Intestinal Research

Original Articles

Predictive accuracy of fecal calprotectin for histologic remission in ulcerative colitis: Arshdeep Singh, Arshia Bhardwaj, Riya Sharma, Bhavjeet Kaur Kahlon, Ashvin Singh Dhaliwal, Dharmatma Singh, Simranjeet Kaur, Devanshi Jain, Namita Bansal, Ramit Mahajan, Kirandeep Kaur, Aminder Singh, Vikram Narang, Harpreet Kaur, Vandana Midha, Ajit Sood; Received May 14, 2024 Accepted July 29, 2024 Published online November 11, 2024; DOI: https://doi.org/10.5217/ir.2024.00068 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Background/Aims
Accurate assessment of disease activity is crucial for effective management and treatment of ulcerative colitis (UC). This study evaluated the correlation between clinical, endoscopic, and histologic measures of disease activity in UC.
Methods
Clinical, biochemical, endoscopic, and histologic disease activity was studied in 347 patients with UC. Agreements among various histologic classification systems, namely the Geboes Score (GS), Continuous GS, Nancy Index (NI), and Robarts Histopathology Index (RHI), were analyzed. The predictive accuracy of fecal calprotectin (FC) for endoscopic and histologic remission was assessed.
Results
We demonstrate a fair to moderate correlation between clinical, endoscopic, and histologic measures of disease activity in UC. There was a robust concordance among GS, Continuous GS, NI, and RHI in distinguishing between patients in histologic remission or activity. The NI detected 75% of patients who met the remission criteria according to the RHI, whereas the RHI identified all patients in remission as defined by the NI. FC levels below 150 μg/g had >70% accuracy in predicting endoscopic remission. FC levels below 150 μg/g showed ≥80% accuracy, and FC levels below 100 μg/g demonstrated ≥ 85% accuracy in predicting histologic remission, regardless of the scoring index applied. Elevated FC levels were associated with both acute and chronic inflammatory infiltrates in biopsy samples.
Conclusions
FC is a reliable predictor of histologic remission, with higher accuracy at lower thresholds. The GS, Continuous GS, NI, and RHI demonstrate comparable performance. FC could help stratify patients’ need for colonoscopy for the assessment of endoscopic and histologic remission.

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IBD

Low prevalence of primary sclerosing cholangitis in patients with inflammatory bowel disease in India: Arshdeep Singh, Vandana Midha, Vikram Narang, Saurabh Kedia, Ramit Mahajan, Pavan Dhoble, Bhavjeet Kaur Kahlon, Ashvin Singh Dhaliwal, Ashish Tripathi, Shivam Kalra, Narender Pal Jain, Namita Bansal, Rupa Banerjee, Devendra Desai, Usha Dutta, Vineet Ahuja, Ajit Sood; Intest Res 2023;21(4):452-459. Published online December 2, 2022; DOI: https://doi.org/10.5217/ir.2022.00087

Abstract PDF PubReader ePub

Background/Aims
Primary sclerosing cholangitis (PSC) represents the most common hepatobiliary extraintestinal manifestation of inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD). Limited data exist on PSC in patients with IBD from India. We aimed to assess the prevalence and disease spectrum of PSC in Indian patients with IBD.
Methods
Database of IBD patients at 5 tertiary care IBD centers in India were analyzed retrospectively. Data were extracted and the prevalence of PSC-IBD was calculated.
Results
Forty-eight patients out of 12,216 patients with IBD (9,231 UC, 2,939 CD, and 46 IBD unclassified) were identified to have PSC, resulting in a prevalence of 0.39%. The UC to CD ratio was 7:1. Male sex and pancolitis (UC) or colonic CD were more commonly associated with PSC-IBD. The diagnosis of IBD preceded the diagnosis of PSC in most of the patients. Majority of the patients were symptomatic for liver disease at diagnosis. Eight patients (16.66%) developed cirrhosis, 5 patients (10.41%), all UC, developed malignancies (3 colorectal cancer [6.25%] and 2 cholangiocarcinoma [4.16%]), and 3 patients died (2 decompensated liver disease [4.16%] and 1 cholangiocarcinoma [2.08%]) on follow-up. None of the patients mandated surgical therapy for IBD.
Conclusions
Concomitant PSC in patients with IBD is uncommon in India and is associated with lower rates of development of malignancies.

