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

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

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
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

Citations to this article as recorded by

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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