Intestinal Research

Volume 8(1); June 2010

Reviews

Changing Epidemiology and Future Challenges of Inflammatory Bowel Disease in Asia: Siew C Ng, MBBS , MRCP; Intest Res 2010;8(1):1-9. Published online June 30, 2010; DOI: https://doi.org/10.5217/ir.2010.8.1.1

In the past decade, many countries in Asia, in particularly in East Asia, are experiencing a progressive rise in the incidence and prevalence of inflammatory bowel disease (IBD). Improved physician awareness and diagnostic methods are unlikely to fully account for this rapid increase. This epidemiological shift is likely to relate to industralization, westernization of lifestyles and changes in eating habits, as part of the socioeconomic development in Asia, although many of these putative environmental factors have not been formally investigated in Asian cohorts. Genetic factors for IBD differ between Asia and the West. NOD2/CARD15 mutation, repeatedly observed in the Caucasian populations, is not associated with Crohn's disease in Asian populations. Familial clustering is generally uncommon in Asia but it is expected to increase as the IBD prevalence in this region rises. Ethnic-racial differences of IBD have been described and Indians appear to be most affected in South-East Asia. Clinical manifestation of IBD in Asia resemble the Western population in general, but with some differences, including higher prevalence of males and ileocolonic disease, lower disease severity, surgical rates and extraintestinal manifestations. These differences may relate to time factor, genetic background and environmental factors. This review summarises recent epidemiological data of IBD including environmental factors associated with the development of IBD in Asia. Future research focusing on studying the epidemiology of IBD in an area of rapidly increasing prevalence such as Asia will allow the opportunity to identify potential risk factors and provide a better understanding of the aetiology of disease in the Asian population. (Intest Res 2010;8:1-8)

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Inflammatory bowel disease evolution in the past two decades: a chronological multinational study
Pezhman Alavinejad, Seyed Jalal Hashemi, Nitin Behl, Ahmad Hormati, Abubakr Elbasuny, Naser Ebrahimi Daryani, Mehdi Pezeshgi Modarres, Masoud Arshadzadeh, Samira Panahande, Dao Viet Hang, Aya Mohammed Mahros, Abazar Parsi, Hazhir Javaherizadeh, Ata Rehman
eClinicalMedicine.2024; 70: 102542. CrossRef
Formulation, Standardization, and a Preliminary Before-After Clinical Trial on Effect of a Traditional Herbal Formula (Maqliasa) on Manifestations of Ulcerative Colitis
Meysam Shirzad, Mohammad Mahdi Ahmadian-Attari, Seyed Mohammad Sadegh Ghafoori, Leila Mohammad Taghizadeh Kashani , Mehdi Pasalar, Alireza Abbassian, Shahram Agah
Current Drug Discovery Technologies.2021; 18(1): 113. CrossRef
Long-term Prognosis of Ulcerative Colitis and its Temporal Change Between 1977 and 2013: A Hospital-based Cohort Study from Korea
Ho-Su Lee, Sang Hyoung Park, Suk-Kyun Yang, Jungbok Lee, Jae Seung Soh, Seohyun Lee, Jung Ho Bae, Hyo Jeong Lee, Dong-Hoon Yang, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Yong Sik Yoon, Chang Sik Yu, Jin-Ho Kim
Journal of Crohn's and Colitis.2015; 9(2): 147. CrossRef
The Changes in Etiology and Clinical Features of Non-Traumatic Small Bowel Perforation
Byeong Gwan Kim, Ji Won Kim, Kook Lae Lee, Jae Kyung Lee, Ji Bong Jeong
Intestinal Research.2012; 10(2): 189. CrossRef
The epidemiology and prevalence of Ulcerative colitis in the South of India
Sivaram Gunisetty, Santosh Kumar Tiwari, Avinash Bardia, Meka Phanibhushan, Vishnupriya Satti, Mohammed Aejaz Habeeb, Aleem Ahmed Khan
Open Journal of Immunology.2012; 02(04): 144. CrossRef

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Pathogenesis of Inflammatory Bowel Diseases: Masakazu Nagahori, Yasuhiro Nemoto, Mamoru Watanabe; Intest Res 2010;8(1):9-17. Published online June 30, 2010; DOI: https://doi.org/10.5217/ir.2010.8.1.9