Citations

Citations to this article as recorded by

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
Prevalence and bidirectional association between primary sclerosing cholangitis and Crohn's disease: A systematic review and meta-analysis
Dongyuan Zheng, Qinke Xu, Jin Wu, Zhouyue Gu, Jieya Chen, Yingchao Liu
Gastroenterología y Hepatología.2025; : 502346. CrossRef
Frequency, spectrum and outcome of patients with primary sclerosing cholangitis among patients presenting with cholestatic jaundice
Srikanth Kothalkar, Sayan Malakar, Piyush Mishra, Akash Mathur, Uday C. Ghoshal
Indian Journal of Gastroenterology.2024;[Epub] CrossRef
Ileal Pouch-Anal Anastomosis for Ulcerative Colitis: Predictors of Early and Late Complications
Yajnadatta Sarangi, Ashok Kumar, Somanath Malage, Nalinikanta Ghosh, Rahul Rahul, Ashish Singh, Supriya Sharma, Rajneesh K Singh, Anu Behari, Ashok Kumar
Cureus.2024;[Epub] CrossRef
Incidence of Hepatobiliary Malignancies in Primary Sclerosing Cholangitis: Systematic Review and Meta-analysis
Matheus Souza, Luan C.V. Lima, Lubna Al-Sharif, Daniel Q. Huang
Clinical Gastroenterology and Hepatology.2024;[Epub] CrossRef
Primary sclerosing cholangitis (PSC) and inflammatory bowel disease (IBD): a condition exemplifying the crosstalk of the gut–liver axis
You Sun Kim, Edward H. Hurley, Yoojeong Park, Sungjin Ko
Experimental & Molecular Medicine.2023; 55(7): 1380. CrossRef
Treatment of primary sclerosing cholangitis combined with inflammatory bowel disease
You Sun Kim, Edward H. Hurley, Yoojeong Park, Sungjin Ko
Intestinal Research.2023; 21(4): 420. CrossRef
Regional variations in the prevalence of primary sclerosing cholangitis associated with inflammatory bowel disease
Kwang Woo Kim, Hyoun Woo Kang
Intestinal Research.2023; 21(4): 413. CrossRef

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IBD

Clinical spectrum of elderly-onset inflammatory bowel disease in India: Yogesh Kumar Gupta, Arshdeep Singh, Vikram Narang, Vandana Midha, Ramit Mahajan, Varun Mehta, Dharmatma Singh, Namita Bansal, Madeline Vithya Barnaba Durairaj, Amit Kumar Dutta, Ajit Sood; Intest Res 2023;21(2):216-225. Published online August 8, 2022; DOI: https://doi.org/10.5217/ir.2021.00177

Abstract PDF PubReader ePub

Background/Aims
Inflammatory bowel disease (IBD) is increasingly being recognized in elderly patients. Data on clinical spectrum of elderly-onset IBD patients is lacking from India.
Methods
A cross-sectional retrospective analysis of a prospectively maintained database of patients diagnosed with IBD was conducted at 2 centers in India. The clinical spectrum of elderly-onset IBD including demographic profile (age and sex), clinical presentation, disease characteristics (disease behavior and severity, extent of disease), and treatment were recorded and compared with adult-onset IBD.
Results
During the study period, 3,922 (3,172 ulcerative colitis [UC] and 750 Crohn’s disease [CD]) patients with IBD were recorded in the database. A total of 186 patients (4.74%; 116 males [62.36%]) had elderly-onset IBD (69.35% UC and 30.64% CD). Diarrhea, blood in stools, nocturnal frequency and pain abdomen were the commonest presentations for UC, whereas pain abdomen, weight loss and diarrhea were the most frequent symptoms in CD. For both elderly onset UC and CD, majority of the patients had moderately severe disease. Left-sided colitis was the commonest disease location in UC. Isolated ileal disease and inflammatory behavior were the most common disease location and behavior, respectively in CD. 5-Aminosalicylates were the commonest prescribed drug for both elderly onset UC and CD. Thiopurines and biologics were used infrequently. Prevalence of colorectal cancer was higher in elderly onset IBD.
Conclusions
Elderly onset IBD is not uncommon in India. Both the elderly onset UC and CD were milder, with no significant differences in disease characteristics (disease extent, location and behavior) when compared to adult-onset IBD. Colorectal cancer was more common in elderly onset IBD.

