Intestinal Research

Original Article

Tumor

Does the size of the cold snare affect the outcome of cold snare polypectomy in the colon? A KASID prospective multicenter study: Seongwoo Choi, Jaeyoung Chun, Geunhyuk Choi, Yoojin Lee, Taegeun Gweon, Yunho Jung; Intest Res 2026;24(1):76-83. Published online January 28, 2026; DOI: https://doi.org/10.5217/ir.2025.00189

Abstract PDF PubReader ePub: Background/Aims
Cold snare polypectomy (CSP) is recommended for colorectal polyps <10 mm; however, the impact of snare size on clinical outcomes remains unclear. This study evaluated the efficacy and safety of 10-mm and 15-mm snares for CSP of small colorectal polyps.
Methods
In this prospective multicenter study, patients with 4–10 mm non-pedunculated polyps underwent CSP with either a 10-mm or 15-mm snare. Both snares had identical wire thickness and hexagonal loop design. The primary outcome was histological complete resection rate (CRR). Secondary outcomes included adverse events and technical parameters.
Results
In total, 182 patients were enrolled (10-mm group: n = 92; 15-mm group: n = 90). Baseline characteristics, including age, sex, polyp size, morphology, location, and pathology, were comparable between groups. Histological CRRs were 90.2% in the 10-mm group and 91.1% in the 15-mm group (P= 0.483). No significant differences were observed in the presence of submucosal tissue within specimens (P= 0.523), iatrogenic ulcer size (P= 0.532), hematoma occurrence (P= 0.391), or intraprocedural bleeding requiring hemostasis (6.5% vs. 5.6%; P= 0.974). No cases of delayed bleeding or perforation were reported. Logistic regression analysis identified iatrogenic ulcer size > 8 mm as an independent predictor of complete resection (odds ratio, 3.89; 95% confidence interval, 1.15–13.21; P= 0.029); snare size was not significantly associated with CRR (P= 0.519).
Conclusions
CSP using either a 10-mm or a 15-mm snare for 4–10 mm non-pedunculated colorectal polyps showed no significant difference in complete resection or safety outcomes within this size range. (Clinical Research Information Service [CRIS], KCT0005031)

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Reviews

Population-based screening colonoscopy in Korea: balancing benefits and limitations: Hyoung Il Choi, Jae Myung Cha; Received August 22, 2025 Accepted September 28, 2025 Published online January 2, 2026; DOI: https://doi.org/10.5217/ir.2025.00188 [Epub ahead of print]

Abstract PDF PubReader ePub: Population-based colonoscopy screening is considered one of the most effective strategies for reducing the incidence and mortality of colorectal cancer. Its major strength lies in its dual benefits: early detection of colorectal cancer and prevention via the removal of precancerous lesions. Colonoscopy has a high sensitivity and provides a full colonic evaluation in a single session, thereby reducing the need for frequent testing. However, this approach has notable limitations. Colonoscopy is an invasive procedure associated with rare but serious complications such as perforation and bleeding. Participation rates tend to be lower than those of noninvasive methods like fecal immunochemical tests. Additionally, implementing colonoscopy as a populationbased tool requires significant resources, including trained endoscopists, endoscopy facilities, and financial investments. The quality of colonoscopy may also vary depending on the operator’s skill and adherence to guidelines. Given these trade-offs, population-based colonoscopy screening must be carefully evaluated in terms of cost-effectiveness, feasibility, and public acceptance within each country’s healthcare system. Therefore, population-based colonoscopy screening should be approached with a balanced understanding of its benefits and limitations to ensure cost-effectiveness, feasibility, alignment with each country’s healthcare infrastructure, and integration with existing screening programs.

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

Abstract PDF PubReader ePub

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

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

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1 Crossref

Endoscopy

Balancing safety and effectiveness in colonoscopy for older adults: a narrative review: Min-Jae Kim, Yuna Kim, Jie-Hyun Kim, Young Hoon Youn, Jaeyoung Chun; Intest Res 2025;23(4):443-454. Published online October 2, 2025; DOI: https://doi.org/10.5217/ir.2025.00092

Abstract PDF PubReader ePub: Colonoscopy is becoming more widely used in older adults for screening and diagnostic evaluation of colorectal cancer. While advanced age itself is not a contraindication, elderly patients often present unique challenges, including frailty, comorbidities and polypharmacy, which increase the risk of complications during the procedure. Rather than chronological age alone, frailty is important in risk assessment and clinical decision-making before performing a colonoscopy. This review summarizes recent evidence, particularly from large cohort studies and clinical guidelines, to provide a balanced evaluation of the advantages and disadvantages of performing colonoscopies on older adults. Ultimately, we emphasize the importance of judicious patient selection, customized bowel preparation and tailored sedation management to optimize the safety and effectiveness of colonoscopy in this vulnerable group.

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Original Articles

Tumor

The impact of the COVID-19 pandemic on clinical practices related to colorectal cancer and colonoscopy in South Korea: a nationwide population-based study: Jin Young Yoon, Moon Hyung Lee, Min Seob Kwak, Jae Myung Cha; Intest Res 2025;23(1):85-95. Published online November 29, 2024; DOI: https://doi.org/10.5217/ir.2024.00066

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Despite of the coronavirus disease 2019 (COVID-19) pandemic, there is little data regarding its impact on colorectal cancer (CRC)-related clinical practice. This study aimed to assess the changes in its impact during the COVID-19 pandemic.
Methods
This was a retrospective national population-based study using the Health Insurance Review and Assessment database from January 2019 to December 2021. The number of patients in 2020 and 2021 was compared with those in 2019 for the diagnostic and therapeutic colonoscopy, CRC-related operation, and any treatment for CRC.
Results
The annual number of patients undergoing diagnostic colonoscopies decreased by 6.9% in 2020 but increased 8.1% in 2021, compared to those in 2019; number of patients undergoing therapeutic colonoscopies increased by 6.0% and 37.7% in 2020 and 2021, respectively; number of patients operated for CRC decreased by 4.2% in 2020 and increased by 2.3% in 2021. The number of patients treated for CRC decreased by 2.8% in 2020 and increased by 4.4% in 2021. Diagnostic and therapeutic colonoscopies and any CRC-related treatment decreased by 43.8%, 37.5%, and 11.3% in March 2020, during the first surge of COVID-19, but increased by 26.0%, 58.1%, and 9.5% in June 2021, respectively. CRC-related operations decreased by 24.1% in April 2020 and increased by 12.6% in August 2021.
Conclusions
Negative impact of the COVID-19 pandemic on clinical practices related to CRC completely recovered within second year. It could be considered for the development of an optimal strategy on CRC management in response to the pandemic-driven crisis.

Citations

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The impact of COVID-19 on clinical practices of colorectal cancer in South Korea
Kwang Woo Kim, Hyoun Woo Kang
Intestinal Research.2025; 23(1): 6. CrossRef

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49 Download
1 Web of Science
1 Crossref

Colorectal neoplasia

A survey of current practices in post-polypectomy surveillance in Korea: Jeongseok Kim, Tae-Geun Gweon, Min Seob Kwak, Su Young Kim, Seong Jung Kim, Hyun Gun Kim, Eun Ran Kim, Sung Noh Hong, Eun Sun Kim, Chang Mo Moon, Dae Seong Myung, Dong Hoon Baek, Shin Ju Oh, Hyun Jung Lee, Ji Young Lee, Yunho Jung, Jaeyoung Chun, Dong-Hoon Yang, on behalf of the Intestinal Tumor Research Group of the Korean Association for the Study of Intestinal Diseases (KASID); Intest Res 2024;22(2):186-207. Published online April 25, 2024; DOI: https://doi.org/10.5217/ir.2023.00109

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
We investigated the clinical practice patterns of post-polypectomy colonoscopic surveillance among Korean endoscopists.
Methods
In a web-based survey conducted between September and November 2021, participants were asked about their preferred surveillance intervals and the patient age at which surveillance was discontinued. Adherence to the recent guidelines of the U.S. Multi-Society Task Force on Colorectal Cancer (USMSTF) was also analyzed.
Results
In total, 196 endoscopists completed the survey. The most preferred first surveillance intervals were: a 5-year interval after the removal of 1–2 tubular adenomas < 10 mm; a 3-year interval after the removal of 3–10 tubular adenomas < 10 mm, adenomas ≥ 10 mm, tubulovillous or villous adenomas, ≤ 20 hyperplastic polyps < 10 mm, 1–4 sessile serrated lesions (SSLs) < 10 mm, hyperplastic polyps or SSLs ≥ 10 mm, and traditional serrated adenomas; and a 1-year interval after the removal of adenomas with highgrade dysplasia, >10 adenomas, 5–10 SSLs, and SSLs with dysplasia. In piecemeal resections of large polyps ( > 20 mm), surveillance colonoscopy was mostly preferred after 1 year for adenomas and 6 months for SSLs. The mean USMSTF guideline adherence rate was 30.7%. The largest proportion of respondents (40.8%–55.1%) discontinued the surveillance at the patient age of 80–84 years.
Conclusions
A significant discrepancy was observed between the preferred post-polypectomy surveillance intervals and recent international guidelines. Individualized measures are required to increase adherence to the guidelines.

Citations

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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
Is cap still useful for colon adenoma detection rate improvement in the artificial intelligence era?
Tae-Woo Kim, Soo-Young Na
Clinical Endoscopy.2026; 59(1): 73. 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
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
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
Determinants of Shorter Surveillance Colonoscopy Intervals: A Nationwide Real‐World Study in Japan
Munenori Honda, Ryosuke Gushima, Kotaro Waki, Kenshi Matsuno, Yoki Furuta, Hideaki Miyamoto, Katsuya Nagaoka, Hideaki Naoe, Yasuhito Tanaka
Journal of Gastroenterology and Hepatology.2025; 40(12): 2944. CrossRef

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Review

Colorectal neoplasia

Summary and comparison of recently updated post-polypectomy surveillance guidelines: Yoon Suk Jung; Intest Res 2023;21(4):443-451. Published online October 26, 2023; DOI: https://doi.org/10.5217/ir.2023.00107

Abstract PDF PubReader ePub

Recently, updated guidelines for post-polypectomy surveillance have been published by the U.S. Multi‐Society Task Force (USMSTF), the British Society of Gastroenterology/Association of Coloproctology of Great Britain and Ireland/Public Health England (BSG/ACPGBI/PHE), the European Society of Gastrointestinal Endoscopy (ESGE), the Japan Gastroenterological Endoscopy Society (JGES), and the Korean Multi-Society Taskforce Committee. This review summarizes and compares the updated recommendations of these 5 guidelines. There are some differences between the guidelines for the recommended post-polypectomy surveillance intervals. In particular, there are prominent differences between the guidelines for 1–4 tubular adenomas < 10 mm with low-grade dysplasia (nonadvanced adenomas [NAAs]) and tubulovillous or villous adenomas. The USMSTF, JGES, and Korean guidelines recommend colonoscopic surveillance for patients with 1–4 NAAs and those with tubulovillous or villous adenomas, whereas the BSG/ACPGBI/PHE and ESGE guidelines do not recommend endoscopic surveillance for such patients. Surveillance recommendations for patients with serrated polyps (SPs) are limited. Although the USMSTF guidelines provide specific recommendations for patients who have undergone SPs removal, these are weak and based on very lowquality evidence. Future studies should examine this topic to better guide the surveillance recommendations for patients with SPs. For countries that do not have separate guidelines, we hope that this review article will help select the most appropriate guidelines as per each country’s healthcare environment.

Citations

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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
Frequency and Risk Factors of Advanced Neoplasia in Korean Inflammatory Bowel Disease Patients with Low-grade Dysplasia
Yong Eun Park, Kyeong Ok Kim, Dong Hyun Kim, Soo-Kyung Park, Yoo Jin Lee, Chang Kyun Lee
The Korean Journal of Gastroenterology.2025; 85(1): 34. CrossRef
The impact of COVID-19 on clinical practices of colorectal cancer in South Korea
Kwang Woo Kim, Hyoun Woo Kang
Intestinal Research.2025; 23(1): 6. CrossRef
Annual Blood Tests Are an Acceptable form of Surveillance to Supplement Colonoscopies for Colorectal Cancer
Rishabh Goyal, Carlene J. Wilson, Ingrid H. Flight, Charles Cock, Graeme P. Young, Molla M. Wassie, Sarah Cohen-Woods, Erin L. Symonds, Maddison Dix
Digestive Diseases and Sciences.2025; 70(4): 1486. CrossRef
Assessing Patient Preferences and Response to Extended Colonoscopy Intervals in a Colorectal Cancer Surveillance Program
Maddison Dix, Syme Aftab, Graeme P. Young, Carlene J. Wilson, Kalindra Simpson, Charles Cock, Erin L. Symonds
Digestive Diseases and Sciences.2025; 70(4): 1328. CrossRef
Developing a Strategy for Prevention of Avoidable Postcolonoscopy Colorectal Cancers: Current and Future Perspectives
Nanette S. Van roermund, Joep E.G. Ijspeert, Evelien Dekker
Gastroenterology.2025; 168(5): 854. CrossRef
Prevention and treatment of recurrence after endoscopic resection of large non-pedunculated colorectal polyps
Samantha Pang, Pedram Tavakoli, Neal Shahidi
World Journal of Gastrointestinal Endoscopy.2025;[Epub] CrossRef
Management of recurrent colorectal polyps post initial polypectomy: a review of the current evidence
Giovanna McGinty, Zeino Zeino
Frontline Gastroenterology.2025; : flgastro-2024-103016. CrossRef
Efficacy and safety of a New D-sorbitol, Ascorbic Acid, and Picosulfate Bowel Cleansing Solution for colonoscopy: A prospective, multicenter, randomized study
Seung Yong Shin, Yoo Jin Lee, Yunho Jung, Jun Lee, Chang Hwan Choi, Jae Jun Park
Digestive and Liver Disease.2025; 57(12): 2441. CrossRef
Causal association between telomere length and colorectal polyps: A bidirectional two-sample Mendelian randomization study
Yin Zhang, Jiaying Wang, Mingyu Zheng, Huanwei Qu, Shuya Yang, Fuzhou Han, Nan Yao, Wenqiang Li, Jun Qu
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Marcello Maida, Dushyant Singh Dahiya, Yash R. Shah, Angad Tiwari, Harishankar Gopakumar, Ishaan Vohra, Aqsa Khan, Fouad Jaber, Daryl Ramai, Antonio Facciorusso
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Original Article

Colorectal neoplasia

The elderly population are more vulnerable for the management of colorectal cancer during the COVID-19 pandemic: a nationwide, population-based study: Hong Sun Kang, Seung Hoon Jeon, Su Bee Park, Jin Young Youn, Min Seob Kwak, Jae Myung Cha; Intest Res 2023;21(4):500-509. Published online August 29, 2023; DOI: https://doi.org/10.5217/ir.2023.00004

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
The impact of coronavirus disease 2019 (COVID-19) on the management of colorectal cancer (CRC) may worse in elderly population, as almost all COVID-19 deaths occurred in the elderly patients. This study aimed to evaluate the impact of COVID-19 on CRC management in the elderly population.
Methods
The numbers of patients who underwent colonoscopy, who visited hospitals or operated for CRC in 2020 and 2021 (COVID-19 era) were compared with those in 2019, according to 3 age groups (≥70 years, 50–69 years, and ≤49 years), based on the nationwide, population-based database (2019–2021) in South Korea.
Results
The annual volumes of colonoscopy and hospital visits for CRC in 2020 were more significantly declined in the old age group than in the young age group (both P<0.001). In addition, the annual volume of patients operated for CRC numerically more declined in old age group than in young age group. During the first surge of COVID-19 (March and April 2020), old age patients showed statistically significant declines for the monthly number of colonoscopies (–46.5% vs. –39.3%, P<0.001), hospital visits (–15.4% vs. –7.9%, P<0.001), CRC operations (–33.8% vs. –0.7%, P<0.05), and colonoscopic polypectomies (–41.8% vs. –38.0%, P<0.001) than young age patients, compared with those of same months in 2019.
Conclusions
Elderly population are more vulnerable for the management of CRC during the COVID-19 pandemic. Therefore, the elderly population are more carefully cared for in the management of CRC during the next pandemic.

Citations

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The impact of COVID-19 on clinical practices of colorectal cancer in South Korea
Kwang Woo Kim, Hyoun Woo Kang
Intestinal Research.2025; 23(1): 6. CrossRef
To overcome medical gap in screening and surveillance of colorectal cancer during the COVID-19 pandemic
Yoo Min Han
Intestinal Research.2023; 21(4): 418. CrossRef

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205 Download
2 Web of Science
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Review

IBD

Animal models of inflammatory bowel disease: novel experiments for revealing pathogenesis of colitis, fibrosis, and colitis-associated colon cancer: Chan Hyung Lee, Seong-Joon Koh, Zaher A Radi, Aida Habtezion; Intest Res 2023;21(3):295-305. Published online May 31, 2023; DOI: https://doi.org/10.5217/ir.2023.00029

Abstract PDF PubReader ePub

Inflammatory bowel disease (IBD), comprising Crohn’s disease and ulcerative colitis, is a lifelong disease that manifests with chronic intestinal inflammation, sequential fibrosis, and an increased risk of colitis-associated colon cancer (CAC). The combined effects of genetic, immunological, environmental, and microbial factors render it difficult to determine the specific mechanism underlying the induction and perpetuation of IBD. Various animal models of IBD have contributed enormously to the understanding of IBD pathogenesis in terms of genomics, transcriptomics, proteomics, microbiome, and drug development of novel therapeutics. Although comprehensive research on IBD has been enabled by advanced technologies, such as genetically engineered models, there is a great need to develop relevant in vivo models of colitis and fibrosis. Here, we review 4 categories of animal models of acute and chronic intestinal inflammation, fibrosis, and CAC: chemically induced, genetically engineered, T cell transfer, and spontaneous gene mutation models.

