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IBD
Management of Crohn’s disease in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease updated in 2023
Jia-Feng Wu, Hsu-Heng Yen, 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, Ching-Pin Lin, Jen-Kou Lin, Wei-Chen Lin, Yen-Hsuan Ni, Ming-Jium Shieh, I-Lun Shih, Chia-Tung Shun, Tzung-Jiun Tsai, Cheng-Yi Wang, Meng-Tzu Weng, Jau-Min Wong, Deng-Chyang Wu, Shu-Chen Wei
Intest Res 2024;22(3):250-285.   Published online July 29, 2024
DOI: https://doi.org/10.5217/ir.2024.00060
AbstractAbstract PDFPubReaderePub
Crohn’s disease (CD) is a chronic, fluctuating inflammatory condition that primarily affects the gastrointestinal tract. Although the incidence of CD in Taiwan is lower than that in Western countries, the severity of CD presentation appears to be similar between Asia and the West. This observation indicates the urgency for devising revised guidelines tailored to the unique reimbursement system, and patient requirements in Taiwan. The core objectives of these updated guidelines include the updated treatment choices and the integration of the treat-to-target strategy into CD management, promoting the achievement of deep remission to mitigate complications and enhance the overall quality of life. Given the diversity in disease prevalence, severity, insurance policies, and access to medical treatments in Taiwan, a customized approach is imperative for formulating these guidelines. Such tailored strategies ensure that international standards are not only adapted but also optimized to local contexts. Since the inception of its initial guidelines in 2017, the Taiwan Society of Inflammatory Bowel Disease (TSIBD) has acknowledged the importance of continuous revisions for incorporating new therapeutic options and evolving disease management practices. The latest update leverages international standards and recent research findings focused on practical implementation within the Taiwanese healthcare system.
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IBD
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, Ching-Pin Lin, Jen-Kou Lin, Wei-Chen Lin, Yen-Hsuan Ni, Ming-Jium Shieh, I-Lun Shih, Chia-Tung Shun, Tzung-Jiun Tsai, Cheng-Yi Wang, Meng-Tzu Weng, Jau-Min Wong, Deng-Chyang Wu, Shu-Chen Wei
Intest Res 2024;22(3):213-249.   Published online July 29, 2024
DOI: https://doi.org/10.5217/ir.2023.00050
AbstractAbstract PDFPubReaderePub
Ulcerative colitis (UC) is a chronic inflammation of the gastrointestinal tract and is characterized by alternating periods of inflammation and remission. Although UC incidence is lower in Taiwan than in Western countries, its impact remains considerable, demanding updated guidelines for addressing local healthcare challenges and patient needs. The revised guidelines employ international standards and recent research, emphasizing practical implementation within the Taiwanese healthcare system. Since the inception of the guidelines in 2017, the Taiwan Society of Inflammatory Bowel Disease has acknowledged the need for ongoing revisions to incorporate emerging therapeutic options and evolving disease management practices. This updated guideline aims to align UC management with local contexts, ensuring comprehensive and context-specific recommendations, thereby raising the standard of care for UC patients in Taiwan. By adapting and optimizing international protocols for local relevance, these efforts seek to enhance health outcomes for patients with UC.