Citations

Citations to this article as recorded by

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
Impact of age at diagnosis on long‐term prognosis in patients with intestinal Behçet's disease
Ji Young Chang, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jae Hee Cheon, Jihye Park
Journal of Gastroenterology and Hepatology.2024; 39(3): 519. CrossRef
Neither hepatic steatosis nor fibrosis is associated with clinical outcomes in patients with intestinal Behçet’s disease
Hye Kyung Hyun, Jihye Park, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jae Seung Lee, Hye Won Lee, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Seung Up Kim, Jae Hee Cheon
European Journal of Gastroenterology & Hepatology.2024; 36(4): 445. 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
A prospective study of inflammatory bowel disease phenotypes in extremes of age and comparison with adults
Nikhil Bhangale, Devendra Desai, Philip Abraham, Tarun Gupta, Pavan Dhoble, Anand Joshi
Indian Journal of Gastroenterology.2023; 42(3): 404. CrossRef
Global Epidemiology and Burden of Elderly-Onset Inflammatory Bowel Disease: A Decade in Review
Pojsakorn Danpanichkul, Kanokphong Suparan, Suchapa Arayakarnkul, Aunchalee Jaroenlapnopparat, Natchaya Polpichai, Panisara Fangsaard, Siwanart Kongarin, Karan Srisurapanont, Banthoon Sukphutanan, Wasuwit Wanchaitanawong, Yatawee Kanjanakot, Jakrapun Pupa
Journal of Clinical Medicine.2023; 12(15): 5142. CrossRef

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Miscellaneous

Clinical profile and outcomes of opioid abuse gastroenteropathy: an underdiagnosed disease entity: Ramit Mahajan, Yogesh Gupta, Arshdeep Singh, Pulkit Dhiman, Vandana Midha, Chandan Kakkar, Vikram Narang, Varun Mehta, Kavita Saggar, Ajit Sood; Intest Res 2020;18(2):238-244. Published online February 25, 2020; DOI: https://doi.org/10.5217/ir.2019.00104

Abstract PDF PubReader ePub

Background/Aims
Opioid-induced bowel dysfunction includes nausea, vomiting, constipation and abdominal distension. We describe patients presenting with gastrointestinal (GI) ulcers and ulcerated strictures secondary to opioid abuse, an entity not well described in literature.
Methods
This retrospective observational study included patients with opioid abuse gastroenteropathy presenting to Dayanand Medical College and Hospital, Ludhiana, India between January 2013 and December 2018. Opioid abuse gastroenteropathy was defined as gastric or small bowel ulcers and ulcerated strictures in patients abusing opioids, where all other possible etiologies of GI ulcers/strictures were excluded. Clinical, biochemical, endoscopic, radiological and histological parameters as well as response to treatment were assessed.
Results
During the study period, 20 patients (mean age, 38.5±14.2 years; 100% males) were diagnosed to have opioid induced GI ulcers and/or ulcerated strictures. The mean duration of opioid consumption was 6.2±3.4 years. The mean duration of symptoms at presentation was 222.1±392.3 days. Thirteen patients (65%) had gastroduodenal involvement, 6 (30%) had a jejunoileal disease and 1 (5%) had an ileocecal stricture. Two patients (10%) presented with upper GI bleeding, 11 (55%) had features of gastric outlet obstruction and 7 (35%) presented with small bowel obstruction. Abdominal pain and iron deficiency anemia were the most common presentations. Only 1 patient (5%) responded to proton pump inhibitors, 3 (15%) had a lasting response to endoscopic balloon dilatation, while all other (80%) required surgical intervention.
Conclusions
Opioid abuse gastroenteropathy presents as ulcers and ulcerated strictures which respond poorly to medical management and endoscopic balloon dilatation. A majority of these cases need surgical intervention.

Citations

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Transdermal fentanyl induced paralytic intestinal obstruction in advanced liver cancer: a case report
Chen Li, Jindong Chu, Xiaodong Jia, Haibin Su
Frontiers in Pharmacology.2025;[Epub] CrossRef
Peptic ulcer characteristics in oral opium and non-opium user patients with upper gastrointestinal bleeding
Mohsen Masoodi, Mohammad Sabzikarian, Nikta Masoodi, Saeed Farhadi, Gholam Reza Rezamand, Seidamir Pasha Tabaeian, Atefeh Talebi, Farimah Fayyaz
BMC Gastroenterology.2024;[Epub] CrossRef
Cryptogenic multifocal ulcerous stenosing enteritis: A ray of light on the umbra of the dark continent
Mithu Bhowmick, Vishal Sharma
Indian Journal of Gastroenterology.2024; 43(6): 1082. CrossRef
Analgesic and Proton Pump Inhibitor Combinations in Prescriptions: An Insights from the Southeastern Region of Bangladesh
Md Abdus Samadd, Ashfia Tasnim Munia, Most. Jannatun Ferdousi, K. M. Yasif Kayes Sikdar, Mohammad Ashraful Islam, A. S. M. Monjur Al Hossain, Md. Raihan Sarkar
Malaysian Journal of Medicine and Health Sciences.2024; 20(4): 107. 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
Endogenous opiates and behavior: 2020
Richard J. Bodnar
Peptides.2022; 151: 170752. CrossRef

