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Original Article
Infection
The impact of the quality improvement program on Clostridioides difficile infection management: a quasi-experimental study
Jung Yun Lee, Jae-Ki Choi, Tae-Geun Gweon, Young Eun An, Hyo Suk Kim, Jae Hyuck Chang, Tae Ho Kim, Chang Whan Kim, Young-Seok Cho
Intest Res 2025;23(4):551-558.   Published online October 28, 2025
DOI: https://doi.org/10.5217/ir.2025.00137
AbstractAbstract PDFPubReaderePub
Background/Aims
Clostridioides difficile infection (CDI) is a major cause of nosocomial diarrhea. This study aimed to implement a quality improvement program to expedite proper CDI treatment, including discontinuing laxatives and associated antibiotics.
Methods
Stool test results positive for CDI were automatically sent via text message to the quality improvement team, specialists in CDI management. The quality improvement team played an advisory role in this treatment. The outcome of this study was the competency of CDI treatment within 24 hours of stool test reporting. Competency was investigated using 3 different models: Model 1, initiation of CDI treatment within 24 hours of positive stool test report; Model 2, Model 1 criteria met with no concurrent laxative use; and Model 3, Model 2 criteria met with no concurrent associated antibiotics. Competency rates were compared between pre- and post-intervention periods (1 year each). Analyses were performed for inpatients with CDI.
Results
In total, 310 inpatients with CDI (129 pre-intervention, 181 post-intervention) were included in this study. The rates of competency for Model 1 (85.3% vs. 95.6%, p= 0.006), Model 2 (81.4% vs. 92.3%, p= 0.004), and Model 3 (35.7% vs. 56.4%, p< 0.001) in the post-intervention group were higher to those in the pre-intervention group.
Conclusions
Quality improvement program enhanced the quality of CDI treatment in terms of prompt treatment and discontinuation of concomitant laxatives and associated antibiotics. (cris.nih.go.kr; KCT0005892)
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Review
Colorectal neoplasia
Pathogenesis and biomarkers of colorectal cancer by epigenetic alteration
Chang Kyo Oh, Young-Seok Cho
Intest Res 2024;22(2):131-151.   Published online February 1, 2024
DOI: https://doi.org/10.5217/ir.2023.00115
AbstractAbstract PDFPubReaderePub
Colorectal cancer (CRC) ranks third in cancer incidence and stands as the second leading cause of cancer-related deaths globally. CRC tumorigenesis results from a cumulative set of genetic and epigenetic alterations, disrupting cancer-regulatory processes like cell proliferation, metabolism, angiogenesis, cell death, invasion, and metastasis. Key epigenetic modifications observed in cancers encompass abnormal DNA methylation, atypical histone modifications, and irregularities in noncoding RNAs, such as microRNAs and long noncoding RNAs. The advancement in genomic technologies has positioned these genetic and epigenetic shifts as potential clinical biomarkers for CRC patients. This review concisely covers the fundamental principles of CRC-associated epigenetic changes, and examines in detail their emerging role as biomarkers for early detection, prognosis, and treatment response prediction.

