Intestinal Research

Reviews

IBD

Crohn’s disease at radiological imaging: focus on techniques and intestinal tract: Giuseppe Cicero, Silvio Mazziotti; Intest Res 2021;19(4):365-378. Published online November 25, 2020; DOI: https://doi.org/10.5217/ir.2020.00097

Over recent years, inflammatory bowel diseases have become an issue of increased attention in daily clinical practice, due to both a rising incidence and improved imaging capability in detection. In particular, the diagnosis of Crohn’s disease is based on clinical picture, laboratory tests and colonoscopy with biopsy. However, colonoscopic evaluation is limited to the mucosal layer. Thus, imaging modalities play a pivotal role in enriching the clinical picture, delivering information on intestinal and extraintestinal involvement. All the imaging modalities can be employed in evaluation of Crohn’s disease patients, each of them with specific strengths as well as limitations. In this wide selection, the choice of a proper diagnostic framework can be challenging for the clinician. Therefore, the aim of this work is to offer an overview of the different imaging techniques, with brief technical details and diagnostic potential related to each intestinal tract.

Citations

Citations to this article as recorded by

Comparison of an Endoscopic Scoring System and the Simplified Magnetic Resonance Index of Activity in Patients with Small Bowel Crohn’s Disease
Ji Eun Na, Hon Soul Kim, Sung Noh Hong, Kyoung Doo Song, Ji Eun Kim, Eun Ran Kim, Young-Ho Kim, Dong Kyung Chang
Gut and Liver.2024; 18(1): 97. CrossRef
Duodenal Crohn’s disease: Case report and systematic review
Muniratu Amadu, Jonathan Soldera
World Journal of Methodology.2024;[Epub] CrossRef
Achieving high-quality magnetic resonance enterography is critical for assessing Crohn’s disease activity
Kyoung Doo Song
Intestinal Research.2024; 22(2): 117. CrossRef
Diagnostic Procedures for Inflammatory Bowel Disease: Laboratory, Endoscopy, Pathology, Imaging, and Beyond
Seung Min Hong, Dong Hoon Baek
Diagnostics.2024; 14(13): 1384. CrossRef
Clinical applications, safety profiles, and future developments of contrast agents in modern radiology: A comprehensive review
Reabal Najjar
iRADIOLOGY.2024; 2(5): 430. CrossRef
Could ultrasound alone substitute MR imaging in evaluation of Crohn’s disease complications?
Hany El-Assaly, Asmaa Abdel Baky Mohamed, Hesham Adel Abdel Fattah Mustafa
Egyptian Journal of Radiology and Nuclear Medicine.2024;[Epub] CrossRef
Current State of CT Enterography in Diagnostics and Surgical Tactics in Crohn’s Disease (Literature Review)
A. L. Aprosimov, D. A. Lezhnev, Yu. V. Kulezneva
Radiology - Practice.2024; (6): 67. CrossRef
Colonic involvement in inflammatory bowel diseases: spotlight on the role of magnetic resonance enterography
Giuseppe Cicero, Velio Ascenti, Laura Maria Chisari, Silvio Mazziotti
Japanese Journal of Radiology.2023;[Epub] CrossRef
Impact of Crohn’s Disease on the Survival of Patients with Small-Bowel Adenocarcinoma in Korea: A Bicenter Cohort Study
Kyuwon Kim, Kookhwan Choi, Sung Wook Hwang, Jong Pil Im, Byong Duk Ye, Joo Sung Kim, Kyu Joo Park, Suk-Kyun Yang, Seong-Joon Koh, Sang Hyoung Park
Gut and Liver.2023; 17(4): 581. CrossRef
Distribution of small bowel involvement and its association with clinical outcomes in patients with Crohn’s disease
Jin Park, Hae Young Kim, Yoon Jin Lee, Hyuk Yoon, Cheol Min Shin, Young Soo Park, Nayoung Kim, Dong Ho Lee
Medicine.2023; 102(40): e35040. CrossRef
Reclassification of Inflammatory Bowel Disease Type Unclassified by Small Bowel Capsule Endoscopy
Ana-Maria Singeap, Catalin Sfarti, Irina Girleanu, Laura Huiban, Cristina Muzica, Sergiu Timofeiov, Carol Stanciu, Anca Trifan
Medicina.2023; 59(12): 2064. CrossRef
Small Bowel Capsule Endoscopy and Enteroscopy: A Shoulder-to-Shoulder Race
Ana-Maria Singeap, Catalin Sfarti, Horia Minea, Stefan Chiriac, Tudor Cuciureanu, Robert Nastasa, Carol Stanciu, Anca Trifan
Journal of Clinical Medicine.2023; 12(23): 7328. CrossRef
Crohn's disease and clinical management today: How it does?
Ronaldo Teixeira da Silva Júnior, Jonathan Santos Apolonio, Jessica Oliveira de Souza Nascimento, Bruna Teixeira da Costa, Luciano Hasimoto Malheiro, Marcel Silva Luz, Lorena Sousa de Carvalho, Cleiton da Silva Santos, Fabrício Freire de Melo
World Journal of Methodology.2023; 13(5): 399. CrossRef
Mimicking conditions of intestinal Crohn’s disease: magnetic resonance enterography findings
Giuseppe Cicero, Alfredo Blandino, Tommaso D’Angelo, Christian Booz, Thomas J. Vogl, Giorgio Ascenti, Silvio Mazziotti
Japanese Journal of Radiology.2022; 40(1): 19. CrossRef
Microbial changes in stool, saliva, serum, and urine before and after anti-TNF-α therapy in patients with inflammatory bowel diseases
Yong Eun Park, Hye Su Moon, Dongeun Yong, Hochan Seo, Jinho Yang, Tae-Seop Shin, Yoon-Keun Kim, Jin Ran Kim, Yoo Na Lee, Young-Ho Kim, Joo Sung Kim, Jae Hee Cheon
Scientific Reports.2022;[Epub] CrossRef
Endoscopic activity in inflammatory bowel disease: clinical significance and application in practice
Kyeong Ok Kim
Clinical Endoscopy.2022; 55(4): 480. CrossRef
Overview of the Large Bowel Assessment using Magnetic Resonance Imaging: Different Techniques for Current and Emerging Clinical Applications
Giuseppe Cicero, Giorgio Ascenti, Alfredo Blandino, Christian Booz, Thomas J. Vogl, Renato Trimarchi, Tommaso D'Angelo, Silvio Mazziotti
Current Medical Imaging Formerly Current Medical Imaging Reviews.2022; 18(10): 1031. CrossRef
Unique coexistence of chronic midgut malrotation, mesenteric cyst, and pancreas divisum in a Crohn's disease patient: MR-enterography assessment
Giuseppe Cicero, Silvio Mazziotti
Radiology Case Reports.2022; 17(11): 4280. CrossRef
Portal hypertensive enteropathy: multimodality assessment through computed tomography and magnetic resonance enterography
Giuseppe Cicero, Francesco Marcello Aricò, Anna Viola, Velio Ascenti, Silvio Mazziotti
Radiology Case Reports.2022; 17(12): 4804. CrossRef
DWI ratios: New indexes for Crohn’s disease activity at magnetic resonance enterography?
Giuseppe Cicero, Angela Alibrandi, Alfredo Blandino, Velio Ascenti, Walter Fries, Anna Viola, Silvio Mazziotti
La radiologia medica.2022;[Epub] CrossRef
Elective surgery outcomes in inflammatory bowel disease: interpretation at magnetic resonance enterography
Giuseppe Cicero, Giorgio Ascenti, Alfredo Blandino, Renato Trimarchi, Christian Booz, Thomas J. Vogl, Tommaso D’Angelo, Silvio Mazziotti
Japanese Journal of Radiology.2021; 39(7): 633. CrossRef
Magnetic resonance enterography in Crohn’s disease patients: current state of the art and future perspectives
Hila Bufman, Rami Eliakim, Noam Tau, Michal Marianne Amitai
Expert Review of Medical Devices.2021; 18(7): 657. CrossRef

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Microbiota

Gut microbiome and checkpoint inhibitor colitis: Kanika Sehgal, Sahil Khanna; Intest Res 2021;19(4):360-364. Published online December 1, 2020; DOI: https://doi.org/10.5217/ir.2020.00116

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Immune checkpoint inhibitor therapies such as ipilimumab, are increasingly being used as a treatment option for a variety of cancers, including metastatic melanoma and have demonstrated effectively a prolonged survival. These agents have an immunological mode of action that predisposes patients to a number of immune-related adverse events, colitis being one of the most commonly encountered complications. The pathogenesis for the development of colitis is unclear, and there is a growing consensus that the ecosystem of the gastrointestinal microbiota plays a significant role. Based on this suspected connection, studies are being carried out to explore the changes in the microbiota in patients on these medications who develop colitis. Conceivably, the modulation of the gut microbiota could offer a therapeutic benefit. Fecal microbiota transplantation is one therapeutic option that is currently being investigated, though there are still more data needed to evaluate its efficacy. In this review, we recapitulate the mechanisms of action of immune checkpoint inhibitors, their adverse events, with a focus on colitis and the role gut microbiota are suspected to play, and finally discuss the microbiota modulation therapies being investigated.

Citations

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What should intensivists know about immune checkpoint inhibitors and their side effects?
Viktor Yordanov Zlatkov Aleksandrov, Fernando Martínez Sagasti, Juncal Pérez-Somarriba Moreno, Helena Huertas Mondéjar
Medicina Intensiva (English Edition).2025; : 502135. CrossRef
Gut Microbiota Modulation of Efficacy and Toxicity of Cancer Chemotherapy and Immunotherapy
Despoina Chrysostomou, Lauren A. Roberts, Julian R. Marchesi, James M. Kinross
Gastroenterology.2023; 164(2): 198. CrossRef
Compositional changes in fecal microbiota associated with clinical phenotypes and prognosis in Korean patients with inflammatory bowel disease
Seung Yong Shin, Young Kim, Won-Seok Kim, Jung Min Moon, Kang-Moon Lee, Sung-Ae Jung, Hyesook Park, Eun Young Huh, Byung Chang Kim, Soo Chan Lee, Chang Hwan Choi
Intestinal Research.2023; 21(1): 148. CrossRef
Obesity Measured via Body Mass Index May Be Associated with Increased Incidence but Not Worse Outcomes of Immune-Mediated Diarrhea and Colitis
Miho Kono, Malek Shatila, Guofan Xu, Yang Lu, Antony Mathew, Wasay Mohajir, Krishnavathana Varatharajalu, Wei Qiao, Anusha S. Thomas, Yinghong Wang
Cancers.2023; 15(8): 2329. CrossRef
Gut microbiome homeostasis and the future of probiotics in cancer immunotherapy
Ankita Singh, Sharon Grace Alexander, Sunil Martin
Frontiers in Immunology.2023;[Epub] CrossRef
Gut Microbiome and Colorectal Cancer
Tae-Geun Gweon
The Korean Journal of Gastroenterology.2023; 82(2): 56. CrossRef
Impact ofHelicobacter pyloriinfection status on outcomes among patients with advanced gastric cancer treated with immune checkpoint inhibitors
Patrick T Magahis, Steven B Maron, Darren Cowzer, Stephanie King, Mark Schattner, Yelena Janjigian, David Faleck, Monika Laszkowska
Journal for ImmunoTherapy of Cancer.2023; 11(10): e007699. CrossRef
Comments on Efficacy of a Synbiotic Containing Lactobacillus paracasei DKGF1 and Opuntia humifusa in Elderly Patients with Irritable Bowel Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial
Kwang Woo Kim
Gut and Liver.2023; 17(6): 954. CrossRef
MTA1 aggravates experimental colitis in mice by promoting transcription factor HIF1A and up-regulating AQP4 expression
Ping Li, Dong-Ping Shi, Tao Jin, Dong Tang, Wei Wang, Liu-Hua Wang
Cell Death Discovery.2022;[Epub] CrossRef
Crosstalk between mucosal microbiota, host gene expression, and sociomedical factors in the progression of colorectal cancer
Namjoo Kim, Jeong-An Gim, Beom Jae Lee, Byung il Choi, Hee Sook Yoon, Seung Han Kim, Moon Kyung Joo, Jong-Jae Park, Chungyeul Kim
Scientific Reports.2022;[Epub] CrossRef
Exploration of Potential Gut Microbiota-Derived Biomarkers to Predict the Success of Fecal Microbiota Transplantation in Ulcerative Colitis: A Prospective Cohort in Korea
Gi-Ung Kang, Sowon Park, Yeongyun Jung, Jai J. Jee, Min-Sueng Kim, Seungjun Lee, Dong-Woo Lee, Jae-Ho Shin, Hong Koh
Gut and Liver.2022; 16(5): 775. CrossRef
Physical Activity as the Best Supportive Care in Cancer: The Clinician’s and the Researcher’s Perspectives
Cécile Torregrosa, Frédéric Chorin, Eva Ester Molina Beltran, Cindy Neuzillet, Victoire Cardot-Ruffino
Cancers.2022; 14(21): 5402. CrossRef
Microbial Modulation in Inflammatory Bowel Diseases
Jongwook Yu, Jae Hee Cheon
Immune Network.2022;[Epub] CrossRef
Immune Checkpoint Inhibitor-Associated Colitis: From Mechanism to Management
Liansha Tang, Jialing Wang, Nan Lin, Yuwen Zhou, Wenbo He, Jiyan Liu, Xuelei Ma
Frontiers in Immunology.2021;[Epub] CrossRef