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IBD

Efficacy of fecal microbiota therapy in steroid dependent ulcerative colitis: a real world intention-to-treat analysis: Ajit Sood, Ramit Mahajan, Garima Juyal, Vandana Midha, Charanpreet Singh Grewal, Varun Mehta, Arshdeep Singh, Mohan C Joshi, Vikram Narang, Kirandeep Kaur, Hasrat Sidhu; Intest Res 2019;17(1):78-86. Published online November 20, 2018; DOI: https://doi.org/10.5217/ir.2018.00089

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Four high-quality randomized controlled trials have proven the efficacy of fecal microbiota transplantation (FMT) in active ulcerative colitis (UC). We assessed the efficacy of FMT in a real-world setting involving steroid-dependent patients with UC.
Methods
This was a single-center prospective analysis of data from steroid-dependent patients with UC treated with FMT from September 2015 to September 2017 at the Dayanand Medical College, a tertiary care center in India. Fecal samples from random unrelated donors were administered through colonoscopy at weeks 0, 2, 6, 10, 14, 18, and 22. The primary outcome was achievement of steroid-free clinical remission, and the secondary outcomes were clinical response and endoscopic remission at 24 weeks. Modified intention-to-treat analysis was performed, which included subjects who underwent at least 1 FMT.
Results
Of 345 patients with UC treated during the study period, 49 (14.2%) had steroid-dependent UC. Of these 49 patients, 41 underwent FMT: 33 completed 7 sessions over 22 weeks according to the protocol, and 8 discontinued treatment (non-response, 5; lost to follow-up, 2; and fear of adverse effects, 1). At week 24, steroid-free clinical remission was achieved in 19 out of 41 (46.3%) patients, whereas clinical response and endoscopic remission were achieved in 31 out of 41 (75.6%) and 26 out of 41 (63.4%) patients, respectively. All patients with clinical response were able to withdraw steroids. There were no serious adverse events necessitating discontinuation.
Conclusions
A multisession FMT via the colonoscopic route is a promising therapeutic option for patients with steroid-dependent UC, as it can induce clinical remission and aid in steroid withdrawal.

