Intestinal Research

IBD

Practices and perceptions of imaging assessment in inflammatory bowel disease: a nationwide survey of physicians in Korea by the KASID Guidelines Taskforce Team: Ji Eun Kim, Young Joo Yang, June Hwa Bae, Seung Yong Shin, Dong Hyun Kim, Seung Min Hong, Eun Mi Song, Jiyoung Yoon, Sang-Bum Kang, Eun Soo Kim, Sung Eun Kim, Seong-Jung Kim, Jun Lee, Soo-Young Na, Soo Jung Park, Sang Hyoung Park, Myung Ha Kim, Won Moon, Sung-Ae Jung, KASID Guidelines Taskforce Team of the Korean Association for the Study of Intestinal Diseases (KASID); Intest Res 2026;24(2):270-280. Published online April 17, 2026; DOI: https://doi.org/10.5217/ir.2026.00043

Abstract PDF Supplementary Material PubReader ePub: Background/Aims
Imaging-based assessment is essential for evaluating disease activity and structural damage in inflammatory bowel disease (IBD). This study aimed to evaluate real-world use and perceptions of imaging modalities among Korean IBD experts and to identify implications for future domestic guideline development.
Methods
A nationwide, web-based survey was conducted among board-certified gastroenterologists affiliated with the Korean Association for the Study of Intestinal Diseases. The questionnaire assessed respondent characteristics, imaging modality use in Crohn’s disease (CD) and ulcerative colitis (UC), and perceptions of clinical utility using a 5-point Likert scale. Results were summarized as frequencies and percentages.
Results
Of 150 invited clinicians, 133 responded, with 74.4% practicing in tertiary referral centers. In CD, computed tomography enterography (CTE) and magnetic resonance enterography (MRE) were the most used modalities at diagnosis and follow-up. In contrast, IUS utilization was low (6.8% at diagnosis and 10.5% during follow-up), and 82.0% reported no intestinal ultrasound (IUS) use in the preceding year. In UC, CT-based strategies also predominated, and more than half reported no imaging during follow-up. Major barriers to IUS adoption included limited experience, time constraints, and institutional or equipment limitations. CT/CTE and MRE were perceived as useful for diagnosis and complication assessment, whereas IUS was viewed as suitable for repeated monitoring but highly operator dependent.
Conclusions
IBD imaging practices in Korea rely predominantly on CT-based modalities, with limited real-world use of MRE and IUS despite their recognized clinical potential. Future Korean guidelines should acknowledge these real-world limitations while encouraging gradual integration of MRE and IUS.

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IBD

Optimal use and cycling strategies of Janus kinase inhibitors in ulcerative colitis: current evidence and clinical implications from the KASID Guidelines Task Force Team: Seung Min Hong, Dong Hyun Kim, June Hwa Bae, Seung Yong Shin, Eun Mi Song, Ji Eun Kim, Young Joo Yang, Jiyoung Yoon, Sang-Bum Kang, Eun Soo Kim, Seong-Eun Kim, Seong-Jung Kim, Jun Lee, Soo-Young Na, Soo Jung Park, Sang Hyoung Park, Miyoung Choi, Myung Ha Kim, Won Moon, Sung-Ae Jung, KASID Guidelines Taskforce Team of the Korean Association for the Study of Intestinal Diseases (KASID); Intest Res 2026;24(1):27-37. Published online January 28, 2026; DOI: https://doi.org/10.5217/ir.2025.00309

Abstract PDF PubReader ePub: Janus kinase (JAK) inhibitors are an important treatment option for ulcerative colitis, providing rapid onset of action, oral administration, and efficacy even after biologic failure. The 3 approved agents—tofacitinib, filgotinib, and upadacitinib—differ in JAK isoform selectivity, leading to clinically meaningful differences in efficacy and safety. Evidence from network meta-analyses, clinical trials, and real-world studies consistently shows that upadacitinib provides the highest efficacy for induction and maintenance of remission, whereas filgotinib demonstrates the most favorable safety profile. The strong efficacy of upadacitinib and tofacitinib is particularly relevant in patients with severe disease, including acute severe ulcerative colitis, and upadacitinib maintains high efficacy regardless of prior advanced therapy exposure. JAK inhibitors also benefit extraintestinal manifestations. Although risks such as herpes zoster, serious infection, thromboembolism, and major cardiovascular events differ among agents, long-term data suggest generally acceptable safety when used appropriately. Intraclass JAK-to-JAK cycling is feasible, with about half of patients achieving steroid-free clinical remission in retrospective cohorts. Based on mechanistic, clinical, and real-world evidence, filgotinib may be a first-line option for patients with lower disease activity or when safety is a priority, whereas upadacitinib or tofacitinib may be preferred in higher disease activity. Strategically selecting agents may improve durability and outcomes.