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Hye-Myung Ryu, S. M. Shamsul Islam, Bushra Riaz, Hasan M. Sayeed, Bunsoon Choi, Seonghyang Sohn
International Journal of Molecular Sciences.2024; 25(16): 8571. CrossRef
Immuno-therapeutic and prophylactic potential of Trichinella spiralis antigens for inflammatory bowel diseases
Majed H. Wakid, Walaa A. El Kholy, Muslimah N. Alsulami, Eman S. El-Wakil
Food and Waterborne Parasitology.2024; 37: e00248. CrossRef
Development of a novel complex inflammatory bowel disease mouse model: Reproducing human inflammatory bowel disease etiologies in mice
Sun-Min Seo, Na-Won Kim, Eun-Seon Yoo, Ji-Hun Lee, Ah-Reum Kang, Han-Bi Jeong, Won-Yong Shim, Dong-Hyun Kim, Young-Jun Park, Kieun Bae, Kyong-Ah Yoon, Yang-Kyu Choi, Pradeep Dudeja
PLOS ONE.2024; 19(11): e0311310. CrossRef
Gut Microbiome and Colorectal Cancer
Tae-Geun Gweon
The Korean Journal of Gastroenterology.2023; 82(2): 56. CrossRef
Mitochondrial dysfunctions in T cells: focus on inflammatory bowel disease
Hoyul Lee, Jae-Han Jeon, Eun Soo Kim
Frontiers in Immunology.2023;[Epub] CrossRef

21,944 View
566 Download
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Original Articles

Infection

Comparative outcomes of acute colonic diverticulitis in immunocompromised versus immunocompetent patients: a systematic review and meta-analysis: Jae Gon Lee, Yong Eun Park, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Shin Hee Lee, Myung-Won You, Seong-Eun Kim; Intest Res 2023;21(4):481-492. Published online May 31, 2023; DOI: https://doi.org/10.5217/ir.2023.00005

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Immunocompromised patients with acute colonic diverticulitis are at high risk for complications and failure of non-surgical treatment. However, evidence on the comparative outcomes of immunocompromised and immunocompetent patients with diverticulitis is lacking. This systematic review and meta-analysis investigated the outcomes of medical treatment in immunocompromised and immunocompetent patients with diverticulitis.
Methods
A comprehensive literature search was conducted in PubMed, Embase, and the Cochrane Library. Studies comparing the clinical outcomes of immunocompromised and immunocompetent patients with diverticulitis were included.
Results
A total of 10 studies with 1,946,461 subjects were included in the quantitative synthesis. The risk of emergency surgery and postoperative mortality after emergency surgery was significantly higher in immunocompromised patients than in immunocompetent patients with diverticulitis (risk ratio [RR], 1.76; 95% confidence interval [CI], 1.31–2.38 and RR, 3.05; 95% CI, 1.70–5.45, respectively). Overall risk of complications associated with diverticulitis was non-significantly higher in immunocompromised than in immunocompetent patients (RR, 1.24; 95% CI, 0.95–1.63). Overall mortality irrespective of surgery was significantly higher in immunocompromised than in immunocompetent patients with diverticulitis (RR, 3.65; 95% CI, 1.73–7.69). By contrast, postoperative mortality after elective surgery was not significantly different between immunocompromised and immunocompetent patients with diverticulitis. In subgroup analysis, the risk of emergency surgery and recurrence was significantly higher in immunocompromised patients with complicated diverticulitis, whereas no significant difference was shown in mild disease.
Conclusions
Immunocompromised patients with diverticulitis should be given the best medical treatment with multidisciplinary approach because they had increased risks of surgery, postoperative morbidity, and mortality than immunocompetent patients.

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Comparison of Outcomes Following Surgery for Diverticulitis Among Immunocompetent and Immunosuppressed Patients
Usama Waqar, Christina Gozza, Courtney L. Devin, Terrah J. Paul Olson, Seth A. Rosen
The American Surgeon™.2025; 91(7): 1093. CrossRef
Global guidelines on diverticular disease of the colon: the Fiesole Consensus report
Antonio Tursi, Giovanni Brandimarte, Francesco Di Mario, Wenjie Ma, Juozas Kupcinskas, Jaroslaw Regula, Giovanni Maconi, Peter Malfertheiner, Giovanni Barbara, Neil Stollman, Savvas Papagrigoriadis, Thomas Golda, Antonio Amato, Mauro Bafutto, Gabrio Basso
Gut.2025; : gutjnl-2025-336902. CrossRef
Does type II diabetes mellitus increase the morbidity of patients with diverticulitis?
Marei H. Alshandeer, Walid M. Abd El Maksoud, Khaled S. Abbas, Fahad S. Al Amri, Maha A. Alghamdi, Hassan A. Alzahrani, Abdullah Dalboh, Mohammed A. Bawahab, Aisha J. Asiri, Yahia Assiri
Medicine.2024; 103(46): e40567. CrossRef
Not all acute colonic diverticulitis follows the same course: a potential risk for immunocompromised individuals
Yehyun Park
Intestinal Research.2023; 21(4): 415. CrossRef

6,773 View
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Colorectal neoplasia

Clinical characteristics and risk factors related to polyposis recurrence and advanced neoplasm development among patients with non-hereditary colorectal polyposis: Jihun Jang, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim; Intest Res 2023;21(4):510-517. Published online May 31, 2023; DOI: https://doi.org/10.5217/ir.2022.00139

Abstract PDF PubReader ePub

Background/Aims
Patients with more than 10 cumulative polyps might involve a greater genetic risk of colorectal neoplasia development. However, few studies have investigated the risk factors of polyposis recurrence and development of advanced neoplasms among patients with non-hereditary colorectal polyposis.
Methods
This study included patients (n=855) with 10 or more cumulative polyps diagnosed at Severance Hospital from January 2012 to September 2021. Patients with known genetic mutations related to polyposis, known hereditary polyposis syndromes, insufficient information, total colectomy, and less than 3 years of follow-up were excluded. Finally, 169 patients were included for analysis. We collected clinical data, including colonoscopy surveillance results, and performed Cox regression analyses of risk factors for polyposis recurrence and advanced neoplasm development.
Results
The 169 patients were predominantly male (84.02%), with a mean age of 64.19±9.92 years. The mean number of adenomas on index colonoscopy was 15.33±8.47. Multivariable analysis revealed history of cancer except colon cancer (hazard ratio [HR], 2.23; 95% confidence interval [CI], 1.23–4.01), current smoking (HR, 2.39; 95% CI, 1.17–4.87), and detection of many polyps (≥15) on index colonoscopy (HR, 2.05; 95% CI, 1.21–3.50) were significant risk factors for recurrence of polyposis. We found no statistically significant risk factors for advanced neoplasm development during surveillance among our cohort.
Conclusions
The presence of many polyps (≥15) on index colonoscopy, history of cancer except colon cancer, and current smoking state were significant risk factors for polyposis recurrence among patients with non-hereditary colorectal polyposis.

Citations

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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
Identification of Genetic Factors Related With Nonhereditary Colorectal Polyposis and Its Recurrence Through Genome‐Wide Association Study
Jung Hyun Ji, Su Hyun Lee, Chan Il Jeon, Jihun Jang, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Sun Ha Jee, Tae Il Kim
Journal of Gastroenterology and Hepatology.2025; 40(2): 482. CrossRef
Machine learning in colorectal polyp surveillance: A paradigm shift in post-endoscopic mucosal resection follow-up
Vasily Isakov
World Journal of Gastroenterology.2025;[Epub] CrossRef
Screening and surveillance for hereditary colorectal cancer
Hee Man Kim, Tae Il Kim
Intestinal Research.2024; 22(2): 119. CrossRef

5,026 View
318 Download
5 Web of Science
4 Crossref

Review

Cancer

Korean Guidelines for Postpolypectomy Colonoscopic Surveillance: 2022 revised edition: Su Young Kim, Min Seob Kwak, Soon Man Yoon, Yunho Jung, Jong Wook Kim, Sun-Jin Boo, Eun Hye Oh, Seong Ran Jeon, Seung-Joo Nam, Seon-Young Park, Soo-Kyung Park, Jaeyoung Chun, Dong Hoon Baek, Mi-Young Choi, Suyeon Park, Jeong-Sik Byeon, Hyung Kil Kim, Joo Young Cho, Moon Sung Lee, Oh Young Lee, Korean Society of Gastrointestinal Endoscopy, Korean Society of Gastroenterology, Korean Association for the Study of Intestinal Diseases; Intest Res 2023;21(1):20-42. Published online January 31, 2023; DOI: https://doi.org/10.5217/ir.2022.00096

Abstract PDF Supplementary Material PubReader ePub

Colonoscopic polypectomy is effective in decreasing the incidence and mortality of colorectal cancer (CRC). Premalignant polyps discovered during colonoscopy are associated with the risk of metachronous advanced neoplasia. Postpolypectomy surveillance is the most important method for managing advanced metachronous neoplasia. A more efficient and evidence-based guideline for postpolypectomy surveillance is required because of the limited medical resources and concerns regarding colonoscopy complications. In these consensus guidelines, an analytic approach was used to address all reliable evidence to interpret the predictors of CRC or advanced neoplasia during surveillance colonoscopy. The key recommendations state that the high-risk findings for metachronous CRC following polypectomy are as follows: adenoma ≥10 mm in size; 3 to 5 (or more) adenomas; tubulovillous or villous adenoma; adenoma containing high-grade dysplasia; traditional serrated adenoma; sessile serrated lesion containing any grade of dysplasia; serrated polyp of at least 10 mm in size; and 3 to 5 (or more) sessile serrated lesions. More studies are needed to fully comprehend the patients who are most likely to benefit from surveillance colonoscopy and the ideal surveillance interval to prevent metachronous CRC.

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Clinical Efficacy of Real-Time Artificial Intelligence-Assisted Colonoscopy in Colorectal Polyp Detection: A Prospective Multicenter Randomized Controlled Trial
Han Jo Jeon, Bora Keum, Eui Sun Jeong, Seong-Eun Kim, Chang Mo Moon, Bomee Lee, Sanghyun Kim, Hyuk Soon Choi, Jae Min Lee, Eun Sun Kim, Yoon Tae Jeen
Gut and Liver.2026; 20(1): 97. CrossRef
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Chan Hyuk Park, Byung Wook Jung, Yoon Suk Jung
Intestinal Research.2026; 24(1): 38. CrossRef
Survey of the Actual Practices Used for Endoscopic Removal of Colon Polyps in Korea: A Comparison with the Current Guidelines
Jeongseok Kim, Tae-Geun Gweon, Min Seob Kwak, Su Young Kim, Seong Jung Kim, Hyun Gun Kim, Sung Noh Hong, Eun Sun Kim, Chang Mo Moon, Dae Seong Myung, Dong-Hoon Baek, Shin Ju Oh, Hyun Jung Lee, Ji Young Lee, Yunho Jung, Jaeyoung Chun, Dong-Hoon Yang, Eun R
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The impact of COVID-19 on clinical practices of colorectal cancer in South Korea
Kwang Woo Kim, Hyoun Woo Kang
Intestinal Research.2025; 23(1): 6. CrossRef
Colorectal Cancer after Colonoscopy: Causes and Prevention Strategies
Seongwoo Choi, Yunho Jung
The Korean Journal of Medicine.2025; 100(1): 19. CrossRef
The histologic features, molecular features, detection and management of serrated polyps: a review
Jin-Dong Wang, Guo-Shuai Xu, Xin-Long Hu, Wen-Qiang Li, Nan Yao, Fu-Zhou Han, Yin Zhang, Jun Qu
Frontiers in Oncology.2024;[Epub] CrossRef
Screening and surveillance for hereditary colorectal cancer
Hee Man Kim, Tae Il Kim
Intestinal Research.2024; 22(2): 119. CrossRef
Prediction of Lymph Node Metastasis in T1 Colorectal Cancer Using Artificial Intelligence with Hematoxylin and Eosin-Stained Whole-Slide-Images of Endoscopic and Surgical Resection Specimens
Joo Hye Song, Eun Ran Kim, Yiyu Hong, Insuk Sohn, Soomin Ahn, Seok-Hyung Kim, Kee-Taek Jang
Cancers.2024; 16(10): 1900. CrossRef
Strategies to improve screening colonoscopy quality for the prevention of colorectal cancer
Joo Hye Song, Eun Ran Kim
The Korean Journal of Internal Medicine.2024; 39(4): 547. CrossRef
Efficacy of Oral Sulfate Tablet and 2 L-Polyethylene Glycol With Ascorbic Acid for Bowel Preparation: A Prospective Randomized KASID Multicenter Trial
Yunho Jung, Hyun Gun Kim, Dong-Hoon Yang, Hyoun Woo Kang, Jae Jun Park, Dong Hoon Baek, Jaeyoung Chun, Tae-Geun Gweon, Hyeon Jeong Goong, Min Seob Kwak, Hyun Jung Lee, Soo-Kyung Park, Jong Hoon Lee
Journal of Korean Medical Science.2024;[Epub] CrossRef
Post-colonoscopy Colorectal Cancer: Causes and Prevention
Jong Yoon Lee
Journal of Digestive Cancer Research.2024; 12(3): 160. CrossRef
Korean Guidelines for Postpolypectomy Colonoscopic Surveillance: 2022 Revision
Su Young Kim
The Korean Journal of Medicine.2023; 98(3): 102. CrossRef
Clinical characteristics and risk factors related to polyposis recurrence and advanced neoplasm development among patients with non-hereditary colorectal polyposis
Jihun Jang, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim
Intestinal Research.2023; 21(4): 510. CrossRef
Summary and comparison of recently updated post-polypectomy surveillance guidelines
Yoon Suk Jung
Intestinal Research.2023; 21(4): 443. CrossRef
Strategy for post-polypectomy colonoscopy surveillance: focus on the revised Korean guidelines
Yong Soo Kwon, Su Young Kim
Journal of the Korean Medical Association.2023; 66(11): 652. CrossRef

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Original Article

Miscellaneous

Characteristics and usefulness of transabdominal ultrasonography in immune-mediated colitis: Kensuke Sakurai, Takehiko Katsurada, Mutsumi Nishida, Satomi Omotehara, Shinya Fukushima, Shinsuke Otagiri, Kazunori Nagashima, Reizo Onishi, Ryo Takagi, Yoshito Komatsu, Naoya Sakamoto; Intest Res 2023;21(1):126-136. Published online July 22, 2022; DOI: https://doi.org/10.5217/ir.2021.00166

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
The usefulness of ultrasonography (US) in diseases of the gastrointestinal tract has been reported recently. This prospective study aimed to determine the features of US findings in immune-mediated colitis (IMC), an adverse event induced by immune checkpoint inhibitor, and examine the correlation between US findings, colonoscopy (CS) findings, and severity of colitis.
Methods
We studied patients examined using CS and US upon suspicion of IMC in Hokkaido University Hospital between April 2018 and February 2021. Endoscopic findings of IMC were assessed using the Ulcerative Colitis Endoscopic Index of Severity (UCEIS). The severity of US findings in IMC was evaluated using US grade, which is the ultrasonographic grading scale in ulcerative colitis. Bowel wall thickness and the intensity of the color Doppler signal were also analyzed. Severity of colitis was evaluated using Common Terminology Criteria for Adverse Events (CTCAE) grade version 5.
Results
Fourteen patients with IMC were enrolled. The US findings were bowel wall thickening, loss of stratification, ulceration and increased blood flow signal. The US grade was moderately correlated with the UCEIS (r=0.687, p=0.009) and CTCAE grade (r=0.628, p=0.035). Bowel wall thickness and UCEIS (r=0.628, p=0.020), as well as color Doppler signal grade and CTCAE grade (r=0.724, p=0.008), were significantly correlated.
Conclusions
US findings in IMC were mainly similar to those of ulcerative colitis, but there were some findings that were characteristic only of IMC. Significant correlation was found between US findings, CS findings, and severity of colitis. Hence, US could be useful for the evaluation of IMC.

Citations

Citations to this article as recorded by

Symptomatic and Sonographic Improvement of Immune Checkpoint Inhibitor Enterocolitis With Risankizumab
Rena Mei, Emily Pepe, David Y Oh, Katy K Tsai, Rishika Chugh, Michael G Kattah
Inflammatory Bowel Diseases.2025; 31(4): 1182. CrossRef
Response
Malek Shatila, Yinghong Wang
Gastrointestinal Endoscopy.2024; 100(2): 349. CrossRef
Ultrasound's echo in the endoscopic realm: navigating checkpoint colitis
Steven Nicolaides, Zaid Ardalan, Alex Boussioutas
Gastrointestinal Endoscopy.2024; 100(2): 349. CrossRef
Systematic review of immune checkpoint inhibitor-related gastrointestinal, hepatobiliary, and pancreatic adverse events
Malek Shatila, Hao Chi Zhang, Anusha Shirwaikar Thomas, Antonio Pizuorno Machado, Sidra Naz, Nitish Mittal, Christine Catinis, Krishnavathana Varatharajalu, Carolina Colli Cruz, Eric Lu, Deanna Wu, Julie R Brahmer, Franck Carbonnel, Stephen B Hanauer, Bre
Journal for ImmunoTherapy of Cancer.2024; 12(11): e009742. CrossRef
Endoscopic findings of immune checkpoint inhibitor-related gastrointestinal adverse events
Min Kyu Kim, Sung Wook Hwang
Clinical Endoscopy.2024; 57(6): 725. CrossRef
Gut microbiome on immune checkpoint inhibitor therapy and consequent immune-related colitis: a review
Sung Wook Hwang, Min Kyu Kim, Mi-Na Kweon
Intestinal Research.2023; 21(4): 433. CrossRef

7,232 View
395 Download
5 Web of Science
6 Crossref

Perspective

IBD

Endoscopy for assessment of mucosal healing in ulcerative colitis: time bound or response guided?: Ajit Sood, Ramit Mahajan, Arshdeep Singh, Vandana Midha, Varun Mehta; Intest Res 2022;20(3):297-302. Published online February 8, 2022; DOI: https://doi.org/10.5217/ir.2021.00099

Abstract PDF PubReader ePub

The timing of colonoscopy in patients with active ulcerative colitis (UC) lacks coherence. The published guidelines and recommendations advocate time-bound colonoscopy in patients with active UC to assess for mucosal healing. However, the practice of performing colonoscopies at fixed time frames lacks reasoning. The time to achieve mucosal healing in UC is not uniform across the patient populations and is influenced by the disease severity and efficacy and time to therapeutic response of the drugs being used. Additionally, with the availability of sensitive noninvasive inflammatory biomarkers such as fecal calprotectin, that parallel the disease activity and correlate with mucosal healing, the notion of performing colonoscopy at fixed intervals sounds unjustifiable. The authors express their view that a response-guided colonoscopy (driven by normalization of clinical symptoms and inflammatory biomarkers), rather than a time-bound colonoscopy, would be more logical, apart from being cost-effective and patient-friendly.

