Intestinal Research

Statement

Role of 5-aminosalicylic acid in ulcerative colitis management in 8 Asian territories: a physician survey: Julajak Limsrivilai, Allen Yu-hung Lai, Silvia T. H. Li, Murdani Abdullah, Raja Affendi Raja Ali, Satimai Aniwan, Hoang Huu Bui, Jen-Wei Chou, Ida Normiha Hilmi, Wee Chian Lim, Jose Sollano, Michelle Mui Hian Teo, Shu-Chen Wei, Wai Keung Leung; Received June 8, 2024 Accepted October 15, 2024 Published online January 6, 2025; DOI: https://doi.org/10.5217/ir.2024.00085 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Clinical guidelines typically endorse conventional therapies such as 5-aminosalicylic acid (5-ASA) as the mainstay of ulcerative colitis management. However, the degree of adoption and application of guideline recommendations by physicians within Asia remains unclear. This study aims to understand the prescribing patterns of 5-ASA and implementation of current guideline recommendations across Asian clinical practice. A physician survey was conducted among inflammatory bowel disease specialists in 8 Asian territories to understand practices and preferences in ulcerative colitis management, focusing on the use of 5-ASA and concordance with guideline recommendations. Survey findings were validated by country experts in diverse healthcare settings. Subgroup analyses stratified data by income levels and treatment reimbursement status. Ninety-eight valid responses were received from inflammatory bowel disease specialists or gastroenterologists among 8 economic entities. Significant differences were found in clinical practices and treatment preferences for ulcerative colitis management among different income-level and government-subsidy groups. Survey results are summarized in 8 findings that illustrate trends in 5-ASA use and guideline implementation across Asian territories. This study emphasizes socioeconomic factors that impact the adoption of guideline recommendations in real-world practice. Our findings indicate an eclectic approach to guideline implementation across Asia, based on resource availability and feasibility of treatment goals.

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Review

IBD

Anti-inflammatory diet and inflammatory bowel disease: what clinicians and patients should know?: Nor Hamizah Shafiee, Zahara Abdul Manaf, Norfilza M. Mokhtar, Raja Affendi Raja Ali; Intest Res 2021;19(2):171-185. Published online February 3, 2021; DOI: https://doi.org/10.5217/ir.2020.00035

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Current treatment for inflammatory bowel disease (IBD) includes the application of anti-inflammatory agents for the induction and remission of IBD. However, prolonged use of anti-inflammatory agents can exert adverse effects on patients. Recently, formulated dietary approach in treating IBD patients is utilized to improve clinical activity scores. An alteration of gastrointestinal microbiota through dietary therapy was found to reduce IBD and is recognized as a promising therapeutic strategy for IBD. One of the recommended formulated diets is an anti-inflammatory diet (AID) that restricts the intake of carbohydrates with modified fatty acids. This diet also contains probiotics and prebiotics that can promote balanced intestinal microbiota composition. However, scientific evidences are limited to support this specific dietary regime in maintaining the remission and prevention relapse of IBD. Therefore, this review aimed to summarize available data from various studies to evaluate the AID diet effectiveness which will be useful for clinicians to manage their IBD patients by application of improved dietary therapy.

