Intestinal Research

Original Articles

IBD

Serum albumin is the strongest predictor of anti-tumor necrosis factor nonresponse in inflammatory bowel disease in resource-constrained regions lacking therapeutic drug monitoring: Peeyush Kumar, Sudheer K. Vuyyuru, Prasenjit Das, Bhaskar Kante, Mukesh Kumar Ranjan, David Mathew Thomas, Sandeep Mundhra, Pabitra Sahu, Pratap Mouli Venigalla, Saransh Jain, Sandeep Goyal, Rithvik Golla, Shubi Virmani, Mukesh K. Singh, Karan Sachdeva, Raju Sharma, Nihar Ranjan Dash, Govind Makharia, Saurabh Kedia, Vineet Ahuja; Intest Res 2023;21(4):460-470. Published online March 17, 2023; DOI: https://doi.org/10.5217/ir.2022.00128

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Background/Aims
Evidence on predictors of primary nonresponse (PNR), and secondary loss of response (SLR) to anti-tumor necrosis factor (anti-TNF) agents in inflammatory bowel disease is scarce from Asia. We evaluated clinical/biochemical/molecular markers of PNR/SLR in ulcerative colitis (UC) and Crohn’s disease (CD).
Methods
Inflammatory bowel disease patients treated with anti-TNF agents (January 2005–October 2020) were ambispectively included. Data concerning clinical and biochemical predictors was retrieved from a prospectively maintained database. Immunohistochemistry for expression of oncostatin M (OSM), OSM receptor (OSM-R), and interleukin-7 receptor (IL-7R) were done on pre anti-TNF initiation mucosal biopsies.
Results
One-hundred eighty-six patients (118 CD, 68 UC: mean age, 34.1±13.7 years; median disease duration at anti-TNF initiation, 60 months; interquartile range, 28–100.5 months) were included. PNR was seen in 17% and 26.5% and SLR in 47% and 28% CD and UC patients, respectively. In CD, predictors of PNR were low albumin (P<0.001), postoperative recurrence (P=0.001) and high IL-7R expression (P<0.027) on univariate; and low albumin alone (hazard ratio [HR], 0.09; 95% confidence interval [CI], 0.03–0.28; P<0.001) on multivariate analysis respectively. Low albumin (HR, 0.31; 95% CI, 0.15–0.62; P=0.001) also predicted SLR. In UC, predictors of PNR were low albumin (P<0.001), and high C-reactive protein (P<0.001), OSM (P<0.04) and OSM-R (P=0.07) stromal expression on univariate; and low albumin alone (HR, 0.11; 95% CI, 0.03–0.39; P=0.001) on multivariate analysis respectively.
Conclusions
Low serum albumin at baseline significantly predicted PNR in UC and PNR/SLR in CD patients. Mucosal markers of PNR were high stromal OSM/OSM-R in UC and high IL-7R in CD patients.