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Editorial

IBD

Does cytomegalovirus load predict the outcome of acute severe ulcerative colitis?: You Sun Kim; Intest Res 2021;19(4):357-359. Published online October 26, 2021; DOI: https://doi.org/10.5217/ir.2021.00120

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Citations

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Tissue quantitative RT–PCR test for diagnostic significance of cytomegalovirus infection in patients with inflammatory bowel disease and treatment response: Cytomegalovirus infection in patients with inflammatory bowel disease
Burcu Ozdemir, Ali Atay, Meral Akdogan Kayhan, Yasemin Ozderin Ozin, Dilara Turan Gokce, Adalet Altunsoy, Rahmet Guner
Medicine.2023; 102(31): e34463. CrossRef
Viral Hepatitis in Patients with Inflammatory Bowel Disease
Seung Hwan Shin, Sang Hyoung Park
The Korean Journal of Gastroenterology.2022; 80(2): 51. CrossRef
Cytomegalovirus Infection in Patients with Inflammatory Bowel Disease
Jun Lee
The Korean Journal of Gastroenterology.2022; 80(2): 60. CrossRef

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Letters to the Editor

Infection

Gastrointestinal tract diseases as a risk factor for SARSCoV2 rectal shedding? An Italian report on 10 COVID-19 patients: Angela Patrì, Biagio Pinchera, Lorenzo Spirito, Mario Delfino, Ciro Imbimbo, Paola Salvatore, Ivan Gentile, Gabriella Fabbrocini; Intest Res 2021;19(3):354-356. Published online November 6, 2020; DOI: https://doi.org/10.5217/ir.2020.00084

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Citations

Citations to this article as recorded by

Korean Association for the Study of Intestinal Diseases guidance for clinical practice of adult inflammatory bowel disease during the coronavirus disease 2019 pandemic: expert consensus statements
Yong Eun Park, Yoo Jin Lee, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Jae Gon Lee, Hee Chan Yang, Miyoung Choi, Seong-Eun Kim, Seung-Jae Myung
Intestinal Research.2022; 20(4): 431. CrossRef
Database of SARS-CoV-2 and coronaviruses kinetics relevant for assessing persistence in food processing plants
Ngoc-Du Martin Luong, Laurent Guillier, Sandra Martin-Latil, Christophe Batejat, India Leclercq, Christine Druesne, Moez Sanaa, Estelle Chaix
Scientific Data.2022;[Epub] CrossRef
KASID Guidance for Clinical Practice Management of Adult Inflammatory Bowel Disease during the COVID-19 Pandemic: Expert Consensus Statement
Yong Eun Park, Yoo Jin Lee, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Jae Gon Lee, Hee Chan Yang, Miyoung Choi, Seong-Eun Kim, Seung-Jae Myung
The Korean Journal of Gastroenterology.2021; 78(2): 105. CrossRef
Clinical Course of COVID-19 in Patients with Inflammatory Bowel Disease in Korea: a KASID Multicenter Study
Jin Wook Lee, Eun Mi Song, Sung-Ae Jung, Sung Hoon Jung, Kwang Woo Kim, Seong-Joon Koh, Hyun Jung Lee, Seung Wook Hong, Jin Hwa Park, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Sang Hyoung Park
Journal of Korean Medical Science.2021;[Epub] CrossRef

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Brief Communication

IBD

Succinate-treated macrophages attenuate dextran sodium sulfate colitis in mice: I Seul Park, Mijeong Son, Hyun Woo Ma, Jihyung Kim, Da Hye Kim, Seung Won Kim, Jae Hee Cheon; Intest Res 2021;19(3):349-353. Published online November 2, 2020; DOI: https://doi.org/10.5217/ir.2020.00075

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Citations

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Cellular succinate metabolism and signaling in inflammation: implications for therapeutic intervention
Hong Huang, Gejing Li, Yini He, Jing Chen, Jianye Yan, Qin Zhang, Liqing Li, Xiong Cai
Frontiers in Immunology.2024;[Epub] CrossRef
Anti-inflammatory properties of butyrate-producing atypical Escherichia coli in a murine colitis model
Ji Hyung Kim, Jee In Yoo, Hyun Woo Ma, I Seul Park, Mijeong Son, Yoojin Shin, Ki Beom Kim, Seung Won Kim, Si Jae Park, Jihye Park
Intestinal Research.2023; 21(2): 266. CrossRef
Succinate metabolism and its regulation of host-microbe interactions
Yi-han Wei, Xi Ma, Jiang-chao Zhao, Xiu-qi Wang, Chun-qi Gao
Gut Microbes.2023;[Epub] CrossRef
Urolithin A Alleviates Colitis in Mice by Improving Gut Microbiota Dysbiosis, Modulating Microbial Tryptophan Metabolism, and Triggering AhR Activation
Mingxia Ma, Yanxin Wang, Siqing Fan, Yumeng Huang, Xiurong Su, Chenyang Lu
Journal of Agricultural and Food Chemistry.2023; 71(20): 7710. CrossRef
Novel Histone Deacetylase 6 Inhibitor Confers Anti-inflammatory Effects and Enhances Gut Barrier Function
Jae-Young Lee, Hyun Woo Ma, Ji Hyung Kim, I Seul Park, Mijeong Son, Keun Ho Ryu, Jieun Shin, Seung Won Kim, Jae Hee Cheon
Gut and Liver.2023; 17(5): 766. CrossRef
Downregulation of Heat Shock Protein 72 Contributes to Fibrostenosis in Crohn’s Disease
Seung Won Kim, Jae-Young Lee, Han Cheol Lee, Jae Bum Ahn, Ji Hyung Kim, I Seul Park, Jae Hee Cheon, Duk Hwan Kim
Gut and Liver.2023; 17(6): 905. CrossRef
Microbial Modulation in Inflammatory Bowel Diseases
Jongwook Yu, Jae Hee Cheon
Immune Network.2022;[Epub] CrossRef
Anti-inflammatory properties of Escherichia coli Nissle 1917 in a murine colitis model
Jihye Park, Da Hye Kim, Soochan Kim, Hyun Woo Ma, I Seul Park, Mijeong Son, Ji Hyung Kim, Yoojin Shin, Seung Won Kim, Jae Hee Cheon
Intestinal Research.2021; 19(4): 478. CrossRef

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Original Articles

Endoscopy

Effect of gut microbiome on minor complications after a colonoscopy: Jae Hyun Kim, Youn Jung Choi, Hye Jung Kwon, Kyoungwon Jung, Sung Eun Kim, Won Moon, Moo In Park, Seun Ja Park; Intest Res 2021;19(3):341-348. Published online November 10, 2020; DOI: https://doi.org/10.5217/ir.2020.00057

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Background/Aims
Minor complications that might occur after colonoscopy, including abdominal discomfort, bloating, diarrhea, and constipation, could a barrier for patients to undergo a screening colonoscopy. In this study, we aimed to identify the effect of gut microbial diversity and composition on minor complications after colonoscopy.
Methods
A total of 24 healthy subjects provided their stools before bowel preparation and on the 7th and 28th day after colonoscopy. On the 7th day after colonoscopy, the presence of minor complications was investigated using a questionnaire. We divided patients into 2 groups, the no complication group and complications group. The fecal microbial diversity, distribution, and composition were then compared between the groups.
Results
Five of the 24 subjects reported that they had undergone minor complications after colonoscopy. Most of the symptoms were mild and self-limited, but 1 patient needed medication. Interestingly, the Firmicutes/Bacteroidetes ratio of the initial stool samples before bowel preparation in the complication group was significantly higher than that in no complication group. After bowel preparation, the Firmicutes/Bacteroidetes ratio of the complication group decreased, but not in the no complication group. The microbial diversity of the no complication group decreased after bowel preparation, but not in the complication group.
Conclusions
The gut microbial composition and diversity before and after bowel preparation could be considered as one of the causes of minor complications after colonoscopy. Further studies are needed to delineate the role of gut microbiota in the occurrence of minor complications after colonoscopy.

Citations

Citations to this article as recorded by

Alteration in gut microbiota after colonoscopy: proposed mechanisms and the role of probiotic interventions
Hyeong Ho Jo, Moon Young Lee, Se Eun Ha, Dong Han Yeom, Yong Sung Kim
Clinical Endoscopy.2025; 58(1): 25. CrossRef
Depressive Symptoms and Gut Microbiota after Bowel Preparation and Colonoscopy: A Pre–Post Intervention Study
Amelia J. McGuinness, Martin O’Hely, Douglas Stupart, David Watters, Samantha L. Dawson, Christopher Hair, Michael Berk, Mohammadreza Mohebbi, Amy Loughman, Glenn Guest, Felice N. Jacka
Microorganisms.2024; 12(10): 1960. CrossRef
Benefits of Probiotic Pretreatment on the Gut Microbiota and Minor Complications after Bowel Preparation for Colonoscopy: A Randomized Double-Blind, Placebo-Controlled Pilot Trial
Dooheon Son, Youn Jung Choi, Min Young Son, Won Moon, Seun Ja Park, Sanghyun Lim, Jae Hyun Kim
Nutrients.2023; 15(5): 1141. CrossRef
Key determinants of success in fecal microbiota transplantation: From microbiome to clinic
Serena Porcari, Nicolas Benech, Mireia Valles-Colomer, Nicola Segata, Antonio Gasbarrini, Giovanni Cammarota, Harry Sokol, Gianluca Ianiro
Cell Host & Microbe.2023; 31(5): 712. CrossRef
Colonoscopy: body and psyche. Can psychiatry contribute to the quality of the examination?
Adam Zaczek, Robert Pudlo
Current Problems of Psychiatry.2023; 24: 253. CrossRef
CO2 Is Beneficial to Gut Microbiota Homeostasis during Colonoscopy: Randomized Controlled Trial
Xue Yang, Wen-Bo Xiu, Jin-Xia Wang, Liang-Ping Li, Chong He, Cai-Ping Gao
Journal of Clinical Medicine.2022; 11(18): 5281. CrossRef
Novel frontiers of agents for bowel cleansing for colonoscopy
Milena Di Leo, Andrea Iannone, Monica Arena, Giuseppe Losurdo, Maria Angela Palamara, Giuseppe Iabichino, Pierluigi Consolo, Maria Rendina, Carmelo Luigiano, Alfredo Di Leo
World Journal of Gastroenterology.2021; 27(45): 7748. CrossRef