Abstract PDF

Our understanding of IBD pathogenesis has been increasing rapidly. The genetically determined interplay between the commensal microbiota, intestinal epithelial cells, and the immune system has been appreciated deeply. The interplay is also considered to be modified by specific environmental factors. This review examines the recent findings from the animal and human studies on IBD pathogenesis and the implications for future effective therapies. (Intest Res 2010;8:9-17)

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Metformin alleviates inflammation in oxazolone induced ulcerative colitis in rats: plausible role of sphingosine kinase 1/sphingosine 1 phosphate signaling pathway
Nageh Ahmed El-Mahdy, Magda El-Sayed El-Sayad, Aya Hassan El-Kadem, Sally EL-Sayed Abu-Risha
Immunopharmacology and Immunotoxicology.2021; 43(2): 192. CrossRef
The efficacy of conditioned medium released by tonsil-derived mesenchymal stem cells in a chronic murine colitis model
Ko Eun Lee, Sung-Ae Jung, Yang-Hee Joo, Eun Mi Song, Chang Mo Moon, Seong-Eun Kim, Inho Jo, Debabrata Banerjee
PLOS ONE.2019; 14(12): e0225739. CrossRef
Interleukin‐23p19 expression in patients with ulcerative colitis and its relation to disease severity
Hanan El‐Bassat, Lobna AboAli, Sahar El Yamany, Hanan Al Shenawy, Rasha A. Al Din, Atef Taha
Advances in Digestive Medicine.2016; 3(3): 88. CrossRef
Does Carotid Intima-Media Thickness Increase in Patients With Inflammatory Bowel Disease?
Kyeong Ok Kim, Byung Ik Jang, Si Hyung Lee
Intestinal Research.2014; 12(4): 293. CrossRef
The Association between the Therapeutic Agent and the Compliance of the Patients with Inflammatory Bowel Diseases
Yun-Seong Kang, So Young Kim, Min Ho Jo, Hyoun Woo Kang, Jun Kyu Lee, Yun Jeong Lim, Moon Soo Koh, Jin Ho Lee, Chang Hun Yang, Jae Hak Kim
The Korean Journal of Gastroenterology.2013; 61(6): 313. CrossRef
Targeting sphingosine kinase 1 (SphK1) and apoptosis by colon-specific delivery formula of resveratrol in treatment of experimental ulcerative colitis in rats
Amany A. Abdin
European Journal of Pharmacology.2013; 718(1-3): 145. CrossRef
Novel Pharmacological Approaches for Inflammatory Bowel Disease: Targeting Key Intracellular Pathways and the IL-23/IL-17 Axis
Leo R. Fitzpatrick
International Journal of Inflammation.2012; 2012: 1. CrossRef

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Original Articles

The Usefulness of F¹⁸-FDG PET/CT in Detection of Colonic Neoplasm: Min Kyung Kang, Sung Pyo Hong, Ji Eun Lee, Tae Joo Jeon, Jong Woo Kim, Chang Il Kwon, Kwang Hyun Ko, Seong Gyu Hwang, Pil Won Park, Kyu Sung Rim; Intest Res 2010;8(1):18-23. Published online June 30, 2010; DOI: https://doi.org/10.5217/ir.2010.8.1.18

Abstract PDF: Background/Aims
The diagnostic value of 2-18F-fluoro-2-deoxy-D-glucose positron emi-ssion to-mo--graphy (FDG PET)/CT in the detection of colon carcinoma and adenoma was evaluated retrospectively. Methods: Between May 2007 and June 2008, 102 patients (42 males and 60 females: age range, 28-89 years) underwent both FDG PET/CT and colonoscopy in < a 3 month interval. FDG uptake on PET/CT was divided into physiologic and pathologic uptake by a nuclear medicine specialist. Pathologic confirmation was obtained in all patients. Results: Forty-three patients had no abnormal findings on both FDG PET/CT and colonoscopy. One hundred five and 59 colonic lesions were detected on FDG PET/CT and colonoscopy, respectively. Eleven of 24 lesions with pathologic FDG uptake were histologically-confirmed to be malignancies. Among 18 lesions with physiologic FDG uptake, 1 carcinoma and 1 adenoma were revealed. One carcinoma, 25 adenomas, and 11 hyperplastic polyps did not reveal FDG uptake. Interpretation of pathologic FDG uptake in the colon had a sensitivity of 84.6% and 28.2%, a specificity of 90.4% and 88.1%, a positive predictive value of 45.8% and 45.8%, and a negative predictive value of 98.4% and 77.8% for carcinomas and adenomas, respectively. Conclusions: FDG PET/CT is a very useful diagnostic method for the detection of colon cancer, but the sensitivity is low for adenomas, which may need further evaluation, such as a screening endoscopy. (Intest Res 2010;8:18-23); Citations