Citations

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Does surgical approach affect Hirschsprung-associated enterocolitis risk? A comparison between transanal Swenson-like and endorectal pull-throughs
Azzahra Fatinnuha Azmi Prayogi Putri, Dwiki Afandy, Ahmad Zakiy Habibiy, Setiani Silvy Nurhidayah, Khanza Adzkia Vujira, Pramana Adhityo, Gilang Vigorous Akbar Eka Candy, Kristy Iskandar, Eko Purnomo, Gunadi, Kota V. Ramana
PLOS One.2026; 21(1): e0340813. CrossRef
HLA-DQB1*03:01 and HLA-DQA1*05:05 as key genetic determinants of infliximab response and immunogenicity in Japanese patients with inflammatory bowel disease
Ryuya Osaka, Takeo Naito, Seik-Soon Khor, Yoichi Kakuta, Yosuke Kawai, Masao Nagasaki, Hiroshi Meguro, Hideya Iwaki, Daisuke Okamoto, Hiroshi Nagai, Yusuke Shimoyama, Rintaro Moroi, Hisashi Shiga, Yoshitaka Kinouchi, Atsushi Masamune
Journal of Gastroenterology.2026; 61(5): 547. CrossRef
Population Pharmacokinetic Model for the Use of Intravenous or Subcutaneous Infliximab in Patients with Inflammatory Bowel Disease: Real-World Data from a Prospective Cohort Study
Joo Hye Song, Sung Noh Hong, Myeong Gyu Kim, Minjung Kim, Seong Kyung Kim, Eun Ran Kim, Dong Kyung Chang, Young-Ho Kim
Gut and Liver.2025; 19(3): 376. CrossRef
The efficacy of infliximab combined with partial enteral nutrition in the treatment of Crohn’s disease: a cohort study
Chen Huang, Chao Chen, Hao Wu, Hanyu Yin, Weixiang Yao, Susu Bai, Baixue Zhuo, Xiaoli Wu
Frontiers in Nutrition.2025;[Epub] CrossRef
Effectiveness of Switching to Subcutaneous Infliximab in Ulcerative Colitis Patients Experiencing Intravenous Infliximab Failure
June Hwa Bae, Jung-Bin Park, Ji Eun Baek, Seung Wook Hong, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Sung Wook Hwang
Gut and Liver.2024; 18(4): 667. CrossRef
Progress in the Study of Inflammatory Bowel Disease Patients with Primary Non-Responsiveness
Yixue Liu, Xiaoping Tan
Journal of Biosciences and Medicines.2024; 12(01): 72. CrossRef
Tofacitinib in Steroid-Refractory Acute Severe Ulcerative Colitis: A Retrospective Analysis
Sayan Malakar, Srikanth Kothalkar, Umair Shamsul Hoda, Uday C Ghoshal
Cureus.2023;[Epub] CrossRef

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Infection

Interferon-gamma release assay has poor diagnostic accuracy in differentiating intestinal tuberculosis from Crohn’s disease in tuberculosis endemic areas: Karan Sachdeva, Peeyush Kumar, Bhaskar Kante, Sudheer K. Vuyyuru, Srikant Mohta, Mukesh K. Ranjan, Mukesh K. Singh, Mahak Verma, Govind Makharia, Saurabh Kedia, Vineet Ahuja; Intest Res 2023;21(2):226-234. Published online June 13, 2022; DOI: https://doi.org/10.5217/ir.2022.00010

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Background/Aims
Intestinal tuberculosis (ITB) and Crohn’s disease (CD) frequently present with a diagnostic dilemma because of similar presentation. Interferon-gamma release assay (IGRA) has been used in differentiating ITB from CD, but with sparse reports on its diagnostic accuracy in tuberculosis endemic regions and this study evaluated the same.
Methods
Patients with definitive diagnosis of ITB (n=59) or CD (n=49) who underwent IGRA testing (n=307) were retrospectively included at All India Institute of Medical Sciences, New Delhi (July 2014 to September 2021). CD or ITB was diagnosed as per standard criteria. IGRA was considered positive at >0.35 IU/mL. Relevant data was collected and IGRA results were compared between ITB and CD to determine its accuracy.
Results
Among 59 ITB patients (mean age, 32.6±13.1 years; median disease duration, 1 year; male, 59.3%), 24 were positive and 35 tested negative for IGRA. Among 49 CD patients (mean age, 37.8±14.0; median disease duration, 4 years; male, 61.2%), 12 were positive and 37 tested negative for IGRA. Hence, for diagnosing ITB, IGRA showed a sensitivity, specificity, positive and negative predictive values of 40.68%, 75.51%, 66.67%, and 51.39%, respectively. The area under the curve of IGRA for ITB diagnosis was 0.66 (95% confidence interval, 0.55–0.75). In a subset (n=64), tuberculin skin test (TST) showed sensitivity, specificity, positive and negative predictive values of 64.7%, 73.3%, 73.3%, and 64.71%, respectively. IGRA and TST were concordant in 38 (59.4%) patients with κ=0.17.
Conclusions
In a tuberculosis endemic region, IGRA had poor diagnostic accuracy for differentiating ITB from CD, suggesting a limited value of IGRA in this setting.

