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Volume 18(2); April 2020
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Editorials
Inflammatory bowel diseases
Enteral nutrition in the biologic era: learn from yesterday, live for today, hope for tomorrow
Tadakazu Hisamatsu
Intest Res 2020;18(2):139-140.   Published online April 20, 2020
DOI: https://doi.org/10.5217/ir.2019.09192
PDFPubReaderePub

Citations

Citations to this article as recorded by  
  • Progress and Clinical Applications of Crohn’s Disease Exclusion Diet in Crohn’s Disease
    Duo Xu, Ziheng Peng, Yong Li, Qian Hou, Yu Peng, Xiaowei Liu
    Gut and Liver.2024; 18(3): 404.     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
  • Clinical Features and Long-Term Outcomes of Paediatric-Onset Inflammatory Bowel Disease in a Population-Based Cohort in the Songpa-Kangdong District of Seoul, Korea
    Sang Hyoung Park, Jong Pil Im, Hyunju Park, Seung Kyu Jeong, Ji Hyun Lee, Kyoung Hoon Rhee, Young-Ho Kim, Sung Noh Hong, Kyung Ho Kim, Seung In Seo, Jae Myung Cha, Sun Yong Park, Joo Sung Kim, Hyuk Yoon, Sung Hoon Kim, Jisun Jang, Jeong Hwan Kim, Seong O
    Journal of Crohn's and Colitis.2022; 16(2): 207.     CrossRef
  • 4,911 View
  • 132 Download
  • 4 Web of Science
  • 3 Crossref
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Inflammatory bowel diseases
Complementary and alternative medicine in patients with inflammatory bowel disease: hype or evidence?
Jae Myung Cha
Intest Res 2020;18(2):141-143.   Published online April 20, 2020
DOI: https://doi.org/10.5217/ir.2020.00022
PDFPubReaderePub

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Citations to this article as recorded by  
  • Use of Complementary and Alternative Medicine by Greek Patients with Inflammatory Bowel Disease
    John K. Triantafillidis, Aristofanis Gikas, Georgia Kontrarou, Manousos Konstantoulakis, Apostolos Papalois
    Nutrients.2024; 16(21): 3679.     CrossRef
  • Comprehensive study on the administrative, economic, regional, and regulatory prospects of complementary and alternative medicine (CAM) in inflammatory bowel disease (IBD)
    Taraneh Mousavi, Shekoufeh Nikfar, Mohammad Abdollahi
    Expert Review of Clinical Pharmacology.2021; 14(7): 865.     CrossRef
  • 4,634 View
  • 118 Download
  • 1 Web of Science
  • 2 Crossref
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Reviews
Inflammatory bowel diseases
Differentiation of fibrotic and inflammatory component of Crohn’s disease-associated strictures
Jordi Rimola, Nunzia Capozzi
Intest Res 2020;18(2):144-150.   Published online April 20, 2020
DOI: https://doi.org/10.5217/ir.2020.00015
AbstractAbstract PDFPubReaderePub
Patients with Crohn’s disease (CD) commonly develop bowel strictures, which may contain various degrees of inflammation and fibrosis. While predominantly inflammatory strictures may benefit from a medical anti-inflammatory treatment approach, fibrotic strictures would require endoscopic balloon dilation or surgery. Cross-sectional imaging surpasses endoscopy for characterization of stenotic segments and potentially may contribute to the optimal clinical management of these patients. This short review aims to discuss the potentialities and limitations of cross-sectional imaging techniques for assessing bowel fibrosis in patients with CD.