Citations

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Ivan Capobianco, Federica Di Vincenzo, Pierluigi Puca, Guia Becherucci, Maria Chiara Mentella, Valentina Petito, Franco Scaldaferri
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Nutritional Profile, Disease Severity, and Quality of Life of Patients with Inflammatory Bowel Disease: A Case–Control Study
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Mobile-based program improves healthy eating of ulcerative colitis patients: A pilot study
Wenjing Tu, Shuxia Yan, Tingting Yin, Sumin Zhang, Wenjing Xu, Ping Zhang, Guihua Xu
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A Specific Carbohydrate Diet Virtual Teaching Kitchen Curriculum Promotes Knowledge and Confidence in Caregivers of Pediatric Patients with Inflammatory Bowel Disease
Nancy Rivera, Kaylie Nguyen, Venus Kalami, Feifei Qin, Maya B. Mathur, Rebecca Blankenburg, Ann Ming Yeh
Nutrients.2023; 15(18): 3999. CrossRef
Abdominal Pain in Inflammatory Bowel Disease: An Evidence-Based, Multidisciplinary Review
Matthew D Coates, Kofi Clarke, Emmanuelle Williams, Nimalan Jeganathan, Sanjay Yadav, David Giampetro, Vitaly Gordin, Sadie Smith, Kent Vrana, Anne Bobb, Thu Thi Gazzio, Heather Tressler, Shannon Dalessio
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Lupeol Esters from the Edible Tubers of American Groundnut (Apios americana)
Alec P. Brundle, Nanea K. Perkins, Mackenzie J. Perpetua, Natalie C. Stagnitti, Emily J. Schafer, Kristopher J. Kolonko, Stephen T. Deyrup
ACS Food Science & Technology.2023; 3(12): 2250. CrossRef
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Tiziana LARUSSA, Ludovico ABENAVOLI, Giulia FABIANO, Maria A. MANCUSO, Natale POLIMENI, Dan L. DUMITRASCU, Francesco LUZZA
Minerva Gastroenterology.2022;[Epub] CrossRef
Screening and Evaluation of Probiotics for Reducing Intestinal Inflammation
雅君陈
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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
Egg white hydrolysate from simulated gastrointestinal digestion alleviates the inflammation and improves the nutritional status in TNBS-induced Crohn’s disease rats
Tianliang Wu, Juanrui Li, Wei Wang, Chenxi Xu, Liying Wang, Long Ding
Journal of Functional Foods.2022; 98: 105288. CrossRef
Development and Validation of a Smartphone Application for Telenutrition in Patients with Inflammatory Bowel Disease
Arti Gupta, Namrata Singh, Divya Madan, Mariyam Farooqui, Neha Singh, David Mathew Thomas, Bhaskar Kante, Mukesh Singh, Shubi Virmani, Mehak Verma, Aditya Bajaj, Manasvini Markandey, Peeyush Kumar, Sudheer Kumar Vuyyuru, Pabitra Sahu, Nitika Monga, Govind
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Aditi Saha, Isabella Dreyfuss, Humaira Sarfraz, Mark Friedman, Joseph Markowitz
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Lorenzo Bertani, Davide Giuseppe Ribaldone, Massimo Bellini, Maria Gloria Mumolo, Francesco Costa
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Original Articles

Functional bowel disorder

An evaluation of dietary adequacy among patients with constipation-predominant irritable bowel syndrome in Malaysia: Nor Hamizah Shafiee, Nurul Huda Razalli, Norfilza M. Mokhtar, Eunice Tan, Raja Affendi Raja Ali; Intest Res 2022;20(1):124-133. Published online January 22, 2021; DOI: https://doi.org/10.5217/ir.2020.00050

Abstract PDF PubReader ePub

Background/Aims
Substantial proportions of patients with constipation-predominant irritable bowel syndrome (IBS-C) linked their symptoms with particular intake of foods. However, there is lack of current data regarding the intake among IBS-C patients before any dietary interventions. Thus, this study aimed to evaluate the dietary adequacy among IBS-C against the standard recommended nutrient intake (RNI) and healthy controls.
Methods
A retrospective case-control study was conducted involving IBS-C patients and healthy control subjects. A validated 126-food items frequency questionnaire was administered to all the subjects to assess their dietary intake, guided by dietitians. The calculated nutrients intake for IBS-C patients was then compared against the standard RNI and healthy controls.
Results
A total of 306 subjects were recruited, among which 218 were diagnosed with IBS-C and 88 were included as healthy controls. IBS-C patients had significantly lower intake of wholegrain products, fried foods, dairy products, fruits, and vegetables compared to healthy controls. The daily intake of energy, certain macronutrients, and micronutrients among IBS-C patients was significantly lower than the healthy subjects. Less than 5% of IBS-C patients and healthy subjects achieved the standard recommendation for dietary fiber. Also, various vitamin intake (B₁, B₂, B₆, folate, B₁₂, E, K, and potassium) among IBS-C patients did not meet the standard RNI.
Conclusions
Dietary intakes of IBS-C patients did not meet the recommended intake for Malaysian and showed the nutritional inadequacies compared to the control subjects. Our study highlighted the importance of dietary evaluation prior to planning strategies for dietary intervention targeting IBS-C patients.