Citations

Citations to this article as recorded by  
  • The combined treatment with TOP-V122, a dual-acting NO-releasing PDE-5 inhibitor, and ionizing irradiation as a novel therapeutical strategy for colorectal carcinoma
    Alba Sanchez-Fernandez, Hermann Tenor, Claire Beckers, Chantal Pauli, Zuzana Garajova, Enni Markkanen, Irene Vetrugno, Lazaros Vasilikos, Tobias Braun, Esra Lone- Kapaklikaya, Yoshita Bhide, Reto Naef, Martin Pruschy
    Radiotherapy and Oncology.2026; 215: 111331.     CrossRef
  • Comparison between endoscopic resection and transanal surgery for treatment of rectal tumors: a systematic review and meta‑analysis
    Chan Hyuk Park, Byung Wook Jung, Yoon Suk Jung
    Intestinal Research.2026; 24(1): 38.     CrossRef
  • The critical role of epithelial-mesenchymal transition (EMT) in colorectal cancer progression and therapeutic outcomes
    Hailang Jiang, Bingtian Xu
    Critical Reviews in Oncology/Hematology.2026; 220: 105189.     CrossRef
  • Precision oncology in colorectal cancer: Integrating molecular subtyping, multidisciplinary management, and emerging therapeutics
    Yi Yang, Huihua Cao, Zhengping Xu, Yanmiao Dai, Xiaolan Dai, Minke Shao, Yizhou Yao, Songbing He
    Clinical Surgical Oncology.2026; 5(1): 100119.     CrossRef
  • Senescence-associated and immune-related 9p21.3 locus genes in colorectal cancer: epigenetic architecture, molecular landscape and therapeutic possibilities
    Darya A. Lisitsa, Vadim V. Shindyapin, Artem R. Nurislamov, Oleg N. Demidov, Daria A. Bogdanova
    Frontiers in Cell and Developmental Biology.2026;[Epub]     CrossRef
  • A review on prognostic biomarker and phytocompound-mediated modulation of signaling pathways in colorectal cancer
    Bhavyaa Krishnakumar, Benedict Christopher Paul, Sabina Evan Prince, Udhaya Lavinya B
    Personalized Medicine.2026; 23(1): 51.     CrossRef
  • Screening, Prognostic, and Predictive Molecular Tools for Colorectal Cancer: Recent Advances in the Classical Background
    Mihaela Cristina Pavalean, Ioana Maria Lambrescu, Mihai Ioan Pavalean, Gisela Gaina, Laura Cristina Ceafalan, Mihail Eugen Hinescu
    International Journal of Molecular Sciences.2026; 27(5): 2251.     CrossRef
  • Influence of Lifestyles on Polyp Burden and Cancer Development in Hereditary Colorectal Cancer Syndromes
    Hye Kyung Hyun, Ji Soo Park, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim
    Journal of Gastroenterology and Hepatology.2025; 40(2): 433.     CrossRef
  • The role of suppressor of cytokine signaling 3 in inflammatory bowel disease and its associated colorectal cancer
    Pengfei Zhang, Bing Pei, Chengxue Yi, Francis Atim Akanyibah, Fei Mao
    Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease.2025; 1871(2): 167578.     CrossRef
  • Chronic Kidney Disease Increases Risk of Delayed Post‐Polypectomy Bleeding: A Large‐Scale Propensity Score‐Matched Analysis
    Hye Kyung Hyun, Nak‐Hoon Son, So Hyeon Gwon, Hyun Chul Lim, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim, Tae‐Hyun Yoo, Shin‐Wook Kang, Hae‐Ryong Yun, Cheal Wung Huh
    United European Gastroenterology Journal.2025; 13(5): 759.     CrossRef
  • An overview of potential of natural compounds to regulate epigenetic modifications in colorectal cancer: a recent update
    Susmita Roy, Dikshita Deka, Suresh Babu Kondaveeti, Pavithra Ayyadurai, Sravani Siripragada, Neha Philip, Surajit Pathak, Asim K. Duttaroy, Antara Banerjee
    Epigenetics.2025;[Epub]     CrossRef
  • Minimum Platelet Count Threshold for Safe Colonoscopic Polypectomy: A Large-Scale Propensity Scored-Matched Analysis
    Hye Kyung Hyun, Nak-Hoon Son, Cheal Wung Huh, Hyun Chul Lim, So Hyeon Gwon, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim