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IBD

Practices and perceptions of 5-aminosalicylic acid use in Crohn’s disease: a nationwide survey of physicians in Korea by KASID Guidelines Taskforce Team: June Hwa Bae, Seung Yong Shin, Dong Hyun Kim, Seung Min Hong, Eun Mi Song, Ji Eun Kim, Young Joo Yang, Jiyoung Yoon, Sang-Bum Kang, Eun Soo Kim, Sung Eun Kim, Seong-Jung Kim, Jun Lee, Soo-Young Na, Soo Jung Park, Sang Hyoung Park, Won Moon, Sung-Ae Jung, KASID Guidelines Taskforce Team of the Korean Association for the Study of the Intestinal Diseases (KASID); Intest Res 2025;23(4):491-501. Published online October 28, 2025; DOI: https://doi.org/10.5217/ir.2025.00211

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Despite international guidelines recommending against the use of 5-aminosalicylic acid (5-ASA) for Crohn’s disease (CD), it remains widely prescribed. This study aimed to investigate current patterns of 5-ASA use and physicians’ perceptions of its efficacy among Korean specialists.
Methods
A nationwide online survey was conducted in August 2025 targeting Korean gastroenterologists and colorectal surgeons managing inflammatory bowel disease. The questionnaire included 19 items addressing prescribing behaviors, perceived efficacy, and clinical decision-making regarding 5-ASA in CD.
Results
A total of 118 out of 124 physicians (95.2%) responded to the survey. The majority (67.8%) reported prescribing 5-ASA to more than half of their patients with CD. Standard to high doses ( > 2 g/day) were commonly used (94.9%), and timedependent formulations were preferred (92.4%). Although 55.1% used 5-ASA irrespective of disease location, it was frequently prescribed for colonic/ileocolonic disease (57.7%). Physicians primarily used 5-ASA in cases of non-active or mildly active CD. Notably, over 70% of respondents perceived 5-ASA to have a marginal yet beneficial effect on clinical remission, biomarker improvement, and mucosal healing. Approximately one-third of physicians reported continuing 5-ASA even after initiating biologics or small molecules.
Conclusions
This survey reveals a substantial gap between clinical guidelines and current practice in Korea regarding 5-ASA use for CD. Many physicians continue to view 5-ASA as a relevant option, particularly for patients with low inflammatory burden. These discrepancies likely reflect practical factors such as clinical experience and drug characteristics, which should be carefully considered before excluding 5-ASA from CD management.

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Practices and perceptions of imaging assessment in inflammatory bowel disease: a nationwide survey of physicians in Korea by the KASID Guidelines Taskforce Team
Ji Eun Kim, Young Joo Yang, June Hwa Bae, Seung Yong Shin, Dong Hyun Kim, Seung Min Hong, Eun Mi Song, Jiyoung Yoon, Sang-Bum Kang, Eun Soo Kim, Sung Eun Kim, Seong-Jung Kim, Jun Lee, Soo-Young Na, Soo Jung Park, Sang Hyoung Park, Myung Ha Kim, Won Moon,
Intestinal Research.2026; 24(2): 270. CrossRef

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The Effect of Indigocarmine on Improvement of the Polyp Detection Rate during Colonoscopic Examination with Hood Cap: Sang Chang Kwon, Sung Won Choi, Seong Ho Choi, Hee Seung Park, Seung Heon Lee, Bong Gun Kim, Eun Hee Seo, Mun Jang, Seung Min Ryu, Dong Hyun Kim, Young Hoon Kim, Jun Ouk Ha, Jae Seung Lee; Intest Res 2014;12(1):60-65. Published online January 28, 2014; DOI: https://doi.org/10.5217/ir.2014.12.1.60

Abstract PDF PubReader

<b>Background/Aims</b><br/>

Hood cap-assisted chromocolonoscopy using indigocarmine is expected to improve the detection rate of colorectal polyps, especially adenomatous polyps. Therefore, aim of the present study was to evaluate the usefulness of hood cap-assisted chromocolonoscopy in routine colonoscopic examinations.