Citations

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Association between dietary vitamin E intake and constipation: NHANES 2005–2010
Junfeng Cai, Danqing Li, Ruijun Xie, Xiaoling Yu, Yuning Wu, Feng Sun, Chenxiong Zhang
Frontiers in Nutrition.2024;[Epub] CrossRef
Systematic review and meta-analysis of habitual intake of fermentable oligo-, di-, mono- saccharides and polyols in the general population and revisiting the low FODMAP diet concept
Yoghatama Cindya Zanzer, Stephan Theis
Journal of Functional Foods.2024; 112: 105914. CrossRef
A randomized, double-blinded, placebo-controlled clinical trial on Lactobacillus-containing cultured milk drink as adjuvant therapy for depression in irritable bowel syndrome
Marlynna Sarkawi, Raja Affendi Raja Ali, Norhazlina Abdul Wahab, Norshafila Diana Abdul Rathi, Norfilza Mohd Mokhtar
Scientific Reports.2024;[Epub] CrossRef
An Asian perspective on irritable bowel syndrome
Kee Wook Jung, Seung-Jae Myung
Intestinal Research.2023; 21(2): 189. CrossRef
Adult‐onset megacolon with focal hypoganglionosis: A detailed phenotyping and prospective cohort study
Jiyoung Yoon, Kee Wook Jung, Nam Seok Ham, Jihun Kim, Yoon Suh Do, Seon Ok Kim, Sang Hyun Choi, Dong Wook Kim, Sung Wook Hwang, Sang Hyoung Park, Dong‐Hoon Yang, Byong Duk Ye, Jeong‐Sik Byeon, Yong Sik Yoon, Chan Wook Kim, Chang Sik Yu, Hwoon‐Yong Jung, S
Neurogastroenterology & Motility.2023;[Epub] CrossRef
Downregulated APOD and FCGR2A correlates with immune infiltration and lipid-induced symptoms of irritable bowel syndrome
Yamei Ran, Kangqi Wu, Chenglin Hu, Renzheng Liang, Li Zhang, Juan Xiao, Yongmei Peng, Wenjing Sun
Scientific Reports.2023;[Epub] CrossRef
Letter to the Editor: Survey-Based Analysis of Clinical Treatment Status of Irritable Bowel Syndrome in Korea: Suggestions for Future Research
Ji Young Chang
Journal of Korean Medical Science.2023;[Epub] CrossRef
Comments on Efficacy of a Synbiotic Containing Lactobacillus paracasei DKGF1 and Opuntia humifusa in Elderly Patients with Irritable Bowel Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial
Kwang Woo Kim
Gut and Liver.2023; 17(6): 954. CrossRef
Correlation Between Zinc Nutritional Status with Serum Zonulin and Gastrointestinal Symptoms in Diarrhea-Predominant Irritable Bowel Syndrome: A Case–Control Study
Mahsa Rezazadegan, Maryam Soheilipour, Mohammad Javad Tarrahi, Reza Amani
Digestive Diseases and Sciences.2022; 67(8): 3632. CrossRef

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Inflammatory bowel diseases

An assessment of dietary intake, food avoidance and food beliefs in patients with ulcerative colitis of different disease status: Nor Hamizah Shafiee, Zahara Abdul Manaf, Norfilza M. Mokhtar, Raja Affendi Raja Ali; Intest Res 2020;18(4):447-458. Published online June 2, 2020; DOI: https://doi.org/10.5217/ir.2019.00042

