Intestinal Research

Impact of Portulaca oleracea L. extract in patients with irritable bowel syndrome: Kwangwoo Nam, Jung Ho Choi, Yong Sung Kim, Seong Lee, Jee Hun Park, Hyeongjoo Kim, Sangyun Lee, Yerin Lee, Doohyuck Lee, Sunghyeok Ryou, Jeong Eun Shin; Received August 31, 2025 Accepted December 28, 2025 Published online April 20, 2026; DOI: https://doi.org/10.5217/ir.2025.00200 [Epub ahead of print]

Abstract PDF: Background/Aims
Portulaca oleracea is known to have anti-inflammatory and immunoregulatory effects, and also showed positive effect on complete spontaneous bowel movement and bowel symptoms in patients with chronic constipation in a previous study. Thus, we aimed to investigate the impact of P. oleracea in patients with irritable bowel syndrome (IBS).
Methods
Patients with IBS defined by ROME IV criteria were enrolled between July 2022 and April 2023. Patients were randomly assigned to P. oleracea or placebo group and took drugs for 8 weeks. Clinical data including gastrointestinal and IBS symptoms, laboratory tests including inflammatory and immunologic laboratory markers, and stool tests including fecal calprotectin and stool microbial analysis were evaluated at the baseline, week 4, and week 8.
Results
A total of 108 patients were initially enrolled and 101 patients were finally included in the analysis. There was significant improvement during 8 weeks in P. oleracea group compared to placebo group in the aspect of gastrointestinal and IBS-related bowel symptoms (Gastrointestinal Symptom Rating Scale total score: from 44.1 to 31.7 vs. from 41.4 to 39.9; IBS-Symptom Severity Score total score: from 232.0 to 120.6 vs. from 202.7 to 178.2), especially in the aspect of abdominal pain. Interleukin-6 (IL-6) was significantly decreased during 8 weeks in P. oleracea group, although there was no significant difference between 2 groups. In addition, increase in IL-6 during study period was significantly associated with dysbiosis in stool microbial analysis. There was no significant adverse event.
Conclusions
P. oleracea has positive impact in patients with IBS showing improvement of immunologic cytokine and stool microbiome.

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Recent updates on the endoscopic treatment of rectal neuroendocrine tumor: Sunghyeok Ryou, Kwangwoo Nam; Received July 18, 2025 Accepted September 8, 2025 Published online November 27, 2025; DOI: https://doi.org/10.5217/ir.2025.00141 [Epub ahead of print]

The incidence of rectal neuroendocrine tumors has been gradually increasing, primarily due to the widespread use of screening colonoscopy and growing awareness of the disease. Most rectal neuroendocrine tumors are small ( < 10 mm), well-differentiated, and low-grade lesions at the time of diagnosis, and they are usually asymptomatic. Given these characteristics, endoscopic resection is considered a feasible treatment option for early-stage lesions. However, due to their inherent malignant potential, a comprehensive initial diagnostic evaluation is essential. Lymph node or distal metastasis can be present at diagnosis or may develop long after apparently successful primary treatment. Therefore, achieving complete resection using the most optimal resection method is crucial. Modified endoscopic mucosal resection and endoscopic submucosal dissection are recommended over conventional forceps or snare polypectomy, which are associated with high incomplete resection rates. In case of incomplete resection, additional endoscopic resection can be a feasible option in selected cases. Furthermore, regular post-resection surveillance is needed, especially in patients with high-risk of recurrence such as poor pathologic result or incomplete resection.

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Endoscopic Resection of Rectal Neuroendocrine Tumors: Pathologic Risk Stratification and Surveillance Strategies
Ji Eun Kim
Journal of Digestive Cancer Research.2025; 13(3): 228. CrossRef

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IBD

Prevalence and risk factors of gallstone disease in Korean patients with ulcerative colitis: Kwangwoo Nam, Jae Yong Lee, Sang Hyoung Park, Ha Won Hwang, Ho-Su Lee, Kyunghwan Oh, Hee Seung Hong, Kyuwon Kim, Jin Hwa Park, Seung Wook Hong, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang; Intest Res 2025;23(4):455-463. Published online November 29, 2024; DOI: https://doi.org/10.5217/ir.2024.00070

Abstract PDF PubReader ePub

Background/Aims
The prevalence of gallstone disease in patients with ulcerative colitis (UC) is higher than in the general population. However, risk factors of gallstone disease in these patients remain unclear. Thus, we investigated the prevalence and risk factors of gallstone disease in Korean patients with UC.
Methods
Patients diagnosed with UC who underwent abdominal imaging studies between 1997 and 2020 were investigated using a well-established referral center-based large volume inflammatory bowel disease cohort. The prevalence and clinical characteristics of patients with gallstone disease were evaluated and compared with those without gallstone disease.
Results
Overall, 2,811 patients with UC were enrolled. During the follow-up period (mean, 5.7 years), 198 patients (7.0%) were diagnosed with gallstone disease and compared with those without gallstone disease (n = 2,613). The proportion of extensive colitis at maximum extent, primary sclerosing cholangitis (PSC), history of cytomegalovirus, corticosteroid use, immunomodulatory use, colectomy, and appendectomy were significantly higher in the gallstone group (all P< 0.05). In multivariate analyses, age ≥ 60 years at gallstone evaluation (odds ratio [OR], 1.027; 95% confidence interval [CI], 1.002–1.052; P= 0.033), PSC (OR, 6.304; 95% CI, 3.162–12.565; P< 0.001), and history of colectomy (OR, 2.494; 95% CI, 1.222–5.087; P= 0.012) were significant risk factors for gallstone disease in patients with UC.
Conclusions
The prevalence of gallstone disease in Korean patients with UC was 7.0%, and age ≥ 60 years at gallstone evaluation, PSC, and history of colectomy were significant risk factors for UC patients with gallstone disease.