    American Journal of Gastroenterology.2025; 120(12): 2918.     CrossRef
  • Anthocyanins: From Natural Colorants to Potent Anticancer Agents
    Muhammad Maaz, Muhammad Tauseef Sultan, Ahmad Mujtaba Noman, Shehnshah Zafar, Naima Tariq, Muzzamal Hussain, Muhammad Imran, Ahmed Mujtaba, Tadesse Fenta Yehuala, Ehab M. Mostafa, Samy Selim, Soad K. Al Jaouni, Suliman A. Alsagaby, Waleed Al Abdulmonem
    Food Science & Nutrition.2025;[Epub]     CrossRef
  • Hsa-miR-21-5p and Hsa-miR-145-5p Expression: From Normal Tissue to Malignant Changes—Context-Dependent Correlation with Estrogen- and Hypoxia–Vascularization-Related Pathways Genes: A Pilot Study
    Mateusz Górecki, Aleksandra Żbikowska, Małgorzata Tokłowicz, Stefan Sajdak, Monika Englert-Golon, Mirosław Andrusiewicz
    International Journal of Molecular Sciences.2025; 26(9): 4461.     CrossRef
  • Epigenetically Regulating Non-coding RNAs in Colorectal Cancer: Promises and Potentials
    Zahra Taheri, Majid Zaki-Dizaji
    Middle East Journal of Digestive Diseases.2025; 17(1): 40.     CrossRef
  • Elevated Methylation Contributes to Suppressed Expression of Special AT‐Rich Sequence‐Binding Protein 2 in Colorectal Cancer: A Gene‐Disease Association Study
    Weitong Cui, Cong Lu, Huaru Xue, Lei Wei, Shuai Li, Lianzheng Su, Dianfang Wei, Xiaoyu Feng, Kai Wang, Chao Song
    Health Science Reports.2025;[Epub]     CrossRef
  • Integrative multi-omics identification and functional validation of potential targets linking metabolism–immune–colorectal cancer causal pathway
    Zequn Zheng, Xiaoling Xu
    Frontiers in Immunology.2025;[Epub]     CrossRef
  • Identification of isatin-triazole-benzenesulfonamide hybrids as dual hCA IX/XII and c-met inhibitors with hypoxia-mediated chemo-sensitizing activity
    Wagdy M. Eldehna, Mohamed R. Elnagar, Simone Giovannuzzi, Amr Tayel, Maha-Hamadien Abdulla, Noura S. Alhassan, Moataz A. Shaldam, Alessio Nocentini, Claudiu T. Supuran, Haytham O. Tawfik
    Bioorganic Chemistry.2025; 166: 109071.     CrossRef
  • TET methylcytosine dioxygenases in cancer: Orchestrators of pathogenesis, immunity, immunotherapy, and chemoresistance
    Yukai Zhang, Jian Li, Juan Liu
    International Immunopharmacology.2025; 167: 115622.     CrossRef
  • Bacteroides fragilis Promotes Mesenchymal Subtype in Colorectal Cancer
    Shin Chang, Jihye Park, Soo Park, Jae Park, Jae Cheon, Dong Kim, Tae Kim
    Cancers.2025; 17(23): 3822.     CrossRef
  • miR-3065-5p and miR-26a-5p as Clinical Biomarkers in Colorectal Cancer: A Translational Study
    Berenice Carbajal-López, Antonio Daniel Martínez-Gutierrez, Eduardo O. Madrigal-Santillán, Germán Calderillo-Ruiz, José Antonio Morales-González, Jossimar Coronel-Hernández, Joey Lockhart, Oliver Millan-Catalan, Monica G. Mendoza-Rodriguez, Leonardo S. Li
    Cancers.2024; 16(21): 3649.     CrossRef
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Original Article
Endoscopy
Clinical comparison of low-volume agents (oral sulfate solution and sodium picosulfate with magnesium citrate) for bowel preparation: the EASE study
Jeeyeon Kim, Hyun Gun Kim, Kyeong Ok Kim, Hyung Wook Kim, Jongha Park, Jeong-Sik Byeon, Sung-Wook Hwang, Hyun Deok Shin, Jeong Eun Shin, Hyo-Joon Yang, Hyun Seok Lee, Yunho Jung, Young-Seok Cho, Young Eun Joo, Dae-Seong Myung, Kyu Chan Huh, Eu Mi Ahn
Intest Res 2019;17(3):413-418.   Published online April 8, 2019
DOI: https://doi.org/10.5217/ir.2018.00156
AbstractAbstract PDFPubReaderePub
Background/Aims
This study compared the efficacy, compliance, and safety of bowel preparation between sodium picosulfate with magnesium citrate (SPMC) and oral sulfate solution (OSS).