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Ulcerative colitis (UC) is a chronic, relapsing and remitting inflammation of the gastrointestinal tract. Little is known about the link between dietary intake, food avoidance, and beliefs among UC patients of different disease severity. Therefore, this study aimed to assess the dietary intake, food avoidance, and beliefs among active and inactive UC patients.
Methods
A cross-sectional study was conducted among UC patients from a tertiary medical center in Kuala Lumpur, Malaysia. Demographic, anthropometric, dietary intake, food avoidance and beliefs were assessed. Disease activity of UC patients was evaluated using the Powell Tuck Index.
Results
UC patients were recruited (64.1% inactive UC and 35.9% active UC). As compared to inactive UC patients, active UC patients were likely to lose weight (75.0% vs. 0%), possess certain food beliefs (95.7% vs. 39.0%), and frequently practiced dietary avoidance (95.7% vs. 43.9%). The dietary intake among inactive UC patients was higher than active UC patients. However, neither of them met the standard nutrients recommendation for protein, calcium, iron, folate, zinc, vitamin D, vitamin B₁₂, and vitamin E.
Conclusions
Active UC patients had poorer dietary intake, were more prone to practicing food avoidance and exhibited certain food beliefs as compared to inactive UC patients. Both macro- and micronutrients intakes were inadequate regardless of patient’s disease status. These findings emphasized the importance for patients to be provided with the nutrition-related knowledge as part of strategies to avoid nutritional inadequacies.

Citations

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Addressing Nutritional Knowledge Gaps in Inflammatory Bowel Disease: A Scoping Review
Eleonora Ribaudi, Simone Amato, Guia Becherucci, Sara Carillo, Carlo Covello, Vincenzina Mora, Maria Chiara Mentella, Franco Scaldaferri, Antonio Gasbarrini, Caterina Fanali, Lucrezia Laterza, Daniele Napolitano
Nutrients.2025; 17(5): 833. CrossRef
Analysis of the Nutritional Value of Diets and Food Choices in Polish Female Ulcerative Colitis Individuals Compared with a Pair-Matched Control Sample
Dominika Głąbska, Dominika Guzek, Gustaw Lech
Nutrients.2023; 15(4): 857. CrossRef
Mobile-based program improves healthy eating of ulcerative colitis patients: A pilot study
Wenjing Tu, Shuxia Yan, Tingting Yin, Sumin Zhang, Wenjing Xu, Ping Zhang, Guihua Xu
DIGITAL HEALTH.2023;[Epub] CrossRef
Self‐reported flares among people living with inflammatory bowel disease are associated with stress and worry but not associated with recent diet changes: The Manitoba Living with IBD Study
Kathy Vagianos, Leigh Anne Shafer, Kelcie Witges, Lesley A. Graff, Laura E. Targownik, Charles N. Bernstein
Journal of Parenteral and Enteral Nutrition.2022; 46(7): 1686. CrossRef
Evaluation of nutritional status using bioelectrical impedance analysis in patients with inflammatory bowel disease
Seung Hyuk Kim, You Sun Kim, Si Hyeong Lee, Hyun Mi Lee, Won Eui Yoon, Seo Hyun Kim, Hee Jun Myung, Jeong Seop Moon
Intestinal Research.2022; 20(3): 321. CrossRef
Dietary beliefs and information resources of ulcerative colitis patients in clinical remission: A cross-sectional survey in Taiwan
Cheng-Tzu Hsieh, Meng-Tzu Weng, Chien-Chih Tung, Nai-Chia Chen, Hui-Chuen Chen, Kuo-Liong Chien, Shu-Chen Wei
Clinical Nutrition ESPEN.2022; 51: 430. CrossRef
Micronutrient deficiency among patients with ulcerative colitis
Amany Hussien, Sawsan Abd El-Moniem, Ziyad Tawhid, Ahmed Altonbary
The Egyptian Journal of Internal Medicine.2022;[Epub] CrossRef

