Intestinal Research

Original Articles

Predictive accuracy of fecal calprotectin for histologic remission in ulcerative colitis: Arshdeep Singh, Arshia Bhardwaj, Riya Sharma, Bhavjeet Kaur Kahlon, Ashvin Singh Dhaliwal, Dharmatma Singh, Simranjeet Kaur, Devanshi Jain, Namita Bansal, Ramit Mahajan, Kirandeep Kaur, Aminder Singh, Vikram Narang, Harpreet Kaur, Vandana Midha, Ajit Sood; Received May 14, 2024 Accepted July 29, 2024 Published online November 11, 2024; DOI: https://doi.org/10.5217/ir.2024.00068 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Background/Aims
Accurate assessment of disease activity is crucial for effective management and treatment of ulcerative colitis (UC). This study evaluated the correlation between clinical, endoscopic, and histologic measures of disease activity in UC.
Methods
Clinical, biochemical, endoscopic, and histologic disease activity was studied in 347 patients with UC. Agreements among various histologic classification systems, namely the Geboes Score (GS), Continuous GS, Nancy Index (NI), and Robarts Histopathology Index (RHI), were analyzed. The predictive accuracy of fecal calprotectin (FC) for endoscopic and histologic remission was assessed.
Results
We demonstrate a fair to moderate correlation between clinical, endoscopic, and histologic measures of disease activity in UC. There was a robust concordance among GS, Continuous GS, NI, and RHI in distinguishing between patients in histologic remission or activity. The NI detected 75% of patients who met the remission criteria according to the RHI, whereas the RHI identified all patients in remission as defined by the NI. FC levels below 150 μg/g had >70% accuracy in predicting endoscopic remission. FC levels below 150 μg/g showed ≥80% accuracy, and FC levels below 100 μg/g demonstrated ≥ 85% accuracy in predicting histologic remission, regardless of the scoring index applied. Elevated FC levels were associated with both acute and chronic inflammatory infiltrates in biopsy samples.
Conclusions
FC is a reliable predictor of histologic remission, with higher accuracy at lower thresholds. The GS, Continuous GS, NI, and RHI demonstrate comparable performance. FC could help stratify patients’ need for colonoscopy for the assessment of endoscopic and histologic remission.

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IBD

Infectious complications in patients with inflammatory bowel disease in Asia: the results of a multinational web-based survey in the 8th Asian Organization for Crohn’s and Colitis meeting: Yu Kyung Jun, Seong-Joon Koh, Dae Seong Myung, Sang Hyoung Park, Choon Jin Ooi, Ajit Sood, Jong Pil Im; Intest Res 2023;21(3):353-362. Published online July 27, 2023; DOI: https://doi.org/10.5217/ir.2023.00013

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Infectious complications are major concerns when treating patients with inflammatory bowel disease (IBD). This study evaluated clinical differences across countries/regions in the management of infectious diseases in patients with IBD.
Methods
A multinational online questionnaire survey was administered to participants at the 8th meeting of the Asian Organization for Crohn’s and Colitis. The questionnaire included questions regarding surveillance, diagnosis, management, and prevention of infection in patients with IBD.
Results
A total of 384 physicians responded to the questionnaire. The majority of Korean (n=70, 63.6%) and Chinese (n=51, 51.5%) physicians preferred vancomycin to metronidazole in the treatment of Clostridium difficile infection, whereas more than half of the Japanese physicians (n=62, 66.7%) preferred metronidazole. Physicians in Korea (n=88, 80.0%) and China (n=46, 46.5%) preferred a 3-month course of isoniazid and rifampin to treat latent tuberculosis infection, whereas most physicians in Japan (n=71, 76.3%) favored a 9-month course of isoniazid. Most Korean physicians (n=89, 80.9%) recommended hepatitis B virus (HBV) vaccination in patients lacking HBV surface antigen, whereas more than half of Japanese physicians (n=53, 57.0%) did not consider vaccination.
Conclusions
Differences in the diagnosis, prevention, and management of infections in patients with IBD across countries/regions reflect different prevalence rates of infectious diseases. This survey may broaden understanding of the real-world clinical settings across Asian countries/regions and provide information for establishing practical guidelines to manage patients with IBD.

Citations

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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
The Korean Journal of Internal Medicine.2025; 40(2): 243. CrossRef
The Burden ofClostridioides difficileInfection in Korea
Seong Ran Jeon
Journal of Korean Medical Science.2024;[Epub] CrossRef
Perception of fecal microbiota transplantation in patients with ulcerative colitis in Korea: a KASID multicenter study
Jebyung Park, Sung Noh Hong, Hong Sub Lee, Jongbeom Shin, Eun Hye Oh, Kwangwoo Nam, Gyeol Seong, Hyun Gun Kim, Jin-Oh Kim, Seong Ran Jeon
The Korean Journal of Internal Medicine.2024; 39(5): 783. CrossRef
Assessing the associations of inflammatory bowel disease and hepatitis B virus infections with two-sample bidirectional mendelian randomization
Ping Han, Chaohui Wang, Yan Qiu
Critical Public Health.2024; 34(1): 1. CrossRef
Diagnosis, management, and prevention of infectious complications in inflammatory bowel disease: variations among Asian countries
Ji Eun Baek, Sung Wook Hwang
Intestinal Research.2023; 21(3): 277. CrossRef

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IBD

Low prevalence of primary sclerosing cholangitis in patients with inflammatory bowel disease in India: Arshdeep Singh, Vandana Midha, Vikram Narang, Saurabh Kedia, Ramit Mahajan, Pavan Dhoble, Bhavjeet Kaur Kahlon, Ashvin Singh Dhaliwal, Ashish Tripathi, Shivam Kalra, Narender Pal Jain, Namita Bansal, Rupa Banerjee, Devendra Desai, Usha Dutta, Vineet Ahuja, Ajit Sood; Intest Res 2023;21(4):452-459. Published online December 2, 2022; DOI: https://doi.org/10.5217/ir.2022.00087

Abstract PDF PubReader ePub

Background/Aims
Primary sclerosing cholangitis (PSC) represents the most common hepatobiliary extraintestinal manifestation of inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD). Limited data exist on PSC in patients with IBD from India. We aimed to assess the prevalence and disease spectrum of PSC in Indian patients with IBD.
Methods
Database of IBD patients at 5 tertiary care IBD centers in India were analyzed retrospectively. Data were extracted and the prevalence of PSC-IBD was calculated.
Results
Forty-eight patients out of 12,216 patients with IBD (9,231 UC, 2,939 CD, and 46 IBD unclassified) were identified to have PSC, resulting in a prevalence of 0.39%. The UC to CD ratio was 7:1. Male sex and pancolitis (UC) or colonic CD were more commonly associated with PSC-IBD. The diagnosis of IBD preceded the diagnosis of PSC in most of the patients. Majority of the patients were symptomatic for liver disease at diagnosis. Eight patients (16.66%) developed cirrhosis, 5 patients (10.41%), all UC, developed malignancies (3 colorectal cancer [6.25%] and 2 cholangiocarcinoma [4.16%]), and 3 patients died (2 decompensated liver disease [4.16%] and 1 cholangiocarcinoma [2.08%]) on follow-up. None of the patients mandated surgical therapy for IBD.
Conclusions
Concomitant PSC in patients with IBD is uncommon in India and is associated with lower rates of development of malignancies.

