**Meet the editor**

Dr O'Connor, who is a native of Cork in Ireland, achieved entry to read Medicine at University College Cork in 2001 with an academic scholarship. He graduated in 2006 and has since pursued a career in the field of Clinical Medicine with an ever growing interest in Clinical Research. He has worked clinically in the areas of Gastroenterology, Infectious Disease, Rheumatology,

Oncology, along with many other specialties. He currently holds the position of Medical Registrar at the South Infirmary Victoria University Hospital, Cork, Ireland, where he is co-founder and co-chair of the "Dr John Walsh Research Foundation". He is an author on more than 100 published medical papers and is an active reviewer for several national and international journals. His publications cover many areas from Gastroenterology, Infectious Disease, Rheumatology, Neurology and Vaccines to Medical Communication skills. This is his first position as Book Editor.

Contents

**Preface IX** 

Chapter 1 **Surgical Treatment of Ulcerative Colitis 3** 

Katsuyoshi Kudo, Shinobu Ohnuma, Hiyroyuki Sasaki and Iwao Sasaki

Chapter 4 **New Biologic Drugs for Ulcerative Colitis 49** 

Chapter 5 **Clinical, Biological, and Laboratory Parameters** 

Chapter 6 **Polysaccharides for Colon–Targeted Drug Delivery: Improved Drug–Release Specificity and** 

> **Factors in Pathogenesis, Prevention and Therapy of Ulcerative Colitis 99**

Chapter 3 **Drug Therapy in Ulcerative Colitis 31** 

**in Ulcerative Colitis 61**  Trine Olsen and Jon Florholmen

**Therapeutic Benefits 83**  Annette Hartzell and Devin J. Rose

Chapter 7 **Food and Intestinal Microorganisms:** 

Rok Orel and Darja Urlep

Silvestro Canonico and Francesco Selvaggi

Chapter 2 **Laparoscopic Surgery for Severe Ulcerative Colitis 15**  Kazuhiro Watanabe, Hitoshi Ogawa, Chikashi Shibata,

> Koh Miura, Takeshi Naitoh, Masayuki Kakyou, Takanori Morikawa, Sho Haneda, Naoki Tanaka,

Gianluca Pellino, Guido Sciaudone, Gabriele Riegler,

Xue-Gang Guo, Xiang-Ping Wang and Chang-Tai Xu

Francesca Zorzi, Emma Calabrese and Francesco Pallone

**as Predictors of Severity of Clinical Outcome and Response to Anti–TNF–Alpha Treatment** 

**Part 1 Treatments 1** 

## Contents

#### **Preface XI**

#### **Part 1 Treatments 1**


X Contents

#### **Part 2 Special Population Groups 115**


#### **Part 3 From Bench to Bedside 159**

Chapter 10 **Animal Models of Colitis: Lessons Learned, and Their Relevance to the Clinic 161**  Matthew Barnett and Alan Fraser

## Preface

Gastroenterology is the branch of medicine whereby the digestive system and its disorders are studied. The name is a combination of three Ancient Greek words *gaster* (*gastros or stomach)*, *enteron* (intestine), and *logos* (reason). Its documented history dates back to Egyptian times where, citing from Egyptian papyri, Nunn identified significant knowledge of gastrointestinal diseases among practicing physicians during the periods of the pharaohs, while Irynakhty, of the tenth dynasty, c. 2125 B.C., was a court physician specializing in gastroenterology and proctology. Among ancient Greeks, Hippocrates attributed digestion to concoction, while Galen's concept of the stomach having four *faculties* was widely accepted up to modernity in the seventeenth century. Since then the works of Maximilian Stroll in 1777 (described cancer of the gallbladder), Karl Wilhelm von Kupffer in 1876 (described the properties of liver Kupffer cells), Burrill Bernard Crohn in 1932 (described Crohn's disease), and Barry Marshall, Robin Warren and James Leavitt in 1982/1983 (discovery of Helicobacter pylori and its role in peptic ulcer disease), to mention just a few, has evolved the thinking of gastroenterology. It is clearly seen by the history of Gastroenterology the speciality continues to develop at a rapid pace due to growth in the understanding of disease processes and the discovery of new diagnostic and treatment strategies. Ulcerative Colitis is no exception to this trend. This book is just another step in marking the current developing knowledge and thinking around the area of Ulcerative colitis.