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Reviews

IBD

Best practices on immunomodulators and biologic agents for ulcerative colitis and Crohn’s disease in Asia: Choon Jin Ooi, Ida Hilmi, Rupa Banerjee, Sai Wei Chuah, Siew Chien Ng, Shu Chen Wei, Govind K Makharia, Pises Pisespongsa, Min Hu Chen, Zhi Hua Ran, Byong Duk Ye, Dong Il Park, Khoon Lin Ling, David Ong, Vineet Ahuja, Khean Lee Goh, Jose Sollano, Wee Chian Lim, Wai Keung Leung, Raja Affendi Raja Ali, Deng Chyang Wu, Evan Ong, Nazri Mustaffa, Julajak Limsrivilai, Tadakazu Hisamatsu, Suk Kyun Yang, Qin Ouyang, Richard Geary, Janaka H De Silva, Rungsun Rerknimitr, Marcellus Simadibrata, Murdani Abdullah, Rupert WL Leong, the Asia Pacific Association of Gastroenterology (APAGE) Working Group on Inflammatory Bowel Disease and Asian Organization for Crohn’s and Colitis; Intest Res 2019;17(3):285-310. Published online May 31, 2019; DOI: https://doi.org/10.5217/ir.2019.00026

Abstract PDF PubReader ePub

The Asia-Pacific Working Group on inflammatory bowel disease (IBD) was established in Cebu, Philippines, under the auspices of the Asian Pacific Association of Gastroenterology with the goal of improving IBD care in Asia. This consensus is carried out in collaboration with Asian Organization for Crohn’s and Colitis. With biologic agents and biosimilars becoming more established, it is necessary to conduct a review on existing literature and establish a consensus on when and how to introduce biologic agents and biosimilars in the conjunction with conventional treatments for ulcerative colitis (UC) and Crohn’s disease (CD) in Asia. These statements also address how pharmacogenetics influence the treatments of UC and CD and provide guidance on response monitoring and strategies to restore loss of response. Finally, the review includes statements on how to manage treatment alongside possible hepatitis B and tuberculosis infections, both common in Asia. These statements have been prepared and voted upon by members of IBD workgroup employing the modified Delphi process. These statements do not intend to be all-encompassing and future revisions are likely as new data continue to emerge.

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IBD

Optimizing the multidimensional aspects of the patient-physician relationship in the management of inflammatory bowel disease: Deborah Chew, Wong Zhiqin, Norhayati Ibrahim, Raja Affendi Raja Ali; Intest Res 2018;16(4):509-521. Published online October 25, 2018; DOI: https://doi.org/10.5217/ir.2018.00074

Abstract PDF PubReader ePub

The patient-physician relationship has a pivotal impact on the inflammatory bowel disease (IBD) outcomes. However, there are many challenges in the patient-physician relationship; lag time in diagnosis which results in frustration and an anchoring bias against the treating gastroenterologist, the widespread availability of medical information on the internet has resulted in patients having their own ideas of treatment, which may be incongruent from the treating physicians’ goals resulting in patient physician discordance. Because IBD is an incurable disease, the goal of treatment is to sustain remission. To achieve this, patients may have to go through several lines of treatment. The period of receiving stepping up, top down or even accelerated stepping up medications may result in a lot of frustration and anxiety for the patient and may compromise the patient-physician relationship. IBD patients are also prone to psychological distress that further compromises the patient-physician relationship. Despite numerous published data regarding the medical and surgical treatment options available for IBD, there is a lack of data regarding methods to improve the therapeutic patient-physician relationship. In this review article, we aim to encapsulate the challenges faced in the patient-physician relationship and ways to overcome in for an improved outcome in IBD.