Citations

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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
Prevalence and bidirectional association between primary sclerosing cholangitis and Crohn's disease: A systematic review and meta-analysis
Dongyuan Zheng, Qinke Xu, Jin Wu, Zhouyue Gu, Jieya Chen, Yingchao Liu
Gastroenterología y Hepatología.2025; : 502346. CrossRef
Frequency, spectrum and outcome of patients with primary sclerosing cholangitis among patients presenting with cholestatic jaundice
Srikanth Kothalkar, Sayan Malakar, Piyush Mishra, Akash Mathur, Uday C. Ghoshal
Indian Journal of Gastroenterology.2024;[Epub] CrossRef
Ileal Pouch-Anal Anastomosis for Ulcerative Colitis: Predictors of Early and Late Complications
Yajnadatta Sarangi, Ashok Kumar, Somanath Malage, Nalinikanta Ghosh, Rahul Rahul, Ashish Singh, Supriya Sharma, Rajneesh K Singh, Anu Behari, Ashok Kumar
Cureus.2024;[Epub] CrossRef
Incidence of Hepatobiliary Malignancies in Primary Sclerosing Cholangitis: Systematic Review and Meta-analysis
Matheus Souza, Luan C.V. Lima, Lubna Al-Sharif, Daniel Q. Huang
Clinical Gastroenterology and Hepatology.2024;[Epub] CrossRef
Primary sclerosing cholangitis (PSC) and inflammatory bowel disease (IBD): a condition exemplifying the crosstalk of the gut–liver axis
You Sun Kim, Edward H. Hurley, Yoojeong Park, Sungjin Ko
Experimental & Molecular Medicine.2023; 55(7): 1380. CrossRef
Treatment of primary sclerosing cholangitis combined with inflammatory bowel disease
You Sun Kim, Edward H. Hurley, Yoojeong Park, Sungjin Ko
Intestinal Research.2023; 21(4): 420. CrossRef
Regional variations in the prevalence of primary sclerosing cholangitis associated with inflammatory bowel disease
Kwang Woo Kim, Hyoun Woo Kang
Intestinal Research.2023; 21(4): 413. CrossRef

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IBD

Inflammatory bowel disease (IBD)-disk accurately predicts the daily life burden and parallels disease activity in patients with IBD: Arshdeep Singh, Yogesh Kumar Gupta, Ashvin Singh Dhaliwal, Bhavjeet Kaur Kahlon, Vasu Bansal, Ramit Mahajan, Varun Mehta, Dharmatma Singh, Ramandeep Kaur, Namita Bansal, Vandana Midha, Ajit Sood; Intest Res 2023;21(3):375-384. Published online October 18, 2022; DOI: https://doi.org/10.5217/ir.2022.00037

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
The inflammatory bowel disease (IBD)-disk is a validated, visual, 10-item, self-administered questionnaire used to evaluate IBD-related disability. The present study aimed to evaluate IBD-disk in assessment of IBD daily life burden and its relation with disease activity. Methods: A cross-sectional study was conducted between June 2021 and December 2021. Patients with IBD were asked to complete the IBD-disk and a visual analogue scale of IBD daily-life burden (scored from 0–10, score >5 indicative of high burden). The internal consistency of IBD-disk, correlation with IBD daily life burden and disease activity (assessed by partial Mayo score and Harvey Bradshaw Index in patients with ulcerative colitis [UC] and Crohn’s disease [CD], respectively) and diagnostic performance of IBD-disk to detect high burden were analyzed. Results: Out of the 546 patients (mean age 40.33±13.74 years, 282 [51.6%] males) who completed the IBD-disk, 464 (84.98%) had UC and the remaining (n=82, 15.02%) had CD. A total of 311 patients (291 UC and 20 CD; 56.95%) had active disease. The mean IBD-disk total score and IBD daily life burden were 18.39±15.23 and 2.45±2.02, respectively. The IBD-disk total score correlated strongly with the IBD daily life burden (ρ=0.94, P<0.001), moderately with partial Mayo score (ρ=0.50) and weakly with Harvey Bradshaw Index (ρ=0.34). The IBD-disk total score >30 predicted high IBD daily-life burden. Conclusions: The IBD-disk accurately predicts the daily life burden and parallels disease activity in patients with IBD and can be applied in clinical practice. (Intest Res, Published online)

Citations

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Is IBD Disk a Reliable Tool to Detect Depression in IBD Patients? A Comparison with Becks’ Depression Inventory
Teodora Spataru, Ana Stemate, Marina Cozma, Alexandru Fleschiu, Remus Popescu, Lucian Negreanu
Gastrointestinal Disorders.2025; 7(1): 23. CrossRef
IBD-PODCAST Spain: A Close Look at Current Daily Clinical Practice in IBD Management
P. Vega, J. M. Huguet, E. Gómez, S. Rubio, P. Suarez, M. I. Vera, J. M. Paredes, A. Hernández-Camba, R. Plaza, M. Mañosa, R. Pajares, B. Sicilia, L. Madero, S. Kolterer, C. Leitner, T. Heatta-Speicher, N. Michelena, R. Santos de Lamadrid, A. Dignass, F. G
Digestive Diseases and Sciences.2024; 69(3): 749. CrossRef
Proportion of inflammatory bowel diseases patients with suboptimal disease control in daily clinical practice—Real‐world evidence from the inflammatory bowel diseases‐podcast study
Ferdinando D’Amico, Fernando Gomollón, Giorgos Bamias, Fernando Magro, Laura Targownik, Claudia Leitner, Tobias Heatta‐Speicher, Naiara Michelena, Stefanie Kolterer, Jennifer Lapthorn, Laura Kauffman, Axel Dignass
United European Gastroenterology Journal.2024; 12(6): 705. CrossRef
A Cross-Sectional Evaluation of Disability in Inflammatory Bowel Disease Using IBD Disk in a Tertiary Center from Romania
Oana-Maria Muru, Corina Silvia Pop, Petruța Violeta Filip, Nicoleta Tiucă, Laura Sorina Diaconu
Journal of Clinical Medicine.2024; 13(23): 7168. CrossRef
Perceptions and Responses to Diseases among Patients with Inflammatory Bowel Disease: Text Mining Analysis of Posts on a Japanese Patient Community Website
Eujin Lee, Hiroaki Tsuchiya, Hajime Iida, Katsumasa Nagano, Yoko Murata, Atsuo Maemoto
Inflammatory Intestinal Diseases.2024; 9(1): 283. CrossRef

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IBD

Clinical spectrum of elderly-onset inflammatory bowel disease in India: Yogesh Kumar Gupta, Arshdeep Singh, Vikram Narang, Vandana Midha, Ramit Mahajan, Varun Mehta, Dharmatma Singh, Namita Bansal, Madeline Vithya Barnaba Durairaj, Amit Kumar Dutta, Ajit Sood; Intest Res 2023;21(2):216-225. Published online August 8, 2022; DOI: https://doi.org/10.5217/ir.2021.00177

Abstract PDF PubReader ePub

Background/Aims
Inflammatory bowel disease (IBD) is increasingly being recognized in elderly patients. Data on clinical spectrum of elderly-onset IBD patients is lacking from India.
Methods
A cross-sectional retrospective analysis of a prospectively maintained database of patients diagnosed with IBD was conducted at 2 centers in India. The clinical spectrum of elderly-onset IBD including demographic profile (age and sex), clinical presentation, disease characteristics (disease behavior and severity, extent of disease), and treatment were recorded and compared with adult-onset IBD.
Results
During the study period, 3,922 (3,172 ulcerative colitis [UC] and 750 Crohn’s disease [CD]) patients with IBD were recorded in the database. A total of 186 patients (4.74%; 116 males [62.36%]) had elderly-onset IBD (69.35% UC and 30.64% CD). Diarrhea, blood in stools, nocturnal frequency and pain abdomen were the commonest presentations for UC, whereas pain abdomen, weight loss and diarrhea were the most frequent symptoms in CD. For both elderly onset UC and CD, majority of the patients had moderately severe disease. Left-sided colitis was the commonest disease location in UC. Isolated ileal disease and inflammatory behavior were the most common disease location and behavior, respectively in CD. 5-Aminosalicylates were the commonest prescribed drug for both elderly onset UC and CD. Thiopurines and biologics were used infrequently. Prevalence of colorectal cancer was higher in elderly onset IBD.
Conclusions
Elderly onset IBD is not uncommon in India. Both the elderly onset UC and CD were milder, with no significant differences in disease characteristics (disease extent, location and behavior) when compared to adult-onset IBD. Colorectal cancer was more common in elderly onset IBD.