Citations

Citations to this article as recorded by

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
Microbiota transplant therapy in inflammatory bowel disease: advances and mechanistic insights
Daphne Moutsoglou, Pavithra Ramakrishnan, Byron P. Vaughn
Gut Microbes.2025;[Epub] CrossRef
The practice of fecal microbiota transplantation in inflammatory bowel disease
Umang Arora, Saurabh Kedia, Vineet Ahuja
Intestinal Research.2024; 22(1): 44. CrossRef
Current perspectives on fecal microbiota transplantation in inflammatory bowel disease
Arshdeep Singh, Vandana Midha, Nar Singh Chauhan, Ajit Sood
Indian Journal of Gastroenterology.2024; 43(1): 129. CrossRef
Artemisia argyi polyphenols Attenuates DSS-induced colitis in mice by regulating the structural composition of gut microbiota
Huaqiang Zhang, Zhonghua Hao, Ruya Zhang, Jiang Tong, Xiaoke Wang, Jingjing Liu, Yingkui Gao, Xuefang Wang, Qing Su, Haojie Wen, Yi Fan, Fang Liu, Xiao Li, Chao Tong, Xuebing Wang
Phytomedicine.2024; 132: 155897. CrossRef
Perception of fecal microbiota transplantation in patients with ulcerative colitis in Korea: a KASID multicenter study
Jebyung Park, Sung Noh Hong, Hong Sub Lee, Jongbeom Shin, Eun Hye Oh, Kwangwoo Nam, Gyeol Seong, Hyun Gun Kim, Jin-Oh Kim, Seong Ran Jeon
The Korean Journal of Internal Medicine.2024; 39(5): 783. CrossRef
Fecal transplantation for treatment of inflammatory bowel disease
Aamer Imdad, Natasha G Pandit, Muizz Zaman, Nathan Zev Minkoff, Emily E Tanner-Smith, Oscar G Gomez-Duarte, Sari Acra, Maribeth R Nicholson
Cochrane Database of Systematic Reviews.2023;[Epub] CrossRef
Single-Donor and Pooling Strategies for Fecal Microbiota Transfer Product Preparation in Ulcerative Colitis: A Systematic Review and Meta-analysis
Benoît Levast, Mathieu Fontaine, Stéphane Nancey, Pierre Dechelotte, Joël Doré, Philippe Lehert
Clinical and Translational Gastroenterology.2023; 14(5): e00568. CrossRef
Lithium carbonate alleviates colon inflammation through modulating gut microbiota and Treg cells in a GPR43-dependent manner
Shengjie Huang, Shiping Hu, Shuang Liu, Bo Tang, Yaojiang Liu, Li Tang, Yuanyuan Lei, Li Zhong, Shiming Yang, Song He
Pharmacological Research.2022; 175: 105992. CrossRef
Gut microbiota in inflammatory bowel disease: a target for therapy not to be missed
Tiziana LARUSSA, Ludovico ABENAVOLI, Giulia FABIANO, Maria A. MANCUSO, Natale POLIMENI, Dan L. DUMITRASCU, Francesco LUZZA
Minerva Gastroenterology.2022;[Epub] CrossRef
Fecal microbiota transplantation for induction of remission, maintenance and rescue in patients with corticosteroid-dependent ulcerative colitis: a long-term follow-up real-world cohort study
Avnish Kumar Seth, Priti Jain
Intestinal Research.2022; 20(2): 251. CrossRef
Systematic review of donor and recipient predictive biomarkers of response to faecal microbiota transplantation in patients with ulcerative colitis
Nia Paddison Rees, Walaa Shaheen, Christopher Quince, Chris Tselepis, Richard D Horniblow, Naveen Sharma, Andrew D Beggs, Tariq H Iqbal, Mohammed Nabil Quraishi
eBioMedicine.2022; 81: 104088. CrossRef
An updated systematic review and meta-analysis of fecal microbiota transplantation for the treatment of ulcerative colitis
Taobi Huang, Jinlan Xu, Maoying Wang, Ke Pu, Longquan Li, Huiyun Zhang, Yuan Liang, Weiming Sun, Yuping Wang
Medicine.2022; 101(30): e29790. CrossRef
Additive effect of probiotics (Mutaflor) on 5-aminosalicylic acid therapy in patients with ulcerative colitis
Soo-Kyung Park, Sang-Bum Kang, SangSoo Kim, Tae Oh Kim, Jae Myung Cha, Jong Pil Im, Chang Hwan Choi, Eun Soo Kim, Geom Seog Seo, Chang Soo Eun, Dong Soo Han, Dong Il Park
The Korean Journal of Internal Medicine.2022; 37(5): 949. CrossRef
Early fecal microbiome transfer after donor defecation determines response in patients with moderate to severe ulcerative colitis
Arshdeep Singh, Ramit Mahajan, Bhavjeet Kaur Kahlon, Ashvin Singh Dhaliwal, Vandana Midha, Varun Mehta, Namita Bansal, Dharmatma Singh, Ajit Sood
Indian Journal of Gastroenterology.2022; 41(4): 389. CrossRef
Physician education can minimize inappropriate steroid use in patients with inflammatory bowel disease: the ACTION study
Yehyun Park, Chang Hwan Choi, Hyun Soo Kim, Hee Seok Moon, Do Hyun Kim, Jin Ju Kim, Dennis Teng, Dong Il Park
Intestinal Research.2022; 20(4): 452. CrossRef
Inflammatory bowel disease in India: challenges and opportunities
Alice Snell, Jonathan Segal, Jimmy Limdi, Rupa Banerjee
Frontline Gastroenterology.2021; 12(5): 390. CrossRef
Clinical Predictors of Response to Faecal Microbiota Transplantation in Patients with Active Ulcerative Colitis
Ajit Sood, Arshdeep Singh, Ramit Mahajan, Vandana Midha, Kirandeep Kaur, Dharmatma Singh, Namita Bansal, Khushdeep Dharni
Journal of Crohn's and Colitis.2021; 15(2): 238. CrossRef
Long-term efficacy and safety of monotherapy with a single fresh fecal microbiota transplant for recurrent active ulcerative colitis: a prospective randomized pilot study
Haiming Fang, Lian Fu, Xuejun Li, Chunxia Lu, Yuan Su, Kangwei Xiong, Lijiu Zhang
Microbial Cell Factories.2021;[Epub] CrossRef
Repeated Fecal Microbial Transplantations and Antibiotic Pre-Treatment Are Linked to Improved Clinical Response and Remission in Inflammatory Bowel Disease: A Systematic Review and Pooled Proportion Meta-Analysis
Valentin Mocanu, Sabitha Rajaruban, Jerry Dang, Janice Y. Kung, Edward C. Deehan, Karen L. Madsen