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Inflammatory Bowel Diseases

Patterns of endoscopy during COVID-19 pandemic: a global survey of interventional inflammatory bowel disease practice: Yan Chen, Qiao Yu, Francis A. Farraye, Gursimran S. Kochhar, Charles N. Bernstein, Udayakumar Navaneethan, Kaicun Wu, Jie Zhong, David A. Schwartz, Hao Wu, Jing-Jing Zheng, Marietta Iacucci, Ravi P. Kiran, Bo Shen; Intest Res 2021;19(3):332-340. Published online June 2, 2020; DOI: https://doi.org/10.5217/ir.2020.00037

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Background/Aims
Performance of diagnostic or therapeutic endoscopic procedures in inflammatory bowel disease (IBD) patients can be challenging during a viral pandemic; the main concerns being the safety and protection of patients and health care providers (HCP). The aim of this study is to identify endoscopic practice patterns and outcomes of IBD and coronavirus disease 19 (COVID-19) with a worldwide survey of HCP.
Methods
The 20-item survey questionnaire was sent to physician members of the American Society for Gastrointestinal Endoscopy Special Interest Group in Interventional IBD, Chinese IBD Society Endoscopy Interest Group, and the China Crohn’s and Colitis Foundation.
Results
A total of 141 respondents submitted valid responses. Nighty-five respondents (67.9%) reported that at least 25% of their scheduled emergent endoscopic procedures were canceled or postponed during the pandemic. Fifty-six respondents (40.0%) have performed emergent endoscopy during the pandemic. A few respondents (9/140, 6.4%) estimated that more than 25% of their patients had worsened disease due to delayed or canceled emergent endoscopy procedures. More than 80% of respondents believed that personal protective equipment (PPE) for the endoscopy team, room sterilization, and pre-procedure screening of patients for COVID-19 were necessary. Out of 140 respondents, 16 (11.4%) reported that several of their patients had COVID-19. Eight clinicians (5.7%) reported that they or their endoscopy colleagues developed work-related COVID-19.
Conclusions
Cancellation of elective and emergent endoscopy in IBD care during the pandemic was common. Few respondents reported that their patients’ disease conditions worsened due to the cancellation of the endoscopy procedure. Most respondents voiced the need for proper PPE during the procedure regardless of patients’ COVID-19 status and screening the patients for COVID-19.

Citations

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The trends and outcomes of inflammatory bowel disease surgery during the COVID‐19 pandemic: A retrospective propensity score‐matched analysis from a multi‐institutional research network
Fiona Wu, Gema H. Ibarburu, Caris Grimes
Health Science Reports.2024;[Epub] CrossRef
Survey of the Impact of COVID-19 on Chronic Liver Disease Patient Care Experiences and Outcomes
Shirley X Jiang, Katerina Schwab, Robert Enns, Hin Hin Ko
Journal of the Canadian Association of Gastroenterology.2023; 6(1): 8. CrossRef
To overcome medical gap in screening and surveillance of colorectal cancer during the COVID-19 pandemic
Yoo Min Han
Intestinal Research.2023; 21(4): 418. CrossRef
National survey regarding the timing of endoscopic procedures during the COVID-19 pandemic
José Daniel Marroquín-Reyes, Sergio Zepeda-Gómez, Alejandra Tepox-Padrón, Mariana Quintanar-Martínez, Omar Edel Trujillo-Benavides, Félix I. Téllez-Avila
Surgical Endoscopy.2022; 36(1): 361. CrossRef
Effect of COVID-19 on gastrointestinal endoscopy practice: a systematic review
Mohamed H. Emara, Mariam Zaghloul, Muhammad Abdel-Gawad, Nahed A. Makhlouf, Mohamed Abdelghani, Doaa Abdeltawab, Aya M. Mahros, Ahmed Bekhit, Nitin S. Behl, Sadek Mostafa, Alejandro Piscoya, Sherief Abd-Elsalam, Mohamed Alboraie
Annals of Medicine.2022; 54(1): 2874. CrossRef
Consequences of Delayed Endoscopies on the IBD Population during the COVID-19 Pandemic
Karen C. Young, Vitaliy Poylin
World Journal of Colorectal Surgery.2022; 11(3): 55. CrossRef
Inflammatory bowel disease and SARS-CoV-2 pandemic: current knowledge and recommendations
Dinko Bekic, Zeljka Belosic Halle
Scandinavian Journal of Gastroenterology.2021; 56(6): 656. CrossRef
Quality of life in patients with IBD during the COVID-19 pandemic in the Netherlands
Ellen de Bock, Mando D Filipe, Vincent Meij, Bas Oldenburg, Fiona D M van Schaik, Okan W Bastian, Herma F Fidder, Menno R Vriens, Milan C Richir
BMJ Open Gastroenterology.2021; 8(1): e000670. CrossRef
Clinical Course of COVID-19 in Patients with Inflammatory Bowel Disease in Korea: a KASID Multicenter Study
Jin Wook Lee, Eun Mi Song, Sung-Ae Jung, Sung Hoon Jung, Kwang Woo Kim, Seong-Joon Koh, Hyun Jung Lee, Seung Wook Hong, Jin Hwa Park, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Sang Hyoung Park
Journal of Korean Medical Science.2021;[Epub] CrossRef
Gastrointestinal Endoscopy in the Era of COVID-19
Abhilash Perisetti, Hemant Goyal, Neil Sharma
Frontiers in Medicine.2020;[Epub] CrossRef

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Inflammatory Bowel Diseases

Long-term outcomes of infliximab in a real-world multicenter cohort of patients with acute severe ulcerative colitis: Shin Ju Oh, Ga Young Shin, Hosim Soh, Jae Gon Lee, Jong Pil Im, Chang Soo Eun, Kang-Moon Lee, Dong Il Park, Dong Soo Han, Hyo Jong Kim, Chang Kyun Lee; Intest Res 2021;19(3):323-331. Published online August 18, 2020; DOI: https://doi.org/10.5217/ir.2020.00039

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Background/Aims
Infliximab (IFX) has proven effective as rescue therapy in steroid-refractory acute severe ulcerative colitis (ASUC), however, the long-term real-world data are scarce. Our study aimed to assess the long-term treatment outcomes of IFX in a real-life cohort.
Methods
We established a multicenter retrospective cohort of hospitalized patients with ASUC, who met Truelove and Witt’s criteria and received intravenous corticosteroid (IVCS) or IFX during index hospitalization between 2006 and 2016 in 5 university hospitals in Korea. The cohort was systematically followed up until colectomy, death or last follow-up visit.
Results
A total of 296 patients were followed up for a mean of 68.9 ± 44.0 months. During index hospitalization, 49 patients were treated with IFX; as rescue therapy for IVCS failure in 37 and as first-line medical therapy for ASUC in 12. All patients treated with IFX avoided colectomy during index hospitalization. The cumulative rates of rehospitalization and colectomy were 20.4% and 6.1% at 3 months and 39.6% and 18.8% at the end of follow-up, respectively. Patients treated with IFX presented with significantly shorter colectomy-free survival than IVCS responders (P= 0.04, log-rank test). Both cytomegalovirus colitis and Clostridioides difficile infection (CDI) were the significant predictors of colectomy in the overall study cohort (hazard ratios of 6.57 and 4.61, respectively). There were no fatalities.
Conclusions
Our real-world cohort study demonstrated that IFX is an effective therapeutic option in Korean patients with ASUC, irrespective of IFX indication. Aggressive vigilance for cytomegalovirus colitis and CDI is warranted for hospitalized patients with ASUC.

Citations

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Inflammatory Bowel Diseases

Incidence and risk factors for venous thrombosis among patients with inflammatory bowel disease in China: a multicenter retrospective study: Jing Liu, Xiang Gao, Ye Chen, Qiao Mei, Liangru Zhu, Jiaming Qian, Pinjin Hu, Qian Cao; Intest Res 2021;19(3):313-322. Published online November 25, 2020; DOI: https://doi.org/10.5217/ir.2020.00017

Abstract PDF PubReader ePub

Background/Aims
Risk of venous thrombosis is increased in patients with inflammatory bowel disease (IBD); data on Asian IBD patients is limited and status quo of thrombosis screening and prophylaxis are unknown. Therefore, we aimed to investigate the incidence, screening, prophylaxis, and risk factors for venous thrombosis among Asian IBD patients.
Methods
Medical files of patients with Crohn’s disease (CD) and ulcerative colitis (UC) from 17 hospitals across China between 2011 and 2016 were reviewed for venous thrombosis, use of screening and prophylaxis. A case-control study was performed among hospitalized patients with venous thrombosis and their age-, sex-matched IBD controls hospitalized around the same period; disease characteristics and known provoking factors of venous thrombosis were recorded. Risk factors were analyzed in both univariate and logistic regression analyses.
Results
A total of 8,459 IBD patients were followed for 12,373 person-year. Forty-six patients (0.54%) had venous thrombosis, yielding an incidence of 37.18 per 10,000 person-year. Incidence increased with age, especially among CD. Less than 20% of patients received screening tests and 35 patients (0.41%) received prophylaxis. Severe disease flare was an independent risk factor for venous thrombosis (odds ratio [95% confidence interval]: CD, 9.342 [1.813– 48.137]; UC, 5.198 [1.268–21.305]); past use of steroids and extensive involvement were 2 additional risk factors in CD and UC, respectively.
Conclusions
Incidence of venous thrombosis in China was 37.18 per 10,000 person-year (0.54%). Use of screening and prophylaxis were rare. Severe disease flare was an independent risk factor for thrombosis among hospitalized patients.

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Characteristics and outcomes of portal vein thrombosis in patients with inflammatory bowel disease in Korea
Ki Jin Kim, Su-Bin Song, Jung-Bin Park, June Hwa Bae, Ji Eun Baek, Ga Hee Kim, Min-Jun Kim, Seung Wook Hong, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Chang Sik Yu, Yong-Sik Yoon, Jong-Lyul Lee, Min Hy
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Anti-tumor Necrosis Factor Alpha Versus Corticosteroids: A 3-fold Difference in the Occurrence of Venous Thromboembolism in Inflammatory Bowel Disease－A Systematic Review and Meta-analysis
Hajnal Székely, Laura Mária Tóth, Anett Rancz, Anna Walter, Nelli Farkas, Miklós Domonkos Sárközi, Szilárd Váncsa, Bálint Erőss, Péter Hegyi, Pál Miheller
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Risk of all-cause and cause-specific mortality associated with immune-mediated inflammatory diseases in Korea
Oh Chan Kwon, See Young Lee, Jaeyoung Chun, Kyungdo Han, Yuna Kim, Ryul Kim, Min-Chan Park, Jie-Hyun Kim, Young Hoon Youn, Hyojin Park
Frontiers in Medicine.2023;[Epub] CrossRef
Cardiovascular manifestations of inflammatory bowel diseases and the underlying pathogenic mechanisms
Ying Xiao, Don W. Powell, Xiaowei Liu, Qingjie Li
American Journal of Physiology-Regulatory, Integrative and Comparative Physiology.2023; 325(2): R193. CrossRef
Comparison of 1-Year Colectomy Risk Between the US and Korean Patients with Acute Severe Ulcerative Colitis: A Propensity Score Matching Analysis
Eun Soo Kim, Kyeong Ok Kim, Byung Ik Jang, Eun Young Kim, Yoo Jin Lee, Hyun Seok Lee, Joon Seop Lee, Sung Kook Kim, Yun Jin Jung, Sang-Bum Kang, Manasi Agrawal, Ryan Ungaro, Jean-Frederic Colombel
Digestive Diseases and Sciences.2022; 67(7): 2866. CrossRef
The Comparative Risk of Serious Adverse Events With Tofacitinib and TNF Inhibitors in Patients With Ulcerative Colitis: The Korean Experience as Revealed by a National Database
Gi Hyeon Seo, Sung Hoon Jung
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Gut and Liver.2022; 16(4): 555. CrossRef
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Hua Zhang, Xuehong Wang
Frontiers in Medicine.2021;[Epub] CrossRef