Citations

Citations to this article as recorded by

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
Impact of age at diagnosis on long‐term prognosis in patients with intestinal Behçet's disease
Ji Young Chang, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jae Hee Cheon, Jihye Park
Journal of Gastroenterology and Hepatology.2024; 39(3): 519. CrossRef
Neither hepatic steatosis nor fibrosis is associated with clinical outcomes in patients with intestinal Behçet’s disease
Hye Kyung Hyun, Jihye Park, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jae Seung Lee, Hye Won Lee, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Seung Up Kim, Jae Hee Cheon
European Journal of Gastroenterology & Hepatology.2024; 36(4): 445. 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
A prospective study of inflammatory bowel disease phenotypes in extremes of age and comparison with adults
Nikhil Bhangale, Devendra Desai, Philip Abraham, Tarun Gupta, Pavan Dhoble, Anand Joshi
Indian Journal of Gastroenterology.2023; 42(3): 404. CrossRef
Global Epidemiology and Burden of Elderly-Onset Inflammatory Bowel Disease: A Decade in Review
Pojsakorn Danpanichkul, Kanokphong Suparan, Suchapa Arayakarnkul, Aunchalee Jaroenlapnopparat, Natchaya Polpichai, Panisara Fangsaard, Siwanart Kongarin, Karan Srisurapanont, Banthoon Sukphutanan, Wasuwit Wanchaitanawong, Yatawee Kanjanakot, Jakrapun Pupa
Journal of Clinical Medicine.2023; 12(15): 5142. CrossRef

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Perspective

IBD

Endoscopy for assessment of mucosal healing in ulcerative colitis: time bound or response guided?: Ajit Sood, Ramit Mahajan, Arshdeep Singh, Vandana Midha, Varun Mehta; Intest Res 2022;20(3):297-302. Published online February 8, 2022; DOI: https://doi.org/10.5217/ir.2021.00099

Abstract PDF PubReader ePub

The timing of colonoscopy in patients with active ulcerative colitis (UC) lacks coherence. The published guidelines and recommendations advocate time-bound colonoscopy in patients with active UC to assess for mucosal healing. However, the practice of performing colonoscopies at fixed time frames lacks reasoning. The time to achieve mucosal healing in UC is not uniform across the patient populations and is influenced by the disease severity and efficacy and time to therapeutic response of the drugs being used. Additionally, with the availability of sensitive noninvasive inflammatory biomarkers such as fecal calprotectin, that parallel the disease activity and correlate with mucosal healing, the notion of performing colonoscopy at fixed intervals sounds unjustifiable. The authors express their view that a response-guided colonoscopy (driven by normalization of clinical symptoms and inflammatory biomarkers), rather than a time-bound colonoscopy, would be more logical, apart from being cost-effective and patient-friendly.

Citations

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Applicability of colon capsule endoscopy for monitoring ulcerative colitis: a systematic review
Mathilde Simone Rasmussen, Lea Østergaard Hansen, Ulrik Deding, Mark Bremholm Ellebæk, Jens Kjeldsen, Thomas Bjørsum-Meyer
Scandinavian Journal of Gastroenterology.2025; 60(4): 336. CrossRef
Seeing Is Believing: Does Red Dichromatic Imaging (RDI) Predict Histological Remission and Clinical Outcomes in Ulcerative Colitis Patients?
Vedran Tomašić
Digestive Diseases and Sciences.2025;[Epub] CrossRef
Comments on Oral Sulfate Solution Is as Effective as Polyethylene Glycol with Ascorbic Acid in a Split Method for Bowel Preparation in Patients with Inactive Ulcerative Colitis: A Randomized, Multicenter, and Single-Blind Clinical Trial
Ji Eun Kim
Gut and Liver.2024; 18(1): 192. CrossRef
Ischemia-modified albumin: a novel blood marker of endoscopic mucosal healing in inflammatory bowel disease
Seung Bum Lee, Hyun-Ki Kim, Sang Hyuk Park, Ji-Hun Lim, Sang Hyoung Park
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A novel serum biomarker of endoscopic mucosal healing in inflammatory bowel disease
Hyoun Woo Kang
Intestinal Research.2024; 22(1): 3. CrossRef
Management of ulcerative colitis in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease updated in 2023
Hsu-Heng Yen, Jia-Feng Wu, Horng-Yuan Wang, Ting-An Chang, Chung-Hsin Chang, Chen-Wang Chang, Te-Hsin Chao, Jen-Wei Chou, Yenn-Hwei Chou, Chiao-Hsiung Chuang, Wen-Hung Hsu, Tzu-Chi Hsu, Tien-Yu Huang, Tsung-I Hung, Puo-Hsien Le, Chun-Che Lin, Chun-Chi Lin
Intestinal Research.2024; 22(3): 213. CrossRef
Histologic improvement predicts endoscopic remission in patients with ulcerative colitis
Ji Eun Kim, Minjee Kim, Min-Ji Kim, Eun Ran Kim, Sung Noh Hong, Dong Kyung Chang, Sang Yun Ha, Young-Ho Kim
Scientific Reports.2024;[Epub] CrossRef
Practical management of mild-to-moderate ulcerative colitis: an international expert consensus
Ferdinando D’Amico, Fernando Magro, Axel Dignass, Sameer Al Awadhi, Ana Gutierrez Casbas, Natália Sousa Freitas Queiroz, Grażyna Rydzewska, Byong Duk Ye, Zhihua Ran, Ailsa Hart, Vipul Jairath, Gionata Fiorino, Laurent Peyrin-Biroulet, Silvio Danese
Expert Review of Gastroenterology & Hepatology.2024; 18(8): 421. CrossRef
Predictive Value of PHRI for Recurrence within One Year after UC Treatment: A Retrospective Study
Kun Zhang, Jianlan Xie, Jianmin Zhao, Mei Jia
British Journal of Hospital Medicine.2024; : 1. CrossRef
Molecular Activity of Inflammation and Epithelial-Mesenchymal Transition in the Microenvironment of Ulcerative Colitis
Yu Kyung Jun, Nayoung Kim, Hyuk Yoon, Ji Hyun Park, Hyung Kyung Kim, Yonghoon Choi, Ji Ae Lee, Cheol Min Shin, Young Soo Park, Dong Ho Lee
Gut and Liver.2024; 18(6): 1037. CrossRef
Comparison of Two Types of 1-L Polyethylene Glycol-ascorbic Acid as Colonoscopic Bowel Preparation: A Prospective Randomized Study
Suh Hyun Choi, Won Eui Yoon, Seung Hyuk Kim, Hee Jun Myung, Seo Hyun Kim, Soon Oh So, Se Hun Kim, Hyun Mi Lee, Yeoun Jung Oh, Jeong Seop Moon, Tae Yeong Park, You Sun Kim
The Korean Journal of Gastroenterology.2022; 80(2): 85. CrossRef

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Review

IBD

Use of thiopurines in inflammatory bowel disease: an update: Arshdeep Singh, Ramit Mahajan, Saurabh Kedia, Amit Kumar Dutta, Abhinav Anand, Charles N. Bernstein, Devendra Desai, C. Ganesh Pai, Govind Makharia, Harsh Vardhan Tevethia, Joyce WY Mak, Kirandeep Kaur, Kiran Peddi, Mukesh Kumar Ranjan, Perttu Arkkila, Rakesh Kochhar, Rupa Banerjee, Saroj Kant Sinha, Siew Chien Ng, Stephen Hanauer, Suhang Verma, Usha Dutta, Vandana Midha, Varun Mehta, Vineet Ahuja, Ajit Sood; Intest Res 2022;20(1):11-30. Published online April 15, 2021; DOI: https://doi.org/10.5217/ir.2020.00155

Abstract PDF PubReader ePub

Inflammatory bowel disease (IBD), once considered a disease of the Western hemisphere, has emerged as a global disease. As the disease prevalence is on a steady rise, management of IBD has come under the spotlight. 5-Aminosalicylates, corticosteroids, immunosuppressive agents and biologics are the backbone of treatment of IBD. With the advent of biologics and small molecules, the need for surgery and hospitalization has decreased. However, economic viability and acceptability is an important determinant of local prescription patterns. Nearly one-third of the patients in West receive biologics as the first/initial therapy. The scenario is different in developing countries where biologics are used only in a small proportion of patients with IBD. Increased risk of reactivation of tuberculosis and high cost of the therapy are limitations to their use. Thiopurines hence become critical for optimal management of patients with IBD in these regions. However, approximately one-third of patients are intolerant or develop adverse effects with their use. This has led to suboptimal use of thiopurines in clinical practice. This review article discusses the clinical aspects of thiopurine use in patients with IBD with the aim of optimizing their use to full therapeutic potential.