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Efficacy and Safety of Fecal Microbiota Transplantation and Prospect of Microbe-based Therapies for Inflammatory Bowel Disease
Hoon Gil Jo, Geom Seog Seo
The Korean Journal of Gastroenterology.2021; 78(1): 31. CrossRef
Intestinal microbiota and inflammatory bowel diseases
Chang Soo Eun
Journal of the Korean Medical Association.2021; 64(9): 588. CrossRef
The Role of Glucocorticoids in Inflammatory Diseases
Sybille D. Reichardt, Agathe Amouret, Chiara Muzzi, Sabine Vettorazzi, Jan P. Tuckermann, Fred Lühder, Holger M. Reichardt
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Acceptability, tolerability, and safety of fecal microbiota transplantation in patients with active ulcerative colitis (AT&S Study)
Ajit Sood, Arshdeep Singh, Ramit Mahajan, Vandana Midha, Varun Mehta, Yogesh Kumar Gupta, Vikram Narang, Kirandeep Kaur
Journal of Gastroenterology and Hepatology.2020; 35(3): 418. CrossRef
Washed microbiota transplantation vs. manual fecal microbiota transplantation: clinical findings, animal studies and in vitro screening
Ting Zhang, Gaochen Lu, Zhe Zhao, Yafei Liu, Quan Shen, Pan Li, Yaoyao Chen, Haoran Yin, Huiquan Wang, Cicilia Marcella, Bota Cui, Lei Cheng, Guozhong Ji, Faming Zhang
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Efficacy of intestinal microbiota transplantation in ulcerative colitis: a review of current literature and knowledge
Krista M. Newman, Byron P. Vaughn
Minerva Gastroenterologica e Dietologica.2020;[Epub] CrossRef
Advances in the understanding of the intestinal micro-environment and inflammatory bowel disease
Peng-Guang Yan, Jing-Nan Li
Chinese Medical Journal.2020; 133(7): 834. CrossRef
Gut microbiota in ulcerative colitis: insights on pathogenesis and treatment
Xiao Yan Guo, Xin Juan Liu, Jian Yu Hao
Journal of Digestive Diseases.2020; 21(3): 147. CrossRef
Enhancing patient adherence to fecal microbiota transplantation maintains the long-term clinical effects in ulcerative colitis
Qianqian Li, Ting Zhang, Xiao Ding, Liyuan Xiang, Bota Cui, Heena Buch, Faming Zhang
European Journal of Gastroenterology & Hepatology.2020; 32(8): 955. CrossRef
Incidental benefits after fecal microbiota transplant for ulcerative colitis
Ramit Mahajan, Vandana Midha, Arshdeep Singh, Varun Mehta, Yogesh Gupta, Kirandeep Kaur, Ritu Sudhakar, Anmol Singh Pannu, Dharmatma Singh, Ajit Sood
Intestinal Research.2020; 18(3): 337. CrossRef
Fecal Microbiota Transplantation for Ulcerative Colitis: The Optimum Timing and Gut Microbiota as Predictors for Long-Term Clinical Outcomes
Qianqian Li, Xiao Ding, Kangjian Liu, Cicilia Marcella, Xiaolin Liu, Ting Zhang, Yafei Liu, Pan Li, Liyuan Xiang, Bota Cui, Jun Wang, Jianling Bai, Faming Zhang
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Fecal microbiota transplantation in inflammatory bowel disease patients: A systematic review and meta-analysis
Luciane de Fátima Caldeira, Helena H. Borba, Fernanda S. Tonin, Astrid Wiens, Fernando Fernandez-Llimos, Roberto Pontarolo, Udai P. Singh
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Efficacy and safety of fecal microbiota transplantation by washed preparation in patients with moderate to severely active ulcerative colitis
Min Chen, Xiao Lei Liu, Yu Jie Zhang, Yong Zhan Nie, Kai Chun Wu, Yong Quan Shi
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Fecal Microbiota Transplantation for Ulcerative Colitis: An Evolving Therapy
Ajit Sood, Arshdeep Singh, Vandana Midha, Ramit Mahajan, Dina Kao, David T Rubin, Charles N Bernstein
Crohn's & Colitis 360.2020;[Epub] CrossRef
Efficacy and safety of fecal microbiota transplantation for treating patients with ulcerative colitis: A systematic review and meta‐analysis
Hai Lan Zhao, Shu Zhen Chen, Hao Ming Xu, You Lian Zhou, Jie He, Hong Li Huang, Jing Xu, Yu Qiang Nie
Journal of Digestive Diseases.2020; 21(10): 534. CrossRef
Optimising management strategies of inflammatory bowel disease in resource-limited settings in Asia
Siew C Ng, Joyce Wing Yan Mak, Partha Pal, Rupa Banerjee
The Lancet Gastroenterology & Hepatology.2020; 5(12): 1089. CrossRef
Lithium Carbonate Treatment Alleviates Gut Inflammation Through Activating Treg Cell Responses in a Microbiota-Dependent Manner
Shengjie Huang, Bo Tang, Li Tang, Yaojiang Liu, Shuang Liu, Yuanyuan Lei, Shiping Hu, Li Zhong, Shiming Yang, Song He
SSRN Electronic Journal .2020;[Epub] CrossRef
Fecal Microbiota Transplantation in Intestinal Disorders: A Primer for Physicians
Ajit Sood, Vandana Midha, Harmeet Kaur, Arshdeep Singh
Journal of Gastrointestinal Infections.2020; 10(1): 16. CrossRef
Multi-session fecal microbiota transplantation using colonoscopy has favorable outcomes for the treatment of steroid-dependent ulcerative colitis
Young-Seok Cho
Intestinal Research.2019; 17(1): 6. CrossRef
Intestinal microbiome as a novel therapeutic target for local and systemic inflammation
Kazuhiko Uchiyama, Yuji Naito, Tomohisa Takagi
Pharmacology & Therapeutics.2019; 199: 164. CrossRef
Role of Faecal Microbiota Transplantation for Maintenance of Remission in Patients With Ulcerative Colitis: A Pilot Study
Ajit Sood, Ramit Mahajan, Arshdeep Singh, Vandana Midha, Varun Mehta, Vikram Narang, Tarundeep Singh, Anmol Singh Pannu
Journal of Crohn's and Colitis.2019; 13(10): 1311. CrossRef
Evolution of fecal microbiota transplantation in methodology and ethical issues
Faming Zhang, Ting Zhang, Heming Zhu, Thomas J Borody
Current Opinion in Pharmacology.2019; 49: 11. CrossRef

