Intestinal Research

Editorial

Role of capsule endoscopy in suspected or established Crohn's disease in real practice: Hyun Joo Jang; Intest Res 2017;15(4):431-433. Published online October 23, 2017; DOI: https://doi.org/10.5217/ir.2017.15.4.431

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Review

The role of small bowel endoscopy in small bowel Crohn's disease: when and how?: Mikang Kim, Hyun Joo Jang; Intest Res 2016;14(3):211-217. Published online June 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.3.211

Endoscopy has a crucial role in the diagnosis, management, and surveillance of inflammatory bowel disease (IBD). It contributes in supporting the diagnosis of IBD with the clinical history, physical examination, laboratory findings, and targeted biopsies. Furthermore, endoscopy has a significant role in assessing disease activity and distribution in treatment efficacy evaluation, post-surgical recurrence risk, and cancer surveillance in patients with long-lasting illness. Endoscopy also provides therapeutic potential for the treatment of IBD, especially with stricture dilatation and treatment of bleeding. Small bowel (SB) endoscopy (capsule endoscopy and device-assisted enteroscopy) and cross-sectional radiologic imaging (computed tomography enterography and magnetic resonance enterography) have become important diagnostic options to diagnose and treat patients with SB Crohn's disease. We reviewed the present role of SB endoscopy in patients with SB Crohn's disease.

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Leucine-rich alpha-2 glycoprotein as a superior biomarker to C-reactive protein for detecting small bowel lesions in Crohn’s disease
Masashi Ohno, Atsushi Nishida, Akinori Otsuki, Yoshihiro Yokota, Takayuki Imai, Shigeki Bamba, Osamu Inatomi
World Journal of Gastrointestinal Endoscopy.2025;[Epub] CrossRef
Aptamer-Functionalized Microbubbles Targeted to P-selectin for Ultrasound Molecular Imaging of Murine Bowel Inflammation
Una Goncin, Laura Curiel, C. Ronald Geyer, Steven Machtaler
Molecular Imaging and Biology.2023; 25(2): 283. CrossRef
Utility of panenteric capsule endoscopy for the detection of small‐bowel Crohn's disease in patients with a normal magnetic resonance enterography: A prospective observational pilot study
Anuj Bohra, Diana Lewis, Jonathan P Segal, Abhinav Vasudevan, Daniel R Van Langenberg, Olga Niewiadomski
JGH Open.2023; 7(12): 966. CrossRef
Enteroscopy in Crohn’s Disease: Are There Any Changes in Role or Outcomes Over Time? A KASID Multicenter Study
Seong Ran Jeon, Jin-Oh Kim, Jeong-Sik Byeon, Dong-Hoon Yang, Bong Min Ko, Hyeon Jeong Goong, Hyun Joo Jang, Soo Jung Park, Eun Ran Kim, Sung Noh Hong, Jong Pil Im, Seong-Eun Kim, Ja Seol Koo, Chang Soo Eun, Dong Kyung Chang
Gut and Liver.2021; 15(3): 375. CrossRef
Small Bowel Enteroscopy – A Joint Clinical Guideline from the Spanish and Portuguese Small Bowel Study Groups
Enrique Pérez-Cuadrado-Robles, Rolando Pinho, Begoña Gonzalez, Susana Mão de Ferro, Cristina Chagas, Pilar Esteban Delgado, Cristina Carretero, Pedro Figueiredo, Bruno Rosa, Javier García Lledó, Óscar Nogales, Ana Ponte, Patrícia Andrade, Jose Francisco J
GE - Portuguese Journal of Gastroenterology.2020; 27(5): 324. CrossRef
Capsule Endoscopy Validation of the Magnetic Enterography Global Score in Patients with Established Crohn’s Disease
Eyal Klang, Marianne M Amitai, Adi Lahat, Doron Yablecovitch, Benjamin Avidan, Sandra Neuman, Nina Levhar, Noa Rozendorn, Batya Weiss, Shomron Ben-Horin, Rami Eliakim, Uri Kopylov
Journal of Crohn's and Colitis.2018; 12(3): 313. CrossRef
Quality Indicators for Small Bowel Capsule Endoscopy
Ki-Nam Shim, Seong Ran Jeon, Hyun Joo Jang, Jinsu Kim, Yun Jeong Lim, Kyeong Ok Kim, Hyun Joo Song, Hyun Seok Lee, Jae Jun Park, Ji Hyun Kim, Jaeyoung Chun, Soo Jung Park, Dong-Hoon Yang, Yang Won Min, Bora Keum, Bo-In Lee
Clinical Endoscopy.2017; 50(2): 148. CrossRef
Gastroduodenal lesions detected during small bowel capsule endoscopy: incidence, diagnostic and therapeutic impact
José Francisco Juanmartiñena Fernández, Ignacio Fernández-Urien Sainz, Beatriz Zabalza Ollo, Cristina Saldaña Dueñas, Marta Montañés Guimera, Alfonso Elosua González, Juan José Vila Costas
Revista Española de Enfermedades Digestivas.2017;[Epub] CrossRef
Clinical outcome after enteroscopy for small bowel angioectasia bleeding: A Korean Associateion for the Study of Intestinal Disease (KASID) multiceter study
Seong Ran Jeon, Jeong‐Sik Byeon, Hyun Joo Jang, Soo Jung Park, Jong Pil Im, Eun Ran Kim, Ja Seol Koo, Bong Min Ko, Dong Kyung Chang, Jin‐Oh Kim, Su Yeon Park
Journal of Gastroenterology and Hepatology.2017; 32(2): 388. CrossRef
An update on small bowel endoscopy
Hey-Long Ching, Mark E. McAlindon, Reena Sidhu
Current Opinion in Gastroenterology.2017; 33(3): 181. CrossRef
Practice patterns and clinical significance of use of capsule endoscopy in suspected and established Crohn's disease
Yonghyun Kim, Seong Ran Jeon, Sang Myung Choi, Hyun Gun Kim, Tae Hee Lee, Jun-Hyung Cho, Yunho Jung, Wan Jung Kim, Bong Min Ko, Jin-Oh Kim, Joon Sung Lee, Moon Sung Lee
Intestinal Research.2017; 15(4): 467. CrossRef
Role of capsule endoscopy in suspected or established Crohn's disease in real practice
Hyun Joo Jang
Intestinal Research.2017; 15(4): 431. CrossRef