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Tofacitinib Versus Oral Prednisolone for Induction of Remission in Moderately Active Ulcerative Colitis [ORCHID]: A Prospective, Open-Label, Randomized, Pilot Study
Arshdeep Singh, Vandana Midha, Kirandeep Kaur, Ramit Mahajan, Dharmatma Singh, Ramandeep Kaur, Aditya Kohli, Avantika Chawla, Kriti Sood, Namita Bansal, Ajit Sood
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Differential molecular mechanisms of substrate recognition by selenium methyltransferases, INMT and TPMT, in selenium detoxification and excretion
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Tofacitinib in Acute Severe Ulcerative Colitis (TACOS): A Randomized Controlled Trial
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Effectiveness of Tofacitinib in Ulcerative Proctitis Compared to Left Sided Colitis and Pancolitis
Arshdeep Singh, Ramit Mahajan, Vandana Midha, Kirandeep Kaur, Dharmatma Singh, Ramandeep Kaur, Shreya Garg, Kirti Arora, Namita Bansal, Ajit Sood
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Original Articles

IBD

Maintaining infliximab induced clinical remission with azathioprine and 5-aminosalicylates in acute severe steroid-refractory ulcerative colitis has lower cost and high efficacy (MIRACLE): a multicenter study: Ramit Mahajan, Arshdeep Singh, Saurabh Kedia, Kirandeep Kaur, Vandana Midha, Pabitra Sahu, Varun Mehta, Dharmatma Singh, Namita Bansal, Khushdeep Dharni, Sandeep Kaushal, Vineet Ahuja, Ajit Sood; Intest Res 2022;20(1):64-71. Published online February 3, 2021; DOI: https://doi.org/10.5217/ir.2020.00100

Abstract PDF PubReader ePub

Background/Aims
Infliximab (IFX) has been used to induce and maintain remission in patients with severe steroid-refractory ulcerative colitis (UC). Long-term use of biologics in developing countries is limited by high cost and frequent side effects. An optimal maintenance strategy in these patients needs to be established.
Methods
A retrospective analysis of maintenance of clinical remission with combination of azathioprine (AZA) and 5-aminosalicylates (5-ASA) in patients with severe steroidrefractory UC where IFX (5 mg/kg intravenously at weeks 0, 2, 6) had been used only as an induction therapy was done at 2 centers in India. Primary outcome was the proportion of patients maintaining corticosteroid-free sustained clinical remission (SCR) at the end of study period. Rates of relapse and cost of therapy were also analyzed.
Results
Of the 137 patients who received rescue IFX induction therapy, 77 (56.2%) achieved clinical remission (mean age 34.81 ± 13.32 years, 68.83% males, median follow-up 4 years, range 3 months to 6 years) and were included. Cumulative corticosteroid-free SCR was maintained in 68%, 59%, 42%, and 35% patients at 1, 2, 4, and 6 years respectively. Sixty-seven relapses were observed in 33 patients. Majority of the relapses (45/67, 67.16%) occurred within first 2 years of follow-up. Two relapses were managed with re-induction with IFX, one required colectomy, whereas all other responded to repeat course(s) of corticosteroids. Annual per capita maintenance therapy with 5-ASA and AZA was cheaper by US$ 4,526 compared to maintaining remission with IFX.
Conclusions
Clinical remission achieved with IFX induction therapy in severe steroid-refractory UC can be sustained over long time with a combination of AZA and 5-ASA.

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Tao Wang, Junquan Tian, Wenxuan Su, Fan Yang, Jie Yin, Qian Jiang, Yuying Li, Kang Yao, Tiejun Li, Yulong Yin
Nutrients.2023; 15(11): 2476. CrossRef
Management of Ulcerative Colitis: A Review of Indian Literature
Santhosh Rajendran, Ratnakar Kini, K. Muthukumaran, I. Shubha, A. Chezhian, R. Murali
Gastroenterology, Hepatology and Endoscopy Practice.2023; 3(4): 127. CrossRef
Advancements in the Management of Moderate-to-Severe Ulcerative Colitis: A Revised 2023 Korean Treatment Guidelines
Soo-Young Na
The Korean Journal of Medicine.2023; 98(5): 223. CrossRef
Effectiveness and Safety of Golimumab in Patients with Ulcerative Colitis: A Multicenter, Prospective, Postmarketing Surveillance Study
Jongwook Yu, Soo Jung Park, Hyung Wook Kim, Yun Jeong Lim, Jihye Park, Jae Myung Cha, Byong Duk Ye, Tae Oh Kim, Hyun-Soo Kim, Hyun Seok Lee, Su Young Jung, Youngdoe Kim, Chang Hwan Choi
Gut and Liver.2022; 16(5): 764. CrossRef
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Alexander Keith Turbayne, Miles Patrick Sparrow
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Identifying Care Challenges as Opportunities for Research and Education in Inflammatory Bowel Disease in South Asia
Madhura Balasubramaniam, Neilanjan Nandi, Tina Aswani-Omprakash, Shaji Sebastian, Vishal Sharma, Parakkal Deepak, Shrinivas Bishu, Neha D. Shah, Sumit Bhatia, Tauseef Ali, Sharan Khela, Kiran Peddi
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Yehyun Park, Chang Hwan Choi, Hyun Soo Kim, Hee Seok Moon, Do Hyun Kim, Jin Ju Kim, Dennis Teng, Dong Il Park
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Identifying Care Challenges as Opportunities for Research and Education in Inflammatory Bowel Disease in South Asia
Madhura Balasubramaniam, Neilanjan Nandi, Tina Aswani-Omprakash, Shaji Sebastian, Vishal Sharma, Parakkal Deepak, Shrinivas Bishu, Neha D. Shah, Sumit Bhatia, Tauseef Ali, Sharan Khela, Kiran Peddi
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Ji Young Chang, Jae Hee Cheon
Precision and Future Medicine.2021; 5(4): 151. CrossRef

7,694 View
456 Download
7 Web of Science
9 Crossref

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

Abstract PDF Supplementary Material PubReader ePub

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.

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Evaluation of Nutritional Characteristics Reveals Similar Prevalence of Malnutrition in Patients with Ulcerative Colitis and Crohn’s Disease
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Review

Inflammatory bowel diseases

Colitis and Crohn’s Foundation (India) consensus statements on use of 5-aminosalicylic acid in inflammatory bowel disease: Ajit Sood, Vineet Ahuja, Vandana Midha, Saroj Kant Sinha, C. Ganesh Pai, Saurabh Kedia, Varun Mehta, Sawan Bopanna, Philip Abraham, Rupa Banerjee, Shobna Bhatia, Karmabir Chakravartty, Sunil Dadhich, Devendra Desai, Manisha Dwivedi, Bhabhadev Goswami, Kirandeep Kaur, Rajeev Khosla, Ajay Kumar, Ramit Mahajan, S. P. Misra, Kiran Peddi, Shivaram Prasad Singh, Arshdeep Singh; Intest Res 2020;18(4):355-378. Published online July 13, 2020; DOI: https://doi.org/10.5217/ir.2019.09176

Abstract PDF PubReader ePub

Despite several recent advances in therapy in inflammatory bowel disease (IBD), 5-aminosalicylic acid (5-ASA) therapy has retained its place especially in ulcerative colitis. This consensus on 5-ASA is obtained through a modified Delphi process, and includes guiding statements and recommendations based on literature evidence (randomized trials, and observational studies), clinical practice, and expert opinion on use of 5-ASA in IBD by Indian gastroenterologists. The aim is to aid practitioners in selecting appropriate treatment strategies and facilitate optimal use of 5-ASA in patients with IBD.

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Original Article

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

Abstract PDF PubReader ePub

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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Case Report

Inflammatory bowel diseases

Incidental benefits after fecal microbiota transplant for ulcerative colitis: Ramit Mahajan, Vandana Midha, Arshdeep Singh, Varun Mehta, Yogesh Gupta, Kirandeep Kaur, Ritu Sudhakar, Anmol Singh Pannu, Dharmatma Singh, Ajit Sood; Intest Res 2020;18(3):337-340. Published online April 22, 2020; DOI: https://doi.org/10.5217/ir.2019.00108

Abstract PDF PubReader ePub

Gut dysbiosis can result in several diseases, including infections (Clostridium difficile infection and infectious gastroenteritis), autoimmune diseases (inflammatory bowel disease, diabetes, and allergic disorders), behavioral disorders and other conditions like metabolic syndrome and functional gastrointestinal disorders. Amongst various therapies targeting gut microbiome, fecal microbiota transplantation (FMT) is becoming a focus in the public media and peer reviewed literature. We have been using FMT for induction of remission in patients with moderate to severe active ulcerative colitis (UC) and also for subsequent maintenance of remission. Four cases reported incidental benefits while being treated with FMT for UC. These included weight loss (n=1), improvement in hair loss (n=1), amelioration of axial arthritis (n=1) and improvement in allergic rhinitis (n=1), thereby suggesting potential clinical applications of FMT in treating extraintestinal diseases associated with gut dysbiosis.