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Is It Useful to Perform Additional Colonoscopy to Detect Unmatched Lesion between Positron Emission Tomography/Computed Tomography and Colonoscopy?
Chang Yong Yun, Jun-Oh Jung, Seong O Suh, Ji Won Yoo, Yu Mi Oh, Soo Min Ahn, Hyoung Hun Sim, Eun Sil Kim, Ji Yoon Bae
The Korean Journal of Gastroenterology.2013; 61(6): 319.     CrossRef
Benign Colonic18F-FDG Uptake on Whole-Body FDG-PET Scan
Byung Ik Jang
Clinical Endoscopy.2012; 45(2): 109.     CrossRef
The Role of F18-FDG PET/CT in Colorectal Neoplasm
Kyung-Jo Kim
Intestinal Research.2010; 8(1): 84.     CrossRef

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Comparison of Bowel Preparation Depending on Completion Time of Polyethylene Glycol Ingestion and Start Time of Colonoscopy: Jang Hyuk Yoon, Dong Il Park, Jeong Eun Shin, Seong Eun Kim, Sung Ae Jung, Suck Ho Lee, Dong Kyung Chang, Chang Soo Eun, Dong Soo Han, Hyun Soo Kim, Seun Ja Park, Il Hyun Baek, Bora Keum, Yoon Tae Jeen; Intest Res 2010;8(1):24-29. Published online June 30, 2010; DOI: https://doi.org/10.5217/ir.2010.8.1.24

Abstract PDF

Background/Aims
Polyethylene glycol (PEG) solution is the most widely used bowel preparation agent for colonoscopy because of its safety and efficacy in colon cleansing. It has been hypothesized that the timing of colon preparation may influence the quality of colon cleansing, and therefore affect the diagnostic yield of colonoscopy. The aim of this study was to determine the optimal interval of time between complete ingestion of PEG and performing colonoscopy. Methods: We prospectively enrolled 1,355 patients who had undergone a PEG-based bowel preparation on the day of colonoscopy in 11 tertiary hospitals in Korea between March 2008 and February 2009. All colonoscopies were performed in the afternoon. The start time of PEG ingestion, completion time of PEG ingestion, dose of PEG ingested, start time of colonoscopy, and the quality of bowel cleansing were recorded. Results: There was no difference of cleansing quality of bowel preparation between three groups of less than 7 hours of elapsed time (2≤ and <3 hours, 3≤ and <5 hours, 5≤ and <7 hours). However, group of more than 7 hours of elapsed time presented poor cleansing quality than others (P<0.01). Conclusions: If >7 hours elapses after ingestion of PEG, the quality of bowel preparation is poor. Therefore, depending on the time colonoscopy is scheduled, the start time of PEG ingestion may need to be adjusted. (Intest Res 2010;8:24-29)