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Inflammatory Bowel Diseases

Long-term safety and effectiveness of adalimumab in 462 patients with intestinal Behçet’s disease: results from a large real-world observational study: Yasuo Suzuki, Takashi Hagiwara, Mariko Kobayashi, Kazuo Morita, Tomoyo Shimamoto, Toshifumi Hibi; Intest Res 2021;19(3):301-312. Published online August 20, 2020; DOI: https://doi.org/10.5217/ir.2020.00013

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
The safety and effectiveness of adalimumab was demonstrated in a phase 3 trial in Japanese patients with intestinal Behçet’s disease. The aim of this study was to evaluate the long-term safety and effectiveness of adalimumab in Japanese patients with intestinal Behçet’s disease.
Methods
This prospective, all-case, post-marketing study was conducted at 254 centers in Japanese patients with intestinal Behçet’s disease receiving adalimumab. The primary endpoint was incidence of adverse drug reactions. Effectiveness endpoints included global improvement rating and change in C-reactive protein levels.
Results
Of the 473 registered patients, 462 and 383 included in the safety and effectiveness populations were administered adalimumab for a mean of 515.3 and 579.5 days, respectively. Overall, 395 patients (85.5%) received adalimumab at the recommended dose. Adverse drug reactions and serious adverse drug reactions were reported in 120 (25.97%) and 51 (11.04%) patients, respectively. The incidence of adverse drug reactions was significantly higher in patients with comorbidities (P< 0.0001), patients taking concomitant oral corticosteroids (P< 0.0001), and those not self-administering adalimumab (P= 0.0257). At study end, global improvement rating was “effective” (n = 156, 40.7%) or “markedly effective” (n = 168, 43.9%) in 324 patients (overall effective, 84.6%). Mean C-reactive protein levels (mg/dL) decreased from 1.96 at baseline (n = 324) to 0.58 at week 24 (n = 208) and 0.25 at week 156 (n = 37).
Conclusions
This large real-world study confirmed the long-term safety and effectiveness of adalimumab in patients with intestinal Behçet’s disease. No new safety concerns were identified. (Clinical trial registration number: NCT01960790)

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Jaewon Song, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jihye Park, Jae Hee Cheon
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Risk Factors for Surgery in Patients with Intestinal Behçet’s Disease During Anti-Tumor Necrosis Factor-Alpha Therapy
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Interplay between chronic inflammation and clonal haematopoiesis of indeterminate potential in Behçet’s disease
Jihye Park, Hongyul An, Jiwoo Lim, I Seul Park, Mi Hyun Kim, Ji Hyung Kim, Seung Won Kim, Young Il Koh, Eun Young Lee, Jae Hee Cheon
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Seung Bum Lee, Hee Seung Hong, Chang Kyun Lee, Bo-In Lee, Sol Kim, Seong-Joon Koh, Hosun Yu, Jung-Bin Park, Sung Wook Hwang, Byong Duk Ye, Suk-Kyun Yang, Sang Hyoung Park
The Korean Journal of Internal Medicine.2023; 38(5): 661. CrossRef
Characteristics and Treatment Outcomes of Transition among Patients with Inflammatory Bowel Disease
Eun Jin Yoo, Sang-Hoon Cho, Soo Jung Park, Tae Il Kim, Won Ho Kim, Jae Hee Cheon
Yonsei Medical Journal.2023; 64(9): 541. CrossRef
Efficacy and Safety of Infliximab in Intestinal Behçet’s Disease: A Multicenter, Phase 3 Study (BEGIN)
Jae Hee Cheon, Hyun-Soo Kim, Dong Soo Han, Sung Kook Kim, Sung Jae Shin, Joo Sung Kim, Byong Duk Ye, Geun Am Song, YoungJa Lee, Youngdoe Kim, Yoosun Lee, Won Ho Kim
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Behçet's disease with intestinal involvement: a case report and review of the literature
Lin Li, Jing Wang, Huifang Li, Chiyi He, Xiaoping Niu
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PD-1-positive cells contribute to the diagnosis of inflammatory bowel disease and can aid in predicting response to vedolizumab
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Jongwook Yu, Sung Jae Shin, Yune-Jung Park, Hyung Wook Kim, Bo-In Lee, Byong Duk Ye, Geun-Tae Kim, Sung Kook Kim, Joo Sung Kim, Young-Ho Kim, Seonjeong Jeong, Jae Hee Cheon
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Qingfeng Zhang, Chunyan Ma, Rongrong Dong, Weizhen Xiang, Meiqi Li, Zhenzhen Ma, Qingrui Yang
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Efficacy of Anti-Tumor Necrosis Factor-α Therapy Against Intestinal Behçet’s Disease Complicated by Recurrent Enterocutaneous Fistulae
Hitomi Kashima, Satohiro Matsumoto, Shu Kojima, Yudai Koito, Takaya Miura, Takehiro Ishii, Hirosato Mashima
Biologics: Targets and Therapy.2022; Volume 16: 1. CrossRef
Long-Term Safety and Effectiveness of Adalimumab in Japanese Patients with Noninfectious Intermediate, Posterior, or Panuveitis: Post-Marketing Surveillance of 251 Patients
Kenichi Namba, Toshikatsu Kaburaki, Hidekazu Tsuruga, Yohei Ogawa, Eri Iwashita, Hiroshi Goto
Ophthalmology and Therapy.2022; 11(3): 1147. CrossRef
Anti-TNF-α agents for refractory intestinal Behçet’s disease: case series and meta-analysis
Shukai Zhan, Caiguang Liu, Na Li, Tong Li, Zhenyi Tian, Min Zhao, Dongxuan Wu, Minhu Chen, Zhirong Zeng, Xiaojun Zhuang
Therapeutic Advances in Gastroenterology.2022;[Epub] CrossRef
Clinical Course of Patients with Intestinal Behçet’s Disease According to Consensus-Based Diagnostic Categories
Yu Young Joo, Bo-In Lee, Seung-Jun Kim, Han Hee Lee, Jin Su Kim, Jae Myung Park, Young-Seok Cho, Kang Moon Lee, Sang Woo Kim, Hwang Choi, Myung-Gyu Choi
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Na Zhao, Yanchun Tang, Shaokun Wang, Liping Cui, Xuehui Sun, Zhihua Wang, Ying Liu
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Successful Switch to Adalimumab after Long-Term Thalidomide-Based Maintenance Therapy for Juvenile Onset Intestinal Behçet's Disease: A Case Report
Masaki Yamashita, Hiroshi Yasuda, Masaki Kato, Hirofumi Kiyokawa, Yoshinori Sato, Tadateru Maehata, Satoko Kimura, Keisuke Tateishi
Journal of St. Marianna University.2022; 13(2): 149. CrossRef
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Jingjing Chen, Xu Yao
Clinical Reviews in Allergy & Immunology.2021; 61(3): 363. CrossRef
Behçet syndrome
Yusuf Yazici, Gulen Hatemi, Bahram Bodaghi, Jae Hee Cheon, Noburu Suzuki, Nicola Ambrose, Hasan Yazici
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C-reactive protein is associated with postoperative outcomes in patients with intestinal Behçet’s disease
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BMC Gastroenterology.2021;[Epub] CrossRef

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Inflammatory Bowel Diseases

Efficacy and tolerability of exclusive enteral nutrition in adult patients with complicated Crohn’s disease: Sanchit Sharma, Arti Gupta, Saurabh Kedia, Samagra Agarwal, Namrata Singh, Sandeep Goyal, Saransh Jain, Vipin Gupta, Pabitra Sahu, Sudheer Kumar Vuyyuru, Bhaskar Kante, Raju Sharma, Rajesh Panwar, Peush Sahni, Govind Makharia, Vineet Ahuja; Intest Res 2021;19(3):291-300. Published online May 26, 2020; DOI: https://doi.org/10.5217/ir.2019.09172

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Exclusive enteral nutrition (EEN), an established modality for pediatric Crohn’s disease (CD) is seldomly utilized in adults. The present study reports the outcome of EEN in adult CD patients at a tertiary care hospital in India.
Methods
This was a retrospective analysis of CD patients who received EEN as a sole modality/adjunct to other treatment. The primary and secondary outcomes changed in Crohn’s Disease Activity Index (CDAI), and clinical response (decline in CDAI > 70), respectively, at 4 and 8 weeks. Subgroup analysis evaluated response across different phenotypes, EEN formulations and prior treatment. Linear mixed effect model was created to assess the predictors of EEN response.
Results
Thirty-one CD patients received EEN over median duration of 4 weeks (range, 2–6 weeks). CDAI showed a significant improvement post EEN at 4 (baseline 290 [260–320] vs. 240 [180–280], P= 0.001) and 8 weeks (baseline 290 [260–320] vs. 186 [160–240], P= 0.001), respectively. The cumulative clinical response rates at 4 and 8 weeks were 37.3% and 80.4% respectively. The clinical response rates at 8 weeks across B1 (n = 4), B2 (n = 18) and B3 (n = 9) phenotypes were 50%, 78.8% and 100% respectively (log-rank test, P= 0.093). The response rates at 8 weeks with polymeric (n = 8) and semi-elemental diet (n = 23) were 75% and 82.6%% respectively (log-rank test, P= 0.49). Baseline CDAI (odds ratio, 1.008; 95% confidence interval, 1.002–1.017; P= 0.046) predicted response to EEN.
Conclusions
EEN was effective in inducing clinical response across different phenotypes of CD. Baseline disease activity remained the most important predictor of clinical response to EEN.

