Intestinal Research

Original Articles

Clinical characteristics and long-term disease course in patients with Crohn’s disease as diagnosed by video capsule endoscopy: a multicenter retrospective matched case-control study: June Hwa Bae, Su Hyun Park, Jung-Bin Park, Ji Eun Baek, Seung Wook Hong, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Kyeong Ok Kim, Byung Ik Jang, Mi Rae Lee, Eun Soo Kim, Sang Hyoung Park; Received April 18, 2024 Accepted July 15, 2024 Published online August 29, 2024; DOI: https://doi.org/10.5217/ir.2024.00056 [Epub ahead of print]

Abstract PDF PubReader ePub: Background/Aims
Video capsule endoscopy is rarely used to diagnose Crohn’s disease in patients with negative ileocolonoscopy or cross-sectional image findings. We evaluated clinical characteristics and long-term outcomes of these rare cases.
Methods
This multicenter study included patients with Crohn’s disease from 3 tertiary hospitals from January 2007 to October 2022. Patients with normal findings on ileocolonoscopy and computed tomography (CT)/magnetic resonance (MR) enterography but had ulcerations at the small bowel detected by video capsule endoscopy were included. The controls were patients with abnormal findings on endoscopy or CT/MR enterography. Controls were case-matched in a ratio of 3:1 for sex, calendar year of diagnosis, and age at diagnosis.
Results
Among 3,752 patients, 24 (0.6%) were diagnosed with Crohn’s disease using video capsule endoscopy findings. The disease location (P< 0.001) and behavior at diagnosis (P= 0.013) of the cases significantly differed from that of controls. The perianal fistula modifier (25.0% vs. 33.3%, P= 0.446) did not differ significantly between the 2 groups. Initial disease activity and C-reactive protein and fecal calprotectin levels were significantly lower in cases versus controls. The median Lewis score was 838 (interquartile range, 393–1,803). Over 10 years of follow-up, the cases showed significantly lower cumulative risk of complicated behavior, biologics use, Crohn’s disease-related hospitalization, and surgeries (log-rank test P< 0.05).
Conclusions
Patients with Crohn’s disease whose lesions were observed only by video capsule endoscopy were rare, and exhibit different clinical characteristics and a more favorable long-term disease course compared to those who were conventionally diagnosed.

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IBD

Perspectives of East Asian patients and physicians on complementary and alternative medicine use for inflammatory bowel disease: results of a cross-sectional, multinational study: Eun Soo Kim, Chung Hyun Tae, Sung-Ae Jung, Dong Il Park, Jong Pil Im, Chang Soo Eun, Hyuk Yoon, Byung Ik Jang, Haruhiko Ogata, Kayoko Fukuhara, Fumihito Hirai, Kazuo Ohtsuka, Jing Liu, Qian Cao, on behalf of the Clinical Research Committee of the Asian Organization for Crohn’s and Colitis; Intest Res 2022;20(2):192-202. Published online April 29, 2022; DOI: https://doi.org/10.5217/ir.2020.00150

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Complementary and alternative medicine (CAM) is prevalent in East Asia. However, information on CAM in East Asian patients with inflammatory bowel disease (IBD) is scarce. We aimed to profile the prevalence and pattern of CAM use among East Asian IBD patients and to identify factors associated with CAM use. We also compared physicians’ perspectives on CAM.
Methods
Patients with IBD from China, Japan, and South Korea were invited to complete questionnaires on CAM use. Patient demographic and clinical data were collected. Logistic regression analysis was applied for predictors of CAM use. Physicians from each country were asked about their opinion on CAM services or products.
Results
Overall, 905 patients with IBD participated in this study (China 232, Japan 255, and South Korea 418). Approximately 8.6% of patients with IBD used CAM services for their disease, while 29.7% of patients sought at least 1 kind of CAM product. Current active disease and Chinese or South Korean nationality over Japanese were independent predictors of CAM use. Chinese doctors were more likely to consider CAM helpful for patients with IBD than were Japanese and South Korean doctors.
Conclusions
In 8.6% and 29.7% of East Asian patients with IBD used CAM services and products, respectively, which does not differ from the prevalence in their Western counterparts. There is a significant gap regarding CAM usage among different Asian countries, not only from the patients’ perspective but also from the physicians’ point of view.

Citations

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Recent Perspective of Lactobacillus in Reducing Oxidative Stress to Prevent Disease
Tingting Zhao, Haoran Wang, Zhenjiang Liu, Yang Liu, DeJi, Bin Li, Xiaodan Huang
Antioxidants.2023; 12(3): 769. CrossRef
The Role of Bitter Melon in Breast and Gynecological Cancer Prevention and Therapy
Iason Psilopatis, Kleio Vrettou, Constantinos Giaginis, Stamatios Theocharis
International Journal of Molecular Sciences.2023; 24(10): 8918. CrossRef

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Review

IBD

Management of inflammatory bowel disease in the COVID-19 era: Kyeong Ok Kim, Byung Ik Jang; Intest Res 2022;20(1):3-10. Published online February 3, 2021; DOI: https://doi.org/10.5217/ir.2020.00156

Abstract PDF PubReader ePub

During the coronavirus disease 2019 (COVID-19) pandemic, many unpredictable changes have occurred in the medical field. Risk of COVID-19 does not seem to increase in patients with inflammatory bowel disease (IBD) considering based on current reports. Current medications for IBD do not increase this risk; on the contrary, some of these might be used as therapeutics against COVID-19 and are under clinical trial. Unless the patients have confirmed COVID-19 and severe pneumonia or a high oxygen demand, medical treatment should be continued during the pandemic, except for the use of high-dose corticosteroids. Adherence to general recommendations such as social distancing, wearing facial masks, and vaccination, especially for pneumococcal infections and influenza, is also required. Patients with COVID-19 need to be withhold immunomodulators or biologics for at least 2 weeks and treated based on both IBD and COVID-19 severity. Prevention of IBD relapse caused by sudden medication interruption is important because negative outcomes associated with disease flare up, such as corticosteroid use or hospitalization, are much riskier than medications. The outpatient clinic and infusion center for biologics need to be reserved safe spaces, and endoscopy or surgery should be considered in urgent cases only.

