Intestinal Research

Original Articles

Lifestyle restrictions are associated with impaired quality of life but not reduction in relapse in ulcerative colitis: Hajime Yamazaki, Masakazu Nagahori, Tadakazu Hisamatsu, Taku Kobayashi, Teppei Omori, Jimmy K. Limdi, John T. McLaughlin, Shu-Chen Wei, Jovelle Fernandez, Shunichi Fukuhara, Katsuyoshi Matsuoka; Received November 29, 2024 Accepted March 18, 2025 Published online May 14, 2025; DOI: https://doi.org/10.5217/ir.2024.00199 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Background/Aims
Patients with ulcerative colitis (UC) in remission commonly restrict thir lifestyle to prevent relapse; however, the effectiveness and impact on quality of life (QOL) is unclear. This study investigated whether lifestyle restrictions are associated with relapse reduction and assessed their impact on QOL.
Methods
This multicenter, prospective cohort study was conducted in Japan (2018–2021) via the YOURS registry, enrolling patients with UC in clinical remission. Patients were followed for 2 years. A baseline questionnaire evaluated lifestyle restrictions in diet, work/study/housework, and physical exercise. QOL was assessed by Disease Impact Scale every 3 months during the first year of follow-up. Associations of lifestyle restrictions with relapse and QOL were assessed by Cox regression analysis and linear mixed-effects models, respectively.
Results
Among 911 patients in clinical remission for > 90 days, 63% had adopted dietary avoidance; 47%, work/study/housework avoidance; and 8%, physical exercise avoidance. Overall, 216 patients relapsed. Lifestyle restrictions were not associated with reduced risk of relapse (multivariableadjusted hazard ratios [95% confidence interval]: dietary avoidance, 1.08 [0.81–1.44]; and work/study/housework avoidance, 1.14 [0.87–1.50]); physical exercise avoidance was associated with increased relapse (multivariable-adjusted hazard ratio, 1.58; 95% confidence interval, 1.02–2.44). All lifestyle restrictions were associated with impaired QOL (P <0.01).
Conclusions
Lifestyle restrictions were not associated with relapse reduction in patients with UC; however, they were associated with impaired QOL. Clinicians should engage in evidence-based discussions with patients with UC in remission regarding lifestyle restrictions (UMIN Clinical Trials Registry; UMIN000031995).

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IBD

Effectiveness of transabdominal ultrasonography in predicting clinical relapse of Crohn’s disease: Shinya Fukushima, Takehiko Katsurada, Mutsumi Nishida, Satomi Omotehara, Kensuke Sakurai, Kana Yamanashi, Reizo Onishi, Naoya Sakamoto; Intest Res 2024;22(1):82-91. Published online January 29, 2024; DOI: https://doi.org/10.5217/ir.2023.00093

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Transabdominal ultrasonography (US) helps evaluate Crohn’s disease (CD) activity. We investigated whether the US could predict subsequent adverse outcomes for patients with CD in clinical remission.
Methods
This single-center retrospective study included patients with CD in clinical remission who underwent US between April 2011 and April 2021, focusing on the predictability of subsequent adverse outcomes within 5 years. We used the US-CD, which was calculated using multiple US findings. Predictive variables were assessed using Cox proportional hazards regression analysis, and the predictive value was evaluated using receiver operating characteristic curves.
Results
Seventy-three patients were included. During a median follow-up of 1,441 days (range, 41–1,825 days), 16.4% (12/73) experienced clinical relapse, 9.6% (7/73) required endoscopic balloon dilation (EBD), 58.9% (43/73) required enhanced treatment, and 20.5% (15/73) underwent surgery. In the multivariate analysis, US-CD was significantly associated with clinical relapse (P= 0.038) and the need for enhanced treatment (P= 0.005). The area under the receiver operating characteristic curve for predicting clinical relapse and the need for EBD was 0.77 and 0.81, respectively, with US-CD (cutoff value = 11), and that for requiring enhanced treatment was 0.74 with US-CD (cutoff value = 6). Patients with US-CD ≥ 11 demonstrated a significantly higher occurrence of clinical relapse (P= 0.001) and EBD (P= 0.002) within 5 years. Patients with US-CD ≥ 6 experienced a significantly higher likelihood of requiring enhanced treatment (P< 0.001) within 5 years.
Conclusions
High US-CD is associated with subsequent adverse outcomes in patients with CD.