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Personalize, participate, predict, and prevent: 4Ps in inflammatory bowel disease
Marco Vincenzo Lenti, Maria Lia Scribano, Livia Biancone, Rachele Ciccocioppo, Daniela Pugliese, Luca Pastorelli, Gionata Fiorino, Edoardo Savarino, Flavio Andrea Caprioli, Sandro Ardizzone, Massimo Claudio Fantini, Gian Eugenio Tontini, Ambrogio Orlando,
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Notable gaps between patients’ and physicians’ perspectives on communication and disease management in Japan: multifaceted ad hoc analyses of the global Ulcerative Colitis Narrative Survey for further optimal care
Kenji Watanabe, Sean Gardiner, Shoko Arai
Therapeutic Advances in Gastroenterology.2022;[Epub] CrossRef
Ulcerative Colitis Narrative Global Survey Findings: The Impact of Living With Ulcerative Colitis—Patients’ and Physicians’ View
Marla C Dubinsky, Kenji Watanabe, Pauliina Molander, Laurent Peyrin-Biroulet, Michele Rubin, Gil Y Melmed, J Jasper Deuring, John Woolcott, Joseph C Cappelleri, Kathy Steinberg, Susan Connor
Inflammatory Bowel Diseases.2021; 27(11): 1747. CrossRef
Physician–patient communication affects patient satisfaction in treatment decision-making: a structural equation modelling analysis of a web-based survey in patients with ulcerative colitis
Katsuyoshi Matsuoka, Hirono Ishikawa, Takeo Nakayama, Yusuke Honzawa, Atsuo Maemoto, Fumihito Hirai, Fumiaki Ueno, Noriko Sato, Yutaka Susuta, Toshifumi Hibi
Journal of Gastroenterology.2021; 56(9): 843. CrossRef

17,560 View
145 Download
4 Web of Science
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IBD

Delineating inflammatory bowel disease through transcriptomic studies: current review of progress and evidence: Seow-Neng Chan, Eden Ngah Den Low, Raja Affendi Raja Ali, Norfilza Mohd Mokhtar; Intest Res 2018;16(3):374-383. Published online July 27, 2018; DOI: https://doi.org/10.5217/ir.2018.16.3.374

Abstract PDF PubReader ePub

Inflammatory bowel disease (IBD), which comprises of Crohn's disease and ulcerative colitis, is an idiopathic relapsing and remitting disease in which the interplay of different environment, microbial, immunological and genetic factors that attribute to the progression of the disease. Numerous studies have been conducted in multiple aspects including clinical, endoscopy and histopathology for the diagnostics and treatment of IBD. However, the molecular mechanism underlying the aetiology and pathogenesis of IBD is still poorly understood. This review tries to critically assess the scientific evidence at the transcriptomic level as it would help in the discovery of RNA molecules in tissues or serum between the healthy and diseased or different IBD subtypes. These molecular signatures could potentially serve as a reliable diagnostic or prognostic biomarker. Researchers have also embarked on the study of transcriptome to be utilized in targeted therapy. We focus on the evaluation and discussion related to the publications reporting the different approaches and techniques used in investigating the transcriptomic changes in IBD with the intention to offer new perspectives to the landscape of the disease.

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CrohnDB: A Web Database for Expression Profiling of Protein-Coding and Long Non-Coding RNA Genes in Crohn Disease
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Colonic Mucosal Transcriptomic Changes in Patients with Long-Duration Ulcerative Colitis Revealed Colitis-Associated Cancer Pathways
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A four-decade analysis of the incidence trends, sociodemographic and clinical characteristics of inflammatory bowel disease patients at single tertiary centre, Kuala Lumpur, Malaysia
Norfilza Mohd Mokhtar, Khairul Najmi Muhammad Nawawi, Jaarvis Verasingam, Wong Zhiqin, Ismail Sagap, Zairul Azwan Mohd Azman, Luqman Mazlan, Hamzaini Abdul Hamid, Nur Yazmin Yaacob, Isa Mohamed Rose, Eden Low Ngah Den, Mah Suit Wan, Raja Affendi Raja Ali
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Irritable bowel syndrome and inflammatory bowel disease overlap syndrome: pieces of the puzzle are falling into place: Rafiz Abdul Rani, Raja Affendi Raja Ali, Yeong Yeh Lee; Intest Res 2016;14(4):297-304. Published online October 17, 2016; DOI: https://doi.org/10.5217/ir.2016.14.4.297

