Intestinal Research

Capsule Endoscopy: In Seok Lee, Myung Gyu Choi; Intest Res 2007;5(1):01-05. Published online June 30, 2007

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Epithelial Homeostasis: Role of NF-κB: Joo Sung Kim; Intest Res 2006;4(2):83-86. Published online December 30, 2006

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Trends in Colitic Cancer in Korea: Dong Kyung Chang; Intest Res 2006;4(2):79-82. Published online December 30, 2006

Abstract PDF: Ulcerative colitis is one of the important risk factor for colorectal cancer. The incidence of colitic cancer is proportioned to the duration of patient's having ulcerative colitis. Patients with ulcerative colitis have been steeply increasing in Korea since mid-1980. Therefore, it is reasonable to presume patients with colitic cancer to begin to appear in earnest in Korea. Korean Association for the Study of Intestinal Diseases (KASID) performed a nation-wide survey on July to September in 2005 to obtain a whole picture about the current status of colitic cancer in Korea. This review summarises the data and suggests of the need of regular surveillance strategy to detect colitic cancer at an early stage. (Intestinal Research 2006;4:79-82)

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Problems in the Diagnosis of Inflammatory Bowel Disease in Korea: Yoon Tae Jeen, Yong Dae Kwon; Intest Res 2006;4(2):75-78. Published online December 30, 2006

Abstract PDF: Inflammatory bowel disease (IBD) is defined as chronic inflammatory intestinal disorder of unknown origin. Not only Crohn's disease (CD) and ulcerative colitis (UC) are widely known as such IBD, but Behcet's colitis and intestinal tuberculosis also belong to IBD. Particularly because intestinal tuberculosis is common disorder in Korea; Crohn's disease (CD) is on the increase, the differentiation of intestinal tuberculosis from CD is very important. Even though theses diseases have similar clinical feature, their eventual course is quite different. However diagnosis of IBD is intricate because of no pathognomonic feature. Recently introduction of CARD15/NOD2 gene polymorphism which causes increasing of incidence of CD intensifies genetic diagnostic tool research, and new diagnostic approach as systematic analysis of endoscopic findings is suggested. Therefore more advanced and more convenient method to diagnose IBD will be developed in near future. (Intestinal Research 2006;4:75-78)

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Rare Diseases of Rectum and Sigmoid Colon: Geun Am Song; Intest Res 2006;4(1):1-6. Published online June 30, 2006

Abstract PDF: The rectum is approximately 10 to 15 cm in length and extends from the sigmoid colon to the anal canal. It contribute to defecation as the rectal walls expand, stretch receptors from the nervous system located in the rectal walls stimulate the desire to defecate. There are some differences between rectum and colon. The rectum is divided into two portion by peritoneal reflection and makes pouch. The pouch is associated with many pathologic conditions, such as rectal shelf in stomach cancer, rectal endometriosis, and spread of pelvic inflammation. The inferior mesenteric arteries and middle, inferior rectal arteries supply the rectum. This dual blood supply system causes different incidence of ischemic inserts and metastatic site in rectum and colon cancer. The function of anal sphincter and rectum in pelvic cavity is significantly important in defecation and its disturbance causes some specific rectal disease. Due to its position, rectum may be injuried by external and internal events and show the initial suggestion of colorectal disease. We describe uncommon specific diseases in rectum classified into inflammatory diseases, functional disease and tumor. (Intestinal Research 2006;4:1-6)

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TLR Signaling in Intestinal Epithelial Tolerance of Commensals: Sang Kil Lee, Hyo Jong Kim; Intest Res 2005;3(2):91-95. Published online December 30, 2005

Abstract PDF: Toll-like receptors (TLR) is emerging as a key mediator of innate host defense in the intestinal mucosa, crucially involved in maintaining mucosal as well as commensal homeostasis. Through spatial and functional localization of TLR, the normal gut maintains a state of controlled inflammation, By contrast, patients with inflammatory bowel disease (IBD) demonstrated inflammation in response to the normal flora. Recent observations suggest new (patho-) physiologic mechanisms of how functional versus dysfunctional TLR pathways may oppose or favor IBD. A better understanding of the delicate regulation of TLR in the gut may lead to improved treatment for enteric infections and IBD. (Intestinal Research 2005;3:91-95)

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Intestinal Behcet's Disease: Suk-Kyun Yang; Intest Res 2005;3(1):1-10. Published online June 30, 2005

Abstract PDF: Behcet's disease is a multisystem disease characterized by recurrent oral and genital ulcerations in association with skin and ocular lesions. Gastrointestinal involvement of Behcet's disease is one of the major causes of morbidity and mortality in this disease, as it often results in serious complications such as perforation and bleeding. However, much remains unknown about the epidemiology, clinical characteristics, treatment, and prognosis of intestinal Behcet's disease. In this brief review, the author summarized the differences in epidemiology and clinical characteristics of intestinal Behcet's disease among different regions, the problems in its diagnosis and treatment, and its clinical course and long-term prognosis. (Intest Res 2005;3:1-10)