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Case Report

Familial Mediterranean Fever With Complete Symptomatic Remission During Pregnancy: Kwang Taek Kim, Hyun Joo Jang, Jae Eun Lee, Mi Kang Kim, Jun Jae Yoo, Gye Yeon Lee, Sea Hyub Kae, Jin Lee; Intest Res 2015;13(3):287-290. Published online June 9, 2015; DOI: https://doi.org/10.5217/ir.2015.13.3.287

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Familial Mediterranean fever (FMF) is an inherited autosomal recessive disorder, ethnically restricted and commonly found among populations surrounding the Mediterranean Sea. FMF is the most prevalent autoinflammatory disease; is characterized by recurrent, self-limited episodes of fever with serositis; and is caused by Mediterranean fever gene (MEFV) mutations on chromosome 16. We describe a case of adult-onset FMF with complete symptomatic remission during pregnancy, without the use of colchicine. A 25-year-old woman had presented with periodic fever, abdominal pain, and vomiting since she was 21. Her abdominal computed tomography scan showed intestinal nonrotation. She underwent exploratory laparotomy and appendectomy for her symptoms 1 year prior. She had a symptom-free pregnancy period, but abdominal pain and fever recurred after delivery. Mutation analysis of the MEFV gene revealed two point mutations (p.Leu110Pro and p.Glu148Gln). We report an adult female patient with FMF in Korea with complete symptomatic remission during pregnancy.