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Miscellaneous

A simple phenotypic classification for celiac disease: Ajit Sood, Vandana Midha, Govind Makharia, B. K. Thelma, Shivalingappa S Halli, Varun Mehta, Ramit Mahajan, Vikram Narang, Kriti Sood, Kirandeep Kaur; Intest Res 2018;16(2):288-292. Published online April 30, 2018; DOI: https://doi.org/10.5217/ir.2018.16.2.288

Abstract PDF PubReader ePub

Background/Aims

Celiac disease is a global health problem. The presentation of celiac disease has unfolded over years and it is now known that it can manifest at different ages, has varied presentations, and is prone to develop complications, if not managed properly. Although the Oslo definitions provide consensus on the various terminologies used in literature, there is no phenotypic classification providing a composite diagnosis for the disease.

Methods

Various variables identified for phenotypic classification included age at diagnosis, age at onset of symptoms, clinical presentation, family history and complications. These were applied to the existing registry of 1,664 patients at Dayanand Medical College and Hospital, Ludhiana, India. In addition, age was evaluated as below 15 and below 18 years. Cross tabulations were used for the verification of the classification using the existing data. Expert opinion was sought from both international and national experts of varying fields.

Results

After empirical verification, age at diagnosis was considered appropriate in between A1 (<18) and A2 (≥18). The disease presentation has been classified into 3 types–P1 (classical), P2 (non-classical) and P3 (asymptomatic). Complications were considered as absent (C0) or present (C1). A single phenotypic classification based on these 3 characteristics, namely age at the diagnosis, clinical presentation, and intestinal complications (APC classification) was derived.

Conclusions

APC classification (age at diagnosis, presentation, complications) is a simple disease explanatory classification for patients with celiac disease aimed at providing a composite diagnosis.

