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IBD
Sarcopenia is common in ulcerative colitis and correlates with disease activity
Pardhu B Neelam, Rimesh Pal, Pankaj Gupta, Anupam K Singh, Jimil Shah, Harshal S Mandavdhare, Harjeet Singh, Aravind Sekar, Sanjay K Bhadada, Usha Dutta, Vishal Sharma
Intest Res 2024;22(2):162-171.   Published online January 22, 2024
DOI: https://doi.org/10.5217/ir.2023.00090
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Association of sarcopenia with disease severity in ulcerative colitis (UC) is not clearly defined. We planned to estimate the prevalence of sarcopenia in patients with UC as per the revised definition and its relation with the disease severity.
Methods
A cross-sectional assessment of sarcopenia in patients with UC was performed. Disease activity was graded according to complete Mayo score. Hand grip strength was assessed with Jamar hand dynamometer, muscle mass using a dual energy X-ray absorptiometry scan, and physical performance with 4-m walk test. Sarcopenia was defined as a reduction of both muscle mass and strength. Severe sarcopenia was defined as reduced gait speed in presence of sarcopenia.
Results
Of 114 patients (62 males, mean age: 36.49±12.41 years), 32 (28%) were in remission, 46 (40.4%) had mild-moderate activity, and 36 (31.6%) had severe UC. Forty-three patients (37.7%) had probable sarcopenia, 25 (21.9%) had sarcopenia, and 14 (12.2%) had severe sarcopenia. Prevalence of sarcopenia was higher in active disease (2 in remission, 6 in active, and 17 in severe, P<0.001). Of 14 with severe sarcopenia, 13 had severe UC while 1 had moderate UC. On multivariate analysis, lower body mass index and higher Mayo score were associated with sarcopenia. Of 37 patients with acute severe colitis, 16 had sarcopenia. Requirement of second-line therapy was similar between patients with and without sarcopenia. On follow-up (median: 18 months), there was a non-significant higher rate of major adverse events in those with sarcopenia (47.4% vs. 33.8%, P=0.273).
Conclusions
Sarcopenia and severe sarcopenia in UC correlate with the disease activity.

Citations

Citations to this article as recorded by  
  • Prevalence and outcome of sarcopenia in patients with inflammatory bowel disease: a follow-up study
    Vikram Dharap, Devendra Desai, Philip Abraham, Tarun Gupta, Pavan Dhoble, Nirad Mehta, Jagdish Modhe
    Intestinal Research.2025;[Epub]     CrossRef
  • Prevalence and impact of sarcopenia in patients with inflammatory bowel diseases: A prospective cohort study
    Solène Dermine, Thomas Bazin, Fatimé Adam Hassan, Johanna Bettolo, Lore Billiauws, Justine Bourdillel, Clément Bresteau, Olivier Corcos, Myriam El khatib, Ashiq Mohamed Gouse, Coralie Hutinet, Alexandre Nuzzo, Francisca Joly
    Clinics and Research in Hepatology and Gastroenterology.2025; 49(4): 102555.     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 body mass index on clinical outcomes in intestinal Behçet’s disease
    Daye Park, Jihye Park, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jae Hee Cheon
    The Korean Journal of Internal Medicine.2025; 40(4): 606.     CrossRef
  • Sarcopenia and frailty in inflammatory bowel disease: Emerging concepts and evidence
    Pardhu B Neelam, Alka Sharma, Vishal Sharma
    JGH Open.2024;[Epub]     CrossRef
  • Utility of SARC‐F for screening for sarcopenia in ulcerative colitis
    Pardhu B. Neelam, Vishal Sharma
    Nutrition in Clinical Practice.2024; 39(5): 1270.     CrossRef
  • Response to “Utility of SARC‐F for screening for sarcopenia in ulcerative colitis”
    Ilkay Ergenc, Chasan Ismail Basa, Alper Uzum, Sevval Sahin, Haluk Tarık Kani, Rahmi Aslan, Aslı Tufan, Özgür Kasımay, Özlen Atuğ, Yeşim Özen Alahdab
    Nutrition in Clinical Practice.2024; 39(5): 1272.     CrossRef
  • Sarcopenia and low prognostic nutritional index as markers of disease activity in patients with inflammatory bowel disease and predictors of poor outcome: a cohort longitudinal study
    Mirella Sherif, Rabab Fouad, Tamer Elbaz, Maryse Awadalla, Omnia Tantawi, Mohamed Negm, Dalia Abd El-kareem, Ibrahim Naguib, Hany Shehab, Hedy A. Badary
    Egyptian Rheumatology and Rehabilitation.2024;[Epub]     CrossRef
  • 5,598 View
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  • 8 Web of Science
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IBD
Assessing quality of magnetic resonance enterography and its impact on disease assessment of ileal Crohn’s disease
Anuj Bohra, Declan J Connoley, Danny Con, Jonathan P Segal, Olga Niewiadomski, Abhinav Vasudevan, Daniel R Van Langenberg, Numan Kutaiba
Intest Res 2024;22(2):152-161.   Published online January 5, 2024
DOI: https://doi.org/10.5217/ir.2023.00095
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Assessment of quality of magnetic resonance enterography (MRE) in small bowel Crohn’s disease (CD) activity evaluation has received little attention. We assessed the impact of bowel distention and motion artifact on MRE activity indices in ileal CD.
Methods
A cohort of patients who underwent contemporaneous MRE and colonoscopy for ileal CD assessment between 2014 and 2021 at 2 centers were audited. An abdominal radiologist blinded to clinical data reviewed each MRE, graded bowel distention and motion artifact upon a pre-specified 3-point scale and calculated the original magnetic resonance index of activity (MaRIA) and simplified MaRIA (sMaRIA), London index and CD MRE index (CDMI). Ileal endoscopic activity was graded via the Simplified Endoscopy Score for CD (SES-CD). The performance of MRE indices in discriminating active disease (SES-CD ≥3) stratified by MRE quality was measured by receiver operator characteristic analyses.
Results
One hundred and thirty-seven patients had MRE and colonoscopy within a median of 16 days (range, 0–30 days) with 63 (46%) exhibiting active disease (SES-CD ≥3). Forty-four MREs (32%) were deemed low quality due to motion artifact and/or moderate to poor distention. Low-quality MREs demonstrated reduced discriminative performance between ileal SES-CD ≥3 and MRE indices (MaRIA 0.838 vs. 0.634, sMaRIA 0.834 vs. 0.527, CDMI 0.850 vs. 0.595, London 0.748 vs. 0.511, P<0.05 for all). Individually the presence of any motion artifact markedly impacted the discriminative performance (e.g., sMaRIA area under the curve 0.544 vs. 0.814, P<0.05).
Conclusions
Image quality parameters can significantly impact MRE disease activity interpretation. Quality metrics should be reported, enabling cautious interpretation in lower-quality studies.

Citations

Citations to this article as recorded by  
  • Magnetic resonance enterography in diagnosing and monitoring of adult-onset IgA vasculitis (Henoch-Schönlein purpura) with gastro-intestinal involvement: Report of two cases
    Edoardo Conticini, Susanna Guerrini, Paolo Falsetti, Maria Antonietta Mazzei, Luca Cantarini, Bruno Frediani
    The Egyptian Rheumatologist.2024; 46(2): 90.     CrossRef
  • Advocating for Consensus: The Crucial Role of Standardised Magnetic Resonance Imaging Protocols and Image Quality Metrics in Assessment of Crohn’s Disease
    Mustafa Mohamedrashed, Mayur Garg, Anuj Bohra
    Journal of Crohn's and Colitis.2024; 18(9): 1524.     CrossRef
  • Achieving high-quality magnetic resonance enterography is critical for assessing Crohn’s disease activity
    Kyoung Doo Song
    Intestinal Research.2024; 22(2): 117.     CrossRef
  • Bowel preparation after mid-gut tubing enhanced the efficacy and compliance of magnetic resonance enterography in Crohn’s disease: a randomized controlled trial
    Yun Wang, Min Dai, Minghui Zheng, Yan Jin, Quan Wen, Bota Cui, Zulun Zhang, Jianguo Zhu, Faming Zhang
    Therapeutic Advances in Gastroenterology.2024;[Epub]     CrossRef
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  • 4 Web of Science
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IBD
Insomnia is common in inflammatory bowel disease (IBD) and is associated with mental health conditions as well as IBD activity
Alex Barnes, Jane M Andrews, Sutapa Mukherjee, Robert V Bryant, Peter Bampton, Robert J. Fraser, Réme Mountifield
Intest Res 2024;22(1):104-114.   Published online November 1, 2023
DOI: https://doi.org/10.5217/ir.2023.00028
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Insomnia is common in people with chronic medical conditions, such as inflammatory bowel disease (IBD), and is readily treatable through cognitive behavioral therapy for insomnia. This study aimed to describe the associations with insomnia in people with IBD and its relationship to IBD-related disability.
Methods
An online questionnaire was administered through 3 tertiary IBD centers, social media, and Crohn’s Colitis Australia. The questionnaire included the Insomnia Severity Index (ISI), a validated assessment of insomnia. Measures of anxiety, depression, physical activity, and disability were also included. IBD activity was assessed using validated patient reported scores. A multivariate model was constructed for clinically significant insomnia and ISI scores. Subpopulations of Crohn’s disease and ulcerative colitis were considered.
Results
In a cohort of 670 respondents the median age was 41 years (range, 32–70 years), with the majority female (78.4%), the majority had Crohn’s disease (57.3%). Increasingly severe disability was associated with worse insomnia score. Clinically significant insomnia was associated with clinically active IBD, abdominal pain, anxiety, and depression, in a multivariate model. In an ulcerative colitis population, Simple Clinical Colitis Activity Index components of general well-being and urgency were associated with worse ISI score in a model including depression and anxiety. In those with Crohn’s disease, the multivariate model included Harvey Bradshaw Index score in addition to depression and anxiety.
Conclusions
Insomnia is common in people with IBD and is associated with increased disability. Abdominal pain and mental health conditions should prompt consideration for screening for insomnia and referral for cognitive behavioral therapy for insomnia.

