Intestinal Research

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Vegetarianism as a protective factor for asymptomatic colonic diverticulosis in Asians: a retrospective cross-sectional and case-control study: Jihun Bong, Hyoun Woo Kang, Hyeki Cho, Ji Hyung Nam, Dong Kee Jang, Jae Hak Kim, Jun Kyu Lee, Yun Jeong Lim, Moon-Soo Koh, Jin Ho Lee; Intest Res 2020;18(1):121-129. Published online November 1, 2019; DOI: https://doi.org/10.5217/ir.2019.00106

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Background/Aims
Dietary fiber intake is considered a protective factor for diverticular disease such as diverticulitis. However, evidence for an inverse connection between dietary fiber consumption and asymptomatic colonic diverticulosis is lacking. Specifically, few studies have investigated this subject in Asians with different presentations of diverticulosis. Therefore, we assessed the protective effects of a vegetarian diet for asymptomatic colonic diverticulosis in Buddhist monks who are obligatory vegetarians for spiritual reasons compared with the general population.
Methods
A retrospective, cross-sectional, case-control study was conducted in age- and sex-matched Buddhist monks and the general population who underwent colonoscopy for screening at a Korean health promotion center from August 2005 to June 2018. We compared the prevalence of asymptomatic diverticulosis between the 2 groups using a self-administered questionnaire.
Results
In this study, a total of 1,316 individuals were included (Buddhist monks of 658 and general population of 658) with a mean age of 52.6±9.5 years. The prevalence of asymptomatic diverticulosis in Buddhist monks was lower compared with the general population (6.7% [44/658] vs. 10.8% [71/658], P=0.008). Buddhist monks had a higher rate of high body mass index (BMI) and metabolic syndrome. By a multivariate regression analysis model, a nonvegetarian diet (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.21–2.72, P=0.004), old age (OR, 4.53; 95% CI, 1.36–15.12; P=0.014), male sex (OR, 1.91; 95% CI, 1.28–2.85; P=0.002), and a high BMI (OR, 1.50; 95% CI, 1.01–2.23; P=0.047) were independent predictors of asymptomatic diverticulosis. Moreover, a nonvegetarian diet was associated with both right-sided and left-sided diverticulosis.
Conclusions
A nonvegetarian diet may increase a risk of asymptomatic colonic diverticulosis in Asians.

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Association of Metabolic Syndrome Components and Colonic Diverticulosis in the Very Elderly: A Tertiary Health Network Study
Hammad Liaquat, Farah Harmouch, Nishit Patel, Zarian Prenatt, Jill Stoltzfus, Berhanu Geme, Noel Martins, Kimberly Chaput
Cureus.2024;[Epub] CrossRef
Not all acute colonic diverticulitis follows the same course: a potential risk for immunocompromised individuals
Yehyun Park
Intestinal Research.2023; 21(4): 415. CrossRef
Age, alcohol, sex, and metabolic factors as risk factors for colonic diverticulosis
Ye Yan, Jian-Sheng Wu, Shuang Pan
World Journal of Clinical Cases.2022; 10(1): 136. CrossRef
Diagnosis and Treatment of Colonic Diverticular Disease
You Sun Kim
The Korean Journal of Gastroenterology.2022; 79(6): 233. CrossRef
The prevalence of right‐sided colonic diverticulosis in a New Zealand population
Greg A. Turner, Michael J. O'Grady, Sajith C. Senadeera, Chris J. Wakeman, Andrew McCombie, Rachel V. Purcell, Frank A. Frizelle
ANZ Journal of Surgery.2021; 91(10): 2110. CrossRef
The Epidemiology and Etiology of Right-Sided Colonic Diverticulosis: A Review
Greg A. Turner, Michael J. O’Grady, Rachel V. Purcell, Frank A. Frizelle
Annals of Coloproctology.2021; 37(4): 196. CrossRef

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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 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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Background/Aims

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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The Effect of Infliximab on Patients with Ulcerative Colitis in Korea: Hyun Il Seo, Dong Il Park, Tae Oh Kim, You Sun Kim, Suck-Ho Lee, Ji Won Kim, Jae Hak Kim, Jeong Eun Shin; Intest Res 2014;12(3):214-220. Published online July 25, 2014; DOI: https://doi.org/10.5217/ir.2014.12.3.214

Abstract PDF PubReader ePub

Background/Aims

Infliximab was introduced recently as a rescue therapy for ulcerative colitis (UC) patients refractory to conventional treatments such as therapy with 5-amiono salicylic acids (5-ASA), immune modulators, and corticosteroids. However, there is insufficient data about its efficacy and safety in Korea.