Citations

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The Anti-SARS-CoV-2 IgG1 and IgG3 Antibody Isotypes with Limited Neutralizing Capacity against Omicron Elicited in a Latin Population a Switch toward IgG4 after Multiple Doses with the mRNA Pfizer–BioNTech Vaccine
Ana M. Espino, Albersy Armina-Rodriguez, Laura Alvarez, Carlimar Ocasio-Malavé, Riseilly Ramos-Nieves, Esteban I. Rodriguez Martinó, Paola López-Marte, Esther A. Torres, Carlos A. Sariol
Viruses.2024; 16(2): 187. CrossRef
Mobile monitoring system detects the disease activity pattern and shows the association with clinical outcomes in patients with newly diagnosed Crohn’s disease
Yoo Jin Lee, Sang Gyu Kwak, Eun Soo Kim, Sung Kook Kim, Hyun Seok Lee, Yun Jin Chung, Byung Ik Jang, Kyeong Ok Kim, Jeongseok Kim, Hyeong Ho Jo, Eun Young Kim
Scientific Reports.2024;[Epub] CrossRef
Has the COVID-19 Pandemic Worsened Health-Related Quality of Life of Patients with Inflammatory Bowel Disease? A Longitudinal Disease Activity-Controlled Study
Ilenia Rosa, Chiara Conti, Luigia Zito, Konstantinos Efthymakis, Matteo Neri, Piero Porcelli
International Journal of Environmental Research and Public Health.2023; 20(2): 1103. CrossRef
Thiopurine therapy in inflammatory bowel disease in the pandemic era: Safe or unsafe?
Shailesh Perdalkar, Pooja Basthi Mohan, Balaji Musunuri, Siddheesh Rajpurohit, Shiran Shetty, Krishnamurthy Bhat, Cannanore Ganesh Pai
International Immunopharmacology.2023; 116: 109597. CrossRef
Coronavirus disease 2019 (COVID-19) in pediatric patients with autoimmune disorders
Parniyan Sadeghi, Parmida Sadat Pezeshki, Nima Rezaei
European Journal of Pediatrics.2023; 182(7): 2967. CrossRef
Perceptions and Behaviors of Patients with Inflammatory Bowel Disease during the COVID-19 Crisis
Yoo Jin Lee, Kyeong Ok Kim, Min Cheol Kim, Kwang Bum Cho, Kyung Sik Park, Byeong Ik Jang
Gut and Liver.2022; 16(1): 81. CrossRef
SARS-CoV-2 vaccination for adult patients with inflammatory bowel disease: expert consensus statement by KASID
Yoo Jin Lee, Seong-Eun Kim, Yong Eun Park, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Jae Gon Lee, Hee Chan Yang, Miyoung Choi, Seung-Jae Myung
Intestinal Research.2022; 20(2): 171. CrossRef
Risks of SARS-CoV-2 Infection and Immune Response to COVID-19 Vaccines in Patients With Inflammatory Bowel Disease: Current Evidence
Susanna Esposito, Caterina Caminiti, Rosanna Giordano, Alberto Argentiero, Greta Ramundo, Nicola Principi
Frontiers in Immunology.2022;[Epub] CrossRef
Update on SARS-CoV-2 vaccination of patients with inflammatory bowel disease: what clinicians need to know
Yoo Jin Lee, Seong-Eun Kim, Yong Eun Park, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Jae Gon Lee, Hee Chan Yang, Seung-Jae Myung
Intestinal Research.2022; 20(3): 386. CrossRef
Inflammatory Bowel Disease Management during the COVID-19 Pandemic: A Literature Review
Ahmad Hormati, Alireza Arezoumand, Hadi Dokhanchi, Mehdi Pezeshgi Modarres, Sajjad Ahmadpour
Middle East Journal of Digestive Diseases.2022; 14(2): 155. CrossRef
Inefficient Induction of Neutralizing Antibodies against SARS-CoV-2 Variants in Patients with Inflammatory Bowel Disease on Anti-Tumor Necrosis Factor Therapy after Receiving a Third mRNA Vaccine Dose
Paola López-Marte, Alondra Soto-González, Lizzie Ramos-Tollinchi, Stephan Torres-Jorge, Mariana Ferre, Esteban Rodríguez-Martinó, Esther A. Torres, Carlos A. Sariol
Vaccines.2022; 10(8): 1301. CrossRef
Vaccination strategies for Korean patients with inflammatory bowel disease
Yoo Jin Lee, Eun Soo Kim
The Korean Journal of Internal Medicine.2022; 37(5): 920. CrossRef
Korean Association for the Study of Intestinal Diseases guidance for clinical practice of adult inflammatory bowel disease during the coronavirus disease 2019 pandemic: expert consensus statements
Yong Eun Park, Yoo Jin Lee, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Jae Gon Lee, Hee Chan Yang, Miyoung Choi, Seong-Eun Kim, Seung-Jae Myung
Intestinal Research.2022; 20(4): 431. CrossRef
Physician education can minimize inappropriate steroid use in patients with inflammatory bowel disease: the ACTION study
Yehyun Park, Chang Hwan Choi, Hyun Soo Kim, Hee Seok Moon, Do Hyun Kim, Jin Ju Kim, Dennis Teng, Dong Il Park
Intestinal Research.2022; 20(4): 452. CrossRef
Endoscopy within 7 days after detecting high calprotectin levels can be useful for therapeutic decision-making in ulcerative colitis
Ho Min Yong, Sung-Jo Park, Seong Ran Jeon, Heesu Park, Hyun Gun Kim, Tae Hee Lee, Junseok Park, Jin-Oh Kim, Joon Seong Lee, Bong Min Ko, Hyeon Jeong Goong, Suyeon Park
Medicine.2021; 100(34): e27065. CrossRef
SARS-CoV-2 Vaccination for Adult Patients with Inflammatory Bowel Disease: Expert Consensus Statements by KASID
Yoo Jin Lee, Seong-Eun Kim, Yong Eun Park, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Jae Gon Lee, Hee Chan Yang, Miyoung Choi, Seung-Jae Myung
The Korean Journal of Gastroenterology.2021; 78(2): 117. CrossRef
KASID Guidance for Clinical Practice Management of Adult Inflammatory Bowel Disease during the COVID-19 Pandemic: Expert Consensus Statement
Yong Eun Park, Yoo Jin Lee, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Jae Gon Lee, Hee Chan Yang, Miyoung Choi, Seong-Eun Kim, Seung-Jae Myung
The Korean Journal of Gastroenterology.2021; 78(2): 105. CrossRef
Risk, Course, and Effect of SARS-CoV-2 Infection in Children and Adults with Chronic Inflammatory Bowel Diseases
Angelica Corrias, Gian Mario Cortes, Flaminia Bardanzellu, Alice Melis, Vassilios Fanos, Maria Antonietta Marcialis
Children.2021; 8(9): 753. CrossRef

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Original Articles

Endoscopy

Histologic discrepancy between endoscopic forceps biopsy and endoscopic mucosal resection specimens of colorectal polyp in actual clinical practice: Moon Joo Hwang, Kyeong Ok Kim, A Lim Kim, Si Hyung Lee, Byung Ik Jang, Tae Nyeun Kim; Intest Res 2018;16(3):475-483. Published online July 27, 2018; DOI: https://doi.org/10.5217/ir.2018.16.3.475

Abstract PDF PubReader ePub

Background/Aims

We aimed to assess the rate of histologic discrepancy (HD) between endoscopic forceps biopsy (EFB) and totally resected specimens in colorectal polyp and analyze the risk factors of discordant group, especially under-diagnosis (UD) cases before complete removal of colorectal polyp.

Methods

From 2010 to 2015, a total of 290 polyps in 210 patients which had baseline pathology report before endoscopic resection (ER) were analyzed. UD cases were defined as those in which the diagnosis changed to a more advanced histologic feature after ER.

Results

A change in the final histology after ER was noted in 137 cases (47.2%), and after excluding 9 insignificant cases, 128 cases were further categorized into over-diagnosed and under-diagnosed group. UD occurred in 86 cases (29.7%) and change from benign to malignancy was noted in 26 cases (8.9%). On univariate analysis, a larger polyp size (>10 mm) was significantly associated with both HD (P<0.001) and UD (P<0.001). Regarding polyp morphology, protruding or flat was not significantly important. On multivariate analysis, polyp size >10 mm was the single most significant predictor of both HD (P<0.001) and UD (P<0.001).

Conclusions

The HD and UD rates were 47.2% and 29.7%, respectively. Polyp size >10 mm was the most important predictor of both HD and UD. We should be careful in making treatment strategy of colorectal polyp based on histologic report of EFB especially when the size of polyp is >10 mm.

Citations

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Genetic Analysis of Biopsy Tissues from Colorectal Tumors in Patients with Ulcerative Colitis
Noriko Yamamoto, Yuji Urabe, Hikaru Nakahara, Takeo Nakamura, Daisuke Shimizu, Hirona Konishi, Kazuki Ishibashi, Misa Ariyoshi, Ryo Miyamoto, Junichi Mizuno, Takeshi Takasago, Akira Ishikawa, Akiyoshi Tsuboi, Hidenori Tanaka, Ken Yamashita, Yuichi Hiyama,
Cancers.2024; 16(19): 3271. CrossRef
Comparing efficacy and factors of postoperative bleeding in endoscopic mucosal resection vs coagulation for intestinal polyps
Zhiang Li, Fei Yu, Chaoqian Wang, Zhang Du
Medicine.2023; 102(37): e34941. CrossRef
“Unresectable” polyp management utilizing advanced endoscopic techniques results in high rate of colon preservation
Carey J. Wickham, Jennifer Wang, Kasim L. Mirza, Erik R. Noren, Joongho Shin, Sang W. Lee, Kyle G. Cologne
Surgical Endoscopy.2022; 36(3): 2121. CrossRef
Potential Factors Predicting Histopathologically Upgrade Discrepancies between Endoscopic Forceps Biopsy of the Colorectal Low-Grade Intraepithelial Neoplasia and Endoscopic Resection Specimens
Junbo Hong, Yining Wang, Jiangshan Deng, Miao Qi, Wei Zuo, Yuanzheng Hao, Anjiang Wang, Yi Tu, Shan Xu, Xiaodong Zhou, Xiaojiang Zhou, Guohua Li, Liang Zhu, Xu Shu, Yin Zhu, Nonghua Lv, Youxiang Chen, Li-kang Sun
BioMed Research International.2022; 2022: 1. CrossRef
Endoscopic vs optical biopsy for patients with colorectal lesions: prospective multicentral trial
K.D. Khalin, M.Yu. Agapov, E.D. Fedorov, L.V. Zvereva, N.E. Ogurchyonok, K.V. Stegnii, E.V. Ivanova, E.R. Dvoinikova, E.V. Gorbachev
Dokazatel'naya gastroenterologiya.2022; 11(3): 11. CrossRef
Long-term Outcomes of Primary Endoscopic Resection vs Surgery for T1 Colorectal Cancer: A Systematic Review and Meta-analysis
Jen-Hao Yeh, Cheng-Hao Tseng, Ru-Yi Huang, Chih-Wen Lin, Ching-Tai Lee, Po-Jen Hsiao, Tsung-Chin Wu, Liang-Tseng Kuo, Wen-Lun Wang
Clinical Gastroenterology and Hepatology.2020; 18(12): 2813. CrossRef
Prophylactic endoscopic coagulation to prevent delayed post-EMR bleeding in the colorectum: a prospective randomized controlled trial (with videos)
Hyun Seok Lee, Seong Woo Jeon, Yong Hwan Kwon, Su Youn Nam, Seonghwan Shin, Ryanghi Kim, Sohyun Ahn
Gastrointestinal Endoscopy.2019; 90(5): 813. CrossRef