Citations

Citations to this article as recorded by  
  • The IBD Clinic of Tomorrow: Holistic, Patient-Centric, and Value-based Care
    Benjamin Click, Raymond K. Cross, Miguel Regueiro, Laurie Keefer
    Clinical Gastroenterology and Hepatology.2025; 23(3): 419.     CrossRef
  • Chronic Poor Sleep is Associated with Increased Disease Activity in Patients with Ulcerative Colitis: Prospective Observational Study in Japan
    Hideaki Oyama, Rintaro Moroi, Atsushi Sakuma, Yusuke Shimoyama, Hiroshi Nagai, Takeo Naito, Hisashi Shiga, Yoichi Kakuta, Yoshitaka Kinouchi, Atsushi Masamune
    Journal of Crohn's and Colitis.2025;[Epub]     CrossRef
  • Association between depression and anxiety with the risk and flare of inflammatory bowel disease: a systematic review and meta-analysis
    Guowei Gong, Cong Xu, Zhenxia Zhang, Yuzhong Zheng
    Internal and Emergency Medicine.2025; 20(1): 35.     CrossRef
  • The Spectrum of Psychiatric Comorbidity in Individuals With Inflammatory Bowel Disease
    Kianna Cadogan, Ruth Ann Marrie, Lesley A Graff, Renee El Gabalawy, Murray W Enns, James M Bolton, Jitender Sareen, Charles N Bernstein
    Crohn's & Colitis 360.2025;[Epub]     CrossRef
  • Type D personality, insomnia severity, perceived stress, and health-related quality of life in inflammatory bowel disease: A case–control study
    Hassan Mohammed Sonbol, Mona Metwally El-Sayed, Mahmoud Abdelwahab Khedr, Mohamad Abulhassan Ibrahim, Manar Osama, Asmaa Adel Abdel-Sattar, Hiam Fathy Elsaied, Eman Abdeen Ali, Shorouk Mohsen, Alaa Salah Abdel Mawgoud
    Journal of Psychosomatic Research.2025; 195: 112199.     CrossRef
  • Development of a technology-enhanced patient-reported outcome evaluation system for inflammatory bowel disease: A multidimensional approach to assessing survival quality
    Qian Jiang, Ling Du
    Technology and Health Care.2025;[Epub]     CrossRef
  • The impact of sleep quality on the prognosis of inflammatory bowel disease commonly overlooked by gastroenterologists
    Ji Young Chang
    Intestinal Research.2024; 22(1): 5.     CrossRef
  • Sleep quality is associated with reduced quality of life in inflammatory bowel disease through its interaction with pain
    Alex Barnes, Robert V Bryant, Sutapa Mukherjee, Paul Spizzo, Réme Mountifield
    JGH Open.2024;[Epub]     CrossRef
  • Abdominal Pain in Inflammatory Bowel Disease-Epidemiology, Pathophysiology, and Management: A Narrative Review
    Wei-wei Tan, Zi-xuan Liu, Xiao-Yan Liu, Wei-bing Zhang, Lie Zheng, Ya-Li Zhang, Yan-Cheng Dai
    Pain and Therapy.2024; 13(6): 1447.     CrossRef
  • Impact of Inflammatory Bowel Disease on Patient’s Quality of Life – A Review
    Kamila Duszyńska, Karol Dolepski, Alicja Góral, Krystian Żuk, Michał Czachajda
    Journal of Health Study and Medicine.2024; 2024(1): 185.     CrossRef
  • 5,206 View
  • 285 Download
  • 7 Web of Science
  • 10 Crossref
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IBD
Association of colonic metaplasia of goblet cells and endoscopic phenotypes of the J pouch in patients with ulcerative colitis: a retrospective pilot study
Shintaro Akiyama, Tsubasa Onoda, Shoko Moue, Noriaki Sakamoto, Taku Sakamoto, Hideo Suzuki, Tsuyoshi Enomoto, Daisuke Matsubara, Tatsuya Oda, Kiichiro Tsuchiya
Intest Res 2024;22(1):92-103.   Published online January 29, 2024
DOI: https://doi.org/10.5217/ir.2023.00105
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Mucosal adaptation of the ileum toward colonic epithelium has been reported in pouchitis in ulcerative colitis (UC); however, the clinical characteristics, endoscopic findings, and outcomes in patients with pouchitis with ileal mucosal adaptation are poorly understood.
Methods
This was a single-center retrospective study comprising UC patients treated by proctocolectomy with ileal pouch-anal anastomosis who had undergone pouchoscopy at the University of Tsukuba Hospital between 2005 and 2022. Endoscopic phenotypes were evaluated according to the Chicago classification. High-iron diamine staining (HID) was performed to identify sulfomucin (colon-type mucin)-producing goblet cells (GCs) in pouch biopsies. We compared clinical data between patients with (high HID group) and without > 10% sulfomucin-producing GCs in at least one biopsy (low HID group).
Results
We reviewed 390 endoscopic examination reports from 50 patients. Focal inflammation was the most common phenotype (78%). Five patients (10%) required diverting ileostomy. Diffuse inflammation and fistula were significant risk factors for diverting ileostomy. The median proportion of sulfomucin-producing GCs on histological analysis of 82 pouch biopsies from 23 patients was 9.9% (range, 0%–93%). The duration of disease was significantly greater in the high HID group compared to the low HID group. The median percentage of sulfomucin-producing GCs was significantly higher in patients with diffuse inflammation or fistula compared to other endoscopic phenotypes (14% vs. 6.0%, P= 0.011).
Conclusions
Greater proportions of sulfomucin-producing GCs were observed in endoscopic phenotypes associated with poor outcomes in UC, indicating patients with pouchitis showing colonic metaplasia of GCs may benefit from early interventions.

Citations

Citations to this article as recorded by  
  • Endoscopic assessment of the J pouch in ulcerative colitis: A narrative review
    Shintaro Akiyama, Edward L Barnes, Tsubasa Onoda, Naoki Ishikawa, Mamiko Shiroyama, Yuka Ito, David T Rubin, Kiichiro Tsuchiya
    DEN Open.2025;[Epub]     CrossRef
  • Prevalence and predictability of the Chicago Classification of Pouchitis in ulcerative colitis: a multicenter study in Japan
    Shintaro Akiyama, Ryohei Hayashi, Takeshi Takasago, Kurando Kusunoki, Hiroki Ikeuchi, Kento Takenaka, Kazuhiro Watanabe, Kazutaka Koganei, Nobuhiro Ueno, Mikihiro Fujiya, Naoki Hosoe, Fumikazu Koyama, Yasuhisa Sakata, Motohiro Esaki, Ken Takeuchi, Makoto
    Journal of Gastroenterology.2025; 60(6): 715.     CrossRef
  • A Comparative Analysis of Clinical Symptoms and Modified Pouchitis Disease Activity Index Among Endoscopic Phenotypes of the J Pouch in Patients With Inflammatory Bowel Disease
    Shintaro Akiyama, Nathaniel A Cohen, Jacob E Ollech, Cindy Traboulsi, Tina Rodriguez, Victoria Rai, Laura R Glick, Yangtian Yi, Joseph Runde, Russell D Cohen, Kinga B Skowron, Roger D Hurst, Konstantin Umanskiy, Benjamin D Shogan, Neil H Hyman, Michele A
    Crohn's & Colitis 360.2024;[Epub]     CrossRef
  • 3,447 View
  • 158 Download
  • 3 Web of Science
  • 3 Crossref
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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
AbstractAbstract PDFSupplementary MaterialPubReaderePub
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
  • 3,044 View
  • 144 Download
  • 1 Web of Science
  • 2 Crossref
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IBD
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
Intest Res 2024;22(1):75-81.   Published online November 1, 2023
DOI: https://doi.org/10.5217/ir.2023.00065
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
The achievement of endoscopic remission is an important therapeutic goal in the treatment of inflammatory bowel diseases (IBD). We aimed to evaluate the role of fecal calprotectin (FCP) and ischemia-modified albumin (IMA) as biomarkers for evaluating IBD disease activity.
Methods
A total of 48 patients with IBD (20 with ulcerative colitis and 28 with Crohn’s disease) were included in this study. FCP and serum C-reactive protein levels, erythrocyte sedimentation rate, and IMA were measured in patients with IBD and compared with endoscopic findings.
Results
Elevated FCP and serum IMA levels were significantly associated with endoscopic non-mucosal healing. The correlation between FCP and IMA was not significant. Analysis of the receiver operating characteristic curve showed that both FCP and IMA had diagnostic value in predicting non-mucosal healing. When the Ln(FCP)+IMA/10 value was calculated using both factors, the predictive value for non-mucosal healing increased; however, no significant difference was observed.
Conclusions
IMA could be a candidate serum biomarker for predicting endoscopic mucosal healing in IBD.

Citations

Citations to this article as recorded by  
  • A novel serum biomarker of endoscopic mucosal healing in inflammatory bowel disease
    Hyoun Woo Kang
    Intestinal Research.2024; 22(1): 3.     CrossRef
  • 3,612 View
  • 251 Download
  • 1 Crossref
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IBD
Combination of leucine-rich alpha-2 glycoprotein and fecal markers detect Crohn’s disease activity confirmed by balloon-assisted enteroscopy
Ami Kawamoto, Kento Takenaka, Shuji Hibiya, Yoshio Kitazume, Hiromichi Shimizu, Toshimitsu Fujii, Eiko Saito, Kazuo Ohtsuka, Ryuichi Okamoto
Intest Res 2024;22(1):65-74.   Published online November 9, 2023
DOI: https://doi.org/10.5217/ir.2023.00092
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Endoscopic activity confirmed by enteroscopy is associated with poor clinical outcome in Crohn’s disease (CD). We investigated which of the existing biomarkers best reflects endoscopic activity in CD patients including the small bowel, and whether their combined use can improve accuracy.
Methods
One hundred and four consecutive patients with ileal and ileocolonic type CD who underwent balloon-assisted enteroscopy (BAE) from October 2021 to August 2022 were enrolled, with clinical and laboratory data prospectively collected and analyzed.
Results
Hemoglobin, platelet count, C-reactive protein, leucine-rich alpha-2 glycoprotein (LRG), fecal calprotectin, and fecal hemoglobin all showed significant difference in those with ulcers found on BAE. LRG and fecal calprotectin showed the highest areas under the curve (0.841 and 0.853) for detecting ulcers. LRG showed a sensitivity of 78% and specificity of 80% at a cutoff value of 13 μg/mL, whereas fecal calprotectin showed a sensitivity of 91% and specificity of 67% at a cutoff value of 151 μg/g. Dual positivity for LRG and fecal calprotectin, as well as LRG and fecal hemoglobin, both predicted ulcers with an improved specificity of 92% and 100%. A positive LRG or fecal calprotectin/hemoglobin showed an improved sensitivity of 96% and 91%. Positivity for LRG and either of the fecal biomarkers was associated with increased risk of hospitalization, surgery, and relapse.
Conclusions
The biomarkers LRG, fecal calprotectin, and fecal hemoglobin can serve as noninvasive and accurate tools for assessing activity in CD patients confirmed by BAE, especially when used in combination.

