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Chronic Inflammatory Bowel Disease

Duane W. Taebel, MD
JAMA. 1975;232(9):963. doi:10.1001/jama.1975.03250090051023.
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The Systemic Manifestations of Inflammatory Bowel Disease,  by William M. Lukash and Raymond B. Johnson, 356 pp, with illus, $15.50, Springfield, Ill, Thomas, 1974.Advances in understanding the pathogenesis of inflammatory bowel disease as well as in its successful medical management have been frustratingly slow over the past decade or two. Major hallmarks of this era include further elucidation of possible immune mechanisms as the most likely pathogenetic factor; initial enthusiasm about the clinical ability to separate colonic involvement into either Crohn disease of the colon or chronic ulcerative colitis has waned somewhat, with many patients falling into a mixed category. Finally, recognition of cancer as a highly likely consequence of protracted ulcerative colitis has raised the disconcerting possible need to recommend prophylactic colectomy even in the patient whose disease is stable. Clinical features, diagnostic criteria, and treatment regimens have remained essentially unchanged.In spite of these limited advances, clinicians


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