Methods
A prospective randomized multicenter study was performed. Split preparation methods were performed in both groups; the SPMC group, 2 sachets on the day before, and 1 sachet on the day of the procedure, the OSS group, half of the OSS with 1 L of water on both the day before and the day of the procedure. The adenoma detection rate (ADR), adequacy of bowel preparation using the Boston Bowel Preparation Scale (BBPS) score, patient satisfaction on a visual analog scale (VAS), and safety were compared between the 2 groups.
Results
This study analyzed 229 patients (121 in the SPMC group and 108 in the OSS group). ADR showed no differences between 2 groups (51.7% vs. 41.7%, P> 0.05). The mean total BBPS score (7.95 vs. 8.11, P> 0.05) and adequate bowel preparation rate (94.9% vs. 96.3%, P> 0.05) were similar between the 2 groups. The mean VAS score for taste (7.62 vs. 6.87, P=0.006) was significantly higher in the SPMC group than in the OSS group. There were no significant differences in any other safety variables between the 2 groups except nausea symptom (36.1% vs. 20.3%, P=0.008).
Conclusions
Bowel preparation for colonoscopy using low volume OSS and SPMC yielded similar ADRs and levels of efficacy. SPMC had higher levels of satisfaction for taste and feeling than did OSS.

Citations

Citations to this article as recorded by  
  • Efficacy and safety of split-dose ultra-low-volume polyethylene glycol with ascorbic acid versus sodium picosulfate with magnesium citrate for bowel preparation: a systematic review and meta-analysis.
    Abdallfatah Abdallfatah, Ahmed W. Hageen, Dania Albader, Abdulaziz Al-Tamimi, Khalid Alsalumi, Abdulrahman Alzmmam, Mahdi Abdullah, Laith Alreshaid, Saleh Aldhuwayhi, Nourah Almarri, Wala Fallatah, Abdullah Altamimi
    European Journal of Gastroenterology & Hepatology.2026;[Epub]     CrossRef
  • Efficacy and Safety of Bowel Cleansing with Mini S-Oral Sulfate Tablet versus the Conventional Oral Sulfate Tablet: A Prospective, Randomized, Investigator-Blinded, Multicenter, Noninferior, Phase 3 Trial
    Soo-Kyung Park, Seong Ran Jeon, Dong-Hoon Yang, Jaeyoung Chun, Jae Myung Cha
    Gut and Liver.2026; 20(2): 294.     CrossRef
  • Comments on Oral Sulfate Solution Is as Effective as Polyethylene Glycol with Ascorbic Acid in a Split Method for Bowel Preparation in Patients with Inactive Ulcerative Colitis: A Randomized, Multicenter, and Single-Blind Clinical Trial
    Ji Eun Kim
    Gut and Liver.2024; 18(1): 192.     CrossRef
  • Oral Sulfate Solution Is as Effective as Polyethylene Glycol with Ascorbic Acid in a Split Method for Bowel Preparation in Patients with Inactive Ulcerative Colitis: A Randomized, Multicenter, and Single-Blind Clinical Trial
    Ji Min Lee, Kang-Moon Lee, Ho Suk Kang, Ja Seol Koo, Hyun Seok Lee, Seok-Hoo Jeong, Jung Ho Kim, Dae Bum Kim
    Gut and Liver.2023; 17(4): 591.     CrossRef
  • Quality indicators in colonoscopy: the chasm between ideal and reality
    Su Bee Park, Jae Myung Cha
    Clinical Endoscopy.2022; 55(3): 332.     CrossRef
  • Comparison of the efficacy and safety between oral sulfate tablet and polyethylene glycol for bowel preparation before colonoscopy according to age
    Jae Hyun Kim, Yong Eun Park, Tae Oh Kim, Jongha Park, Gyu Man Oh, Won Moon, Seun Ja Park
    Medicine.2022; 101(27): e29884.     CrossRef
  • Efficacy, safety and tolerability of oral sulphate tablet for bowel preparation in patients with inflammatory bowel disease: A multicentre randomized controlled study
    Kyeong Ok Kim, Eun Young Kim, Yoo Jin Lee, Hyun Seok Lee, Eun Soo Kim, Yun Jin Chung, Byung Ik Jang, Sung Kook Kim, Chang Heon Yang
