July 2004: Inflammatory Bowel Disease -- A Guide to Medscape Gastroenterology's Key Resources

July 2004: Inflammatory Bowel Disease -- A Guide to Medscape Gastroenterology's Key Resources The Editor provides a tour of Medscape Gastroenterology's key information tools on the clinically important entity of IBD. journalArticle diagnosis,collitis,bowell,regional enteritis,inflammatory bowel disease, ulcerative colitis,colitis ulcerative,crohns,crohn`s,chrons,crohn's's,IBD, Crohn's disease,intestine,ileitis,chron's,chrohns,small,ulcereative,crohn,dx,disorder,chrohn's,cholitis,choliits Maria L. Gaiso, PhD Maria L. Gaiso, PhD, Site Editor/Program Director, Medscape Gastroenterology Medscape Medscape Gastroenterology 07/27/2004 6 2 Nearly 300 years ago, in what is believed to be the first report of a case of Crohn's disease, Giovanni Battista Morgagni described the clinical course of granulomatous enterocolitis in a 20-year-old man. The patient died due to perforation of the terminal ileum. It was almost 150 years ago that ulcerative colitis was described at Guy's Hospital in the United Kingdom. Subsequently, John Berg in 1898, and Polish surgeon Antoni Leśniowski in 1904, described other cases of what is believed to be inflammatory bowel disease (IBD). In 1913, at the meeting of the British Medical Association, the Scottish physician T. Kennedy Dalziel, described 9 cases of disseminated thickening of the distal small intestine as well as the right colon.We now shift our focus to the United States where, in 1920, Eli Moschcowitz and A.O. Wilensky of Mount Sinai Hospital in New York published a clinical and pathologic study of intestinal granulomas. However, it was not until 1932 that the pathology we know today as Crohn's disease received its name. In that year, a paper entitled "Terminal Ileitis" was presented at the 83rd Annual Session of the American Medical Association held in New Orleans, Louisiana. This paper reported on 14 surgical cases involving granulomatous inflammation of the distal ileum. The lecture was delivered by Burrill Bernard Crohn, Leon Ginzburg, and Gordon Oppenheimer, all of whom were also from Mount Sinai. On publication of this manuscript, the entity was redesignated "regional ileitis" in response to a protest by J.A. Bargen that the term "terminal" was misleading and inappropriate, for most of the patients survived. Because Crohn's name was listed first on this landmark paper, so is the name of this clinical entity derived. Today, it is recognized that Crohn's disease is not limited to the distal ileum.Indeed, throughout the historical medical literature, there have been various cases reported by physicians describing entities that today would be known collectively as IBD. The term IBD refers to a group of disorders (predominantly, ulcerative colitis and Crohn's disease) that is characterized by an inflammation of the intestines. Generally, approach to treatment involves medical therapy; although in some cases, due to persistent and severe disease, additional medications or even surgery may be warranted.It is estimated that more than 1 million individuals in the United States have ulcerative colitis or Crohn's disease. Thus, IBD represents a clinically important problem facing the practicing gastroenterologist. As such, issues in epidemiology, advances in genetics, and approaches to treatment all remain fundamental to our ongoing elucidation of these inflammatory disorders. In recognition of the latter, Medscape Gastroenterology maintains its mission to bring you the most timely and relevant clinical information on this disorder, with a view toward implications for practice.Ideally, perhaps the first place to visit on Medscape Gastroenterology is the <a href="/pages/editorial/resourcecenters/public/ibd/rc-ibd.ov?src=hp20.rcbottom">Inflammatory Bowel Disease Resource Center</a>. This tool serves as a directory of sorts to house Medscape's key clinical content on the topic. Thus, all relevant material on IBD has been collected and stratified by Medscape's editors to provide this single-site destination to optimize and facilitate the focus on IBD.Among the more dynamic of Medscape's information tools is our coverage of key conferences in the field. Such conferences as the annual meeting of the American College of Gastroenterology (ACG) and Digestive Disease Week (DDW) stand as essential venues for the presentation of key findings and new perspectives in the diagnosis and management of diseases of the gastrointestinal tract. To bring you in-depth, CME-certified, timely coverage of key issues based on select sessions from these meetings, Medscape Gastroenterology placed independent, authoritative physician-authors on site to filter and distill down the most significant and topical developments presented during the core proceedings, adding clinical context as necessary. In this setting, Medscape Gastroenterology is pleased to direct you to our coverage of <a href="/viewprogram/2698">ACG 2003</a> and <a href="/viewprogram/3103">DDW 2004</a>. Each of these programs includes coverage of the latest developments in IBD. In "<a href="/viewarticle/463425">Clinical Advances in Ulcerative Colitis</a>," Bret A. Lashner, MD, of the Cleveland Clinic, discusses diagnostic considerations and disease course, and explores current and future therapies for patients with this inflammatory bowel disorder, as based on key presentations at ACG 2003. Our coverage of select sessions at DDW 2004 also features expert-authored reports on IBD. In "<a href="/viewarticle/480243?src=search">Select Topics in the Clinical Epidemiology of Inflammatory Bowel Disease</a>," Dr. Lashner again provides us with the latest insight as he discusses the current state of the field regarding cancer and dysplasia in IBD, predictors of complications in IBD, and issues directly affecting the management of patients with IBD. Finally, in "<a href="/viewarticle/480242">Evolving Biologic Therapies for IBD</a>," Stephen B. Hanauer, MD, of the University of Chicago Pritzker School of Medicine, explores the current state of emerging biologic therapies for Crohn's disease, including human monoclonal anti-tumor necrosis factor-alpha antibody strategies and novel methods of cytokine inhibition.Thank you for allowing me to spend my time with you this month by providing a little historical perspective on the clinically important entity of IBD as a means of reacquainting you with some of the more key and timely resources on this topic that are available on Medscape Gastroenterology. I invite and encourage your continued feedback as we move forward with our mission to provide our audience with the most topical and relevant information in clinical gastroenterology. You may contact me directly at <a href="mailto:gastroeditor@webmd.net">gastroeditor@webmd.net</a>. (If your concern is technical, however, please contact our customer support staff at <a href="mailto:medscapecustomersupport@webmd.net">medscapecustomersupport@webmd.net</a>) Crohn BB, Ginzburg L, Oppenheimer GD. Landmark article Oct 15, 1932. Regional ileitis. A pathological and clinical entity. JAMA. 1984;251:73-79.