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A Case of Familial Mediterranean Fever With Severe Attacks During Withdrawal Bleeding After Controlled Ovarian Hyperstimulation
Mio Tatara, Yuji Tanaka, Akie Takebayashi, Shunichiro Tsuji, Takashi Murakami
Cureus.2024;[Epub] CrossRef
Inherited Autoinflammatory Disease with Immunodeficiency Combined with IgA Nephropathy
Zhifeng Jiang, Aiqiao Feng, L I Tao
Aktuelle Rheumatologie.2020; 45(06): 574. CrossRef
A Case of Schnitzler's Syndrome without Monoclonal Gammopathy-Associated Chronic Urticaria Treated with Anakinra
Min Joo Ahn, Ji Eun Yu, Jiung Jeong, Da Woon Sim, Young-Il Koh
Yonsei Medical Journal.2018; 59(1): 154. CrossRef
Thiol/disulphide homeostasis in pregnant women with Familial Mediterranean fever
Aykan Yucel, Cem Yasar Sanhal, Korkut Daglar, Ozgur Kara, Dilek Uygur, Ozcan Erel
Redox Report.2016; 21(6): 287. CrossRef

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Original Article

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 Park; Intest Res 2014;12(4):281-286. Published online October 27, 2014; DOI: https://doi.org/10.5217/ir.2014.12.4.281

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<b>Background/Aims</b><br/>

Several recent studies have reported that the early use of infliximab (IFX) improves the prognosis of Crohn's disease (CD). However, no data are available from Asian populations, as the forementioned studies have all been conducted in Western countries. The aim of the current study was to evaluate the impact of early use of IFX on the prognosis of Korean patients with CD.

Methods

Patients with a diagnosis of CD established between July 1987 and January 2012 were investigated in 12 university hospitals in Korea. Because insurance coverage for IFX treatment began in August 2005, patients were assigned to either of 2 groups based on diagnosis date. The first group included patients diagnosed from July 1987 to December 2005, and the second from January 2006 to January 2012. We compared the cumulative probabilities of operation and reoperation between the two groups using the Kaplan-Meier method and a log-rank test.

Results

Of the 721 patients investigated, 443 (61.4%) comprized the second group. Although the cumulative probabilities of immunosuppressant (P<0.001) and IFX use (P<0.001) after diagnosis were significantly higher in the second group, there were no significant differences in cumulative probabilities of operation (P=0.905) or reoperation (P=0.418) between two groups.

Conclusions

The early use of IFX did not reduce CD-related surgery requirements in Korean patients with CD. These study results suggest that the early use of IFX may have little impact on the clinical outcome of CD in Korean patients in the setting of a conventional step-up algorithm.