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Ece Tüsüz Önata, Öner Özdemir
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Yi Tang, Yongchuan She, Danping Chen, Yibo Zhou, Dan Xie, Zhai Liu
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α‐Lipoic acid alleviates dextran sulfate sodium salt‐induced ulcerative colitis via modulating the Keap1–Nrf2 signaling pathway and inhibiting ferroptosis
Peng Jiang, Zongzhen Zhai, Linxian Zhao, Kai Zhang, Liwei Duan
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Compositional changes in fecal microbiota associated with clinical phenotypes and prognosis in Korean patients with inflammatory bowel disease
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Original Articles

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

Abstract PDF PubReader ePub

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.

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Chen Li, Jindong Chu, Xiaodong Jia, Haibin Su
Frontiers in Pharmacology.2025;[Epub] CrossRef
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Mohsen Masoodi, Mohammad Sabzikarian, Nikta Masoodi, Saeed Farhadi, Gholam Reza Rezamand, Seidamir Pasha Tabaeian, Atefeh Talebi, Farimah Fayyaz
BMC Gastroenterology.2024;[Epub] CrossRef
Cryptogenic multifocal ulcerous stenosing enteritis: A ray of light on the umbra of the dark continent
Mithu Bhowmick, Vishal Sharma
Indian Journal of Gastroenterology.2024; 43(6): 1082. CrossRef
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Md Abdus Samadd, Ashfia Tasnim Munia, Most. Jannatun Ferdousi, K. M. Yasif Kayes Sikdar, Mohammad Ashraful Islam, A. S. M. Monjur Al Hossain, Md. Raihan Sarkar
Malaysian Journal of Medicine and Health Sciences.2024; 20(4): 107. CrossRef
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Jiyoung Yoon, Kee Wook Jung, Nam Seok Ham, Jihun Kim, Yoon Suh Do, Seon Ok Kim, Sang Hyun Choi, Dong Wook Kim, Sung Wook Hwang, Sang Hyoung Park, Dong‐Hoon Yang, Byong Duk Ye, Jeong‐Sik Byeon, Yong Sik Yoon, Chan Wook Kim, Chang Sik Yu, Hwoon‐Yong Jung, S
Neurogastroenterology & Motility.2023;[Epub] CrossRef
Endogenous opiates and behavior: 2020
Richard J. Bodnar
Peptides.2022; 151: 170752. CrossRef

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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

Abstract PDF Supplementary Material PubReader ePub

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

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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.2025; 16(1): 3. CrossRef
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
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
Incidence and Prevalence of Inflammatory Bowel Disease across Asia
Jihye Park, Jae Hee Cheon
Yonsei Medical Journal.2021; 62(2): 99. CrossRef
Review of exclusive enteral therapy in adult Crohn’s disease
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
Enteral nutrition in the biologic era: learn from yesterday, live for today, hope for tomorrow
Tadakazu Hisamatsu
Intestinal Research.2020; 18(2): 139. CrossRef

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186 Download
10 Web of Science
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IBD

Efficacy of fecal microbiota therapy in steroid dependent ulcerative colitis: a real world intention-to-treat analysis: Ajit Sood, Ramit Mahajan, Garima Juyal, Vandana Midha, Charanpreet Singh Grewal, Varun Mehta, Arshdeep Singh, Mohan C Joshi, Vikram Narang, Kirandeep Kaur, Hasrat Sidhu; Intest Res 2019;17(1):78-86. Published online November 20, 2018; DOI: https://doi.org/10.5217/ir.2018.00089

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Four high-quality randomized controlled trials have proven the efficacy of fecal microbiota transplantation (FMT) in active ulcerative colitis (UC). We assessed the efficacy of FMT in a real-world setting involving steroid-dependent patients with UC.
Methods
This was a single-center prospective analysis of data from steroid-dependent patients with UC treated with FMT from September 2015 to September 2017 at the Dayanand Medical College, a tertiary care center in India. Fecal samples from random unrelated donors were administered through colonoscopy at weeks 0, 2, 6, 10, 14, 18, and 22. The primary outcome was achievement of steroid-free clinical remission, and the secondary outcomes were clinical response and endoscopic remission at 24 weeks. Modified intention-to-treat analysis was performed, which included subjects who underwent at least 1 FMT.
Results
Of 345 patients with UC treated during the study period, 49 (14.2%) had steroid-dependent UC. Of these 49 patients, 41 underwent FMT: 33 completed 7 sessions over 22 weeks according to the protocol, and 8 discontinued treatment (non-response, 5; lost to follow-up, 2; and fear of adverse effects, 1). At week 24, steroid-free clinical remission was achieved in 19 out of 41 (46.3%) patients, whereas clinical response and endoscopic remission were achieved in 31 out of 41 (75.6%) and 26 out of 41 (63.4%) patients, respectively. All patients with clinical response were able to withdraw steroids. There were no serious adverse events necessitating discontinuation.
Conclusions
A multisession FMT via the colonoscopic route is a promising therapeutic option for patients with steroid-dependent UC, as it can induce clinical remission and aid in steroid withdrawal.

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Miscellaneous

A simple phenotypic classification for celiac disease: Ajit Sood, Vandana Midha, Govind Makharia, B. K. Thelma, Shivalingappa S Halli, Varun Mehta, Ramit Mahajan, Vikram Narang, Kriti Sood, Kirandeep Kaur; Intest Res 2018;16(2):288-292. Published online April 30, 2018; DOI: https://doi.org/10.5217/ir.2018.16.2.288

Abstract PDF PubReader ePub

Background/Aims

Celiac disease is a global health problem. The presentation of celiac disease has unfolded over years and it is now known that it can manifest at different ages, has varied presentations, and is prone to develop complications, if not managed properly. Although the Oslo definitions provide consensus on the various terminologies used in literature, there is no phenotypic classification providing a composite diagnosis for the disease.

Methods

Various variables identified for phenotypic classification included age at diagnosis, age at onset of symptoms, clinical presentation, family history and complications. These were applied to the existing registry of 1,664 patients at Dayanand Medical College and Hospital, Ludhiana, India. In addition, age was evaluated as below 15 and below 18 years. Cross tabulations were used for the verification of the classification using the existing data. Expert opinion was sought from both international and national experts of varying fields.

Results

After empirical verification, age at diagnosis was considered appropriate in between A1 (<18) and A2 (≥18). The disease presentation has been classified into 3 types–P1 (classical), P2 (non-classical) and P3 (asymptomatic). Complications were considered as absent (C0) or present (C1). A single phenotypic classification based on these 3 characteristics, namely age at the diagnosis, clinical presentation, and intestinal complications (APC classification) was derived.

Conclusions

APC classification (age at diagnosis, presentation, complications) is a simple disease explanatory classification for patients with celiac disease aimed at providing a composite diagnosis.

Citations

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Nidhya Ganesan, S. Shrinnivi, R. Shivani, R. K. Kartikayan
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Indian Journal of Gastroenterology.2019; 38(6): 518. CrossRef

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IBD

Efficacy and safety of the adalimumab biosimilar Exemptia as induction therapy in moderate-to-severe ulcerative colitis: Vandana Midha, Ramit Mahajan, Varun Mehta, Vikram Narang, Arshdeep Singh, Kirandeep Kaur, Ajit Sood; Intest Res 2018;16(1):83-89. Published online January 18, 2018; DOI: https://doi.org/10.5217/ir.2018.16.1.83

Abstract PDF PubReader ePub

Background/Aims

Data on the efficacy and safety of the adalimumab biosimilar Exemptia are limited.

Methods

Patients with moderate-to-severe active steroid-refractory ulcerative colitis (UC) treated at Dayanand Medical College and Hospital, India were offered cyclosporine A, biologicals or biosimilars, or surgery. A retrospective analysis was conducted on patients who were treated with the adalimumab biosimilar, Exemptia. These patients were administered an induction dosing schedule of 160 mg Exemptia at week 0, 80 mg at week 2, and then 40 mg every other week from week 4 to 8. The clinical response and remission were assessed at week 8 using Mayo score.