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IBD

Nonimmunity against hepatitis B virus infection in patients newly diagnosed with inflammatory bowel disease: Seong Jae Yeo, Hyun Seok Lee, Byung Ik Jang, Eun Soo Kim, Seong Woo Jeon, Sung Kook Kim, Kyeong Ok Kim, Yoo Jin Lee, Hyun Jik Lee, Kyung Sik Park, Yun Jin Jung, Eun Young Kim, Chang Heon Yang; Intest Res 2018;16(3):400-408. Published online July 27, 2018; DOI: https://doi.org/10.5217/ir.2018.16.3.400

Abstract PDF PubReader ePub

Background/Aims

This study aimed to elucidate the prevalence of hepatitis B virus (HBV) serologic markers in Korean patients newly diagnosed with, but not yet treated for inflammatory bowel disease (IBD).

Methods

We prospectively enrolled 210 patients newly diagnosed with IBD (109 with ulcerative colitis and 101 with Crohn's disease). Hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis B core antibody (anti-HBc) levels were measured and compared with those of 1,100 sex- and age-matched controls.

Results

The prevalence of chronic HBV infection (positive HBsAg, positive anti-HBc, and negative anti-HBs results) and past infection (negative HBsAg, positive anti-HBc, and positive or negative anti-HBs results) were not significantly different between the patients and controls (chronic HBV infection: IBD, 3.8% vs. control, 4.9%, P=0.596; past infection: IBD, 26.2% vs. control, 28.8%, P=0.625). The patients with IBD aged <20 years were at a higher susceptibility risk (nonimmune) for HBV infection than the controls (IBD, 41.5% vs. control, 22.4%; P=0.018). In the multivariate analysis, an age of <20 years (P=0.024) and symptom duration of ≥12 months before diagnosis (P=0.027) were identified as independent risk factors for nonimmunity against HBV infection.

Conclusions

The patients newly diagnosed with IBD were susceptible to HBV infection. The frequency of nonimmunity was high, especially in the patients aged <20 years and those with a longer duration of symptoms before diagnosis. Therefore, it is necessary to screen for HBV serologic markers and generate a detailed vaccination plan for patients newly diagnosed with IBD.

Citations

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Prevalence of hepatitis B virus and hepatitis C virus infection in patients with inflammatory bowel disease: a systematic review and meta-analysis
Suprabhat Giri, Dhiraj Agrawal, Shivaraj Afzalpurkar, Sunil Kasturi, Amrit Gopan, Sridhar Sundaram, Aditya Kale
Intestinal Research.2023; 21(3): 392. CrossRef
Viral Hepatitis in Patients with Inflammatory Bowel Disease
Seung Hwan Shin, Sang Hyoung Park
The Korean Journal of Gastroenterology.2022; 80(2): 51. CrossRef
Vaccination strategies for Korean patients with inflammatory bowel disease
Yoo Jin Lee, Eun Soo Kim
The Korean Journal of Internal Medicine.2022; 37(5): 920. CrossRef
Management of hepatitis B virus infection in patients with inflammatory bowel disease under immunosuppressive treatment
Georgios Axiaris, Evanthia Zampeli, Spyridon Michopoulos, Giorgos Bamias
World Journal of Gastroenterology.2021; 27(25): 3762. CrossRef
Prevention and management of viral hepatitis in inflammatory bowel disease: a clinical practice guideline by the Korean Association for the Study of Intestinal Diseases
Soo-Kyung Park, Chang Hwan Choi, Jaeyoung Chun, Heeyoung Lee, Eun Sun Kim, Jae Jun Park, Chan Hyuk Park, Bo-In Lee, Yunho Jung, Dong-Il Park, Do Young Kim, Hana Park, Yoon Tae Jeen
Intestinal Research.2020; 18(1): 18. CrossRef
Evaluating Hepatitis B Seroprotection and Revaccination for Children With Inflammatory Bowel Disease
Erica J Brenner, Ravi Jhaveri, Michael D Kappelman, Ajay S Gulati
Inflammatory Bowel Diseases.2019; 25(9): e108. CrossRef
The importance of immunization in immune-mediated inflammatory disease cannot be overstated
Sang Hyoung Park
Intestinal Research.2018; 16(3): 325. CrossRef

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Endoscopy

Prospective analysis of factors associated with inadequate bowel preparation for colonoscopy in actual clinical practice: Dae Hyung Woo, Kyeong Ok Kim, Da Eun Jeong, Yoon Jeong Nam, Si Hyung Lee, Byung Ik Jang, Tae Nyeun Kim; Intest Res 2018;16(2):293-298. Published online April 30, 2018; DOI: https://doi.org/10.5217/ir.2018.16.2.293

Abstract PDF PubReader ePub

Background/Aims

Inadequate bowel preparation can result in prolonged procedure time and increased missed lesion and complication rates. This prospective study aimed to evaluate bowel preparation quality and identify the predictive factors for inadequate bowel preparation in actual clinical practice.

Methods

We included 399 patients who underwent colonoscopy between June 2015 and July 2016. Using the Aronchick bowel preparation scale, we defined a score ≤2 as adequate preparation and a score >2 as inadequate preparation.

Results

Mean patient age was 58.38±12.97 years; 60.6% were male. Indications for colonoscopy included screening (69.7%) and surveillance after polyp removal (21.3%). A split-dose regimen was prescribed to 55.4% of patients. The inadequate bowel preparation rate was 28.1%. Overall, the median time between the last bowel preparation agent dose and start of colonoscopy was 5.0 hours (range, 1.5–16.0 hours); that of the adequate group was 5.0 hours (range, 1.5–16.0 hours); and that of the inadequate group was 5 hours (range, 2–23 hours). The mean bowel preparation scale score of the ascending colon (1.94±0.25) was significantly higher than that of other colon segments. On multivariate analysis, elderly age, history of cerebrovascular disease, history of gastrectomy or appendectomy, and total preparation solution uptake <2 L were the independent predictors of inadequate bowel preparation.

Conclusions

The inadequate bowel preparation rate was 28.1%. Risk factors included elderly age and history of cerebrovascular disease or abdominal surgery. Patients with these risk factors require special care and education.