    Journal of Crohn's and Colitis.2022; 16(11): 1706.     CrossRef
  • Comparison of Two Types of 1-L Polyethylene Glycol-ascorbic Acid as Colonoscopic Bowel Preparation: A Prospective Randomized Study
    Suh Hyun Choi, Won Eui Yoon, Seung Hyuk Kim, Hee Jun Myung, Seo Hyun Kim, Soon Oh So, Se Hun Kim, Hyun Mi Lee, Yeoun Jung Oh, Jeong Seop Moon, Tae Yeong Park, You Sun Kim
    The Korean Journal of Gastroenterology.2022; 80(2): 85.     CrossRef
  • Correlation between Surrogate Quality Indicators for Adenoma Detection Rate and Adenoma Miss Rate in Qualified Colonoscopy, CORE Study: KASID Multicenter Study
    Jae Hee Han, Hyun Gun Kim, Eu Mi Ahn, Suyeon Park, Seong Ran Jeon, Jae Myung Cha, Min Seob Kwak, Yunho Jung, Jeong Eun Shin, Hyun Deok Shin, Young-Seok Cho
    Gut and Liver.2022; 16(5): 716.     CrossRef
  • How to Choose the Optimal Bowel Preparation Regimen for Colonoscopy
    Ji Eun Na, Eun Ran Kim
    The Ewha Medical Journal.2021; 44(4): 122.     CrossRef
  • Optimal Laxatives for Oral Colonoscopy Bowel Preparation: from High-volume to Novel Low-volume Solutions
    Soo-Young Na, Won Moon
    The Korean Journal of Gastroenterology.2020; 75(2): 65.     CrossRef
  • No inferioridad entre dos agentes de bajo volumen (Picosulfato de Sodio/Citrato de Magnesio vs. Sulfato de Sodio/Potasio/Magnesio) en la preparación de colon para procedimientos diagnósticos: estudio observacional
    Erika D. Pérez-Riveros, Margarita Rey R., Belén Mendoza De Molano, Juan Carlos Robayo, Jaime Solano Mariño, Rafael García Duperly, Andrés Gómez, Renzo Pinto Carta, Gerardo Ardila, Jose De la Hoz-Valle, Fernando Sierra-Arango
    Revista Colombiana de Gastroenterología.2020; 35(4): 436.     CrossRef
  • 13,730 View
  • 269 Download
  • 12 Web of Science
  • 12 Crossref
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Editorial
IBD
Multi-session fecal microbiota transplantation using colonoscopy has favorable outcomes for the treatment of steroid-dependent ulcerative colitis
Young-Seok Cho
Intest Res 2019;17(1):6-8.   Published online January 25, 2019
DOI: https://doi.org/10.5217/ir.2018.00171
PDFPubReaderePub

Citations

Citations to this article as recorded by  
  • 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
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  • 148 Download
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Case Report
Fecal microbiota transplantation for refractory Crohn's disease
Seon Ho Bak, Hyun Ho Choi, Jinhee Lee, Mi Hee Kim, Youn Hee Lee, Jin Su Kim, Young-Seok Cho
Intest Res 2017;15(2):244-248.   Published online April 27, 2017
DOI: https://doi.org/10.5217/ir.2017.15.2.244
AbstractAbstract PDFPubReaderePub

Approximately one-third of patients with Crohn's disease do not respond to conventional treatments, and some experience significant adverse effects, such as serious infections and lymphoma, and many patients require surgery due to complications. Increasing evidence suggests that specific changes in the composition of gut microbiota, termed as dysbiosis, are a common feature in patients with inflammatory bowel disease (IBD). Dysbiosis can lead to activation of the mucosal immune system, resulting in chronic inflammation and the development of mucosal lesions. Recently, fecal microbiota transplantation, aimed at modifying the composition of gut microbiota to overcome dysbiosis, has become a potential alternative therapeutic option for IBD. Herein, we present a patient with Crohn's colitis in whom biologic therapy failed previously, but clinical remission and endoscopic improvement was achieved after a single fecal microbiota transplantation infusion.