Results

A total of 29 patients (62.1% male; mean age, 34.9 ± 9.7 years) with moderate-to-severe steroid-refractory active UC (mean disease duration, 6.3±5.1 years; pancolitis in 9 patients [31.1%]; left-sided colitis in 20 patients [68.9%]) were treated with the Exemptia induction dosing schedule. The mean Mayo score at presentation was 8.2±1.4. At week 8, clinical response was observed in 7 patients (24.1%), whereas clinical remission was observed only in 1 patient (3.5%). Among the non-responders (n=21), 4 patients required colectomy, 1 died, 1 was lost to follow-up, 10 were offered fecal microbiota transplant, 3 were administered infliximab, and 2 patients were administered cyclosporine and tacrolimus, respectively. Four patients (13.8%) developed extrapulmonary tuberculosis.

Conclusions

The adalimumab biosimilar Exemptia has limited efficacy for the attainment of clinical response and remission in moderate-to-severe steroid-refractory UC, with a significant risk of acquisition or reactivation of tuberculosis in developing countries such as India.

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IBD

Association of endoscopic and histological remission with clinical course in patients of ulcerative colitis: Vikram Narang, Ravneet Kaur, Bhavna Garg, Ramit Mahajan, Vandana Midha, Neena Sood, Ajit Sood; Intest Res 2018;16(1):55-61. Published online January 18, 2018; DOI: https://doi.org/10.5217/ir.2018.16.1.55

Abstract PDF PubReader ePub

Background/Aims

The therapeutic goal for treating ulcerative colitis (UC) patients has shifted to achieving mucosal healing over the past few years. However, at present, limited data is available on the correlation between endoscopic findings and histological remission in patients with endoscopic mucosal healing.

Methods

This was a prospective observational study conducted over a period of 18 months (January 2014 to June 2015) at Dayanand Medical College and Hospital, Ludhiana, Punjab, India. Patients diagnosed with UC who had been in clinical remission (n=76) for at least 6 months were evaluated for endoscopic remission. Those in endoscopic remission (Mayo score ≤1; 46/76, 60.5%) were subjected to multiple biopsies from the rectosigmoid region and histological remission, which was then defined as grade 0/1 as per the Geboes criteria.

Results

Of the 46 patients in endoscopic remission (age, 18–73 years; male:female=1.5:1.0), majority had E1 (proctitis) disease (21/46, 45.6%) followed by E2 (left sided colitis) (18/46, 39.1%) and E3 disease (pancolitis) (7/46, 15.2%) at baseline. Histological remission was noted in 67.3% (31/46) of the patients, while 32.7% (15/46) still retained the histologically active disease in the form of infiltration of the lamina propria by eosinophils and neutrophils (13/15, 86.6%), cryptitis (14/15, 93.3%), and crypt abscesses (8/15, 53.3%). On follow-up, after 1 year, 87.1% (27/31) of the patients who had been in histological remission remained clinically asymptomatic, while 12.9% (4/31) had relapsed. Among the 15 histologically active patients, 46.6% (7/15) remained in clinical remission, while 53.3% (8/15) had relapsed.

Conclusions

Histological remission, rather than endoscopic remission, predicts a sustained clinical remission and allows monitoring of therapy for the subsequent disease course in patients with UC.