Citations

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Strategies to improve screening colonoscopy quality for the prevention of colorectal cancer
Joo Hye Song, Eun Ran Kim
The Korean Journal of Internal Medicine.2024; 39(4): 547. CrossRef
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Shanshan Chen, Tingting Zhang, Saie Zhu, Yi Zhou
Current Medical Research and Opinion.2024; 40(9): 1545. CrossRef
Performance of Computer-Aided Detection and Quality of Bowel Preparation: A Comprehensive Analysis of Colonoscopy Outcomes
Dalton A. Norwood, Shyam Thakkar, Amanda Cartee, Fayez Sarkis, Tatiana Torres-Herman, Eleazar E. Montalvan-Sanchez, Kirk Russ, Patricia Ajayi-Fox, Anam Hameed, Ramzi Mulki, Sergio A. Sánchez-Luna, Douglas R. Morgan, Shajan Peter
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Wen‐Feng Hsu, Han‐Mo Chiu
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Yasuhiko Hamada, Kyosuke Tanaka, Yohei Ikenoyama, Noriyuki Horiki, Junya Tsuboi, Reiko Yamada, Misaki Nakamura, Hayato Nakagawa
Journal of the Anus, Rectum and Colon.2023; 7(3): 168. CrossRef
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Jahanbakhsh Amirarsalani, Leyla Alilu, Masoumeh Hemmati-Maslakpak, Javad Rasouli
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Sung Hoon Jung, Chul-Hyun Lim, Tae-Geun Gweon, Jinsu Kim, Jung Hwan Oh, Kyu-Tae Yoon, Jee Young An, Jeong‑Seon Ji, Hwang Choi
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Su Bee Park, Jae Myung Cha
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Efficacy, safety and tolerability of oral sulphate tablet for bowel preparation in patients with inflammatory bowel disease: A multicentre randomized controlled study
Kyeong Ok Kim, Eun Young Kim, Yoo Jin Lee, Hyun Seok Lee, Eun Soo Kim, Yun Jin Chung, Byung Ik Jang, Sung Kook Kim, Chang Heon Yang
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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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Shashank Sarvepalli, Ari Garber, Carol A. Burke, Niyati Gupta, Mounir Ibrahim, John McMichael, Gareth Morris-Stiff, Amit Bhatt, John Vargo, Maged Rizk, Michael B. Rothberg
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Chen-Shuan Chung, Chih-Ming Lin, Ming-Shu Chen
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Tae-Geun Gweon, Kyu-Tae Yoon, Chang Hyun Kim, Jin-Jo Kim
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Ji Eun Na, Eun Ran Kim
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Yohan Lee, Haejung Lee
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Comparison of bowel-cleansing efficacy of split-dose and same-day dose bowel preparation for afternoon colonoscopy in patients with gastrectomy: a prospective randomized study
Tae-Geun Gweon, Cheal Wung Huh, Jeong Seon Ji, Chang Hyun Kim, Jin-Jo Kim, Seung-Man Park
Surgical Endoscopy.2020; 34(10): 4413. CrossRef
Combination of bisacodyl suppository and 1 L polyethylene glycol plus ascorbic acid is a non‐inferior and comfortable regimen compared to 2 L polyethylene glycol plus ascorbic acid
Sun Hwa Kim, Eun Ran Kim, Kyunga Kim, Tae Jun Kim, Sung Noh Hong, Dong Kyung Chang, Young‐Ho Kim
Digestive Endoscopy.2020; 32(4): 600. CrossRef
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Youn I Choi, Jong-Joon Lee, Jun-Won Chung, Kyoung Oh Kim, Yoon Jae Kim, Jung Ho Kim, Dong Kyun Park, Kwang An Kwon
Journal of Clinical Medicine.2020; 9(10): 3286. CrossRef
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BMJ Open.2019; 9(8): e029483. CrossRef
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Seung-Joo Nam, Young Jin Kim, Bora Keum, Jae Min Lee, Seung Han Kim, Hyuk Soon Choi, Eun Sun Kim, Yeon Seok Seo, Yoon Tae Jeen, Hong Sik Lee, Hoon Jai Chun, Soon Ho Um, Chang Duck Kim
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IBD

Characteristics and management of patients with inflammatory bowel disease between a secondary and tertiary hospitals: a propensity score analysis: Ki Hwan Song, Eun Soo Kim, Yoo Jin Lee, Byung Ik Jang, Kyeong Ok Kim, Sang Gyu Kwak, Hyun Seok Lee; Intest Res 2018;16(2):216-222. Published online April 30, 2018; DOI: https://doi.org/10.5217/ir.2018.16.2.216

Abstract PDF PubReader ePub

Background/Aims

This study aimed to compare the clinical characteristics and management patterns of inflammatory bowel disease (IBD) patients in a secondary hospital (SH) with those in tertiary referral centers (TRC).

Methods

Data from IBD patients in SH and 2 TRCs were retrospectively reviewed. The cumulative thiopurine use rate was compared between hospitals after controlling for different baseline characteristics using propensity score matching.

Results

Among the total of 447 patients with IBD, 178 Crohn's disease (CD) and 269 ulcerative colitis (UC) patients were included. Regarding initial CD symptoms, patients from SH were more likely to show perianal symptoms, such as anal pain or discharge (56.6% vs. 34.3%, P=0.003), whereas those from TRCs more often had luminal symptoms, such as abdominal pain (54.9% vs. 17.1%, P<0.001), diarrhea (44.1% vs. 18.4%, P<0.001), and body weight loss (9.8% vs. 1.3%, P=0.025). Complicating behaviors, such as stricturing and penetrating, were significantly higher in TRCs, while perianal disease was more common in SH. Ileal location was more frequently observed in TRCs. For UC, SH had a more limited extent of disease (proctitis 58.8% vs. 21.2%, P<0.001). The cumulative azathioprine use rate in SH was significantly lower than that in TRCs in both CD and UC patients after controlling for disease behavior, location, and perianal disease of CD and extent of UC.

Conclusions

The clinical characteristics and management of the IBD patients in SH were substantially different from those in TRCs. Thiopurine treatment was less commonly used for SH patients.

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Early course of newly diagnosed moderate‐to‐severe ulcerative colitis in Korea: Results from a hospital‐based inception cohort study (MOSAIK)
Jin Young Yoon, Jae Myung Cha, Chang Kyun Lee, Young Sook Park, Kyu Chan Huh, Jeong Eun Shin, You Sun Kim, Chang Soo Eun, Soon Man Yoon, Jae Hee Cheon, Young Soo Park, Byong Duk Ye, YoungJa Lee, Youngdoe Kim, Hyo Jong Kim
Journal of Gastroenterology and Hepatology.2021; 36(8): 2149. CrossRef
VALIDation of the IBD-Disk Instrument for Assessing Disability in Inflammatory Bowel Diseases in a French Cohort: The VALIDate Study
Catherine Le Berre, Mathurin Flamant, Guillaume Bouguen, Laurent Siproudhis, Marie Dewitte, Nina Dib, Elodie Cesbron-Metivier, Thomas Goronflot, Matthieu Hanf, Pierre-Antoine Gourraud, Elise Kerdreux, Alexandra Poinas, Arnaud Bourreille, Caroline Trang-Po
Journal of Crohn's and Colitis.2020; 14(11): 1512. CrossRef

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A wide variation of the quality of colonoscopy reporting system in the real clinical practice in southeastern area of Korea: Jung Min Lee, Yu Jin Kang, Eun Soo Kim, Yoo Jin Lee, Kyung Sik Park, Kwang Bum Cho, Seong Woo Jeon, Min Kyu Jung, Hyun Seok Lee, Eun Young Kim, Jin Tae Jung, Byung Ik Jang, Kyeong Ok Kim, Yun Jin Chung, Chang Hun Yang; Intest Res 2016;14(4):351-357. Published online October 17, 2016; DOI: https://doi.org/10.5217/ir.2016.14.4.351

Abstract PDF PubReader

Background/Aims

Establishment of a colonoscopy reporting system is a prerequisite to determining and improving quality. This study aimed to investigate colonoscopists' opinions and the actual situation of a colonoscopy reporting system in a clinical practice in southeastern area of Korea and to assess the factors predictive of an inadequate reporting system.

Methods

Physicians who performed colonoscopies in the Daegu-Gyeongbuk province of Korea and were registered with the Korean Society of Gastrointestinal Endoscopy (KSGE) were interviewed via mail about colonoscopy reporting systems using a standardized questionnaire.

Results

Of 181 endoscopists invited to participate, 125 responded to the questionnaires (response rate, 69%). Most responders were internists (105/125, 84%) and worked in primary clinics (88/125, 70.4%). Seventy-one specialists (56.8%) held board certifications for endoscopy from the KSGE. A median of 20 colonoscopies (interquartile range, 10–47) was performed per month. Although 88.8% of responders agreed that a colonoscopy reporting system is necessary, only 18.4% (23/125) had achieved the optimal reporting system level recommended by the Quality Assurance Task Group of the National Colorectal Cancer Roundtable. One-third of endoscopists replied that they did not use a reporting document for the main reasons of "too busy" and "inconvenience." Non-endoscopy specialists and primary care centers were independent predictive factors for failure to use a colonoscopy reporting system.