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The optimal bowel preparation intervals before colonoscopy: A randomized study comparing polyethylene glycol and low-volume solutions
Vladimir Kojecky, Jan Matous, Radan Keil, Milan Dastych, Zdena Zadorova, Michal Varga, Radek Kroupa, Jiri Dolina, Miroslav Misurec, Ales Hep, Martin Griva
Digestive and Liver Disease.2018; 50(3): 271. CrossRef
Comparative Study on Bowel Preparation Efficacy of Ascorbic Acid Containing Polyethylene Glycol by Adding Either Simethicone or 1 L of Water in Health Medical Examination Patients: A Prospective Randomized Controlled Study
Se Hwan Yeo, Jae Hoon Kwak, Yeo Un Kim, Tae Ho Kwon, Jeong Bae Park, Jun Hyung Park, Yong Kook Lee, Yun Jeong Lim, Chang Heon Yang
The Korean Journal of Gastroenterology.2016; 67(4): 189. CrossRef
Randomized Controlled Trial of Sodium Phosphate Tablets versus 2 L Polyethylene Glycol Solution for Bowel Cleansing prior to Colonoscopy
Yun Ho Lee, Seong Yeon Jeong, You Sun Kim, Hye Jin Jung, Min Jung Kwon, Cheol Hun Kwak, Song I Bae, Jeong Seop Moon, Ji Won Kim, Su Hwan Kim, Kook Lae Lee
The Korean Journal of Gastroenterology.2015; 65(1): 27. CrossRef
Importance of the Time Interval between Bowel Preparation and Colonoscopy in Determining the Quality of Bowel Preparation for Full-Dose Polyethylene Glycol Preparation
Tae Kyung Kim, Hyung Wook Kim, Su Jin Kim, Jong Kun Ha, Hyung Ha Jang, Young Mi Hong, Su Bum Park, Cheol Woong Choi, Dae Hwan Kang
Gut and Liver.2014; 8(6): 625. CrossRef
A Comparison of 2 L of Polyethylene Glycol and 45 mL of Sodium Phosphate versus 4 L of Polyethylene Glycol for Bowel Cleansing: A Prospective Randomized Trial
Suh Eun Bae, Kyung-Jo Kim, Jun Bum Eum, Dong Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim
Gut and Liver.2013; 7(4): 423. CrossRef
A Clear Liquid Diet Is Not Mandatory for Polyethylene Glycol-Based Bowel Preparation for Afternoon Colonoscopy in Healthy Outpatients
Yoon Suk Jung, Hyo Sun Seok, Dong Il Park, Chang Seok Song, Seong Eun Kim, Suck Ho Lee, Chang Soo Eun, Dong Soo Han, Yong Soo Kim, Chang Kyun Lee
Gut and Liver.2013; 7(6): 681. CrossRef
Comparison of Bowel Preparation Quality between Clear-liquid Diet and No Diet Restriction
Woo Shin Jeong, Dong Il Park, Hyo Sun Seok, Seong Eun Kim, Suck-Ho Lee, Chang Kyun Lee, Chang Soo Eun, Dong Soo Han
Intestinal Research.2012; 10(3): 272. CrossRef
Comparison among Conventional 4 L Polyethylene Glycol, Split Method of 4 L Polyethylene Glycol and Combination of 2 L Polyethylene Glycol and Sodium Phosphate Solution for Colonoscopy Preparation
So Young Jo, Nayoung Kim, Jung Won Lee, Ji Hwan Lim, Chiun Choi, Ilyoung Chon, Ho Kil, Bo Young Min, Young Sang Byoun, Ban Seok Lee, Sang Eon Jang, Hyun Kyung Park, Hyun Jin Jo, Cheol Min Shin, Sang Hyup Lee, Young Soo Park, Jin-Hyeok Hwang, Jin-Wook Kim,
The Korean Journal of Gastroenterology.2012; 59(6): 414. CrossRef

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Pregnancy Outcomes of the Patients with Inflammatory Bowel Disease in Korea: Young Wook Noh, Sung-Ae Jung, Min-Jung Kang, Ji Min Jung, Seong-Eun Kim, Ki-Nam Shim, Tae Hun Kim, Kwon Yoo; Intest Res 2010;8(1):30-39. Published online June 30, 2010; DOI: https://doi.org/10.5217/ir.2010.8.1.30