Methods

From 7 tertiary referral hospitals, 33 patients who were treated with infliximab for moderate to severe (Mayo score 6-12) UC refractory to conventional treatment were recruited to this study. Clinical remission was defined as a total Mayo score of 2 or lower and every subscore less than 2. Partial response was defined as a decrease of Mayo score at least 3 points from baseline.

Results

Twenty-three patients (69.7%) showed clinical remission and 29 patients (87.8%) showed partial response in the observation period. When the remission and non-remission groups were compared in univariate analysis, only a higher total Mayo score at base line (11.0±0.9 vs. 9.9±1.5; P=0.04) was related to remission. The remission maintenance rate decreased with time in the Kaplan-Meier analysis. Two patients experienced re-remission after the first remission followed by aggravation during infliximab treatment. Three patients stopped infliximab treatment owing to adverse events including rhabdomyolysis, pneumonia, and fever of unknown origin.

Conclusions

If there is no choice except surgery for UC patients refractory to conventional treatment, infliximab is an effective and relatively safe treatment option for these patients in Korea.

Citations

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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
Long-term outcomes of infliximab treatment and predictors of response in 195 patients with ulcerative colitis: a hospital-based cohort study from Korea
Hyungil Seo, Kiju Chang, Sun-Ho Lee, Eun-Mi Song, Gwang-Un Kim, Myeongsook Seo, Ho-Su Lee, Sung-Wook Hwang, Dong-Hoon Yang, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Sang Hyoung Park
Scandinavian Journal of Gastroenterology.2017; 52(8): 857. CrossRef
Colectomy rates in patients with ulcerative colitis following treatment with infliximab or ciclosporin
Kymberley Thorne, Laith Alrubaiy, Ashley Akbari, David G. Samuel, Sian Morrison-Rees, Stephen E. Roberts
European Journal of Gastroenterology & Hepatology.2016; 28(4): 369. CrossRef
Efficacy and safety of CT‐P13, a biosimilar of infliximab, in patients with inflammatory bowel disease: A retrospective multicenter study
Yoon Suk Jung, Dong Il Park, Young Ho Kim, Ji Hyun Lee, Pyoung Ju Seo, Jae Hee Cheon, Hyoun Woo Kang, Ji Won Kim
Journal of Gastroenterology and Hepatology.2015; 30(12): 1705. CrossRef
Inflammatory Bowel Disease Cohort Studies in Korea: Present and Future
Jung Won Lee, Jong Pil Im, Jae Hee Cheon, You Sun Kim, Joo Sung Kim, Dong Soo Han
Intestinal Research.2015; 13(3): 213. CrossRef
Circulating Ghrelin Levels and Obestatin/Ghrelin Ratio as a Marker of Activity in Ulcerative Colitis
Ja Young Jung, Ji Bong Jeong, Ji Won Kim, Su Hwan Kim, Seong-Joon Koh, Byeong Gwan Kim, Kook Lae Lee
Intestinal Research.2015; 13(1): 68. CrossRef
How to Write Bibliographies for Citing Domestic Academic Resources
Hyun Jung Yi
The Korean Journal of Gastroenterology.2015; 65(1): 70. CrossRef
Does the Cyclosporine Still Have a Potential Role in the Treatment of Acute Severe Steroid-Refractory Ulcerative Colitis?
Chang Soo Eun, Dong Soo Han
Gut and Liver.2015;[Epub] CrossRef
Current and Emerging Biologics for Ulcerative Colitis
Sung Chul Park, Yoon Tae Jeen
Gut and Liver.2015; 9(1): 18. CrossRef

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Association between the Position of Colorectal Polyps and Clinical Outcomes of Polypectomy: Focused on Procedure Time, Complication and Histopatholgic Result: Jung Hyun Park, Jae Hyeok Choi, Hyeong Jung Na, Won Geon Kwak, Jong Sun Choi, Eo Jin Kim, Jae Hak Kim; Intest Res 2013;11(3):191-197. Published online July 30, 2013; DOI: https://doi.org/10.5217/ir.2013.11.3.191