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Beyond conventional endoscopy: Image-enhanced techniques in quiescent ulcerative colitis assessment
Vedran Tomašić, Petra Ćaćić, Neven Baršić, Alen Bišćanin
World Journal of Gastrointestinal Endoscopy.2026;[Epub] CrossRef
Applicability of colon capsule endoscopy for monitoring ulcerative colitis: a systematic review
Mathilde Simone Rasmussen, Lea Østergaard Hansen, Ulrik Deding, Mark Bremholm Ellebæk, Jens Kjeldsen, Thomas Bjørsum-Meyer
Scandinavian Journal of Gastroenterology.2025; 60(4): 336. CrossRef
Seeing Is Believing: Does Red Dichromatic Imaging (RDI) Predict Histological Remission and Clinical Outcomes in Ulcerative Colitis Patients?
Vedran Tomašić
Digestive Diseases and Sciences.2025; 70(7): 2254. 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
Ischemia-modified albumin: a novel blood marker of endoscopic mucosal healing in inflammatory bowel disease
Seung Bum Lee, Hyun-Ki Kim, Sang Hyuk Park, Ji-Hun Lim, Sang Hyoung Park
Intestinal Research.2024; 22(1): 75. CrossRef
A novel serum biomarker of endoscopic mucosal healing in inflammatory bowel disease
Hyoun Woo Kang
Intestinal Research.2024; 22(1): 3. CrossRef
Management of ulcerative colitis in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease updated in 2023
Hsu-Heng Yen, Jia-Feng Wu, Horng-Yuan Wang, Ting-An Chang, Chung-Hsin Chang, Chen-Wang Chang, Te-Hsin Chao, Jen-Wei Chou, Yenn-Hwei Chou, Chiao-Hsiung Chuang, Wen-Hung Hsu, Tzu-Chi Hsu, Tien-Yu Huang, Tsung-I Hung, Puo-Hsien Le, Chun-Che Lin, Chun-Chi Lin
Intestinal Research.2024; 22(3): 213. CrossRef
Histologic improvement predicts endoscopic remission in patients with ulcerative colitis
Ji Eun Kim, Minjee Kim, Min-Ji Kim, Eun Ran Kim, Sung Noh Hong, Dong Kyung Chang, Sang Yun Ha, Young-Ho Kim
Scientific Reports.2024;[Epub] CrossRef
Practical management of mild-to-moderate ulcerative colitis: an international expert consensus
Ferdinando D’Amico, Fernando Magro, Axel Dignass, Sameer Al Awadhi, Ana Gutierrez Casbas, Natália Sousa Freitas Queiroz, Grażyna Rydzewska, Byong Duk Ye, Zhihua Ran, Ailsa Hart, Vipul Jairath, Gionata Fiorino, Laurent Peyrin-Biroulet, Silvio Danese
Expert Review of Gastroenterology & Hepatology.2024; 18(8): 421. CrossRef
Predictive Value of PHRI for Recurrence within One Year after UC Treatment: A Retrospective Study
Kun Zhang, Jianlan Xie, Jianmin Zhao, Mei Jia
British Journal of Hospital Medicine.2024; : 1. CrossRef
Molecular Activity of Inflammation and Epithelial-Mesenchymal Transition in the Microenvironment of Ulcerative Colitis
Yu Kyung Jun, Nayoung Kim, Hyuk Yoon, Ji Hyun Park, Hyung Kyung Kim, Yonghoon Choi, Ji Ae Lee, Cheol Min Shin, Young Soo Park, Dong Ho Lee
Gut and Liver.2024; 18(6): 1037. 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

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Original Articles

IBD

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; Intest Res 2022;20(2):251-259. Published online February 8, 2022; DOI: https://doi.org/10.5217/ir.2021.00069

Abstract PDF PubReader ePub

Background/Aims
To study role of fecal microbiota transplantation (FMT) in induction, maintenance, and rescue in patients with corticosteroid-dependent ulcerative colitis (CDUC).
Methods
Patients with active CDUC received 3 fortnightly sessions of colonoscopic induction FMT (iFMT) in addition to standard of care. In patients who achieved clinical remission (CR) or response, prednisolone was tapered from week 4 and azathioprine from week 12. Responders were advised maintenance FMT (mFMT) every 6 months. Those with relapse were offered rescue FMT (rFMT), and low dose prednisolone was added if there was no improvement in 2 weeks.
Results
All 27 patients enrolled completed iFMT and were followed up for 39 months (range, 9–71 months). The mean Mayo score decreased from 6.4±2.5 at baseline to 2.6±3.7 at week 4, 2.6±3.4 at week 12, and 2.8±3.8 at week 24 (P<0.05). Corticosteroid-free CR and clinical response at week 12 were seen in 13 patients (48%) and 1 patient (3.7%), respectively. Corticosteroid and azathioprine-free CR at week 24 was seen in 13 patients (48%) and in them histological response was seen in 2 patients (15.2%) at week 4, 5 patients (38.4%) at week 12, and 10 patients (76.9%) at week 24. First relapse was seen in 10 of 13 responders (76.9%) at a median of 14.8 months (range, 6–34 months) after iFMT and was less frequent in patients on mFMT. Relapse was treated successfully with rFMT alone in 4 patients (40%) and rFMT with low dose steroids in 5 patients (50%).
Conclusions
iFMT, mFMT, and rFMT may have a role in treatment of selected patients with CDUC.

Citations

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Improvement of the inflammation-damaged intestinal barrier and modulation of the gut microbiota in ulcerative colitis after FMT in the SHIME® model
Anna Kamlárová, Monika Kvaková, Ľuboš Ambro, René Link, Izabela Bertková, Zdenka Hertelyová, Martin Janíčko, Emília Hijová, Jana Štofilová
BMC Complementary Medicine and Therapies.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
The Impact of Microbiome Interventions on the Progression and Severity of Inflammatory Bowel Disease: A Systematic Review
Malik Kasapoglu, Rajesh Yadavalli, Sarosh Nawaz, Abdulaziz Althwanay, Esraa M AlEdani, Harleen Kaur, Samia Butt
Cureus.2024;[Epub] CrossRef
Fecal Microbiota Transplantation
Suranjana Banik, Balamurugan Ramadass
Gastroenterology, Hepatology and Endoscopy Practice.2023; 3(2): 44. 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
The Relationship Between Rosacea and Inflammatory Bowel Disease: A Systematic Review and Meta-analysis
Yu Kyung Jun, Da-Ae Yu, Yoo Min Han, Soo Ran Lee, Seong-Joon Koh, Hyunsun Park
Dermatology and Therapy.2023; 13(7): 1465. CrossRef
Faecal microbiota transplantation with anti-inflammatory diet (FMT-AID) followed by anti-inflammatory diet alone is effective in inducing and maintaining remission over 1 year in mild to moderate ulcerative colitis: a randomised controlled trial
Saurabh Kedia, Shubi Virmani, Sudheer K Vuyyuru, Peeyush Kumar, Bhaskar Kante, Pabitra Sahu, Kanav Kaushal, Mariyam Farooqui, Mukesh Singh, Mahak Verma, Aditya Bajaj, Manasvini Markandey, Karan Sachdeva, Prasenjit Das, Govind K Makharia, Vineet Ahuja
Gut.2022; 71(12): 2401. CrossRef

8,079 View
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7 Crossref

IBD

Factors associated with anti-tumor necrosis factor effectiveness to prevent postoperative recurrence in Crohn’s disease: Anthony Buisson, Lisa Cannon, Konstantin Umanskiy, Roger D. Hurst, Neil H. Hyman, Atsushi Sakuraba, Joel Pekow, Sushila Dalal, Russell D. Cohen, Bruno Pereira, David T. Rubin; Intest Res 2022;20(3):303-312. Published online August 4, 2021; DOI: https://doi.org/10.5217/ir.2021.00018

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
We assessed the effectiveness of anti-TNF agents and its associated factors to prevent endoscopic and clinical postoperative recurrence (POR) in Crohn’s disease (CD).
Methods
From a prospectively-maintained database, we retrieved 316 CD patients who underwent intestinal resection (2011–2017). Endoscopic (Rutgeerts index ≥ i2 at 6 months) and clinical (recurrence of symptoms leading to hospitalization or therapeutic escalation) POR were assessed.
Results
In 117 anti-TNF-naïve patients, anti-TNF therapy was more effective than immunosuppressive agents (odds ratio [OR], 8.8; 95% confidence interval [CI], 1.8–43.9; P= 0.008) and no medication/5-aminosalicylates (OR, 5.2; 95% CI, 1.0–27.9; P= 0.05) to prevent endoscopic POR. In 199 patients exposed to anti-TNF prior to the surgery, combination with anti-TNF and immunosuppressive agents was more effective than anti-TNF monotherapy (OR, 2.32; 95% CI, 1.02–5.31; P= 0.046) to prevent endoscopic POR. Primary failure to anti-TNF agent prior to surgery was predictive of anti-TNF failure to prevent endoscopic POR (OR, 2.41; 95% CI, 1.10–5.32; P= 0.03). When endoscopic POR despite anti-TNF prophylactic medication (n = 55), optimizing anti-TNF and adding an immunosuppressive drug was the most effective option to prevent clinical POR (hazard ratio, 7.38; 95% CI, 1.54–35.30; P= 0.012). Anti-TNF therapy was the best option to prevent clinical POR (hazard ratio, 3.10; 95% CI, 1.09–8.83; P= 0.034) in patients with endoscopic POR who did not receive any biologic to prevent endoscopic POR (n = 55).
Conclusions
Anti-TNF was the most effective medication to prevent endoscopic and clinical POR. Combination with anti-TNF and immunosuppressive agents should be considered in patients previously exposed to anti-TNF.

Citations

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Systematic review and network meta-analysis comparing the efficacy of conventional therapy and biologics to prevent endoscopic postoperative recurrence in patients with Crohn’s disease
Marianne Hupé, Bruno Pereira, Anthony Buisson
Therapeutic Advances in Gastroenterology.2025;[Epub] CrossRef
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Review

Microbiota

The role of microbiome in colorectal carcinogenesis and its clinical potential as a target for cancer treatment: Sang Hoon Kim, Yun Jeong Lim; Intest Res 2022;20(1):31-42. Published online May 21, 2021; DOI: https://doi.org/10.5217/ir.2021.00034

Abstract PDF PubReader ePub

The role of gut microbiome-intestinal immune complex in the development of colorectal cancer and its progression is well recognized. Accordingly, certain microbial strains tend to colonize or vanish in patients with colorectal cancer. Probiotics, prebiotics, and synbiotics are expected to exhibit both anti-tumor effects and chemopreventive effects during cancer treatment through mechanisms such as xenometabolism, immune interactions, and altered eco-community. Microbial modulation can also be safely used to prevent complications during peri-operational periods of colorectal surgery. A deeper understanding of the role of intestinal microbiota as a target for colorectal cancer treatment will lead the way to a better prognosis for colorectal cancer patients.

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Original Articles

Colorectal neoplasia

Postgastrectomy gastric cancer patients are at high risk for colorectal neoplasia: a case control study: Tae-Geun Gweon, Kyu-Tae Yoon, Chang Hyun Kim, Jin-Jo Kim; Intest Res 2021;19(2):239-246. Published online November 13, 2020; DOI: https://doi.org/10.5217/ir.2020.00009

Abstract PDF PubReader ePub

Background/Aims
Several studies have shown that colorectal neoplasms (CRN) including colorectal cancer (CRC) may be prevalent in patients with gastric cancer. However, in most of these studies, colonoscopy to investigate the prevalence of CRN was performed prior to surgery. We aimed to investigate whether CRN was more prevalent in postgastrectomy gastric cancer patients than in healthy individuals.
Methods
We reviewed the medical records of those patients within a cohort of gastric cancer patients with gastrectomy who underwent colonoscopy between 2016 and 2017. Controls age- and sex-matched with gastric cancer patients at a 2:1 ratio were identified among those who underwent colonoscopy at a health-promotion center. The frequencies of CRN, advanced CRN (ACRN), and CRC among patients with gastrectomy were compared with those in the control subjects. A total of 744 individuals (gastric cancer, 248; control, 496) were included.
Results
The rates of CRN and ACRN in the gastric cancer group were higher than those in the healthy individuals (CRN, 47.6% vs. 34.7%, P< 0.001; ACRN, 16.9% vs. 10.9%, P= 0.020). The rate of CRC was comparable between the 2 groups (2.0% vs. 0.6%, P= 0.125). Multivariate analysis identified previous gastrectomy for gastric cancer and male sex as significant risk factors for (A)CRN.
Conclusions
CRN and ACRN were more prevalent in patients who underwent surgery for gastric cancer than in the control group. Regular surveillance colonoscopy at appropriate intervals is indicated after gastrectomy.

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Gastrointestinal Endoscopy.2025; 101(4): 866. CrossRef
Gastric Cancer and Microbiota: Exploring the Microbiome’s Role in Carcinogenesis and Treatment Strategies
Daniela-Cornelia Lazăr, Sorin-Dan Chiriac, George-Andrei Drăghici, Elena-Alina Moacă, Alexandra Corina Faur, Mihaela-Flavia Avram, Vladiana-Romina Turi, Mihaela-Roxana Nicolin, Adrian Goldiș, Matin Asad Salehi, Radu Jipa
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Jun He, Bixian Luo, Hongming Liu, Dong Cao, Weihua Gong
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Effect of bowel preparation completion time on bowel cleansing efficacy: Prospective randomized controlled trial of different bowel preparation completion times precolonoscopy
Hye Min Kim, Hyo Suk Kim, Young Eun An, Jae Hyuck Chang, Tae Ho Kim, Chang Whan Kim, Tae‐Geun Gweon
Digestive Endoscopy.2024; 36(12): 1347. CrossRef
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Young-Jo Wi, Soo-Young Na
The Korean Journal of Gastroenterology.2023; 82(2): 47. CrossRef
Comparison of 2 L Polyethylene Glycol Plus Ascorbic Acid and 4 L Polyethylene Glycol in Elderly Patients Aged 60–79: A Prospective Randomized Study
Sung Hoon Jung, Chul-Hyun Lim, Tae-Geun Gweon, Jinsu Kim, Jung Hwan Oh, Kyu-Tae Yoon, Jee Young An, Jeong‑Seon Ji, Hwang Choi
Digestive Diseases and Sciences.2022; 67(10): 4841. CrossRef
Colonoscopy Insertion in Patients with Gastrectomy: Does Position Impact Cecal Intubation Time?
Jae Hyun Kim, Youn Jung Choi, Hye Jung Kwon, Gyu Man Oh, Kyoungwon Jung, Sung Eun Kim, Won Moon, Moo In Park, Seun Ja Park
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American Journal of Gastroenterology.2022; 117(11): 1877. CrossRef

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Endoscopy

Effect of gut microbiome on minor complications after a colonoscopy: Jae Hyun Kim, Youn Jung Choi, Hye Jung Kwon, Kyoungwon Jung, Sung Eun Kim, Won Moon, Moo In Park, Seun Ja Park; Intest Res 2021;19(3):341-348. Published online November 10, 2020; DOI: https://doi.org/10.5217/ir.2020.00057

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Minor complications that might occur after colonoscopy, including abdominal discomfort, bloating, diarrhea, and constipation, could a barrier for patients to undergo a screening colonoscopy. In this study, we aimed to identify the effect of gut microbial diversity and composition on minor complications after colonoscopy.
Methods
A total of 24 healthy subjects provided their stools before bowel preparation and on the 7th and 28th day after colonoscopy. On the 7th day after colonoscopy, the presence of minor complications was investigated using a questionnaire. We divided patients into 2 groups, the no complication group and complications group. The fecal microbial diversity, distribution, and composition were then compared between the groups.
Results
Five of the 24 subjects reported that they had undergone minor complications after colonoscopy. Most of the symptoms were mild and self-limited, but 1 patient needed medication. Interestingly, the Firmicutes/Bacteroidetes ratio of the initial stool samples before bowel preparation in the complication group was significantly higher than that in no complication group. After bowel preparation, the Firmicutes/Bacteroidetes ratio of the complication group decreased, but not in the no complication group. The microbial diversity of the no complication group decreased after bowel preparation, but not in the complication group.
Conclusions
The gut microbial composition and diversity before and after bowel preparation could be considered as one of the causes of minor complications after colonoscopy. Further studies are needed to delineate the role of gut microbiota in the occurrence of minor complications after colonoscopy.

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Milena Di Leo, Andrea Iannone, Monica Arena, Giuseppe Losurdo, Maria Angela Palamara, Giuseppe Iabichino, Pierluigi Consolo, Maria Rendina, Carmelo Luigiano, Alfredo Di Leo
World Journal of Gastroenterology.2021; 27(45): 7748. CrossRef

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Review

Cancer

Two intertwined compartments coexisting in sporadic conventional colon adenomas: Carlos A. Rubio; Intest Res 2021;19(1):12-20. Published online February 24, 2020; DOI: https://doi.org/10.5217/ir.2019.00133

Abstract PDF PubReader ePub

Sporadic conventional colon adenomas are microscopically built of 2 intertwined compartments: one on top, harboring the dysplastic tissue that defines their histo-biomolecular attributes, and the other below, composed of non-dysplastic crypts with corrupted shapes (CCS). The CCS of 306 colon adenomas revealed asymmetric, haphazardly-distributed proliferating cell-domains (PC). In contrast, the PC-domains in normal controls were symmetric, being limited to the lower thirds of the crypts. In 28% out of 501 sporadic conventional adenomas, foci of p53-upregulated dysplastic tissue were found. The CCS in 30% of 108 sporadic adenomas showed p53-upregulated single cells, suggesting mounting somatic mutations. No p53-upregulated cells were found in the crypts of controls. In polypoid adenomas, the mucosa of the stalk without dysplastic tissue on top disclosed CCS with asymmetrical PC-domains and single p53-upregulated cells. The latter observations suggested that CCS had developed prior to and not after the growth of the dysplastic tissue on top. CCS were also found below colon adenomas in carcinogen-treated rats. It is concluded that the 2 intertwined histo-biological compartments of sporadic conventional colon adenomas are probably interdependent components. These findings may open new directions aimed to uncover the link between the normal colonic mucosa and the histogenesis of, conventional adenomas.