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The Potential of Molecular Remission: Tissue Neutrophil Elastase Is Better Than Histological Activity for Predicting Long-Term Relapse in Patients With Ulcerative Colitis in Endoscopic Remission
Yu Kyung Jun, Hyeon Jeong Oh, Ji Ae Lee, Yonghoon Choi, Cheol Min Shin, Young Soo Park, Nayoung Kim, Dong Ho Lee, Hyuk Yoon
Inflammatory Bowel Diseases.2025; 31(2): 514. CrossRef
Differences in the risk of clinical failure between thiopurine and methotrexate in bio-naïve patients with Crohn’s disease: a Korean nationwide population-based study
Yu Kyung Jun, Eunjeong Ji, Hye Ran Yang, Yonghoon Choi, Cheol Min Shin, Young Soo Park, Nayoung Kim, Dong Ho Lee, Hyuk Yoon
Therapeutic Advances in Gastroenterology.2024;[Epub] CrossRef
Efficacy of COVID-19 vaccines in inflammatory bowel disease patients receiving anti-TNF therapy: A systematic review and meta-analysis
Dan Dou, Fangyi Zhang, Xin Deng, Yun Ma, Shuqing Wang, Xingyu Ji, Xihan Zhu, Dianpeng Wang, Shengsheng Zhang, Luqing Zhao
Heliyon.2023; 9(9): e19609. CrossRef
Pharmacodynamic mechanisms behind a refractory state in inflammatory bowel disease
Rasmus Goll, Øystein K. Moe, Kay-Martin Johnsen, Renate Meyer, Joachim Friestad, Mona D. Gundersen, Hege Kileng, Knut Johnsen, Jon R. Florholmen
BMC Gastroenterology.2022;[Epub] CrossRef
Editorial: does anti‐TNF “treatment persistence” always equate to “effective treatment”? Only objective disease assessments can answer the question
Ashish Srinivasan, Daniel R. van Langenberg
Alimentary Pharmacology & Therapeutics.2021; 54(5): 718. CrossRef
Blocking tumor necrosis factor paved the way for targeted therapeutics in inflammatory diseases
Cong-Qiu Chu
Chinese Medical Journal.2021; 134(21): 2525. CrossRef
A State-of-the-Art Review of New and Emerging Therapies for the Treatment of IBD
Kenechukwu O Chudy-Onwugaje, Kaci E Christian, Francis A Farraye, Raymond K Cross
Inflammatory Bowel Diseases.2019; 25(5): 820. CrossRef
Efficacy of Anti-TNF Therapy for the Treatment of Patients with Moderate-to-Severe Inflammatory Bowel Disease; a First Iranian Report
Samaneh Mohagheghi Darehranj, Sudabeh Alatab, Homayoon Vahedi, Anahita Sadeghi, Alireza Sima, Masoud Malekzadeh, Amir Anoshiravani, Hafez Fakheri, Nasser Ebrahimi Daryani, Abdolhamid Mousavi, Fariborz Mansour-Ghanaei, Mohammad Javad Zahedi, Reza Malekzade
Middle East Journal of Digestive Diseases.2019; 12(1): 12. CrossRef
Novel treatments for inflammatory bowel disease
Hyo Sun Lee, Soo-Kyung Park, Dong Il Park
The Korean Journal of Internal Medicine.2018; 33(1): 20. CrossRef
Association of Perianal Fistulas with Clinical Features and Prognosis of Crohn's Disease in Korea: Results from the CONNECT Study
Jaeyoung Chun, Jong Pil Im, Ji Won Kim, Kook Lae Lee, Chang Hwan Choi, Hyunsoo Kim, Jae Hee Cheon, Byong Duk Ye, Young-Ho Kim, You Sun Kim, Yoon Tae Jeen, Dong Soo Han, Won Ho Kim, Joo Sung Kim
Gut and Liver.2018; 12(5): 544. CrossRef
Physicians Should Provide Shared Decision-Making for Anti-TNF Therapy to Inflammatory Bowel Disease Patients
Jae Myung Cha, Dong Il Park, Sang Hyoung Park, Jeong Eun Shin, Wan Soo Kim, Suk-Kyun Yang
Journal of Korean Medical Science.2017; 32(1): 85. CrossRef
Fecal microbiota transplantation for refractory Crohn's disease
Seon Ho Bak, Hyun Ho Choi, Jinhee Lee, Mi Hee Kim, Youn Hee Lee, Jin Su Kim, Young-Seok Cho
Intestinal Research.2017; 15(2): 244. CrossRef
Long-Term Outcomes of Infliximab Treatment in 582 Korean Patients with Crohn’s Disease: A Hospital-Based Cohort Study
Sang Hyoung Park, Sung Wook Hwang, Min Seob Kwak, Wan Soo Kim, Jeong-Mi Lee, Ho-Su Lee, Dong-Hoon Yang, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Yong Sik Yoon, Chang Sik Yu, Jin-Ho Kim, Suk-Kyun Yang
Digestive Diseases and Sciences.2016; 61(7): 2060. CrossRef
Factors Contributing to the Preference of Korean Patients with Crohn's Disease When Selecting an Anti-Tumor Necrosis Factor Agent (CHOICE Study)
Eun Soo Kim, Kyeong Ok Kim, Byung Ik Jang, Chang Kyun Lee, Hyo Jong Kim, Kang-Moon Lee, You Sun Kim, Chang Soo Eun, Sung-Ae Jung, Suk-Kyun Yang, Jun Lee, Tae-Oh Kim, Yunho Jung, Geom Seog Seo, Soon Man Yoon
Gut and Liver.2016;[Epub] CrossRef
The Efficiency of Intravenous Iron Therapy in Korean Inflammatory Bowel Disease Patients
Kyeong Ok Kim
Gut and Liver.2016; 10(4): 487. 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
Intestinal Research.2016; 14(1): 30. CrossRef
Advanced age impacts surgical characteristics and postoperative course in patients with Crohn's disease
Stanislaus Argeny, Anton Stift, Martina Mittlböck, Amy C. Lord, Svenja Maschke, Mathias Schneeweiß, Stefan Riss
International Journal of Surgery.2016; 33: 182. CrossRef
The clinical usefulness of a web-based messaging system between patients with Crohn disease and their physicians
Da Eun Jeong, Kyeong Ok Kim, Byung Ik Jang, Eun Young Kim, Jin Tae Jung, Seong Woo Jeon, Hyun Seok Lee, Eun Soo Kim, Kyung Sik Park, Kwang Bum Cho
Medicine.2016; 95(26): e4028. CrossRef
The clinical characteristics of patients with free perforation in Korean Crohn’s disease: results from the CONNECT study
Young Seok Doh, You Sun Kim, Song I Bae, Jong Pil Im, Jae Hee Cheon, Byong Duk Ye, Ji Won Kim, Young Sook Park, Ji Hyun Lee, Young-Ho Kim, Joo Sung Kim, Dong Soo Han, Won Ho Kim
BMC Gastroenterology.2015;[Epub] CrossRef
Management of Anemia in Patients with Inflammatory Bowel Disease
Kyeong Ok Kim
The Korean Journal of Gastroenterology.2015; 65(3): 145. CrossRef
Could Early Anti-Tumor Necrosis Factor Therapy Change the Prognosis of Crohn's Disease?
Byong Duk Ye
Intestinal Research.2014; 12(4): 263. CrossRef