Citations

Citations to this article as recorded by  
  • Contemporary Imaging Assessment of Strictures and Fibrosis in Crohn Disease, With Focus on Quantitative Biomarkers: From the AJR Special Series on Imaging of Fibrosis
    Jordi Rimola, Kim J. Beek, Ingrid Ordás, Krisztina B. Gecse, Míriam Cuatrecasas, Jaap Stoker
    American Journal of Roentgenology.2024;[Epub]     CrossRef
  • Characterization of patient-derived intestinal organoids for modelling fibrosis in Inflammatory Bowel Disease
    Ilaria Laudadio, Claudia Carissimi, Noemi Scafa, Alex Bastianelli, Valerio Fulci, Alessandra Renzini, Giusy Russo, Salvatore Oliva, Roberta Vitali, Francesca Palone, Salvatore Cucchiara, Laura Stronati
    Inflammation Research.2024; 73(8): 1359.     CrossRef
  • Crohn's-like Ileal Pouch Illness and Ileal Pouch Salvage Strategies
    Alex L. Huang, Marnie Abeshouse, Katherine C. Lee, Emily Rinebold, Maia Kayal, Michael C. Plietz
    Clinics in Colon and Rectal Surgery.2024;[Epub]     CrossRef
  • Quantitative Magnetic Resonance Imaging (qMRI) of the Small Bowel in Crohn's Disease: State‐of‐the‐Art and Future Directions
    Naomi S. Sakai, Timothy J.P. Bray, Stuart A. Taylor
    Journal of Magnetic Resonance Imaging.2024;[Epub]     CrossRef
  • Invasive Therapeutic Strategies for Stricturing Crohn’s Disease in Childhood: A Systematic Review and Meta-Analysis
    Matheus Ferreira de Carvalho, Alexandre de Sousa Carlos, Angelo So Taa Kum, Alexandre Moraes Bestetti, Igor Logetto Caetité Gomes, Luiza Bicudo de Oliveira, Luiza Martins Baroni, Wanderley Marques Bernardo, Eduardo Guimarães Hourneaux de Moura
    Inflammatory Bowel Diseases.2024;[Epub]     CrossRef
  • Inhibition of intestinal inflammation and fibrosis by Scutellaria Baicalensis georgi and Boswellia serrata in human epithelial cells and fibroblasts
    Ilaria Laudadio, Beatrice Leter, Francesca Palone, Salvatore Cucchiara, Claudia Carissimi, Noemi Scafa, Daniela Secci, Roberta Vitali, Laura Stronati
    Immunity, Inflammation and Disease.2024;[Epub]     CrossRef
  • Elastography as a Discriminator Between Fibrotic and Inflammatory Strictures in Crohn’s Disease: A Dead End or Bright Future in Clinical Decision-Making? Critical Review
    Maryla Kuczyńska, Monika Zbroja, Anna Drelich-Zbroja
    Diagnostics.2024; 14(20): 2299.     CrossRef
  • Adipokine C1q/Tumor Necrosis Factor- Related Protein 3 (CTRP3) Attenuates Intestinal Inflammation Via Sirtuin 1/NF-κB Signaling
    Huimin Yu, Zixin Zhang, Gangping Li, Yan Feng, Lingling Xian, Fatemeh Bakhsh, Dongqing Xu, Cheng Xu, Tyrus Vong, Bin Wu, Florin M. Selaru, Fengyi Wan, Mark Donowitz, G. William Wong
    Cellular and Molecular Gastroenterology and Hepatology.2023; 15(4): 1000.     CrossRef
  • Frequency, outcomes, and need for intervention in stricturing gastrointestinal tuberculosis: a systematic review and meta-analysis
    Anuraag Jena, Ritin Mohindra, Kirtan Rana, Pardhu B. Neelam, Dhuni Chand Thakur, Harjeet Singh, Pankaj Gupta, Vikas Suri, Vishal Sharma
    BMC Gastroenterology.2023;[Epub]     CrossRef
  • Replacing Endoscopy with Magnetic Resonance Enterography for Mucosal Activity Assessment in Terminal Ileal Crohn’s Disease: Are We There Yet?
    Anuj Bohra, Abhinav Vasudevan, Numan Kutaiba, Daniel Ross Van Langenberg
    Diagnostics.2023; 13(6): 1061.     CrossRef
  • Fibro-Stenosing Crohn’s Disease: What Is New and What Is Next?
    Virginia Solitano, Arianna Dal Buono, Roberto Gabbiadini, Marek Wozny, Alessandro Repici, Antonino Spinelli, Stefania Vetrano, Alessandro Armuzzi
    Journal of Clinical Medicine.2023; 12(9): 3052.     CrossRef
  • Intestinal MRI in Inflammatory Bowel Disease – Literature and Survey-Based Recommendations regarding Reporting by the German Radiological Society (DRG) and the German Competence Network for Inflammatory Bowel Diseases
    Johannes Wessling, Torsten Kucharzik, Dominik Bettenworth, Andreas Luegering, Christian Maaser, Lars Grenacher, Markus S. Juchems, Kristina I. Ringe, Thomas Lauenstein, Andreas G. Schreyer
    RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren.2023; 195(08): 675.     CrossRef
  • The Role of Genetic and Epigenetic Regulation in Intestinal Fibrosis in Inflammatory Bowel Disease: A Descending Process or a Programmed Consequence?
    Sara Jarmakiewicz-Czaja, Aneta Sokal, Katarzyna Ferenc, Elżbieta Motyka, Kacper Helma, Rafał Filip
    Genes.2023; 14(6): 1167.     CrossRef
  • The Role of Magnetic Resonance Enterography for Detection and Differentiation of Pediatric Inflammatory Bowel Diseases
    Eda ALMUS, Özge YAPICI
    Genel Tıp Dergisi.2023; 33(6): 726.     CrossRef
  • Revisiting fibrosis in inflammatory bowel disease: the gut thickens
    Silvia D’Alessio, Federica Ungaro, Daniele Noviello, Sara Lovisa, Laurent Peyrin-Biroulet, Silvio Danese
    Nature Reviews Gastroenterology & Hepatology.2022; 19(3): 169.     CrossRef
  • Ultrasound elastography
    Xin-Wu Cui, Kang-Ning Li, Ai-Jiao Yi, Bin Wang, Qi Wei, Ge-Ge Wu, Christoph F. Dietrich
    Endoscopic Ultrasound.2022; 11(4): 252.     CrossRef
  • ECCO-ESGAR Topical Review on Optimizing Reporting for Cross-Sectional Imaging in Inflammatory Bowel Disease
    Torsten Kucharzik, Jeroen Tielbeek, Dan Carter, Stuart A Taylor, Damian Tolan, Rune Wilkens, Robert V Bryant, Christine Hoeffel, Isabelle De Kock, Christian Maaser, Giovanni Maconi, Kerri Novak, Søren R Rafaelsen, Martina Scharitzer, Antonino Spinelli, Jo
    Journal of Crohn's and Colitis.2022; 16(4): 523.     CrossRef
  • Positionspapier zur Befunderhebung von Darmultraschallbefunden bei chronisch entzündlichen Darmerkrankungen
    Torsten Kucharzik, Raja Atreya, Oliver Bachmann, Daniel C. Baumgart, Jan Daebritz, Ulf Helwig, Johannes Janschek, Peter Kienle, Jost Langhorst, Jonas Mudter, Carsten Schmidt, Andreas G. Schreyer, Michael Vieth, Johannes Wessling, Christian Maaser
    Zeitschrift für Gastroenterologie.2022; 60(06): 978.     CrossRef
  • Crohn's disease related strictures in cross‐sectional imaging: More than meets the eye?
    Joseph Sleiman, Prathyush Chirra, Namita S. Gandhi, Mark E. Baker, Cathy Lu, Ilyssa O. Gordon, Satish E. Viswanath, Florian Rieder
    United European Gastroenterology Journal.2022; 10(10): 1167.     CrossRef
  • Prevention and Treatment of Stricturing Crohn’s Disease – Perspectives and Challenges
    Joseph Sleiman, Sara El Ouali, Taha Qazi, Benjamin Cohen, Scott R. Steele, Mark E. Baker, Florian Rieder
    Expert Review of Gastroenterology & Hepatology.2021; 15(4): 401.     CrossRef
  • Molecular targets and the use of biologics in the management of small bowel fibrosis in inflammatory bowel disease
    Muaad Abdulla, Thean Soon Chew
    Current Opinion in Gastroenterology.2021; 37(3): 275.     CrossRef
  • Ileal Crohn's Disease Exhibits Similar Transmural Fibrosis Irrespective of Phenotype
    Helena Tavares de Sousa, Irene Gullo, Claudia Castelli, Cláudia Camila Dias, Florian Rieder, Fátima Carneiro, Fernando Magro
    Clinical and Translational Gastroenterology.2021; 12(4): e00330.     CrossRef
  • Intestinal stricture in Crohn's disease: A 2020 update
    Xiao Xuan Lin, Yun Qiu, Xiao Jun Zhuang, Fen Liu, Xiao Min Wu, Min Hu Chen, Ren Mao
    Journal of Digestive Diseases.2021; 22(7): 390.     CrossRef
  • Crohn’s disease at radiological imaging: focus on techniques and intestinal tract
    Giuseppe Cicero, Silvio Mazziotti
    Intestinal Research.2021; 19(4): 365.     CrossRef
  • Mechanism of fibrosis and stricture formation in Crohn's disease
    Johannes Alfredsson, Mary Jo Wick
    Scandinavian Journal of Immunology.2020;[Epub]     CrossRef
  • 6,389 View
  • 250 Download
  • 27 Web of Science
  • 25 Crossref
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Inflammatory bowel diseases
Recent updates on the basic mechanisms and pathogenesis of inflammatory bowel diseases in experimental animal models
Emiko Mizoguchi, Daren Low, Yui Ezaki, Toshiyuki Okada
Intest Res 2020;18(2):151-167.   Published online April 20, 2020
DOI: https://doi.org/10.5217/ir.2019.09154
AbstractAbstract PDFPubReaderePub
The specific pathogenesis underlining inflammatory bowel disease (IBD) is very complicated, and it is further more difficult to clearly explain the pathophysiology of 2 major forms of IBD, Crohn’s disease (CD) and ulcerative colitis (UC), and both disorders affect individuals throughout life. Despite every extensive effort, the interplay among genetic factors, immunological factors, environmental factors and intestinal microbes is still completely unrevealed. Animal models are indispensable to find out mechanistic details that will facilitate better preclinical setting to target specific components involved in the pathogenesis of IBD. Based on many recent reports, dysbiosis of the commensal microbiota is implicated in the pathogenesis of several diseases, not only IBD but also colon cancer, obesity, psoriasis as well as allergic disorders, in both human and animal models. Advanced technologies including cell-specific and inducible knockout systems, which are recently employed to mouse IBD models, have further enhanced the ability of developing new therapeutic strategies for IBD. Furthermore, data from these mouse models highlight the critical involvement of dysregulated immune responses and impaired colonic epithelial defense system in the pathogenesis of IBD. In this review, we will explain from the history of animal models of IBD to the recent reports of the latest compounds, therapeutic strategies, and approaches tested on IBD animal models.