Citations

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Calcium, Vitamin D, and Colorectal Cancer
Young-Jo Wi, Soo-Young Na
The Korean Journal of Gastroenterology.2023; 82(2): 47. CrossRef
Gut Microbiome and Colorectal Cancer
Tae-Geun Gweon
The Korean Journal of Gastroenterology.2023; 82(2): 56. CrossRef
Summary and comparison of recently updated post-polypectomy surveillance guidelines
Yoon Suk Jung
Intestinal Research.2023; 21(4): 443. CrossRef
Asymmetric crypt fission in colectomy specimens in patients with ulcerative colitis
Carlos A Rubio, Peter T Schmidt
Journal of Clinical Pathology.2020; : jclinpath-2020-206694. CrossRef

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Original Articles

Colorectal neoplasia

Microvascular density under magnifying narrow-band imaging endoscopy in colorectal epithelial neoplasms: Takahiro Gonai, Keisuke Kawasaki, Shotaro Nakamura, Shunichi Yanai, Risaburo Akasaka, Kunihiko Sato, Yousuke Toya, Kensuke Asakura, Jun Urushikubo, Yasuko Fujita, Makoto Eizuka, Noriyuki Uesugi, Tamotsu Sugai, Takayuki Matsumoto; Intest Res 2020;18(1):107-114. Published online November 4, 2019; DOI: https://doi.org/10.5217/ir.2019.00061

Abstract PDF PubReader ePub

Background/Aims
Magnifying endoscopic classification systems, such as the Japan narrow-band imaging (NBI) Expert Team (JNET) classification, have been widely used for predicting the histologic diagnosis and invasion depth of colorectal epithelial tumors. However, disagreement exists among observers regarding magnifying endoscopic diagnosis, because these classification systems are subjective. We herein investigated the utility of endoscopic microvascular density (eMVD) calculated from magnifying NBI endoscopic images in colorectal tumors.
Methods
We reviewed magnifying NBI endoscopic images from 169 colorectal epithelial tumors (97 adenomas, 72 carcinomas/high-grade dysplasias) resected endoscopically or surgically. The eMVD on magnifying NBI endoscopic images was evaluated using image-editing software, and relationships between eMVD and clinical, endoscopic, and pathological findings were retrospectively analyzed.
Results
The eMVD in carcinomas (0.152 ± 0.079) was significantly higher than that in adenomas (0.119 ± 0.059, P< 0.05). The best cutoff value for distinguishing carcinoma from adenoma was 0.133. Sensitivity, specificity, and accuracy were 56.9%, 67.0%, and 62.7%, respectively. In addition, JNET type 2B tumors showed significantly higher eMVD (0.162 ± 0.079) compared to type 2A tumors (0.111 ± 0.050, P< 0.05).
Conclusions
The eMVD as determined by magnifying NBI endoscopy is considered to be a possible objective indicator for differentiating colorectal carcinomas from adenomas.

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Md. Ariful Islam, Labanya Talukder, Md. Firoj Al, Subrata K. Sarker, S. M. Muyeen, Prangon Das, Md. Mehedi Hasan, Sajal K. Das, Md. Manirul Islam, Md. Robiul Islam, Sumaya Ishrat Moyeen, Faisal R. Badal, Md. Hafiz Ahamed, Sarafat Hussain Abhi
Frontiers in Robotics and AI.2023;[Epub] CrossRef
Emergence of a New Optical Marker for Colorectal Neoplasms: To What Extent Should We Accept It?
Han Hee Lee
Clinical Endoscopy.2022; 55(2): 315. CrossRef
Endoscopic diagnosis and treatment of early colorectal cancer
Seung Wook Hong, Jeong-Sik Byeon
Intestinal Research.2022; 20(3): 281. CrossRef
Colonic Chicken Skin Mucosa Surrounding Colon Polyps Is an Endoscopic Predictive Marker for Colonic Neoplastic Polyps
Yu Mi Lee, Kyung Ho Song, Hoon Sup Koo, Choong-Sik Lee, Inseok Ko, Sang Hyuk Lee, Kyu Chan Huh
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Artificial intelligence-based colorectal polyp histology prediction using narrow-band image-magnifying colonoscopy: a stepping stone for clinical practice
Ji Young Chang
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Response to Artificial intelligence-based colorectal polyp histology prediction using narrow-band image-magnifying colonoscopy: a stepping stone for clinical practice
Istvan Racz, Andras Horvath, Zoltán Horvath
Clinical Endoscopy.2022; 55(5): 701. CrossRef
Photoacoustic endoscopy: A progress review
Heng Guo, Ying Li, Weizhi Qi, Lei Xi
Journal of Biophotonics.2020;[Epub] CrossRef
Diagnostic efficacy of the Japan Narrow-band-imaging Expert Team and Pit pattern classifications for colorectal lesions: A meta-analysis
Yu Zhang, Hui-Yan Chen, Xiao-Lu Zhou, Wen-Sheng Pan, Xin-Xin Zhou, Hang-Hai Pan
World Journal of Gastroenterology.2020; 26(40): 6279. CrossRef

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Miscellaneous

Primary epiploic appendagitis: compared with diverticulitis and focused on obesity and recurrence: Youn I Choi, Hyun Sun Woo, Jun-Won Chung, Young Sup Shim, Kwang An Kwon, Kyoung Oh Kim, Yoon Jae Kim, Dong Kyun Park; Intest Res 2019;17(4):554-560. Published online October 14, 2019; DOI: https://doi.org/10.5217/ir.2018.00148

Abstract PDF PubReader ePub

Background/Aims
There is limited data to compare the clinical characteristics and recurrence rates between left-sided primary epiploic appendagitis (PEA) versus left-sided acute colonic diverticulitis (ACD), and right-sided PEA versus right-sided ACD, respectively.
Methods
We retrospectively reviewed the medical records and radiologic images of the patients who presented with left-sided or right-sided acute abdominal pain and had computer tomography performed at the time of presentation showing radiological signs of PEA or ACD between January 2004 and December 2014. We compared the clinical characteristics of left PEA versus left ACD and right PEA versus right ACD, respectively.
Results
Fifty-six patients (left:right = 27:29) and 308 patients (left:right = 24:284) were diagnosed with symptomatic PEA and ACD, respectively. Left-sided PEA were statistically significantly younger (50.2 ± 15.4 years vs. 62.1 ± 15.8 years, P= 0.009), more obese (body mass index [BMI]: 26.3 ± 2.9 kg/m2 vs. 22.3 ± 3.1 kg/m2 , P< 0.001), and had more tendencies with normal or mildly elevated high-sensitivity C-reactive protein (hsCRP) (1.2 ± 1.3 mg/dL vs. 8.4 ± 7.9 mg/dL, P< 0.001) than patients with left-sided ACD. The discriminative function of age, BMI and CRP between left-sided PEA versus left-sided ACD was 0.71 (cutoff: age ≤ 59 years, sensitivity of 66.7%, specificity of 77.8%), 0.83 (cutoff: BMI > 24.5 kg/m2 , sensitivity of 80.0%, specificity of 80.0%) and 0.80 (cutoff: CRP < 1.8 mg/dL, sensitivity of 72.2%, specificity of 85.7%).
Conclusions
If patients with left lower quadrant abdominal pain are less than 60 years, obese (BMI > 24.5 kg/m2 ) with or without normal to mild elevated CRP levels (CRP < 1.8 mg/dL), it might be necessary for clinicians to suspect the diagnosis of PEA rather than ACD.

Citations

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Epiploic Appendagitis Following Blunt Abdominal Trauma: A Case Report with Literature Review
Ayah Obeid, Douglas Degler
ASIDE Case Reports.2025; 1(2): 6. CrossRef
From CT to Cytokines: Evaluating the Role of Systemic Inflammation and Metabolic Markers in Epiploic Appendagitis
Şeref Barbaros Arik, İrfan Esen, Oğuzhan Özdemir
Bratislava Medical Journal.2025; 126(12): 3709. CrossRef
Characteristic CT Imaging Features of Atraumatic Peritoneal and Subperitoneal Pathologies in Emergency Settings: A Pictorial Review
Christopher D Louviere, Jennifer L Wen, Neal M Hall, Ruben G Ortiz, Dheeraj R Gopireddy, Grit A Adler, Renato Abu Hana
Cureus.2025;[Epub] CrossRef
Diagnosis and treatment of epiploic appendagitis in a Middle Eastern country: An observational retrospective analysis of 156 cases
Ayman El‐Menyar, Syed G. A. Naqvi, Omer Al‐Yahri, Abdelaziz MA Abusal, Abdulwahhab Al‐Shaikhli, Sadia Sajid, Husham Abdelrahman, Ahmad G. Kloub, Muhamed Ibnas, Rifat Latifi, Yasser M. R. Toble, Hassan Al‐Thani
World Journal of Surgery.2024; 48(6): 1363. CrossRef
Epiploic Adipose Tissue (EPAT) in Obese Individuals Promotes Colonic Tumorigenesis: A Novel Model for EPAT-Dependent Colorectal Cancer Progression
Rida Iftikhar, Patricia Snarski, Angelle N. King, Jenisha Ghimire, Emmanuelle Ruiz, Frank Lau, Suzana D. Savkovic
Cancers.2023; 15(3): 977. CrossRef
Recurrencia en pacientes con apendagitis epiploica: un reporte de caso
Mía Alejandra Gómez Corrales, Fabian Andrés Chávez Ecos, Jackeline Alexandra Espinoza Utani, Carlos Alberto Dávila Hernández
Revista colombiana de Gastroenterología.2023; 38(1): 94. CrossRef

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6 Crossref

Case Report

Colorectal neoplasia

Primary malignant melanoma without melanosis of the colon: Nam Hee Yi, Sang Heon Lee, Sang Heon Lee, Ji Hyun Kim, Sam Ryong Jee, Sang Yong Seol; Intest Res 2019;17(4):561-564. Published online August 5, 2019; DOI: https://doi.org/10.5217/ir.2019.00020

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Primary malignant melanoma (PMM) of the gastrointestinal tract is rare. Reported cases of PMM of the lower gastrointestinal tract typically describe anal and rectal involvement rather than colonic lesions. This report describes a rare case of a 50-year-old woman with PMM originating in the colon. The patient presented to Inje University Busan Paik Hospital with a 3-day history of blood-tinged stools. She underwent colonoscopy for a diagnosis of hematochezia. The colonoscopic examination revealed a large-sized semi-pedunculated sigmoid colon polyp with a reddish-colored mucosal surface. Endoscopic mucosal resection was performed, and the final histopathological findings were consistent with a diagnosis of malignant melanoma. Systemic work-up was performed for assessment of metastasis and to identify the primary tumor considering the high metastatic rate of gastrointestinal malignant melanoma; however, no other malignant lesion was detected. Thus, she was diagnosed with colonic PMM. She underwent laparoscopic low anterior resection and lymph node dissection and has been recurrence-free for > 2 years.

Citations

Citations to this article as recorded by

Malignant primary melanoma of the colon: a case report
Claire K Foley, Marybeth S Hughes, Charles T Hehman
Journal of Surgical Case Reports.2023;[Epub] CrossRef

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1 Crossref

Original Articles

Colorectal neoplasia

Clinical outcomes of positive resection margin after endoscopic mucosal resection of early colon cancers: Junseok Park, Hyun Gun Kim, Shin Ok Jeong, Hoon gil Jo, Hyo Yeop Song, Jeeyeon Kim, Seri Ryu, Youngyun Cho, Hyun Jin Youn, Seong Ran Jeon, Jin-Oh Kim, Bong Min Ko, Yoon Mi Jeen, So-Young Jin; Intest Res 2019;17(4):516-526. Published online May 31, 2019; DOI: https://doi.org/10.5217/ir.2018.00169

Abstract PDF PubReader ePub

Background/Aims
When determining the subsequent management after endoscopic resection of the early colon cancer (ECC), various factors including the margin status should be considered. This study assessed the subsequent management and outcomes of ECCs according to margin status.
Methods
We examined the data of 223 ECCs treated by endoscopic mucosal resection (EMR) from 215 patients during 2004 to 2014, and all patients were followed-up at least for 2 years.
Results
According to histological analyses, the margin statuses of all lesions after EMR were as follows: 138 cases (61.9%) were negative, 65 cases (29.1%) were positive for dysplastic cells on the resection margins, and 20 cases (8.9%) were uncertain. The decision regarding subsequent management was affected not only by pathologic outcomes but also by the endoscopist’s opinion on whether complete resection was obtained. Surgery was preferred if the lesion extended to the submucosa (odds ratio [OR], 25.46; 95% confidence interval [CI], 7.09–91.42), the endoscopic resection was presumed incomplete (OR, 15.55; 95% CI, 4.28–56.56), or the lymph system was invaded (OR, 13.69; 95% CI, 1.76–106.57). Fourteen patients (6.2%) had residual or recurrent malignancies at the site of the previous ECC resection and were significantly associated with presumed incomplete endoscopic resection (OR, 4.59; 95% CI, 1.21–17.39) and submucosal invasion (OR, 5.14; 95% CI, 1.18–22.34).
Conclusions
Subsequent surgery was associated with submucosa invasion, lymphatic invasion, and cancer-positive margins. Presumed completeness of the resection may be helpful for guiding the subsequent management of patients who undergo endoscopic resection of ECC.

Citations

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Risk Factors for Perforation in Endoscopic Treatment for Early Colorectal Cancer: A Nationwide ENTER-K Study
Ik Hyun Jo, Hyun Gun Kim, Young-Seok Cho, Hyun Jung Lee, Eun Ran Kim, Yoo Jin Lee, Sung Wook Hwang, Kyeong-Ok Kim, Jun Lee, Hyuk Soon Choi, Yunho Jung, Chang Mo Moon
Gut and Liver.2025; 19(1): 95. CrossRef
Long-term outcomes after endoscopic versus surgical resection of T1 colorectal carcinoma
Hyun Jin Bae, Hoyeon Ju, Han Hee Lee, Jinsu Kim, Bo-In Lee, Sung Hak Lee, Daeyoun David Won, Yoon Suk Lee, In Kyu Lee, Young-Seok Cho
Surgical Endoscopy.2023; 37(2): 1231. CrossRef
Emergence of a New Optical Marker for Colorectal Neoplasms: To What Extent Should We Accept It?
Han Hee Lee
Clinical Endoscopy.2022; 55(2): 315. CrossRef
Comparison of long-term recurrence-free survival between primary surgery and endoscopic resection followed by secondary surgery in T1 colorectal cancer
Eun Hye Oh, Nayoung Kim, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Chang Sik Yu, Jin Cheon Kim, Jeong-Sik Byeon
Gastrointestinal Endoscopy.2021; 94(2): 394. CrossRef
Clinical outcomes of submucosal colorectal cancer diagnosed after endoscopic resection: a focus on the need for surgery
Yun Sik Choi, Wan Soo Kim, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Jeong-Sik Byeon
Intestinal Research.2020; 18(1): 96. CrossRef

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5 Crossref

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

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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

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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

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Endoscopy

Clinicopathological feature and treatment outcome of patients with colorectal laterally spreading tumors treated by endoscopic submucosal dissection: Young-Hoon Jeong, Jun Lee, Sang-Wook Kim, Geom-Seog Seo, Hyun-Soo Kim, Young-Eun Joo; Intest Res 2019;17(1):127-134. Published online October 10, 2018; DOI: https://doi.org/10.5217/ir.2018.00075

Abstract PDF PubReader ePub

Background/Aims
Endoscopic submucosal dissection (ESD) is an advanced technique that can be used to treat precancerous and early colorectal neoplasms by facilitating en bloc resection regardless of tumor size. In our study, we investigated the clinicopathological feature and the treatment outcome of patients with colorectal laterally spreading tumors (LSTs) that were treated by ESD.
Methods
The study enrolled all of 210 patients with colorectal LSTs who underwent ESD. Clinical outcomes were analyzed by retrospectively reviewing medical records.
Results
A cancerous pit pattern (Vi/Vn) was more common in pseudo-depressed (PD) subtype than in flat elevated (FE) subtype. The incidence of adenocarcinoma in the PD subtype and nodular mixed (NM) subtypes was significantly higher than in the homogenous (HG) subtype and FE subtype. The en bloc and R0 resection rates were 89.0% and 85.7%, respectively. The bleeding and perforation rates were 5.2% and 1.9%, respectively. The mean procedure time was much longer in the PD subtype than in the FE subtype. The en bloc resection rate was significantly higher in the NM subtype than in the HG subtype. However, there were no statistically significant differences in mean procedure time, en bloc resection rate, R0 resection rate, bleeding rate, or perforation rate between LST-granular and LST-nongranular types.
Conclusions
These results indicate that ESD is acceptable for treating colorectal LSTs concerning en bloc resection, curative resection, and risk of complications. Careful consideration is required for complete resection of the PD subtype and NM subtype because of their higher malignant potential.

