Intestinal Research

Endoscopic radial incision and cutting using balloonassisted enteroscopy for small intestinal stenosis related to Crohn’s disease: a pilot study: Rintaro Moroi, Kotaro Nochioka, Satoshi Miyata, Hideya Iwaki, Hirofumi Chiba, Hiroshi Nagai, Yusuke Shimoyama, Takeo Naito, Hisashi Shiga, Masaki Tosa, Yoichi Kakuta, Shoichi Kayaba, Seiichi Takahashi, Yoshitaka Kinouchi, Atsushi Masamune; Received September 11, 2024 Accepted October 24, 2024 Published online January 21, 2025; DOI: https://doi.org/10.5217/ir.2024.00143 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Background/Aims
Radial incision and cutting (RIC) is an alternative dilation method for stenosis of the lower gastrointestinal tract. However, its safety and efficacy for the small intestine requiring balloon-assisted enteroscopy (BAE) remain limited. Therefore, this pilot study aimed to evaluate the safety and efficacy of RIC using BAE.
Methods
We included 10 patients with Crohn’s disease and performed 12 sessions of RIC for 10 lesions. The rate of adverse events 1 month after RIC was the primary outcome, whereas short- and long-term prognoses and improvements in subjective symptoms that were evaluated using a visual analog scale were the secondary outcomes.
Results
The technical success rate for RIC, defined as scope passage immediately following the procedure, was 100% (12/12). The rates of delayed bleeding and perforation were 0% (0/12). One patient developed restenosis because of the worsening of Crohn’s disease and underwent surgery 2 months after RIC. The cumulative restenosis-, reintervention-, and surgery-free rates at 1 year after RIC were 67.5%, 78.7%, and 90.0%, respectively. Abdominal pain, abdominal bloating, nausea, and difficulties in defecation significantly improved 4 weeks after RIC.
Conclusions
RIC for small intestine using BAE has the potential to be safe and effective for relieving symptoms (jRCT identifier jRCTs022200040).

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Miscellaneous

Hydroxyurea associated ileocecal valve ulcer: evidence for causality: Thevaraajan Jayaraman, Ruveena Bhavani Rajaram, Gin Gin Gan, Ida Hilmi; Intest Res 2021;19(4):468-471. Published online December 1, 2020; DOI: https://doi.org/10.5217/ir.2020.00099

Hydroxyurea is an antimetabolite drug that is commonly used in many hematological disorders. Ulcer formation in the gastrointestinal tract is a rare phenomenon associated with this drug. We report a case of a 73-year-old woman who was found to have an isolated ileocecal valve ulcer while on hydroxyurea 1 g daily for essential thrombocythemia. A comprehensive evaluation ruled out all other causes. The cytoreductive therapy was switched to anagrelide and the endoscopic evaluation 6 months later showed complete healing of the ulcer. However, the hydroxyurea was resumed due to increasing platelet counts and intolerance to dose increments of the anagrelide. Subsequently, the patient was found to have a recurrence of the ulcer. Apart from oral ulcers, there have also been reports of ulcers involving the small bowel and the colon associated with the use of hydroxyurea. The pathophysiology of the non-oral gastrointestinal ulceration in relation to this drug is unclear. Withdrawal of the drug typically leads to complete resolution. Increasing awareness of the rare association between the use of hydroxyurea and nonoral gastrointestinal ulcers is essential for early detection to prevent related complications.