Citations

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Clinicopathologic Analysis of Malabsorption Syndrome in a Tertiary Care Center in South India
Nidhya Ganesan, S. Shrinnivi, R. Shivani, R. K. Kartikayan
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Daniel Vasile Balaban, Alina Dima, Ciprian Jurcut, Alina Popp, Mariana Jinga
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Indian Journal of Gastroenterology.2019; 38(6): 518. CrossRef

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Efficacy and safety of the adalimumab biosimilar Exemptia as induction therapy in moderate-to-severe ulcerative colitis: Vandana Midha, Ramit Mahajan, Varun Mehta, Vikram Narang, Arshdeep Singh, Kirandeep Kaur, Ajit Sood; Intest Res 2018;16(1):83-89. Published online January 18, 2018; DOI: https://doi.org/10.5217/ir.2018.16.1.83

Abstract PDF PubReader ePub

Background/Aims

Data on the efficacy and safety of the adalimumab biosimilar Exemptia are limited.

Methods

Patients with moderate-to-severe active steroid-refractory ulcerative colitis (UC) treated at Dayanand Medical College and Hospital, India were offered cyclosporine A, biologicals or biosimilars, or surgery. A retrospective analysis was conducted on patients who were treated with the adalimumab biosimilar, Exemptia. These patients were administered an induction dosing schedule of 160 mg Exemptia at week 0, 80 mg at week 2, and then 40 mg every other week from week 4 to 8. The clinical response and remission were assessed at week 8 using Mayo score.

Results

A total of 29 patients (62.1% male; mean age, 34.9 ± 9.7 years) with moderate-to-severe steroid-refractory active UC (mean disease duration, 6.3±5.1 years; pancolitis in 9 patients [31.1%]; left-sided colitis in 20 patients [68.9%]) were treated with the Exemptia induction dosing schedule. The mean Mayo score at presentation was 8.2±1.4. At week 8, clinical response was observed in 7 patients (24.1%), whereas clinical remission was observed only in 1 patient (3.5%). Among the non-responders (n=21), 4 patients required colectomy, 1 died, 1 was lost to follow-up, 10 were offered fecal microbiota transplant, 3 were administered infliximab, and 2 patients were administered cyclosporine and tacrolimus, respectively. Four patients (13.8%) developed extrapulmonary tuberculosis.

Conclusions

The adalimumab biosimilar Exemptia has limited efficacy for the attainment of clinical response and remission in moderate-to-severe steroid-refractory UC, with a significant risk of acquisition or reactivation of tuberculosis in developing countries such as India.

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Association of endoscopic and histological remission with clinical course in patients of ulcerative colitis: Vikram Narang, Ravneet Kaur, Bhavna Garg, Ramit Mahajan, Vandana Midha, Neena Sood, Ajit Sood; Intest Res 2018;16(1):55-61. Published online January 18, 2018; DOI: https://doi.org/10.5217/ir.2018.16.1.55

Abstract PDF PubReader ePub

Background/Aims

The therapeutic goal for treating ulcerative colitis (UC) patients has shifted to achieving mucosal healing over the past few years. However, at present, limited data is available on the correlation between endoscopic findings and histological remission in patients with endoscopic mucosal healing.

Methods

This was a prospective observational study conducted over a period of 18 months (January 2014 to June 2015) at Dayanand Medical College and Hospital, Ludhiana, Punjab, India. Patients diagnosed with UC who had been in clinical remission (n=76) for at least 6 months were evaluated for endoscopic remission. Those in endoscopic remission (Mayo score ≤1; 46/76, 60.5%) were subjected to multiple biopsies from the rectosigmoid region and histological remission, which was then defined as grade 0/1 as per the Geboes criteria.

Results

Of the 46 patients in endoscopic remission (age, 18–73 years; male:female=1.5:1.0), majority had E1 (proctitis) disease (21/46, 45.6%) followed by E2 (left sided colitis) (18/46, 39.1%) and E3 disease (pancolitis) (7/46, 15.2%) at baseline. Histological remission was noted in 67.3% (31/46) of the patients, while 32.7% (15/46) still retained the histologically active disease in the form of infiltration of the lamina propria by eosinophils and neutrophils (13/15, 86.6%), cryptitis (14/15, 93.3%), and crypt abscesses (8/15, 53.3%). On follow-up, after 1 year, 87.1% (27/31) of the patients who had been in histological remission remained clinically asymptomatic, while 12.9% (4/31) had relapsed. Among the 15 histologically active patients, 46.6% (7/15) remained in clinical remission, while 53.3% (8/15) had relapsed.

Conclusions

Histological remission, rather than endoscopic remission, predicts a sustained clinical remission and allows monitoring of therapy for the subsequent disease course in patients with UC.

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