Citations

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Endoscopic resection of colorectal laterally spreading tumors: Clinicopathologic characteristics and risk factors for treatment outcomes
Li-Hua Guo, Ke-Feng Hu, Min Miao, Yong Ding, Xin-Jun Zhang, Guo-Liang Ye
World Journal of Gastrointestinal Endoscopy.2025;[Epub] CrossRef
Risk factors for unsuccessful colorectal endoscopic submucosal dissection: A systematic review and meta-analysis
Feng Gu, Wei Jiang, Jingyi Zhu, Lei Ma, Boyuan He, Huihong Zhai
Digestive and Liver Disease.2024; 56(8): 1288. CrossRef
Prognosis and risk factors of electrocoagulation syndrome after endoscopic submucosal dissection in the colon and rectum. Large cohort study
Seong-Jung Kim, Su Young Kim, Jun Lee
Surgical Endoscopy.2022; 36(8): 6243. CrossRef
Blue laser imaging combined with JNET (Japan NBI Expert Team) classification for pathological prediction of colorectal laterally spreading tumors
Si-lin Huang, Wen-xin Tan, Qun Peng, Wen-hua Zhang, Hai-tao Qing, Qiang Zhang, Jun Wu, Liang-dou Lin, Zhi-bin Lu, Yu Chen, Wei-guang Qiao
Surgical Endoscopy.2021; 35(10): 5430. CrossRef
Comparison of long-term recurrence-free survival between primary surgery and endoscopic resection followed by secondary surgery in T1 colorectal cancer
Eun Hye Oh, Nayoung Kim, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Chang Sik Yu, Jin Cheon Kim, Jeong-Sik Byeon
Gastrointestinal Endoscopy.2021; 94(2): 394. CrossRef
Second-look endoscopy findings after endoscopic submucosal dissection for colorectal epithelial neoplasms
Soo-kyung Park, Hyeon Jeong Goong, Bong Min Ko, Haewon Kim, Hyo Sun Seok, Moon Sung Lee
The Korean Journal of Internal Medicine.2021; 36(5): 1063. CrossRef

9,359 View
212 Download
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6 Crossref

Endoscopy

The current capacity and quality of colonoscopy in Korea: Jae Ho Choi, Jae Myung Cha, Jin Young Yoon, Min Seob Kwak, Jung Won Jeon, Hyun Phil Shin; Intest Res 2019;17(1):119-126. Published online October 10, 2018; DOI: https://doi.org/10.5217/ir.2018.00060

Abstract PDF PubReader ePub

Background/Aims
Little is known for the capacity and quality of colonoscopy, and adherence to colonoscopy surveillance guidelines in Korea. This study aimed to investigate the present and potential colonoscopic capacity, colonoscopic quality, and adherence to colonoscopy surveillance guidelines in Korea.
Methods
We surveyed representative endoscopists of 72 endoscopy units from June to August 2015, using a 36-item questionnaire regarding colonoscopic capacity, quality, and adherence to colonoscopy surveillance guidelines of each hospitals.
Results
Among the 62 respondents who answered the questionnaire, 51 respondents were analyzed after exclusion of 11 incomplete answers. Only 1 of 3 of endoscopy units can afford to perform additional colonoscopies in addition to current practice, and the potential maximum number of colonoscopies per week was only 42. The quality of colonoscopy was variable as reporting of quality indicators of colonoscopy were considerably variable (29.4%–94.1%) between endoscopy units. Furthermore, there are substantial gaps in the adherence to colonoscopy surveillance guidelines, as concordance rate for guideline recommendation was less than 50% in most scenarios.
Conclusions
The potential capacity and quality of colonoscopy in Korea was suboptimal. Considering suboptimal reporting of colonoscopic quality indicators and low adherence rate for colonoscopy surveillance guidelines, quality improvement of colonoscopy should be underlined in Korea.

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Ga Hee Kim, Yeong Chan Lee, Tae Jun Kim, Sung Noh Hong, Dong Kyung Chang, Young-Ho Kim, Dong-Hoon Yang, Chang Mo Moon, Kyunga Kim, Hyun Gun Kim, Eun-Ran Kim
World Journal of Gastrointestinal Oncology.2024; 16(1): 51. CrossRef
Factors Affecting Adherence to National Colorectal Cancer Screening: A 12-Year Longitudinal Study Using Multi-Institutional Pooled Data in Korea
Dae Sung Kim, Jeeyoung Hong, Kihyun Ryu, Sang Hyuk Lee, Hwanhyi Cho, Jehyeong Yu, Jieun Lee, Jong-Yeup Kim
Journal of Korean Medical Science.2024;[Epub] CrossRef
Strategies to improve screening colonoscopy quality for the prevention of colorectal cancer
Joo Hye Song, Eun Ran Kim
The Korean Journal of Internal Medicine.2024; 39(4): 547. CrossRef
Faecal immunochemical tests can improve colonoscopy triage in patients with iron deficiency: A systematic review and meta-analysis
Jennifer Pham, Geraldine Laven-Law, Erin L. Symonds, Molla M. Wassie, Charles Cock, Jean M. Winter
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Jae Woong Lim, Min Jae Kim, Gang Han Lee, Dae Sol Kim, Sang Hyuk Jung, Yu Yeon Kim, Jin Won Kim, Yohan Lee, Hyun Soo Kim, Seon Young Park, Dong Hyun Kim
Chonnam Medical Journal.2024; 60(3): 192. CrossRef
Overview of the National Cancer Screening Program for Colorectal Cancer in Korea over 14 Years (2004-2017)
Bomi Park, Eun Young Her, Kyeongmin Lee, Fatima Nari, Jae Kwan Jun, Kui Son Choi, Mina Suh
Cancer Research and Treatment.2023; 55(3): 910. CrossRef
Sessile serrated lesions in patients with adenoma on index colonoscopy do not increase metachronous advanced adenoma risk
Seung Wook Hong, Jeongseok Kim, Ji Young Lee, Jong‐Soo Lee, Hye‐Sook Chang, Hye Won Park, Gwang‐Un Kim, Jiyoung Yoon, Byong Duk Ye, Jeong‐Sik Byeon, Seung‐Jae Myung, Suk‐Kyun Yang, Jaewon Choe, Dong‐Hoon Yang
Digestive Endoscopy.2022; 34(4): 850. CrossRef
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Sung Noh Hong, Chang Kyun Lee, Jong Pil Im, Chang Hwan Choi, Jeong-Sik Byeon, Young-Seok Cho, Sung-Ae Jung, Tae Il Kim, Yoon Tae Jeen
Gastrointestinal Endoscopy.2022; 95(3): 500. CrossRef
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Xuan Quy Luu, Kyeongmin Lee, Jae Kwan Jun, Mina Suh, Kyu‐Won Jung, Kui Son Choi
International Journal of Cancer.2022; 150(12): 1958. CrossRef
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Dong Yang, Yuqin Li, Haibo Sun, Chuan He, Geng Chen, Zhuo Zhao, Tongyu Tang, Amosy M'Koma
Gastroenterology Research and Practice.2022; 2022: 1. CrossRef
Risk of Metachronous Colorectal Advanced Neoplasia and Cancer in Patients With 3–4 Nonadvanced Adenomas at Index Colonoscopy: A Systematic Review and Meta-Analysis
Suyeon Park, Seong Ran Jeon, Hyun Gun Kim, Yunho Jung, Min-Seob Kwak, Su Young Kim, Jong Wook Kim, Seung-Joo Nam, Eun Hye Oh, Seon-Young Park, Soo-Kyung Park, Jeong-Sik Byeon, Sun-Jin Boo, Dong Hoon Baek, Soon Man Yoon, Jaeyoung Chun, Jooyoung Lee, Miyoun
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The Influence of Face Shields on the Quality of Colonoscopy in the Era of the COVID-19 Pandemic
Jin Wook Lee, Hyo Jeong Lee, Dae Sung Kim, Jiyoung Yoon, Seung Wook Hong, Ha Won Hwang, Jong-Soo Lee, Gwang-Un Kim, Sinwon Lee, Jaewon Choe, Jin Hwa Park, Dong-Hoon Yang, Jeong-Sik Byeon
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Su Bee Park, Jae Myung Cha
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Intentions to undergo primary screening with colonoscopy under the National Cancer Screening Program in Korea
Kyeongmin Lee, Haejoo Seo, Sunho Choe, Seung-Yong Jeong, Ji Won Park, Mina Suh, Aesun Shin, Kui Son Choi, Filipe Prazeres
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Colonoscopy quality in community hospitals and nonhospital facilities in Korea
Jae Gon Lee, Dong Soo Han, Young-Eun Joo, Dae-Seong Myung, Dong Il Park, Seul Ki Kim, Yunho Jung, Won Hyun Lee, Eun Soo Kim, Joon Seok Yoon, Chang Soo Eun
The Korean Journal of Internal Medicine.2021; 36(Suppl 1): S35. CrossRef
Real-World National Colonoscopy Volume in Korea: A Nationwide Population-Based Study over 12 Years
Jae Myung Cha, Min Seob Kwak, Hyun-Soo Kim, Su Young Kim, Sohee Park, Geun U Park, Jung Kuk Lee, Soo Jin Kim, Hun Hee Lee, Joo Sung Kim, Won Ho Kim
Gut and Liver.2020; 14(3): 338. CrossRef

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Colorectal neoplasia

Rates of metachronous adenoma after curative resection for left-sided or right-sided colon cancer: Yuk Fai Lam, Wai Kay Seto, Teresa Tong, Ka Shing Cheung, Oswens Lo, Ivan FN Hung, Wai Lun Law, Wai K Leung; Intest Res 2018;16(4):619-627. Published online October 10, 2018; DOI: https://doi.org/10.5217/ir.2018.00013

Abstract PDF PubReader ePub

Background/Aims
We determined the rates of metachronous colorectal neoplasm in colorectal cancer (CRC) patients after resection for right (R)-sided or left (L)-sided cancer.
Methods
Consecutive CRC patients who had undergone surgical resection for curative intent in our hospital between 2001 and 2004 were identified. R-sided colonic cancers refer to cancer proximal to splenic flexure whereas L-sided cancers include rectal cancers. Patients were included only if they had a clearing colonoscopy performed either before or within 6 months after the operation. Findings of surveillance colonoscopy performed up to 5 years after colonic resection were included in the analysis.
Results
Eight hundred and sixty-three CRC patients underwent curative surgical resection during the study period. Three hundred and twenty-seven patients (107 R-sided and 220 L-sided) fulfilled the inclusion criteria and had at least 1 postoperative surveillance colonoscopy performed. The proportion of patients who had polyp and adenoma on surveillance colonoscopy was significantly higher among patients with L-sided than R-sided cancers (polyps: 30.9% vs. 19.6%, P=0.03; adenomas: 25.5% vs. 13.1%, P=0.01). The mean number of adenoma per patient on surveillance colonoscopy was also higher for patients with L-sided than R-sided tumors (0.52; 95% confidence interval [CI], 0.37–0.68 vs. 0.22; 95% CI, 0.08–0.35; P<0.01). Multivariate analysis showed that L-sided cancers, age, male gender and longer follow-up were independent predictors of adenoma detection on surveillance colonoscopy.
Conclusions
Patients with Lsided cancer had a higher rate of metachronous polyps and adenoma than those with R-sided cancer on surveillance colonoscopy.

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Miscellaneous

Risk factors for severity of colonic diverticular hemorrhage: Ken Kinjo, Toshiyuki Matsui, Takashi Hisabe, Hiroshi Ishihara, Toshiki Kojima, Kenta Chuman, Shigeyoshi Yasukawa, Tsuyoshi Beppu, Akihiro Koga, Satoshi Ishikawa, Masahiro Kishi, Noritaka Takatsu, Fumihito Hirai, Kenshi Yao, Toshiharu Ueki, Masakazu Washio; Intest Res 2018;16(3):458-466. Published online July 27, 2018; DOI: https://doi.org/10.5217/ir.2018.16.3.458

Abstract PDF PubReader ePub

Background/Aims

Colonic diverticular hemorrhage (DH) was a rare disease until the 1990s, and its incidence has increased rapidly since 2000 in Japan. In recent years, colonic DH has been the most frequent cause of lower gastrointestinal bleeding (LGIB). Nearly all cases of DH are mild, with the bleeding often stopping spontaneously. Some cases, however, require surgery or arterial embolization. In this study, using a cohort at Fukuoka University Chikushi Hospital, we investigated factors associated with severe colonic DH.

Methods

Among patients with LGIB who underwent colonoscopy at our hospital between 1995 and 2013, DH was identified in 273 patients. Among them, 62 patients (22.7%) were defined as having severe colonic DH according to recurrence of bleeding in a short period, and/or the necessity of transfusion, arterial embolization, or surgery. We then evaluated risk factors for severe DH among DH patients in this retrospective cohort.

Results

Among the 273 patients with DH, use of non-steroidal anti-inflammatory drugs (NSAIDs) (odds ratio [OR], 2.801; 95% confidence interval [CI], 1.164–6.742), Charlson Risk Index (CRI) ≥2 (OR, 3.336; 95% CI, 1.154–7.353), right-sided colonic DH (OR, 3.873; 95% CI, 1.554–9.653), and symptoms of cerebral hypoperfusion (such as light-headedness, dizziness, or syncope) (OR, 2.926; 95% CI, 1.310–6.535) showed an increased risk of severe DH even after controlling for other factors.

Conclusions

Severe DH occurred in 23% of DH patients, and NSAID use, CRI ≥2, right-sided colonic DH, and symptoms of cerebral hypoperfusion are suggested to be predictors of severe DH.

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Hirohito Amano, Takatsugu Yamamoto, Ken Ikusaka, Naoaki Aoki, Miyoko Sakurai, Taku Honda, Kyohei Maruyama, Hitoshi Aoyagi, Akari Isono, Koichiro Abe, Yoshinari Asaoka, Shinya Kodashima, Atsushi Tanaka
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Endoscopy

Difficult colonoscopy: air, carbon dioxide, or water insufflation?: Alisha Chaubal, Vikas Pandey, Ruchir Patel, Prateik Poddar, Aniruddha Phadke, Meghraj Ingle, Prabha Sawant; Intest Res 2018;16(2):299-305. Published online April 30, 2018; DOI: https://doi.org/10.5217/ir.2018.16.2.299

Abstract PDF Supplementary Material PubReader ePub

Background/Aims

This study aimed to compare tolerance to air, carbon dioxide, or water insufflation in patients with anticipated difficult colonoscopy (young, thin, obese individuals, and patients with prior abdominal surgery or irradiation).

Methods

Patients with body mass index (BMI) less than 18 kg/m² or more than 30 kg/m², or who had undergone previous abdominal or pelvic surgeries were randomized to air, carbon dioxide, or water insufflation during colonoscopy. The primary endpoint was cecal intubation with mild pain (less than 5 on visual analogue scale [VAS]), without use of sedation.

Results

The primary end point was achieved in 32.7%, 43.8%, and 84.9% of cases with air, carbon dioxide and water insufflation (P<0.001). The mean pain scores were 5.17, 4.72, and 3.93 on the VAS for air, carbon dioxide, and water insufflation (P<0.001). The cecal intubation rate or procedure time did not differ significantly between the 3 groups.

Conclusions

Water insufflation was superior to air or carbon dioxide for pain tolerance. This was seen in the subgroups with BMI <18 kg/m² and the post-surgical group, but not in the group with BMI >30 kg/m².

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Endoscopy

Prospective analysis of factors associated with inadequate bowel preparation for colonoscopy in actual clinical practice: Dae Hyung Woo, Kyeong Ok Kim, Da Eun Jeong, Yoon Jeong Nam, Si Hyung Lee, Byung Ik Jang, Tae Nyeun Kim; Intest Res 2018;16(2):293-298. Published online April 30, 2018; DOI: https://doi.org/10.5217/ir.2018.16.2.293

Abstract PDF PubReader ePub

Background/Aims

Inadequate bowel preparation can result in prolonged procedure time and increased missed lesion and complication rates. This prospective study aimed to evaluate bowel preparation quality and identify the predictive factors for inadequate bowel preparation in actual clinical practice.

Methods

We included 399 patients who underwent colonoscopy between June 2015 and July 2016. Using the Aronchick bowel preparation scale, we defined a score ≤2 as adequate preparation and a score >2 as inadequate preparation.

Results

Mean patient age was 58.38±12.97 years; 60.6% were male. Indications for colonoscopy included screening (69.7%) and surveillance after polyp removal (21.3%). A split-dose regimen was prescribed to 55.4% of patients. The inadequate bowel preparation rate was 28.1%. Overall, the median time between the last bowel preparation agent dose and start of colonoscopy was 5.0 hours (range, 1.5–16.0 hours); that of the adequate group was 5.0 hours (range, 1.5–16.0 hours); and that of the inadequate group was 5 hours (range, 2–23 hours). The mean bowel preparation scale score of the ascending colon (1.94±0.25) was significantly higher than that of other colon segments. On multivariate analysis, elderly age, history of cerebrovascular disease, history of gastrectomy or appendectomy, and total preparation solution uptake <2 L were the independent predictors of inadequate bowel preparation.

Conclusions

The inadequate bowel preparation rate was 28.1%. Risk factors included elderly age and history of cerebrovascular disease or abdominal surgery. Patients with these risk factors require special care and education.

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Review

Endoscopy

Quality is the key for emerging issues of population-based colonoscopy screening: Jin Young Yoon, Jae Myung Cha, Yoon Tae Jeen; Intest Res 2018;16(1):48-54. Published online January 18, 2018; DOI: https://doi.org/10.5217/ir.2018.16.1.48

Abstract PDF PubReader ePub

Colonoscopy is currently regarded as the gold standard and preferred method of screening for colorectal cancer (CRC). However, the benefit of colonoscopy screening may be blunted by low participation rates in population-based screening programs. Harmful effects of population-based colonoscopy screening may include complications induced by colonoscopy itself and by sedation, psychosocial distress, potential over-diagnosis, and socioeconomic burden. In addition, harmful effects of colonoscopy may increase with age and comorbidities. As the risk of adverse events in population-based colonoscopy screening may offset the benefit, the adverse events should be managed and monitored. To adopt population-based colonoscopy screening, consensus on the risks and benefits should be developed, focusing on potential harm, patient preference, socioeconomic considerations, and quality improvement of colonoscopy, as well as efficacy for CRC prevention. As suboptimal colonoscopy quality is a major pitfall of population-based screening, adequate training and regulation of screening colonoscopists should be the first step in minimizing variations in quality. Gastroenterologists should promote quality improvement, auditing, and training for colonoscopy in a population-based screening program.