Abstract PDF: Background/Aims
It is unknown what effect inflammatory bowel disease (IBD) has on pregnancy in Korean patients. We aimed to determine the effect of IBD and its treatment on pregnancy outcomes using web-based survey. Methods: A web-based survey was conducted in three Korean internet communities for IBD patients between May and September 2008. Pregnancy and birth outcomes were examined, and the influence of IBD activity and drug therapy were analyzed. Results: Of 56 pregnancies in 36 female IBD patients, live births occurred in 60.7%, miscarriages in 10.7%, and artificial abortions in 17.8%. These results were similar to those expected for pregnant women in the general Korean population. All artificial abortions occurred in unplanned pregnancies, and 80% of those cases were due to a misunderstanding of IBD and medications. IBD was aggravated in 11.1% of the patients in remission or with mild activity and in 85.7% of patients with moderate or severe activity at the time of early pregnancy. Of 57 pregnancies in the spouses of 39 male patients, live births occurred in 78.9%, miscarriages in 8.8%, and artificial abortions in 3.5%. There was no significant influence of therapeutic medications on the natural course of pregnancies. Conclusions: Pregnancy outcomes in IBD patients appear to be similar to those of the general Korean population. A properly planned pregnancy and a comprehensive treatment course before and during pregnancy are important considerations for increasing the likelihood of a normal pregnancy in those with IBD. (Intest Res 2010;8:30-39)

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Clinical Course of Intestinal BehcӇet's Disease according tothe Characteristics of Ulcer in Colonoscopy: Min Cheul Kim, Sung Jae Shin, Sun Gyo Lim, Kyung Rok Lee, Hak Woo, Sang Jo Choi, Jung Soo Jo, Jung Ho Eum, Dong Youb Cha, Jae Chul Hwang, Ki Myung Lee, Kwang Jae Lee, Jin Hong Kim; Intest Res 2010;8(1):40-47. Published online June 30, 2010; DOI: https://doi.org/10.5217/ir.2010.8.1.40

Abstract PDF

Background/Aims
Intestinal involvement with bleeding and perforation is one of the main causes of morbidity and mortality in patients with Behçet's disease (BD); however, the clinical course of intestinal BD has not been defined. The aim of this study was to determine the clinical course of intestinal BD based on the characteristics of ulcers visualized during colonoscopy. Methods: We retrospectively reviewed the medical records and colonoscopic findings of 41 patients with intestinal BD. All patients were classified into subgroups according to ulcer depth, size, and number, and we analyzed the clinical manifestations, subset type of BD, medications, surgical procedures, and relapse rate among the subgroups. Results: The median age at the time of diagnosis was 38 years (range, 18-74 years); 25 patients were females (M:F=1:1.56). Abdominal pain (n=40), diarrhea (n=27), and RLQ tenderness (n=21) were common symptoms. The number of complete, incomplete, and suspected types was 3, 17, and 21, respectively. In an analysis according to ulcer depth, the rate of steroid use and intestinal surgeries was more frequent in the deep ulcer group compared with the aphthous and shallow ulcer groups (50.0% vs. 0% vs. 17.6%; P=0.012; 42.9% vs. 0% vs. 23.5%: P=0.013) The rate of steroid use and relapse tended to be higher as the size of the ulcer increased; however, there was no difference in the rates of steroid use, surgeries, and relapse based on the number of intestinal ulcers. Conclusions: The prognosis was worse in patients with intestinal BD who have deeper and larger ulcers. Therefore, we suggest that such patients need to be treated aggressively. (Intest Res 2010;8:40-47)

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Simultaneous Involvement of Nervous and Gastrointestinal Systems in Behçet's Disease
Jae Yeol Lee, Ji-Youn Park, En Hyung Kim, Mi Jin Hee Tak, Eun-So Lee
Annals of Dermatology.2012; 24(2): 225. CrossRef

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Clinical Characteristics of Constipation with Hypothyroidism: Jaeil Kim, Seung-Jae Myung, Dong-Hoon Yang, In Ja Yoon, So Young Seo, Heun Sook Ku, Soon Man Yoon, Kyung-Jo Kim, Byong Duk Ye, Jung-Sik Byeon, Suk-Kyun Yang, Jin-Ho Kim; Intest Res 2010;8(1):48-57. Published online June 30, 2010; DOI: https://doi.org/10.5217/ir.2010.8.1.48

