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IBD
Proposal of novel staging system CNM (Crohn’s primary site, nodes, mesentery) to predict postoperative recurrence of Crohn’s disease
Guduru Venkat Rao, Partha Pal, Anuradha Sekaran, Pradeep Rebala, Manu Tandan, D. Nageshwar Reddy
Intest Res 2023;21(2):196-204.   Published online August 8, 2022
DOI: https://doi.org/10.5217/ir.2022.00045
AbstractAbstract PDFPubReaderePub
After oncologic resection, histological grading and staging of the tumor give important prognostic information about the future risk of recurrence and hence influence the subsequent management plan. Several studies and their meta-analysis have shown that various histological features (e.g., microscopic positive resection margins, plexitis, granuloma, mesenteric inflammatory activity) can predict postoperative clinical/endoscopic/surgical recurrence after resection in Crohn’s disease (CD). Inclusion of mesentery in surgical resection specimens has been shown to reduce surgical recurrence after ileocolonic resection in CD. However, there is no uniform histopathological staging system for risk stratification in postoperative CD to systematically predict postoperative recurrence. This is because the prediction to date is based on clinical characteristics (smoking status, disease phenotype, surgical history). Histopathological predictors are still not adopted in routine clinical practice due to the lack of a uniform staging system, heterogeneity of published studies and lack of standardized definition of histological features. In this article, we attempted to incorporate all such histological features in a single histological staging system CNM (Crohn’s primary site [resection margin positivity, plexitis, granuloma, depth of infiltration], nodes [presence of granuloma], mesentery [involved or not]) in surgical resection specimen in CD. The proposed CNM classification would help to enable systematic reporting, design future clinical trials, stratify postoperative recurrence risk and choose appropriate postoperative prophylaxis.

Citations

Citations to this article as recorded by  
  • Endoscopic Assessment of Postoperative Recurrence in Crohn's Disease
    Partha Pal, D. Nageshwar Reddy, Guduru Venkat Rao
    Gastrointestinal Endoscopy Clinics of North America.2025; 35(1): 121.     CrossRef
  • Managing Crohn’s Disease Postoperative Recurrence Beyond Prophylaxis: A Comprehensive Review with Meta-Analysis
    Andrei Ovidiu Olteanu, Artsiom Klimko, Eugen Nicolae Tieranu, Andreea Daniela Bota, Carmen Monica Preda, Ioana Tieranu, Christopher Pavel, Mihai Radu Pahomeanu, Cristian Valentin Toma, Adrian Saftoiu, Elena Mirela Ionescu, Cristian George Tieranu
    Biomedicines.2024; 12(11): 2434.     CrossRef
  • 7,453 View
  • 501 Download
  • 2 Web of Science
  • 2 Crossref
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Original Articles
Inflammatory Bowel Diseases
Very early onset inflammatory bowel disease in a South Asian country where inflammatory bowel disease is emerging: a distinct clinical phenotype from later onset disease
Rupa Banerjee, Partha Pal, Zaheer Nabi, Upender Shava, Girish Ganesh, D. Nageshwar Reddy
Intest Res 2021;19(4):398-407.   Published online November 20, 2020
DOI: https://doi.org/10.5217/ir.2020.00107
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Information on pediatric inflammatory bowel disease (PIBD) and very early onset IBD (VEOIBD) are sparse in India, where IBD is emerging. We aimed to evaluate characteristics of VEOIBD and later onset PIBD (LO-PIBD) in India.
Methods
We performed retrospective analysis of a large, prospectively maintained IBD registry. PIBD was divided in to VEOIBD ( < 6 years) and LO-PIBD (6–17 years). Demographic data, disease characteristics and treatment were compared between the PIBD groups and with other Asian/Western studies as well as the adult patients of the registry.