Citations

Citations to this article as recorded by  
  • Short-term and long-term outcomes of acute severe ulcerative colitis in Taiwan: a multicenter study with pre- and post-biologics comparison
    Wei-Chen Lin, Chun-Chi Lin, Wen-Hung Hsu, Feng-Fan Chiang, Chen-Wang Chang, Tzu-Chi Hsu, Deng-Chyang Wu, Horng-Yuan Wang, Jau-Min Wong, Shu-Chen Wei
    Intestinal Research.2025;[Epub]     CrossRef
  • Endoscopic Techniques for Colorectal Neoplasia Surveillance in Inflammatory Bowel Disease: A Systematic Review and Network Meta‐Analysis
    Chih‐Wen Huang, Hsu‐Heng Yen, Yang‐Yuan Chen
    United European Gastroenterology Journal.2025;[Epub]     CrossRef
  • Rescue Therapies for Steroid-refractory Acute Severe Ulcerative Colitis: A Systematic Review and Network Meta-analysis
    Chih-Wen Huang, Hsu-Heng Yen, Yang-Yuan Chen
    Journal of Crohn's and Colitis.2024; 18(12): 2063.     CrossRef
  • High prevalence of vitamin D deficiency in Taiwanese patients with inflammatory bowel disease
    Chen-Ta Yang, Hsu-Heng Yen, Pei-Yuan Su, Yang-Yuan Chen, Siou-Ping Huang
    Scientific Reports.2024;[Epub]     CrossRef
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  • 252 Download
  • 4 Crossref
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Original Article
IBD
Performing colonoscopy before steroid induction is associated with shorter steroid use in patients with ulcerative colitis
Taku Kobayashi, Eri Udagawa, Lisa Hirose, Toshifumi Hibi
Intest Res 2023;21(2):205-215.   Published online December 15, 2022
DOI: https://doi.org/10.5217/ir.2021.00164
AbstractAbstract PDFPubReaderePub
Background/Aims
Risks of long-term steroid use in patients with ulcerative colitis (UC) outweigh the benefits, thus dosing should be tapered once a response is achieved. Colonoscopy is a key technique for assessing disease severity and optimizing treatment involving steroids. This retrospective longitudinal cohort study of patients with UC explored factors associated with the duration of systemic steroid use.
Methods
The Japan Medical Data Center database, an employer-based insurance claims database, was used to select individuals initiating prednisolone, with a prescription issued between January 1, 2010, and January 31, 2018. The study included adults with a confirmed diagnosis of UC, who had received ≥1 year of continuous treatment with 5-aminosalicylic acid, biologics, or thiopurine. Factors associated with prednisolone duration were assessed using a multivariate regression model.
Results
Median duration of prednisolone treatment was 98 days, and colonoscopy was performed ≤1 month before or at the first prescription of prednisolone (index date) in 32.8% of patients (607/1,853). Shorter durations of prednisolone treatment were associated with colonoscopy ≤1 month before or at the index date and higher prednisolone dose at index date, with incidence rate ratios (IRRs) of 0.776 (95% confidence interval [CI], 0.682–0.884; P<0.001) and 0.998 (95% CI, 0.996–1.000; P=0.018), respectively. Charlson Comorbidity Index scores of 1 and ≥2 predicted longer prednisolone treatment (IRR, 1.332; 95% CI, 1.174–1.511; P<0.001 and IRR, 1.599; 95% CI, 1.357–1.885; P<0.001, respectively).
Conclusions
Performing colonoscopy before or at the time of initiating steroid was associated with a shorter duration of steroid use in patients with UC.

Citations

Citations to this article as recorded by  
  • Quercus infectoria galls mitigates colitis in mice through alleviating mucosal barrier impairment and suppressing inflammatory factors
    Yan Ding, Jiao-Jiao Bai, Sabahat Ablimit, Muyassar Yasen, Arfidin Anwar, Kudelaidi Kuerban, Mubarak Iminjan, Guo-Qiang Zhang
    Journal of Ethnopharmacology.2025; 343: 119487.     CrossRef
  • 3,694 View
  • 359 Download
  • 2 Web of Science
  • 1 Crossref
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Review
IBD
Korean clinical practice guidelines on biologics and small molecules for moderate-to-severe ulcerative colitis
Soo-Young Na, Chang Hwan Choi, Eun Mi Song, Ki Bae Bang, Sang Hyoung Park, Eun Soo Kim, Jae Jun Park, Bora Keum, Chang Kyun Lee, Bo-In Lee, Seung-Bum Ryoo, Seong-Joon Koh, Miyoung Choi, Joo Sung Kim, on behalf of the IBD Research Group of the Korean Association for the Study of Intestinal Diseases
Intest Res 2023;21(1):61-87.   Published online May 31, 2022
DOI: https://doi.org/10.5217/ir.2022.00007
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Ulcerative colitis (UC), a relapsing-remitting chronic inflammatory bowel disease (IBD), has a variable natural course but potentially severe disease course. Since the development of anti-tumor necrosis factor (TNF) agents has changed the natural disease course of moderate-to-severe UC, therapeutic options for patients who failed conventional treatments are expanding rapidly. IBD clinical trials have demonstrated the potential efficacy and safety of novel biologics such as anti-integrin α4β7 and anti-interleukin-12/23 monoclonal antibodies and small molecules such as a Janus kinase inhibitor. Anti-TNF biosimilars also have been approved and are widely used in IBD patients. Wise drug choices should be made considering evidence-based efficacy and safety. However, the best position of these drugs remains several questions, with limited data from direct comparative trials. In addition, there are still concerns to be elucidated on the effect of therapeutic drug monitoring and combination therapy with immunomodulators. The appropriate treatment regimens in acute severe UC and the risk of perioperative use of biologics are unclear. As novel biologics and small molecules have been approved in Korea, we present the Korean guidelines for medical management of adult outpatients with moderate-to-severe UC and adult hospitalized patients with acute severe UC, focusing on biologics and small molecules.