Citations

Citations to this article as recorded by  
  • Leucine-rich alpha-2 glycoprotein in combination with C-reactive protein for predicting endoscopic activity in Crohn’s disease: a single-centre, cross-sectional study
    Yoshiaki Takada, Hiroki Kiyohara, Yohei Mikami, Masataka Taguri, Ryoya Sakakibara, Yasuhiro Aoki, Kosaku Nanki, Takaaki Kawaguchi, Yusuke Yoshimatsu, Shinya Sugimoto, Tomohisa Sujino, Kaoru Takabayashi, Naoki Hosoe, Haruhiko Ogata, Motohiko Kato, Yasushi
    Annals of Medicine.2025;[Epub]     CrossRef
  • Leucine-rich alpha-2 glycoprotein as a superior biomarker to C-reactive protein for detecting small bowel lesions in Crohn’s disease
    Masashi Ohno, Atsushi Nishida, Akinori Otsuki, Yoshihiro Yokota, Takayuki Imai, Shigeki Bamba, Osamu Inatomi
    World Journal of Gastrointestinal Endoscopy.2025;[Epub]     CrossRef
  • The usefulness of serum leucine-rich alpha-2 glycoprotein as a novel biomarker in monitoring inflammatory bowel disease: a systematic review and meta-analysis
    Fatemeh Ojaghi Shirmard, Seyed Morteza Pourfaraji, Behrad Saeedian, Tannaz Bagheri, Abdulrahman Ismaiel, Satohiro Matsumoto, Nastaran Babajani
    European Journal of Gastroenterology & Hepatology.2025; 37(8): 891.     CrossRef
  • Diagnostic accuracy and cut-off values of serum leucine-rich alpha-2 glycoprotein for Crohn’s disease activity in the small bowel
    Muneyori Okita, Kento Takenaka, Fumihito Hirai, Shinya Ashizuka, Hideki Iijima, Shigeki Bamba, Toshimitsu Fujii, Kenji Watanabe, Yosuke Shimodaira, Hisashi Shiga, Sakiko Hiraoka, Toshihiro Inokuchi, Takeshi Yamamura, Ryo Emoto, Shigeyuki Matsui
    Journal of Gastroenterology.2025; 60(5): 573.     CrossRef
  • Leucine-rich alpha-2 glycoprotein is useful in predicting clinical relapse in patients with Crohn’s disease during biological remission
    Naohiro Nakamura, Yusuke Honzawa, Yuka Ito, Yasuki Sano, Naoto Yagi, Sanshiro Kobayashi, Mamiko Aoi, Takashi Tomiyama, Tomomitsu Tahara, Norimasa Fukata, Toshiro Fukui, Makoto Naganuma
    Intestinal Research.2025; 23(2): 170.     CrossRef
  • Efficient diagnosis for endoscopic remission in Crohn’s diseases by the combination of three non-invasive markers
    Kensuke Takei, Toshihiro Inokuchi, Sakiko Hiraoka, Mikako Ishiguro, Junki Toyosawa, Yuki Aoyama, Shoko Igawa, Keiko Takeuchi, Yasushi Yamasaki, Hideaki Kinugasa, Masahiro Takahara, Seiji Kawano, Toshiharu Mitsuhashi, Motoyuki Otsuka
    BMC Gastroenterology.2025;[Epub]     CrossRef
  • Usefulness of Prostaglandin E-Major Urinary Metabolite in Monitoring Crohn’s Disease Activity: A Prospective Cross-Sectional Study
    Natsuki Ishida, Satoshi Tamura, Tomohiro Takebe, Kenichi Takahashi, Yusuke Asai, Tomoharu Matsuura, Mihoko Yamade, Moriya Iwaizumi, Yasushi Hamaya, Takanori Yamada, Satoshi Osawa, Ken Sugimoto
    Inflammatory Bowel Diseases.2025;[Epub]     CrossRef
  • Which biomarkers best reflect the degree of inflammation in Crohn’s disease?
    Jihye Park
    Intestinal Research.2024; 22(1): 1.     CrossRef
  • Efficacy of serum leucine-rich alpha-2 glycoprotein in predicting findings of Crohn’s disease small bowel lesion in capsule endoscopy
    Teppei Omori, Miki Koroku, Shun Murasugi, Ayumi Ito, Maria Yonezawa, Shinichi Nakamura, Katsutoshi Tokushige
    Intestinal Research.2024; 22(4): 464.     CrossRef
  • Selection of anti-cytokine biologics by pretreatment levels of serum leucine-rich alpha-2 glycoprotein in patients with inflammatory bowel disease
    Takahiro Amano, Takeo Yoshihara, Shinichiro Shinzaki, Yuko Sakakibara, Takuya Yamada, Naoto Osugi, Satoshi Hiyama, Yoko Murayama, Koji Nagaike, Hideharu Ogiyama, Toshio Yamaguchi, Yuki Arimoto, Ichizo Kobayashi, Shoichiro Kawai, Satoshi Egawa, Takashi Kiz
    Scientific Reports.2024;[Epub]     CrossRef
  • 4,684 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
AbstractAbstract PDFPubReaderePub
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
  • 3,207 View
  • 313 Download
  • 4 Web of Science
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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
AbstractAbstract PDFSupplementary MaterialPubReaderePub
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
  • 3,199 View
  • 201 Download
  • 2 Web of Science
  • 2 Crossref
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Infection
How the COVID-19 pandemic affected the severity and clinical presentation of diverticulitis
Sara S. Soliman, Rolando H. Rolandelli, Grace C. Chang, Amanda K. Nemecz, Zoltan H. Nemeth
Intest Res 2023;21(4):493-499.   Published online October 26, 2023
DOI: https://doi.org/10.5217/ir.2022.00042
AbstractAbstract PDFPubReaderePub
Background/Aims
Single-institution studies showed that patients presented with more severe diverticulitis and underwent more emergency operations during the coronavirus disease 2019 (COVID-19) pandemic. Therefore, we studied this trend using nationwide data from the American College of Surgeons National Surgical Quality Improvement Program database.
Methods
Patients (n = 23,383) who underwent a colectomy for diverticulitis in 2018 (control year) and 2020 (pandemic year) were selected. We compared these groups for differences in disease severity, comorbidities, perioperative factors, and complications.
Results
During the pandemic, colonic operations for diverticulitis decreased by 13.14%, but the rates of emergency operations (17.31% vs. 20.04%, P< 0.001) and cases with a known abscess/perforation (50.11% vs. 54.55%, P< 0.001) increased. Likewise, the prevalence of comorbidities, such as congestive heart failure, acute renal failure, systemic inflammatory response syndrome, and septic shock, were higher during the pandemic (P< 0.05). During this same period, significantly more patients were classified under American Society of Anesthesiologists classes 3, 4, and 5, suggesting their preoperative health states were more severe and life-threatening. Correspondingly, the average operation time was longer (P< 0.001) and complications, such as organ space surgical site infection, wound disruption, pneumonia, acute renal failure, septic shock, and myocardial infarction, increased (P< 0.05) during the pandemic.
Conclusions
During the pandemic, surgical volume decreased, but the clinical presentation of diverticulitis became more severe. Due to resource reallocation and possibly patient fear of seeking medical attention, diverticulitis was likely underdiagnosed, and cases that would have been elective became emergent. This underscores the importance of monitoring patients at risk for diverticulitis and intervening when criteria for surgery are met.

Citations

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  • Impact of the COVID-19 Pandemic on the Management of Acute Colonic Diverticulitis: A Retrospective Observational Study
    Manuela Mastronardi , Aurora Bertini, Margherita Sandano, Paola Germani, Marina Troian, Nicolò de Manzini, Alan Biloslavo
    Cureus.2025;[Epub]     CrossRef
  • Surgical and non-operative treatment of acute complicated diverticulitis in a COVID hospital
    A. E. Tyagunov, N. A. Shcherbakov, R. R. Akhmedov, N. S. Donchenko, B. K. Laipanov, Z. M. Alieva, E. A. Stradymov, A. V. Tavadov, A. T. Mirzoyan, D. D. Fyodorov, A. A. Tyagunov, A. V. Sazhin
    Koloproktologia.2024; 23(2): 108.     CrossRef
  • 3,189 View
  • 142 Download
  • 2 Crossref
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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
AbstractAbstract PDFSupplementary MaterialPubReaderePub
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.

Citations

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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
  • 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
  • 4,292 View
  • 360 Download
  • 3 Web of Science
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IBD
Malnutrition and inflammation status in nonobese patients with inflammatory bowel disease are associated with nonalcoholic fatty liver disease: a retrospective study
Takahiro Nagata, Sadahiro Funakoshi, Daisuke Morihara, Satoshi Shakado, Keiji Yokoyama, Kazuhide Takata, Takashi Tanaka, Atsushi Fukunaga, Ryo Yamauchi, Hiromi Fukuda, Hiroki Matsuoka, So Imakiire, Hideto Sakisaka, Satoshi Matsuoka, Nobuaki Kuno, Koichi Abe, Hideki Ishibashi, Shinya Ashizuka, Fumihito Hirai
Intest Res 2023;21(4):471-480.   Published online August 11, 2023
DOI: https://doi.org/10.5217/ir.2023.00035
AbstractAbstract PDFPubReaderePub
Background/Aims
The frequency and details of nonalcoholic fatty liver disease (NAFLD) complications in patients with inflammatory bowel disease (IBD) remain unclear. This study aimed to clarify characteristics of NAFLD in patients with IBD.
Methods
We retrospectively identified and enrolled patients with IBD diagnosed with or without NAFLD by undergoing abdominal computed tomography (CT) at our institution between 2005 and 2020. The primary endpoint was the complication rate of NAFLD in patients with IBD. Secondary endpoints were the clinical characteristics of nonobese patients with IBD and comorbid NAFLD and their association with nutritional and inflammatory parameters.
Results
Twenty-one (21.9%) of 96 eligible patients with IBD also had NAFLD. In nonobese patients (defined as patients with a body mass index <25 kg/m2), C-reactive protein (CRP; P<0.001) and alanine aminotransferase (P=0.018) levels were higher and the albumin level (P=0.005) and prognostic nutritional index (PNI; P=0.002) values were lower in patients with NAFLD than in those without NAFLD. The PNI value was positively correlated (P<0.001) and the CRP level was negatively correlated (P=0.001) with the hepatosplenic ratio. However, in the NAFLD combined group, PNI (P<0.05) and CRP values (P<0.001) were improved over time after CT imaging by continuing IBD treatment.
Conclusions
Worsening nutritional and inflammatory status in IBD patients is associated with complications of NAFLD. Diagnosis of NAFLD in IBD patients using CT imaging might be useful not only for early detection of NAFLD but also in assessing the need for therapeutic intervention for IBD.

Citations

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  • Elucidating the association between nonalcoholic fatty liver disease and incidence of inflammatory bowel disease: a focus on systemic inflammation
    Sihyun Kim, Jong Pil Im
    Intestinal Research.2025; 23(1): 3.     CrossRef
  • Metabolic Disorders and Inflammatory Bowel Diseases
    Hye Kyung Hyun, Jae Hee Cheon
    Gut and Liver.2025; 19(3): 307.     CrossRef
  • Impact of body mass index on clinical outcomes in intestinal Behçet’s disease
    Daye Park, Jihye Park, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jae Hee Cheon
    The Korean Journal of Internal Medicine.2025; 40(4): 606.     CrossRef
  • 3,753 View
  • 255 Download
  • 3 Web of Science
  • 3 Crossref
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IBD
Serum albumin is the strongest predictor of anti-tumor necrosis factor nonresponse in inflammatory bowel disease in resource-constrained regions lacking therapeutic drug monitoring
Peeyush Kumar, Sudheer K. Vuyyuru, Prasenjit Das, Bhaskar Kante, Mukesh Kumar Ranjan, David Mathew Thomas, Sandeep Mundhra, Pabitra Sahu, Pratap Mouli Venigalla, Saransh Jain, Sandeep Goyal, Rithvik Golla, Shubi Virmani, Mukesh K. Singh, Karan Sachdeva, Raju Sharma, Nihar Ranjan Dash, Govind Makharia, Saurabh Kedia, Vineet Ahuja
Intest Res 2023;21(4):460-470.   Published online March 17, 2023
DOI: https://doi.org/10.5217/ir.2022.00128
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Evidence on predictors of primary nonresponse (PNR), and secondary loss of response (SLR) to anti-tumor necrosis factor (anti-TNF) agents in inflammatory bowel disease is scarce from Asia. We evaluated clinical/biochemical/molecular markers of PNR/SLR in ulcerative colitis (UC) and Crohn’s disease (CD).
Methods
Inflammatory bowel disease patients treated with anti-TNF agents (January 2005–October 2020) were ambispectively included. Data concerning clinical and biochemical predictors was retrieved from a prospectively maintained database. Immunohistochemistry for expression of oncostatin M (OSM), OSM receptor (OSM-R), and interleukin-7 receptor (IL-7R) were done on pre anti-TNF initiation mucosal biopsies.
Results
One-hundred eighty-six patients (118 CD, 68 UC: mean age, 34.1±13.7 years; median disease duration at anti-TNF initiation, 60 months; interquartile range, 28–100.5 months) were included. PNR was seen in 17% and 26.5% and SLR in 47% and 28% CD and UC patients, respectively. In CD, predictors of PNR were low albumin (P<0.001), postoperative recurrence (P=0.001) and high IL-7R expression (P<0.027) on univariate; and low albumin alone (hazard ratio [HR], 0.09; 95% confidence interval [CI], 0.03–0.28; P<0.001) on multivariate analysis respectively. Low albumin (HR, 0.31; 95% CI, 0.15–0.62; P=0.001) also predicted SLR. In UC, predictors of PNR were low albumin (P<0.001), and high C-reactive protein (P<0.001), OSM (P<0.04) and OSM-R (P=0.07) stromal expression on univariate; and low albumin alone (HR, 0.11; 95% CI, 0.03–0.39; P=0.001) on multivariate analysis respectively.
Conclusions
Low serum albumin at baseline significantly predicted PNR in UC and PNR/SLR in CD patients. Mucosal markers of PNR were high stromal OSM/OSM-R in UC and high IL-7R in CD patients.