Results
Of 3,752 IBD patients, 292 (7.8%) had PIBD (0–17 years) (175 Crohn’s disease [CD], 113 ulcerative colitis [UC], 4 IBD-undifferentiated; 22 VEOIBD [7.5%], and 270 LO-PIBD [92.5%]). VEOIBD patients had more severe disease compared to LO-PIBD in both UC (P= 0.003) and CD (P< 0.001). Familial IBD was more common in VEOIBD (13.6%) compared to LO-PIBD (9.2%). Ileal disease (L1) was an independent risk factor for diagnostic delay in pediatric CD. Diagnostic delay ( > 6 months) was significantly lower in VEOIBD (40.9%) than in LO-PIBD (78.8%) (P< 0.001). Compared to other Asian and Western studies, extensive UC (72.5%) and complicated CD (stricturing/penetrating: 42.7%) were relatively more common. Perianal CD was relatively less frequent (7.4%). PIBD had a significantly higher number of complicated and ileal CD and extensive UC comparison to adult cohort of the registry.
Conclusions
VEOIBD has more aggressive phenotype than LO-PIBD. Disease appears distinct from other Asian and Western studies and adult onset disease, with more complicated CD and extensive UC.

Citations

Citations to this article as recorded by  
  • Delays in Diagnosing Pediatric Inflammatory Bowel Disease in Korea: Impact on Disease Severity and the Need for Early Recognition
    So Yoon Choi, Sujin Choi, Ben Kang, Byung-Ho Choe, Yeoun Joo Lee, Jae Hong Park, Yu Bin Kim, Jae Young Kim, Kunsong Lee, Kyung Jae Lee, Ki Soo Kang, Yoo Min Lee, Hyun Jin Kim, Yunkoo Kang, Hyo-Jeong Jang, Dae Yong Yi, Suk Jin Hong, You Jin Choi, Jeana Hon
    Journal of Korean Medical Science.2026;[Epub]     CrossRef
  • Clinical characteristics and treatment patterns of older and younger patients with inflammatory bowel disease
    Fatih Kivrakoglu, Vedat Kilic, Mustafa Ergin, Harun Kucuk, Cagdas Erdogan, Ilhami Yuksel
    World Journal of Gastroenterology.2026;[Epub]     CrossRef
  • Diagnostic interval of inflammatory bowel disease in Chinese children and its relationship with growth parameters: a retrospective study
    Juan Zhou, BinRong Chen, ZhiCheng Wang, Li Liu, HongJuan OuYang, YanHong Luo, WenTing Zhang, ChenXi Liu, MeiZheng Zhan, JiaQi Duan, CanLin Li, Na Jiang, JieYu You, HongMei Zhao
    Frontiers in Pediatrics.2025;[Epub]     CrossRef
  • Inflammatory bowel disease in south Asia: a scoping review
    Shabari Shenoy, Anuraag Jena, Carrie Levinson, Vishal Sharma, Parakkal Deepak, Tina Aswani-Omprakash, Shaji Sebastian, Jean-Frederic Colombel, Manasi Agrawal
    The Lancet Gastroenterology & Hepatology.2025; 10(3): 259.     CrossRef
  • Disease phenotypic and outcome of very-early onset inflammatory bowel disease in Asian children: an understudied population
    Way-Seah Lee, Kee-Seang Chew, James-Guoxian Huang, Pornthep Tanpowpong, Karen S. C. Mercado, Almida Reodica, Veena Logarajah, K. L. W. Hathagoda, Shaman Rajindrajith, Yoko Kin-Yoke Wong, Suporn Treepongkaruna, Marion Margaret Aw
    Frontiers in Pediatrics.2025;[Epub]     CrossRef
  • Epidemiology and the cost burden of hospitalized pediatric‐onset inflammatory bowel disease in China: A national database study
    Xiaolu Nie, Jing Li, Hui Xu, Fang Hu, Xiaolin Ye, Mengmeng Yu, Guoshuang Feng, Yueping Zeng, Xin Ni, Jie Wu, Xiaoxia Peng
    Pediatric Investigation.2025; 9(3): 282.     CrossRef
  • Management of pediatric inflammatory bowel diseases in limited‐resource settings: A position paper from the Paediatric IBD Porto Group of ESPGHAN
