to School? 62
Can I Get and Keep a Job? 63
Will I Need to Be Hospitalized? 64
Will I Need to Have Surgery? 65
Will I Need a "Bag" Outside My Body to Collect Stool? 65
What Lifestyle Changes Will I Need to Make? 66
Will 1 Be Able to Become Pregnant? 67
Can I Take My Medication during Pregnancy? 68
Will My Condition Flare during Pregnancy? 69
Will This Disease Affect the Birth of My Child? 69
Can I Travel If I Have IBD? 70
What Causes IBD? 73
4 How Did I Get This Disease? 74
Causal Factors 75
Possible Infectious Causes 76
Possible Environmental Causes 78
Possible Inherited (Genetic) Factors 81
Unified Theory 88
Implications for Treatment 89
Part 2 Managing Inflammatory Bowel Disease
5 Dietary Strategies for Managing IBD 92
Reliable Information 93
The Right Diet 94
Preventing Malnutrition 95
Diet Modifications 102
Elimination Diets 103
Lactose-Restricted Diets 104
Calcium Sources 108
Vitamin D 111
Other Vitamin and Mineral Supplements 113
Liquid Calorie Supplements 116
Low-Fiber Diets 118
High-Stool-Output Management Diets 121
Fluid Diets 124
Food Fears 127
Nutrition Support 127
Nutrition Research 129
Diet Counseling 133
6 Psychological Support for Managing IBD 134
Psychological Concerns 134
Stress 136
Depression 137
Coping Strategies 140
Coping with the Medical System 148
7 Drug Therapy for Managing IBD 152
Treatment Goals 152
Medication Considerations 154
Drug Therapy Options 160
Nonsteroidal Anti-Inflammatory Drugs 161
Mesalamine (5-Aminosalicylic Acid) Containing Drugs 163
Glucocorticoid (Steroid) Medications 170
Antibiotics 179
Immunosuppressant Medications 181
Non-Biologic (Small-Molecule Drugs) 188
Biologic Drugs 190
Future Medical Therapies 202
Complementary and Alternative Medicine 205
Clinical Research Study Designs 208
Surgery Option 210
8 Surgical Treatment of IBD 211
The Need for Surgery 212
Ileostomy and Colostomy 213
Surgical Procedures for Ulcerative Colitis 214
Surgical Procedures for Crohn's Disease 222
Laparoscopic Surgery 233
Preventing Recurrence 234
Children with IBD 236
9 Treating Children with IBD 238
Family Challenges 239
Special Management 239
Prospects 245
Resources and References 246
Index 255