Citations

Citations to this article as recorded by  
  • Deep Learning Model Using Stool Pictures for Predicting Endoscopic Mucosal Inflammation in Patients With Ulcerative Colitis
    Jung Won Lee, Dongwon Woo, Kyeong Ok Kim, Eun Soo Kim, Sung Kook Kim, Hyun Seok Lee, Ben Kang, Yoo Jin Lee, Jeongseok Kim, Byung Ik Jang, Eun Young Kim, Hyeong Ho Jo, Yun Jin Chung, Hanjun Ryu, Soo-Kyung Park, Dong-Il Park, Hosang Yu, Sungmoon Jeong
    American Journal of Gastroenterology.2025; 120(1): 213.     CrossRef
  • Optimizing 5-aminosalicylate for moderate ulcerative colitis: expert recommendations from the Asia-Pacific, Middle East, and Africa Inflammatory Bowel Disease Coalition
    Filiz Akyüz, Yoon Kyo An, Jakob Begun, Satimai Aniwan, Huu Hoang Bui, Webber Chan, Chang Hwan Choi, Nazeer Chopdat, Susan J Connor, Devendra Desai, Emma Flanagan, Taku Kobayashi, Allen Yu-Hung Lai, Rupert W Leong, Alex Hwong-Ruey Leow, Wai Keung Leung, Ju
    Intestinal Research.2025; 23(1): 37.     CrossRef
  • Characteristics and outcomes of portal vein thrombosis in patients with inflammatory bowel disease in Korea
    Ki Jin Kim, Su-Bin Song, Jung-Bin Park, June Hwa Bae, Ji Eun Baek, Ga Hee Kim, Min-Jun Kim, Seung Wook Hong, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Chang Sik Yu, Yong-Sik Yoon, Jong-Lyul Lee, Min Hy
    The Korean Journal of Internal Medicine.2025; 40(2): 243.     CrossRef
  • Comparison of 1‐Year Clinical Course in Patients With Newly Diagnosed Inflammatory Bowel Disease Between Vietnam and Korea: A Multinational, Multicenter Retrospective Cohort Study
    Luan Minh Dang, Eun Soo Kim, Kyeong Ok Kim, Yoo Jin Lee, Hoang Huu Bui, Chuong Dinh Nguyen, Chi Thi Nguyen, Nam Hoai Nguyen, Hien Thi‐Thu Nguyen, Nga Thi Dinh, Lien Thi‐Phuong Nguyen, Khien Van Vu, Minh Cuong Duong
    JGH Open.2025;[Epub]     CrossRef
  • Temporal trends in obesity and its prognostic impact in Korean patients with inflammatory bowel disease
    Min Kyu Kim, Seung Hwan Shin, Cheol-Hyung Lee, Soyoung Kim, Jong Whan Kim, Songhyun Lee, Seung Wook Hong, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Sung Wook Hwang
    Journal of Gastroenterology.2025;[Epub]     CrossRef
  • Metabolic musculoskeletal disorders in patients with inflammatory bowel disease
    Young Joo Yang, Seong Ran Jeon
    The Korean Journal of Internal Medicine.2025; 40(2): 181.     CrossRef
  • Impact of age at diagnosis on long‐term prognosis in patients with intestinal Behçet's disease
    Ji Young Chang, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jae Hee Cheon, Jihye Park
    Journal of Gastroenterology and Hepatology.2024; 39(3): 519.     CrossRef
  • Factors Associated with Reaching Mid-Parental Height in Patients Diagnosed with Inflammatory Bowel Disease in Childhood and Adolescent Period
    So Yoon Choi, Sujin Choi, Byung-Ho Choe, Jae Hong Park, Kwang-Hae Choi, Hae Jeong Lee, Ji Sook Park, Ji-Hyun Seo, Jae Young Kim, Hyo-Jeong Jang, Suk Jin Hong, Eun Young Kim, Yeoun Joo Lee, Ben Kang