Citations

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ECCO consensus on management of inflammatory bowel disease in low- and middle-income countries
Alaa El-Hussuna, Almuthe Christina Hauer, Tarkan Karakan, Valerie Pittet, Henit Yanai, Jalpa Devi, Jesus K Yamamoto-Furusho, Ali Reza Sima, Hailemichael Desalegn, Mutaz Idrees Sultan, Vishal Sharma, Hany Shehab, Lamya Mrabti, Natalia Queiroz, Anuraag Jena
Journal of Crohn’s and Colitis.2026;[Epub] CrossRef
The Overlap Between Crohn’s Disease and Intestinal Tuberculosis: A Never-Ending Story
Sergiu Marian Cazacu, Costin Teodor Streba, Cristian Constantin, Claudiu Marinel Ionele, Ion Rogoveanu, Alexandru Valentin Popescu, Mirela-Marinela Florescu
Medicina.2026; 62(4): 794. CrossRef
Mistakes to avoid in the management of abdominal tuberculosis
Abhirup Chatterjee, Daya Krishna Jha, Aravind Sekar, Vishal Sharma
Expert Review of Anti-infective Therapy.2025; 23(2-4): 197. CrossRef
Interferon-Gamma Release Assays Versus Tuberculin Skin Test for Active Tuberculosis Diagnosis: A Systematic Review and Diagnostic Meta-Analysis
Muhammad Abubaker Tobaiqi, Musleh Naser Alshamrani, Shyamkumar Sriram, Ahmad Bakur Mahmoud, Hammad Ali Fadlalmola, Muayad Albadrani
Diagnostics.2025; 15(18): 2343. CrossRef
An Updated Review on Differential Diagnosis of Crohn's Disease and Intestinal Tuberculosis
Ravi K Sharma, Alpa Singh, Saurabh Dawra
Journal of Postgraduate Medicine, Education and Research.2025; 60(1): 18. CrossRef
New diagnostic strategies to distinguish Crohn's disease and gastrointestinal tuberculosis
Himanshu Narang, Saurabh Kedia, Vineet Ahuja
Current Opinion in Infectious Diseases.2024; 37(5): 392. CrossRef
Interferon-gamma release assays as a tool for differential diagnosis of gastrointestinal tuberculosis
Tsvetelina Velikova, Anita Aleksandrova
World Journal of Clinical Cases.2024; 12(27): 6015. CrossRef
Diagnostic yield and technical performance of the novel motorized spiral enteroscopy compared with single-balloon enteroscopy in suspected Crohn's disease: a prospective study (with video)
Partha Pal, Piyush Vishwakarma, Aniruddha Pratap Singh, Palle Manohar Reddy, Mohan Ramchandani, Rupa Banerjee, Anuradha Sekaran, Polina Vijayalaxmi, Hardik Rughwani, Pradev Inavolu, Santosh Darishetty, Pradeep Rebala, Guduru Venkat Rao, Manu Tandan, D. Na
Gastrointestinal Endoscopy.2023; 97(3): 493. CrossRef
Evidence-based approach to diagnosis and management of abdominal tuberculosis
Daya Krishna Jha, Mythili Menon Pathiyil, Vishal Sharma
Indian Journal of Gastroenterology.2023; 42(1): 17. CrossRef
Technical performance and diagnostic yield of motorised spiral enteroscopy compared with single-balloon enteroscopy in suspected Crohn’s disease: a randomised controlled, open-label study (the MOTOR-CD trial)
Partha Pal, Mohan Ramchandani, Rupa Banerjee, Piyush Viswakarma, Aniruddha Pratap Singh, Manohar Reddy, Hardik Rughwani, Rajendra Patel, Anuradha Sekaran, Swathi Kanaganti, Santosh Darisetty, Zaheer Nabi, Jagadish Singh, Rajesh Gupta, Sundeep Lakhtakia, R
Gut.2023; 72(10): 1866. CrossRef

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Brief Communication

IBD

Correlation of fecal calprotectin and patient-reported outcome measures in patients with ulcerative colitis: Nagesh Kamat, Sudheer K Vuyyuru, Saurabh Kedia, Pabitra Sahu, Bhaskar Kante, Peeyush Kumar, Mukesh Kumar Ranjan, Mukesh Kumar Singh, Sambuddha Kumar, Vikas Sachdev, Govind Makharia, Vineet Ahuja; Intest Res 2022;20(2):269-273. Published online February 8, 2022; DOI: https://doi.org/10.5217/ir.2021.00064