Abstract PDF

Background/Aims
Constipation is a well-recognized gastrointestinal symptom in patients with untreated hypothyroidism. Although thyroid function tests are recommended to exclude hypothyroidism in patients with constipation, there have been no reports to determine the causal relationship between thyroid function and constipation. The aim of this study was to determine the prevalence of hypothyroidism in constipated patients and the clinical features of constipation associated with hypothyroidism. Methods: A total of 1,481 constipated patients were included. These patients were divided into overt hypothyroidism, subclinical hypothyroidism, and normal thyroid function groups based on thyroid function tests. We reviewed the clinical presentation, anorectal function, colonic transit time, defecographic findings, and response to biofeedback therapy. Results: The prevalence of overt and subclinical hypothyroidism was 0.41% (men, 0.36%; women, 0.53%) and 1.76% (men, 1.28%; women 2.03%), respectively. There were no differences in total or segmental colonic transit times and subtypes of constipation among the normal thyroid function (n=54), overt hypothyroidism (n=4), and subclinical hypothyroidism groups (n=21). On anorectal manometry, the prevalence of dyssynergic defecation did not differ between the three groups. Rectal hyposensitivity was more frequent in the overt hypothyroidism group (overt hypothyroidism group, 50.0%; subclinical hypothyroidism group, 19.0%; normal thyroid function group, 20.4%) without statistical significance (P=0.372). Conclusions: The prevalence of overt and subclinical hypothyroidism in constipated patients was very low. The colonic transit time is not affected by thyroid function. (Intest Res 2010;8:48-57)

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Long-Term Risks of Parkinson’s Disease, Surgery, and Colorectal Cancer in Patients With Slow-Transit Constipation
Eun Mi Song, Hyo Jeong Lee, Kee Wook Jung, Mi Jung Kim, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Jaewon Choe, Suk-Kyun Yang, Satish S.C. Rao, Seung-Jae Myung
Clinical Gastroenterology and Hepatology.2021; 19(12): 2577. CrossRef
Chronic Constipation in the Elderly Patient: Updates in Evaluation and Management
Amir Mari, Mahmud Mahamid, Hana Amara, Fadi Abu Baker, Afif Yaccob
Korean Journal of Family Medicine.2020; 41(3): 139. CrossRef
Primary Care Management of Chronic Constipation in Asia: The ANMA Chronic Constipation Tool
Kok-Ann Gwee, Uday C Ghoshal, Sutep Gonlachanvit, Andrew Seng Boon Chua, Seung-Jae Myung, Shaman Rajindrajith, Tanisa Patcharatrakul, Myung-Gyu Choi, Justin C Y Wu, Min-Hu Chen, Xiao-Rong Gong, Ching-Liang Lu, Chien-Lin Chen, Nitesh Pratap, Philip Abraham
Journal of Neurogastroenterology and Motility.2013; 19(2): 149. CrossRef

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Case Reports

Recurrent Primary Signet Ring Cell Cancer of the Colon at Anastomosis Site after Curative Resection: Yu Jin Suh, Jae Myung Cha, Joung Il Lee, Kwang Ro Joo, Sung Won Jung, Hyun Phil Shin, Soo Woong Kim; Intest Res 2010;8(1):58-62. Published online June 30, 2010; DOI: https://doi.org/10.5217/ir.2010.8.1.58

Abstract PDF: A primary signet ring cell cancer (SRCC) is a rare form of an adenocarcinoma of the large intestine. The prognosis of SRCC of the colon has been reported to be worse than classic adenocarcinoma of the colon; however, there is no difference in the post-operative surveillance for SRCC. We report a case of SRCC of the colon with negative resection margins that recurred at the anastomosis site 26 months after curative resection. A 55-year-old male presented to the hospital with abdominal pain. The initial colonoscopy and abdominal computed tomography revealed SRCC of the proximal ascending colon. He underwent extensive curative surgical resection and adjuvant chemotherapy for 8 months. However, 26 months post-operatively, the cancer recurred at the anastomosis site without peritoneal dissemination. Physicians should be aware that SRCC may have different recurrence patterns compared with classic adenocarcinoma, and may need more vigorous surveillance, even after curative surgery. (Intest Res 2010;8:58-62)