    Gut and Liver.2024; 18(1): 106.     CrossRef
  • Continued JAK inhibitor treatment on the risk of recurrent herpes zoster reactivation in patients with immune-mediated inflammatory diseases: A nationwide population-based study in South Korea
    Young-Eun Kim, Ye-Jee Kim, Dae Hyun Jeong, Seonok Kim, Min Jee Kim, Hyeon Hwa Kim, Kyung-Wook Jo, Sang Hyoung Park, Seokchan Hong
    Seminars in Arthritis and Rheumatism.2024; 65: 152362.     CrossRef
  • Predictors of histologic remission in patients with biologic-naïve, moderate-to-severe ulcerative colitis treated with first-line biologic agents and small-molecule drugs: a single-center, retrospective cohort study
    Kijae Jo, Kwang Woo Kim, Hyun Jung Lee, Jong Pil Im, Joo Sung Kim, Seong-Joon Koh
    Intestinal Research.2024; 22(4): 453.     CrossRef
  • Risk Factors of Pneumocystis jirovecii Pneumonia in Patients with Inflammatory Bowel Disease: A Nationwide Population-Based Study
    Jiyoung Yoon, Seung Wook Hong, Kyung-Do Han, Seung-Woo Lee, Cheol Min Shin, Young Soo Park, Nayoung Kim, Dong Ho Lee, Joo Sung Kim, Hyuk Yoon
    Gut and Liver.2024; 18(3): 489.     CrossRef
  • Optimal Treatment Approaches to Intestinal Behçet's Disease Complicated by Myelodysplastic Syndrome: The KASID and KSBD Multicenter Study
    Jung-Bin Park, So Jung Han, Seung Bum Lee, Dong Hyun Kim, Jae Hee Cheon, Sung Wook Hwang, Byong Duk Ye, Suk-Kyun Yang, Soo Jung Park, Sang Hyoung Park
    Yonsei Medical Journal.2024; 65(5): 265.     CrossRef
  • Is the writing on the wall? The relationship between the number of disease-modifying anti-inflammatory bowel disease drugs used and the risk of surgical resection
    Marc M. Mankarious, Alicia C. Greene, Eric W. Schaefer, Kofi Clarke, Afif N. Kulaylat, Nimalan A. Jeganathan, Michael J. Deutsch, Audrey S. Kulaylat
    Journal of Gastrointestinal Surgery.2024; 28(6): 836.     CrossRef
  • Clinical Significance of Prognostic Nutrition Index in Patients with Crohn’s Disease after Primary Bowel Resection
    Hyeon Woo Bae, Yong Joon Lee, Min Young Park, Seung Yoon Yang, Yoon Dae Han, Min Soo Cho, Hyuk Hur, Kang Young Lee, Jae Hee Cheon, Joseph C. Carmichael, Byung Soh Min
    Yonsei Medical Journal.2024; 65(7): 380.     CrossRef
  • Current Management of Acute Severe Ulcerative Colitis: New Insights on the Surgical Approaches
    Sara Lauricella, Francesco Brucchi, Federica Cavalcoli, Emanuele Rausa, Diletta Cassini, Michelangelo Miccini, Marco Vitellaro, Roberto Cirocchi, Gianluca Costa
    Journal of Personalized Medicine.2024; 14(6): 580.     CrossRef
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    Pharmaceuticals.2024; 17(7): 925.     CrossRef
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    Therapeutic Advances in Gastroenterology.2024;[Epub]     CrossRef
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    Yonsei Medical Journal.2024; 65(11): 636.     CrossRef
