Digestive-Diseases Books

Crohn's disease and ulcerative colitis are chronic diseases which vary widely between patients and over time in the same patient -- so writing a helpful book about understanding and managing these two related disorders is an ambitious undertaking. Unfortunately, Dr. Steinhart's book falls well short of the goal, as the book does not have enough information to be helpful to a patient.

The text is too superficial and general. For example, the text devotes only 15 pages to discussing the causes of these two, distinct chronic illnesses -- which is surprising since the causes are not scientifically known and substantial lay controversy exists regarding potential causes like the bacteria that causes Johne's disease in cattle. Those pages include almost no details regarding the scientific bases for the consideration of the potential causes nor the learned rejection or ambivalence regarding some of those potential causes.

The discussion of dietary strategies is equally frustrating. Diet and medication are likely to be the two areas that most patients are interested in as well as the two areas that patient knowledge will be most helpful for (i.e., the patient can do little with knowledge of the cause but quite a lot with knowledge of dietary strategies). As Dr. Steinhart notes, no one diet is accepted as efficacious. However, the doctor devotes little time to the exploration of the many diets popular with the lay experts that patients are likely to be curious about - and a terse rejection is unlikely to be helpful to a curious patient. The one exception appears to be lactose-intolerance issues - if the text was devoted to other dietary concerns in the same way it addressed lactose intolerance, the book would have been much better

Additionally, much of the advice is frustratingly fruitless. Dr. Steinhart counsels repeatedly (and not surprisingly) that patients should seek advice from their doctors and not from Internet sources. However, any dutiful investigator will quickly find that the most fruitful source of detailed information is the Internet. Obviously, credibility issues abound, but doctors are not beyond mistake either. Dr. Steinhart does not provide a useful way to evaluate credibility or a listing of Internet sources likely (or unlikely) to be useful.

Also, perhaps things are different in Canada, but in the United States it is not likely to be very productive to seek to learn everything from your doctor. Most doctors meetings are quick, and the doctor has a list of things she'd like to accomplish. The time available for general inquiry is usually short, and appointments are often infrequent. The doctor can answer some questions or point the patient down the right research path, but the good patient will conduct a great deal of outside research - indeed, that is the point of books like this.

Similarly, the reader is advised that it is generally the case (hence, presumably not always) that denial, avoiding any response, and acting out of anger are "less successful" ways of coping. Although there may well be cases where denial, avoidance, and anger are successful, most of us would generally assume otherwise, and don't need to be advised as much. If, indeed, there are times when these "strategies" care called for, Dr. Steinhart provides no suggestion of what criteria to look for or what questions to ask.

In sum, Dr. Steinhart's book is an extensive exercise in "Ask your doctor," not particularly useful advice for the sufferers of these two chronic illnesses - 2 stars.