Citations

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  • Population Pharmacokinetic Model for the Use of Intravenous or Subcutaneous Infliximab in Patients with Inflammatory Bowel Disease: Real-World Data from a Prospective Cohort Study
    Joo Hye Song, Sung Noh Hong, Myeong Gyu Kim, Minjung Kim, Seong Kyung Kim, Eun Ran Kim, Dong Kyung Chang, Young-Ho Kim
    Gut and Liver.2025; 19(3): 376.     CrossRef
  • The efficacy of infliximab combined with partial enteral nutrition in the treatment of Crohn’s disease: a cohort study
    Chen Huang, Chao Chen, Hao Wu, Hanyu Yin, Weixiang Yao, Susu Bai, Baixue Zhuo, Xiaoli Wu
    Frontiers in Nutrition.2025;[Epub]     CrossRef
  • Effectiveness of Switching to Subcutaneous Infliximab in Ulcerative Colitis Patients Experiencing Intravenous Infliximab Failure
    June Hwa Bae, Jung-Bin Park, Ji Eun Baek, Seung Wook Hong, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Sung Wook Hwang
    Gut and Liver.2024; 18(4): 667.     CrossRef
  • Tofacitinib in Steroid-Refractory Acute Severe Ulcerative Colitis: A Retrospective Analysis
    Sayan Malakar, Srikanth Kothalkar, Umair Shamsul Hoda, Uday C Ghoshal
    Cureus.2023;[Epub]     CrossRef
  • 5,760 View
  • 462 Download
  • 4 Web of Science
  • 4 Crossref
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IBD
Low prevalence of primary sclerosing cholangitis in patients with inflammatory bowel disease in India
Arshdeep Singh, Vandana Midha, Vikram Narang, Saurabh Kedia, Ramit Mahajan, Pavan Dhoble, Bhavjeet Kaur Kahlon, Ashvin Singh Dhaliwal, Ashish Tripathi, Shivam Kalra, Narender Pal Jain, Namita Bansal, Rupa Banerjee, Devendra Desai, Usha Dutta, Vineet Ahuja, Ajit Sood
Intest Res 2023;21(4):452-459.   Published online December 2, 2022
DOI: https://doi.org/10.5217/ir.2022.00087
AbstractAbstract PDFPubReaderePub
Background/Aims
Primary sclerosing cholangitis (PSC) represents the most common hepatobiliary extraintestinal manifestation of inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD). Limited data exist on PSC in patients with IBD from India. We aimed to assess the prevalence and disease spectrum of PSC in Indian patients with IBD.
Methods
Database of IBD patients at 5 tertiary care IBD centers in India were analyzed retrospectively. Data were extracted and the prevalence of PSC-IBD was calculated.
Results
Forty-eight patients out of 12,216 patients with IBD (9,231 UC, 2,939 CD, and 46 IBD unclassified) were identified to have PSC, resulting in a prevalence of 0.39%. The UC to CD ratio was 7:1. Male sex and pancolitis (UC) or colonic CD were more commonly associated with PSC-IBD. The diagnosis of IBD preceded the diagnosis of PSC in most of the patients. Majority of the patients were symptomatic for liver disease at diagnosis. Eight patients (16.66%) developed cirrhosis, 5 patients (10.41%), all UC, developed malignancies (3 colorectal cancer [6.25%] and 2 cholangiocarcinoma [4.16%]), and 3 patients died (2 decompensated liver disease [4.16%] and 1 cholangiocarcinoma [2.08%]) on follow-up. None of the patients mandated surgical therapy for IBD.
Conclusions
Concomitant PSC in patients with IBD is uncommon in India and is associated with lower rates of development of malignancies.

Citations

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  • Inflammatory bowel disease in south Asia: a scoping review
    Shabari Shenoy, Anuraag Jena, Carrie Levinson, Vishal Sharma, Parakkal Deepak, Tina Aswani-Omprakash, Shaji Sebastian, Jean-Frederic Colombel, Manasi Agrawal
    The Lancet Gastroenterology & Hepatology.2025; 10(3): 259.     CrossRef
  • Prevalence and bidirectional association between primary sclerosing cholangitis and Crohn's disease: A systematic review and meta-analysis
    Dongyuan Zheng, Qinke Xu, Jin Wu, Zhouyue Gu, Jieya Chen, Yingchao Liu
    Gastroenterología y Hepatología.2025; : 502346.     CrossRef
  • Phenotypic Differences and Clinical Outcomes of South Asian Children With IBD: A Singapore–Malaysia Study From the Asian PIBD Registry Network
    James Guoxian Huang, Kee Seang Chew, Veena Logarajah, Way Seah Lee, Marion Margaret Aw
    Journal of Gastroenterology and Hepatology.2025;[Epub]     CrossRef
  • Frequency, spectrum and outcome of patients with primary sclerosing cholangitis among patients presenting with cholestatic jaundice
    Srikanth Kothalkar, Sayan Malakar, Piyush Mishra, Akash Mathur, Uday C. Ghoshal
    Indian Journal of Gastroenterology.2024;[Epub]     CrossRef
  • Ileal Pouch-Anal Anastomosis for Ulcerative Colitis: Predictors of Early and Late Complications
    Yajnadatta Sarangi, Ashok Kumar, Somanath Malage, Nalinikanta Ghosh, Rahul Rahul, Ashish Singh, Supriya Sharma, Rajneesh K Singh, Anu Behari, Ashok Kumar
    Cureus.2024;[Epub]     CrossRef
  • Incidence of Hepatobiliary Malignancies in Primary Sclerosing Cholangitis: Systematic Review and Meta-analysis
    Matheus Souza, Luan C.V. Lima, Lubna Al-Sharif, Daniel Q. Huang
    Clinical Gastroenterology and Hepatology.2024;[Epub]     CrossRef
  • Primary sclerosing cholangitis (PSC) and inflammatory bowel disease (IBD): a condition exemplifying the crosstalk of the gut–liver axis
    You Sun Kim, Edward H. Hurley, Yoojeong Park, Sungjin Ko
    Experimental & Molecular Medicine.2023; 55(7): 1380.     CrossRef
  • Treatment of primary sclerosing cholangitis combined with inflammatory bowel disease
    You Sun Kim, Edward H. Hurley, Yoojeong Park, Sungjin Ko
    Intestinal Research.2023; 21(4): 420.     CrossRef
  • Regional variations in the prevalence of primary sclerosing cholangitis associated with inflammatory bowel disease
    Kwang Woo Kim, Hyoun Woo Kang
    Intestinal Research.2023; 21(4): 413.     CrossRef
  • 5,990 View
  • 578 Download
  • 7 Web of Science
  • 9 Crossref
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IBD
Prevalence of hepatitis B virus and hepatitis C virus infection in patients with inflammatory bowel disease: a systematic review and meta-analysis
Suprabhat Giri, Dhiraj Agrawal, Shivaraj Afzalpurkar, Sunil Kasturi, Amrit Gopan, Sridhar Sundaram, Aditya Kale
Intest Res 2023;21(3):392-405.   Published online December 2, 2022
DOI: https://doi.org/10.5217/ir.2022.00094
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
The data on the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in patients with inflammatory bowel disease (IBD) are conflicting. The present systematic review was thus conducted to study the prevalence of HBV and HCV markers in patients with IBD.
Methods
A comprehensive literature search of 3 databases was conducted from 2000 to April 2022 for studies evaluating the prevalence of HBV or HCV in patients with IBD. Pooled prevalence rates across studies were expressed with summative statistics.
Results
A total of 34 studies were included in the final analysis. The pooled prevalence of hepatitis B surface antigen (HBsAg) and hepatitis B core antibodies were 3.3% and 14.2%, respectively. In HBsAg positive IBD patients, hepatitis B e antigen positivity and detectable HBV DNA were seen in 15.3% and 61.0% of patients, respectively. Only 35.6% of the IBD patients had effective HBV vaccination. The pooled prevalence of anti-HCV and detectable HCV RNA were 1.8% and 0.8%, respectively. The pooled prevalence of markers of HBV infection was higher in Asian studies, while the prevalence of markers of HCV infection was higher in European studies. The prevalence of viral hepatitis markers was similar between IBD patients and the general population and that between ulcerative colitis and Crohn’s disease.
Conclusions
The prevalence of markers of viral hepatitis remains same as the general population with significant regional variations, although the quality of evidence remains low due to publication bias. Only a small proportion of IBD patients had an effective HBV vaccination, requiring improvement in screening and vaccination practices.

Citations

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  • Hepatobiliary and pancreatic manifestations in inflammatory bowel disease: an umbrella review of meta-analyses
    Runsheng Hong, Zhixue Li, Meng Li, Yun Dai
    Therapeutic Advances in Gastroenterology.2025;[Epub]     CrossRef
  • Serological Assessment of Hepatitis in Patients with Inflammatory Bowel Disease in Taiwan: A Retrospective Cohort Analysis
    Yueh-An Lee, Hsu-Heng Yen, Yang-Yuan Chen
    Life.2025; 15(6): 893.     CrossRef
  • British Society of Gastroenterology guidelines on inflammatory bowel disease in adults: 2025
    Gordon W Moran, Morris Gordon, Vassiliki Sinopolou, Shellie J Radford, Ana-Maria Darie, Sudheer Kumar Vuyyuru, Laith Alrubaiy, Naila Arebi, Jonathan Blackwell, Thomas D Butler, Thean Chew, Michael Colwill, Rachel Cooney, Gabriele De Marco, Said Din, Shahi
    Gut.2025; 74(Suppl 2): s1.     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
  • Assessing the associations of inflammatory bowel disease and hepatitis B virus infections with two-sample bidirectional mendelian randomization
    Ping Han, Chaohui Wang, Yan Qiu
    Critical Public Health.2024; 34(1): 1.     CrossRef
  • Associations between chronic hepatitis B infection and inflammatory bowel diseases in East Asian populations
    Haiyan Ye, Deqin Wei, Yike Huang
    Future Virology.2024; 19(16-18): 563.     CrossRef
  • Protective role of flavonoids quercetin and silymarin in the viral-associated inflammatory bowel disease: an updated review
    Elham Zarenezhad, Hussein T. Abdulabbas, Ahmed Shayaa Kareem, Seyed Amin Kouhpayeh, Silvia Barbaresi, Sohrab Najafipour, Abdulbaset Mazarzaei, Mitra Sotoudeh, Abdolmajid Ghasemian
    Archives of Microbiology.2023;[Epub]     CrossRef
  • Infectious complications in patients with inflammatory bowel disease in Asia: the results of a multinational web-based survey in the 8th Asian Organization for Crohn’s and Colitis meeting
    Yu Kyung Jun, Seong-Joon Koh, Dae Seong Myung, Sang Hyoung Park, Choon Jin Ooi, Ajit Sood, Jong Pil Im
    Intestinal Research.2023; 21(3): 353.     CrossRef
  • Ulcerative colitis coexisting with hepatitis C: A rare occurrence
    Xiaoqiang Liu, Yisen Huan, Yubin Wang, Yingxuan Huang
    Medicine.2023; 102(50): e36629.     CrossRef
  • 5,633 View
  • 394 Download
  • 8 Web of Science
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IBD
Submucosal fat accumulation in Crohn’s disease: evaluation with sonography
Tomás Ripollés, María Jesús Martínez-Pérez, José María Paredes, José Vizuete, Gregorio Martin, Lidia Navarro
Intest Res 2023;21(3):385-391.   Published online March 17, 2023
DOI: https://doi.org/10.5217/ir.2022.00030
AbstractAbstract PDFPubReaderePub
Background/Aims
The study objective is to investigate the ultrasound features that allow suspecting the presence of submucosal fat deposition, called the fat halo sign (FHS), in the intestinal wall of patients with Crohn’s disease.
Methods
Computed tomography (CT) examinations over a period of 10 years were reviewed for the presence of the FHS in the bowel wall. A measurement of less than –10 Hounsfield units was regarded as indicative of fat. We included only patients who had undergone ultrasound examinations 3 months before or after CT. The study cohort group comprised 68 patients. Wall and submucosal thickness were measured on longitudinal ultrasound sections. A receiver operating characteristic curve was constructed to determine the best cutoff of ultrasound submucosal wall thickness value for predicting FHS in the bowel wall determined on CT.
Results
The FHS was present in 22 patients (31%) on CT. There were significant differences between submucosal thickness of patients with FHS and patients without FHS (4.19 mm vs. 2.41 mm). From the receiver operating characteristic curve, a threshold value of 3.1 mm of submucosal thickness had the best sensitivity and specificity to suspect FHS (95.5% and 89.1%, respectively; area under the curve, 0.962), with an odds ratio of 172. All of 16 patients with a submucosal thickness >3.9 mm had FHS.
Conclusions
FHS in patients with Crohn’s disease can be suspected on ultrasound in cases with marked thickening of the submucosa layer. In these cases, the activity of the disease should be measured by other parameters such as the color Doppler.