    Almuthe Christine Hauer, Mutaz Sultan, Andy Darma, Eyad Altamimi, Daniela Elena Serban, Amit Assa, Claudia Patricia Sánchez Franco, Lissy de Ridder, David C. Wilson, Nadeem Ahmad Afzal, Jiri Bronsky, Miglena Georgieva, Marina Aloi, Vaidotas Urbonas, Vícto
    Journal of Pediatric Gastroenterology and Nutrition.2025; 81(3): 866.     CrossRef
  • Clinical features and outcomes of perianal disease in pediatric onset Crohn’s disease
    Lin Wang, Yuhuan Wang, Ping Li, Shengnan Wang, Cuifang Zheng, Ying Huang
    Digestive and Liver Disease.2025; 57(12): 2331.     CrossRef
  • Advanced therapy is delayed in pediatric South Asian inflammatory bowel disease patients in the United States
    Megha Tandon, Jennifer Bachand, Nurgul Yegembayeva, Lauren V. Collen, Sushrut Jangi
    Journal of Pediatric Gastroenterology and Nutrition.2025; 81(6): 1469.     CrossRef
  • Asian–Pacific perspectives on the management of very early-onset inflammatory bowel disease
    Ichiro Takeuchi, Katsuhiro Arai, Pornthep Tanpowpong, Ming-Wei Lai, Andrew S Day, Way Seah Lee, James Guoxian Huang, Karen Sophia Calixto-Mercado, Rosanna Ming Sum Wong, Muhammad Arshad Alvi, Zubin Grover, Jung Ok Shim, Ujjal Poddar
    Intestinal Research.2025; 23(4): 405.     CrossRef
  • Spectrum and trend of pediatric inflammatory bowel disease: A two-decade experience from northern India
    Neelam Mohan, Shivani Deswal, Anubhuti Bhardwaj
    Indian Journal of Gastroenterology.2024; 43(1): 208.     CrossRef
  • Inflammatory bowel disease: a narrative review of disease evolution in South Asia and India over the last decade
    Sahana Shankar, Snehali Majumder, Suparna Mukherjee, Anirban Bhaduri, Rangarajan Kasturi, Subrata Ghosh, Marietta Iacucci, Uday N. Shivaji
    Therapeutic Advances in Gastroenterology.2024;[Epub]     CrossRef
  • Medical management of pediatric inflammatory bowel disease in the Asia‐Pacific region: A position paper by the Asian Pan‐Pacific Society for Pediatric Gastroenterology, Hepatology, and Nutrition (APPSPGHAN) PIBD Working Group
    Way Seah Lee, Katsuhiro Arai, George Alex, Suporn Treepongkaruna, Kyung Mo Kim, Chee Liang Choong, Karen S. C. Mercado, Andy Darma, Anshu Srivastava, Marion M. Aw
    Journal of Gastroenterology and Hepatology.2023; 38(4): 523.     CrossRef
  • Very-early-onset inflammatory bowel disease versus late-onset inflammatory bowel disease in relation to clinical phenotype: A cross-sectional study
    Hala H. Mansour, Saeed S. Seddek, Manal E. Abd E. L. Meguid, Ayman E. Eskander, Sara T. Galal
    Indian Journal of Gastroenterology.2023; 42(2): 185.     CrossRef
  • Twenty-first Century Trends in the Global Epidemiology of Pediatric-Onset Inflammatory Bowel Disease: Systematic Review
    M. Ellen Kuenzig, Stephen G. Fung, Luba Marderfeld, Joyce W.Y. Mak, Gilaad G. Kaplan, Siew C. Ng, David C. Wilson, Fiona Cameron, Paul Henderson, Paulo G. Kotze, Jasmine Bhatti, Vixey Fang, Samantha Gerber, Evelyne Guay, Supun Kotteduwa Jayawarden, Leo Ka
    Gastroenterology.2022; 162(4): 1147.     CrossRef
  • Epidemiological characteristics of Asian children with inflammatory bowel disease at diagnosis: Insights from an Asian-Pacific multi-centre registry network
    James Guoxian Huang, Yoko Kin Yoke Wong, Kee Seang Chew, Pornthep Tanpowpong, Karen Sophia Calixto Mercado, Almida Reodica, Shaman Rajindrajith, Kai-Chi Chang, Yen-Hsuan Ni, Suporn Treepongkaruna, Way-Seah Lee, Marion Margaret Aw
    World Journal of Gastroenterology.2022; 28(17): 1830.     CrossRef