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Role of Peroxisome Proliferator-Activated Receptor g in Inflammatory Bowel Disease and Colon Cancer: Sang Kil Lee, Hyo Jong Kim; Intest Res 2004;2(2):53-57. Published online December 22, 2004

Abstract PDF: The peroxisome proliferator-activated receptor γ (PPARγ) and its partner the retinoid X receptor (RXR) are two nuclear receptors that are expressed mainly in adipose tissue and which have a role in lipid metabolism and insulin sensitization. New sites of PPARγ expression have been described, especially in the intestinal tract. Concomitantly, new functions have been attributed to PPARγ in regulation of inflammation and carcinogenesis. These new functions of PPARγ have led to novel ideas about pathophysiology of inflammatory bowel disease and colon cancer to development of innovative treatment strategies with PPARγ agonist. (Intestinal Research 2004;2:53-57)

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Post-infectious Irritable Bowel Syndrome: Young Soo Park, Dong Ho Lee; Intest Res 2004;2(1):11-14. Published online April 16, 2004

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Clinical Usage of Probiotics and Its Mechanism of Action: Dong Soo Han, Joon Yong Park; Intest Res 2004;2(1):5-10. Published online April 16, 2004

Abstract PDF: Probiotics has been prescribed for various medical purposes. The benefit of using probiotics has been clarified in antibiotics associated diarrhea, travelers' diarrhea, acute diarrhea, diarrhea in the pediatric field, functional diarrhea and some part of inflammatory bowel disease. However, the mechanism of action of probiotics is still in the investigation. Its functions of excreting bacterial products, adhesion to bowel wall, competition with other bacteria, and promoting mucin secretion from bowel mucosa have been discussed as the mechanism of action of probiotics. Recently the immune modulation of probiotics started to be regarded as the main part of its mechanism of action. Probiotics may produce its immune modulation by modifying the activation of Toll-like receptor: the main receptor of inducing innate immunity. (Intestinal Research 2004;2:5-10)

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Experimental Model for the Study of Intestinal Diseases: Ki Baik Hahm; Intest Res 2003;1(2):159-167. Published online November 27, 2003

Abstract PDF: No abstract available

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Inflammatory Bowel Disease and Pregnancy: Won Ho Kim; Intest Res 2003;1(2):141-158. Published online November 27, 2003

Abstract PDF: Because peak age of onset for inflammatory bowel disease (IBD) coincides with the peak age for conception and pregnancy, female patients with IBD concern pregnancy-related problems including sexual health, inheritance of disease in the offspring, fertility, the effect of pregnancy on disease, and conversely, the effect of disease on the course of pregnancy, as well as the safety of drugs. The clinicians must be prepared to address these issues and to discuss with patients and their spouses. Generally fertility is normal, although may be decreased in women with active Crohn's disease and in patients who received operation for IBD in both Crohn's disease and ulcerative colitis. Women with inactive IBD do not have increased risk of complicated pregnancy. However, active disease is associated with 2-3 times higher risk of complications such as preterm delivery or low birth weight. Inadequate therapy for IBD may results in exacerbation of disease and consequently, cause many pregnancy-related problems, including infertility, miscarriage or pre-term delivery. Furthermore, evidences have suggested that both Crohn's disease and ulcerative colitis tend to worsen if the disease is active at conception. Therefore, the focus should be on inducing remission before conception and maintaining remission during pregnancy. Treatment strategies in pregnant patients with IBD need to be evaluated carefully, and possibility of medication side effects on both the patients and the fetus must be weighed against the risks of active disease. Although the data on the safety of medications in pregnancy are limited, a key principle of management is that active disease, not the medications used to treat it, poses the greatest danger to pregnancy. (Intestinal Research 2003;2:141-158)

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Current Status and Perspectives for Colonic Polyp Researches in Korea: Jin Bae Kim, Dong Soo Han; Intest Res 2003;1(1):19-21. Published online May 27, 2003

Abstract PDF: Colorectal cancer is one of the most common malignancies in the United States and Europe. In the United States, approximately 131,000 new cases of colon cancer occur annually, of which 57,000 will lead to death. Recently, the incidence of colorectal cancer has been increasing markedly in Korea. Most of colorectal cancers follow typical adenoma-carcinoma sequences, therefore it is meanwhile epidemiologic and clinical study for colon polyps, because removal of colon polyps can significantly reduce the mortality from colorectal cancers. There were few epidemiologic data about colonic polyps in Korea. Therefore, it would be needed prospective multicenter study to find clinical characteristics of colon polyp in Korea. Here, we present preliminary data about clinical, endoscopic, and histological aspects of colon polyps in Korea and review perspectives. (Intestinal Research 2003;1:19-21)