Citations

Citations to this article as recorded by  
  • Role and mechanism of gut microbiota-host interactions in the pathogenesis of Crohn’s disease
    Yao Xu, Runxiang Xie, Yuqing Weng, Yewei Fang, Shuan Tao, He Zhang, Huimin Chen, Axiang Han, Qi Jiang, Wei Liang
    International Journal of Colorectal Disease.2025;[Epub]     CrossRef
  • Epigenetics and the role of nutraceuticals in health and disease
    Amr El-Sayed, Lotfi Aleya, Mohamed Kamel
    Environmental Science and Pollution Research.2023; 30(11): 28480.     CrossRef
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    Izel Aycan BASOGLU, Berna KARAKOYUN
    Marmara Medical Journal.2023; 36(2): 249.     CrossRef
  • Alteration of microbiota antibody‐mediated immune selection contributes to dysbiosis in inflammatory bowel diseases
    Eva Michaud, Louis Waeckel, Rémi Gayet, Roman Goguyer‐Deschaumes, Blandine Chanut, Fabienne Jospin, Katell Bathany, Magali Monnoye, Coraline Genet, Amelie Prier, Caroline Tokarski, Philippe Gérard, Xavier Roblin, Nicolas Rochereau, Stéphane Paul
    EMBO Molecular Medicine.2022;[Epub]     CrossRef
  • Gut microbiota: A new target for T2DM prevention and treatment
    Lulu Liu, Jiheng Zhang, Yi Cheng, Meng Zhu, Zhifeng Xiao, Guangcong Ruan, Yanling Wei
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • Current Trends and Challenges of Fecal Microbiota Transplantation—An Easy Method That Works for All?
    Cátia Almeida, Rita Oliveira, Pilar Baylina, Rúben Fernandes, Fábio G. Teixeira, Pedro Barata
    Biomedicines.2022; 10(11): 2742.     CrossRef
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    Frontiers in Cellular and Infection Microbiology.2022;[Epub]     CrossRef
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    Sahil Khanna
    Intestinal Research.2021; 19(3): 265.     CrossRef
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    Environmental Science and Pollution Research.2021; 28(36): 49343.     CrossRef
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    Acta Tropica.2018; 188: 16.     CrossRef
  • The Safety of Fecal Microbiota Transplantation for Crohn’s Disease: Findings from A Long-Term Study
    Honggang Wang, Bota Cui, Qianqian Li, Xiao Ding, Pan Li, Ting Zhang, Xiaozhong Yang, Guozhong Ji, Faming Zhang
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    Chang Soo Eun
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    Hyun-Soo Kim
    Journal of the Korean Medical Association.2017; 60(6): 484.     CrossRef
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  • 25 Web of Science
  • 26 Crossref
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