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Images of the Issue

A Patient with Recurrent Abdominal Pain and Intestinal Obstruction: Jung Wan Han, Hyun Joo Jang; Intest Res 2014;12(2):166-168. Published online April 29, 2014; DOI: https://doi.org/10.5217/ir.2014.12.2.166

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Original Article

The Iatrogenic Complications of Colonoscopic Polypectomy: A Multicenter Retrospective Study: Min Ho Choi, Yun Sun Choi, Chan Soo So, Woon Geon Shin, Kyoung Oh Kim, Hyun Joo Jang, Cheol Hee Park, Kyung Ho Kim, Jin Bae Kim, Il Hyun Baek, Kwang Ho Baik, Sea Hyub Kae, Hak Yang Kim; Intest Res 2013;11(1):46-51. Published online January 31, 2013; DOI: https://doi.org/10.5217/ir.2013.11.1.46

Abstract PDF

Background/Aims
Colonoscopic polypectomy is an effective tool for the treatment of colonic polyps. With the recent widespread use of colonoscopic polypectomy, there is a growing concern about iatrogenic complications, such as bleeding and perforation. The aim of this study is to analyze the clinical presentation and management of complications during colonoscopic polypectomy. Methods: We retrospectively reviewed the medical records of colonoscopic examinations performed at 5 hospitals of Hallym University Medical Center between June 2005 and June 2008. Results: A total of 26,773 colonoscopies and 4,123 colonoscopic polypectomy were performed. The overall rate of complication was 1.04% (43/4,123). Perforation occurred in 0.19% (8/4,123) of cases, and bleeding occurred in 0.85% (35/4,123) of cases. Perforation occurred in 0.05% of snare polypectomies, 1.09% of endoscopic mucosal resections (EMR), and 7.14% of endoscopic submucosal dissections (ESD). Bleeding occurred in 0.8% of snare polypectomies, 1.09% of EMRs, and 3.57% of ESDs. The complication rate of ESDs was higher than in EMRs and snare polypectomies (P<0.001). Endoscopic clippings were performed in 25% of perforation and 66.7% of bleeding cases. Medical treatment was successful in 75% of perforation and 100% of bleeding cases. Conclusions: Colonoscopic polypectomy is a safe procedure for the treatment of colonic polyps, but rarely, serious complications occur. Compared to a snare polypectomy or an EMR, the complication of an ESD occurs more frequently. Endoscopic treatment and further conservative management seems to be appropriate in most cases with complication. (Intest Res 2011;13:46-51)

