- IBD
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Physician education can minimize inappropriate steroid use in patients with inflammatory bowel disease: the ACTION study
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Yehyun Park, Chang Hwan Choi, Hyun Soo Kim, Hee Seok Moon, Do Hyun Kim, Jin Ju Kim, Dennis Teng, Dong Il Park
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Intest Res 2022;20(4):452-463. Published online March 11, 2022
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DOI: https://doi.org/10.5217/ir.2021.00125
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 Abstract
 PDF Supplementary Material PubReader ePub
- Background/Aims
Epidemiological data on steroid use in South Korean patients with inflammatory bowel disease (IBD) are limited. We documented the steroid use patterns in these patients, and whether physician education on appropriate steroid use affected these patterns.
Methods
ACTION was an observational cohort study conducted in adults (≥19 years) with IBD. A retrospective chart review was performed at baseline (cohort 1) and 1 year after physician training (cohort 2). Eligible cases with excessive or inappropriate steroid use were identified, along with any associated risk factors.
Results
Data were collected during May 2018-July 2019 from patients with Crohn’s disease (CD) and ulcerative colitis (UC) in cohort 1 (n=1,685) and cohort 2 (n=1,649). At baseline, 155 patients (9.2%) had received steroids within the previous 12 months, 46 (29.7%) of whom had used steroids excessively, 16 (34.8%) of these having inappropriately used excessive steroids. Although steroid exposure was similar in cohort 1 (9.2%) and cohort 2 (9.7%), the latter comprised fewer excessive steroid users (20.0% vs. 29.7%). Severe disease was associated with excessive steroid use in cases with UC, but not with CD.
Conclusions
Although, overall steroid use was relatively low in South Korean patients with IBD, one-third of steroid users used them excessively, and one-third among these used excessive steroids inappropriately. High disease activity was the main risk factor for excessive steroid use which may potentially be reduced by physician education, especially in cases with UC. Active screening to minimize excessive and inappropriate steroid use through physician education should be considered.
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Citations
Citations to this article as recorded by  - Corticosteroid Use in Randomized Clinical Trials of Biologics and Small Molecules in Inflammatory Bowel Disease: A Systematic Review
Bruno César da Silva, Sam Papasotiriou, Stephen B Hanauer
Inflammatory Bowel Diseases.2024;[Epub] CrossRef - The Reliability and Quality of Short Videos as a Source of Dietary Guidance for Inflammatory Bowel Disease: Cross-sectional Study
Zixuan He, Zhijie Wang, Yihang Song, Yilong Liu, Le Kang, Xue Fang, Tongchang Wang, Xuanming Fan, Zhaoshen Li, Shuling Wang, Yu Bai
Journal of Medical Internet Research.2023; 25: e41518. CrossRef - Corticosteroid, a double-edged sword in inflammatory bowel disease management: possibility of reducing corticosteroid use through physician education
Seulji Kim, Seong-Joon Koh
Intestinal Research.2022; 20(4): 389. CrossRef
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- Inflammatory bowel diseases
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Is fasting beneficial for hospitalized patients with inflammatory bowel diseases?
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Yong Eun Park, Yehyun Park, Soo Jung Park, Tae Il Kim, Won Ho Kim, Jung Nam Kim, Na Rae Lee, Jae Hee Cheon
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Intest Res 2020;18(1):85-95. Published online July 19, 2019
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DOI: https://doi.org/10.5217/ir.2019.00055
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Abstract
PDFSupplementary MaterialPubReaderePub
- Background/Aims
Patients with inflammatory bowel disease (IBD) are usually hospitalized because of aggravated gastrointestinal symptoms. Many clinicians empirically advise these patients to fast once they are admitted. However, there has been no evidence that maintaining a complete bowel rest improves the disease course. Therefore, we aimed to investigate the effects of fasting on disease course in admitted patients with IBD or intestinal Behçet’s disease.
Methods
A total of 222 patients with IBD or intestinal Behçet’s disease, who were admitted for disease-related symptoms, were retrospectively analyzed. We divided them into 2 groups: fasting group (allowed to take sips of water but no food at the time of admission) and dietary group (received liquid, soft, or general diet).
Results
On admission, 124 patients (55.9%) started fasting and 98 patients (44.1%) started diet immediately. Among patients hospitalized through the emergency room, a significantly higher proportion underwent fasting (63.7% vs. 21.4%, P<0.001); however, 96.0% of the patients experienced dietary changes. Corticosteroid use (P<0.001; hazard ratio, 2.445; 95% confidence interval, 1.506–3.969) was significantly associated with a reduction in the disease activity score, although there was no significant difference between the fasting group and the dietary group in disease activity reduction (P=0.111) on multivariate analysis.
Conclusions
In terms of disease activity reduction, there was no significant difference between the fasting and dietary groups in admitted patients with IBD, suggesting that imprudent fasting is not helpful in improving the disease course. Therefore, peroral diet should not be avoided unless not tolerated by the patient.