Methods

From January, 2013 through March, 2013, a total of 86 patients were enrolled (M:F=33:53, mean age=60 years). For each patient, hood cap-assisted colonoscopic examination was performed, followed by hood cap-assisted chromocolonoscopy using 0.2% indigocarmine from the cecum to the hepatic flexure. Total numbers and characteristics of polyps were compared before and after indigo carmine dye spraying.

Results

Prior to dye spraying, 48 polyps were found in 37 patients, and after dye spraying, 53 additional polyps were found in 34 patients. Of these undetected polyps, 45 (85%) were small sized polyps (≤0.5 cm). Histologically, 19 (36%) were adenomatous polyps, and of these, 15 (28%) were tubular adenomas and 4 (8%) were serrated adenomas. As for the polyp detection rate, there was no difference between the expert and the non-expert groups.

Conclusion

Hood cap-assisted chromocolonoscopic examination using indigocarmine was helpful in detecting cecum and ascending colon polyps, especially small sized polyps (<0.5 cm) and neoplastic polyps.

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Risk factors for peritonitis in patients on continuous ambulatory peritoneal dialysis who undergo colonoscopy: a retrospective multicentre study
Tae-Geun Gweon, Sung Hoon Jung, Sang Woo Kim, Kang-Moon Lee, Dae Young Cheung, Bo-In Lee, Hwang Choi
BMC Gastroenterology.2019;[Epub] CrossRef
A prospective randomized comparative study of cold forceps polypectomy by using narrow-band imaging endoscopy versus cold snare polypectomy in patients with diminutive colorectal polyps
Soo-kyung Park, Bong Min Ko, Jae Pil Han, Su Jin Hong, Moon Sung Lee
Gastrointestinal Endoscopy.2016; 83(3): 527. CrossRef
Is Retroflexion Helpful in Detecting Adenomas in the Right Colon?: A Single Center Interim Analysis
Hyun Seok Lee, Seong Woo Jeon
Intestinal Research.2015; 13(4): 326. CrossRef
Detection of Polyps Including Adenomas in the Ascending Colon by Cap-assisted Chromocolonoscopy with Indigo Carmine
Hyun Seok Lee
Intestinal Research.2014; 12(1): 3. CrossRef

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Necrotizing Myositis as an Extraintestinal Manifestation of Crohn's Disease: Dong Hyun Kim, Kyu Hyun Paik, Hee Jun Shim, Su Yeon Rhie, Lae Ik Jung, Beom Jin Kim, Jae Gyu Kim; Intest Res 2013;11(4):303-305. Published online October 30, 2013; DOI: https://doi.org/10.5217/ir.2013.11.4.303

Abstract PDF

Inflammatory bowel disease is associated with extraintestinal manifestations involving almost every organ system in the body. Crohn's disease (CD) appears to be more commonly associated with an inflammatory myopathy than ulcerative colitis. However, myopathy of the thigh in patients with CD is rare. We report an unusual site of necrotizing myositis in a patient with CD. A 23-year-old woman presented with swelling and pain at the left popliteal area that had lasted for 1 week. Twenty-two months before admission, she had presented with pyoderma gangrenosum on the left upper chest and was diagnosed with CD. A magnetic resonance imaging scan of her leg revealed diffuse swelling in the left semimembranous muscle and biceps femoris muscle that was compatible with myositis, and a cystic lesion in the distal portion of the semimembranous muscle. The findings from semimembranous muscle biopsy were also consistent with necrotizing myositis. In conclusion, myositis, although rare, can be an extraintestinal manifestation of CD. (Intest Res 2013;11:303-305)

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Prevention and Treatment of Thromboembolism in Patients with Inflammatory Bowel Disease
Jae Jun Park
The Korean Journal of Gastroenterology.2015; 65(3): 151. CrossRef

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