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Hellen Kuo, Katrina Tognolini, Rumbidzai Mutsekwa, Dheeraj Shukla, Laura Willmann, Hadi Moattar, Alexander Dorrington, Naveed Ishaq, Maneesha Bhullar, John Edwards, Waled Mohsen, Pradeep Kakkadasam Ramaswamy
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Shabari Shenoy, Anuraag Jena, Carrie Levinson, Vishal Sharma, Parakkal Deepak, Tina Aswani-Omprakash, Shaji Sebastian, Jean-Frederic Colombel, Manasi Agrawal
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Duo Xu, Ziheng Peng, Yong Li, Qian Hou, Yu Peng, Xiaowei Liu
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Andreas Sturm, Raja Atreya, Dominik Bettenworth, Bernd Bokemeyer, Axel Dignass, Robert Ehehalt, Christoph-Thomas Germer, P. C. Grunert, Ulf Helwig, Karoline Horisberger, Klaus Herrlinger, Peter Kienle, Torsten Kucharzik, Jost Langhorst, Christian Maaser,
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Kush Fansiwala, Neha D. Shah, Kelly A. McNulty, Mary R. Kwaan, Berkeley N. Limketkai
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Andreas Sturm, Raja Atreya, Dominik Bettenworth, Bernd Bokemeyer, Axel Dignaß, Robert Ehehalt, Christoph Germer, Philip C. Grunert, Ulf Helwig, Klaus Herrlinger, Peter Kienle, Martin E. Kreis, Torsten Kucharzik, Jost Langhorst, Christian Maaser, Johann Oc
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Inflammatory Bowel Diseases

Trends of inflammatory bowel disease at a tertiary care center in northern India: Ajit Sood, Kirandeep Kaur, Arshdeep Singh, Vandana Midha, Ramit Mahajan, Namita Bansal, Varun Mehta, Dharmatma Singh; Intest Res 2021;19(3):282-290. Published online August 18, 2020; DOI: https://doi.org/10.5217/ir.2020.00010

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Background/Aims
Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), is increasingly being reported from India and other Asian countries. This study looks into the changing trends of IBD at a tertiary care center in north India over last two decades.
Methods
Retrospective analysis of a prospectively maintained database of patients diagnosed with IBD between January 1991 and December 2015 was conducted. The study period was divided into five times cohorts (1991–1995, 1996–2000, 2001–2005, 2006–2010, 2011–2015).
Results
During the study period, 2,467 patients (UC [n = 2,137, 86.6%], CD [n = 330, 13.3%], mean age 38.5 ± 13.3 years; 55.9% males) were registered. The proportion of patients with CD increased (ratio of UC to CD declined from 15.7:1 to 4:1). The mean age at diagnosis decreased for UC (45.7 ± 12.1 years in 1991–1995 vs. 37.6 ± 13.0 years in 2011–2015; P= 0.001) and remained consistent for CD (41.3 ± 13.6 years in 1996–2000 vs. 41.3 ± 16.9 years in 2011–2015, P= 0.86). Patients with proctitis in UC and isolated ileal disease in CD increased over the study period (P= 0.001 and P= 0.007, respectively). Inflammatory CD increased (P= 0.009) whereas stricturing CD decreased (P= 0.01) across all cohorts. There was a trend towards less severe presentation of both UC and CD. The use of thiopurines (P= 0.02) and biologics increased (P= 0.001) with no significant change in trends for requirements of surgery (P= 0.9).
Conclusions
Increasing prevalence of CD, younger age at diagnosis, diagnosis at an earlier and milder stage, greater use of thiopurines and biologics were observed.

Citations

Citations to this article as recorded by

Burden of inflammatory bowel disease in India: analysis of the Global Burden of Disease study from 1990 to 2019
Suprabhat Giri, Anuraag Jena, Praveen Kumar-M, Jaikumar Rajavoor Muniswamy, Preetam Nath, Vishal Sharma
Intestinal Research.2025;[Epub] CrossRef
Inflammatory bowel disease in south Asia: a scoping review
Shabari Shenoy, Anuraag Jena, Carrie Levinson, Vishal Sharma, Parakkal Deepak, Tina Aswani-Omprakash, Shaji Sebastian, Jean-Frederic Colombel, Manasi Agrawal
The Lancet Gastroenterology & Hepatology.2025; 10(3): 259. CrossRef
Inflammatory bowel disease: a narrative review of disease evolution in South Asia and India over the last decade
Sahana Shankar, Snehali Majumder, Suparna Mukherjee, Anirban Bhaduri, Rangarajan Kasturi, Subrata Ghosh, Marietta Iacucci, Uday N. Shivaji
Therapeutic Advances in Gastroenterology.2024;[Epub] CrossRef
Evaluation of Nutritional Characteristics Reveals Similar Prevalence of Malnutrition in Patients with Ulcerative Colitis and Crohn’s Disease
Arshdeep Singh, Vandana Midha, Ramit Mahajan, Shruti Verma, Chandan Kakkar, Jasmine Grover, Dharmatma Singh, Ramandeep Kaur, Abhishek Masih, Namita Bansal, Catherine Wall, Ajit Sood
Digestive Diseases and Sciences.2023; 68(2): 580. CrossRef
Impact of Sarcopenia on Clinical Course of Inflammatory Bowel Disease in Korea
Kwangwoo Nam, Jae Yong Lee, Yousun Ko, Kyung Won Kim, Ho-Su Lee, Seung Wook Hong, Jin Hwa Park, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byoun, Seung-Jae Myung, Suk-Kyun Yang, Sang Hyoung Park
Digestive Diseases and Sciences.2023; 68(6): 2165. CrossRef
Real-world effectiveness and safety of ustekinumab induction therapy for Korean patients with Crohn’s disease: a KASID prospective multicenter study
Kyunghwan Oh, Hee Seung Hong, Nam Seok Ham, Jungbok Lee, Sang Hyoung Park, Suk-Kyun Yang, Hyuk Yoon, You Sun Kim, Chang Hwan Choi, Byong Duk Ye
Intestinal Research.2023; 21(1): 137. CrossRef
Clinical and magnetic resonance imaging spectrum of complex perianal fistulizing Crohn’s disease: A cohort study from northern India
Arshdeep Singh, Chandan Kakkar, Shreya Garg, Kirti Arora, Vandana Midha, Ramit Mahajan, Satpal Singh Virk, Narender Pal Jain, Dharmatma Singh, Kriti Sood, Ashish Tripathi, Dhruv Gupta, Ishita Gupta Kaushal, Ritu Dhawan Galhotra, Kavita Saggar, Ajit Sood
Indian Journal of Gastroenterology.2023; 42(5): 668. CrossRef
Update on the epidemiology of inflammatory bowel disease in Asia: where are we now?
Sang Hyoung Park
Intestinal Research.2022; 20(2): 159. CrossRef
Medication Adherence in Korean Patients with Inflammatory Bowel Disease and Its Associated Factors
Kyunghwan Oh, Eun Ja Kwon, Jeong Hye Kim, Kyuwon Kim, Jae Yong Lee, Hee Seung Hong, Seung Wook Hong, Jin Hwa Park, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Jeong Yun Park, Sang Hyoung Park
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Seung Hwan Shin, Sang Hyoung Park
The Korean Journal of Gastroenterology.2022; 80(2): 51. CrossRef
Clinical Features and Long-term Prognosis of Crohn’s Disease in Korea: Results from the Prospective CONNECT Study
Seung Wook Hong, Byong Duk Ye, Jae Hee Cheon, Ji Hyun Lee, Ja Seol Koo, Byung Ik Jang, Kang-Moon Lee, You Sun Kim, Tae Oh Kim, Jong Pil Im, Geun Am Song, Sung-Ae Jung, Hyun Soo Kim, Dong Il Park, Hyun-Soo Kim, Kyu Chan Huh, Young-Ho Kim, Jae Myung Cha, Ge
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Soo-Young Na, Yun-Jeong Lim
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Reviews

IBD

Effect of resistance exercise training on Crohn’s disease patients: Konstantinos Papadimitriou; Intest Res 2021;19(3):275-281. Published online November 20, 2020; DOI: https://doi.org/10.5217/ir.2020.00043

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Crohn’s disease (CD) is observed with increased levels of cytokines which cause inflammation in many parts of the digestive tract. Aerobic exercise contributes to the reduction of the intestine’s inflammation and increases the quality of life. Another type of exercise that shows research interest about its effects on CD symptoms is the resistance exercise (RE). The aim of the study was to review the influence of RE on CD patients. The study’s literature was collected from PubMed and Scholar databases. According to the results, the main phase of a RE training program must have a gradual increase of intensity (60%–80%) and resting periods of 15–30 seconds after each exercise, and 2–3 minutes between exercises. Also, CD patients who were in remission improved the muscle strength and quality of life via their participation in RE training program. However, the secretion of interleukin-6 in both CD and RE contributes in various physiological mechanisms setting a contradictory role in the effectiveness of RE at the disease’s inflammatory situation. So, the use of RE training in CD patients needs more research for safer participation.

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S. V. Kostyukevich, I. G. Bakulin
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Ting Pan, Danlei Chen, Zhihui Yu, Qing Liu, Yan Chen, Ailing Zhang, Fang Kong
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Shao-Peng Sun, Jia-Jia Chen, Ming-Xu Zheng, Yi-Hong Fan, Bin Lv
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Konstantinos Papadimitriou, Sousana K. Papadopoulou
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IBD

Management of Clostridioides difficile infection in patients with inflammatory bowel disease: Sahil Khanna; Intest Res 2021;19(3):265-274. Published online August 18, 2020; DOI: https://doi.org/10.5217/ir.2020.00045

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Inflammatory bowel disease (IBD) is a common diarrheal illness with gastrointestinal and extraintestinal manifestations and complications. The most common infectious complication associated with IBD is Clostridioides difficile infection (CDI). Active IBD predisposes to CDI due to alterations in the gut microbiome. C. difficile is a toxin producing bacterium leading to worsening of underlying IBD, increasing the risk of IBD treatment failure and an increased risk of hospitalization and surgery. Since the symptoms of CDI overlap with those of an IBD flare; it is prudent to recognize that the diagnosis of CDI is challenging and diagnostic tests (nucleic-acid and toxin-based assays) should be interpreted in context of symptoms and test performance. First line treatments for management of CDI in IBD include vancomycin or fidaxomicin. Recurrence prevention strategies should be implemented to mitigate recurrent CDI risk. One needs to monitor IBD disease progression and manage immunosuppression. The risk of recurrent CDI after a primary infection is higher in IBD compared to non-IBD patients. Microbiota restoration therapies are effective to prevent recurrent CDI in IBD patients. This review summarizes the epidemiology, pathophysiology, diagnostic testing, outcomes and management of both CDI and IBD, in CDI complicating IBD.

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IBD

Correlation of serum levels of anti-tumor necrosis factor agents with perianal fistula healing in Crohn’s disease: a narrative review: Eron Fabio Miranda, Rodrigo Bremer Nones, Paulo Gustavo Kotze; Intest Res 2021;19(3):255-264. Published online November 6, 2020; DOI: https://doi.org/10.5217/ir.2020.00029

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With the overspread use of measurement of serum levels of anti-tumor necrosis factor (TNF) agents (therapeutic drug monitoring, TDM), new therapeutic strategies have been used in the management of Crohn’s disease (CD). Different targets are correlated with increased levels of circulating drugs. Recent evidence demonstrated that higher serum levels of anti-TNF agents may be associated to better outcomes in perianal fistulizing CD (PFCD). Overall, patients with healed fistulas had higher serum levels of infliximab and adalimumab as compared to those with active drainage. This was demonstrated in some cohort studies, in induction and maintenance, in adults and children with PFCD. In this narrative review, authors summarize current evidence on the use of serum level measurement of anti-TNF agents and its correlation with perianal fistula healing in CD patients. Data on the use of TDM in PFCD is discussed in detail. The retrospective design of the studies and the lack of objective parameters to measure fistula healing are the main limitations of published data. Prospective studies, with central reading of objective radiological parameters, such as pelvic magnetic resonance imaging scores, can improve the level of evidence on the possible advantages of TDM in perianal fistula in CD and are warranted.