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    Jacek Stalewski, Amy Y. Shih, Romeo Papazyan, Jocelyn Ramirez, Gerardo Ibanez, Peng Hsiao, Yong Yue, Jun Yin, Calen Badger, Shije Wu, Akemi Ueki, Bryan C. Fuchs, Marie-Laure Rives
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    雅君 陈
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  • Leaky gut model of the human intestinal mucosa for testing siRNA-based nanomedicine targeting JAK1
    Olga Hartwig, Brigitta Loretz, Adrien Nougarede, Dorothée Jary, Eric Sulpice, Xavier Gidrol, Fabrice Navarro, Claus-Michael Lehr
    Journal of Controlled Release.2022; 345: 646.     CrossRef
  • Asymptomatic sacroiliitis detected by magnetic resonance enterography in patients with Crohn's disease: prevalence, association with clinical data, and reliability among radiologists in a multicenter study of adult and pediatric population
    Lorenzo Cereser, Giovanni Zancan, Ivan Giovannini, Carmelo Cicciò, Ilaria Tinazzi, Angela Variola, Matteo Bramuzzo, Flora Maria Murru, Marco Marino, Annarita Tullio, Salvatore De Vita, Rossano Girometti, Alen Zabotti
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  • Update on the epidemiology of inflammatory bowel disease in Asia: where are we now?
    Sang Hyoung Park
    Intestinal Research.2022; 20(2): 159.     CrossRef
  • Polysaccharides from soybean residue fermented by Neurospora crassa alleviate DSS-induced gut barrier damage and microbiota disturbance in mice
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  • Mesenchymal stem cell treatment for enteric neuropathy in the Winnie mouse model of spontaneous chronic colitis
    Ainsley M. Robinson, Rhian Stavely, Sarah Miller, Rajaraman Eri, Kulmira Nurgali
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  • Continued Postoperative Use of Tumor Necrosis Factor-α Inhibitors for the Prevention of Crohn’s Disease Recurrence
    Jongwook Yu, Hye Kyung Hyun, Jihye Park, Eun Ae Kang, Soo Jung Park, Jae Jun Park, Tae Il Kim, Won Ho Kim, Jae Hee Cheon
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Novel biomarkers for the diagnosis and prognosis of colorectal cancer
Hyung-Hoon Oh, Young-Eun Joo
Intest Res 2020;18(2):168-183.   Published online November 30, 2019
DOI: https://doi.org/10.5217/ir.2019.00080
AbstractAbstract PDFPubReaderePub
Colorectal cancer (CRC) is among the most common malignancies and remains a major cause of cancer-related death worldwide. Despite recent advances in surgical and multimodal therapies, the overall survival of advanced CRC patients remains very low. Cancer progression, including invasion and metastasis, is a major cause of death among CRC patients. The underlying mechanisms of action resulting in cancer progression are beginning to unravel. The reported molecular and biochemical mechanisms that might contribute to the phenotypic changes in favor of carcinogenesis include apoptosis inhibition, enhanced tumor cell proliferation, increased invasiveness, cell adhesion perturbations, angiogenesis promotion, and immune surveillance inhibition. These events may contribute to the development and progression of cancer. A biomarker is a molecule that can be detected in tissue, blood, or stool samples to allow the identification of pathological conditions such as cancer. Thus, it would be beneficial to identify reliable and practical molecular biomarkers that aid in the diagnostic and therapeutic processes of CRC. Recent research has targeted the development of biomarkers that aid in the early diagnosis and prognostic stratification of CRC. Despite that, the identification of diagnostic, prognostic, and/or predictive biomarkers remains challenging, and previously identified biomarkers might be insufficient to be clinically applicable or offer high patient acceptability. Here, we discuss recent advances in the development of molecular biomarkers for their potential usefulness in early and less-invasive diagnosis, treatment, and follow-up of CRC.