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Original Articles

Endoscopy

Three-year colonoscopy surveillance after polypectomy in Korea: a Korean Association for the Study of Intestinal Diseases (KASID) multicenter prospective study: Won Seok Choi, Dong Soo Han, Chang Soo Eun, Dong Il Park, Jeong-Sik Byeon, Dong-Hoon Yang, Sung-Ae Jung, Sang Kil Lee, Sung Pil Hong, Cheol Hee Park, Suck-Ho Lee, Jeong-Seon Ji, Sung Jae Shin, Bora Keum, Hyun Soo Kim, Jung Hye Choi, Sin-Ho Jung; Intest Res 2018;16(1):126-133. Published online January 18, 2018; DOI: https://doi.org/10.5217/ir.2018.16.1.126

Abstract PDF PubReader ePub

Background/Aims

Colonoscopic surveillance is currently recommended after polypectomy owing to the risk of newly developed colonic neoplasia. However, few studies have investigated colonoscopy surveillance in Asia. This multicenter and prospective study was undertaken to assess the incidence of advanced adenoma based on baseline adenoma findings at 3 years after colonoscopic polypectomy.

Methods

A total of 1,323 patients undergoing colonoscopic polypectomy were prospectively assigned to 3-year colonoscopy surveillance at 11 tertiary endoscopic centers. Relative risks for advanced adenoma after 3 years were calculated according to baseline adenoma characteristics.

Results

Among 1,323 patients enrolled, 387 patients (29.3%) were followed up, and the mean follow-up interval was 31.0±9.8 months. The percentage of patients with advanced adenoma on baseline colonoscopy was higher in the surveillance group compared to the non-surveillance group (34.4% vs. 25.7%). Advanced adenoma recurrence was observed in 17 patients (4.4%) at follow-up. The risk of advanced adenoma recurrence was 2 times greater in patients with baseline advanced adenoma than in those with baseline non-advanced adenoma, though the difference was not statistically significant (6.8% [9/133] vs. 3.1% [8/254], P=0.09). Advanced adenoma recurrence was observed only in males and in subjects aged ≥50 years. In contrast, adenoma recurrence was observed in 187 patients (48.3%) at follow-up. Male sex, older age (≥50 years), and multiple adenomas (≥3) at baseline were independent risk factors for adenoma recurrence.

Conclusions

A colonoscopy surveillance interval of 3 years in patients with baseline advanced adenoma can be considered appropriate.

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High C-reactive protein level is associated with high-risk adenoma: Hyae Min Lee, Jae Myung Cha, Jung Lok Lee, Jung Won Jeon, Hyun Phil Shin, Kwang Ro Joo, Jin Young Yoon, Joung Il Lee; Intest Res 2017;15(4):511-517. Published online October 23, 2017; DOI: https://doi.org/10.5217/ir.2017.15.4.511

Abstract PDF PubReader ePub

Background/Aims

There is substantial evidence supporting a role of inflammation in the pathogenesis of colorectal cancer; however, little is known about the association between serum C-reactive protein (CRP) and the risk of colorectal adenoma. This study was conducted to investigate the association between serum CRP and colorectal adenoma risk.

Methods

A retrospective cross-sectional study was performed on first-time screening colonoscopies in asymptomatic subjects who also had their serum CRP level measured during a routine health check-up between September 2006 and September 2009 in Korea. Serum CRP level was compared between high-risk and low-risk adenoma groups and independent predictors of high-risk adenoma were analyzed using multivariate regression analysis.

Results

Among the 3,309 eligible patients, the high-risk adenoma group had higher serum CRP levels than the low-risk adenoma group (P=0.000). In addition, patients with a high-risk adenoma were more frequently included in the high CRP group than in the low CRP group (8.6% vs. 4.0%, P<0.001). The prevalence of high-risk adenoma was 3.5 times higher in the highest quartile of CRP level (P=0.000) compared with that in the lowest quartile. In logistic regression analysis, a higher quartile CRP level was found to be an independent risk factor for high-risk adenoma (odds ratio, 1.8; 95% confidence interval, 1.3–2.5; P=0.000).

Conclusions

High CRP level is associated with high-risk adenoma in both men and women. Our data may support the association between chronic inflammation and colorectal neoplasia, which warrants further investigation.

Citations

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Clinical and Translational Gastroenterology.2020; 11(3): e00143. CrossRef

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Local recurrence and subsequent endoscopic treatment after endoscopic piecemeal mucosal resection with or without precutting in the colorectum: Myeongsook Seo, Eun Mi Song, Gwang Un Kim, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Kyung-Jo Kim, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Jeong-Sik Byeon; Intest Res 2017;15(4):502-510. Published online October 23, 2017; DOI: https://doi.org/10.5217/ir.2017.15.4.502

Abstract PDF PubReader ePub

Background/Aims

Precutting before endoscopic piecemeal mucosal resection (EPMR) may increase colorectal polyp resection effectiveness. We aimed to identify risk factors for recurrence after conventional EPMR (CEPMR) and precut EPMR (PEPMR) and investigated endoscopic treatment outcomes for recurrent cases.

Methods

The medical records of patients with colorectal polyps treated by EPMR were analyzed. Patients without follow-up surveillance colonoscopies were excluded.

Results

Among 359 lesions, the local recurrence rate on the first surveillance colonoscopy was 5.8% (18/312) and 6.4% (3/47) after CEPMR and PEPMR, respectively. Among lesions without recurrence at the first surveillance colonoscopy, the rates of late recurrence on subsequent surveillance colonoscopy were 3.9% (6/152) and 0% after CEPMR and PEPMR, respectively. Larger tumor size was the only independent risk factor for recurrence (odds ratio, 7.93; 95% confidence interval, 1.95–32.30; P<0.001). Endoscopic treatment was performed for all 27 recurrences. A combination of ≥2 endoscopic treatment modalities was used in 19 of 27 recurrences (70.4%). Surveillance colonoscopies were performed in 20 of 27 recurrences after endoscopic treatment. One (5.0%) had a re-recurrence and was treated by surgical resection because recurrence occurred at the appendiceal orifice. Nineteen of 20 lesions (95.0%) could be cured endoscopically, although 3 of the 19 showed second or third recurrences and were treated by repeat endoscopic resection.

Conclusions

The local recurrence rates after CEPMR and PEPMR were similar. Larger tumor size was an independent risk factor for local recurrence after EPMR. Endoscopic treatment of recurrences resulted in high cure rates, although combination methods were necessary in many cases.

Citations

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Review

Sedation for routine gastrointestinal endoscopic procedures: a review on efficacy, safety, efficiency, cost and satisfaction: Otto S. Lin; Intest Res 2017;15(4):456-466. Published online October 23, 2017; DOI: https://doi.org/10.5217/ir.2017.15.4.456

Abstract PDF PubReader ePub

Most gastrointestinal endoscopic procedures are now performed with sedation. Moderate sedation using benzodiazepines and opioids continue to be widely used, but propofol sedation is becoming more popular because its unique pharmacokinetic properties make endoscopy almost painless, with a very predictable and rapid recovery process. There is controversy as to whether propofol should be administered only by anesthesia professionals (monitored anesthesia care) or whether properly trained non-anesthesia personnel can use propofol safely via the modalities of nurse-administered propofol sedation, computer-assisted propofol sedation or nurse-administered continuous propofol sedation. The deployment of non-anesthesia administered propofol sedation for low-risk procedures allows for optimal allocation of scarce anesthesia resources, which can be more appropriately used for more complex cases. This can address some of the current shortages in anesthesia provider supply, and can potentially reduce overall health care costs without sacrificing sedation quality. This review will discuss efficacy, safety, efficiency, cost and satisfaction issues with various modes of sedation for non-advanced, non-emergent endoscopic procedures, mainly esophagogastroduodenoscopy and colonoscopy.

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Original Articles

Miss rate of colorectal neoplastic polyps and risk factors for missed polyps in consecutive colonoscopies: Nam Hee Kim, Yoon Suk Jung, Woo Shin Jeong, Hyo-Joon Yang, Soo-Kyung Park, Kyuyong Choi, Dong Il Park; Intest Res 2017;15(3):411-418. Published online June 12, 2017; DOI: https://doi.org/10.5217/ir.2017.15.3.411

Abstract PDF PubReader ePub

Background/Aims

Colonoscopic polypectomy is the best diagnostic and therapeutic tool to detect and prevent colorectal neoplasms. However, previous studies have reported that 17% to 28% of colorectal polyps are missed during colonoscopy. We investigated the miss rate of neoplastic polyps and the factors associated with missed polyps from quality-adjusted consecutive colonoscopies.

Methods

We reviewed the medical records of patients who were found to have colorectal polyps at a medical examination center of the Kangbuk Samsung Hospital between March 2012 and February 2013. Patients who were referred to a single tertiary academic medical center and underwent colonoscopic polypectomy on the same day were enrolled in our study. The odds ratios (ORs) associated with polyp-related and patient-related factors were evaluated using logistic regression analyses.

Results

A total of 463 patients and 1,294 neoplastic polyps were analyzed. The miss rates for adenomas, advanced adenomas, and carcinomas were 24.1% (312/1,294), 1.2% (15/1,294), and 0% (0/1,294), respectively. Flat/sessile-shaped adenomas (adjusted OR, 3.62; 95% confidence interval [CI], 2.40–5.46) and smaller adenomas (adjusted OR, 5.63; 95% CI, 2.84– 11.15 for ≤5 mm; adjusted OR, 3.18; 95% CI, 1.60–6.30 for 6–9 mm, respectively) were more frequently missed than pedunculated/sub-pedunculated adenomas and larger adenomas. In patients with 2 or more polyps compared with only one detected (adjusted OR, 2.37; 95% CI, 1.55–3.61 for 2–4 polyps; adjusted OR, 11.52; 95% CI, 4.61–28.79 for ≥5 polyps, respectively) during the first endoscopy, the risk of missing an additional polyp was significantly higher.

Conclusions

One-quarter of neoplastic polyps was missed during colonoscopy. We encourage endoscopists to detect smaller and flat or sessile polyps by using the optimal withdrawal technique.

Citations

Citations to this article as recorded by

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Colonic dysmotility and morphological abnormality frequently detected in Japanese patients with irritable bowel syndrome: Takeshi Mizukami, Shinya Sugimoto, Tatsuhiro Masaoka, Hidekazu Suzuki, Takanori Kanai; Intest Res 2017;15(2):236-243. Published online April 27, 2017; DOI: https://doi.org/10.5217/ir.2017.15.2.236

Abstract PDF PubReader ePub

Background/Aims

Colonoscopy and computed tomography (CT) are used primarily to exclude organic diseases in patients with irritable bowel syndrome (IBS), rather than to assess the pathophysiology of IBS. We aimed to evaluate colonic dysmotility and morphology in Japanese patients with IBS.

Methods

One hundred eighty-four patients with IBS and 49 asymptomatic controls who underwent colonoscopy in combination with CT colonography or barium enema were retrospectively reviewed between 2008 and 2012. Water-aided colonoscopy was performed without sedation by a single endoscopist. The duration and pattern of colonic movement and cecal intubation time were recorded. To assess colonic morphology, barium enema or CT colonography were performed immediately after colonoscopy.

Results

Colonic dysmotility was more frequent in the IBS group (28.8% vs. 2.0% in controls, P<0.001), especially in cases of IBS with diarrhea (IBS-D) (IBS with constipation [IBS-C] 28.8% vs. IBS-D 60.0% vs. mixed IBS [IBS-M] 5.1%, P<0.001). Colonic morphological abnormality was more frequent in the IBS group than in the control group (77.7% vs. 24.5%, P<0.001), especially in IBS-M and IBS-C groups (IBS-C 77.5% vs. IBS-D 48.9% vs. IBS-M 100%, P<0.001). Most patients with IBS with colonic dysmotility had experienced stress related to their symptoms. Cecal intubation time was significantly longer in the IBS group than in the control group (12.1±6.9 minutes vs. 4.6±1.9 minutes, P<0.001).

Conclusions

Unsedated colonoscopy, combined with radiographic findings, can detect colonic dysmotility and morphological abnormality. Technical difficulties observed during cecal intubation may partially explain the pathophysiology of IBS.

Citations

Citations to this article as recorded by

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Clinical outcome of endoscopic management in delayed postpolypectomy bleeding: Jeong-Mi Lee, Wan Soo Kim, Min Seob Kwak, Sung-Wook Hwang, Dong-Hoon Yang, Seung-Jae Myung, Suk-Kyun Yang, Jeong-Sik Byeon; Intest Res 2017;15(2):221-227. Published online April 27, 2017; DOI: https://doi.org/10.5217/ir.2017.15.2.221

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Background/Aims

The clinical course after endoscopic management of delayed postpolypectomy bleeding (DPPB) has not been clearly determined. This study aimed to assess clinical outcomes after endoscopic hemostasis of DPPB and evaluate risk factors for rebleeding after initial hemostasis.

Methods

We reviewed medical records of 198 patients who developed DPPB and underwent endoscopic hemostasis between January 2010 and February 2015. The performance of endoscopic hemostasis was assessed. Rebleeding negative and positive patients were compared.

Results

DPPB developed 1.4±1.6 days after colonoscopic polypectomy. All patients achieved initial hemostasis. Clipping was the most commonly used technique. Of 198 DPPB patients, 15 (7.6%) had rebleeding 3.3±2.5 days after initial hemostasis. The number of clips required for hemostasis was higher in the rebleeding positive group (3.2±1.6 vs. 4.2±1.9, P=0.047). Combinations of clipping with other modalities such as injection methods were more common in the rebleeding positive group (67/291, 23.0% vs. 12/17, 70.6%; P<0.001). Multivariate analysis showed a large number of clips and combination therapy were independent risk factors for rebleeding. All the rebleeding cases were successfully managed by repeat endoscopic hemostasis.

Conclusions

Endoscopic hemostasis is effective for the management of DPPB because of its high initial hemostasis rate and low rebleeding rate. Endoscopists should carefully observe patients in whom a large number of clips and/or combination therapy have been used to manage DPPB because these may be related to the severity of DPPB and a higher risk of rebleeding.

Citations

Citations to this article as recorded by

Delphi consensus statement for the management of delayed post-polypectomy bleeding
Enrique Rodríguez de Santiago, Sandra Pérez de la Iglesia, Diego de Frutos, José Carlos Marín-Gabriel, Carolina Mangas-SanJuan, Raúl Honrubia López, Hugo Uchima, Marta Aicart-Ramos, Miguel Ángel Rodríguez Gandía, Eduardo Valdivielso Cortázar, Felipe Ramos
Therapeutic Advances in Gastroenterology.2025;[Epub] CrossRef
Updates on the Prevention and Management of Post-Polypectomy Bleeding in the Colon
Hisham Wehbe, Aditya Gutta, Mark A. Gromski
Gastrointestinal Endoscopy Clinics of North America.2024; 34(2): 363. CrossRef
The Use of Clips to Prevent Post-Polypectomy Bleeding: A Clinical Review
Matthew A. O’Mara, Peter G. Emanuel, Aaron Tabibzadeh, Robert J. Duve, Jonathan S. Galati, Gregory Laynor, Samantha Gross, Seth A. Gross
Journal of Clinical Gastroenterology.2024; 58(8): 739. CrossRef
Is endoscopic hemostasis safe and effective for delayed post-polypectomy bleeding?
Jae-Yong Cho, Yunho Jung, Han Hee Lee, Jung-Wook Kim, Kee Myung Lee, Hyun Lim, Geun-Hyuk Choi, Seong Woo Choi, Bo-In Lee
International Journal of Gastrointestinal Intervention.2024; 13(4): 122. CrossRef
Endoscopic management of delayed bleeding after polypectomy of small colorectal polyps: two or more clips may be safe
Xue-Feng Guo, Xiang-An Yu, Jian-Cong Hu, De-Zheng Lin, Jia-Xin Deng, Ming-Li Su, Juan Li, Wei Liu, Jia-Wei Zhang, Qing-Hua Zhong
Gastroenterology Report.2022;[Epub] CrossRef
Management and Outcomes of Bleeding Within 30 Days of Colonic Polypectomy in a Large, Real-Life, Multicenter Cohort Study
Enrique Rodríguez de Santiago, Maria Hernández-Tejero, Liseth Rivero-Sánchez, Oswaldo Ortiz, Irene García de la Filia-Molina, Jose Ramon Foruny-Olcina, Hector Miguel Marcos Prieto, Maria García-Prada, Almudena González-Cotorruelo, Miguel Angel De Jorge Tu
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A. Rajendran, S. Pannick, S. Thomas‐Gibson, S. Oke, C. Anele, N. Sevdalis, A. Haycock
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Child-Pugh B or C Cirrhosis Increases the Risk for Bleeding Following Colonoscopic Polypectomy
Hosim Soh, Jaeyoung Chun, Seung Wook Hong, Seona Park, Yun Bin Lee, Hyun Jung Lee, Eun Ju Cho, Jeong-Hoon Lee, Su Jong Yu, Jong Pil Im, Yoon Jun Kim, Joo Sung Kim, Jung-Hwan Yoon
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Post-polypectomy Visible Vessel
Matthew Woo, Robert Bechara
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Tae-Geun Gweon, Jinsu Kim
International Journal of Gastrointestinal Intervention.2018; 7(3): 123. CrossRef

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Clinical outcomes of sigmoid colon volvulus: identification of the factors associated with successful endoscopic detorsion: Tomoya Iida, Suguru Nakagaki, Shuji Satoh, Haruo Shimizu, Hiroyuki Kaneto, Hiroshi Nakase; Intest Res 2017;15(2):215-220. Published online April 27, 2017; DOI: https://doi.org/10.5217/ir.2017.15.2.215

Abstract PDF PubReader ePub

Background/Aims

Although multiple treatment options exist for the management of sigmoid colon volvulus, no study has examined the factors associated with successful endoscopic detorsion. This study aimed to examine the clinical course of patients with sigmoid colon volvulus and to identify factors related to successful endoscopic detorsion.

Methods

This study included 30 cases (21 patients) of sigmoid volvulus from among 545 cases of intestinal obstruction at a single center. We retrospectively examined the clinical course and the factors associated with the possibility of endoscopic detorsion of sigmoid colon volvulus.