Conclusions

The quality of colonoscopy reporting systems varies widely and is considerably suboptimal in actual clinical practice settings in southeastern Korea, indicating considerable room for quality improvements in this field.

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Association of Poor Differentiation or Positive Vertical Margin with Residual Disease in Patients with Subsequent Colectomy after Complete Macroscopic Endoscopic Resection of Early Colorectal Cancer
Ki Ju Kim, Hyun Seok Lee, Seong Woo Jeon, Sun Jin, Sang Won Lee
Gastroenterology Research and Practice.2017; 2017: 1. CrossRef
Derivation and validation of a risk scoring model to predict advanced colorectal neoplasm in adults of all ages
Hyo‐Joon Yang, Sungkyoung Choi, Soo‐Kyung Park, Yoon Suk Jung, Kyu Yong Choi, Taesung Park, Ji Yeon Kim, Dong Il Park
Journal of Gastroenterology and Hepatology.2017; 32(7): 1328. CrossRef
Screening strategy for colorectal cancer according to risk
Dong Soo Han
Journal of the Korean Medical Association.2017; 60(11): 893. CrossRef

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Old Age at Diagnosis Is Associated With Favorable Outcomes in Korean Patients With Inflammatory Bowel Disease: Jae Hyuk Choi, Eun Soo Kim, Kwang Bum Cho, Kyung Sik Park, Yoo Jin Lee, Sang Min Lee, Yu Jin Kang, Byung Ik Jang, Kyeong Ok Kim; Intest Res 2015;13(1):60-67. Published online January 29, 2015; DOI: https://doi.org/10.5217/ir.2015.13.1.60

Abstract PDF PubReader

Background/Aims

Despite the rising incidence and prevalence of inflammatory bowel disease (IBD) in Asian populations, data regarding clinical characteristics of patients in Asia based on age at diagnosis are relatively sparse. The aim of this study was to compare clinical characteristics based on the age at diagnosis according to the Montreal Classification in Korean IBD patients.

Methods

We recruited consecutive patients with IBD at two tertiary hospitals and retrospectively reviewed their medical information. Patients were divided into three groups according to their age at diagnosis: youth (<17 years), young adult (17-40 years), and middle-old (>40 years). The main clinical characteristics for comparison were the achievement of a remission state at the last follow-up visit, cumulative rate of surgery, and cumulative use of immunomodulators and tumor necrosis factor-α (TNFα) blockers during the follow-up period.

Results

In total, 346 IBD patients were included (Crohn's disease [CD] 146 and ulcerative colitis 200; 36 youth, 202 young adult, and 113 middle-old). The middle-old group with CD was characterized by a predominance of uncomplicated behavior (P=0.013) and a lower frequency of perianal disease (P=0.009). The middle-old group was associated more with a less aggressive disease course than the younger group, as shown by more frequent remission (P=0.004), being less likely to undergo surgery (P<0.001), and lower cumulative use of immunomodulators and TNFα blockers (P<0.001).

Conclusions

Age at diagnosis according to the Montreal Classification is an important prognostic factor for Korean IBD patients.

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Ji Young Chang, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jae Hee Cheon, Jihye Park
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Peripheral blood neutrophil-to-lymphocyte ratio in inflammatory bowel disease and disease activity: A meta-analysis
Wei Fu, Hu Fu, Weixia Ye, Yinsuo Han, Xianqiang Liu, Sirui Zhu, Hongmin Li, Rong Tang, Qin Wang
International Immunopharmacology.2021; 101: 108235. CrossRef
Earlier Anti-Tumor Necrosis Factor Therapy of Crohn’s Disease Correlates with Slower Progression of Bowel Damage
Hinaben Panchal, Mathilde Wagner, Manjil Chatterji, Bachir Taouli, Russell McBride, Jeromy R. Patterson, Ryan Ungaro, Marla Dubinsky, Judy Cho, David B. Sachar
Digestive Diseases and Sciences.2019; 64(11): 3274. CrossRef
Characteristics and management of patients with inflammatory bowel disease between a secondary and tertiary hospitals: a propensity score analysis
Ki Hwan Song, Eun Soo Kim, Yoo Jin Lee, Byung Ik Jang, Kyeong Ok Kim, Sang Gyu Kwak, Hyun Seok Lee
Intestinal Research.2018; 16(2): 216. CrossRef
Risk Factors for Vitamin D, Zinc, and Selenium Deficiencies in Korean Patients with Inflammatory Bowel Disease
Yoo Min Han, Hyuk Yoon, Soo Lim, Mi-Kyung Sung, Cheol Min Shin, Young Soo Park, Nayoung Kim, Dong Ho Lee, Joo Sung Kim
Gut and Liver.2017; 11(3): 363. CrossRef
Sampling Strategies for Three-Dimensional Spatial Community Structures in IBD Microbiota Research
Shaocun Zhang, Xiaocang Cao, He Huang
Frontiers in Cellular and Infection Microbiology.2017;[Epub] CrossRef
Influence of age at diagnosis on the clinical characteristics of Crohn's disease in Korea: Results from the CONNECT study
Sung Wook Hwang, Jee Hyun Kim, Jong Pil Im, Byong Duk Ye, Hoon Sup Koo, Kyu Chan Huh, Jae Hee Cheon, You Sun Kim, Young Ho Kim, Dong Soo Han, Won Ho Kim, Joo Sung Kim
Journal of Gastroenterology and Hepatology.2017; 32(10): 1716. CrossRef
Impact of inflammatory bowel disease on daily life: an online survey by the Korean Association for the Study of Intestinal Diseases
Young Sun Kim, Sung-Ae Jung, Kang-Moon Lee, Soo Jung Park, Tae Oh Kim, Chang Hwan Choi, Hyun Gun Kim, Won Moon, Chang Mo Moon, Hye Kyoung Song, Soo-Young Na, Suk-Kyun Yang
Intestinal Research.2017; 15(3): 338. CrossRef
Clinical Efficacy of Beclomethasone Dipropionate in Korean Patients with Ulcerative Colitis
Yoon Jee Lee, Jae Hee Cheon, Jae Hyun Kim, SunHo Yoo, Hyun Jung Lee, Soo Jung Park, Sung Pil Hong, Tae Il Kim, Won Ho Kim
Yonsei Medical Journal.2017; 58(1): 144. CrossRef
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Solvey Schüle, Jean‐Benoît Rossel, Diana Frey, Luc Biedermann, Michael Scharl, Jonas Zeitz, Natália Freitas‐Queiroz, Valérie Pittet, Stephan R Vavricka, Gerhard Rogler, Benjamin Misselwitz
United European Gastroenterology Journal.2016; 4(5): 669. CrossRef
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Jae Hyun Kim, Jae Hee Cheon, Yehyun Park, Hyun Jung Lee, Soo Jung Park, Tae Il Kim, Won Ho Kim
Scandinavian Journal of Gastroenterology.2016; 51(9): 1069. CrossRef
Patients with perianal Crohn's disease have poor disease outcomes after primary bowel resection
Yoo Min Han, Ji Won Kim, Seong‐Joon Koh, Byeong Gwan Kim, Kook Lae Lee, Jong Pil Im, Joo Sung Kim, Hyun Chae Jung
Journal of Gastroenterology and Hepatology.2016; 31(8): 1436. CrossRef
Clinical features of Crohn's disease in Korean patients residing in Busan and Gyeongnam
Eun Ji Lee, Tae Oh Kim, Geun Am Song, Jong hun Lee, Hyung Wook Kim, Sam Ryong Jee, Seun Ja Park, Hyun Jin Kim, Jong Ha Park
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Raja Affendi Raja Ali
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Continuous duodenal levodopa infusion in a patient with Crohn's disease and small bowel surgery — Case report
Svetlana Tomic, Danijela Skelac, Dario Mick, Ivan Segec, Bojan Resan, Silva Butkovic Soldo
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Does Carotid Intima-Media Thickness Increase in Patients With Inflammatory Bowel Disease?: Kyeong Ok Kim, Byung Ik Jang, Si Hyung Lee; Intest Res 2014;12(4):293-298. Published online October 27, 2014; DOI: https://doi.org/10.5217/ir.2014.12.4.293

Abstract PDF PubReader ePub

Background/Aims

Mesenteric microvascular thrombosis has been implicated as a contributing factor to the pathogenesis of inflammatory bowel disease (IBD). The aim of the current study was to assess the possibility of subclinical atherosclerosis in patients with IBD by measuring their carotid intima-media thickness (c-IMT).