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Original Articles
Inflammatory bowel diseases
Exclusive enteral nutrition for induction of remission in anti-tumor necrosis factor refractory adult Crohn’s disease: the Indian experience
Ajit Sood, Arshdeep Singh, Ritu Sudhakar, Vandana Midha, Ramit Mahajan, Varun Mehta, Yogesh Kumar Gupta, Kirandeep Kaur
Intest Res 2020;18(2):184-191.   Published online February 25, 2020
DOI: https://doi.org/10.5217/ir.2019.00094
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Exclusive enteral nutrition (EEN) is recommended for induction of remission in pediatric Crohn’s disease (CD). However, it is not currently recommended for inducing remission in adults. This report describes the use of 12-week EEN for induction of remission in anti-tumor necrosis factor (anti-TNF) refractory adult CD.
Methods
This is a retrospective analysis of adults with moderate to severe active (Crohn’s Disease Activity Index [CDAI] >220) anti-TNF refractory CD, who received EEN for 12 weeks between April 2018 and March 2019 at Dayanand Medical College and Hospital, Ludhiana, India. Primary outcomes included achievement of clinical remission and fistula healing at 12 weeks. Improvement in inflammatory markers and nutritional status were the secondary end points.
Results
Out of 23 patients who received anti-TNF agents, 7 (30.4%) were refractory and were offered EEN as a salvage therapy. Six patients (66.7% females, mean age 25.6±6.5 years) consented. Four patients (66.6%) achieved clinical remission (CDAI <150). Mean CDAI of patients decreased significantly after 12 weeks of EEN (388.8±74.8 vs. 160.0±25.2, P<0.001). Perianal fistulas showed clinical response (drainage decreased by >50%), though none achieved remission. Entero-enteric fistulae showed complete healing. Mean body mass index improved from 15.6±3.1 to 18.9±1.9 kg/m2 at week 12 (P=0.003). Hemoglobin and serum albumin also improved from 8.2±1.1 g/dL and 2.8±0.3 g/dL at baseline to 12.6±0.6 g/dL and 3.6±0.5 g/dL post-EEN respectively (P<0.001 and P=0.006 respectively).
Conclusions
EEN appears to be an effective and well tolerated therapy for induction of remission in anti-TNF refractory adult CD. More data from prospective trials with larger number of patients is required.