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Citations

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Clinical Insights on “Tolerability and Effectiveness of Glucagon‑Like Peptide‑1 Receptor Agonists in Patients with Inflammatory Bowel Disease”
XiRui Yang, FengJie Xie
Digestive Diseases and Sciences.2026; 71(2): 743. CrossRef
A patient-reported outcome measure comprising the stool frequency and abdominal pain items from the Crohn’s Disease Activity Index: psychometric evaluation in adults with Crohn’s disease
James D. Lewis, Aisha Vadhariya, Sylvia Su, Xian Zhou, Frederick Durand, Ariane K. Kawata, Larissa Stassek, Claudine Clucas, Stefan Schreiber
Journal of Patient-Reported Outcomes.2025;[Epub] CrossRef
Predictive accuracy of fecal calprotectin in assessing clinical activity and disease severity in patients with Ulcerative Colitis and Crohn’s disease
Ankit V. Jain, Sandeep Gopal, Anurag J. Shetty, Suresh Shenoy, B. V. Tantry, B. Unnikrishnan, Ramesh Holla, Rishit Anand
BMC Gastroenterology.2025;[Epub] CrossRef
Clinical outcome assessment may be a more useful tool for supporting inflammatory bowel disease clinical practice than just patient-reported outcome measures
Nagesh Kamat, Gaurav Patil, Ankit Dalal, Amit Maydeo
Current Medical Research and Opinion.2025; 41(6): 1041. CrossRef
Patient-reported outcome measures poorly correlate with objective inflammatory bowel disease activity measures: a systematic review
Xavier Calvet, Maria Giovanna Ferrario, Vanessa Marfil, Santos Armenteros, Manuel Barreiro-de Acosta
Journal of Crohn’s and Colitis.2025;[Epub] CrossRef
AI-Guided Multi-Omic Microbiome Modulation Improves Clinical and Inflammatory Outcomes in Refractory IBD: A Real-World Study
Raluca Lupusoru, Lavinia Cristina Moleriu, Ruxandra Mare, Ioan Sporea, Alina Popescu, Roxana Sirli, Adrian Goldis, Camelia Nica, Tudor Voicu Moga, Bogdan Miutescu, Iulia Ratiu, Oana Belei, Laura Olariu, Victor Dumitrascu, Radu Dumitru Dragomir
International Journal of Molecular Sciences.2025; 27(1): 201. CrossRef
Depression and active disease are the major risk factors for fatigue and sleep disturbance in inflammatory bowel disease with consequent poor quality of life: Analysis of the interplay between psychosocial factors from the developing world
Partha Pal, Rupa Banerjee, Polina Vijayalaxmi, D. Nageshwar Reddy, Manu Tandan
Indian Journal of Gastroenterology.2024; 43(1): 226. CrossRef
Research Progress in the Study of Biomarkers for Diagnosing Ulcerative Colitis or Assessing Its Activity
琳杨
Advances in Clinical Medicine.2024; 14(01): 1167. CrossRef
A novel serum biomarker of endoscopic mucosal healing in inflammatory bowel disease
Hyoun Woo Kang
Intestinal Research.2024; 22(1): 3. CrossRef
The prevalence and burden of Rome IV faecal incontinence in ulcerative colitis: A cross‐sectional study
Dipesh H. Vasant, Gaurav B. Nigam, Sebastian Bate, Shaheen Hamdy, Jimmy K. Limdi
Alimentary Pharmacology & Therapeutics.2023; 58(1): 26. CrossRef
Current and emerging biomarkers for ulcerative colitis
Jan K. Nowak, Rahul Kalla, Jack Satsangi
Expert Review of Molecular Diagnostics.2023; 23(12): 1107. CrossRef

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Original Articles

IBD

Efficacy and tolerability of hyperbaric oxygen therapy in small bowel stricturing Crohn’s disease: a pilot study: Bhaskar Kante, Pabitra Sahu, Saurabh Kedia, Sudheer K. Vuyyuru, Kapil Soni, Maneesh Singhal, Raju Sharma, Govind Makharia, Vineet Ahuja; Intest Res 2022;20(2):231-239. Published online February 8, 2022; DOI: https://doi.org/10.5217/ir.2021.00056