Methods

Thirty-eight patients with IBD who were followed-up for at least 3 years participated. Patients with a history of cardiovascular disease and known risk factors for atherosclerosis were excluded. As a control group, 38 healthy patients matched for age and gender without atherosclerosis risk factors were included. Carotid ultrasonography was performed in all patients and controls. Patient baseline characteristics and laboratory parameters were recorded to evaluate atherosclerosis risk factors.

Results

The mean age of patients with IBD was 38.5±6.62 years. Twenty-three patients with IBD were diagnosed with ulcerative colitis and the other 15 cases were diagnosed with Crohn's disease. The median duration of disease was 52.0 months. Serologic markers such as erythrocyte sedimentation rate, C-reactive protein (CRP), and cholesterol levels differed significantly, however, there was no significant difference in c-IMT between patients with IBD and those in the control group (0.53±0.10 mm vs. 0.53±0.07; P=0.85). Multivariate analysis revealed that body mass index, CRP, disease duration, and age were significantly correlated with c-IMT in patients with IBD.

Conclusions

The results of the current study did not show an increase in c-IMT in patients with IBD. Further studies that include more subjects and a longer follow-up period will be necessary in order to evaluate the risk of atherosclerosis in Korean patients with IBD.

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Ocular endothelial dysfunction in pediatric inflammatory bowel disease
Giovanni Di Nardo, Mariachiara Di Pippo, Letizia Zenzeri, Maurizio Mennini, Marisa Piccirillo, Silvia Furio, Giovanna Quatrale, Melania Evangelisti, Pasquale Parisi, Livia Lucchini, Alessandro Ferretti, Maria Pia Villa, Gianluca Scuderi, David Sarzi Amadè
Journal of Pediatric Gastroenterology and Nutrition.2024; 78(6): 1297. CrossRef
Endothelial Dysfunction and Arterial Stiffness in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis
Hao Wu, Meihua Xu, Hong Hao, Michael A. Hill, Canxia Xu, Zhenguo Liu
Journal of Clinical Medicine.2022; 11(11): 3179. CrossRef
Subclinical Atherosclerosis in Patients With Inflammatory Bowel Diseases: A Systematic Review and Meta-Analysis
Guo-Cui Wu, Rui-Xue Leng, Qi Lu, Yin-Guang Fan, De-Guang Wang, Dong-Qing Ye
Angiology.2017; 68(5): 447. CrossRef
Usefulness of Measuring Serum Procalcitonin Levels in Patients with Inflammatory Bowel Disease
Sook Hee Chung, Hye Won Lee, Seung Won Kim, Soo Jung Park, Sung Pil Hong, Tae Il Kim, Won Ho Kim, Jae Hee Cheon
Gut and Liver.2016; 10(4): 574. CrossRef
Endothelial dysfunction in inflammatory bowel diseases: Pathogenesis, assessment and implications
Dorota Cibor
World Journal of Gastroenterology.2016; 22(3): 1067. CrossRef

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A Double-Blind, Randomized, Active Drug Comparative, Parallel-Group, Multi-Center Clinical Study to Evaluate the Safety and Efficacy of Probiotics (Bacillus licheniformis, Zhengchangsheng® capsule) in Patients with Diarrhea: Jun Heo, Sung Kook Kim, Kyung Sik Park, Hye Kyung Jung, Joong Goo Kwon, Byung Ik Jang; Intest Res 2014;12(3):236-244. Published online July 25, 2014; DOI: https://doi.org/10.5217/ir.2014.12.3.236

Abstract PDF PubReader ePub

Background/Aims

Bacillus Licheniformis, a probiotic used in the treatment of diarrhea, has been shown to suppress the growth of pathologic bacteria. This study was performed to assess the therapeutic efficacy and safety of Zhengchangsheng® (Bacillus Licheniformis) in comparison with another probiotic, Bioflor® (Saccharomyces Boulardii) for the treatment of diarrhea.

Methods

Patients with diarrhea (n=158) were randomized to receive Zhengchangsheng® or Bioflor® for 5 days. The existence or non-existence of formed feces, changes in daily stool frequency, improvement of subjective symptoms, and changes in the severity of diarrhea were compared.

Results

Of the 158 full analysis set (FAS) patient population, 151 patients comprised the per protocol (PP) analysis. The rates of recovered to formed feces in the Bacillus and Saccharomyces groups were 91.0% vs. 95.0% in the FAS (P=0.326) and 90.5% vs. 96.1% in the PP analysis (P=0.169), respectively. The mean duration of diarrhea changing to formed feces was 3.15±1.10 days in the Bacillus group and 3.22±1.01 in the Saccharomyces group (P=0.695, FAS). The frequency of defecation, subjective symptoms, and degree of severe diarrhea were improved in both groups, however, there were no statistically significant differences between the 2 groups. Analysis of the 95% confidence intervals for the differences in the rate of recovery to formed feces between the 2 groups met the criteria for non-inferiority of Bacillus compared to Saccharomyces. No significant adverse events were observed during the study period.

Conclusions

Zhengchangsheng® is not inferior to Bioflor® in therapeutic efficacy and is a safe and useful therapeutic agent for the treatment of diarrhea.

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Clinical and Translational Medicine.2023;[Epub] CrossRef
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Yuyuan Li, Man Liu, He Liu, Xiaoqing Wei, Xianying Su, Ming Li, Jieli Yuan
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Review

Stem Cells in Inflammatory Bowel Disease: New Potential Therapeutic Target: In Hwan Song, Byung Ik Jang; Intest Res 2013;11(2):79-84. Published online April 30, 2013; DOI: https://doi.org/10.5217/ir.2013.11.2.79

Abstract PDF

Understanding of the pathophysiology of inflammatory bowel disease (IBD) is constantly evolving and, recently, a number of biologic agents that selectively target specific molecules or pathways to correct the imbalance of the gut immune system have been developed. Among them, an antibody to tumor necrosis factor (anti-TNF) is the first developed drug which has dramatically improved the management of patients with IBD. However, more than one-third of IBD patients do not respond to medications, and there is the problem of antibody formation. Therefore, enormous efforts have been made into the development of novel anti-cytokines and stem cell injection as an alternative to has been made. However, the efficacy and safety of stem cell treatment are under investigation. Some studies have reported very promising data; however, others have shown conflicting results. In addition, most trials involved a very small number of subjects and did not compare stem cell treatment with anti-TNF. The present paper reviews the function and therapeutic mechanism of stem cells for the treatment of IBD. (Intest Res 2013;11:79-84)

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Hyun Jung Lee, Sun-Hee Oh, Hui Won Jang, Ji-Hee Kwon, Kyoung Jin Lee, Chung Hee Kim, Soo Jung Park, Sung Pil Hong, Jae Hee Cheon, Tae Il Kim, Won Ho Kim
Gut and Liver.2016;[Epub] CrossRef

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Special Review

Guidelines for the Management of Crohn's Disease: Byong Duk Ye, Suk-Kyun Yang, Sung Jae Shin, Kang Moon Lee, Byung Ik Jang, Jae Hee Cheon, Chang Hwan Choi, Young-Ho Kim, Heeyoung Lee, IBD Study Group of the Korean Association for the Study of Intestinal Diseases; Intest Res 2012;10(1):26-66. Published online February 29, 2012; DOI: https://doi.org/10.5217/ir.2012.10.1.26

Abstract PDF

Crohn's disease (CD) is a chronic inflammatory bowel disease (IBD) with uncertain etiopathogenesis. CD can involve any site of gastrointestinal tract from the mouth to anus and is associated with serious complications such as bowel strictures, perforations, and fistula formation. The incidence and prevalence rates of CD in Korea are still lower than those of Western countries, but have been rapidly increasing during the past decades. Although there are no definitive curative modalities for CD, various medical and surgical therapies are currently applied for diverse clinical situations of CD. However, a lot of decisions on the management of CD are made depending on the personal experiences and choices of physicians. To suggest preferable approaches to diverse problems of CD and to minimize the variations according to physicians, guidelines for the management of CD are needed. Therefore, IBD Study Group of the Korean Association for the Study of the Intestinal Diseases has set out to develop the guidelines for the management of CD in Korea. These guidelines were developed using the adaptation methods and encompass the treatment of inflammatory disease, stricturing disease, and penetrating disease. The guidelines also cover the indication of surgery, prevention of recurrence after surgery, and CD in pregnancy and lactation. These are the first Korean guidelines for the management of CD and the update with further scientific data and evidences is needed. (Intest Res 2012;10:26-66)