Citations

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  • Metabolic Disorders and Inflammatory Bowel Diseases
    Hye Kyung Hyun, Jae Hee Cheon
    Gut and Liver.2025; 19(3): 307.     CrossRef
  • A novel serum biomarker of endoscopic mucosal healing in inflammatory bowel disease
    Hyoun Woo Kang
    Intestinal Research.2024; 22(1): 3.     CrossRef
  • Role of Intestinal Ultrasound for IBD Care: A Practical Approach
    Joerg C. Hoffmann, Tobias Ungewitter
    Diagnostics.2024; 14(15): 1639.     CrossRef
  • 4,906 View
  • 238 Download
  • 3 Web of Science
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IBD
Inflammatory bowel disease (IBD)-disk accurately predicts the daily life burden and parallels disease activity in patients with IBD
Arshdeep Singh, Yogesh Kumar Gupta, Ashvin Singh Dhaliwal, Bhavjeet Kaur Kahlon, Vasu Bansal, Ramit Mahajan, Varun Mehta, Dharmatma Singh, Ramandeep Kaur, Namita Bansal, Vandana Midha, Ajit Sood
Intest Res 2023;21(3):375-384.   Published online October 18, 2022
DOI: https://doi.org/10.5217/ir.2022.00037
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
The inflammatory bowel disease (IBD)-disk is a validated, visual, 10-item, self-administered questionnaire used to evaluate IBD-related disability. The present study aimed to evaluate IBD-disk in assessment of IBD daily life burden and its relation with disease activity. Methods: A cross-sectional study was conducted between June 2021 and December 2021. Patients with IBD were asked to complete the IBD-disk and a visual analogue scale of IBD daily-life burden (scored from 0–10, score >5 indicative of high burden). The internal consistency of IBD-disk, correlation with IBD daily life burden and disease activity (assessed by partial Mayo score and Harvey Bradshaw Index in patients with ulcerative colitis [UC] and Crohn’s disease [CD], respectively) and diagnostic performance of IBD-disk to detect high burden were analyzed. Results: Out of the 546 patients (mean age 40.33±13.74 years, 282 [51.6%] males) who completed the IBD-disk, 464 (84.98%) had UC and the remaining (n=82, 15.02%) had CD. A total of 311 patients (291 UC and 20 CD; 56.95%) had active disease. The mean IBD-disk total score and IBD daily life burden were 18.39±15.23 and 2.45±2.02, respectively. The IBD-disk total score correlated strongly with the IBD daily life burden (ρ=0.94, P<0.001), moderately with partial Mayo score (ρ=0.50) and weakly with Harvey Bradshaw Index (ρ=0.34). The IBD-disk total score >30 predicted high IBD daily-life burden. Conclusions: The IBD-disk accurately predicts the daily life burden and parallels disease activity in patients with IBD and can be applied in clinical practice. (Intest Res, Published online)

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  • Is IBD Disk a Reliable Tool to Detect Depression in IBD Patients? A Comparison with Becks’ Depression Inventory
    Teodora Spataru, Ana Stemate, Marina Cozma, Alexandru Fleschiu, Remus Popescu, Lucian Negreanu
    Gastrointestinal Disorders.2025; 7(1): 23.     CrossRef
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    P. Vega, J. M. Huguet, E. Gómez, S. Rubio, P. Suarez, M. I. Vera, J. M. Paredes, A. Hernández-Camba, R. Plaza, M. Mañosa, R. Pajares, B. Sicilia, L. Madero, S. Kolterer, C. Leitner, T. Heatta-Speicher, N. Michelena, R. Santos de Lamadrid, A. Dignass, F. G
    Digestive Diseases and Sciences.2024; 69(3): 749.     CrossRef
  • Proportion of inflammatory bowel diseases patients with suboptimal disease control in daily clinical practice—Real‐world evidence from the inflammatory bowel diseases‐podcast study
    Ferdinando D’Amico, Fernando Gomollón, Giorgos Bamias, Fernando Magro, Laura Targownik, Claudia Leitner, Tobias Heatta‐Speicher, Naiara Michelena, Stefanie Kolterer, Jennifer Lapthorn, Laura Kauffman, Axel Dignass
    United European Gastroenterology Journal.2024; 12(6): 705.     CrossRef
  • A Cross-Sectional Evaluation of Disability in Inflammatory Bowel Disease Using IBD Disk in a Tertiary Center from Romania
    Oana-Maria Muru, Corina Silvia Pop, Petruța Violeta Filip, Nicoleta Tiucă, Laura Sorina Diaconu
    Journal of Clinical Medicine.2024; 13(23): 7168.     CrossRef
  • Perceptions and Responses to Diseases among Patients with Inflammatory Bowel Disease: Text Mining Analysis of Posts on a Japanese Patient Community Website
    Eujin Lee, Hiroaki Tsuchiya, Hajime Iida, Katsumasa Nagano, Yoko Murata, Atsuo Maemoto
    Inflammatory Intestinal Diseases.2024; 9(1): 283.     CrossRef
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Vaccination in patients with inflammatory bowel disease–Asian perspectives: the results of a multinational web-based survey in the 8th Asian Organization for Crohn’s and Colitis meeting
Su Bum Park, Kyeong Ok Kim, Hong Sub Lee, Chang Hwan Choi, Shu Chen Wei, Min Hu Chen, Katsuyoshi Matsuoka
Intest Res 2023;21(3):363-374.   Published online June 16, 2023
DOI: https://doi.org/10.5217/ir.2023.00015
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Long-term immunosuppressive therapies used to treat inflammatory bowel disease (IBD) are associated with an increased risk of infections, many of which can be prevented by vaccination. We assessed physicians’ current approaches and clinical practices regarding vaccinations for IBD patients in different Asian countries/regions.
Methods
An internet-based survey was conducted among members of the Asian Organization for Crohn’s and Colitis from September 2020 to November 2020. The questionnaire consisted of 2 parts covering general opinion on the relevance of vaccinations and clinical practice of vaccination.
Results
Overall, 384 Asian medical doctors responded to the survey. The majority of respondents considered it very (57.6%) or sufficiently (39.6%) important to perform vaccinations as recommended by the guidelines. About half of the Asian physicians (52.6%) were usually or always performing vaccinations. The influenza vaccine was the most frequently recommended vaccine for IBD patients. Half of the respondents (51.3%) did not recommend hepatitis A vaccine, especially in China (61.6%) and Japan (93.6%). The diphtheria, tetanus, and pertussis vaccine were never (35.2%) or rarely (29.4%) recommended.
Conclusions
The findings of this survey indicated similarities among countries/regions in terms of the current approaches and practices regarding vaccination of IBD patients; however, there are some differences that might reflect each country’s domestic vaccination guidelines and health insurance particularly with certain vaccines in some countries/regions. Although Asian physicians largely recommend vaccination, more awareness among doctors and Asian consensus regarding differences in IBD vaccination among countries/regions may be required.

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  • Herpes zoster infection in patients with inflammatory bowel disease
    Dong Hyun Kim, Sang-Bum Kang
    The Korean Journal of Internal Medicine.2025; 40(3): 347.     CrossRef
  • Suboptimal Vaccination Coverage and Serological Screening in Western Australian Children With Inflammatory Bowel Disease Receiving Immunosuppressive Therapy: An Opportunity for Improvement
    Muhammad Shahzad Shabir, Sibgha Arif, Dan Yeoh, Zubin Grover
    Cureus.2024;[Epub]     CrossRef
  • Beyond the survey, to the ideal therapy for Asian
    Ki Jae Jo, Jong Pil Im
    Intestinal Research.2023; 21(3): 280.     CrossRef
  • Crohn's disease and clinical management today: How it does?
    Ronaldo Teixeira da Silva Júnior, Jonathan Santos Apolonio, Jessica Oliveira de Souza Nascimento, Bruna Teixeira da Costa, Luciano Hasimoto Malheiro, Marcel Silva Luz, Lorena Sousa de Carvalho, Cleiton da Silva Santos, Fabrício Freire de Melo
    World Journal of Methodology.2023; 13(5): 399.     CrossRef
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IBD
Infectious complications in patients with inflammatory bowel disease in Asia: the results of a multinational web-based survey in the 8th Asian Organization for Crohn’s and Colitis meeting
Yu Kyung Jun, Seong-Joon Koh, Dae Seong Myung, Sang Hyoung Park, Choon Jin Ooi, Ajit Sood, Jong Pil Im
Intest Res 2023;21(3):353-362.   Published online July 27, 2023
DOI: https://doi.org/10.5217/ir.2023.00013
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Infectious complications are major concerns when treating patients with inflammatory bowel disease (IBD). This study evaluated clinical differences across countries/regions in the management of infectious diseases in patients with IBD.
Methods
A multinational online questionnaire survey was administered to participants at the 8th meeting of the Asian Organization for Crohn’s and Colitis. The questionnaire included questions regarding surveillance, diagnosis, management, and prevention of infection in patients with IBD.
Results
A total of 384 physicians responded to the questionnaire. The majority of Korean (n=70, 63.6%) and Chinese (n=51, 51.5%) physicians preferred vancomycin to metronidazole in the treatment of Clostridium difficile infection, whereas more than half of the Japanese physicians (n=62, 66.7%) preferred metronidazole. Physicians in Korea (n=88, 80.0%) and China (n=46, 46.5%) preferred a 3-month course of isoniazid and rifampin to treat latent tuberculosis infection, whereas most physicians in Japan (n=71, 76.3%) favored a 9-month course of isoniazid. Most Korean physicians (n=89, 80.9%) recommended hepatitis B virus (HBV) vaccination in patients lacking HBV surface antigen, whereas more than half of Japanese physicians (n=53, 57.0%) did not consider vaccination.
Conclusions
Differences in the diagnosis, prevention, and management of infections in patients with IBD across countries/regions reflect different prevalence rates of infectious diseases. This survey may broaden understanding of the real-world clinical settings across Asian countries/regions and provide information for establishing practical guidelines to manage patients with IBD.

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  • 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
  • Guselkumab in East Asians With Moderate‐to‐Severe Ulcerative Colitis: Subgroup Analysis of the QUASAR Induction and Maintenance Studies
    Baili Chen, Byong Duk Ye, Qian Cao, Fumihito Hirai, Masayuki Saruta, Minhu Chen, Susan Pelak, Nicole Shipitofsky, Ye Miao, Keira Herr, Bryan Wahking, Jianmin Zhuo, Tadakazu Hisamatsu
    Journal of Gastroenterology and Hepatology.2025;[Epub]     CrossRef
  • The Burden ofClostridioides difficileInfection in Korea
    Seong Ran Jeon
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Perception of fecal microbiota transplantation in patients with ulcerative colitis in Korea: a KASID multicenter study
    Jebyung Park, Sung Noh Hong, Hong Sub Lee, Jongbeom Shin, Eun Hye Oh, Kwangwoo Nam, Gyeol Seong, Hyun Gun Kim, Jin-Oh Kim, Seong Ran Jeon
    The Korean Journal of Internal Medicine.2024; 39(5): 783.     CrossRef
  • Assessing the associations of inflammatory bowel disease and hepatitis B virus infections with two-sample bidirectional mendelian randomization
    Ping Han, Chaohui Wang, Yan Qiu
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  • Diagnosis, management, and prevention of infectious complications in inflammatory bowel disease: variations among Asian countries
    Ji Eun Baek, Sung Wook Hwang
    Intestinal Research.2023; 21(3): 277.     CrossRef
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IBD
Treatment of inflammatory bowel disease–Asian perspectives: the results of a multinational web-based survey in the 8th Asian Organization for Crohn’s and Colitis meeting
Eun Mi Song, Soo-Young Na, Sung Noh Hong, Siew Chien Ng, Tadakazu Hisamatsu, Byong Duk Ye
Intest Res 2023;21(3):339-352.   Published online July 27, 2023
DOI: https://doi.org/10.5217/ir.2022.00135
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
As the characteristics of inflammatory bowel disease (IBD) differ between Asians and Westerners, it is necessary to determine adequate therapeutic strategy for Asian IBD patients. We evaluated the current treatment of IBD in Asian countries/regions using a web-based survey.
Methods
The Korean Association for the Study of Intestinal Diseases conducted a multinational web-based survey for current IBD care in Asia between September 16, 2020, and November 13, 2020.
Results
A total of 384 doctors treating IBD patients from 24 Asian countries/regions responded to the survey. Anti-tumor necrosis factor (TNF) agents, anti-integrins, and anti-interleukin-12/23 agents were available for use by 93.8%, 72.1%, and 70.1% of respondents in Asian countries/regions. Compared with a previous survey performed in 2014, an increased tendency for treatment with biologics, including anti-TNF agents, was observed. In the treatment of corticosteroid-refractory acute severe ulcerative colitis, 72.1% of respondents chose anti-TNF agents, followed by tacrolimus (11.7%). In the treatment of corticosteroid-refractory Crohn’s disease, 90.4% chose anti-TNF agents, followed by thiopurines (53.1%), anti-interleukin-12/23 agents (39.3%), and anti-integrin agents (35.7%). In the treatment of Crohn’s disease patients refractory to anti-TNF agents, the most preferred strategy was to measure serum levels of anti-TNF and anti-drug antibodies (40.9%), followed by empiric dose escalation or shortening of dosing intervals (25.3%).
Conclusions
Although there were some differences, treatment strategies for patients with IBD were mostly similar among Asian doctors. Based on the therapeutic outcomes, it is necessary to identify the most appropriate therapeutic strategy for Asian IBD patients.