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Arshdeep Singh, Vandana Midha, Gursimran Singh Kochhar, Bo Shen, Ajit Sood
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Maria P Vallejo, Arturo P Jaramillo, Carlos Luis Guanín Cabrera, Maria G Cueva, Mario Navarro Grijalva, Xavier Grandes
Cureus.2024;[Epub] CrossRef
Comparison of the Pharmacokinetics of CT-P13 Between Crohn’s Disease and Ulcerative Colitis
Eun Soo Kim, Sung Kook Kim, Dong Il Park, Hyo Jong Kim, Yoo Jin Lee, Ja Seol Koo, Eun Sun Kim, Hyuk Yoon, Ji Hyun Lee, Ji Won Kim, Sung Jae Shin, Hyung Wook Kim, Hyun-Soo Kim, Young Sook Park, You Sun Kim, Tae Oh Kim, Jun Lee, Chang Hwan Choi, Dong Soo Ha
Journal of Clinical Gastroenterology.2023; 57(6): 601. CrossRef
Early Infliximab Trough Levels Predict the Long-term Efficacy of Infliximab in a Randomized Controlled Trial in Patients with Active Crohn’s Disease Comparing, between CT-P13 and Originator Infliximab
Jihye Park, Jae Hee Cheon, Kang-Moon Lee, Young-Ho Kim, Byong Duk Ye, Chang Soo Eun, Sung Hyun Kim, Sun Hee Lee, Joon Ho Lee, Stefan Schreiber
Gut and Liver.2023; 17(3): 430. CrossRef
Therapeutic Drug Monitoring in Perianal Fistulizing Crohn’s Disease
Mir Zulqarnain, Parakkal Deepak, Andres J. Yarur
Journal of Clinical Medicine.2022; 11(7): 1813. CrossRef
Management of Non-response and Loss of Response to Anti-tumor Necrosis Factor Therapy in Inflammatory Bowel Disease
Jan Marsal, Manuel Barreiro-de Acosta, Irina Blumenstein, Maria Cappello, Thomas Bazin, Shaji Sebastian
Frontiers in Medicine.2022;[Epub] CrossRef
Editorial: higher concentrations of cytokine blockers are needed to obtain small bowel mucosal healing during maintenance therapy in Crohn's disease
Shana Rakowsky, Adam S. Cheifetz, Konstantinos Papamichael
Alimentary Pharmacology & Therapeutics.2021; 54(8): 1085. CrossRef

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Images of the Issue

Miscellaneous

Bloating in a supine position: Akira Hokama, Yasuka Nakada, Aki Yanagida, Erika Koga, Kunikazu Hoshino, Jiro Fujita; Intest Res 2021;19(2):252-253. Published online June 18, 2020; DOI: https://doi.org/10.5217/ir.2020.00019

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Case Report

IBD

Non-cirrhotic portal hypertension related to azathioprine therapy in a patient with Crohn’s disease: Jong Won Seo, Eun Soo Kim, Man-Hoon Han, Young Oh Kweon; Intest Res 2021;19(2):247-251. Published online July 2, 2020; DOI: https://doi.org/10.5217/ir.2020.00016

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Azathioprine is widely used for the treatment of Crohn’s disease (CD). Few cases from Western countries have reported idiopathic non-cirrhotic portal hypertension (NCPH) related to thiopurine therapy in patients with inflammatory bowel disease. Idiopathic NCPH is a rare hepatic condition with intrahepatic portal hypertension but no evidence of cirrhosis or chronic liver disease. Patients with idiopathic NCPH present with symptoms of portal hypertension such as thrombocytopenia, splenomegaly and esophageal varices. We report a case of idiopathic NCPH in a 51-year-old male patient with CD who had been taking azathioprine for 5 years. He was admitted due to esophageal variceal bleeding along with splenomegaly and thrombocytopenia. Evaluation of cirrhosis or chronic liver disease showed normal-range results as estimated by FibroScan evaluation, laboratory examination for autoimmune hepatitis or viral hepatitis, and liver biopsy. This case may suggest the need for careful monitoring for manifestations of portal hypertension in Asian patients with inflammatory bowel disease receiving thiopurine treatment.

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Hye Kyung Hyun, Hye Won Lee, Jihye Park, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jae Seung Lee, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Seung Up Kim, Jae Hee Cheon
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Original Articles

Colorectal neoplasia

Postgastrectomy gastric cancer patients are at high risk for colorectal neoplasia: a case control study: Tae-Geun Gweon, Kyu-Tae Yoon, Chang Hyun Kim, Jin-Jo Kim; Intest Res 2021;19(2):239-246. Published online November 13, 2020; DOI: https://doi.org/10.5217/ir.2020.00009

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Background/Aims
Several studies have shown that colorectal neoplasms (CRN) including colorectal cancer (CRC) may be prevalent in patients with gastric cancer. However, in most of these studies, colonoscopy to investigate the prevalence of CRN was performed prior to surgery. We aimed to investigate whether CRN was more prevalent in postgastrectomy gastric cancer patients than in healthy individuals.
Methods
We reviewed the medical records of those patients within a cohort of gastric cancer patients with gastrectomy who underwent colonoscopy between 2016 and 2017. Controls age- and sex-matched with gastric cancer patients at a 2:1 ratio were identified among those who underwent colonoscopy at a health-promotion center. The frequencies of CRN, advanced CRN (ACRN), and CRC among patients with gastrectomy were compared with those in the control subjects. A total of 744 individuals (gastric cancer, 248; control, 496) were included.
Results
The rates of CRN and ACRN in the gastric cancer group were higher than those in the healthy individuals (CRN, 47.6% vs. 34.7%, P< 0.001; ACRN, 16.9% vs. 10.9%, P= 0.020). The rate of CRC was comparable between the 2 groups (2.0% vs. 0.6%, P= 0.125). Multivariate analysis identified previous gastrectomy for gastric cancer and male sex as significant risk factors for (A)CRN.
Conclusions
CRN and ACRN were more prevalent in patients who underwent surgery for gastric cancer than in the control group. Regular surveillance colonoscopy at appropriate intervals is indicated after gastrectomy.

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Effect of bowel preparation completion time on bowel cleansing efficacy: Prospective randomized controlled trial of different bowel preparation completion times precolonoscopy
Hye Min Kim, Hyo Suk Kim, Young Eun An, Jae Hyuck Chang, Tae Ho Kim, Chang Whan Kim, Tae‐Geun Gweon
Digestive Endoscopy.2024; 36(12): 1347. CrossRef
Safety of cold snare resection techniques for removal of polyps in the small colon in patients taking clopidogrel and aspirin: a Korean Association for the Study of Intestinal Diseases prospective multicenter study
Tae-Geun Gweon, Hyun Gun Kim, Yunho Jung, Seong Ran Jeon, Soo-Young Na, Yoo Jin Lee, Tae Ho Kim
Gastrointestinal Endoscopy.2024;[Epub] CrossRef
Calcium, Vitamin D, and Colorectal Cancer
Young-Jo Wi, Soo-Young Na
The Korean Journal of Gastroenterology.2023; 82(2): 47. CrossRef
Comparison of 2 L Polyethylene Glycol Plus Ascorbic Acid and 4 L Polyethylene Glycol in Elderly Patients Aged 60–79: A Prospective Randomized Study
Sung Hoon Jung, Chul-Hyun Lim, Tae-Geun Gweon, Jinsu Kim, Jung Hwan Oh, Kyu-Tae Yoon, Jee Young An, Jeong‑Seon Ji, Hwang Choi
Digestive Diseases and Sciences.2022; 67(10): 4841. CrossRef
Colonoscopy Insertion in Patients with Gastrectomy: Does Position Impact Cecal Intubation Time?
Jae Hyun Kim, Youn Jung Choi, Hye Jung Kwon, Gyu Man Oh, Kyoungwon Jung, Sung Eun Kim, Won Moon, Moo In Park, Seun Ja Park
Digestive Diseases and Sciences.2022; 67(9): 4533. CrossRef
Early gastric neoplasms are significant risk factor for colorectal adenoma: A prospective case-control study
Seong-Jung Kim, Jun Lee, Dae Youb Baek, Jun Hyung Lee, Ran Hong
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Colorectal Neoplasia in CDH1 Pathogenic Variant Carriers: A Multicenter Analysis
Peter P. Stanich, Dareen Elgindi, Elena Stoffel, Erika Koeppe, Ajay Bansal, Rachel Stetson, Debra L. Collins, Dana Farengo Clark, Eve Karloski, Beth Dudley, Randall E. Brand, Michael J. Hall, Yana Chertock, Brian A. Sullivan, Charles Muller, Alice Hinton,
American Journal of Gastroenterology.2022; 117(11): 1877. CrossRef

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Inflammatory Bowel Diseases

Prospective validation of CD4⁺CD25⁺FOXP3⁺ T-regulatory cells as an immunological marker to differentiate intestinal tuberculosis from Crohn’s disease: Ritika Rampal, Saurabh Kedia, Mohamad Nahidul Wari, Deepak Madhu, Amit Kumar Singh, Veena Tiwari, V. Pratap Mouli, Srikant Mohta, Govind Makharia, Vineet Ahuja; Intest Res 2021;19(2):232-238. Published online May 8, 2020; DOI: https://doi.org/10.5217/ir.2019.09181

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Background/Aims
Crohn’s disease (CD) and intestinal tuberculosis (ITB) remain “difficult-to-differentiate” diseases. We have previously documented peripheral blood frequency of CD4⁺CD25⁺FOXP3⁺ T-regulatory cells (Treg) as a biomarker to differentiate CD and ITB. We tried to validate these results in a larger cohort of CD and ITB patients.
Methods
Seventy treatment naïve patients of CD (n = 23) and ITB (n = 47) (diagnosed by standard criteria) were recruited prospectively from October 2016 to May 2017. Patients with history of antitubercular therapy in the past were excluded. The frequency of Treg cells in peripheral blood was determined by flow cytometry, and compared between CD and ITB patients.
Results
Similar to our previous study, frequency of Treg cells in peripheral blood was significantly increased in ITB as compared to CD patients (40.9 [interquartile range, 33–50] vs. 24.9 [interquartile range, 14.4–29.6], P< 0.001). Further, the receiver operating characteristics curve also showed good diagnostic accuracy with an area under the curve (AUC) of 0.77 (95% confidence interval, 0.65–0.89) and a FOXP3⁺ cutoff value of > 31.3% had a sensitivity and specificity of 83% and 82.6% respectively, to differentiate ITB from CD. Even for the indeterminate cases (n = 33), Treg cell frequency had similar diagnostic accuracy with an AUC of 0.85 (95% confidence interval, 0.68–0.95) and a cutoff of 32.37% had sensitivity and specificity of 87% and 95% respectively, to differentiate ITB from CD.
Conclusions
The current findings validate that the increased frequency of CD4⁺CD25⁺FOXP3⁺ Treg in the peripheral blood can be used as a biomarker with high diagnostic accuracy to differentiate ITB from CD.

Citations

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New diagnostic strategies to distinguish Crohn's disease and gastrointestinal tuberculosis
Himanshu Narang, Saurabh Kedia, Vineet Ahuja
Current Opinion in Infectious Diseases.2024; 37(5): 392. CrossRef
Evidence-based approach to diagnosis and management of abdominal tuberculosis
Daya Krishna Jha, Mythili Menon Pathiyil, Vishal Sharma
Indian Journal of Gastroenterology.2023; 42(1): 17. CrossRef
Gut Microbiome in Probable Intestinal Tuberculosis and Changes following Anti-Tuberculosis Treatment
Hyuk Yoon, Young Soo Park, Cheol Min Shin, Nayoung Kim, Dong Ho Lee
Yonsei Medical Journal.2022; 63(1): 34. CrossRef
Single-nucleotide polymorphisms and activities of indoleamine 2,3-dioxygenase isoforms, IDO1 and IDO2, in tuberculosis patients
Tingming Cao, Guangming Dai, Hongqian Chu, Chengcheng Kong, Huijuan Duan, Na Tian, Zhaogang Sun
Hereditas.2022;[Epub] CrossRef
Recent advances in the diagnosis of intestinal tuberculosis
Hasan Maulahela, Marcellus Simadibrata, Erni Juwita Nelwan, Nur Rahadiani, Editha Renesteen, S. W. T. Suwarti, Yunita Windi Anggraini
BMC Gastroenterology.2022;[Epub] CrossRef
Addition of computed tomography chest increases the diagnosis rate in patients with suspected intestinal tuberculosis
Saurabh Kedia, Raju Sharma, Sudheer Kumar Vuyyuru, Deepak Madhu, Pabitra Sahu, Bhaskar Kante, Prasenjit Das, Ankur Goyal, Karan Madan, Govind Makharia, Vineet Ahuja
Intestinal Research.2022; 20(2): 184. CrossRef
Inflammatory bowel disease in Korea: epidemiology and pathophysiology
Jung Won Lee, Chang Soo Eun
The Korean Journal of Internal Medicine.2022; 37(5): 885. CrossRef
Intestinal tuberculosis or Crohn's disease: Illusion or delusion or allusion
Saurabh Kedia, Vineet Ahuja
JGH Open.2021; 5(2): 177. CrossRef
Deep‐learning system for real‐time differentiation between Crohn's disease, intestinal Behçet's disease, and intestinal tuberculosis
Jung Min Kim, Jun Gu Kang, Sungwon Kim, Jae Hee Cheon
Journal of Gastroenterology and Hepatology.2021; 36(8): 2141. CrossRef
Mycobacterium tuberculosis (MTB) antigen-induced upregulation of interleukin-35 expression in patients with MTB infection: In vitro blockade of the effects of interleukin-35 on T lymphocyte subsets
Hongbin Jiang, Beinian Cui, Jun Zhang
Pathogens and Disease.2021;[Epub] CrossRef