  • Prevalence and risk factors for gallstone and renal stone formation in patients with intestinal Behçet’s disease
    Jaewon Song, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jihye Park, Jae Hee Cheon
    The Korean Journal of Internal Medicine.2024; 39(5): 770.     CrossRef
  • Safety and effectiveness of tofacitinib in Korean adult patients with ulcerative colitis: post-marketing surveillance study
    Hyuk Yoon, Byong Duk Ye, Sang-Bum Kang, Kang-Moon Lee, Chang Hwan Choi, Joo-young Jo, Juwon Woo, Jae Hee Cheon
    BMC Gastroenterology.2024;[Epub]     CrossRef
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    Hye Kyung Hyun, Ji Won Kim, Jun Lee, Yoon Tae Jeen, Tae-Oh Kim, Joo Sung Kim, Jae Jun Park, SungNoh Hong, Dong Il Park, Hyun-Soo Kim, YooJin Lee, Eun Suk Jung, Youngdoe Kim, Su Young Jung, Jae Hee Cheon
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    Journal of Personalized Medicine.2024; 14(10): 1066.     CrossRef
  • Ganjiang Huangqin Huanglian Renshen Decoction protects against ulcerative colitis by modulating inflammation, oxidative stress, and gut microbiota
    Ce Zhou, Bo Peng, Mingxing Zhang, Yang Yang, Zelin Yi, Yinghua Wu
    Phytomedicine.2024; 135: 156172.     CrossRef
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    Intestinal Research.2023; 21(1): 168.     CrossRef
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  • “Theranekron: A Novel Anti-inflammatory Candidate for Acetic Acid-Induced Colonic Inflammation in Rats”
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    Molecular Biology Reports.2022; 49(9): 8753.     CrossRef
  • 10,777 View
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  • 34 Web of Science
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Statement
IBD
Korean Association for the Study of Intestinal Diseases guidance for clinical practice of adult inflammatory bowel disease during the coronavirus disease 2019 pandemic: expert consensus statements
Yong Eun Park, Yoo Jin Lee, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Jae Gon Lee, Hee Chan Yang, Miyoung Choi, Seong-Eun Kim, Seung-Jae Myung
Intest Res 2022;20(4):431-444.   Published online January 5, 2022
DOI: https://doi.org/10.5217/ir.2021.00111
AbstractAbstract PDFPubReaderePub
Many unexpected problems have resulted from the unprecedented coronavirus disease 2019 (COVID-19) pandemic. The optimal management of patients with inflammatory bowel disease (IBD) during the COVID-19 pandemic has also been a challenge. Therefore, the Korean Association for the Study of Intestinal Diseases (KASID) developed a consensus statement of experts regarding the management of IBD during the COVID-19 pandemic. This consensus statement made recommendations regarding the risk and treatment of COVID-19 in IBD patients. This statement emphasizes that IBD is not a risk factor for COVID-19, and care should be taken not to exacerbate IBD in patients in remission state by maintaining their medications, except for corticosteroids.