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Background/Aims
Existing therapeutic options for complicated Crohn’s disease (CD) like biologics and surgery are limited by inadequate long-term efficacy, cost, and adverse effects. Tissue hypoxia is important in CD pathogenesis and may be ameliorated with hyperbaric oxygen therapy (HBOT). We assessed the efficacy and tolerability of HBOT in small bowel stricturing CD.
Methods
This pilot study included patients of small bowel stricturing CD (from April 2019 to January 2020) who underwent HBOT. These patients were refractory to conventional medical treatment or had multiple strictures not amenable to resection. Each session of HBOT was given for 60 minutes with a pressure of 1.5–2.5 atm. Clinical, biochemical responses and Short Inflammatory Bowel Disease (SIBD) questionnaire were evaluated at 2 and 6 months, and radiological response was evaluated at 6 months.
Results
Fourteen patients (mean age, 42.9±15.7 years; male, 50%) were subjected to 168 HBOT sessions. Thirteen patients (92.7%) had strictures and 1 patient had enterocutaneous fistula in addition. Median number of HBOT sessions was 11 (range, 3–20) which were administered over a median of 4 weeks. Most patients tolerated it well except 1 who had hemotympanum. At 2 and 6 months of follow-up, 64.2% of patients had a clinical response, 50% and 64.2% of patients had clinical remission respectively. Steroid-free clinical remission was seen in 8 (57%) of patients with radiological improvement in 50%. There was a significant improvement in SIBD scores at 2-month follow-up (59.4 vs. 44.5, P=0.03).
Conclusions
HBOT can be a safe and effective therapeutic option in patients with stricturing small bowel CD refractory to conventional medical treatment.

Citations

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Characterization of fatty acid composition of bone marrow by 3-T MRI in patients with Crohn’s disease
Shuling Wang, Shuaishuai Liu, Shuyue Wang, Yongsen Han, Rui Ji, Rui Tang, Yun Tu, Caixia Fu, Manuel Schneider, Jingqi Zhu
European Radiology.2026;[Epub] CrossRef
From Pharmaceutical to Biophysical Therapies: New Horizons in Inflammatory Bowel Disease Management
Benedetta Ricchi, Alejandra A. Carriles, Samuel Elias Pineda Chavez, Stefanos Bonovas, Arianna Dal Buono, Cristina Bezzio, Alessandro Armuzzi, Stefania Vetrano
JCC Plus.2026;[Epub] CrossRef
Hyperbaric oxygen therapy in inflammatory bowel disease: Current evidence and research progress
Zhe-Heng Li, Wen-Song Ge
World Chinese Journal of Digestology.2026; 34(3): 236. CrossRef
Risk of avascular necrosis in patients with inflammatory bowel disease: Insights from a nationwide cohort study and the impact of corticosteroid use
Jung Min Moon, Kyoung-Eun Kwon, Ju Won Lee, Kyung Rok Minn, Kyuwon Kim, Jeongkuk Seo, Seung Yong Shin, Sun-Young Jung, Chang Hwan Choi
Digestive and Liver Disease.2025; 57(1): 176. CrossRef
Hyperbaric oxygen therapy as a possible therapeutic candidate for sepsis-associated encephalopathy: A novel hypothesis
Sung Eun Lee, Eunjung Park, Ji-yun Kim, HyukHoon Kim
Medical Hypotheses.2024; 182: 111212. CrossRef
Treating paediatric Crohn’s disease is challenging but new treatments hold promise
Tina Nie
Drugs & Therapy Perspectives.2024; 40(3): 121. CrossRef
The Future of Advanced Therapies for Pediatric Crohn’s Disease
Julie Gallagher, Joel R. Rosh, Benjamin Sahn
Pediatric Drugs.2023; 25(6): 621. CrossRef
Role of hyperbaric oxygen therapy in patients with inflammatory bowel disease
Harpreet Kaur, Gursimran Singh Kochhar, Parambir S. Dulai
Current Opinion in Gastroenterology.2023; 39(4): 263. CrossRef

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Miscellaneous

Addition of computed tomography chest increases the diagnosis rate in patients with suspected intestinal tuberculosis: Saurabh Kedia, Raju Sharma, Sudheer Kumar Vuyyuru, Deepak Madhu, Pabitra Sahu, Bhaskar Kante, Prasenjit Das, Ankur Goyal, Karan Madan, Govind Makharia, Vineet Ahuja; Intest Res 2022;20(2):184-191. Published online May 4, 2021; DOI: https://doi.org/10.5217/ir.2020.00104