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Inflammatory Bowel Diseases

Effect of acid-reducing agents on clinical relapse in ulcerative colitis with pH-dependent-released 5-aminosalicylic acid: a multicenter retrospective study in Japan: Yosuke Shimodaira, Kengo Onochi, Kenta Watanabe, So Takahashi, Sho Fukuda, Noboru Watanabe, Shigeto Koizumi, Tamotsu Matsuhashi, Katsunori Iijima; Intest Res 2021;19(2):225-231. Published online August 18, 2020; DOI: https://doi.org/10.5217/ir.2020.00023

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Background/Aims
5-Aminosalicylic acid (5-ASA) is a basic drug for inducing and maintaining remission for ulcerative colitis. One of its formulations has a coating with a pH-dependent degradation that ensures the release 5-ASA at the terminal ileum. No evidence has been shown concerning the effects of proton pump inhibitors (PPIs) or H₂ receptor antagonists (H2RAs) on the clinical course of ulcerative colitis patients in remission. The present study assessed the effect of PPIs or H2RAs on the relapse of ulcerative colitis patients in clinical remission maintained by pH-dependent released 5-ASA.
Methods
Ulcerative colitis patients who had been prescribed time- or pH-dependent-released 5-ASA between January 2015 and December 2018 were enrolled in this multicenter retrospective study. The period of remission until relapse occurred was analyzed among the patients taking time-dependent-released 5-ASA or pH-dependent-released 5-ASA with/without PPIs or H2RAs.
Results
One hundred and nineteen patients were analyzed in this study. In the primary endpoint, the relapse rate was higher in patients taking pH-dependent-released 5-ASA and PPIs or H2RAs than in those taking the pH-dependent-released 5-ASA without PPIs or H2RAs, while the relapse rate was similar in patients taking the time-dependent-released 5-ASA with or without PPIs or H2RAs concomitantly. Patients with a short duration of disease and middle-aged patients more frequently showed relapse with PPIs or H2RAs than the other patients.
Conclusions
The coadministration of PPIs or H2RAs affects the clinical course of ulcerative colitis in remission maintained by pH-dependent-released 5-ASA.

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Updates on conventional therapies for inflammatory bowel diseases: 5-aminosalicylates, corticosteroids, immunomodulators, and anti-TNF-α
Jihye Park, Jae Hee Cheon
The Korean Journal of Internal Medicine.2022; 37(5): 895. CrossRef
The insoluble excretion of multi-matrix system mesalazine preparations in patients with ulcerative colitis
Yuichiro Ohtaki, Kan Uchiyama, Hirotaka Kamiya, Eri Moriizumi, Moe Yamada, Yuma Aoki, Toshimune Watanabe, Sachie Kiryu, Shizuka Suzuki, Yoshihiro Matsumoto, Zensho Ito, Toshifumi Ohkusa, Shigeo Koido, Masayuki Saruta
BMC Gastroenterology.2022;[Epub] CrossRef

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Inflammatory Bowel Diseases

Ustekinumab for the treatment of refractory pediatric Crohn’s disease: a single-center experience: Alexandra Cohen, Najma Ahmed, Ana Sant’Anna; Intest Res 2021;19(2):217-224. Published online April 22, 2020; DOI: https://doi.org/10.5217/ir.2019.09164

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Background/Aims
Despite the well-established efficacy of tumor necrosis factor (TNF) antagonists as treatment options for Crohn’s disease, many pediatric patients need a change in therapy due to adverse events and loss of response, highlighting the necessity for medications with a different mechanism of action. Ustekinumab has been shown to be effective in inducing clinical remission in some adults with disease refractory to anti-TNF agents, however, minimal data exists in the pediatric population.
Methods
We conducted a retrospective chart review of 11 pediatric patients receiving ustekinumab, specifically extracting baseline data, information on prior treatment and response, indications for starting ustekinumab, clinical information, and laboratory parameters pre- and post-therapy. Clinical response was defined as a decrease in abbreviated Pediatric Crohn’s Disease Activity Index score.
Results
Patients ranged from 12 to 17 years of age upon initiation of treatment with ustekinumab. Five of 11 patients demonstrated a clinical response. Among these patients, 2 remained in clinical remission, while the remaining 3 experienced a secondary loss of response. The other 6 patients were primary nonresponders who either remained unwell or demonstrated slight clinical worsening. All patients who clinically responded to ustekinumab and had an initially elevated CRP experienced complete normalization of their values. Mucosal healing was seen on endoscopy in 1 responder, with 2 other patients showing endoscopic improvement.
Conclusions
These results demonstrate for the first time that ustekinumab has the potential to induce not only clinical and biochemical remission, but also endoscopic improvement, in the pediatric population. Future research is needed to determine factors that influence response to therapy.

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Oral manifestations of Crohn disease managed with ustekinumab
Patrick Ruck, Elizabeth S. Gosnell, James R. Rick
The Journal of the American Dental Association.2025; 156(2): 160. CrossRef
Clinical effectiveness and safety of ustekinumab in youth with refractory inflammatory bowel disease: A retrospective cohort study
Abdulhamid Alhadab, Amal Almarhoon, Amena AlAlwan, AbdelHai Hammo
Saudi Journal of Gastroenterology.2024;[Epub] CrossRef
STEP-CD study: ustekinumab use in paediatric Crohn’s disease—a multicentre retrospective study from paediatric IBD Porto group of ESPGHAN
Gemma Pujol-Muncunill, Víctor Manuel Navas-López, Oren Ledder, Shlomi Cohen, Marina Lekar, Dan Turner, Kaija-Leena Kolho, Arie Levine, Nicholas M. Croft, Jiri Bronsky, Dror S. Shouval, Amit Assa, Rachel Harris, Fevronia Kiparissi, Marina Aloi, Nadeem Ahma
European Journal of Pediatrics.2024; 183(8): 3253. CrossRef
Medical management of pediatric inflammatory bowel disease in the Asia‐Pacific region: A position paper by the Asian Pan‐Pacific Society for Pediatric Gastroenterology, Hepatology, and Nutrition (APPSPGHAN) PIBD Working Group
Way Seah Lee, Katsuhiro Arai, George Alex, Suporn Treepongkaruna, Kyung Mo Kim, Chee Liang Choong, Karen S. C. Mercado, Andy Darma, Anshu Srivastava, Marion M. Aw
Journal of Gastroenterology and Hepatology.2023; 38(4): 523. CrossRef
Real-world effectiveness and safety of ustekinumab induction therapy for Korean patients with Crohn’s disease: a KASID prospective multicenter study
Kyunghwan Oh, Hee Seung Hong, Nam Seok Ham, Jungbok Lee, Sang Hyoung Park, Suk-Kyun Yang, Hyuk Yoon, You Sun Kim, Chang Hwan Choi, Byong Duk Ye
Intestinal Research.2023; 21(1): 137. CrossRef
Effectiveness and Safety of Ustekinumab for Pediatric Inflammatory Bowel Disease: A Systematic Review
Shengbo Fang, Sixi Zhang, Chunyan Zhang, Libo Wang
Pediatric Drugs.2023; 25(5): 499. CrossRef
Real-World Evidence of the Effectiveness and Safety of Ustekinumab for the Treatment of Crohn’s Disease: Systematic Review and Meta-Analysis of Observational Studies
Cristina Rubín de Célix, María Chaparro, Javier P. Gisbert
Journal of Clinical Medicine.2022; 11(14): 4202. CrossRef
Management of inflammatory bowel disease beyond tumor necrosis factor inhibitors: novel biologics and small-molecule drugs
Soo-Young Na, You Sun Kim
The Korean Journal of Internal Medicine.2022; 37(5): 906. CrossRef
Augmented ustekinumab dosing is needed to achieve clinical response in patients with anti-TNF refractory pediatric Crohn’s disease: a retrospective chart review
Phinga Do, John Andersen, Ashish Patel, Gaith Semrin, Luis Sifuentes-Dominguez, Phuong Luu, Bhaskar Gurram
F1000Research.2021; 9: 316. CrossRef
Ustekinumab Dose Intensification in Paediatric Crohn's Disease
Rosa Rodríguez‐Mauriz, Carlos Seguí Solanes, Isabel Masiques Mas, Nuria Rudi Sola
Journal of Paediatrics and Child Health.2021; 57(7): 1148. CrossRef

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Inflammatory Bowel Diseases

Colitis and Crohn’s Foundation (India): a first nationwide inflammatory bowel disease registry: Ajit Sood, Kirandeep Kaur, Ramit Mahajan, Vandana Midha, Arshdeep Singh, Sarit Sharma, Amarender Singh Puri, Bhabhadev Goswami, Devendra Desai, C. Ganesh Pai, Kiran Peddi, Mathew Philip, Rakesh Kochhar, Sandeep Nijhawan, Shobna Bhatia, N. Sridhara Rao; Intest Res 2021;19(2):206-216. Published online July 13, 2020; DOI: https://doi.org/10.5217/ir.2019.09169

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Background/Aims
The national registry for inflammatory bowel disease (IBD) was designed to study epidemiology and prescribing pattern of treatment of IBD in India.
Methods
A multicenter, cross-sectional, prospective registry was established across four geographical zones of India. Adult patients with ulcerative colitis (UC) or Crohn’s disease (CD) were enrolled between January 2014 and December 2015. Information related to demographics; disease features; complications; and treatment history were collected and analyzed.
Results
A total of 3,863 patients (mean age, 36.7 ± 13.6 years; 3,232 UC [83.7%] and 631 CD [16.3%]) were enrolled. The majority of patients with UC (n = 1,870, 57.9%) were from north, CD was more common in south (n = 348, 55.5%). The UC:CD ratio was 5.1:1. There was a male predominance (male:female = 1.6:1). The commonest presentation of UC was moderately severe (n = 1,939, 60%) and E2 disease (n = 1,895, 58.6%). Patients with CD most commonly presented with ileocolonic (n = 229, 36.3%) inflammatory (n = 504, 79.9%) disease. Extraintestinal manifestations were recorded among 13% and 20% of patients in UC and CD respectively. Less than 1% patients from both cohorts developed colon cancer (n = 26, 0.7%). The commonly used drugs were 5-aminosalicylates (99%) in both UC and CD followed by azathioprine (34.4%). Biologics were used in only 1.5% of patients; more commonly for UC in north and CD in south.
Conclusions
The national IBD registry brings out diversities in the 4 geographical zones of India. This will help in aiding research on IBD and improving quality of patient care.