  • Personalized medicine in inflammatory bowel disease: Perspectives on Asia
    Su Hyun Park, Sang Hyoung Park
    Journal of Gastroenterology and Hepatology.2022; 37(8): 1434.     CrossRef
  • Inflammatory bowel disease in Korea: epidemiology and pathophysiology
    Jung Won Lee, Chang Soo Eun
    The Korean Journal of Internal Medicine.2022; 37(5): 885.     CrossRef
  • Racial and Ethnic Variation in Presentation, Diagnosis, Treatment, and Outcome of Pediatric Crohn Disease
    Savini Lanka Britto, Justin Qian, Faith Dorsey Ihekweazu, Richard Kellermayer
    Journal of Pediatric Gastroenterology and Nutrition.2022; 75(3): 313.     CrossRef
  • Phenotypic Pattern of Early Versus Later‐Onset Pediatric Inflammatory Bowel Disease in a Eurasian Country
    Bilge S. Akkelle, Deniz Ertem, Burcu Volkan, Engin Tutar
    Journal of Pediatric Gastroenterology and Nutrition.2022;[Epub]     CrossRef
  • Clinical Features and Long-Term Outcomes of Paediatric-Onset Inflammatory Bowel Disease in a Population-Based Cohort in the Songpa-Kangdong District of Seoul, Korea
    Sang Hyoung Park, Jong Pil Im, Hyunju Park, Seung Kyu Jeong, Ji Hyun Lee, Kyoung Hoon Rhee, Young-Ho Kim, Sung Noh Hong, Kyung Ho Kim, Seung In Seo, Jae Myung Cha, Sun Yong Park, Joo Sung Kim, Hyuk Yoon, Sung Hoon Kim, Jisun Jang, Jeong Hwan Kim, Seong O
    Journal of Crohn's and Colitis.2021;[Epub]     CrossRef
  • Predictors of Positive Video Capsule Endoscopy Findings for Chronic Unexplained Abdominal Pain: Single-Center Retrospective Study and Meta-Analysis
    Wonshik Kim, Beomjae Lee, Ahyoung Yoo, Seunghan Kim, Moonkyung Joo, Jong-Jae Park
    Diagnostics.2021; 11(11): 2123.     CrossRef
  • 13,218 View
  • 246 Download
  • 24 Web of Science
  • 22 Crossref
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Inflammatory bowel diseases
Familial aggregation of inflammatory bowel disease in India: prevalence, risks and impact on disease behavior
Rupa Banerjee, Partha Pal, Susan Hutfless, B Girish Ganesh, D Nageshwar Reddy
Intest Res 2019;17(4):486-495.   Published online August 6, 2019
DOI: https://doi.org/10.5217/ir.2018.00174
AbstractAbstract PDFPubReaderePub
Background/Aims
Information about familial aggregation of inflammatory bowel disease (IBD) in Asia is limited. We aimed to analyze the prevalence and risk of familial IBD in an Indian cohort and compare familial and sporadic cases.
Methods
Familial IBD cases were identified from a large prospectively maintained IBD registry. The prevalence of IBD in first- and seconddegree relatives of index cases was evaluated. The disease behavior was compared to that of sporadic cases.
Results
Total 3,553 patients (ulcerative colitis [UC], 2,053; Crohn’s disease [CD], 1,500) were included. Familial IBD was noted in 4.13% of CD and 4.34% of UC patients. Family history was commoner in pediatric group (< 18 years) (P= 0.0002; odds ratio [OR], 2.8; 95% confidence interval [CI], 1.6–4.8). Majority had paternal transmission (UC, 67.42%; CD, 70.97%). Concordance of disease type was higher in UC (79.7%) compared to CD (37.1%). Familial IBD was associated with higher cumulative relapse rate (CD, P< 0.001; UC, P< 0.001), higher cumulative rate of surgery (CD, P< 0.001; UC, P< 0.001) and higher rate of biologic use (CD, P= 0.010; UC, P= 0.015). Pan-colitis was higher in familial UC (P= 0.003; OR, 1.935; 95% CI, 1.248–3.000). Fistulizing disease was commoner in familial CD (P= 0.041; OR, 2.044; 95% CI, 1.030–4.056).