Results

The rate of laxative use among the study participants was 76.2%; the rate of comorbid neuropsychiatric disorders was 61.9%; and 57.1% of patients had a history of open abdominal surgery. All patients were initially treated with endoscopic detorsion, and this procedure had a 61.9% success rate. The recurrence rate after detorsion was as high as 46.2%, but detorsion during revision endoscopy was possible in all cases. Statistical analysis revealed that the absence of abdominal tenderness (P=0.027), the use of laxatives (P=0.027), and a history of open abdominal surgery (P=0.032) were factors predictive of successful endoscopic detorsion.

Conclusions

The results of our study are consistent with previous reports with respect to the success rate of endoscopic detorsion, the subsequent recurrence rate, and the proportion of patients requiring surgical treatment. In addition, we identified the absence of abdominal tenderness, the use of laxatives, and history of open abdominal surgery as factors predicting successful endoscopic detorsion of sigmoid colon volvulus.

Citations

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Review

Current status of endoscopic balloon dilation for Crohn's disease: Fumihito Hirai; Intest Res 2017;15(2):166-173. Published online April 27, 2017; DOI: https://doi.org/10.5217/ir.2017.15.2.166

Abstract PDF PubReader ePub

The therapeutic target in Crohn's disease (CD) has been raised to the achievement of mucosal healing. Although effective treatments that target cytokines and other molecules has been widely used for CD, intestinal strictures are still a major cause of surgery. Endoscopic balloon dilation (EBD) is known to be an effective and safe intervention for intestinal strictures in CD. Since frequent intestinal resection often results in short bowel syndrome and can decrease the quality of life, EBD can help avoid surgery. EBD with a conventional colonoscope for Crohn's strictures of the colon and ileo-colonic anastomosis has established efficacy and safety. In addition, EBD using balloon-assisted enteroscopy has recently been applied for small bowel Crohn's strictures. Although the evidence is not strong, EBD may become an alternative to surgery in small bowel strictures in CD. EBD and other new methods such as self-expanding stent implantation for Crohn's strictures may be useful and safe; however, it is important to address several issues regarding these interventions and to establish a protocol for combined therapies.

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Original Article

15-Hydroxyprostaglandin dehydrogenase as a marker in colon carcinogenesis: analysis of the prostaglandin pathway in human colonic tissue: Dong-Hoon Yang, Yeon-Mi Ryu, Sun-Mi Lee, Jin-Yong Jeong, Soon Man Yoon, Byong Duk Ye, Jeong-Sik Byeon, Suk-Kyun Yang, Seung-Jae Myung; Intest Res 2017;15(1):75-82. Published online January 31, 2017; DOI: https://doi.org/10.5217/ir.2017.15.1.75

Abstract PDF PubReader ePub

Background/Aims

Cyclooxygenase-2 (COX-2), 15-hydroxyprostaglandin dehydrogenase (15-PGDH), and microsomal prostaglandin E synthase-1 (mPGEs-1) regulate prostaglandin E₂ (PGE₂) expression and are involved in colon carcinogenesis. We investigated the expression of PGE₂ and its regulating genes in sporadic human colon tumors and matched normal tissues.

Methods

Twenty colonic adenomas and 27 colonic adenocarcinomas were evaluated. COX-2 and 15-PGDH expression was quantified by real-time polymerase chain reaction. The expression of PGE₂ and mPGEs-1 was measured using enzyme-linked immunosorbent assay and Western blotting, respectively.

Results

The expression of COX-2, mPGEs-1, and PGE₂ did not differ between the adenomas and matched distant normal tissues. 15-PGDH expression was lower in adenomas than in the matched normal colonic tissues (P<0.001). In adenocarcinomas, mPGEs-1 and PGE₂ expression was significantly higher (P<0.001 and P=0.020, respectively), and COX-2 expression did not differ from that in normal tissues (P=0.207). 15-PGDH expression was significantly lower in the normal colonic mucosa from adenocarcinoma patients than in the normal mucosa from adenoma patients (P=0.018).

Conclusions

Early inactivation of 15-PGDH, followed by activation of COX-2 and mPGEs-1, contributes to PGE₂ production, leading to colon carcinogenesis. 15-PGDH might be a novel candidate marker for early detection of field defects in colon carcinogenesis.

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The prostanoid pathway contains potential prognostic markers for glioblastoma
Alexandros Theodoros Panagopoulos, Renata Nascimento Gomes, Fernando Gonçalves Almeida, Felipe da Costa Souza, José Carlos Esteves Veiga, Anna Nicolaou, Alison Colquhoun
Prostaglandins & Other Lipid Mediators.2018; 137: 52. CrossRef

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Case Report

Crohn's disease with ankylosing spondylitis in an adolescent patient who had undergone long ileo-colonic anastomosis for Hirschsprung's disease as an infant: Ha Yeon Kim, Tae Wook Kim; Intest Res 2017;15(1):133-137. Published online January 31, 2017; DOI: https://doi.org/10.5217/ir.2017.15.1.133

Abstract PDF PubReader ePub

Crohn's disease (CD) is a chronic, idiopathic, inflammatory disorder of the gastrointestinal tract. In rare cases, CD has been associated with Hirschsprung's disease (HD); however, the underlying pathophysiology of this and other comorbidities is not yet fully understood. In this report, we describe the case of a 17-year-old patient who was diagnosed with both CD and ankylosing spondylitis (AS), having undergone a long ileo-colonic anastomosis to treat HD at 12 months of age. To our knowledge, this is the first documented case of CD combined with AS in a patient with HD.

Citations

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The Frequency and Characteristics of Inflammatory Bowel Disease in Pediatric Patients with Hirschsprung's Disease: A Case-Control Study
Naghi Dara, Niloofar Ziba, Leily Mohajerzadeh, Yasaman Zarinfar, Arshia Dara, Amirhossein Hosseini, Saleheh Tajalli, Nathalia Sernizon Guimarães, Mohammadreza Esmaeili Dooki, Mahmoud Hajipour, Farid Imanzadeh
Gastroenterology & Endoscopy.2025;[Epub] CrossRef
Crohn’s disease in patients with Hirschsprung disease and Hirschsprung-associated enterocolitis: A review
Victoria A. Glushkova, Aleksey V. Podkamenev, Tatyana V. Gabrusskaya
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care.2024; 14(1): 97. CrossRef
Transcriptome profiling of intact bowel wall reveals that PDE1A and SEMA3D are possible markers with roles in enteric smooth muscle apoptosis, proliferative disorders, and dysautonomia in Crohn’s disease
Yun Yang, Lin Xia, Wenming Yang, Ziqiang Wang, Wenjian Meng, Mingming Zhang, Qin Ma, Junhe Gou, Junjian Wang, Ye Shu, Xiaoting Wu
Frontiers in Genetics.2023;[Epub] CrossRef
A unicentric cross-sectional observational study on chronic intestinal inflammation in total colonic aganglionosis: beware of an underestimated condition
M Erculiani, F Poluzzi, G Mottadelli, E Felici, Novi ML, M Caraccia, A Grandi, S Casella, L Giacometti, G Montobbio, I Ceccherini, E Di Marco, C Bonaretti, R Biassoni, M Squillario, A Pietrantoni, V Villanacci, A Pini Prato
Orphanet Journal of Rare Diseases.2023;[Epub] CrossRef
Clinical characteristics and validation of diagnosis in individuals with Hirschsprung disease and inflammatory bowel disease
Anna Löf Granström, Jonas F Ludvigsson, Tomas Wester
Journal of Pediatric Surgery.2021; 56(10): 1799. CrossRef
Crohn-Like Colitis in a Young Boy With Hirschsprung Disease
Alessandra Verde, Angelina Grammegna, Emma Petrone, Augusto Mastrominico, Daniele De Brasi, Claudia Mandato, Giusy Ranucci, Maria Simona Sabbatino, Michelina Sibilio, Paolo Quitadamo
Inflammatory Bowel Diseases.2021; 27(9): e112. CrossRef
Inflammatory bowel disease in patients with Hirschsprung’s disease: a systematic review and meta-analysis
H. Nakamura, T. Lim, P. Puri
Pediatric Surgery International.2018; 34(2): 149. CrossRef
Increased Risk of Inflammatory Bowel Disease in a Population‐based Cohort Study of Patients With Hirschsprung Disease
Anna Löf Granström, Leila Amin, Henrik Arnell, Tomas Wester
Journal of Pediatric Gastroenterology and Nutrition.2018; 66(3): 398. CrossRef

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Original Articles

Determining the optimal surveillance interval after a colonoscopic polypectomy for the Korean population?: Jung Lok Lee, Jae Myung Cha, Hye Min Lee, Jung Won Jeon, Min Seob Kwak, Jin Young Yoon, Hyun Phil Shin, Kwang Ro Joo, Joung Il Lee, Dong Il Park; Intest Res 2017;15(1):109-117. Published online January 31, 2017; DOI: https://doi.org/10.5217/ir.2017.15.1.109

Abstract PDF PubReader ePub

Background/Aims

Western surveillance strategies cannot be directly adapted to the Korean population. The aim of this study was to estimate the risk of metachronous neoplasia and the optimal surveillance interval in the Korean population.

Methods

Clinical and pathological data from index colonoscopy performed between June 2006 and July 2008 and who had surveillance colonoscopies up to May 2015 were compared between low- and high-risk adenoma (LRA and HRA) groups. The 3- and 5-year cumulative risk of metachronous colorectal neoplasia in both groups were compared.

Results

Among 895 eligible patients, surveillance colonoscopy was performed in 399 (44.6%). Most (83.3%) patients with LRA had a surveillance colonoscopy within 5 years and 70.2% of patients with HRA had a surveillance colonoscopy within 3 years. The cumulative risk of metachronous advanced adenoma was 3.2% within 5 years in the LRA group and only 1.7% within 3 years in the HRA group. The risk of metachronous neoplasia was similar between the surveillance interval of <5 and ≥5 years in the LRA group; however, it was slightly higher at surveillance interval of ≥3 than <3 years in the HRA group (9.4% vs. 2.4%). In multivariate analysis, age and the ≥3-year surveillance interval were significant independent risk factors for metachronous advanced adenoma (P=0.024 and P=0.030, respectively).

Conclusions

Patients had a surveillance colonoscopy before the recommended guidelines despite a low risk of metachronous neoplasia. However, the risk of metachronous advanced adenoma was increased in elderly patients and those with a ≥3-year surveillance interval.

Citations

Citations to this article as recorded by

Risk of developing metachronous colorectal neoplasia after the resection of proximal versus distal adenomas
Yoon Suk Jung, Nam Hee Kim, Youngwoo Kim, Dong Il Park
Digestive and Liver Disease.2022; 54(4): 537. CrossRef
Post-polypectomy surveillance interval and advanced neoplasia detection rates: a multicenter, retrospective cohort study
Amanda J. Cross, Emma C. Robbins, Kevin Pack, Iain Stenson, Matthew D. Rutter, Andrew M. Veitch, Brian P. Saunders, Stephen W. Duffy, Kate Wooldrage
Endoscopy.2022; 54(10): 948. CrossRef
Comparison of Risk of Metachronous Advanced Colorectal Neoplasia in Patients with Sporadic Adenomas Aged < 50 Versus ≥ 50 years: A Systematic Review and Meta-Analysis
Yoon Suk Jung, Jung Ho Park, Chan Hyuk Park
Journal of Personalized Medicine.2021; 11(2): 120. CrossRef
British Society of Gastroenterology/Association of Coloproctology of Great Britain and Ireland/Public Health England post-polypectomy and post-colorectal cancer resection surveillance guidelines
Matthew D Rutter, James East, Colin J Rees, Neil Cripps, James Docherty, Sunil Dolwani, Philip V Kaye, Kevin J Monahan, Marco R Novelli, Andrew Plumb, Brian P Saunders, Siwan Thomas-Gibson, Damian J M Tolan, Sophie Whyte, Stewart Bonnington, Alison Scope,
Gut.2020; 69(2): 201. CrossRef
Urine-NMR metabolomics for screening of advanced colorectal adenoma and early stage colorectal cancer
Eun Ran Kim, Hyuk Nam Kwon, Hoonsik Nam, Jae J. Kim, Sunghyouk Park, Young-Ho Kim
Scientific Reports.2019;[Epub] CrossRef
A Comparison of the Cumulative Incidences of Metachronous Colorectal Adenoma and Cancer According to the Initial FindingsAmong Colonoscopically Followed-up Patients
Seiji Kimura, Masanori Tanaka, Shinsaku Fukuda
Nippon Daicho Komonbyo Gakkai Zasshi.2019; 72(6): 395. CrossRef
Impact of obesity and metabolic abnormalities on the risk of metachronous colorectal neoplasia after polypectomy in men
Nam Hee Kim, Yoon Suk Jung, Jung Ho Park, Dong Il Park, Chong Il Sohn
Journal of Gastroenterology and Hepatology.2019; 34(9): 1504. CrossRef
Risk of developing metachronous advanced colorectal neoplasia after colonoscopic polypectomy in patients aged 30 to 39 and 40 to 49 years
Nam Hee Kim, Yoon Suk Jung, Jung Ho Park, Dong Il Park, Chong Il Sohn
Gastrointestinal Endoscopy.2018; 88(4): 715. CrossRef
Quality is the Key for Emerging Issues of Population-Based Colonoscopy Screening
Jin Young Yoon, Jae Myung Cha, Yoon Tae Jeen
Clinical Endoscopy.2018; 51(1): 50. CrossRef
Histologic discrepancy between endoscopic forceps biopsy and endoscopic mucosal resection specimens of colorectal polyp in actual clinical practice
Moon Joo Hwang, Kyeong Ok Kim, A Lim Kim, Si Hyung Lee, Byung Ik Jang, Tae Nyeun Kim
Intestinal Research.2018; 16(3): 475. CrossRef
Quality is the key for emerging issues of population-based colonoscopy screening
Jin Young Yoon, Jae Myung Cha, Yoon Tae Jeen
Intestinal Research.2018; 16(1): 48. CrossRef

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A wide variation of the quality of colonoscopy reporting system in the real clinical practice in southeastern area of Korea: Jung Min Lee, Yu Jin Kang, Eun Soo Kim, Yoo Jin Lee, Kyung Sik Park, Kwang Bum Cho, Seong Woo Jeon, Min Kyu Jung, Hyun Seok Lee, Eun Young Kim, Jin Tae Jung, Byung Ik Jang, Kyeong Ok Kim, Yun Jin Chung, Chang Hun Yang; Intest Res 2016;14(4):351-357. Published online October 17, 2016; DOI: https://doi.org/10.5217/ir.2016.14.4.351

Abstract PDF PubReader

Background/Aims

Establishment of a colonoscopy reporting system is a prerequisite to determining and improving quality. This study aimed to investigate colonoscopists' opinions and the actual situation of a colonoscopy reporting system in a clinical practice in southeastern area of Korea and to assess the factors predictive of an inadequate reporting system.

Methods

Physicians who performed colonoscopies in the Daegu-Gyeongbuk province of Korea and were registered with the Korean Society of Gastrointestinal Endoscopy (KSGE) were interviewed via mail about colonoscopy reporting systems using a standardized questionnaire.

Results

Of 181 endoscopists invited to participate, 125 responded to the questionnaires (response rate, 69%). Most responders were internists (105/125, 84%) and worked in primary clinics (88/125, 70.4%). Seventy-one specialists (56.8%) held board certifications for endoscopy from the KSGE. A median of 20 colonoscopies (interquartile range, 10–47) was performed per month. Although 88.8% of responders agreed that a colonoscopy reporting system is necessary, only 18.4% (23/125) had achieved the optimal reporting system level recommended by the Quality Assurance Task Group of the National Colorectal Cancer Roundtable. One-third of endoscopists replied that they did not use a reporting document for the main reasons of "too busy" and "inconvenience." Non-endoscopy specialists and primary care centers were independent predictive factors for failure to use a colonoscopy reporting system.

Conclusions

The quality of colonoscopy reporting systems varies widely and is considerably suboptimal in actual clinical practice settings in southeastern Korea, indicating considerable room for quality improvements in this field.

Citations

Citations to this article as recorded by

Association of Poor Differentiation or Positive Vertical Margin with Residual Disease in Patients with Subsequent Colectomy after Complete Macroscopic Endoscopic Resection of Early Colorectal Cancer
Ki Ju Kim, Hyun Seok Lee, Seong Woo Jeon, Sun Jin, Sang Won Lee
Gastroenterology Research and Practice.2017; 2017: 1. CrossRef
Derivation and validation of a risk scoring model to predict advanced colorectal neoplasm in adults of all ages
Hyo‐Joon Yang, Sungkyoung Choi, Soo‐Kyung Park, Yoon Suk Jung, Kyu Yong Choi, Taesung Park, Ji Yeon Kim, Dong Il Park
Journal of Gastroenterology and Hepatology.2017; 32(7): 1328. CrossRef
Screening strategy for colorectal cancer according to risk
Dong Soo Han
Journal of the Korean Medical Association.2017; 60(11): 893. CrossRef

8,583 View
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3 Crossref

Characteristics and outcomes of endoscopically resected colorectal cancers that arose from sessile serrated adenomas and traditional serrated adenomas: Ji Yeon Seo, Seung Ho Choi, Jaeyoung Chun, Changhyun Lee, Ji Min Choi, Eun Hyo Jin, Sung Wook Hwang, Jong Pil Im, Sang Gyun Kim, Joo Sung Kim; Intest Res 2016;14(3):270-279. Published online June 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.3.270

Abstract PDF PubReader ePub

Background/Aims

The efficacy and safety of endoscopic resection of colorectal cancer derived from sessile serrated adenomas or traditional serrated adenomas are still unknown. The aims of this study were to verify the characteristics and outcomes of endoscopically resected early colorectal cancers developed from serrated polyps.

Methods

Among patients who received endoscopic resection of early colorectal cancers from 2008 to 2011, cancers with documented pre-existing lesions were included. They were classified as adenoma, sessile serrated adenoma, or traditional serrated adenoma according to the baseline lesions. Clinical characteristics, pathologic diagnosis, and outcomes were reviewed.