Citations

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Clinical Characteristics of Colonoscopic Perforation and Risk Factors for Complications After Surgical Treatment
Liang Li, Bing Xue, Chunxia Yang, Zhongbo Han, Hongqiang Xie, Meng Wang
Journal of Laparoendoscopic & Advanced Surgical Techniques.2020; 30(11): 1153. CrossRef
How Should We Manage Iatrogenic Perforation Caused by Colonoscopy?
Eun Sun Kim
Clinical Endoscopy.2016; 49(3): 214. CrossRef
Efficacy of Laparoscopic Primary Repair in the Treatment of Colonic Perforation After Colonoscopy: A Review of 40,127 Patients
Wu Zhong, Chongrong Qiu, Chuanyuan Liu, Chuanfa Fang, Laiyang Xia, Junlin Liang, Seng Zhang, Lisheng Chen
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2016; 26(6): e105. CrossRef
The Feasibility of Performing Colorectal Endoscopic Submucosal Dissection Without Previous Experience in Performing Gastric Endoscopic Submucosal Dissection
Dong-Hoon Yang, Gwi Hong Jeong, Yerim Song, Sang Hyoung Park, Soo-Kyung Park, Jong Wook Kim, Kee Wook Jung, Kyung-Jo Kim, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim, Young Soo Park, Jeong-Sik Byeon
Digestive Diseases and Sciences.2015; 60(11): 3431. CrossRef

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Selected Summary

Small-Bowel Imaging in Crohn's Disease: A Prospective, Blinded, 4-way Comparison Trial (Gastrointestinal Endoscopy 2008;68:255-266): Yun Sun Choi, Hyun Joo Jang; Intest Res 2009;7(2):137-139. Published online December 30, 2009

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Original Article

The Usefulness of Double Balloon Enteroscopy for Diagnosis and Treatment of Small Bowel Diseases: Min Ho Choi, Kyung Hae Lee, Je Hyun Ryu, Seung Yong Han, Hyeon Woo Byun, Dong Hee Koh, Hyun Joo Jang, Chang Soo Eun, Sea Hyub Kae, Jin Lee; Intest Res 2008;6(1):31-36. Published online June 30, 2008

Abstract PDF: Background/Aims
Double balloon eneterscopy is a promising endoscopic method to examine the entire small bowel and to conduct therapeutic procedures. This study was performed to evaluate the clinical outcome and usefulness of double balloon enteroscopy. Methods: We enrolled patients with suspected small bowel disease. Double balloon enteroscopy was performed in 61 patients and 89 procedures were undetaken between August 2004 and October 2007 at Hangang Sacred Heart Hospital. Results: Indications for double balloon enteroscopy were obscure gastrointestinal bleeding, chronic abdominal pain or diarrhea and the presence of a suspicious small bowel tumor. Double balloon enteroscopy contributed to the diagnosis of small bowel diseases in 82.0% of patients. In 46 patients (75.4%), specific treatments were influenced by the results of double balloon enteroscopy. There were no significant complications. Conclusions: Double balloon enteroscopy is one of the most useful methods for the diagnosis and treatment of small bowel disease. (Intest Res 2008;6:31-36)

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Review

Current State of Small Bowel Investigation: Practical Use of Double Balloon Enteroscopy: Hyun Joo Jang, Jin Lee; Intest Res 2007;5(1):13-18. Published online June 30, 2007

Abstract PDF: The small intestine has been regarded as the most difficult area of the gastrointestinal tract to investigate by endoscopic view. Capsule endoscopy provided a complete evaluation of the small bowel and has become one of the major approaches in diagnosis of suspected small bowel diseases. However, this technique has several limitations, including its inability to perform conventional endoscopic procedures, taking biopsy specimens, and therapeutic interventions. Another novel method, double balloon enteroscopy, introduced by Yamamoto et al. in 2001, makes it possible to overcome these limitations. Since then, several studies have reported diagnostic and therapeutic outcomes. In this brief review, the authors summarized the current clinical outcomes and practical use of double balloon enteroscopy in suspected small bowel disorders. (Intest Res 2007;5:13-18)

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