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  • The Potential of Molecular Remission: Tissue Neutrophil Elastase Is Better Than Histological Activity for Predicting Long-Term Relapse in Patients With Ulcerative Colitis in Endoscopic Remission
    Yu Kyung Jun, Hyeon Jeong Oh, Ji Ae Lee, Yonghoon Choi, Cheol Min Shin, Young Soo Park, Nayoung Kim, Dong Ho Lee, Hyuk Yoon
    Inflammatory Bowel Diseases.2025; 31(2): 514.     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
  • Impact of early aggressive treatment on long-term biochemical marker patterns in inflammatory bowel disease
    Yu Kyung Jun, Yonghoon Choi, Cheol Min Shin, Young Soo Park, Nayoung Kim, Dong Ho Lee, Soyeon Ahn, Hyuk Yoon
    Journal of Gastroenterology.2025; 60(7): 854.     CrossRef
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    Julajak Limsrivilai, Allen Yu-hung Lai, Silvia T. H. Li, Murdani Abdullah, Raja Affendi Raja Ali, Satimai Aniwan, Hoang Huu Bui, Jen-Wei Chou, Ida Normiha Hilmi, Wee Chian Lim, Jose Sollano, Michelle Mui Hian Teo, Shu-Chen Wei, Wai Keung Leung
    Intestinal Research.2025; 23(2): 117.     CrossRef
  • Optimizing Infliximab Use in Real-World Inflammatory Bowel Disease: Insights from a Population Pharmacokinetic Model Integrating Intravenous and Subcutaneous Formulations
    Sung Hoon Jung, Sang-Bum Kang
    Gut and Liver.2025; 19(3): 299.     CrossRef
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    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
  • Continuing or stopping 5‐aminosalicylates in patients with inflammatory bowel disease on anti‐TNF therapy: A nationwide population‐based study
    Jeongkuk Seo, Seonok Kim, Seung Wook Hong, Sung Wook Hwang, Sang Hyoung Park, Dong‐Hoon Yang, Jeong‐Sik Byeon, Seung‐Jae Myung, Suk‐Kyun Yang, Ye‐Jee Kim, Byong Duk Ye
    Alimentary Pharmacology & Therapeutics.2024; 60(3): 389.     CrossRef
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    Won-ho Kong, Bum-hoi Kim, Won-ill Kim
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    Sahana Shankar, Snehali Majumder, Suparna Mukherjee, Anirban Bhaduri, Rangarajan Kasturi, Subrata Ghosh, Marietta Iacucci, Uday N. Shivaji
    Therapeutic Advances in Gastroenterology.2024;[Epub]     CrossRef
  • How have treatment patterns for patients with inflammatory bowel disease changed in Asian countries?
    Jihye Park
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  • Enrichment of Activated Fibroblasts as a Potential Biomarker for a Non-Durable Response to Anti-Tumor Necrosis Factor Therapy in Patients with Crohn’s Disease
    Soo-Kyung Park, Gi-Young Lee, Sangsoo Kim, Chil-Woo Lee, Chang-Hwan Choi, Sang-Bum Kang, Tae-Oh Kim, Jaeyoung Chun, Jae-Myung Cha, Jong-Pil Im, Kwang-Sung Ahn, Seon-Young Kim, Min-Suk Kim, Chang-Kyun Lee, Dong-Il Park
    International Journal of Molecular Sciences.2023; 24(19): 14799.     CrossRef
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IBD
Diagnosis of inflammatory bowel disease–Asian perspectives: the results of a multinational web-based survey in the 8th Asian Organization for Crohn’s and Colitis meeting
Han Hee Lee, Jae Jun Park, Bo-In Lee, Ida Hilmi, Jose Sollano, Zhi Hua Ran
Intest Res 2023;21(3):328-338.   Published online July 27, 2023
DOI: https://doi.org/10.5217/ir.2023.00012
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Inflammatory bowel disease (IBD) is no longer a rare disease in Asia, thus it needs to prepare recommendations relevant to Asian patients. This study aimed to identify disparities in the process of the diagnosis of IBD in Asian countries/regions.
Methods
In line with the 2020 Asian Organization for Crohn’s and Colitis annual meeting, a multinational web-based survey about Asian physicians’ perspectives on IBD was conducted.
Results
A total of 384 Asian physicians (99 in China, 93 in Japan, 110 in Korea, and 82 in other Asian countries/regions) treating IBD patients from 24 countries/regions responded to the survey. Most respondents were gastroenterologists working in an academic teaching hospital. About half of them had more than 10 years of clinical experience in caring for patients with IBD. The European Crohn’s Colitis Organisation guideline was used most commonly for the diagnosis of IBD except for Japanese physicians who preferred their own national guideline. The Mayo score and Crohn’s Disease Activity Index were the most commonly used activity scoring systems for ulcerative colitis and Crohn’s disease, respectively. Endoscopy, not surprisingly, was the main investigation in assessing the extent and activity of IBD. On the other hand, there were disparities across countries/regions with regard to the favored modalities of small bowel and perianal evaluation of Crohn’s disease, as well as the use of serologic markers.
Conclusions
Results of the present survey revealed practical behaviors of Asian physicians in the diagnosis of IBD. Investigating the reasons for different diagnostic approaches among countries/regions might help us develop Asian guidelines further.

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  • The intestinal ultrasound role in inflammatory bowel disease in clinical practice and a critical appraisal of the current guidelines (mini-review)
    Sarah El-Nakeep
    The Egyptian Journal of Internal Medicine.2024;[Epub]     CrossRef
  • 3,990 View
  • 113 Download
  • 3 Web of Science
  • 1 Crossref
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IBD
Risk of venous thromboembolism with a central venous catheter in hospitalized Japanese patients with inflammatory bowel disease: a propensity score-matched cohort study
Yasuhiro Aoki, Hiroki Kiyohara, Yohei Mikami, Kosaku Nanki, Takaaki Kawaguchi, Yusuke Yoshimatsu, Shinya Sugimoto, Tomohisa Sujino, Kaoru Takabayashi, Naoki Hosoe, Haruhiko Ogata, Yasushi Iwao, Takanori Kanai
Intest Res 2023;21(3):318-327.   Published online February 10, 2023
DOI: https://doi.org/10.5217/ir.2022.00116
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Thromboprophylaxis is recommended for hospitalized patients with inflammatory bowel disease (IBD) in Western countries, although it is selectively administered to high-risk patients in East Asia. A central venous catheter (CVC) is commonly placed in patients with IBD. Although CVC placement is considered a risk factor for venous thromboembolism (VTE), the degree of increased risk in patients with IBD is uncertain. This study aimed to identify the risk of VTE with CVC placement in hospitalized Japanese patients with IBD without thromboprophylaxis.
Methods
This retrospective cohort study included patients with ulcerative colitis or Crohn’s disease who were admitted for disease flares at Keio University Hospital between January 2016 and December 2020. Patients who already had thrombosis or were administered any antithrombotic treatment on admission were excluded. VTE development during the hospitalization was surveyed, and VTE risk associated with CVC indwelling was estimated using propensity score matching and inverse probability of treatment weighting analyses.
Results
Altogether, 497 hospitalized patients with IBD (ulcerative colitis, 327; Crohn’s disease, 170) were enrolled. VTE developed in 9.30% (12/129) of catheterized patients and in 0.82% (3/368) of non-catheterized patients. The propensity score matching yielded 127 matched pairs of patients. The catheterized group demonstrated higher odds for VTE than the non-catheterized group (odds ratio, 13.15; 95% confidence interval, 1.68–102.70). A similar result was obtained in the inverse probability of treatment weighting analysis (odds ratio, 11.02; 95% confidence interval, 2.64–46.10).
Conclusions
CVC placement is a major risk factor for VTE among hospitalized Japanese patients with IBD without thromboprophylaxis.

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  • Incidence of Venous Thromboembolism in Asian Patients With Inflammatory Bowel Disease: A Systematic Review and Meta‐Analysis
    Joo Hye Song, Sung Ryul Shim, Dae Sung Kim, Hoon Sup Koo, Kyu Chan Huh
    Journal of Gastroenterology and Hepatology.2025; 40(4): 774.     CrossRef
  • Metabolic Disorders and Inflammatory Bowel Diseases
    Hye Kyung Hyun, Jae Hee Cheon
    Gut and Liver.2025; 19(3): 307.     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
  • 4,390 View
  • 315 Download
  • 3 Web of Science
  • 3 Crossref
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IBD
Risks of colorectal cancer and biliary cancer according to accompanied primary sclerosing cholangitis in Korean patients with ulcerative colitis: a nationwide population-based study
Eun Hye Oh, Ye-Jee Kim, Minju Kim, Seung Ha Park, Tae Oh Kim, Sang Hyoung Park
Intest Res 2023;21(2):252-265.   Published online December 2, 2022
DOI: https://doi.org/10.5217/ir.2022.00092
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
We conducted a nationwide population-based study to investigate incidence rates of colorectal and biliary cancers according to accompanying primary sclerosing cholangitis in Korean ulcerative colitis patients.
Methods
We used the Health Insurance Review and Assessment claim database from January 2007 to April 2020. Standardized incidence ratios of colorectal and biliary cancers in ulcerative colitis patients were calculated.
Results
Among 35,189 newly diagnosed ulcerative colitis patients, 1,224 patients were diagnosed with primary sclerosing cholangitis. During the study period, 122 and 52 patients were diagnosed with colorectal and biliary cancers, respectively. Incidences of colorectal cancer were not higher in ulcerative colitis patients than those in the general population (standardized incidence ratios, 0.83; 95% confidence interval, 0.69–0.99), regardless of accompanied primary sclerosing cholangitis (standardized incidence ratio, 0.73; 95% confidence interval, 0.24–1.71). While incidences of biliary cancer were not higher in ulcerative colitis patients than those in the general population (standardized incidence ratio, 1.14; 95% confidence interval, 0.80–1.58), these were much higher with accompanied primary sclerosing cholangitis (standardized incidence ratio, 10.07; 95% confidence interval, 5.75–16.36). Cumulative incidences of colorectal and biliary cancers increased in patients who were diagnosed with ulcerative colitis at an older age.
Conclusions
In Korean ulcerative colitis patients, colorectal cancer incidences were not higher than those in the general population regardless of accompanied primary sclerosing cholangitis. However, biliary cancer incidences were much higher in ulcerative colitis patients with primary sclerosing cholangitis than in those without, or in the general population.

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  • Treatment of primary sclerosing cholangitis combined with inflammatory bowel disease
    You Sun Kim, Edward H. Hurley, Yoojeong Park, Sungjin Ko
    Intestinal Research.2023; 21(4): 420.     CrossRef
  • Are the risks of colorectal cancer and biliary cancer really increased if patients with ulcerative colitis have primary sclerosing cholangitis?
    Jung Wook Lee, Won Moon
    Intestinal Research.2023; 21(2): 171.     CrossRef
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IBD
Concomitant ankylosing spondylitis can increase the risk of biologics or small molecule therapies to control inflammatory bowel disease
Yu Kyung Jun, Hyuk Yoon, Seong-Joon Koh, A Hyeon Kim, Kwang Woo Kim, Jun Won Park, Hyun Jung Lee, Hyoun Woo Kang, Jong Pil Im, Young Soo Park, Joo Sung Kim, on behalf of Seoul National University Inflammatory Bowel Disease Research Network (SIRN)
Intest Res 2023;21(2):244-251.   Published online August 8, 2022
DOI: https://doi.org/10.5217/ir.2022.00057
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Patients with inflammatory bowel disease (IBD) are diagnosed with ankylosing spondylitis (AS) often. However, the disease course of patients with both IBD and AS is not well understood. This study aims to evaluate the effect of concomitant AS on IBD outcomes.
Methods
Among the 4,722 patients with IBD who were treated in 3 academic hospitals from 2004 to 2021, 55 were also diagnosed with AS (IBD-AS group). Based on patients’ electronic medical records, the outcomes of IBD in IBD-AS group and IBD group without AS (IBD-only group) were appraised.
Results
The proportion of patients treated with biologics or small molecule therapies was significantly higher in IBD-AS group than the proportion in IBD-only group (27.3% vs. 12.7%, P= 0.036). Patients with both ulcerative colitis and AS had a significantly higher risk of biologics or small molecule therapies than patients with only ulcerative colitis (P< 0.001). For univariable logistic regression, biologics or small molecule therapies were associated with concomitant AS (odds ratio, 4.099; 95% confidence interval, 1.863–9.021; P< 0.001) and Crohn’s disease (odds ratio, 3.552; 95% confidence interval, 1.590–7.934; P= 0.002).
Conclusions
Concomitant AS is associated with the high possibility of biologics or small molecule therapies for IBD. IBD patients who also had AS may need more careful examination and active treatment to alleviate the severity of IBD.