Results

Overall, 208 colorectal cancers detected from 198 patients were included: 198 with adenoma, five with sessile serrated adenoma, and five with traditional serrated adenoma. The sessile serrated adenoma group had a higher prevalence of high-grade dysplasia (40.0% vs. 25.8%, P<0.001) than the adenoma group. During follow-up, local recurrence did not occur after endoscopic resection of early colorectal cancers developed from serrated polyps. In contrast, two cases of metachronous recurrence were detected within a short follow-up period.

Conclusions

Cautious observation and early endoscopic resection are recommended when colorectal cancer from serrated polyp is suspected. Colorectal cancers from serrated polyp can be treated successfully with endoscopy.

Citations

Citations to this article as recorded by

Association of lifestyle and dietary preferences with precancerous serrated polyps: a hospital-based case-control study in Guangzhou, China
Shaoyu Cheng, Liji Chen, Shujun Liu, Haiyan Zhang, Cailing Zhong, Tianwen Liu
BMC Gastroenterology.2025;[Epub] CrossRef
Small sessile serrated polyps might not be at a higher risk for future advanced neoplasia than low-risk adenomas or polyp-free groups
Eun Hyo Jin, Ji Yeon Seo, Jung Ho Bae, Jooyoung Lee, Ji Min Choi, Yoo Min Han, Joo Hyun Lim
Scandinavian Journal of Gastroenterology.2022; 57(1): 99. CrossRef
The incidence and risk factors of sessile serrated adenomas in left side colon cancer patients after curative surgery
Myung Hee Kim, Hee Seok Moon, In Sun Kwon, Ju Seok Kim, Sun Hyung Kang, Jae Kyu Sung, Eaum Seok Lee, Seok Hyun Kim, Byung Seok Lee, Hyun Yong Jeong
Medicine.2020; 99(29): e20799. CrossRef
Improved Real-Time Optical Diagnosis of Colorectal Polyps Following a Comprehensive Training Program
Jung Ho Bae, Changhyun Lee, Hae Yeon Kang, Min-Sun Kwak, Eun Young Doo, Ji Yeon Seo, Ji Hyun Song, Sun Young Yang, Jong In Yang, Seon Hee Lim, Jeong Yoon Yim, Joo Hyun Lim, Goh Eun Chung, Su Jin Chung, Eun Hyo Jin, Boram Park, Joo Sung Kim
Clinical Gastroenterology and Hepatology.2019; 17(12): 2479. CrossRef
Clinical outcomes of surveillance colonoscopy for patients with sessile serrated adenoma
Sung Jae Park, Hyuk Yoon, In Sub Jung, Cheol Min Shin, Young Soo Park, Na Young Kim, Dong Ho Lee
Intestinal Research.2018; 16(1): 134. CrossRef
Surveillance colonoscopy in patients with sessile serrated adenoma
Ji Hyung Nam, Hyoun Woo Kang
Intestinal Research.2018; 16(3): 502. CrossRef
Identification of risk factors for sessile and traditional serrated adenomas of the colon by using big data analysis
Jeung Hui Pyo, Sang Yun Ha, Sung Noh Hong, Dong Kyung Chang, Hee Jung Son, Kyoung‐Mee Kim, Hyeseung Kim, Kyunga Kim, Jee Eun Kim, Yoon‐Ho Choi, Young‐Ho Kim
Journal of Gastroenterology and Hepatology.2018; 33(5): 1039. CrossRef
Endoscopic Resection of Cecal Polyps Involving the Appendiceal Orifice: A KASID Multicenter Study
Eun Mi Song, Hyo-Joon Yang, Hyun Jung Lee, Hyun Seok Lee, Jae Myung Cha, Hyun Gun Kim, Yunho Jung, Chang Mo Moon, Byung Chang Kim, Jeong-Sik Byeon
Digestive Diseases and Sciences.2017; 62(11): 3138. CrossRef
Is colorectal cancer screening necessary before 50 years of age?
Yoon Suk Jung
Intestinal Research.2017; 15(4): 550. CrossRef
Derivation and validation of a risk scoring model to predict advanced colorectal neoplasm in adults of all ages
Hyo‐Joon Yang, Sungkyoung Choi, Soo‐Kyung Park, Yoon Suk Jung, Kyu Yong Choi, Taesung Park, Ji Yeon Kim, Dong Il Park
Journal of Gastroenterology and Hepatology.2017; 32(7): 1328. CrossRef
Risk factors of missed colorectal lesions after colonoscopy
Jeonghun Lee, Sung Won Park, You Sun Kim, Kyung Jin Lee, Hyun Sung, Pil Hun Song, Won Jae Yoon, Jeong Seop Moon
Medicine.2017; 96(27): e7468. CrossRef

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Comparison of the efficacy of disinfectants in automated endoscope reprocessors for colonoscopes: tertiary amine compound (Sencron2®) versus ortho-phthalaldehyde (Cidex®OPA): Hyun Il Seo, Dae Sung Lee, Eun Mi Yoon, Min-Jung Kwon, Hyosoon Park, Yoon Suk Jung, Jung Ho Park, Chong Il Sohn, Dong Il Park; Intest Res 2016;14(2):178-182. Published online April 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.2.178

Abstract PDF PubReader ePub

Background/Aims

To prevent the transmission of pathogens by endoscopes, following established reprocessing guidelines is critical. An ideal reprocessing step is simple, fast, and inexpensive. Here, we evaluated and compared the efficacy and safety of two disinfectants, a tertiary amine compound (TAC) and ortho-phthalaldehyde (OPA).

Methods

A total of 100 colonoscopes were randomly reprocessed using two same automated endoscope reprocessors, according to disinfectant. The exposure time was 10 minutes for 0.55% OPA (Cidex® OPA, Johnson & Johnson) and 5 minutes for 4% TAC (Sencron2®, Bab Gencel Pharma & Chemical Ind. Co.). Three culture samples were obtained from each colonoscope after reprocessing.

Results

A total of nine samples were positive among the 300 culture samples. The positive culture rate was not statistically different between the two groups (4% for OPA and 2% for TAC, P=0.501). There were no incidents related to safety during the study period.

Conclusions

TAC was non-inferior in terms of reprocessing efficacy to OPA and was safe to use. Therefore, TAC seems to be a good alternative disinfectant with a relatively short exposure time and is also less expensive than OPA.

Citations

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What doesn’t kill biofilm, makes them stronger: critical methodological considerations for endoscope reprocessing
R. Kanaujia, A. Sharma, M. Biswal, V. Singh
Journal of Hospital Infection.2025; 156: 135. CrossRef
Synthesis, Characterization and Investigation of Antimicrobial Activity of Orthophtaldehyde Nanoflowers
Gülten CAN SEZGİN, Nilay ILDİZ
Middle Black Sea Journal of Health Science.2023; 9(2): 245. CrossRef
A Manufacturer and User Facility Device Experience Analysis of Upper Aerodigestive Endoscopy Contamination: Is Flexible Laryngoscopy Different?
Roy Jiang, David A. Kasle, Faisal Alzahrani, Nikita Kohli, Michael Z. Lerner
The Laryngoscope.2021; 131(3): 598. CrossRef
Electrochemical and Spectrometric Study of Reactivity of Orthophthalaldehyde with Hydroxylamine: Mechanistic Considerations
Joël Donkeng‐Dazie, Jiří Urban, Jiří Ludvík
ChemistrySelect.2021; 6(20): 4881. CrossRef
Reactivity of orthophthalaldehyde with aliphatic, alicyclic and aromatic primary diamines: Electrochemical study and mechanistic considerations
Joël Donkeng Dazie, Alan Liška, Jiří Urban, Jiří Ludvík
Journal of Electroanalytical Chemistry.2018; 821: 131. CrossRef
Efficacy of Peracetic Acid (EndoPA®) for Disinfection of Endoscopes
Ji Min Lee, Kang-Moon Lee, Dae Bum Kim, Se Eun Go, Sungwoo Ko, Yoongoo Kang, Solim Hong
The Korean Journal of Gastroenterology.2018; 71(6): 319. CrossRef
Planarity of substituted pyrrole and furan rings in (3R*, 1′S*, 3′R*)-3-(1′-tert-butylamino-1′H, 3′ H-benzo[c]furan-3′-yl)-2-tert-butyl-2,3-dihydro-1H-benzo[c]pyrrol-1-one
Joel Donkeng Dazie, Alan Liška, Jiří Ludvík, Jan Fábry, Michal Dušek, Václav Eigner
Zeitschrift für Kristallographie - Crystalline Materials.2017; 232(6): 441. CrossRef

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7 Crossref

Do we need colonoscopy verification in patients with fundic gland polyp?: Hee Sook Lee, Younjeong Choi, Ja Young Jung, Young-Jun Sung, Dong Won Ahn, Ji Bong Jeong, Byeong Gwan Kim, Kook Lae Lee, Seong-Joon Koh, Ji Won Kim; Intest Res 2016;14(2):172-177. Published online April 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.2.172

Abstract PDF PubReader ePub

Background/Aims

The aim of this study was to evaluate the prevalence of colorectal neoplasia in subjects with fundic gland polyps (FGPs) and the relationship between FGPs and colorectal neoplasia in Korea.

Methods

We analyzed 128 consecutive patients with FPGs who underwent colonoscopy between January 2009 and December 2013. For each case, age- (±5 years) and sex-matched controls were identified from among patients with hyperplastic polyps, gastric neoplasms, and healthy controls. Clinical characteristics were reviewed from medical records, colonoscopic findings, pathologic findings, and computed tomography images. The outcome was evaluated by comparison of advanced colonic neoplasia detection rates.

Results

Of the 128 patients, seven (5.1%) had colon cancers and seven (5.1%) had advanced adenomas. A case-control study revealed that the odds of detecting a colorectal cancer was 3.8 times greater in patients with FGPs than in the age- and sex-matched healthy controls (odds ratio [OR], 3.80; 95% confidence interval [CI], 1.09–13.24; P =0.04) and 4.1 times greater in patients with FGPs than in healthy controls over 50 years of age (OR, 4.10; 95% CI, 1.16–14.45; P =0.04). Among patients with FGPs over 50 years old, male sex (OR, 4.83; 95% CI, 1.23–18.94; P =0.02), and age (OR, 9.90; 95% CI, 1.21–81.08; P =0.03) were associated with an increased prevalence of advanced colorectal neoplasms.

Conclusions

The yield of colonoscopy in colorectal cancer patients with FGPs was substantially higher than that in average-risk subjects. Colonoscopy verification is warranted in patients with FGPs, especially in those 50 years of age or older.

Citations

Citations to this article as recorded by

Current Guidelines and Advances in the Management of Fundic Gland Polyps
Majed Ali, Lynn Srour, Mustapha Bitar, Karam Karam, Ihab I. El Hajj, Elias Fiani
Journal of Gastroenterology and Hepatology.2025; 40(6): 1374. CrossRef
Cold snare polypectomy for fundic gland polyps
Chi‐Hung Chen, Jen‐Chieh Huang, Jeng‐Shiann Shin
Advances in Digestive Medicine.2022; 9(1): 17. CrossRef
Clinical features of fundic gland polyps and their correlation with colorectal tumors
Xue-Mei Yang, Hong Xu
World Chinese Journal of Digestology.2020; 28(20): 1036. CrossRef
Parietalzellhypertrophie und Drüsenkörperzysten
M. Venerito, A. Canbay, M. Vieth
Der Gastroenterologe.2018; 13(2): 90. CrossRef

8,531 View
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4 Crossref

Case Report

Refractory pseudomembranous colitis that was treated successfully with colonoscopic fecal microbial transplantation: Jun Young Shin, Eun Jung Ko, Seung Ho Lee, Jong Bum Shin, Shin Il Kim, Kye Sook Kwon, Hyung Gil Kim, Yong Woon Shin, Byoung Wook Bang; Intest Res 2016;14(1):83-88. Published online January 25, 2016; DOI: https://doi.org/10.5217/ir.2016.14.1.83

Abstract PDF PubReader ePub

Pseudomembranous colitis (PMC) is a nosocomial and opportunistic infection caused by Clostridium difficile. PMC is related to the use of antibiotics leading to intestinal dysbiosis and an overgrowth of C. difficile. Metronidazole or vancomycin is considered to be the standard therapy for the management of PMC. However, PMC has a 15%–30% recurrence rate and can be refractory to standard treatments, resulting in morbidity and mortality. Here we describe a patient who experienced refractory PMC who was treated with fecal microbiota transplantation. A 69-year-old woman was admitted to the hospital with consistent abdominal pain and diarrhea, which had been present for 5 months. She was diagnosed with PMC by colonoscopy and tested positive for C. difficile toxin. Even though she took metronidazole for 10 days, followed by vancomycin for 4 weeks, her symptoms did not improve. Because of her recurrent and refractory symptoms, we decided to perform fecal microbiota transplantation. Fifty grams of fresh feces from a donor were obtained on the day of the procedure, mixed with 500 mL of normal saline, and then filtered. The filtered solution was administered to the patient's colon using a colonoscope. After the procedure, her symptoms rapidly improved and a follow-up colonoscopy showed that the PMC had resolved without recurrence.

Citations

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Fecal microbiota transplantation: present and future
Ra Ri Cha, Irene Sonu
Clinical Endoscopy.2025; 58(3): 352. CrossRef
Fecal Microbiota Transplantation for Fulminant Clostridioides Difficile Infection: A Combined Medical and Surgical Case Series
Ellen J Spartz, Mina Estafanos, Reema Mallick, Wolfganag Gaertner, Victor Vakayil, Cyrus Jahansouz, Rishav Aggarwal, Sayeed Ikramuddin, Alexander Khoruts, James V Harmon
Cureus.2023;[Epub] CrossRef
Efficacy and Safety of Fecal Microbiota Transplantation for Clearance of Multidrug-Resistant Organisms under Multiple Comorbidities: A Prospective Comparative Trial
Jongbeom Shin, Jung-Hwan Lee, Soo-Hyun Park, Boram Cha, Kye Sook Kwon, Hyungkil Kim, Yong Woon Shin
Biomedicines.2022; 10(10): 2404. CrossRef
The evaluation of fecal microbiota transplantation vs vancomycin in a Clostridioides difficile infection model
Qiaomai Xu, Shumeng Zhang, Jiazheng Quan, Zhengjie Wu, Silan Gu, Yunbo Chen, Beiwen Zheng, Longxian Lv, Lanjuan Li
Applied Microbiology and Biotechnology.2022; 106(19-20): 6689. CrossRef
The gut microbiota and gut disease
Sasha R. Fehily, Chamara Basnayake, Emily K. Wright, Michael A. Kamm
Internal Medicine Journal.2021; 51(10): 1594. CrossRef
RecurrentClostridium difficileInfection: Risk Factors, Treatment, and Prevention
Jung Hoon Song, You Sun Kim
Gut and Liver.2019; 13(1): 16. CrossRef
Clostridium difficile in Asia: Opportunities for One Health Management
Deirdre A. Collins, Thomas V. Riley
Tropical Medicine and Infectious Disease.2018; 4(1): 7. CrossRef
Current challenges in the treatment of severe Clostridium difficile infection: early treatment potential of fecal microbiota transplantation
Yvette H. van Beurden, Max Nieuwdorp, Pablo J. E. J. van de Berg, Chris J. J. Mulder, Abraham Goorhuis
Therapeutic Advances in Gastroenterology.2017; 10(4): 373. CrossRef
Fecal microbiota transplant in severe and severe-complicatedClostridium difficile: A promising treatment approach
Monika Fischer, Brian Sipe, Yao-Wen Cheng, Emmalee Phelps, Nicholas Rogers, Sashidhar Sagi, Matthew Bohm, Huiping Xu, Zain Kassam
Gut Microbes.2017; 8(3): 289. CrossRef
Fecal Microbiota Transplantation for Refractory and RecurrentClostridium difficileInfection: A Case Series of Nine Patients
Byoung Wook Bang, Jin-Seok Park, Hyung Kil Kim, Yong Woon Shin, Kye Sook Kwon, Hea Yoon Kwon, Ji Hyeon Baek, Jin-Soo Lee
The Korean Journal of Gastroenterology.2017; 69(4): 226. CrossRef

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Original Article

Colon Transit Time May Predict Inadequate Bowel Preparation in Patients With Chronic Constipation: Hong Jun Park, Myeong Hun Chae, Hyun-Soo Kim, Jae Woo Kim, Moon Young Kim, Soon Koo Baik, Sang Ok Kwon, Hee Man Kim, Kyong Joo Lee; Intest Res 2015;13(4):339-345. Published online October 15, 2015; DOI: https://doi.org/10.5217/ir.2015.13.4.339

Abstract PDF PubReader ePub

Background/Aims

We evaluated whether colonic transit time (CTT) can predict the degree of bowel preparation in patients with chronic constipation undergoing scheduled colonoscopy in order to assist in the development of better bowel preparation strategies for these patients.

Methods

We analyzed the records of 160 patients with chronic constipation from March 2007 to November 2012. We enrolled patients who had undergone a CTT test followed by colonoscopy. We defined patients with a CTT ≥30 hours as the slow transit time (STT) group, and patients with a CTT <30 hours as the normal transit time (NTT) group. Boston Bowel Preparation Scale (BBPS) scores were compared between the STT and NTT groups.

Results

Of 160 patients with chronic constipation, 82 (51%) were included in the STT group and 78 (49%) were included in the NTT group. Patients with a BBPS score of <6 were more prevalent in the STT group than in the NTT group (31.7% vs. 10.3%, P=0.001). Multivariate analysis showed that slow CTT was an independent predictor of inadequate bowel preparation (odds ratio, 0.261; 95% confidence interval, 0.107-0.634; P=0.003). The best CTT cut-off value for predicting inadequate bowel preparation in patients with chronic constipation was 37 hours, as determined by receiver operator characteristic (ROC) curve analysis (area under the ROC curve: 0.676, specificity: 0.735, sensitivity: 0.643).

Conclusions

Patients with chronic constipation and a CTT >30 hours were at risk for inadequate bowel preparation. CTT measured prior to colonoscopy could be useful for developing individualized strategies for bowel preparation in patients with slow CTT, as these patients are likely to have inadequate bowel preparation.

Citations

Citations to this article as recorded by

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