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Clinical Experience of Thalidomide in the Treatment of Korean Patients with Intestinal BehcӇet's Disease: Pilot Experience in a Single Center: Hyun Jung Lee, Jae Hee Cheon, Kyong Joo Lee, Hui Won Jang, Kyu Sik Jung, Eun Suk Jung, Jin Ha Lee, Seung Min Jeon, Sung Pil Hong, Tae Il Kim, Won Ho Kim; Intest Res 2010;8(1):63-69. Published online June 30, 2010; DOI: https://doi.org/10.5217/ir.2010.8.1.63

Abstract PDF

Intestinal BehcӇet's disease (BD) often leads to severe complications, such as perforation or massive bleeding, and therefore is one of the major causes of morbidity and mortality. As thalidomide has been identified and its anti-inflammatory and immunomodulatory properties clarified, this drug has been used in cases of systemic BD with some success. Herein we report a case series of four patients with intestinal BD to share our clinical experience with thalidomide treatment. We studied the effects of thalidomide in four patients who had a chronic relapse of intestinal BD requiring the frequent use of systemic steroids due to refractoriness to prior treatments, such as 5-aminosalycylic acid and immunosuppressants. Pre- and post-treatment clinical and laboratory data, including clinical symptoms, laboratory data, disease activity index for intestinal BD, and thalidomide toxicity were recorded. Three of the four patients had a clinical and radiologic improvement after thalidomide treatment and all of the patients discontinued steroid therapy. Although two patients tolerated thalidomide, two patients could not continue the treatment because they suffered from edema and neutropenia. Thalidomide could be considered a therapeutic option for the treatment of intestinal BD. (Intest Res 2010;8:63-69)

Citations

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Advances in Management of Intestinal Behçet’s Disease: A Perspective From Gastroenterologists
Jae Hee Cheon
Journal of Rheumatic Diseases.2021; 28(1): 4. CrossRef
An Overview of Conventional and Recent Treatment Options for Behcet’s Disease
Kader Cetin Gedik, Micol Romano, Roberta A. Berard, Erkan Demirkaya
Current Treatment Options in Rheumatology.2020; 6(2): 99. CrossRef
Updated treatment strategies for intestinal Behçet’s disease
Yong Eun Park, Jae Hee Cheon
The Korean Journal of Internal Medicine.2018; 33(1): 1. CrossRef
Update on the Medical Management of Gastrointestinal Behçet’s Disease
Giuseppe Lopalco, Donato Rigante, Vincenzo Venerito, Claudia Fabiani, Rossella Franceschini, Michele Barone, Giovanni Lapadula, Mauro Galeazzi, Bruno Frediani, Florenzo Iannone, Luca Cantarini
Mediators of Inflammation.2017; 2017: 1. CrossRef
An update on the diagnosis, treatment, and prognosis of intestinal Behçet's disease
Jae Hee Cheon, Won Ho Kim
Current Opinion in Rheumatology.2015; 27(1): 24. CrossRef
Update on the Treatment of Intestinal Behçet's Disease
Kyung-Jo Kim
Journal of Rheumatic Diseases.2014; 21(4): 176. CrossRef
The Medical Treatments of Intestinal Behçet's Disease: An Update
Hye Won Lee, Won Ho Kim, Jae Hee Cheon
Intestinal Research.2013; 11(3): 155. CrossRef
Efficacy of Infliximab in Intestinal Behçet’s Disease
Jin Ha Lee, Jae Hee Cheon, Seong Woo Jeon, Byong Duk Ye, Suk-Kyun Yang, Young-Ho Kim, Kang-Moon Lee, Jong Pil Im, Joo Sung Kim, Chang Kyun Lee, Hyo Jong Kim, Eun Young Kim, Kyeong Ok Kim, Byung Ik Jang, Won Ho Kim
Inflammatory Bowel Diseases.2013; : 1. CrossRef

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A Case of Degos' Disease Presenting with Abdominal Angina and Widespread Skin Lesions: Bon-Ho Ku, Yeun Jung Lim, Hyo Kyung Choi, Young Ho Kim, Jongwook Park, Chi Hoon Kim, Tae-Hoon Jang, Yong Woo Seo, Young Cheol Jo, Kee-Taek Jang, Chang Ohk Sung, Dong-Kyung Chang; Intest Res 2010;8(1):70-74. Published online June 30, 2010; DOI: https://doi.org/10.5217/ir.2010.8.1.70