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Citations
Citations to this article as recorded by - Dietary content and eating behavior in ulcerative colitis: a narrative review and future perspective
Lingxi Qin, Wenliang Lv
Nutrition Journal.2025;[Epub] CrossRef - Outcomes of dietary management approaches in active ulcerative colitis: A systematic review
Abigail Marsh, Sophie Rindfleish, Kalina Bennett, Anthony Croft, Veronique Chachay
Clinical Nutrition.2022; 41(2): 298. CrossRef - Effect of Ramadan intermittent fasting on inflammatory markers, disease severity, depression, and quality of life in patients with inflammatory bowel diseases: A prospective cohort study
Mohamed Negm, Ahmed Bahaa, Ahmed Farrag, Rania M. Lithy, Hedy A. Badary, Mahmoud Essam, Shimaa Kamel, Mohamed Sakr, Waleed Abd El Aaty, Mostafa Shamkh, Ahmed Basiony, Ibrahim Dawoud, Hany Shehab
BMC Gastroenterology.2022;[Epub] CrossRef - Circadian Influences of Diet on the Microbiome and Immunity
Danping Zheng, Karina Ratiner, Eran Elinav
Trends in Immunology.2020; 41(6): 512. CrossRef
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14,434
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- Miscellaneous
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Efficacy and tolerability of methotrexate therapy for refractory intestinal Behçet's disease: a single center experience
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Jihye Park, Jae Hee Cheon, Yehyun Park, Soo Jung Park, Tae Il Kim, Won Ho Kim
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Intest Res 2018;16(2):315-318. Published online April 30, 2018
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DOI: https://doi.org/10.5217/ir.2018.16.2.315
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PDFPubReaderePub
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Citations
Citations to this article as recorded by - Behçet's syndrome
Giacomo Emmi, Alessandra Bettiol, Gülen Hatemi, Domenico Prisco
The Lancet.2024; 403(10431): 1093. CrossRef - Current pharmacological solutions for Behçet’s syndrome
Yesim Ozguler, Sinem Nihal Esatoglu, Gulen Hatemi
Expert Opinion on Pharmacotherapy.2023; 24(2): 221. CrossRef - Treatment Options in Pediatric Behçet’s Disease
Teresa Giani, Angela Flavia Luppino, Giovanna Ferrara
Pediatric Drugs.2023; 25(2): 165. CrossRef - Advances in Management of Intestinal Behçet’s Disease: A Perspective From Gastroenterologists
Jae Hee Cheon
Journal of Rheumatic Diseases.2021; 28(1): 4. CrossRef - Long-term outcome and predictors of remission in Behçet’s disease in daily practice
Aida Malek Mahdavi, Alireza Khabbazi, Mehrzad Hajialilo
Modern Rheumatology.2021; 31(6): 1148. CrossRef - Lactobacillus plantarum CBT LP3 ameliorates colitis via modulating T cells in mice
Da Hye Kim, Soochan Kim, Jae Bum Ahn, Jae Hyeon Kim, Hyun Woo Ma, Dong Hyuk Seo, Xiumei Che, Ki Cheong Park, Jeong Yong Jeon, Sang Yong Kim, Han Cheol Lee, Jae-Young Lee, Tae Il Kim, Won Ho Kim, Seung Won Kim, Jae Hee Cheon
International Journal of Medical Microbiology.2020; 310(2): 151391. CrossRef - Successful combination therapy using adalimumab and 5-aminosalicylic acid for a resistant case of intestinal Behçet’s disease
H. J. Kim, K.‑t. Kim, S.-G. Lee, Y. Kim
Zeitschrift für Rheumatologie.2020; 79(7): 702. CrossRef - Safety of systemic treatments for Behçet’s syndrome
Giuseppe Lopalco, Donato Rigante, Antonio Lopalco, Giacomo Emmi, Vincenzo Venerito, Antonio Vitale, Giovanna Capozio, Nunzio Denora, Luca Cantarini, Florenzo Iannone
Expert Opinion on Drug Safety.2020; 19(10): 1269. CrossRef - Update on the treatment of Behçet’s syndrome
Sinem Nihal Esatoglu, Gulen Hatemi
Internal and Emergency Medicine.2019; 14(5): 661. CrossRef
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5,744
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Newly designed flared-end covered versus uncovered self-expandable metallic stents for palliation of malignant colorectal obstruction: a randomized, prospective study
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Soo Jung Park, Yehyun Park, Hyun Jung Lee, Jae Jun Park, Jae Hee Cheon, Won Ho Kim, Tae Il Kim
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Received August 23, 2024 Accepted November 20, 2024 Published online February 24, 2025
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DOI: https://doi.org/10.5217/ir.2024.00135
[Epub ahead of print]
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Abstract
PDFSupplementary MaterialPubReaderePub
- Background/Aims
Self-expandable metallic stents (SEMSs) are widely used as palliative or bridge to surgery treatments in patients with malignant colorectal obstruction (MCO). Stent occlusion is more common with uncovered stents, but stent migration is more common with covered stents. Our purpose was to compare the efficacy and safety of a newly designed covered SEMS with an uncovered proximal flared end (CSEMS-UPF) with that of the conventional uncovered SEMS (UCSEMS) in the treatment of MCO.
Methods
This prospective randomized trial was conducted at a tertiary-care academic hospital. We enrolled 87 patients with stage 4 cancer and MCO: colorectal cancer in 60 patients and extracolonic cancer in 27 patients. Insertion of UCSEMS was randomly assigned to 43 patients, and 44 patients received the CSEMS-UPF. The primary outcome was the duration of stent patency after successful placement. The secondary outcomes were the number of patients with technical and clinical success and early and late complications from the stent insertion.
Results
The median patency of the stent did not differ between the UCSEMS and CSEMS-UPF groups (484 [231–737] days vs. 216 [66–366] days, P= 0.242). The technical and clinical success rates did not differ significantly between the groups, either (100.0% vs. 93.2%, respectively, P= 0.241; 100.0% vs. 92.7%, respectively, P= 0.112), nor did the early (n = 2 [4.7%] vs. n = 4 [9.8%], P> 0.999) or late (n = 12 [27.9%] vs. n = 15 [36.6%], P> 0.999) stent complication rates differ between the groups.
Conclusions
The UCSEMS and newly developed CSEMS-UPF are similarly effective treatments for MCO, with no differences in the stent migration or occlusion rates (Clinical trial registration number: NCT02640781).
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