Abstract PDF PubReader

Irritable bowel syndrome (IBS), a common gastrointestinal disorder involving the gut-brain axis, and inflammatory bowel disease (IBD), a chronic relapsing inflammatory disorder, are both increasing in incidence and prevalence in Asia. Both have significant overlap in terms of symptoms, pathophysiology, and treatment, suggesting the possibility of IBS and IBD being a single disease entity albeit at opposite ends of the spectrum. We examined the similarities and differences in IBS and IBD, and offer new thoughts and approaches to the disease paradigm.

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Crohn’s disease, irritable bowel syndrome, and chronic fatigue: the importance of communication and symptom management—a case report
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Editorial

The Positive Influences of Increasing Age at Diagnosis of Inflammatory Bowel Disease on Disease Prognostication in Asian Perspective: Raja Affendi Raja Ali; Intest Res 2015;13(1):4-5. Published online January 29, 2015; DOI: https://doi.org/10.5217/ir.2015.13.1.4

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A four-decade analysis of the incidence trends, sociodemographic and clinical characteristics of inflammatory bowel disease patients at single tertiary centre, Kuala Lumpur, Malaysia
Norfilza Mohd Mokhtar, Khairul Najmi Muhammad Nawawi, Jaarvis Verasingam, Wong Zhiqin, Ismail Sagap, Zairul Azwan Mohd Azman, Luqman Mazlan, Hamzaini Abdul Hamid, Nur Yazmin Yaacob, Isa Mohamed Rose, Eden Low Ngah Den, Mah Suit Wan, Raja Affendi Raja Ali
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Delineating inflammatory bowel disease through transcriptomic studies: current review of progress and evidence
Seow-Neng Chan, Eden Ngah Den Low, Raja Affendi Raja Ali, Norfilza Mohd Mokhtar
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Can narrow-band imaging of Peyer's patches predict the recurrence of ulcerative colitis?
Yoon Jae Kim
Intestinal Research.2016; 14(4): 295. 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

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Review

Inflammatory Bowel Disease-related Colorectal Cancer in the Asia-Pacific Region: Past, Present, and Future: Wong Zhiqin, Shanthi Palaniappan, Raja Affendi Raja Ali; Intest Res 2014;12(3):194-204. Published online July 25, 2014; DOI: https://doi.org/10.5217/ir.2014.12.3.194

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Patients with inflammatory bowel disease (IBD) are at an increased risk of developing colorectal cancer (CRC), and key contributing factors include chronic colonic inflammation and the extent and duration of disease. This increase in risk is more likely to result from chronic inflammation of the colonic mucosa than from any clearly defined genetic predisposition. However, globally, the true magnitude of this risk is debatable, since results from different studies are heterogeneous in terms of geographical and methodological variables. The prevalence of IBD-related CRC in the Asia-Pacific region ranges from 0.3% to 1.8% and a recent study found that the cumulative incidence of IBD-related CRC is comparable to that in Western countries. However, the CRC mortality rate in the Asia-Pacific region is on the rise compared with that in Western countries, and a few Asian countries show particularly rapid upward trends in CRC incidence. Although our understanding of the molecular and clinical basis for IBD-related CRC has improved substantially, our means of prevention, endoscopic surveillance, chemoprevention, and prophylactic surgery remain modest at best. Furthermore, published data on IBD-related CRC in the Asia-Pacific region is lacking, and this review addresses many aspects including epidemiology, natural history, etiopathogenesis, morphology, and biological behaviors of IBD-related CRC and sporadic CRC in the Asia-Pacific region. In this review, we will also discuss the risk factors for CRC in IBD patients, endoscopic technology screening, and surveillance programs and management strategies for IBD-related CRC.

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