Citations

Citations to this article as recorded by  
  • Management of Perianal Fistulizing Crohn’s Disease
    Arshdeep Singh, Vandana Midha, Gursimran Singh Kochhar, Bo Shen, Ajit Sood
    Inflammatory Bowel Diseases.2024; 30(9): 1579.     CrossRef
  • Pharmacogenetics in personalized treatment in pediatric patients with inflammatory bowel disease (IBD)
    Daniela Kosorínová, Pavlína Suchá, Zuzana Havlíčeková, Marek Pršo, Pavol Dvoran, Peter Bánovčin
    Česko-slovenská pediatrie.2024; 79(4): 213.     CrossRef
  • Adjunct polymeric exclusive enteral nutrition helps achieve biochemical remission in active Crohn’s disease in adults irrespective of disease location and concomitant corticosteroid use
    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
    Frontline Gastroenterology.2024; : flgastro-2024-102749.     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
  • Use of oral diet and nutrition support in management of stricturing and fistulizing Crohn's disease
    Kush Fansiwala, Neha D. Shah, Kelly A. McNulty, Mary R. Kwaan, Berkeley N. Limketkai
    Nutrition in Clinical Practice.2023; 38(6): 1282.     CrossRef
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    Jihye Park, Jae Hee Cheon
    Yonsei Medical Journal.2021; 62(2): 99.     CrossRef
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    Nikola Mitrev, Hin Huang, Barbara Hannah, Viraj Chandana Kariyawasam
    BMJ Open Gastroenterology.2021; 8(1): e000745.     CrossRef
  • Pharmacogenetics-based personalized treatment in patients with inflammatory bowel disease: A review
    Ji Young Chang, Jae Hee Cheon
    Precision and Future Medicine.2021; 5(4): 151.     CrossRef
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    Tadakazu Hisamatsu
    Intestinal Research.2020; 18(2): 139.     CrossRef
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Inflammatory bowel diseases
Changes in prevalence and perception of complementary and alternative medicine use in Korean inflammatory bowel disease patients: results of an 8-year follow-up survey
Sun-Ho Lee, Kiju Chang, Ki Seok Seo, Yun Kyung Cho, Eun Mi Song, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Sang Hyoung Park
Intest Res 2020;18(2):192-199.   Published online April 3, 2020
DOI: https://doi.org/10.5217/ir.2019.00115
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
The use of complementary and alternative medicine (CAM) is a global phenomenon, including inflammatory bowel disease (IBD) patients. We aimed to assess the change in prevalence and patterns of CAM use, and attitudes towards CAM over an 8-year time interval (2006 vs. 2014) among IBD patients in Korea.
Methods
A total of 221 IBD patients (CD=142, UC=79) were asked to complete a questionnaire regarding CAM at two time points: at enrollment (2006) and 8 years later (2014/2015).
Results
The proportion of patients ever using CAM increased significantly from 60.2% in 2006 to 79.6% in 2014 (P<0.001), while the proportion of current CAM users increased slightly (35.7% to 38.0%, P=0.635); 21.7% used CAM consistently at both time points. The proportion of patients who felt CAM was less effective (P<0.001) and more expensive (P=0.04) than conventional treatments increased over time. Also, the proportion among ever CAM users who perceived a positive effect from CAM significantly decreased in 2014 compared to 2006 (P=0.004). Higher education (adjusted odds ratio [aOR], 2.10), prior side effects to conventional therapies (aOR, 2.23), and prior use of corticosteroids (aOR, 2.51) were associated with CAM use. Interestingly, use of CAM before IBD diagnosis (aOR, 2.73) was significantly associated with consistent CAM use.
Conclusions
Although the attitudes toward CAM have become less favorable, the majority of IBD patients have experienced CAM with an overall increase of current CAM users over time. Moreover, more than half of current CAM users used CAM consistently over time.