Abstract PDF: Malignant atrophic papulosis (MAP), also known as Degos' disease, is a rare and often fatal occlusive thrombotic vasculopathy, with fewer than seven cases reported in Korea. MAP is characterized by porcelain-white, atrophic, papular skin lesions and multi-organ system involvement, especially the gastrointestinal (GI) tract and nervous system. Involvement of the GI tract is usually associated with a poor prognosis. To date, no treatment has been shown to be effective in the treatment of MAP. We describe a 52-year-old man who presented with a 5-month history of abdominal angina and a 2-year history of multiple skin lesions on the trunk and extremities. The skin lesions were papules, 4-6 mm in diameter, with a porcelain-white center and a slightly raised erythematous telangiectatic rim. A biopsy of a skin lesion showed a wedge-shaped degeneration of collagen in the dermis and atrophic epidermis. An explorative laparoscopy revealed multiple, yellow-white plaques scattered throughout the small bowel. A biopsy of the small bowel showed sclerotic vascular alterations containing intravascular fibrin thrombi. He was started on aspirin (100 mg daily) and has survived for 24 months since the onset of gastrointestinal symptoms. (Intest Res 2010;8:70-74)

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Postradiation Malignant Fibrous Histiocytoma of the Colon: A Case Report: Jin Young Yoon, Do Kyung Kim, Jae Hee Cheon, Chang Mo Moon, Jae Jun Park, Joo Won Chung, Eun Young Kim, Tae Hoon Kim, Chan Joo Lee, Eun Young Park, Sang Hoon Shin, Sung Pil Hong, Tae Il Kim, Nam Kyu Kim, Ho Guen Kim, Won Ho Kim; Intest Res 2010;8(1):75-79. Published online June 30, 2010; DOI: https://doi.org/10.5217/ir.2010.8.1.75

Abstract PDF: Post-radiation soft tissue sarcomas are recognized as rare complications of radiation therapy. The most common type of post-radiation soft tissue sarcoma is a malignant fibrous histiocytoma (MFH), which originates from mesenchymal cells with a predominance of histiocytes and fibroblasts. The two most common sites of occurrence for post-radiation soft tissue sarcomas are the chest wall and pelvic cavity. Post-radiation colorectal MFHs are extremely rare and all of the reported cases of post-radiation sarcomas have occurred ＞3 years after radiation therapy. Recently, we managed a case of colorectal MFH which developed in a 48-year-old male who had undergone a low anterior resection for rectal adenocarcinoma and had received chemoradiotherapy as adjuvant treatment. Twelve months after radiotherapy, a 4 cm mass was detected 8 cm superior to the anastomosis site on colonoscopic examination. A soft tissue sarcoma was suspected on pathologic examination of the biopsy specimen. Therefore, he underwent a Hartmann's operation and the final pathologic finding revealed MFH with a storiform pattern of tumor cells composed of pleomorphic, multinucleated giant cells. This is the first case of MFH that had a latency period ＜3 years (i.e., 1 year) between the time of radiotherapy and diagnosis. (Intest Res 2010;8:75-79)

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A Case of Bleeding Meckel's Diverticulum in a Patient with Crohn's Disease: Hee Ju Oh, Byung Ik Jang, Dong Hee Kim, Yong Gil Kim, Kyeong Ok Kim, Si Hyung Lee; Intest Res 2010;8(1):80-83. Published online June 30, 2010; DOI: https://doi.org/10.5217/ir.2010.8.1.80

Abstract PDF: Meckel's diverticulum is the most common congenital anomaly of the intestine. The association between Meckel's diverticulum and Crohn's disease is unclear. Meckel's diverticulum has previously been reported to be present in patients with Crohn's disease. However, the finding is typically incidental, and a bleeding Meckel's diverticulum in a patient with Crohn's disease is uncommon. Recently, we managed a 27-year-old man with known Crohn's disease who presented with hematochezia thought to be due to an ileal ulcer of Crohn's disease. At the time of intra-operative small bowel endoscopy, the hematochezia was shown to be due to bleeding from Meckel's diverticulum. Although the patient had already been diagnosed with Crohn's disease, we need to consider the possibility of other causes of bleeding. (Intest Res 2010;8:80-83)