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Mayank Jain
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Kyunghwan Oh, Hee Seung Hong, Nam Seok Ham, Jungbok Lee, Sang Hyoung Park, Suk-Kyun Yang, Hyuk Yoon, You Sun Kim, Chang Hwan Choi, Byong Duk Ye
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Mi Rae Lee, Eun Soo Kim
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Su Bee Park, Jin Young Yoon, Jae Myung Cha
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Inflammatory Bowel Diseases

Yarrow oil ameliorates ulcerative colitis in mice model via regulating the NF-κB and PPAR-γ pathways: Maged E. Mohamed, Sahar A. Elsayed, Hafez R. Madkor, Heba M. Saad Eldien, Omar M. Mohafez; Intest Res 2021;19(2):194-205. Published online August 21, 2020; DOI: https://doi.org/10.5217/ir.2020.00021

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Background/Aims
Ulcerative colitis (UC) is a chronic inflammatory disorder with indefinite etiology; however, environmental, genetic, immune factors and microbial agents could be implicated in its pathogenesis. UC treatment is lifelong, therefore; the potential side effects and cost of the therapy are significant. Yarrow is a promising medicinal plant with the ability to treat many disorders, owing to its bioactive compounds especially the essential oil. The main aim of this research was to investigate the therapeutic effect of the yarrow oil on colitis including the involved mechanism of action.
Methods
In 21-female C57BL/6 mice were divided into 3 groups; control group, colitis model group, and oil-treated group. Groups 2 and 3 received 5% dextran sulfate sodium (DSS) in drinking water for 9 days, and concomitantly, only group 3 was given 100 mg/kg yarrow oil. Mice were examined for their body weight, stool consistency and bleeding, and the disease activity indexes were calculated.
Results
Oral administration of yarrow oil markedly repressed the severity of UC via the reduction of the inflammatory signs and restoring colon length. The oil was able to down-regulate nuclear factor kappa light chain enhancer of activated B cells (NF-κB), up-regulate peroxisome proliferator-activated receptor gamma (PPAR-γ), and enhance transforming growth factor-β expression. The oil normalized the tumor necrosis factor-α expression, restored the normal serum level of interleukin-10 (IL-10) and reduced the serum level of IL-6.
Conclusions
Yarrow oil mitigated UC symptoms and regulated the inflammatory cytokines secretion via regulation of NF-κB and PPAR-γ pathways in the mice model, however, this recommendation requires further investigations using clinical studies to confirm the use of the oil on humans.

Citations

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Pyrazole derivatives ameliorate synovial inflammation in collagen-induced arthritis mice model via targeting p38 MAPK and COX-2
Ahlam M. Abdallah, Amany H. Abdel Naiem, Salama R. Abdelraheim, Omar M. Mohafez, Hend M. Abdelghany, Sahar A. Elsayed, Wafaey Gomaa, Heba Marey
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Inflammatory Bowel Diseases

Temporal trend in the natural history of ulcerative colitis in a country with a low incidence of ulcerative colitis from 2000 through 2018: Satimai Aniwan, Julajak Limsrivilai, Supot Pongprasobchai, Nonthalee Pausawasdi, Piyapan Prueksapanich, Natanong Kongtub, Rungsun Rerknimitr; Intest Res 2021;19(2):186-193. Published online August 18, 2020; DOI: https://doi.org/10.5217/ir.2020.00028

Abstract PDF PubReader ePub

Background/Aims
The incidence of ulcerative colitis (UC) in Thailand (crude incidence rate of 0.28 per 100,000 persons) is much lower than in the West. The burden of UC varies in different populations. The aim of this study was to evaluate the natural history of UC over the two decades in Bangkok, Thailand.
Methods
This retrospective study included patients who were diagnosed with UC between 2000 and 2018 in 2 university hospitals. To evaluate changes in the disease course, we stratified patients into 2000–2009 cohort and 2010–2018 cohort. The cumulative probability of endoscopic healing, UC-related hospitalization and colectomy was estimated using the Kaplan-Meier method.
Results
A total of 291 UC patients were followed for total of 2,228 person-years. Comparison between 2 cohorts, there were no differences in disease pattern and severity whereas an increase in the combination use of oral and topical mesalamine and the early use of thiopurine was observed. Only 1% of patients for each cohort required biologic agent at 5 years. The rate of achieving mucosal healing increased from 15% to 46% at 3 years (P< 0.01). The rate of UC-related hospitalization decreased from 30% to 21% at 5 years (P< 0.05). The rate of colectomy decreased from 6% to 2% at 5 years (P< 0.05).
Conclusions
The natural history of UC in a low incidence country was less aggressive than the West. Over the past two decades, the rates of UC-related hospitalization and colectomy have been decreasing which were similar to the West.

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Reviews

IBD

Anti-inflammatory diet and inflammatory bowel disease: what clinicians and patients should know?: Nor Hamizah Shafiee, Zahara Abdul Manaf, Norfilza M. Mokhtar, Raja Affendi Raja Ali; Intest Res 2021;19(2):171-185. Published online February 3, 2021; DOI: https://doi.org/10.5217/ir.2020.00035

Abstract PDF PubReader ePub

Current treatment for inflammatory bowel disease (IBD) includes the application of anti-inflammatory agents for the induction and remission of IBD. However, prolonged use of anti-inflammatory agents can exert adverse effects on patients. Recently, formulated dietary approach in treating IBD patients is utilized to improve clinical activity scores. An alteration of gastrointestinal microbiota through dietary therapy was found to reduce IBD and is recognized as a promising therapeutic strategy for IBD. One of the recommended formulated diets is an anti-inflammatory diet (AID) that restricts the intake of carbohydrates with modified fatty acids. This diet also contains probiotics and prebiotics that can promote balanced intestinal microbiota composition. However, scientific evidences are limited to support this specific dietary regime in maintaining the remission and prevention relapse of IBD. Therefore, this review aimed to summarize available data from various studies to evaluate the AID diet effectiveness which will be useful for clinicians to manage their IBD patients by application of improved dietary therapy.

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IBD

The impact of tobacco smoking on treatment choice and efficacy in inflammatory bowel disease: Steven Nicolaides, Abhinav Vasudevan, Tony Long, Daniel van Langenberg; Intest Res 2021;19(2):158-170. Published online October 13, 2020; DOI: https://doi.org/10.5217/ir.2020.00008

Abstract PDF PubReader ePub

Smoking significantly increases the risk of developing and worsens Crohn’s disease (CD), yet protects against the development and reduces the severity of ulcerative colitis. It is less clear whether smoking impacts the efficacy of therapeutics in inflammatory bowel disease (IBD). We review the literature regarding the relationship between smoking and the efficacy of medical and surgical therapy in IBD. Smoking is associated with alterations in thiopurine metabolism and may affect time to disease relapse. The outcomes of anti-tumor necrosis factor therapy in active smokers appear neutral with data lacking for newer biologics. Smoking increases the risk of postoperative recurrence in those requiring resection for CD, likely attributable to perturbations of the gut microbiota although further implications of these for disease onset/progression and treatment efficacy remain unclear. Multiple lifestyle and psychosocial confounders are likely under-recognized cofactors in the association between smoking and IBD. Despite the widely promulgated risks associated with cigarette smoking in CD, more incisive data are required to further elucidate the actual relationship between smoking and disease pathways, while accounting for the several negative cofactors prevalent in smokers which cast uncertainty on the magnitude of the direct effect of smoking on disease pathophysiology and the efficacy of therapy.

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Statement

Cancer

Clinical practice guideline for endoscopic resection of early gastrointestinal cancer: Chan Hyuk Park, Dong-Hoon Yang, Jong Wook Kim, Jie-Hyun Kim, Ji Hyun Kim, Yang Won Min, Si Hyung Lee, Jung Ho Bae, Hyunsoo Chung, Kee Don Choi, Jun Chul Park, Hyuk Lee, Min-Seob Kwak, Bun Kim, Hyun Jung Lee, Hye Seung Lee, Miyoung Choi, Dong-Ah Park, Jong Yeul Lee, Jeong-Sik Byeon, Chan Guk Park, Joo Young Cho, Soo Teik Lee, Hoon Jai Chun; Intest Res 2021;19(2):127-157. Published online October 13, 2020; DOI: https://doi.org/10.5217/ir.2020.00020

Abstract PDF Supplementary Material PubReader ePub

Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.

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Case Report

Infection

Whipple disease mimicking inflammatory bowel disease: Maiko Tatsuki, Takashi Ishige, Yoshiko Igarashi, Reiko Hatori, Akira Hokama, Junko Hirato, Aleixo Muise, Takumi Takizawa, Hirokazu Arakawa; Intest Res 2021;19(1):119-125. Published online July 3, 2020; DOI: https://doi.org/10.5217/ir.2019.09177

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Whipple disease is a systemic chronic infection caused by Tropheryma whipplei. Although chronic diarrhea is a common gastrointestinal symptom, diagnosis is often difficult because there are no specific endoscopic findings, and the pathogen is not detectable by stool culture. We present a female patient with Whipple disease who developed chronic bloody diarrhea and growth retardation at the age of 4 years. Colonoscopy showed a mildly edematous terminal ileum and marked erythema without vascular patterns throughout the sigmoid colon and rectum. Subsequently, a primary diagnosis of ulcerative colitis was made. Histopathological analysis of the terminal ileum showed the presence of foamy macrophages filled with periodic acidSchiff-positive particles. Polymerase chain reaction using DNA from a terminal ileum biopsy sample amplified a fragment of 16S rRNA from T. whipplei. Antibiotic treatment relieved the patient’s symptoms. There was no evidence of immunodeficiency in the present case. Since Whipple disease worsens after anti-tumor necrosis factor inhibitor therapy, considering this infection in the differential diagnosis may be important in patients with inflammatory bowel disease, especially before initiation of immunotherapy.

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Brief Communication

IBD

Rapid prediction of 1-year efficacy of tofacitinib for treating refractory ulcerative colitis: Hiromichi Shimizu, Toshimitsu Fujii, Shuji Hibiya, Maiko Motobayashi, Kohei Suzuki, Kento Takenaka, Eiko Saito, Masakazu Nagahori, Kazuo Ohtsuka, Mamoru Watanabe; Intest Res 2021;19(1):115-118. Published online June 11, 2020; DOI: https://doi.org/10.5217/ir.2020.00030

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Original Article

Miscellaneous

Patients with celiac disease are at high risk of developing metabolic syndrome and fatty liver: Ashish Agarwal, Alka Singh, Wajiha Mehtab, Vipin Gupta, Ashish Chauhan, Mahendra Singh Rajput, Namrata Singh, Vineet Ahuja, Govind K. Makharia; Intest Res 2021;19(1):106-114. Published online April 22, 2020; DOI: https://doi.org/10.5217/ir.2019.00136

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Background/Aims
Gluten-free diet has an excess of fats and simple sugars and puts patients with celiac disease at risk of metabolic complications including metabolic syndrome and fatty liver. We assessed prevalence of metabolic syndrome and fatty liver in two cohorts of celiac disease.
Methods
Study was done in 2 groups. In group 1, 54 treatment naïve patients with celiac disease were recruited. Of them, 44 returned after 1-year of gluten-free diet and were reassessed. In group 2, 130 celiac disease patients on gluten-free diet for ≥1 year were recruited. All patients were assessed for anthropometric and metabolic parameters and fatty liver. Metabolic syndrome was defined as per consensus definition for Asian Indians. Fatty liver was defined as controlled attenuation parameter value >263 decibels by FibroScan.
Results
In group 1, of 44 treatment naïve patients with celiac disease, metabolic syndrome was present in 5 patients (11.4%) at baseline and 9 (18.2%) after 1 year of gluten-free diet. Patients having fatty liver increased from 6 patients (14.3%) at baseline to 13 (29.5%) after 1year of gluten-free diet (P=0.002). In group 2, of 130 patients with celiac disease on gluten-free diet for a median duration of 4 years, 30 out of 114 (26.3%) and 30 out of 130 patients (23%) had metabolic syndrome and fatty liver, respectively.
Conclusions
Patients with celiac disease are at high risk of developing metabolic syndrome and fatty liver, which increases further with gluten-free diet. These patients should be assessed for nutritional and metabolic features and counseled about balanced diet and physical activity regularly.

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