Citations

Citations to this article as recorded by  
  • Mobile monitoring system detects the disease activity pattern and shows the association with clinical outcomes in patients with newly diagnosed Crohn’s disease
    Yoo Jin Lee, Sang Gyu Kwak, Eun Soo Kim, Sung Kook Kim, Hyun Seok Lee, Yun Jin Chung, Byung Ik Jang, Kyeong Ok Kim, Jeongseok Kim, Hyeong Ho Jo, Eun Young Kim
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  • Update on SARS-CoV-2 vaccination of patients with inflammatory bowel disease: what clinicians need to know
    Yoo Jin Lee, Seong-Eun Kim, Yong Eun Park, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Jae Gon Lee, Hee Chan Yang, Seung-Jae Myung
    Intestinal Research.2022; 20(3): 386.     CrossRef
  • 5,599 View
  • 546 Download
  • 2 Web of Science
  • 2 Crossref
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Reviews
Management of Crohn's disease in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease
Shu-Chen Wei, Ting-An Chang, Te-Hsin Chao, Jinn-Shiun Chen, Jen-Wei Chou, Yenn-Hwei Chou, Chiao-Hsiung Chuang, Wen-Hung Hsu, Tien-Yu Huang, Tzu-Chi Hsu, Chun-Chi Lin, Hung-Hsin Lin, Jen-Kou Lin, Wei-Chen Lin, Yen-Hsuan Ni, Ming-Jium Shieh, I-Lun Shih, Chia-Tung Shun, Yuk-Ming Tsang, Cheng-Yi Wang, Horng-Yuan Wang, Meng-Tzu Weng, Deng-Chyang Wu, Wen-Chieh Wu, Hsu-Heng Yen, Jau-Min Wong
Intest Res 2017;15(3):285-310.   Published online June 12, 2017
DOI: https://doi.org/10.5217/ir.2017.15.3.285
AbstractAbstract PDFPubReaderePub

Crohn's disease (CD) is a chronic relapsing and remitting inflammatory disease of the gastrointestinal tract. CD is rare in Taiwan and other Asian countries, but its prevalence and incidence have been steadily increasing. A steering committee was established by the Taiwan Society of Inflammatory Bowel Disease to formulate statements on the diagnosis and management of CD taking into account currently available evidence and the expert opinion of the committee. Thorough clinical, endoscopic, and histological assessments are required for accurate diagnosis of CD. Computed tomography and magnetic resonance imaging are complementary to endoscopic evaluation for disease staging and detecting complications. The goals of CD management are to induce and maintain remission, reduce the risk of complications, and improve quality of life. Corticosteroids are the mainstay for inducing re-mission. Immunomodulating and biologic therapies should be used to maintain remission. Patients should be evaluated for hepatitis B virus and tuberculosis infection prior to treatment and receive regular surveillance for cancer. These consensus statements are based on current local evidence with consideration of factors, and could be serve as concise and practical guidelines for supporting clinicians in the management of patients with CD in Taiwan.

Citations

Citations to this article as recorded by  
  • Factors affecting perception and acceptance of colonoscopy in patients with inflammatory bowel disease
    Chang-Hung Liao, Peng-Jen Chen, Yu-Lueng Shih, Wei-Kuo Chang, Tsai-Yuan Hsieh, Tien-Yu Huang
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    Nai‐Yu Chen, Chiao‐Hsiung Chuang, Yu‐Ching Chang, Yea‐Huei Kao Yang, Peng‐Hsu Chen, Ching‐Lan Cheng
    Clinical Pharmacology & Therapeutics.2023; 114(4): 914.     CrossRef
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    Simcha Weissman, Hannah K. Systrom, Ayrton Bangolo, Daniel Elias, Marcel Awasi, Tamer Zahdeh, Chukwuemeka E. Ogbu, Mishka Hoo Kim, Meenal Kalra, Kavya Khota, Ritu B. Kasarapu, Erasmus Mutabi, Moinulhaq Makrani, Sanskrita Nemalikanti, Jim Thomas, Joseph P.
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Management of ulcerative colitis in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease
Shu-Chen Wei, Ting-An Chang, Te-Hsin Chao, Jinn-Shiun Chen, Jen-Wei Chou, Yenn-Hwei Chou, Chiao-Hsiung Chuang, Wen-Hung Hsu, Tien-Yu Huang, Tzu-Chi Hsu, Chun-Chi Lin, Hung-Hsin Lin, Jen-Kou Lin, Wei-Chen Lin, Yen-Hsuan Ni, Ming-Jium Shieh, I-Lun Shih, Chia-Tung Shun, Yuk-Ming Tsang, Cheng-Yi Wang, Horng-Yuan Wang, Meng-Tzu Weng, Deng-Chyang Wu, Wen-Chieh Wu, Hsu-Heng Yen, Jau-Min Wong
Intest Res 2017;15(3):266-284.   Published online June 12, 2017
DOI: https://doi.org/10.5217/ir.2017.15.3.266
AbstractAbstract PDFPubReaderePub