Citations

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    Hsiao-Yun Chang, Yu-Yao Huang, Chin-Jung Chung, Feng-Hsuan Liu
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    Taraneh Mousavi, Shekoufeh Nikfar, Mohammad Abdollahi
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    Jae Myung Cha
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Inflammatory bowel diseases
Risk Factors Associated with Impaired Ovarian Reserve in Young Women of Reproductive Age with Crohn’s Disease
Yue Zhao, Baili Chen, Yao He, Shenghong Zhang, Yun Qiu, Rui Feng, Hongsheng Yang, Zhirong Zeng, Shomron Ben-Horin, Minhu Chen, Ren Mao
Intest Res 2020;18(2):200-209.   Published online March 31, 2020
DOI: https://doi.org/10.5217/ir.2019.00103
AbstractAbstract PDFPubReaderePub
Background/Aims
Crohn’s disease (CD) primarily affects young female adults of reproductive age. Few studies have been conducted on this population’s ovarian reserve status. The aim of study was to investigate potential risk factors associated with low ovarian reserve, as reflected by serum anti-Müllerian hormone (AMH) in women of reproductive age with CD.
Methods
This was a case-control study. Cases included 87 patients with established CD, and healthy controls were matched by age, height and weight in a 1:1 ratio. Serum AMH levels were measured by enzyme-linked immunosorbent assay.
Results
The average serum AMH level was significantly lower in CD patients than in control group (2.47±2.08 ng/mL vs. 3.87±1.96 ng/mL, respectively, P<0.001). Serum AMH levels were comparable between CD patients and control group under 25 years of age (4.41±1.52 ng/mL vs. 3.49±2.10 ng/mL, P=0.06), however, serum AMH levels were significantly lower in CD patients over 25 years of age compared to control group (P<0.05). Multivariable analysis showed that an age greater than 25 (odds ratio [OR], 10.03; 95% confidence interval [CI], 1.90–52.93, P=0.007), active disease state (OR, 27.99; 95% CI, 6.13–127.95, P<0.001) and thalidomide use (OR, 15.66; 95% CI, 2.22–110.65, P=0.006) were independent risk factors associated with low ovarian reserve (serum AMH levels <2 ng/mL) in CD patients.
Conclusions
Ovarian reserve is impaired in young women of reproductive age with CD. Age over 25 and an active disease state were both independently associated with low ovarian reserve. Thalidomide use could result in impaired ovarian reserve.