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Gallstone burden and risk in Korean patients with ulcerative colitis
Seong Ran Jeon
Intestinal Research.2025; 23(4): 391. CrossRef

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Endoscopy

Use of device-assisted enteroscopy in small bowel disease: an expert consensus statement by the Korean Association for the Study of Intestinal Diseases: Han Hee Lee, Jin Su Kim, Hyeon Jeong Goong, Shin Hee Lee, Eun Hye Oh, Jihye Park, Min Cheol Kim, Kwangwoo Nam, Young Joo Yang, Tae Jun Kim, Seung-Joo Nam, Hee Seok Moon, Jae Hyun Kim, Duk Hwan Kim, Seong-Eun Kim, Seong Ran Jeon, Seung-Jae Myung, The Small Intestine Research Group of the Korean Association for the Study of Intestinal Diseases (KASID); Intest Res 2023;21(1):3-19. Published online January 31, 2023; DOI: https://doi.org/10.5217/ir.2022.00108

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The introduction of device-assisted enteroscopy (DAE) in the beginning of 21st century has revolutionized the diagnosis and treatment of diseases of the small intestine. In contrast to capsule endoscopy, the other main diagnostic modality of the small bowel diseases, DAE has the unique advantages of observing the region of interest in detail and enabling tissue acquisition and therapeutic intervention. As DAE becomes an essential procedure in daily clinical practice, there is an increasing need for correct guidelines on when and how to perform it and what technical factors should be considered. In response to these needs, the Korean Association for the Study of Intestinal Diseases developed an expert consensus statement on the performance of DAE by reviewing the current evidence. This expert consensus statement particularly focuses on the indications, choice of insertion route, therapeutic intervention, complications, and relevant technical points.

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Clinical implications of endoscopic phenotypes in primary small intestinal lymphoma
Yoo Jin Lee
Clinical Endoscopy.2026; 59(2): 242. CrossRef
Effect of Different Types of Antithrombotic Agents on Clinical Outcomes in Patients With Small Bowel Bleeding Who Underwent Balloon‐Assisted Enteroscopy: A KASID Multicenter Study
Jihye Park, Jin Su Kim, Joo Hye Song, Kwangwoo Nam, Seong‐Eun Kim, Eui Sun Jeong, Jae Hyun Kim, Seong Ran Jeon
Journal of Gastroenterology and Hepatology.2025; 40(2): 456. CrossRef
Balloon-assisted enteroscopy in the management of adult small-bowel intussusception: a comparative analysis of with and without double-balloon enteroscopy
Won Shik Kim, Beom Jae Lee, Moon Kyung Joo, Seung Han Kim, Jong-Jae Park
Surgical Endoscopy.2025; 39(3): 2044. CrossRef
Comparative Study of MiroCam MC2000 and PillCam SB3 in Detecting Small Bowel Bleeding: A Multicenter Prospective Randomized Crossover Study
Ji Eun Kim, Eun Ran Kim, Jae Jun Park, Kyeong Ok Kim, Yehyun Park, Young Joo Yang, Hyun Joo Jang
Gut and Liver.2025; 19(4): 569. CrossRef
From Data to Insights: How Is AI Revolutionizing Small-Bowel Endoscopy?
Joana Mota, Maria João Almeida, Francisco Mendes, Miguel Martins, Tiago Ribeiro, João Afonso, Pedro Cardoso, Helder Cardoso, Patrícia Andrade, João Ferreira, Miguel Mascarenhas, Guilherme Macedo
Diagnostics.2024; 14(3): 291. CrossRef
Role of Device-Assisted Enteroscopy in Crohn’s Disease
Giulia Catassi, Clelia Marmo, Antonio Gasbarrini, Maria Elena Riccioni
Journal of Clinical Medicine.2024; 13(13): 3919. CrossRef
Discordance Rate and Risk Factor of Other Diagnostic Modalities for Small Bowel Tumors Detected by Device-Assisted Enteroscopy: A Korean Association for the Study of Intestinal Disease (KASID) Multicenter Study
Jihye Park, Jin Su Kim, Joo Hye Song, Kwangwoo Nam, Seong-Eun Kim, Eui Sun Jeong, Jae Hyun Kim, Seong Ran Jeon
Gut and Liver.2024; 18(4): 686. CrossRef

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