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  • Author's Reply: “Association of early antibiotic use with risk of ulcerative colitis”
    Junseok Park, Sungjin Woo, Seong-Joon Koh
    Digestive and Liver Disease.2025; 57(3): 795.     CrossRef
  • Risk of all-cause and cause-specific mortality associated with immune-mediated inflammatory diseases in Korea
    Oh Chan Kwon, See Young Lee, Jaeyoung Chun, Kyungdo Han, Yuna Kim, Ryul Kim, Min-Chan Park, Jie-Hyun Kim, Young Hoon Youn, Hyojin Park
    Frontiers in Medicine.2023;[Epub]     CrossRef
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  • 455 Download
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IBD
Laparoscopic surgery contributes to a decrease in short-term complications in surgical ulcerative colitis patients during 2008–2017: a multicenter retrospective study in China
Zerong Cai, Xiaosheng He, Jianfeng Gong, Peng Du, Wenjian Meng, Wei Zhou, Jinbo Jiang, Bin Wu, Weitang Yuan, Qi Xue, Lianwen Yuan, Jinhai Wang, Jiandong Tai, Jie Liang, Weiming Zhu, Ping Lan, Xiaojian Wu
Intest Res 2023;21(2):235-243.   Published online December 2, 2022
DOI: https://doi.org/10.5217/ir.2022.00012
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
The aim of this study was to analyze the chronological changes in postoperative complications in surgical ulcerative colitis patients over the past decade in China and to investigate the potential parameters that contributed to the changes.
Methods
Ulcerative colitis patients who underwent surgery during 2008–2017 were retrospectively enrolled from 13 hospitals in China. Postoperative complications were compared among different operation years. Risk factors for complications were identified by logistic regression analysis.
Results
A total of 446 surgical ulcerative colitis patients were analyzed. Fewer short-term complications (24.8% vs. 41.0%, P=0.001) and more laparoscopic surgeries (66.4% vs. 25.0%, P<0.001) were found among patients who received surgery during 2014–2017 than 2008–2013. Logistic regression suggested that independent protective factors against short-term complications were a higher preoperative body mass index (odds ratio [OR], 0.870; 95% confidence interval [CI], 0.785–0.964; P=0.008), laparoscopic surgery (OR, 0.391; 95% CI, 0.217–0.705; P=0.002) and elective surgery (OR, 0.213; 95% CI, 0.067–0.675; P=0.009). The chronological decrease in short-term complications was associated with an increase in laparoscopic surgery.
Conclusions
Our data revealed a downward trend of short-term postoperative complications among surgical ulcerative colitis patients in China during the past decade, which may be due to the promotion of minimally invasive techniques among Chinese surgeons.

Citations

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  • Surgical trend including minimally invasive surgeries for ulcerative colitis in the COSUC study: the largest multicenter cohort study in Japan
    Koya Hida, Yoshiki Okita, Yusuke Fujii, Toru Miyake, Yoshiaki Kuriu, Yu Hidaka, Tomohiro Arita, Kiyotaka Kawaguchi, Shingo Ochi, Yusuke Fujita, Kazutaka Obama, Takeshi Naitoh, Nobuhisa Matsuhashi, Yudai Fukui, Shintaro Kohama, Manabu Takata, Shin Takesue,
    Surgical Endoscopy.2025; 39(6): 3911.     CrossRef
  • Surgical Options for Appropriate Length of J-Pouch Construction for Better Outcomes and Long-term Quality of Life in Patients with Ulcerative Colitis after Ileal Pouch-Anal Anastomosis
    Weimin Xu, Wenbo Tang, Wenjun Ding, Zhebin Hua, Yaosheng Wang, Xiaolong Ge, Long Cui, Xiaojian Wu, Wei Zhou, Zhao Ding, Peng Du
    Gut and Liver.2024; 18(1): 85.     CrossRef
  • Time trend in surgical indications and outcomes in ulcerative colitis—A two decades in-depth retrospective analysis
    Guillaume Le Cosquer, Lena Capirchio, Pauline Rivière, Marie Armelle Denis, Florian Poullenot, Christophe Remue, Frank Zerbib, Daniel Leonard, Bertrand Célérier, Alex Kartheuser, David Laharie, Olivier Dewit
    Digestive and Liver Disease.2023; 55(10): 1338.     CrossRef
  • Surgical Treatment in Ulcerative Colitis, Still Topical: A Narrative Review
    Eduard Slonovschi, Pratyusha Kodela, Monalisa Okeke, Sandeep Guntuku, Shanmukh Sai Pavan Lingamsetty
    Cureus.2023;[Epub]     CrossRef
  • Surgical outcomes and stoma-related complications in inflammatory bowel disease in Saudi Arabia: a retrospective study
    Thamer A. Bin Traiki, Sulaiman A. Alshammari, Mansoor A. Abdulla, Fayez G. Aldarsouni, Noura S. Alhassan, Maha-Hamdien Abdullah, Awadh Alqahtani, Khayal A. Alkhayal
    Annals of Saudi Medicine.2023; 43(6): 386.     CrossRef
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Infection
Interferon-gamma release assay has poor diagnostic accuracy in differentiating intestinal tuberculosis from Crohn’s disease in tuberculosis endemic areas
Karan Sachdeva, Peeyush Kumar, Bhaskar Kante, Sudheer K. Vuyyuru, Srikant Mohta, Mukesh K. Ranjan, Mukesh K. Singh, Mahak Verma, Govind Makharia, Saurabh Kedia, Vineet Ahuja
Intest Res 2023;21(2):226-234.   Published online June 13, 2022
DOI: https://doi.org/10.5217/ir.2022.00010
AbstractAbstract PDFPubReaderePub
Background/Aims
Intestinal tuberculosis (ITB) and Crohn’s disease (CD) frequently present with a diagnostic dilemma because of similar presentation. Interferon-gamma release assay (IGRA) has been used in differentiating ITB from CD, but with sparse reports on its diagnostic accuracy in tuberculosis endemic regions and this study evaluated the same.
Methods
Patients with definitive diagnosis of ITB (n=59) or CD (n=49) who underwent IGRA testing (n=307) were retrospectively included at All India Institute of Medical Sciences, New Delhi (July 2014 to September 2021). CD or ITB was diagnosed as per standard criteria. IGRA was considered positive at >0.35 IU/mL. Relevant data was collected and IGRA results were compared between ITB and CD to determine its accuracy.
Results
Among 59 ITB patients (mean age, 32.6±13.1 years; median disease duration, 1 year; male, 59.3%), 24 were positive and 35 tested negative for IGRA. Among 49 CD patients (mean age, 37.8±14.0; median disease duration, 4 years; male, 61.2%), 12 were positive and 37 tested negative for IGRA. Hence, for diagnosing ITB, IGRA showed a sensitivity, specificity, positive and negative predictive values of 40.68%, 75.51%, 66.67%, and 51.39%, respectively. The area under the curve of IGRA for ITB diagnosis was 0.66 (95% confidence interval, 0.55–0.75). In a subset (n=64), tuberculin skin test (TST) showed sensitivity, specificity, positive and negative predictive values of 64.7%, 73.3%, 73.3%, and 64.71%, respectively. IGRA and TST were concordant in 38 (59.4%) patients with κ=0.17.
Conclusions
In a tuberculosis endemic region, IGRA had poor diagnostic accuracy for differentiating ITB from CD, suggesting a limited value of IGRA in this setting.

Citations

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  • Mistakes to avoid in the management of abdominal tuberculosis
    Abhirup Chatterjee, Daya Krishna Jha, Aravind Sekar, Vishal Sharma
    Expert Review of Anti-infective Therapy.2025; 23(2-4): 197.     CrossRef
  • New diagnostic strategies to distinguish Crohn's disease and gastrointestinal tuberculosis
    Himanshu Narang, Saurabh Kedia, Vineet Ahuja
    Current Opinion in Infectious Diseases.2024; 37(5): 392.     CrossRef
  • Interferon-gamma release assays as a tool for differential diagnosis of gastrointestinal tuberculosis
    Tsvetelina Velikova, Anita Aleksandrova
    World Journal of Clinical Cases.2024; 12(27): 6015.     CrossRef
  • Diagnostic yield and technical performance of the novel motorized spiral enteroscopy compared with single-balloon enteroscopy in suspected Crohn's disease: a prospective study (with video)
    Partha Pal, Piyush Vishwakarma, Aniruddha Pratap Singh, Palle Manohar Reddy, Mohan Ramchandani, Rupa Banerjee, Anuradha Sekaran, Polina Vijayalaxmi, Hardik Rughwani, Pradev Inavolu, Santosh Darishetty, Pradeep Rebala, Guduru Venkat Rao, Manu Tandan, D. Na
    Gastrointestinal Endoscopy.2023; 97(3): 493.     CrossRef
  • Evidence-based approach to diagnosis and management of abdominal tuberculosis
    Daya Krishna Jha, Mythili Menon Pathiyil, Vishal Sharma
    Indian Journal of Gastroenterology.2023; 42(1): 17.     CrossRef
  • Technical performance and diagnostic yield of motorised spiral enteroscopy compared with single-balloon enteroscopy in suspected Crohn’s disease: a randomised controlled, open-label study (the MOTOR-CD trial)
    Partha Pal, Mohan Ramchandani, Rupa Banerjee, Piyush Viswakarma, Aniruddha Pratap Singh, Manohar Reddy, Hardik Rughwani, Rajendra Patel, Anuradha Sekaran, Swathi Kanaganti, Santosh Darisetty, Zaheer Nabi, Jagadish Singh, Rajesh Gupta, Sundeep Lakhtakia, R
    Gut.2023; 72(10): 1866.     CrossRef
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IBD
Clinical spectrum of elderly-onset inflammatory bowel disease in India
Yogesh Kumar Gupta, Arshdeep Singh, Vikram Narang, Vandana Midha, Ramit Mahajan, Varun Mehta, Dharmatma Singh, Namita Bansal, Madeline Vithya Barnaba Durairaj, Amit Kumar Dutta, Ajit Sood
Intest Res 2023;21(2):216-225.   Published online August 8, 2022
DOI: https://doi.org/10.5217/ir.2021.00177
AbstractAbstract PDFPubReaderePub
Background/Aims
Inflammatory bowel disease (IBD) is increasingly being recognized in elderly patients. Data on clinical spectrum of elderly-onset IBD patients is lacking from India.
Methods
A cross-sectional retrospective analysis of a prospectively maintained database of patients diagnosed with IBD was conducted at 2 centers in India. The clinical spectrum of elderly-onset IBD including demographic profile (age and sex), clinical presentation, disease characteristics (disease behavior and severity, extent of disease), and treatment were recorded and compared with adult-onset IBD.
Results
During the study period, 3,922 (3,172 ulcerative colitis [UC] and 750 Crohn’s disease [CD]) patients with IBD were recorded in the database. A total of 186 patients (4.74%; 116 males [62.36%]) had elderly-onset IBD (69.35% UC and 30.64% CD). Diarrhea, blood in stools, nocturnal frequency and pain abdomen were the commonest presentations for UC, whereas pain abdomen, weight loss and diarrhea were the most frequent symptoms in CD. For both elderly onset UC and CD, majority of the patients had moderately severe disease. Left-sided colitis was the commonest disease location in UC. Isolated ileal disease and inflammatory behavior were the most common disease location and behavior, respectively in CD. 5-Aminosalicylates were the commonest prescribed drug for both elderly onset UC and CD. Thiopurines and biologics were used infrequently. Prevalence of colorectal cancer was higher in elderly onset IBD.
Conclusions
Elderly onset IBD is not uncommon in India. Both the elderly onset UC and CD were milder, with no significant differences in disease characteristics (disease extent, location and behavior) when compared to adult-onset IBD. Colorectal cancer was more common in elderly onset IBD.