Citations

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    Matteo Bramuzzo, Fabiola Giudici, Serena Arrigo, Paolo Lionetti, Giovanna Zuin, Claudio Romano, Francesco Graziano, Simona Faraci, Patrizia Alvisi, Sara Signa, Luca Scarallo, Stefano Martelossi, Grazia Di Leo
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    Camilla Ronchetti, Federico Cirillo, Noemi Di Segni, Martina Cristodoro, Andrea Busnelli, Paolo Emanuele Levi-Setti
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    Eugenia Shmidt, Marla C. Dubinsky
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Inflammatory bowel diseases
Histologically confirmed upper gastrointestinal Crohn’s disease: is it rare or are we just not searching hard enough?
Omar Ibrahim Saadah, Kholoud Bakur Fallatah, Cedric Baumann, Abdulrahman Ahmed Elbaradie, Fatimah Talat Howladar, Motaz Tariq Daiwali, Omar Hamad Alshuaibi, Majid Abdulaziz Alsahafi, Rana Yaqoob Bokhary, Yousef Abdulfattah Qari, Laurent Peyrin-Biroulet, Mahmoud Hisham Mosli
Intest Res 2020;18(2):210-218.   Published online February 7, 2020
DOI: https://doi.org/10.5217/ir.2019.00091
AbstractAbstract PDFPubReaderePub
Background/Aims
Crohn’s disease (CD) may involve the upper parts of the gastrointestinal (GI) tract including the esophagus, stomach, and duodenum. Clinical features of upper GI CD (UGICD) are not well characterized in the Gulf region. We therefore aimed to assess the prevalence and clinical characteristics of patients diagnosed with UGICD.
Methods
We performed a retrospective analysis of all patients diagnosed with CD who underwent upper GI endoscopy between 2012 and 2017 at King Abdulaziz University Hospital, irrespective of age. Patients who had endoscopy of the upper GI tract at baseline and had histologically confirmed UGICD were included. Data on patients’ demographics, clinical characteristics, extraintestinal manifestations and complications were reviewed.
Results
We identified 78 CD patients who underwent upper GI endoscopy from our medical records. The mean age was 17.2±8.7 years and 55.1% were males. Of the total, 19 out of 78 patients (24.4%) had histologically confirmed UGICD (3 esophageal, 16 gastric, and 9 duodenal), of which 52.6% were symptomatic. Disease distribution was ileal in 57.8%, colonic in 21.1% and ileo-colonic in 21.1%. A non-stricturing and non-penetrating phenotype was reported in 89.4%, stricturing in 5.3%, and penetrating in 5.3%. Perianal disease was found in 10.5%. UGICD was complicated by stricture formation in 2 patients (esophageal and gastric).
Conclusions
The prevalence of UGICD is considered high among CD Saudi patients who undergo upper GI endoscopy at baseline, and is asymptomatic in 47.4% of patients. This reported prevalence is not dissimilar from reports originating from Western countries.

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    Badr AbdullGaffar, Hoda Quraishi
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    Yip Han Chin, Cheng Han Ng, Snow Yunni Lin, Sneha Rajiv Jain, Gwyneth Kong, Jeffery Wei Heng Koh, Darren Jun Hao Tan, David Eng Hui Ong, Mark Dhinesh Muthiah, Choon Seng Chong, Fung Joon Foo, Rupert Leong, Webber Pak Wo Chan
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    Luca Mastracci, Federica Grillo, Paola Parente, Elettra Unti, Serena Battista, Paola Spaggiari, Michela Campora, Luca Valle, Matteo Fassan, Roberto Fiocca
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Inflammatory bowel diseases
Inhibition of plasminogen activator inhibitor-1 attenuates against intestinal fibrosis in mice
Jin Imai, Takashi Yahata, Hitoshi Ichikawa, Abd Aziz Ibrahim, Masaki Yazawa, Hideaki Sumiyoshi, Yutaka Inagaki, Masashi Matsushima, Takayoshi Suzuki, Tetsuya Mine, Kiyoshi Ando, Toshio Miyata, Katsuto Hozumi
Intest Res 2020;18(2):219-228.   Published online February 17, 2020
DOI: https://doi.org/10.5217/ir.2019.00037
AbstractAbstract PDFPubReaderePub
Background/Aims
Intestinal fibrosis is a major complication of Crohn’s disease (CD). The profibrotic protein transforming growth factor-β (TGF-β) has been considered to be critical for the induction of the fibrotic program. TGF-β has the ability to induce not only the expression of extracellular matrix (ECM) including collagen, but also the production of plasminogen activator inhibitor-1 (PAI-1) that prevents enzymatic degradation of the ECM during the onset of fibrotic diseases. However, the significance of PAI-1 in the developing intestinal fibrosis has not been fully understood. In the present study, we examined the actual expression of PAI-1 in fibrotic legion of intestinal inflammation and its correlation with the abnormal ECM deposition.
Methods
Chronic intestinal inflammation was induced in BALB/c mice using 8 repeated intrarectal injections of 2,4,6-trinitrobenzene sulfonic acid (TNBS). TM5275, a PAI-1 inhibitor, was orally administered as a carboxymethyl cellulose suspension each day for 2 weeks after the sixth TNBS injection.
Results
Using a publicly available dataset (accession number, GSE75214) and TNBS-treated mice, we observed increases in PAI-1 transcripts at active fibrotic lesions in both patients with CD and mice with chronic intestinal inflammation. Oral administration of TM5275 immediately after the onset of intestinal fibrosis upregulated MMP-9 (matrix metalloproteinase 9) and decreased collagen accumulation, resulting in attenuation of the fibrogenesis in TNBS-treated mice.
Conclusions
PAI-1-mediated fibrinolytic system facilitates collagen degradation suppression. Hence, PAI-1 inhibitor could be applied as an anti-fibrotic drug in CD treatment.