Citations

Citations to this article as recorded by

Non-invasive monitoring of inflammatory bowel disease using intestinal ultrasound
Hakima Abid, Hajar Cherkaoui, Fatima Benahsine, Asmae Lamine, Maria Lahlali, Ismail Chaouche, Fatima Bartal, Nada Lahmidani, Amine Elmekkaoui, Dafr Allah Benajah, Mohammed Abkari, Sidi Adil Ibrahimi, Karima Elghazi, Mustapha Maaroufi, Mounia Elyousfi
World Journal of Gastrointestinal Endoscopy.2025;[Epub] CrossRef
Intestinal ultrasound in Crohn’s disease: A systematic review of its role in diagnosis, monitoring, and treatment response
Partha Pal, Mohammad Abdul Mateen, Kanapuram Pooja, Nandhakumar Rajadurai, Rajesh Gupta, Manu Tandan, Nageshwar Reddy Duvvuru
World Journal of Meta-Analysis.2025;[Epub] CrossRef

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Review

IBD

Anti-inflammatory diet and inflammatory bowel disease: what clinicians and patients should know?: Nor Hamizah Shafiee, Zahara Abdul Manaf, Norfilza M. Mokhtar, Raja Affendi Raja Ali; Intest Res 2021;19(2):171-185. Published online February 3, 2021; DOI: https://doi.org/10.5217/ir.2020.00035

Abstract PDF PubReader ePub

Current treatment for inflammatory bowel disease (IBD) includes the application of anti-inflammatory agents for the induction and remission of IBD. However, prolonged use of anti-inflammatory agents can exert adverse effects on patients. Recently, formulated dietary approach in treating IBD patients is utilized to improve clinical activity scores. An alteration of gastrointestinal microbiota through dietary therapy was found to reduce IBD and is recognized as a promising therapeutic strategy for IBD. One of the recommended formulated diets is an anti-inflammatory diet (AID) that restricts the intake of carbohydrates with modified fatty acids. This diet also contains probiotics and prebiotics that can promote balanced intestinal microbiota composition. However, scientific evidences are limited to support this specific dietary regime in maintaining the remission and prevention relapse of IBD. Therefore, this review aimed to summarize available data from various studies to evaluate the AID diet effectiveness which will be useful for clinicians to manage their IBD patients by application of improved dietary therapy.

Citations

Citations to this article as recorded by

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Current Gastroenterology Reports.2025;[Epub] CrossRef
Resveratrol and rutin alleviate DSS-induced ulcerative colitis by affecting the polarization of intestinal epithelial T cells
Lifang Feng, Tianyu Zhang, Wei Ye, Daofeng Qu
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Nutrients.2025; 17(11): 1879. CrossRef
Diet and Nutrition in Inflammatory Bowel Disease: A Review of the Literature
Scott Manski, Nicholas Noverati, Tatiana Policarpo, Emily Rubin, Raina Shivashankar
Crohn's & Colitis 360.2024;[Epub] CrossRef
Adverse Food Reactions in Inflammatory Bowel Disease: State of the Art and Future Perspectives
Ivan Capobianco, Federica Di Vincenzo, Pierluigi Puca, Guia Becherucci, Maria Chiara Mentella, Valentina Petito, Franco Scaldaferri
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Mixed-method Irish study exploring the role of diet in IBD based on an online questionnaire and a patient panel opinion
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Medicinal Herbs for the Treatment of Peptic Ulcers
Divyansh Tiwari, Aftab Alam, Shivang Dhoundiyal, Shaweta Sharma, Shikha Yadav
Current Traditional Medicine.2024;[Epub] CrossRef
Comparison and recommendation of dietary patterns based on nutrients for Eastern and Western patients with inflammatory bowel disease
Yue Hou, Sai-Feng Wang, Ke Zhou, Shi-Xue Dai
Frontiers in Nutrition.2023;[Epub] CrossRef
Association of immune-mediated inflammatory diseases with depression and anxiety in patients with type 2 diabetes: A nationwide population-based study
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The importance of anti-inflammatory diet in depression: a literature review and recommendations
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26 Crossref

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