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Azathioprine and 6-Mercaptopurine in Ulcerative Colitis: Won Ho Kim, In Hye Park, Jae Hee Cho, Tae Il Kim; Intest Res 2003;1(1):5-18. Published online May 27, 2003

Abstract PDF: Most of patients with ulcerative colitis have intermittent chronic disease demonstrating recurrent flare-ups of bloody diarrhea and symptom-free periods. Sulfasalazine and mesalazine are the first-line medical therapy in patients with mild to moderate activity, as both of them are effective in inducing and maintenance of remission. However, significant proportion of patients needs stronger drugs such as corticosteroids. As corticosteroids are ineffective for the prevention of relapse and associated with frequents side-effects, immunosuppressors, 6-mercaptopurine (6-MP) and its prodrug azathioprine, have been used in selected patients. After absorption azatioprine is rapidly converted to 6-MP non-enzymatically and 6-MP is either inactivated by thiopurine methyltransferase (TPMT) to 6-methylmercaptopurine or by xanthine oxidase to 6-thiouric acid, or it is activated via a multistep enzymatic pathway to the putative active metabolites, 6-thioguanine nucleotides (6-TGN). Clinical responsiveness and side effects are associated with TPMT genotype and phenotype, because the enzymatic activity of TPMT is genetically determined. Until now, significant proportion of patients with proper indication are not receiving immunosuppressors because of safety concern and delayed onset of action. Recently, however, gastroenterologists' acceptance for immunomodulators is increasing based on favorable results regarding efficacy and safety. The recent application of the study of variability in drug response due to genetic factors, termed pharmacogenetics, has provided a chance for tailored dosing in the individual patients. (Intestinal Research 2003;1:5-18)

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Gut, bone, and muscle: the triad of osteosarcopenia in inflammatory bowel disease: Shilpa Sharma; Received November 9, 2024 Accepted March 6, 2025 Published online April 29, 2025; DOI: https://doi.org/10.5217/ir.2024.00185 [Epub ahead of print]

Abstract PDF PubReader ePub: Inflammatory bowel disease (IBD) is a group of chronic inflammatory conditions affecting the gastrointestinal tract that can lead to multiple systemic complications. Among these, osteosarcopenia has emerged as a significant concern, characterized by the concurrent deterioration of bone density and muscle mass, strength, and function. This dual deterioration significantly elevates the risk of falls and fractures, thereby exacerbating morbidity and diminishing quality of life. The pathogenesis of IBD-associated osteosarcopenia is multifactorial, with chronic intestinal inflammation serving as a central driver. Pro-inflammatory cytokines simultaneously disrupt bone homeostasis and muscle metabolism, creating a catabolic environment that impacts both tissues. Nutritional deficiencies, common in IBD due to malabsorption and decreased dietary intake, further compromise both bone mineralization and muscle protein synthesis. Management requires a comprehensive approach combining nutritional optimization, structured physical therapy, and lifestyle modifications. Pharmacological interventions integrate diseasespecific treatments with targeted therapies including vitamin D supplementation, hormonal treatments, and bisphosphonates when indicated. This review synthesizes current evidence regarding the prevalence, pathogenesis, and clinical impact of osteosarcopenia in IBD, highlighting areas requiring further investigation.

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Evolution of inflammatory bowel disease in Korea: a 60-year perspective on clinical and research development: Suk-Kyun Yang; Received May 6, 2024 Accepted June 2, 2025 Published online June 23, 2025; DOI: https://doi.org/10.5217/ir.2025.00073 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Inflammatory bowel disease (IBD) was once considered rare in Korea, with the first reported case documented in 1961. Since then, its incidence and prevalence have increased markedly, accompanied by significant progress in clinical care and research. This narrative review traces the historical evolution of IBD in Korea, dividing the timeline into 4 periods: 1960–1979, 1980–1999, 2000–2019, and 2020–2039. For each period, major developments in the research environment and trends, diagnostic process, patient population and characteristics, and treatment are outlined. Over the past 6 decades, diagnostic and therapeutic approaches in Korea have advanced markedly, transitioning from limited diagnostic capacity and symptom-based management to practices that align with global standards. Notably, Korean patients with IBD exhibit distinctive clinical features compared with Western counterparts, including a markedly higher proportion of proctitis and a lower long-term risk of colectomy in ulcerative colitis, and a substantially higher prevalence of perianal fistulas in Crohn’s disease, highlighting the need for population- specific strategies to advance personalized medicine. In parallel, the research landscape has evolved through multicenter collaborations, expanded research capacity, and growing international engagement, positioning Korea as an increasingly active contributor to the global IBD research community. Looking ahead, the future of IBD research in Korea is expected to be shaped by innovation-driven research, including advances in artificial intelligence, large-scale data integration, and deeper international collaboration. By tracing the clinical and research trajectory of IBD in Korea, this review offers insight into how the country has adapted to global trends and is preparing to meet future challenges.

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