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Intestinal Research.2024;[Epub] CrossRef
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Rochelle Wong, Paris Charilaou, Amy Hemperly, Lihui Qin, Yushan Pan, Prerna Mathani, Randy Longman, Brigid S Boland, Parambir S Dulai, Ariela K Holmer, Dana Lukin, Siddharth Singh, Mark A Valasek, William J Sandborn, Ellen Scherl, Niels Vande Casteele, Ro
Crohn's & Colitis 360.2024;[Epub] CrossRef
Histologic Activity and Steroid Use History Are Risk Factors of Clinical Relapse in Ulcerative Colitis With Mayo Endoscopic Subscore of 0 or 1
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Inflammatory Bowel Diseases.2023; 29(2): 238. CrossRef
(Re)Appraising Remission in Ulcerative Colitis
Ajit Sood, Arshdeep Singh, Ramit Mahajan, Vandana Midha, Charles N Bernstein, David T Rubin
Inflammatory Bowel Diseases.2023; 29(8): 1317. CrossRef
Artificial Intelligence Enables Quantitative Assessment of Ulcerative Colitis Histology
Fedaa Najdawi, Kathleen Sucipto, Pratik Mistry, Stephanie Hennek, Christina K.B. Jayson, Mary Lin, Darren Fahy, Shawn Kinsey, Ilan Wapinski, Andrew H. Beck, Murray B. Resnick, Archit Khosla, Michael G. Drage
Modern Pathology.2023; 36(6): 100124. CrossRef
Impaired Intestinal Permeability Assessed by Confocal Laser Endomicroscopy—A New Potential Therapeutic Target in Inflammatory Bowel Disease
Stefan Chiriac, Catalin Victor Sfarti, Horia Minea, Carol Stanciu, Camelia Cojocariu, Ana-Maria Singeap, Irina Girleanu, Tudor Cuciureanu, Oana Petrea, Laura Huiban, Cristina Maria Muzica, Sebastian Zenovia, Robert Nastasa, Remus Stafie, Adrian Rotaru, Er
Diagnostics.2023; 13(7): 1230. CrossRef
HISTOPATHOLOGICAL FEATURES IN RELAPSE OF ULCERATIVE COLITIS.
Saroash Iqbal, Aman Ur Rehman, Nausheen Henna, Zara Madiha, Sahar Moeed, Uzma Aslam
JAIMC: Journal of Allama Iqbal Medical College.2023;[Epub] CrossRef
Mucosal Atrophy Predicts Poorer Outcomes in Pediatric Ulcerative Colitis—A National Inception Cohort Study
Emily Stenke, Lorraine Stallard, Sarah Cooper, Anna Dominik, Abigail Pilkington, Sheila Sugrue, Maureen O’Sullivan, Michael McDermott, Shoana Quinn, Annemarie Broderick, Billy Bourke, Séamus Hussey
Journal of Pediatric Gastroenterology & Nutrition.2023; 76(5): 603. CrossRef
Automating Ground Truth Annotations for Gland Segmentation Through Immunohistochemistry
Tushar Kataria, Saradha Rajamani, Abdul Bari Ayubi, Mary Bronner, Jolanta Jedrzkiewicz, Beatrice S. Knudsen, Shireen Y. Elhabian
Modern Pathology.2023; 36(12): 100331. CrossRef
Evaluation of Disease Activity in Inflammatory Bowel Disease: Diagnostic Tools in the Assessment of Histological Healing
Alina Ecaterina Jucan, Otilia Gavrilescu, Mihaela Dranga, Iolanda Valentina Popa, Ioana-Ruxandra Mihai, Vasile-Claudiu Mihai, Gabriela Stefanescu, Vasile Liviu Drug, Cristina Cijevschi Prelipcean, Radu-Alexandru Vulpoi, Oana-Bogdana Barboi, Irina Ciortesc
Biomedicines.2023; 11(11): 3090. CrossRef
Selected Cytokines and Metalloproteinases in Inflammatory Bowel Disease
Barbara Sosna, David Aebisher, Angelika Myśliwiec, Klaudia Dynarowicz, Dorota Bartusik-Aebisher, Piotr Oleś, Grzegorz Cieślar, Aleksandra Kawczyk-Krupka
International Journal of Molecular Sciences.2023; 25(1): 202. CrossRef
Utilizing Deep Learning to Analyze Whole Slide Images of Colonic Biopsies for Associations Between Eosinophil Density and Clinicopathologic Features in Active Ulcerative Colitis
Niels Vande Casteele, Jonathan A Leighton, Shabana F Pasha, Frank Cusimano, Aart Mookhoek, Catherine E Hagen, Christophe Rosty, Reetesh K Pai, Rish K Pai
Inflammatory Bowel Diseases.2022; 28(4): 539. CrossRef
Randomised clinical trial: a phase 1b study of GB004, an oral HIF‐1α stabiliser, for treatment of ulcerative colitis
Silvio Danese, Barrett G. Levesque, Brian G. Feagan, Alina Jucov, Bal Raj Bhandari, Rish K. Pai, Kristen Taylor Meadows, Brian J. Kirby, Jean‐Marie Bruey, Allan Olson, Robin Osterhout, Courtney Van Biene, Julia Ford, Richard Aranda, Kartik Raghupathi, Wil
Alimentary Pharmacology & Therapeutics.2022; 55(4): 401. CrossRef
PICaSSO Histologic Remission Index (PHRI) in ulcerative colitis: development of a novel simplified histological score for monitoring mucosal healing and predicting clinical outcomes and its applicability in an artificial intelligence system
Xianyong Gui, Alina Bazarova, Rocìo del Amor, Michael Vieth, Gert de Hertogh, Vincenzo Villanacci, Davide Zardo, Tommaso Lorenzo Parigi, Elin Synnøve Røyset, Uday N Shivaji, Melissa Anna Teresa Monica, Giulio Mandelli, Pradeep Bhandari, Silvio Danese, Jos
Gut.2022; 71(5): 889. CrossRef
Systematic review and meta-analysis: the advantage of endoscopic Mayo score 0 over 1 in patients with ulcerative colitis
Angelo Viscido, Marco Valvano, Gianpiero Stefanelli, Annalisa Capannolo, Chiara Castellini, Eugenia Onori, Antonio Ciccone, Filippo Vernia, Giovanni Latella
BMC Gastroenterology.2022;[Epub] CrossRef
Appendiceal Orifice Inflammation Is Associated with Lower Rate of Complete Endoscopic Remission in Patients with Ulcerative Colitis
Chang Kyo Oh, Han Hee Lee, Jin Su Kim, Bo-In Lee, Young-Seok Cho
Journal of Personalized Medicine.2022; 12(5): 748. CrossRef
ECCO Position on Harmonisation of Crohn’s Disease Mucosal Histopathology
F Magro, J Sabino, F Rosini, M Tripathi, P Borralho, P Baldin, S Danese, A Driessen, I O Gordon, M Iacucci, N Noor, M Svrcek, L Peyrin-Biroulet, R Feakins
Journal of Crohn's and Colitis.2022; 16(6): 876. CrossRef
Constrained multiple instance learning for ulcerative colitis prediction using histological images
Rocío del Amor, Pablo Meseguer, Tommaso Lorenzo Parigi, Vincenzo Villanacci, Adrián Colomer, Laëtitia Launet, Alina Bazarova, Gian Eugenio Tontini, Raf Bisschops, Gert de Hertogh, Jose G. Ferraz, Martin Götz, Xianyong Gui, Bu’Hussain Hayee, Mark Lazarev,
Computer Methods and Programs in Biomedicine.2022; 224: 107012. CrossRef
Ulcerative colitis: Impact of early disease clearance on long‐term outcomes ‐ A multicenter cohort study
Ferdinando D’Amico, Gionata Fiorino, Virginia Solitano, Eugenia Massarini, Lucas Guillo, Mariangela Allocca, Federica Furfaro, Alessandra Zilli, Stefanos Bonovas, Fernando Magro, Laurent Peyrin‐Biroulet, Silvio Danese
United European Gastroenterology Journal.2022; 10(7): 775. CrossRef
Efficacy and safety of ozanimod for ulcerative colitis (review)
M. V. Shapina, A. V. Poletova, T. A. Baranova
Koloproktologia.2022; 21(3): 119. CrossRef
Deep learning-based automated quantification of goblet cell mucus using histological images as a predictor of clinical relapse of ulcerative colitis with endoscopic remission
Jun Ohara, Tetsuo Nemoto, Yasuharu Maeda, Noriyuki Ogata, Shin-ei Kudo, Toshiko Yamochi
Journal of Gastroenterology.2022; 57(12): 962. CrossRef
Clinical Predictors of Response to Faecal Microbiota Transplantation in Patients with Active Ulcerative Colitis
Ajit Sood, Arshdeep Singh, Ramit Mahajan, Vandana Midha, Kirandeep Kaur, Dharmatma Singh, Namita Bansal, Khushdeep Dharni
Journal of Crohn's and Colitis.2021; 15(2): 238. CrossRef
Therapeutic drug monitoring of anti‐tumour necrosis factor‐α agents in inflammatory bowel disease: Limits and improvements
José María Giráldez‐Montero, Jaime Gonzalez‐Lopez, Manuel Campos‐Toimil, María Jesús Lamas‐Díaz
British Journal of Clinical Pharmacology.2021; 87(5): 2216. CrossRef
Histologic Features of Colon Biopsies (Geboes Score) Associated With Progression of Ulcerative Colitis for the First 36 Months After Biopsy
Fernando Magro, Catarina Alves, Joanne Lopes, Susana Lopes, Helena Tavares de Sousa, José Cotter, Vitor Macedo da Silva, Paula Lago, Ana Vieira, Mariana Brito, Maria A.M. Duarte, Francisco Portela, João P. Silva, Paula Ministro, Bruno Arroja, Liliana Carv
Clinical Gastroenterology and Hepatology.2021; 19(12): 2567. CrossRef
Treat to Target: The Role of Histologic Healing in Inflammatory Bowel Diseases: A Systematic Review and Meta-analysis
Akshita Gupta, Amy Yu, Laurent Peyrin-Biroulet, Ashwin N. Ananthakrishnan
Clinical Gastroenterology and Hepatology.2021; 19(9): 1800. CrossRef
Fecal calprotectin as a noninvasive test to predict deep remission in patients with ulcerative colitis
Ludimilla dos Reis Malvão, Kalil Madi, Barbara Cathalá Esberard, Renata Fernandes de Amorim, Kelly dos Santos Silva, Katia Farias e Silva, Heitor Siffert Pereira de Souza, Ana Teresa Pugas Carvalho
Medicine.2021; 100(3): e24058. CrossRef
Real-life evaluation of histologic scores for Ulcerative Colitis in remission
Christian Børde Arkteg, Sveinung Wergeland Sørbye, Lene Buhl Riis, Stig Manfred Dalen, Jon Florholmen, Rasmus Goll, Valérie Pittet
PLOS ONE.2021; 16(3): e0248224. CrossRef
Long-Term Efficacy and Safety of Ozanimod in Moderately to Severely Active Ulcerative Colitis: Results From the Open-Label Extension of the Randomized, Phase 2 TOUCHSTONE Study