Abstract PDF: Background/Aims
Colonoscopic polypectomy should be performed on the five to seven hour of clock (standard position). However, outcomes of polypectomy at non-standard positions have not yet been investigated. This study was to compare the clinical outcomes of colonoscopic polypectomy including procedure time, status of resection margin and complications between standard and non-standard position. Methods: Patients who underwent screening colonoscopy were prospectively recruited from Oct 2011 to Feb 2012 at Dongguk University Ilsan Hosptial, Goyang, Korea. Standard position was defined as polyps which were located from 5 to 7 hour of clock on colonoscopic view. Results: A total of 168 adenomatous polyps of 114 patients were investigated. Mean size of polyp was 7.1±3.2 mm. The most common shape of polyps was sessile in 77 cases (45.8%). Mean overall procedure time per patient was 25.5±12.3 min. 130 adenomatous polyps were resected in standard position (77.4%) and 38 polyps were in non-standard position (22.6%). Overall complete resection rate was 63.7% and immediate bleeding rate was 9.8%. There was no significant difference in overall polypectomy time per polyp (2.9±1.3 min vs. 3.0±1.8 min, P=0.32). Complete resection rates and complication were not statistically different. Conclusions: There was no difference according to procedure time, status of resection margin and complications between standard position and non-standard position. Colonoscopic polypectomy is thus safe and feasible on any position. (Intest Res 2013;11:191-197)

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A Survey of Actual Clinical Practice Patterns in the Treatment of Inflammatory Bowel Disease in Korea: Jae Hak Kim, Jae Hee Cheon, Tae Il Kim, Won Ho Kim; Intest Res 2009;7(2):79-85. Published online December 30, 2009

Abstract PDF: Background/Aims
The aim of this study was to determine the actual practice patterns of clinicians caring for Korean patients with inflammatory bowel diseases (IBDs). Methods: Questionnaires, including te indications and doses of 5-aminosalicylic acid (5-ASA), corticosteroids, or azathioprine/6-mercaptopurine (AZA/6-MP), assessment of response, the surveillance method, and the interval for adverse effects, were distributed during the 2008 KASID annual lecture. Thirty questionnaires were collected. Results: Most of the responders (93.3%) were board-certified with sub-specialty training in gastroenterology. For active diseases, 43.3% of the responders escalated the dose of 5-ASA from conventional to maximal doses. Of the patients in disease remission, 36.7% were maintained on the conventional or a reduced dose for a fixed period of time. Corticosteroids were prescribed by dose-base (20/30 [66.7%]). In most cases, the starting dose was 40 mg/d (15/19 [78.9%]), and tapered within a 1 (43.3%) or 2 week interval (40.0%). There were various definitions of corticosteroid-refractoriness and -dependency among the responders. Most of the responders initiated AZA at 50 mg/d; 68.4% of the patients increased the dose by 25 mg and 55.6% of the patients increased the dose within a 4-week interval. For monitoring adverse events, such as leukopenia, 63.3% of the patients checked a complete blood count for 2 weeks in the 1st month of therapy. Conclusions: There were various patterns of practice in the treatment of Korean IBD patients, especially in terms of the prescribing patterns of drugs and assessment of response, which suggests that standard therapeutic guidelines of IBD should be established in Korea. (Intest Res 2009;7:79-85)

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Clinical Associations between the Supplementary Examinations of the Terminal Ileal Mucosal Lesion and the Lesion of the Ileocecal Valve: Ji Hyung Nam, Jae Hak Kim, Jong Ho Lee, Jong-Sun Choi, Jeong Bae Park, Jun Kyu Lee, Yun Jeong Lim, Moon-Soo Koh, Jin Ho Lee; Intest Res 2008;6(2):121-127. Published online December 30, 2008

Abstract PDF: Background/Aims
The diagnostic value of terminal ileum (TI) biopsies during colonoscopy remains controversial. This study assessed the clinical characteristics of terminal ileal lesions during colonoscopy to find the affecting factors for the specific investigations in addition to TI biopsies. Methods: Thirty-seven patients (male to female ratio of 1.6, mean age 42.2±12.2 years, range 20-68 years) who had undergone colonoscopy with biopsies of TI at Dongguk University International Hospital from September 2005 to December 2007 were retrospectively studied. We analyzed the characteristics of patients, endoscopic and histopathologic findings, followed by multivariate analysis of those significant variables. Results: Ulcerative lesions were most frequently found in 17 cases (45.9%) and multiple lesions were observed in eight cases (21.6%). Aphthoid shape was evident in 19 cases (51.4%). Eight cases (21.6%) were combined with ileocecal valve (ICV) lesion. On histopathologic examination, nonspecific inflammation was evident in 19 cases (51.4%). The diagnostic yield of TI biopsies was 5.4%. Presence of ICV lesion (p=0.004) and multiple lesions (p=0.027) were associated with clinically significant TI lesion. By multivariate analysis, only ICV lesion was statistically significant (Odds ratio 8.3: 95% confidence interval 1.3-54.1, p=0.026). Conclusions: Not all patients who undergo colonoscopy require intubation of TI. However, a careful examination of ICV could be useful to determine whether intubation of TI would be necessary or not. (Intest Res 2008;6:121-127)

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