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Background/Aims
Intestinal tuberculosis (ITB) is difficult to diagnose due to poor sensitivity of definitive diagnostic tests. ITB may be associated with concomitant pulmonary tuberculosis (PTB) which may remain undetected on chest X-ray. We assessed the role of contrast enhanced computed tomography (CECT) chest in detecting the prevalence of active PTB, and increasing the diagnostic yield in patients with suspected ITB.
Methods
Consecutive treatment naïve patients with suspected ITB (n=200) who underwent CECT chest (n=88) and had follow-up duration>1 year were recruited in this retrospective study (February 2016 to October 2018). ITB was diagnosed in the presence of caseating granuloma, positive acid fast stain or culture for Mycobacterium tuberculosis on biopsy, presence of necrotic lymph nodes (LNs) on CT enterography or positive response to anti-tubercular therapy. Evidence of active tuberculosis on CECT-chest was defined as presence of centrilobular nodules with or without consolidation/miliary nodules/thick-walled cavity/enlarged necrotic mediastinal LNs.
Results
Sixty-five of eighty-eight patients (mean age, 33.8±12.8 years; 47.7% of females) were finally diagnosed as ITB (4-caseating granuloma on biopsy, 12-necrotic LNs on CT enterography, 1-both, and 48-response to anti-tubercular therapy) and 23 were diagnosed as Crohn’s disease. Findings of active TB on CECT chest with or without necrotic abdominal LNs were demonstrated in 5 and 20 patients, respectively. No patient with Crohn’s disease had necrotic abdominal LNs or active PTB. Addition of CECT chest in the diagnostic algorithm improved the sensitivity of ITB diagnosis from 26.2% to 56.9%.
Conclusions
Addition of CECT chest significantly improves the sensitivity for definite diagnosis in a patient with suspected ITB.

Citations

Citations to this article as recorded by

The Overlap Between Crohn’s Disease and Intestinal Tuberculosis: A Never-Ending Story
Sergiu Marian Cazacu, Costin Teodor Streba, Cristian Constantin, Claudiu Marinel Ionele, Ion Rogoveanu, Alexandru Valentin Popescu, Mirela-Marinela Florescu
Medicina.2026; 62(4): 794. CrossRef
Navigating the Differential Diagnosis of Intestinal Tuberculosis and Crohn's Disease
Venigalla Pratap Mouli, Saurabh Kedia, Vishal Sharma, Anna Benjamin Pulimood, Raju Sharma, Vineet Ahuja
Gastroenterology.2025; 169(6): 1139. CrossRef
Tuberculosis intestinal: una aproximación a su diagnóstico desde el punto de vista tomográfico
Carlos Alfredo Iñiguez-Guzmán, Joel Sebastian Vintimilla-Contreras
Health Care & Global Health.2025; : 149. CrossRef
Imaging in Abdominal Tuberculosis
Anuradha Sharma, Ankur Goyal, Devasenathipathy Kandasamy, Saurabh Kedia, Vineet Ahuja, Raju Sharma
Indographics.2024; 03(02): 045. CrossRef
Evidence-based approach to diagnosis and management of abdominal tuberculosis
Daya Krishna Jha, Mythili Menon Pathiyil, Vishal Sharma
Indian Journal of Gastroenterology.2023; 42(1): 17. CrossRef
Risk factors identification of COVID‐19 patients with chronic obstructive pulmonary disease: A retrospective study in Punjab‐Pakistan
Muhammad Muneeb Hassan, M. H. Tahir, Muhammad Ameeq, Farrukh Jamal, John T. Mendy, Christophe Chesneau
Immunity, Inflammation and Disease.2023;[Epub] CrossRef
Strengthening Tuberculosis Services for Children and Adolescents in Low Endemic Settings
Jeffrey R. Starke, Connie Erkens, Nicole Ritz, Ian Kitai
Pathogens.2022; 11(2): 158. CrossRef
Stringent screening strategy significantly reduces reactivation rates of tuberculosis in patients with inflammatory bowel disease on anti‐TNF therapy in tuberculosis endemic region
Peeyush Kumar, Sudheer K. Vuyyuru, Bhaskar Kante, Pabitra Sahu, Sandeep Goyal, Deepak Madhu, Saransh Jain, Mukesh Kumar Ranjan, Sandeep Mundhra, Rithvik Golla, Mukesh Singh, Shubi Virmani, Anvita Gupta, Nidhi Yadav, Mani Kalaivani, Raju Sharma, Prasenjit
Alimentary Pharmacology & Therapeutics.2022; 55(11): 1431. CrossRef