Citations

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  • Inflammatory bowel disease in south Asia: a scoping review
    Shabari Shenoy, Anuraag Jena, Carrie Levinson, Vishal Sharma, Parakkal Deepak, Tina Aswani-Omprakash, Shaji Sebastian, Jean-Frederic Colombel, Manasi Agrawal
    The Lancet Gastroenterology & Hepatology.2025; 10(3): 259.     CrossRef
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    Hye Kyung Hyun, Jae Hee Cheon
    Gut and Liver.2025; 19(3): 307.     CrossRef
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    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
  • Neither hepatic steatosis nor fibrosis is associated with clinical outcomes in patients with intestinal Behçet’s disease
    Hye Kyung Hyun, Jihye Park, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jae Seung Lee, Hye Won Lee, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Seung Up Kim, Jae Hee Cheon
    European Journal of Gastroenterology & Hepatology.2024; 36(4): 445.     CrossRef
  • Inflammatory bowel disease: a narrative review of disease evolution in South Asia and India over the last decade
    Sahana Shankar, Snehali Majumder, Suparna Mukherjee, Anirban Bhaduri, Rangarajan Kasturi, Subrata Ghosh, Marietta Iacucci, Uday N. Shivaji
    Therapeutic Advances in Gastroenterology.2024;[Epub]     CrossRef
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    Nikhil Bhangale, Devendra Desai, Philip Abraham, Tarun Gupta, Pavan Dhoble, Anand Joshi
    Indian Journal of Gastroenterology.2023; 42(3): 404.     CrossRef
  • Global Epidemiology and Burden of Elderly-Onset Inflammatory Bowel Disease: A Decade in Review
    Pojsakorn Danpanichkul, Kanokphong Suparan, Suchapa Arayakarnkul, Aunchalee Jaroenlapnopparat, Natchaya Polpichai, Panisara Fangsaard, Siwanart Kongarin, Karan Srisurapanont, Banthoon Sukphutanan, Wasuwit Wanchaitanawong, Yatawee Kanjanakot, Jakrapun Pupa
    Journal of Clinical Medicine.2023; 12(15): 5142.     CrossRef
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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

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  • 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
  • Main active components of Sishen Wan may modulate T cells-related proinflammatory cytokines via alleviating mitochondrial damage caused by oxidative stress in dextran sulphate sodium-induced ulcerative colitis
    Ke Li, Weiguang Lv, Boning Zhang, Shengnan Han, Jing Han, Yu Zhang, Wei Wang, Weiyu Zang, Anqi Yang, Hongjia Wang, Chenggang Zhang
    Chinese Journal of Analytical Chemistry.2025; : 100562.     CrossRef
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Microbiota
Compositional changes in fecal microbiota associated with clinical phenotypes and prognosis in Korean patients with inflammatory bowel disease
Seung Yong Shin, Young Kim, Won-Seok Kim, Jung Min Moon, Kang-Moon Lee, Sung-Ae Jung, Hyesook Park, Eun Young Huh, Byung Chang Kim, Soo Chan Lee, Chang Hwan Choi, on behalf of the IBD Research Group of the Korean Association for the Study of Intestinal Diseases
Intest Res 2023;21(1):148-160.   Published online June 14, 2022
DOI: https://doi.org/10.5217/ir.2021.00168
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
The fecal microbiota of Korean patients with inflammatory bowel disease (IBD) was investigated with respect to disease phenotypes and taxonomic biomarkers for diagnosis and prognosis of IBD.
Methods
Fecal samples from 70 ulcerative colitis (UC) patients, 39 Crohn’s disease (CD) patients, and 100 healthy control individuals (HC) were collected. The fecal samples were amplified via polymerase chain reaction and sequenced using Illumina MiSeq. The relationships between fecal bacteria and clinical phenotypes were analyzed using the EzBioCloud database and 16S microbiome pipeline.
Results
The alpha-diversity of fecal bacteria was significantly lower in UC and CD (P<0.05) compared to that in HC. Bacterial community compositions in UC and CD were significantly different from that of HC according to Bray-Curtis dissimilarities, and there was also a difference between community composition in UC and CD (P=0.01). In UC, alpha-diversity was further decreased when the disease was more severe and the extent of disease was greater, and community composition significantly differed depending on the extent of the disease. We identified 9 biomarkers of severity and 6 biomarkers of the extent of UC. We also identified 5 biomarkers of active disease and 3 biomarkers of ileocolonic involvement in CD. Lachnospiraceae and Ruminococcus gnavus were biomarkers for better prognosis in CD.
Conclusions
The fecal microbiota profiles of IBD patients were different from those of HC, and several bacterial taxa may be used as biomarkers to determine disease phenotypes and prognosis. These data may also help discover new therapeutic targets for IBD.

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  • Gut microbiota dysbiosis in a novel mouse model of colitis potentially increases the risk of colorectal cancer
    Abrory A. C. Pramana, Guanying Bianca Xu, Siyuan Liang, Erick Omar Garcia Vazquez, Jacob M. Allen, Brett R. Loman, Wenyan Mei, Yuan-Xiang Pan, Hong Chen
    American Journal of Physiology-Gastrointestinal and Liver Physiology.2025; 328(6): G831.     CrossRef
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    Aditya Bajaj, Manasvini Markandey, Saurabh Kedia, Vineet Ahuja
    Indian Journal of Gastroenterology.2024; 43(1): 103.     CrossRef
  • An Update on the Role and Potential Molecules in Relation to Ruminococcus gnavus in Inflammatory Bowel Disease, Obesity and Diabetes Mellitus
    Jinni Hong, Tingting Fu, Weizhen Liu, Yu Du, Junmin Bu, Guojian Wei, Miao Yu, Yanshan Lin, Cunyun Min, Datao Lin
    Diabetes, Metabolic Syndrome and Obesity.2024; Volume 17: 1235.     CrossRef
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    Junyi Bai, Ying Wang, Fuhao Li, Yueyao Wu, Jun Chen, Meng Li, Xi Wang, Bin Lv
    Science Progress.2024;[Epub]     CrossRef
  • Integrated Analysis of Microbiome and Metabolome Reveals Disease-Specific Profiles in Inflammatory Bowel Diseases and Intestinal Behçet’s Disease
    Yehyun Park, Jae Bum Ahn, Da Hye Kim, I Seul Park, Mijeong Son, Ji Hyung Kim, Hyun Woo Ma, Seung Won Kim, Jae Hee Cheon
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    Han Na Oh, Seung Yong Shin, Jong-Hwa Kim, Jihye Baek, Hyo Jong Kim, Kang-Moon Lee, Soo Jung Park, Seok-Young Kim, Hyung-Kyoon Choi, Wonyong Kim, Woo Jun Sul, Chang Hwan Choi
    Gut Pathogens.2024;[Epub]     CrossRef
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    Min Heo, Young Soo Park, Hyuk Yoon, Nam-Eun Kim, Kangjin Kim, Cheol Min Shin, Nayoung Kim, Dong Ho Lee
    Gut and Liver.2023; 17(1): 108.     CrossRef
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    Emmanuelle H Crost, Erika Coletto, Andrew Bell, Nathalie Juge
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    Yu Kyung Jun, Da-Ae Yu, Yoo Min Han, Soo Ran Lee, Seong-Joon Koh, Hyunsun Park
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  • Risk of all-cause and cause-specific mortality associated with immune-mediated inflammatory diseases in Korea
    Oh Chan Kwon, See Young Lee, Jaeyoung Chun, Kyungdo Han, Yuna Kim, Ryul Kim, Min-Chan Park, Jie-Hyun Kim, Young Hoon Youn, Hyojin Park
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  • Comments on Efficacy of a Synbiotic Containing Lactobacillus paracasei DKGF1 and Opuntia humifusa in Elderly Patients with Irritable Bowel Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial
    Kwang Woo Kim
    Gut and Liver.2023; 17(6): 954.     CrossRef
  • Evaluation of Bacterial and Fungal Biomarkers for Differentiation and Prognosis of Patients with Inflammatory Bowel Disease
    Hyuk Yoon, Sunghyouk Park, Yu Kyung Jun, Yonghoon Choi, Cheol Min Shin, Young Soo Park, Nayoung Kim, Dong Ho Lee
    Microorganisms.2023; 11(12): 2882.     CrossRef
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    Hyeonwoo Kim, Ji Eun Na, Sangsoo Kim, Tae-Oh Kim, Soo-Kyung Park, Chil-Woo Lee, Kyeong Ok Kim, Geom-Seog Seo, Min Suk Kim, Jae Myung Cha, Ja Seol Koo, Dong-Il Park
    Microorganisms.2023; 12(1): 36.     CrossRef
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IBD
Real-world effectiveness and safety of ustekinumab induction therapy for Korean patients with Crohn’s disease: a KASID prospective multicenter study
Kyunghwan Oh, Hee Seung Hong, Nam Seok Ham, Jungbok Lee, Sang Hyoung Park, Suk-Kyun Yang, Hyuk Yoon, You Sun Kim, Chang Hwan Choi, Byong Duk Ye, on behalf of the Korean Association for the Study of Intestinal Diseases
Intest Res 2023;21(1):137-147.   Published online July 12, 2022
DOI: https://doi.org/10.5217/ir.2021.00173
Correction in: Intest Res 2023;21(2):273
AbstractAbstract PDFPubReaderePub
Background/Aims
We investigated the real-world effectiveness and safety of ustekinumab (UST) as induction treatment for Koreans with Crohn’s disease (CD).
Methods
CD patients who started UST were prospectively enrolled from 4 hospitals in Korea. All enrolled patients received intravenous UST infusion at week 0 and subcutaneous UST injection at week 8. Clinical outcomes were assessed using Crohn’s Disease Activity Index (CDAI) scores at weeks 8 and 20 among patients with active disease (CDAI ≥150) at baseline. Clinical remission was defined as a CDAI <150, and clinical response was defined as a reduction in CDAI ≥70 points from baseline. Safety and factors associated with clinical remission at week 20 were also analyzed.
Results
Sixty-five patients were enrolled between January 2019 and December 2020. Among 49 patients with active disease at baseline (CDAI ≥150), clinical remission and clinical response at week 8 were achieved in 26 (53.1%) and 30 (61.2%) patients, respectively. At week 20, 27 (55.1%) and 35 (71.4%) patients achieved clinical remission and clinical response, respectively. Twenty-seven patients (41.5%) experienced adverse events, with serious adverse events in 3 patients (4.6%). One patient (1.5%) stopped UST therapy due to poor response. Underweight (body mass index <18.5 kg/m2) (odds ratio [OR], 0.085; 95% confidence interval [CI], 0.014–0.498; P=0.006) and elevated C-reactive protein at baseline (OR, 0.133; 95% CI, 0.022–0.823; P=0.030) were inversely associated with clinical remission at week 20.
Conclusions
UST was effective and well-tolerated as induction therapy for Korean patients with CD.

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    Chang Kyun Lee, Won Moon, Jaeyoung Chun, Eun Soo Kim, Hyung Wook Kim, Hyuk Yoon, Hyun Soo Kim, Yoo Jin Lee, Chang Hwan Choi, Yunho Jung, Sung Chul Park, Geun Am Song, Jong Hun Lee, Eun Suk Jung, Youngdoe Kim, Su Young Jung, Jong Min Choi, Byong Duk Ye
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    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
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    Jae Hee Cheon, Byong Duk Ye, Alessandro Armuzzi, Florian Rieder, Giampiero Girolomoni, Luis Puig, Hojung Jung, Steven R. Feldman
    Expert Opinion on Biological Therapy.2025; 25(6): 615.     CrossRef
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    Francesca Bello, Samer Muhsen, Haider Sabhan, Alexandra Borin, Fredrik Johansson, Charlotte Höög, Ole Forsberg, Christina Wennerström, Charlotte Söderman, Mikael Lördal, Sven Almer
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    Nikil Vootukuru, Abhinav Vasudevan
    World Journal of Gastroenterology.2024; 30(22): 2902.     CrossRef
  • Corrigendum: Real-world effectiveness and safety of ustekinumab induction therapy for Korean patients with Crohn’s disease: a KASID prospective multicenter study
    Kyunghwan Oh, Hee Seung Hong, Nam Seok Ham, Jungbok Lee, Sang Hyoung Park, Suk-Kyun Yang, Hyuk Yoon, You Sun Kim, Chang Hwan Choi, Byong Duk Ye
    Intestinal Research.2023; 21(2): 273.     CrossRef
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