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Ji Min Lee, Kang-Moon Lee, Joo Sung Kim, You Sun Kim, Jae Hee Cheon, Byong Duk Ye, Young-Ho Kim, Dong Soo Han, Chang Kyun Lee, Hyun-Ju Park
Medicine.2018; 97(16): e0459. CrossRef
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Jae Jun Park, Suk-Kyun Yang, Byong Duk Ye, Jong Wook Kim, Dong Il Park, Hyuk Yoon, Jong Pil Im, Kang Moon Lee, Sang Nam Yoon, Heeyoung Lee
The Korean Journal of Gastroenterology.2017; 69(1): 29. CrossRef
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Jae Jun Park, Suk-Kyun Yang, Byong Duk Ye, Jong Wook Kim, Dong Il Park, Hyuk Yoon, Jong Pil Im, Kang Moon Lee, Sang Nam Yoon, Heeyoung Lee
Intestinal Research.2017; 15(1): 38. CrossRef
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Young Sun Kim, Sung-Ae Jung, Kang-Moon Lee, Soo Jung Park, Tae Oh Kim, Chang Hwan Choi, Hyun Gun Kim, Won Moon, Chang Mo Moon, Hye Kyoung Song, Soo-Young Na, Suk-Kyun Yang
Intestinal Research.2017; 15(3): 338. CrossRef
Computed Tomography Enterography and Magnetic Resonance Enterography in the Diagnosis of Crohn's Disease
Se Hyung Kim
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Crohn's Disease Clinical Network and Cohort (CONNECT) Study: The First Step Toward Nationwide Multicenter Research of Crohn's Disease in Korea
Jae Hee Cheon, You Sun Kim, Byong Duk Ye, Kang Moon Lee, Young Ho Kim, Joo Sung Kim, Dong Soo Han, Won Ho Kim
Intestinal Research.2014; 12(3): 173. CrossRef
Crohn's disease in Korea: past, present, and future
Kang-Moon Lee, Ji Min Lee
The Korean Journal of Internal Medicine.2014; 29(5): 558. CrossRef
Patients with Crohn's disease on anti-tumor necrosis factor therapy are at significant risk of inadequate response to the 23-valent pneumococcal polysaccharide vaccine
Chang Kyun Lee, Hyun-Soo Kim, Byong Duk Ye, Kang-Moon Lee, You Sun Kim, Sang Youl Rhee, Hyo-Jong Kim, Suk-Kyun Yang, Won Moon, Ja-Seol Koo, Suck-Ho Lee, Geom Seog Seo, Soo Jung Park, Chang Hwan Choi, Sung-Ae Jung, Sung Noh Hong, Jong Pil Im, Eun Soo Kim
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Seong Yeon Jeong, Jeong Seop Moon, Kyu Joo Park, You Sun Kim
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Long-Term Clinical Outcomes of Korean Patient With Crohn's Disease Following Early Use of Infliximab
Nam Hee Kim, Yoon Suk Jung, Chang Mo Moon, Shin Yeong Lee, Eun Ran Kim, Young Ho Kim, Chang Kyun Lee, Suck Ho Lee, Jae Hak Kim, Kyu Chan Huh, Soon Man Yoon, Hyun Joo Song, Sun-Jin Boo, Hyun Joo Jang, You Sun Kim, Kang-Moon Lee, Jeong Eun Shin, Dong Il Par
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Clinical Outcome of Treatment with Infliximab in Crohn's Disease: A Single-Center Experience
Yeon-Ju Kim, Jung-Wook Kim, Chang Kyun Lee, Hyun Jin Park, Jae-Jun Shim, Jae Young Jang, Suk Ho Dong, Hyo Jong Kim, Byung-Ho Kim, Young Woon Chang
The Korean Journal of Gastroenterology.2013; 61(5): 270. CrossRef

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Case Reports

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

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

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A Case of Lipoma of Terminal Ileum Causing Intussusception of the Transverse Colon: Yong Gil Kim, Byung Ik Jang, Si Hyung Lee; Intest Res 2009;7(2):110-113. Published online December 30, 2009

Abstract PDF: Intestinal intussusception is rare in adults. Intestinal intussusception is distinct from pediatric intussusception in that an identifiable leading lesion alters normal bowel peristalsis and forms the leading edge of the intussusceptum. The occurrence of lipomas is most common in the colon, followed by the small intestine, and then the stomach. Large lipomas may be associated with complications, such as intussusception or intestinal hemorrhage. In this case, a 77-year-old man was admitted to the hospital with a 10-day history of intermittent abdominal cramping. Computed tomography showed an intussusception of the transverse colon due to a primary mass with a dominant fatty density. The patient's obstructive symptoms resolved after colonoscopic reduction. Colonoscopy plays a useful role in the diagnosis and management of intussusception. The clinical, radiographic, and endoscopic findings are described herein with a brief review of the pertinent literature. (Intest Res 2009;7:110-113)

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A Case of Hemorrhagic Cerebral Infarction in Ulcerative Colitis: Eun Jung Choi, Byung Ik Jang, Kyung Ae Chang, Sang Hun Lee, Yong Kil Kim, Kyeong Ok Kim, Si Hyung Lee, Seok Jin Yoon; Intest Res 2009;7(1):52-55. Published online June 30, 2009

Abstract PDF: Ulcerative colitis is associated with a number of extraintestinal complications, including the infrequent occurrence of thromboembolic disease. Cerebral venous thrombosis is an extremely rare and fatal complication of ulcerative colitis. A 38-year-old woman presented with sluggish mentation and left hemiplegia. Ulcerative colitis had been diagnosed 3 years earlier by colonoscopy and biopsy, and had been controlled with a mesalazine. On admission, a brain computed tomography revealed a high density area in the right frontal lobe, and T2-weighted magnetic resonance imaging demonstrated an abnormal signal in the right frontal area, suggestive of a hemorrhagic cerebral infarction. She was managed with a decompressive craniectomy and conventional treatment for ulcerative colitis. (Intest Res 2009;7:52-55)

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Original Article

Overview of the Annual Frequency and Clinical Manifestations of Colonic Diverticulosis: Kyeong Ok Kim, Byung Ik Jang, Tae Nyeun Kim, Hee Jung Moon; Intest Res 2008;6(2):116-120. Published online December 30, 2008

Abstract PDF: Background/Aims
The prevalence of colonic diverticulosis in Korea is lower than in Western contries and the involved site is different. But, the recently increasing prevalence in Korea may be due to changing life style and advances in diagnostic approachs. We analyzed the annual incidence and clinical manifestations of colonic diverticulosis of the patients who underwent colonofibroscopy. Methods: Medical records of 25,808 patients who underwent colonofibroscopy at Yeungnam University Medical Center from January 2000 to December 2007 were retrospectively reviewed. Results: Overall prevalence was 5.5%. The mean age of the patients was 57.02±12.41 years (range 19-97 years) and the most frequent occurrence (28.8%) occurred in the 7th decade of life. Male to female ratio was 977：159. The annual incidence rate increased from 4.6% to 7.2% since 2000. Diverticulum occurred more frequently in the right side colon (997 cases) than the left side colon (159 cases), with involvement of both sides in 62 cases. The rate of left sided colon increased with age. In 516 patients, only one diverticulum was detected and the other 682 patients had multiple diverticuli. Complications were evident in 51 cases, consisting of diverticulititis in 35 cases and bleeding in 16 cases. Conclusions: According to this single center analysis, the annual incidence rate of colonic diverticulosis is increasing with right sided colon as the predominant site. But, the frequency in left-sided colon is increasing with age. (Intest Res 2008;6:116-120)

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Review

Animal Models of Inflammatory Bowel Disease: Byung Ik Jang; Intest Res 2008;6(1):8-18. Published online June 30, 2008