Citations

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Esophageal and Ileal Ulcers Caused by Hydroxycarbamide: A Case Report and Literature Review
Takumi Inaba, Yu Yamamoto, Kaho Hirayama, Takuma Kobayashi, Naoto Izumi, Hirotsugu Sakamoto, Shuji Hatakeyama, Masami Matsumura
Internal Medicine.2025; 64(6): 845. CrossRef
Hydroxyurea-related ileocecal region ulcers as a rare complication: A case report
Wen-Jin Yuan, Yi-Juan Zheng, Bing-Rong Zhang, Yi-Jie Lin, You Li, Yan-Yan Qiu, Xue-Ping Yu
World Journal of Clinical Cases.2025;[Epub] CrossRef
Repairing of recurrent leg ulcer induced by hydroxyurea with posterior tibial artery perforator propeller flap: Case report
Zheng-Dong Wan, Wu-Zhou Li
International Journal of Surgery Case Reports.2024; 114: 109049. CrossRef

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Functional bowel disorders

Frequency and intensity of gastrointestinal symptoms in exercisers individuals at rest and during physical exercise: an internet-based survey: Claudio Andre Barbosa de Lira, Ricardo Borges Viana, Kaylla Priscilla Mesquista, Douglas de Assis Teles Santos, Mário Hebling Campos, Marília Santos Andrade, Rodrigo Luiz Vancini; Intest Res 2019;17(4):537-545. Published online May 7, 2019; DOI: https://doi.org/10.5217/ir.2018.00162

Abstract PDF PubReader ePub

Background/Aims
Despite the evidence of a modest to high prevalence of gastrointestinal (GI) symptoms in recreational runners and endurance athletes, the frequency and intensity of GI symptoms in exercisers, but nonathletes, individuals from different modalities have been less investigated. Therefore, the present study aimed to assess the prevalence of GI symptoms in individuals that practice moderate or vigorous physical exercise, at rest and during physical exercise training session.
Methods
The sample consisted of 142 exercisers individuals (64 women and 78 men with mean age of 32.9 ± 10.7 years). Out of the 142 participants, 71 reported to perform moderate physical exercise and 71 reported to perform vigorous physical exercise. Participants were assessed by an internet-based questionnaire designed to assess the frequency and intensity (at rest and during physical exercise training session) of 18 GI symptoms.
Results
The GI symptoms most frequently reported by the respondents (during rest and physical exercise training session, respectively) were flatulence (90.8% and 69.7%), abdominal noise (77.5% and 41.5%), and eructation (73.9% and 52.1%). Overall, the frequency and intensity of symptoms were higher (P< 0.050) during rest than physical exercise training session for who perform moderate and vigorous physical exercise.
Conclusions
It can be concluded that GI symptoms in exercisers, but nonathletes, individuals are more prevalent during rest than during physical exercise training session, suggesting that moderate and vigorous physical exercise may act as a regulator of the GI tract.

Citations

Citations to this article as recorded by

The Frequency and Severity of Gastrointestinal Symptoms in Rugby Players
Sarah Chantler, Ruth Wood-Martin, Adrian Holliday, Glen Davison, Daniel R. Crabtree, Clint Readhead, Ben Jones
International Journal of Sports Medicine.2024; 45(04): 323. CrossRef
Use of Carbohydrate (CHO), Gluten-Free, and FODMAP-Free Diets to Prevent Gastrointestinal Symptoms in Endurance Athletes: A Systematic Review
Karen Montero-Carrasco, Maria Jose Arias-Tellez, Johana Soto-Sánchez
Nutrients.2024; 16(22): 3852. CrossRef
Exercise-Induced Gastrointestinal Symptoms in Endurance Sports: A Review of Pathophysiology, Symptoms, and Nutritional Management
Emanuela Ribichini, Giulia Scalese, Alessandra Cesarini, Chiara Mocci, Nadia Pallotta, Carola Severi, Enrico Stefano Corazziari
Dietetics.2023; 2(3): 289. CrossRef
Comparison of physiological and psychobiological acute responses between high intensity functional training and high intensity continuous training
Douglas A.T. Santos, Naiane S. Morais, Ricardo B. Viana, Gustavo C.T. Costa, Marilia S. Andrade, Rodrigo L. Vancini, Katja Weiss, Beat Knechtle, Claudio A.B. de Lira
Sports Medicine and Health Science.2023;[Epub] CrossRef

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