William J Sandborn, Brian G Feagan, Stephen Hanauer, Severine Vermeire, Subrata Ghosh, Wenzhong J Liu, AnnKatrin Petersen, Lorna Charles, Vivian Huang, Keith Usiskin, Douglas C Wolf, Geert D’Haens
Journal of Crohn's and Colitis.2021; 15(7): 1120. CrossRef
Ultra-high Magnification Endocytoscopy and Molecular Markers for Defining Endoscopic and Histologic Remission in Ulcerative Colitis—An Exploratory Study to Define Deep Remission
Marietta Iacucci, Louisa Jeffery, Animesh Acharjee, Olga Maria Nardone, Davide Zardo, Samuel C L Smith, Alina Bazarova, Rosanna Cannatelli, Uday N Shivaji, John Williams, Georgios Gkoutos, Subrata Ghosh
Inflammatory Bowel Diseases.2021; 27(11): 1719. CrossRef
Raman spectroscopy accurately differentiates mucosal healing from non-healing and biochemical changes following biological therapy in inflammatory bowel disease
Samuel C. L. Smith, Carl Banbury, Davide Zardo, Rosanna Cannatelli, Olga M. Nardone, Uday N. Shivaji, Subrata Ghosh, Pola Goldberg Oppenheimer, Marietta Iacucci, Pradeep Dudeja
PLOS ONE.2021; 16(6): e0252210. CrossRef
Accurate diagnosis of endoscopic mucosal healing in ulcerative colitis using deep learning and machine learning
Tien-Yu Huang, Shan-Quan Zhan, Peng-Jen Chen, Chih-Wei Yang, Henry Horng-Shing Lu
Journal of the Chinese Medical Association.2021; 84(7): 678. CrossRef
Is histological remission of ulcerative colitis achievable?
Oleg V. Knyazev, Anna V. Kagramanova, Sergei G. Khomeriki, Asfold I. Parfenov
Terapevticheskii arkhiv.2021; 93(8): 975. CrossRef
Current Trends in IBD—Development of Mucosal-Based Biomarkers and a Novel Minimally Invasive Recoverable Sampling System
Yunki Y Yau, Valerie C Wasinger, Robert P Hirten, Emil Chuang, Merodean Huntsman, Jack Stylli, Jeff Shimizu, Vijay Yajnik, Jeffrey Smith, Shaoying N Lee, Sharat Singh, Christopher Wahl, Rupert W Leong, Bruce E Sands
Inflammatory Bowel Diseases.2021; 27(Supplement): S17. CrossRef
Histological remission of ulcerative colitis with combined anti-cytokine and cell therapy
Oleg V. Knyazev, Sergey G. Khomeriki, Аnna V. Kagramanova, Albina A. Lishchinskaya, Olga A. Smirnova, Karina K. Noskova, Asfold I. Parfenov
Terapevticheskii arkhiv.2021; 93(12): 1435. CrossRef
Histologic Activity and Steroid Use History are Risk Factors of Clinical Relapse in Ulcerative Colitis with Endoscopic Remission
Gyeol Seong, Joo Hye Song, Ji Eun Kim, Tae Jun Kim, Eun Ran Kim, Sung Noh Hong, Dong Kyung Chang, Seok-Hyung Kim, Sang Yun Ha, Young-Ho Kim
SSRN Electronic Journal .2021;[Epub] CrossRef
Relationship between Mayo endoscopic score and histological scores in ulcerative colitis: A prospective study
Jimil Shah, Usha Dutta, Ashim Das, Vishal Sharma, Harshal Mandavdhare, Pankaj Sharma, Dimple Kalsi, Priyanka Popli, Rakesh Kochhar
JGH Open.2020; 4(3): 382. CrossRef
Complete Resolution of Mucosal Neutrophils Associates With Improved Long-Term Clinical Outcomes of Patients With Ulcerative Colitis
Rish K. Pai, Douglas J. Hartman, Claudia Ramos Rivers, Miguel Regueiro, Marc Schwartz, David G. Binion, Reetesh K. Pai
Clinical Gastroenterology and Hepatology.2020; 18(11): 2510. CrossRef
Prostaglandin E-major urinary metabolite versus fecal immunochemical occult blood test as a biomarker for patient with ulcerative colitis
Natsuki Ishida, Takahiro Miyazu, Ryosuke Takano, Satoshi Tamura, Shinya Tani, Takuma Kagami, Mihoko Yamade, Yasushi Hamaya, Moriya Iwaizumi, Satoshi Osawa, Takahisa Furuta, Hiroaki Miyajima, Ken Sugimoto
BMC Gastroenterology.2020;[Epub] CrossRef
ECCO Position Paper: Harmonization of the Approach to Ulcerative Colitis Histopathology
Fernando Magro, Glen Doherty, Laurent Peyrin-Biroulet, Magali Svrcek, Paula Borralho, Alissa Walsh, Fatima Carneiro, Francesca Rosini, Gert de Hertogh, Luc Biedermann, Lieven Pouillon, Michael Scharl, Monika Tripathi, Silvio Danese, Vincenzo Villanacci, R
Journal of Crohn's and Colitis.2020; 14(11): 1503. CrossRef
Fecal calprotectin: current and future perspectives for inflammatory bowel disease treatment
Lorenzo Bertani, Maria Gloria Mumolo, Gherardo Tapete, Eleonora Albano, Giovanni Baiano Svizzero, Federico Zanzi, Linda Ceccarelli, Massimo Bellini, Santino Marchi, Francesco Costa
European Journal of Gastroenterology & Hepatology.2020; 32(9): 1091. CrossRef
What is the appropriate cut-off value of CRP to predict endoscopic remission in patients with ulcerative colitis in clinical remission?
Jongbeom Shin, Sung Min Kong, Gyeol Seong, Young-Ho Kim
International Journal of Colorectal Disease.2020; 35(12): 2249. CrossRef
Treat to target or ‘treat to clear’ in inflammatory bowel diseases: one step further?
Arianna Dal Buono, Giulia Roda, Marjorie Argollo, Eirini Zacharopoulou, Laurent Peyrin-Biroulet, Silvio Danese
Expert Review of Gastroenterology & Hepatology.2020; 14(9): 807. CrossRef
Incremental Benefit of Achieving Endoscopic and Histologic Remission in Patients With Ulcerative Colitis: A Systematic Review and Meta-Analysis
Hyuk Yoon, Sushrut Jangi, Parambir S. Dulai, Brigid S. Boland, Larry J. Prokop, Vipul Jairath, Brian G. Feagan, William J. Sandborn, Siddharth Singh
Gastroenterology.2020; 159(4): 1262. CrossRef
Assessing Severity of Disease in Patients with Ulcerative Colitis
Baldeep Singh Pabla, David Allen Schwartz
Gastroenterology Clinics of North America.2020; 49(4): 671. CrossRef
Colitis and Crohn’s Foundation (India) consensus statements on use of 5-aminosalicylic acid in inflammatory bowel disease
Ajit Sood, Vineet Ahuja, Vandana Midha, Saroj Kant Sinha, C. Ganesh Pai, Saurabh Kedia, Varun Mehta, Sawan Bopanna, Philip Abraham, Rupa Banerjee, Shobna Bhatia, Karmabir Chakravartty, Sunil Dadhich, Devendra Desai, Manisha Dwivedi, Bhabhadev Goswami, Kir
Intestinal Research.2020; 18(4): 355. CrossRef
‘Treat to Target’ in Mild to Moderate Ulcerative Colitis: Evidence to Support this Strategy
Arianna Dal Buono, Giulia Roda, Marjorie Argollo, Kristine Paridaens, Laurent Peyrin-Biroulet, Silvio Danese
Current Drug Targets.2020; 22(1): 117. CrossRef
What is the role of histopathology in the evaluation of disease activity in Crohn’s Disease?
Rish K. Pai, Vipul Jairath
Best Practice & Research Clinical Gastroenterology.2019;[Epub] CrossRef
Vedolizumab Trough Levels and Histological Healing During Maintenance Therapy in Ulcerative Colitis
Lieven Pouillon, Hélène Rousseau, Hélène Busby-Venner, Marcelo De Carvalho Bittencourt, Myriam Choukour, Guillaume Gauchotte, Camille Zallot, Silvio Danese, Cédric Baumann, Laurent Peyrin-Biroulet
Journal of Crohn's and Colitis.2019; 13(8): 970. CrossRef
Prediction of treatment outcome and relapse in inflammatory bowel disease
Jun Kato, Takeichi Yoshida, Sakiko Hiraoka
Expert Review of Clinical Immunology.2019; 15(6): 667. CrossRef
Role of Faecal Microbiota Transplantation for Maintenance of Remission in Patients With Ulcerative Colitis: A Pilot Study
Ajit Sood, Ramit Mahajan, Arshdeep Singh, Vandana Midha, Varun Mehta, Vikram Narang, Tarundeep Singh, Anmol Singh Pannu
Journal of Crohn's and Colitis.2019; 13(10): 1311. CrossRef
Mucosal healing in inflammatory bowel disease: Expanding horizon
Jimil Shah, Manik Lal Thakur, Usha Dutta
Indian Journal of Gastroenterology.2019; 38(2): 98. CrossRef
A Treat-to-Target Update in Ulcerative Colitis: A Systematic Review
Ryan Ungaro, Jean-Frédéric Colombel, Trevor Lissoos, Laurent Peyrin-Biroulet
American Journal of Gastroenterology.2019; 114(6): 874. CrossRef
A Simplified Definition of Histologic Improvement in Ulcerative Colitis and its Association With Disease Outcomes up to 30 Weeks from Initiation of Therapy: Post Hoc Analysis of Three Clinical Trials
Katherine Li, Richard Strauss, Colleen Marano, Linda E Greenbaum, Joshua R Friedman, Laurent Peyrin-Biroulet, Carrie Brodmerkel, Gert De Hertogh
Journal of Crohn's and Colitis.2019; 13(8): 1025. CrossRef
Can advanced endoscopic techniques for assessment of mucosal inflammation and healing approximate histology in inflammatory bowel disease?
Olga Maria Nardone, Rosanna Cannatelli, Davide Zardo, Subrata Ghosh, Iacucci Marietta
Therapeutic Advances in Gastroenterology.2019;[Epub] CrossRef
The emerging role of histologic disease activity assessment in ulcerative colitis
Rish K. Pai, Vipul Jairath, Niels Vande Casteele, Florian Rieder, Claire E. Parker, Gregory Y. Lauwers
Gastrointestinal Endoscopy.2018; 88(6): 887. CrossRef
Temporal clinical, proteomic, histological and cellular immune responses of dextran sulfate sodium-induced acute colitis
Natalia Schneider Nunes, Saejeong Kim, Maggie Sundby, Parwathy Chandran, Scott Robert Burks, Ana Helena Paz, Joseph Alan Frank
World Journal of Gastroenterology.2018; 24(38): 4341. CrossRef
Can histologic remission be a better prognostic factor and therapeutic target beyond endoscopic mucosal healing in patients with ulcerative colitis?
Hyo Jun Ahn, Sang-Bum Kang
Intestinal Research.2018; 16(1): 1. CrossRef

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