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Inflammatory Bowel Diseases

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

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

Citations

Citations to this article as recorded by

Advancing Clinical Trial Methodology and Reporting of Outcomes for Exclusive Enteral Nutrition and Partial Enteral Nutrition in Crohn's Disease: Challenges and Recommendations
Sarah L. Melton, Jessica Fitzpatrick, Matthew K. W. Chu, Konstantinos Gkikas, Emily Monro, Jemma Matthews, Emma P. Halmos, Alice S. Day
JCC Plus.2026;[Epub] CrossRef
Using machine learning to predict clinical remission with exclusive enteral nutrition in pediatric Crohn disease
Ricardo G. Suarez Suarez, Daniel G. McClement, Roberto Vega, Hien Q. Huynh, Ayub Shaikh, Anthony Otley, Kevan Jacobson, Mary Sherlock, David R. Mack, Colette Deslandres, Wael El‐Matary, Eileen Crowley, Jennifer deBruyn, Thomas Walters, Anne M. Griffiths,
Journal of Pediatric Gastroenterology and Nutrition.2026; 82(2): 465. CrossRef
ECCO consensus on management of inflammatory bowel disease in low- and middle-income countries
Alaa El-Hussuna, Almuthe Christina Hauer, Tarkan Karakan, Valerie Pittet, Henit Yanai, Jalpa Devi, Jesus K Yamamoto-Furusho, Ali Reza Sima, Hailemichael Desalegn, Mutaz Idrees Sultan, Vishal Sharma, Hany Shehab, Lamya Mrabti, Natalia Queiroz, Anuraag Jena
Journal of Crohn’s and Colitis.2026;[Epub] CrossRef
The Crohn's Disease Exclusion Diet Across the Lifespan, Indications and the Globe: An Expert Review Towards Personalized Therapy in Crohn's Disease
Rotem Sigall Boneh, Elena Banci, Luca Scarallo, Marta Herrador‐López, Emma P. Halmos, Dror S. Shouval, Nicolette Wierdsma, Chen Sarbagili‐Shabat, Víctor Manuel Navas‐López, Javier Martín‐de‐Carpi, Yulia Ron, Lindsey Albenberg, Henit Yanai, Franck Carbonne
JCC Plus.2026;[Epub] CrossRef
Exclusive enteral nutrition for induction of remission in Crohn’s disease in adults: A systematic review and meta-analysis of randomized trials and real-world studies
Kirandeep Kaur, Arshdeep Singh, Simrat Kaur, Riya Sharma, Sanya Malik, Arshia Bhardwaj, Anuraag Jena, Ramit Mahajan, Vandana Midha, Ajit Sood
Indian Journal of Gastroenterology.2026;[Epub] CrossRef
Adjunct polymeric exclusive enteral nutrition helps achieve biochemical remission in active Crohn’s disease in adults irrespective of disease location and concomitant corticosteroid use
Hellen Kuo, Katrina Tognolini, Rumbidzai Mutsekwa, Dheeraj Shukla, Laura Willmann, Hadi Moattar, Alexander Dorrington, Naveed Ishaq, Maneesha Bhullar, John Edwards, Waled Mohsen, Pradeep Kakkadasam Ramaswamy
Frontline Gastroenterology.2025; 16(1): 3. CrossRef
Inflammatory bowel disease in south Asia: a scoping review
Shabari Shenoy, Anuraag Jena, Carrie Levinson, Vishal Sharma, Parakkal Deepak, Tina Aswani-Omprakash, Shaji Sebastian, Jean-Frederic Colombel, Manasi Agrawal
The Lancet Gastroenterology & Hepatology.2025; 10(3): 259. CrossRef
Enteral Nutrition in Crohn’s Disease: A Comprehensive Review of Its Role in Induction and Maintenance of Remission and Perioperative Management in Adult Patients
André Bargas, Carolina Palmela, Luisa Glória
Nutrients.2025; 17(9): 1481. CrossRef
Pancreatic Enzyme Replacement Therapy Improves Exclusive Enteral Nutrition Related Diarrhea in Crohn's Disease: A Prospective Randomized Trial
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