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Endoscopy
Prototype single-balloon enteroscopy with passive bending and high force transmission improves depth of insertion in the small intestine
Yasuhiro Morita, Shigeki Bamba, Osamu Inatomi, Kenichiro Takahashi, Takayuki Imai, Masaki Murata, Masashi Ohno, Masaya Sasaki, Tomoyuki Tsujikawa, Akira Andoh
Intest Res 2020;18(2):229-237.   Published online April 9, 2020
DOI: https://doi.org/10.5217/ir.2019.09150
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
We retrospectively analyzed Crohn’s disease (CD) patients with small intestinal strictures who underwent single-balloon enteroscopy (SBE) to ascertain whether prototype SBEs with a passive bending mechanism and high force transmission insertion tube had better insertability in the small intestine than a conventional SBE.
Methods
Among 253 CD patients who underwent SBE, we identified 94 CD patients who had undergone attempted endoscopic balloon dilatation (EBD) for small intestinal stenosis for inclusion in this study. We analyzed whether the type of scope used for their initial procedure affected the cumulative surgery-free rate. For the insertability analysis, patients who underwent SBE at least twice were divided into 3 groups according to the type of scope used: conventional SBE only, prototype SBE only, and both conventional and prototype SBEs. For each group, depth of insertion, procedure time, and number of EBDs were compared in the same patient at different time points.
Results
The success rate of EBD was 88.3%. The 5- and 10-year cumulative surgery-free rate was 75.7% and 72.8%, respectively. Cox regression analysis indicated that the factors contributing to surgery were long stricture (≥2 cm), EBD failure, and elevated Crohn’s Disease Activity Index, but not the type of scope used for EBD. The prototype SBEs significantly improved the depth of insertion (P=0.03, Wilcoxon’s signed-rank test).
Conclusions
In CD patients with small intestinal stenosis, the prototype SBEs with a passive bending mechanism and high force transmission insertion tube did not improve long-term EBD outcome but did improve deep insertability. (Clinical Trial Registration No. UMIN000037102)

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    Ji Hee Song, Seong Ran Jeon, Jin Su Kim, Bo-In Lee, Jin-Oh Kim, Han Hee Lee
    Digestive Diseases and Sciences.2023; 68(6): 2545.     CrossRef
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    Xiao Xuan Lin, Yun Qiu, Xiao Jun Zhuang, Fen Liu, Xiao Min Wu, Min Hu Chen, Ren Mao
    Journal of Digestive Diseases.2021; 22(7): 390.     CrossRef
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Miscellaneous
Clinical profile and outcomes of opioid abuse gastroenteropathy: an underdiagnosed disease entity
Ramit Mahajan, Yogesh Gupta, Arshdeep Singh, Pulkit Dhiman, Vandana Midha, Chandan Kakkar, Vikram Narang, Varun Mehta, Kavita Saggar, Ajit Sood
Intest Res 2020;18(2):238-244.   Published online February 25, 2020
DOI: https://doi.org/10.5217/ir.2019.00104
AbstractAbstract PDFPubReaderePub
Background/Aims
Opioid-induced bowel dysfunction includes nausea, vomiting, constipation and abdominal distension. We describe patients presenting with gastrointestinal (GI) ulcers and ulcerated strictures secondary to opioid abuse, an entity not well described in literature.
Methods
This retrospective observational study included patients with opioid abuse gastroenteropathy presenting to Dayanand Medical College and Hospital, Ludhiana, India between January 2013 and December 2018. Opioid abuse gastroenteropathy was defined as gastric or small bowel ulcers and ulcerated strictures in patients abusing opioids, where all other possible etiologies of GI ulcers/strictures were excluded. Clinical, biochemical, endoscopic, radiological and histological parameters as well as response to treatment were assessed.
Results
During the study period, 20 patients (mean age, 38.5±14.2 years; 100% males) were diagnosed to have opioid induced GI ulcers and/or ulcerated strictures. The mean duration of opioid consumption was 6.2±3.4 years. The mean duration of symptoms at presentation was 222.1±392.3 days. Thirteen patients (65%) had gastroduodenal involvement, 6 (30%) had a jejunoileal disease and 1 (5%) had an ileocecal stricture. Two patients (10%) presented with upper GI bleeding, 11 (55%) had features of gastric outlet obstruction and 7 (35%) presented with small bowel obstruction. Abdominal pain and iron deficiency anemia were the most common presentations. Only 1 patient (5%) responded to proton pump inhibitors, 3 (15%) had a lasting response to endoscopic balloon dilatation, while all other (80%) required surgical intervention.
Conclusions
Opioid abuse gastroenteropathy presents as ulcers and ulcerated strictures which respond poorly to medical management and endoscopic balloon dilatation. A majority of these cases need surgical intervention.

Citations

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    Mithu Bhowmick, Vishal Sharma
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    Richard J. Bodnar
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  • 173 Download
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