Conclusions
The prevalence of familial IBD in India appears comparable to rest of Asia but lower than the West. It is associated with a younger age of onset, higher incidence of pan-colitis in UC and fistulizing complications in CD. Familial IBD has higher cumulative relapse, surgery and biologic use rates. Hence, family history of IBD could have important prognostic implications.

Citations

Citations to this article as recorded by  
  • The Impact of Smoking on Ulcerative Colitis and Interaction With Family History: A Population‐Based Cohort Study
    Hyeong Sik Ahn, Heather Swan, Sayada Zartasha Kazmi, Young Shin Kim, Gahwi Hong, Seeun Choi, Taeuk Kang, Minjung Kim, Jaewoo Cha, Hoo Jae Hann, Hyun Jung Kim
    Journal of Gastroenterology and Hepatology.2025; 40(2): 446.     CrossRef
  • Inflammatory bowel disease in south Asia: a scoping review
    Shabari Shenoy, Anuraag Jena, Carrie Levinson, Vishal Sharma, Parakkal Deepak, Tina Aswani-Omprakash, Shaji Sebastian, Jean-Frederic Colombel, Manasi Agrawal
    The Lancet Gastroenterology & Hepatology.2025; 10(3): 259.     CrossRef
  • Influence of Familial Inflammatory Bowel Disease History on the Use of Immunosuppressants, Biological Agents and Surgery in Patients with Pediatric-Onset of the Disease in the Era of Biological Therapies. Results from the ENEIDA Registry
    Carlos González-Muñoza, Antonio Giordano, Elena Ricart, Pilar Nos, Eva Iglesias, Javier P. Gisbert, Santiago García-López, Francisco Mesonero, Isabel Pascual, Carlos Tardillo, Montserrat Rivero, Sabino Riestra, Míriam Mañosa, Yamile Zabana, Fernando Gomol
    Journal of Clinical Medicine.2025; 14(10): 3352.     CrossRef
  • Unravelling the genetic architecture of inflammatory bowel disease multiplex families with rare and common variant polygenic risk scores
    Deborah S Jans, Jana Depovere, Ho-Su Lee, Yasmina Abakkouy, Sara Becelaere, Margaux David, Maaike Vancamelbeke, Justien Degry, Marc Ferrante, João Sabino, Séverine Vermeire, Isabelle Cleynen
    Journal of Crohn’s and Colitis.2025;[Epub]     CrossRef
  • Spectrum and trend of pediatric inflammatory bowel disease: A two-decade experience from northern India
    Neelam Mohan, Shivani Deswal, Anubhuti Bhardwaj
    Indian Journal of Gastroenterology.2024; 43(1): 208.     CrossRef
  • Influence of familial forms of inflammatory bowel disease on the use of immunosuppressants, biological agents, and surgery in the era of biological therapies. Results from the ENEIDA project
    Carlos González-Muñoza, Margalida Calafat, Javier P Gisbert, Eva Iglesias, Miguel Mínguez, Beatriz Sicilia, Montserrat Aceituno, Fernando Gomollón, Xavier Calvet, Elena Ricart, Luisa De Castro, Montserrat Rivero, Francisco Mesonero, Lucía Márquez, Pilar N
    Postgraduate Medical Journal.2024; 100(1189): 836.     CrossRef
  • Differences of clinical phenotype between familial and sporadic Crohn’s disease in East China
    Siyuan Dong, Xiaoxia Xiang, Yu Zhang, Rongbei Liu, Lingna Ye, Qian Cao
    International Journal of Colorectal Disease.2024;[Epub]     CrossRef
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    Elad Boaz, Ariella Bar-Gil Shitrit, Menachem Schechter, Eran Goldin, Petachia Reissman, Shlomo Yellinek, Benjamin Koslowsky
    Scandinavian Journal of Gastroenterology.2023; 58(1): 20.     CrossRef