Ulcerative colitis (UC) is an inflammatory bowel disease characterized by chronic mucosal inflammation of the colon, and the prevalence and incidence of UC have been steadily increasing in Taiwan. A steering committee was established by the Taiwan Society of Inflammatory Bowel Disease to formulate statements on the diagnosis and management of UC taking into account currently available evidence and the expert opinion of the committee. Accurate diagnosis of UC requires thorough clinical, endoscopic, and histological assessment and careful exclusion of differential diagnoses, particularly infectious colitis. The goals of UC therapy are to induce and maintain remission, reduce the risk of complications, and improve quality of life. As outlined in the recommended treatment algorithm, choice of treatment is dictated by severity, extent, and course of disease. Patients should be evaluated for hepatitis B virus and tuberculosis infection prior to immunosuppressive treatment, especially with steroids and biologic agents, and should be regularly monitored for reactivation of latent infection. These consensus statements are also based on current local evidence with consideration of factors, and could be serve as concise and practical guidelines for supporting clinicians in the management of UC in Taiwan.

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Original Article
Maternal and fetal outcomes in pregnant Japanese women with inflammatory bowel disease: our experience with a series of 23 cases
Naoki Minami, Minoru Matsuura, Yorimitsu Koshikawa, Satoshi Yamada, Yusuke Honzawa, Shuji Yamamoto, Hiroshi Nakase
Intest Res 2017;15(1):90-96.   Published online January 31, 2017
DOI: https://doi.org/10.5217/ir.2017.15.1.90
AbstractAbstract PDFPubReaderePub
<b>Background/Aims</b><br/>

Our physicians work to expand the possibilities to treat female patients with inflammatory bowel disease (IBD) who wish to become pregnant. Although many drugs, including 5-aminosalicylate (5-ASA), corticosteroids, immunomodulators, and biologics, are used safely during pregnancy, few reports have described the therapeutic regimen throughout pregnancy and the management of patients who relapse during pregnancy precisely. The aim of this study was to assess the management of patients with IBD during pregnancy.

Methods

We identified 19 patients (five with Crohn's disease and 14 with ulcerative colitis [UC]) who became pregnant with a total of 23 pregnancies between May 2005 and May 2015 by reviewing the medical records of Kyoto University Hospital. The following data were collected: the maternal variables, the IBD treatment type, the disease activity, the pregnancy outcome, and the mode of delivery.

Results

Among the 19 patients, 18 had become pregnant after being diagnosed with IBD, while one had developed UC newly after pregnancy. Throughout the gestation, all patients were treated with probiotics, 5-ASA, prednisolone, cytapheresis, or infliximab. The relapse rate during pregnancy was 21.7% (5/23 cases). The five patients who experienced a relapse were able to pursue their pregnancy after intensification of their treatments. There were no adverse fetal or neonatal problems, except in one case that required an emergency Caesarean section because of placental dysfunction and in which a very low-birth-weight infant was born preterm.

Conclusions

Our present data confirmed that even if the disease flares up during pregnancy, good pregnancy outcomes can be achieved with an optimal intensification of the patient's treatment.

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  • The pregnancy outcome and drug usage during pregnancy among Taiwanese inflammatory bowel disease patients
    Chen‐Wang Chang, Shu‐Chen Wei, Jen‐Wei Chou, Tien‐Yu Huang, Chia‐Jung Kuo, Wen‐Hung Hsu, Chen‐Shuan Chung, Tzu‐Chi Hsu, Wei‐Chen Lin, Ming‐Jen Chen, Horng‐Yuan Wang
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Reviews
Second Korean guidelines for the management of ulcerative colitis
Chang Hwan Choi, Won Moon, You Sun Kim, Eun Soo Kim, Bo-In Lee, Yunho Jung, Yong Sik Yoon, Heeyoung Lee, Dong Il Park, Dong Soo Han
Intest Res 2017;15(1):7-37.   Published online January 31, 2017
DOI: https://doi.org/10.5217/ir.2017.15.1.7
AbstractAbstract PDFPubReaderePub

Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by a relapsing and remitting course. The direct and indirect costs of the treatment of UC are high, and the quality of life of patients is reduced, especially during exacerbation of the disease. The incidence and prevalence of UC in Korea are still lower than those of Western countries, but have been rapidly increasing during the past decades. Various medical and surgical therapies, including biologics, are currently used for the management of UC. However, many challenging issues exist, which sometimes lead to differences in practice between clinicians. Therefore, the IBD study group of the Korean Association for the Study of Intestinal Diseases established the first Korean guidelines for the management of UC in 2012. This is an update of the first guidelines. It was generally made by the adaptation of several foreign guidelines as was the first edition, and encompasses treatment of active colitis, maintenance of remission, and indication of surgery for UC. The specific recommendations are presented with the quality of evidence and classification of recommendations.

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Second Korean guidelines for the management of Crohn's disease
Jae Jun Park, Suk-Kyun Yang, Byong Duk Ye, Jong Wook Kim, Dong Il Park, Hyuk Yoon, Jong Pil Im, Kang Moon Lee, Sang Nam Yoon, Heeyoung Lee
Intest Res 2017;15(1):38-67.   Published online January 31, 2017
DOI: https://doi.org/10.5217/ir.2017.15.1.38
AbstractAbstract PDFSupplementary MaterialPubReaderePub

Crohn's disease (CD) is a chronic, progressive, and disabling inflammatory bowel disease (IBD) with an uncertain etiopathogenesis. CD can involve any site of the gastrointestinal tract from the mouth to the anus, and is associated with serious complications, such as bowel strictures, perforations, and fistula formation. The incidence and prevalence rates of CD in Korea are still lower compared with those in Western countries, but they have been rapidly increasing during the recent decades. Although there are no definitive curative modalities for CD, various medical and surgical therapies have been applied for the treatment of this disease. Concerning CD management, there have been substantial discrepancies among clinicians according to their personal experience and preference. To suggest recommendable approaches to the diverse problems of CD and to minimize the variations in treatment among physicians, guidelines for the management of CD were first published in 2012 by the IBD Study Group of the Korean Association for the Study of Intestinal Diseases. These are the revised guidelines based on updated evidence, accumulated since 2012. These guidelines were developed by using mainly adaptation methods, and encompass induction and maintenance treatment of CD, treatment based on disease location, treatment of CD complications, including stricture and fistula, surgical treatment, and prevention of postoperative recurrence. These are the second Korean guidelines for the management of CD and will be continuously revised as new evidence is collected.

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Intestinal Stricture in Crohn's Disease
Chen-Wang Chang, Jau-Min Wong, Chien-Chih Tung, I-Lun Shih, Horng-Yuan Wang, Shu-Chen Wei
Intest Res 2015;13(1):19-26.   Published online January 29, 2015
DOI: https://doi.org/10.5217/ir.2015.13.1.19
AbstractAbstract PDFPubReader

Crohn's disease (CD) is a disease with chronic inflammation of unknown etiology involving any part of the gastrointestinal tract. The incidence and prevalence of CD are increasing recently in Asia. Half of the CD patients will have intestinal complications, such as strictures or fistulas, within 20 years after diagnosis. Twenty-five percentage of CD patients have had at least one small bowel stricture and 10% have had at least one colonic stricture and lead to significant complications. Most of these patients will require at least one surgery during their lifetime. Early diagnosis and evaluation with adequate managements for the patients can prevent disability and mortality of these patient. Here, we reviewed the current incidence of CD with stricture, the etiology of stricture, and how to diagnose and manage the stricture.

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    Digestive Diseases and Sciences.2017; 62(6): 1607.     CrossRef
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  • Genetic Influences on the Development of Fibrosis in Crohn’s Disease
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    Frontiers in Medicine.2016;[Epub]     CrossRef
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    Visceral Medicine.2015; 31(4): 280.     CrossRef
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