This book, which comes in two volumes, is intended to act as an up to date reference point and knowledge developer for all readers interested in the area of gastroenterology and in particular Ulcerative Colitis. All of the chapter authors are experts in their fields of publication and deserve individual credit and praise for their contributions to this book. We hope that you will find this publication informative, stimulating and a reference point for the area of Ulcerative colitis as we move forward in our understanding of the field of medicine. With that hope, I remind you of the though provoking quote by the French Philosopher and writer, Voltaire (1694 – 1778), *"Doctors are men who prescribe medicines of which they know little, to cure disease of which they know less, in human beings of whom they know nothing"*.

#### X Preface

#### **Acknowledgements**

Many thanks to the authors of each Chapter of this book. The outstanding contributions they have made resulted in a very easy book to edit. It was very enjoyable and a privilege reading each contribution. Your work is now a mark for the future.

To the publisher, InTech, thank you for being ever present and encouraging me in my endeavors to stay up to date with the review and editing process. I would never have been so organized without the assistance of Ms. Danijela Duric, Publishing Process Manager. It was a pleasure to edit my first book with such a wonderful group.

To my father (Tim) and late mother (Eileen), thank you for all the encouragement over the years to achieve my goals and become the ever developing doctor that I am today. I could not have achieved a fraction of my success without the support and love. Mam, I know you are always watching over and guiding me from a place nearby.

Dr Catherine O'Connor, my late aunt, who was always an inspiration. The ever present support and guidance in my early years of life and career where far beyond the role of an aunt or godmother. You will always be an example of professionalism I will strive to achieve.

Finally, to my other half, Bernie. All those long evenings spent without me while I was reading chapters and doing background knowledge discovery for this book are finally over. Your support is always beyond the call of duty and appreciated. Thank you.

> **Mortimer B. O'Connor** Department of Medicine, South Infirmary Victoria University Hospital, Old Blackrock Road, Cork Ireland

X Preface

future.

**Acknowledgements** 

will strive to achieve.

Many thanks to the authors of each Chapter of this book. The outstanding contributions they have made resulted in a very easy book to edit. It was very enjoyable and a privilege reading each contribution. Your work is now a mark for the

To the publisher, InTech, thank you for being ever present and encouraging me in my endeavors to stay up to date with the review and editing process. I would never have been so organized without the assistance of Ms. Danijela Duric, Publishing Process

To my father (Tim) and late mother (Eileen), thank you for all the encouragement over the years to achieve my goals and become the ever developing doctor that I am today. I could not have achieved a fraction of my success without the support and love. Mam,

Dr Catherine O'Connor, my late aunt, who was always an inspiration. The ever present support and guidance in my early years of life and career where far beyond the role of an aunt or godmother. You will always be an example of professionalism I

Finally, to my other half, Bernie. All those long evenings spent without me while I was reading chapters and doing background knowledge discovery for this book are finally over. Your support is always beyond the call of duty and appreciated. Thank you.

Department of Medicine, South Infirmary Victoria University Hospital,

**Mortimer B. O'Connor**

Old Blackrock Road, Cork

Ireland

Manager. It was a pleasure to edit my first book with such a wonderful group.

I know you are always watching over and guiding me from a place nearby.

**Part 1** 

**Treatments** 

**Part 1** 

**Treatments** 

**1** 

*Italy* 

*1General Surgery Unit 2Division of Gastroenterology Second University of Naples* 

**Surgical Treatment of Ulcerative Colitis** 

Ulcerative colitis (UC) is an ubiquitously distributed inflammatory bowel disease. Its incidence varies slightly between geographical areas, most likely because of either the different genetic patrimonies of the involved populations or several environmental factors. In socially evolved Countries UC incidence is of approximately 6 cases per 100.000 white adult individuals, with a prevalence of 40-100/100.000. This incidence notably decreases in Countries with lower socio-economic levels. Female gender is slightly more affected than

The aetiology of UC still remains mainly unknown, even if a multifactorial genesis is now

Unlike Crohn's disease, UC is a continuous disease involving mainly the rectum, suddenly expanding proximally to the colon, with no alternation of healthy or diseased mucosal area. Figure 1 depicts the possible localization of UC at the time of clinical presentation (Binder et

**1. Introduction** 

widely accepted.

male, with a gender ratio F/M of 1.5/1.

al., 1982; Stonnington et al., 1987)

Fig. 1. Extension of ulcerative colitis at presentation

Gianluca Pellino1, Guido Sciaudone1, Gabriele Riegler2,

Silvestro Canonico1 and Francesco Selvaggi1