  • Clinical Phenotype and Disease Course of Inflammatory Bowel Disease: A Comparison Between Sporadic and Familial Cases
    Bahar Saberzadeh-Ardestani, Amir Anushiravani, Fariborz Mansour-Ghanaei, Hafez Fakheri, Homayoon Vahedi, Farshad Sheikhesmaeili, Abbas Yazdanbod, Seyed Hamid Moosavy, Hasan Vosoghinia, Iradj Maleki, Siavosh Nasseri-Moghaddam, Bardia Khosravi, Masoud Malek
    Inflammatory Bowel Diseases.2022; 28(7): 1004.     CrossRef
  • Emerging inflammatory bowel disease demographics, phenotype, and treatment in South Asia, South‐East Asia, and Middle East: Preliminary findings from the Inflammatory Bowel Disease‐Emerging Nations' Consortium
    Rupa Banerjee, Partha Pal, Ida Hilmi, Uday C Ghoshal, Devendra C Desai, Mohammed Masudur Rahman, Usha Dutta, Syed A Mohiuddin, Munnera Al Mohannadi, Mathew Philip, Ganesh N Ramesh, Madunil A Niriella, Arjuna P De Silva, Hithanadura Janaka de Silva, Pises
    Journal of Gastroenterology and Hepatology.2022; 37(6): 1004.     CrossRef
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    Saurabh Kedia, Vineet Ahuja
    JGH Open.2022; 6(6): 365.     CrossRef
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    Su Bee Park, Jin Young Yoon, Jae Myung Cha
    Gut and Liver.2022; 16(5): 676.     CrossRef
  • Phenotypic Pattern of Early Versus Later‐Onset Pediatric Inflammatory Bowel Disease in a Eurasian Country
    Bilge S. Akkelle, Deniz Ertem, Burcu Volkan, Engin Tutar
    Journal of Pediatric Gastroenterology and Nutrition.2022;[Epub]     CrossRef
  • Following the Indian Immigrant: adoption of westernization results in a western gut microbiome and an increased risk of inflammatory bowel diseases
    Leah D D'Aloisio, Vignesh Shetty, Mamatha Ballal, Deanna L Gibson
    FEMS Microbiology Ecology.2022;[Epub]     CrossRef
  • Inflammatory bowel disease in India: challenges and opportunities
    Alice Snell, Jonathan Segal, Jimmy Limdi, Rupa Banerjee
    Frontline Gastroenterology.2021; 12(5): 390.     CrossRef
  • Epidemiology and diagnosis of inflammatory bowel diseases
    Kang-Moon Lee
    Journal of the Korean Medical Association.2021; 64(9): 579.     CrossRef
  • Impact of Demographic, Clinical and Psychosocial Variables on Drug Adherence and Outcomes in Indian Patients With Inflammatory Bowel Disease
    Rupa Banerjee, Partha Pal, Bhargavi Adigopula, Duvvuru Nageshwar Reddy
    Journal of Clinical Gastroenterology.2021; 55(10): e92.     CrossRef
  • Very early onset inflammatory bowel disease in a South Asian country where inflammatory bowel disease is emerging: a distinct clinical phenotype from later onset disease
    Rupa Banerjee, Partha Pal, Zaheer Nabi, Upender Shava, Girish Ganesh, D. Nageshwar Reddy
    Intestinal Research.2021; 19(4): 398.     CrossRef
  • Inflammatory bowel diseases in Tamil Nadu: A survey of demographics, clinical profile, and practices
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  • Inflammatory Bowel Diseases in South Asian Patients: Underappreciated and Understudied
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    Endocrine Practice.2020; 26(3): 305.     CrossRef
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    European Journal of Gastroenterology & Hepatology.2020; 32(10): 1305.     CrossRef
  • 10,693 View
  • 172 Download
  • 22 Web of Science
  • 22 Crossref
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