Abstract PDF: Inflammatory bowel disease (IBD) is a chronic inflammatory disease of unknown etiology that includes two main disease entities-ulcerative colitis and Crohn's disease. Although the pathogenesis of IBD remains unclear, it is widely accepted that genetic, environmental and immunological factors are involved. Animal models of IBD are indispensable for the understanding of the pathogenesis and novel therapeutic applications for IBD. IBD animal models can be divided into several different categories, including models of spontaneous colitis (cotton-top tamarin colitis); inducible forms of colitis (using acetic acid, dextran sulfate sodium and indomethacin); an adoptive transfer model (CD45RB^high transfer model); genetically engineered models (with IL-10 knockout or TCR-Ձ chain knockout mice). However, there is no 'perfect' model for human disease. Investigators must make judicious choices when selecting a model for a particular study. In this review, an overview of the different IBD animal models is provided and the contribution of the models to the current understanding of disease mechanisms is discussed, with the ultimate goal to develop future therapeutic trials. (Intest Res 2008;6:8-18)

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Original Articles

The Effect of 5-Aminosalicylic Acid on Renal Function in Patients with Inflammatory Bowel Disease: Kyeong Ok Kim, Byung Ik Jang, Tae Nyeun Kim, Si Hyung Lee; Intest Res 2008;6(1):45-49. Published online June 30, 2008

Abstract PDF: Background/Aims
An increasing number of case reports indicate the potential nephrotoxicity of 5-aminosalicylic acid (ASA). The aim of this study was to investigate the effect of long-term use of 5-ASA on renal function in patients with inflammatory bowel disease (IBD). Methods: The medical records of 318 patients with IBD that were treated with 5-ASA from 2001 to 2007 at Yeungnam University Hospital were reviewed. Changes in creatinine clearance (CCr), as measured by modification of diet with the renal disease study (MDRD) method, and risk factors were analyzed. Results: One-hundred patients were available for analysis. The male to female ratio was 55：45 and the mean age was 35.89±14.1 years. Fifty-eight patients were diagnosed with Crohn's disease and the other patients were diagnosed with ulcerative colitis. The mean treatment duration with 5-ASA was 2.6±2.5 years and 85 patients were treated with mesalazine and eight patients were treated with sulfasalazine. The mean baseline glomerular filtration rate (GFR) was 112.9±25.3 mL/min. The mean CCr declined to 106.3±28.3 ml/min/m² with an annual decline of 1.44 ml/min/year/m², but there was no statistically significant change in the mean CCr. Changes in the CCr were correlated with the pretreatment CCr. Conclusions: There was no statistically significant change in serum CCr. Although 5-ASA therapy in IBD patients resulted in no meaningful effect on renal function, the annual decline was within the normal range (0.4-1 mL/min/m²). Serial follow-up of GFR has significance. A large prospective study with a longer time is needed to confirm these findings. (Intest Res 2008;6:45-49)

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Role of Echocardiography for the Evaluation of Ischemic Colitis: Kyu Hyung Lee, Byung Ik Jang, Kyeong Ok Kim, Si Hyung Lee, Jae Won Choi, Youn Sun Park, Sang Hoon Lee, Jun Young Lee, Jong Ryul Eun, Tae Nyeun Kim; Intest Res 2007;5(2):165-169. Published online December 30, 2007

Abstract PDF: Background/Aims
Ischemic colitis is recognized as the most common intestinal vascular disorder, especially in the elderly. Several predisposing factors, especially a cardiac embolism, have been reported for ischemic colitis. The aims of this study were to evaluate the prevalence of cardiovascular disease and the role of echocardiography in ischemic colitis. Methods: Thirty-six patients with ischemic colitis from January 2000 to February 2007 were analyzed retrospectively. Results: The mean age of subjects was 68.8±8.4 years. The prevalence of cardiovascular disease in ischemic colitis patients was 33% (12/36 cases). There were eight ischemic heart disease cases, four valvular heart disease cases, three arrhythmia cases and one hypertrophic cardiomyopathy case. Echocardiography was performed in 21 cases; cardiovascular disease could be detected in 11/12 cases (92%) and four cases were previously unknown. Anticoagulant therapy was required in 25% of the patients. Factors influencing hospital stay were the presence of cardiovascular disease. The presence of an associated medical illness did not influence hospital stay. Conclusions: Echocardiography may be useful to evaluate predisposing factors and to determine the use of anticoagulation therapy in ischemic colitis. (Intest Res 2007;5:165-169)

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Case Report

A Case of Colonic Perforation following Colonoscopy in Collagenous Colitis: Youn Sun Park, Byung Ik Jang, Tae Nyeun Kim, Jong Ryul Eun, Jae Won Choi, Kyu Hyung Lee, Kyeong Ok Kim, Si Hyung Lee, Mi Jin Kim; Intest Res 2007;5(1):77-80. Published online June 30, 2007

Abstract PDF: Collagenous colitis is a clinicopathological syndrome characterized by: (1) chronic watery diarrhea and crampy abdominal pain and (2) thickened subepithelial collagen band and increased intraepithelial lymphocytes on histology. The mucosa generally appears endoscopically normal, although some nonspecific abnormalities such as patchy erythema, an abnormal vascular pattern or erythema may be found in upto one third of cases. Collagenous colitis is generally regarded as a benign disease and serious complication are uncommon. The frequency of colonic perforation in collagenous coliltis is unknown, but is probably very rare. Only 16 patients, excluding our cases, have so far been reported. We report a case of a 80-year-old woman with collagenous colitis who presented with colonic perforation two days after the colonoscopy. (Intest Res 2007;5:77-80)

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Editorial

Role of Sigmoidoscopy for Pseudomembranous Colitis: Byung Ik Jang; Intest Res 2007;5(1):95-98. Published online June 30, 2007

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Case Reports

A Case of Colon Mucinous Carcinoma Mimicking Diverticular Disease with Abscess on Colonoscopy: Jae Won Choi, Byung Ik Jang, Youn Sun Park, Kook Hyun Kim, Jong Ryul Eun, Tae Nyeun Kim, Yong-Jin Kim, Chang Heon Yang; Intest Res 2006;4(2):106-109. Published online December 30, 2006

Abstract PDF: A 51-year-old male visited our hospital for investigation of abdominal pain. Barium enema revealed luminal protruding mass at descending colon, but relatively intact colonic mucosal surface and several orifices with whitish exudates observed during colonoscopic examination, these findings suggested colonic diverticular disease with abscess. Also, specimen from ultrasound guided needle biopsy demonstrated chronic inflammation. Antibiotics applied, but mass lesion showed no improvement. The patient underwent operation two month later, the histologic exam demonstrated mucinous carcinoma. (Intestinal Research 2006;4:106-109)

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Recur of Malignant Mixed Mullerian Tumor of the Ovary in Intestine: Ji Eun Lee, Jang Won Sohn, Hee Jung Moon, Sang Hoon Lee, Youn Sun Park, Jae Won Choi, Kook Hyun Kim, Jong Ryul Eun, Byung Ik Jang, Tae Nyeun Kim, Jae Hwang Kim, Mi Jin Kim; Intest Res 2006;4(1):53-56. Published online June 30, 2006

Abstract PDF: Malignant mixed mullerian tumor (MMMT) is rare tumor of the ovary, representing less than 1% of all ovarian malignancies. MMMT is an uncommon tumor containing epithelial and mesenchymal components. Most of all were heterologous type and 80% occur in postmenopausal women. It is a aggressive and rapidly progressive tumor. MMMT is highly malignant and the prognosis is poor because of frequent metastasis and recurrance. The survival rate is very low in spite of surgery, chemotherapy and radiotherapy. The optimal treatment is still controversial. We experienced one recur case of malignant mixed mullerian tumor of the ovary in intestine and report with brief review of literature. (Intestinal Research 2006;4:53-56)

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Positron Emission Tomography Finding of Small Bowel Crohn's Disease: Report of a Case: Youn Sun Park, Kook Hyun Kim, Jae Won Choi, Jong Ryul Eun, Byung Ik Jang, Tae Nyeun Kim; Intest Res 2006;4(1):57-60. Published online June 30, 2006

Abstract PDF: Endoscopic and radiologic studies are frequently required in inflammatory bowel disease to determine disease activity, extent of disease, and delineating type. Positron emission tomography (PET) using fluorine-18-fluoro-deoxyglucose to identify metabolically active tissues may offer a simple noninvasive alternative to conventional studies in identification and localization of active intestinal inflammation with inflammatory bowel disease. Crohn's disease can also be detected by PET-CT. In this case, we discribe a small bowel Crohn's disease with PET-CT finding. There was intensely increased fluorine-18-fluoro-deoxyglucose uptake in terminal ileum area. (Intestinal Research 2006;4:57-60)

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