Intestinal Research

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Original Articles

Colitis-associated colorectal neoplasia in ulcerative colitis with primary sclerosing cholangitis: a nationwide study: Koichi Komatsu, Takahide Shinagawa, Motoi Uchino, Hiroki Ikeuchi, Koji Okabayashi, Shiro Oka, Kitaro Futami, Michio Itabashi, Kazuhiro Watanabe, Masatsune Shibutani, Yoshiki Okita, Toshifumi Wakai, Yusuke Mizuuchi, Kinya Okamoto, Kazutaka Yamada, Yu Sato, Takayuki Ogino, Hideaki Kimura, Kenichi Takahashi, Koya Hida, Yusuke Kinugasa, Fumio Ishida, Junji Okuda, Koji Daito, Takayuki Yamamoto, Seiichiro Yamamoto, Fumikazu Koyama, Tsunekazu Hanai, Koji Komori, Dai Shida, Junya Arakaki, Yoshito Akagi, Shigeki Yamaguchi, Hideki Ueno, Keiji Matsuda, Atsuo Maemoto, Riichiro Nezu, Shin Sasaki, Eiji Sunami, Tatsuki Noguchi, Kenichi Sugihara, Yoichi Ajioka, Soichiro Ishihara, the Study Group for Inflammatory Bowel Disease Associated Intestinal Cancers by the Japanese Society for Cancer of the Colon and Rectum; Received July 14, 2025 Accepted September 21, 2025 Published online February 12, 2026; DOI: https://doi.org/10.5217/ir.2025.00133 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Background/Aims
Ulcerative colitis (UC)-associated colorectal neoplasia (UCAN) in patients with UC and primary sclerosing cholangitis (PSC) has not been studied well in Japan. This retrospective study examined the clinicopathological features and prognosis of UCAN in patients with PSC-UC.
Methods
A total of 808 patients with UCAN were enrolled from 1983 to 2020 and categorized into PSC (PSC-UCAN, n = 26) and no PSC (UCAN-alone, n = 782) groups. Clinicopathological features were compared between the 2 groups, and the 10-year overall survival (OS) and cancer-specific survival (CSS) were analyzed.
Results
The PSC-UCAN group had a shorter UC duration before UCAN diagnosis (12.8 years vs. 16.9 years, P= 0.044), were younger at UCAN diagnosis (47.8 years vs. 53.3 years, P= 0.046), and developed UCAN more frequently in the right-sided colon (34.6% vs. 15.9%, P= 0.028) than the UCAN-alone group. The PSC-UCAN group showed a trend toward a lower proportion of high-grade dysplasia (19.2% vs. 30.7%) and a higher proportion of early-stage cancers (53.9% vs. 31.2%). The 10-year OS (64.6% vs. 79.3%, P=0.080) and CSS (80.8% vs. 83.9%, P=0.60) were comparable.
Conclusions
Patients with PSC-UCAN showed earlier and younger development of UCAN than patients with only UCAN, with a high prevalence in the right-sided colon. Early-stage cancer was more frequently observed in the PSC-UCAN group, despite the shorter duration of UC. Patients with PSC-UC probably benefit from early initiation of surveillance colonoscopy.

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IBD

Intestinal ultrasound for intestinal Behçet disease reflects endoscopic activity and histopathological findings: Katsuki Yaguchi, Reiko Kunisaki, Sho Sato, Kaori Hirai, Misato Izumi, Yoshimi Fukuno, Mami Tanaka, Mai Okazaki, Rongrong Wu, Yurika Nishikawa, Yusuke Matsune, Shunsuke Shibui, Yoshinori Nakamori, Masafumi Nishio, Mao Matsubayashi, Tsuyoshi Ogashiwa, Ayako Fujii, Kenichiro Toritani, Hideaki Kimura, Eita Kumagai, Yukiko Sasahara, Yoshiaki Inayama, Satoshi Fujii, Toshiaki Ebina, Kazushi Numata, Shin Maeda; Intest Res 2024;22(3):297-309. Published online July 16, 2024; DOI: https://doi.org/10.5217/ir.2023.00129

Abstract PDF PubReader ePub

Background/Aims
Intestinal Behçet disease is typically associated with ileocecal punched-out ulcers and significant morbidity and mortality. Intestinal ultrasound is a noninvasive imaging technique for disease monitoring. However, no previous reports have compared intestinal ultrasound with endoscopic ulcer activity or histopathological findings for intestinal Behçet disease. We evaluated the usefulness of intestinal ultrasound for assessing the activity of ileocecal ulcers in intestinal Behçet disease.
Methods
We retrospectively compared intestinal ultrasound findings with 73 corresponding endoscopic images and 6 resected specimens. The intestinal ultrasound findings were assessed for 7 parameters (bowel wall thickness, vascularity [evaluated using the modified Limberg score with color Doppler], bowel wall stratification, white-plaque sign [strong hyperechogenic lines or spots], mesenteric lymphadenopathy, extramural phlegmons, and fistulas), and endoscopic ulcer activity was classified into active, healing, and scar stages. Histopathological findings were evaluated by consensus among experienced pathologists.
Results
Bowel wall thickness (P< 0.001), vascularity (P< 0.001), loss of bowel wall stratification (P= 0.015), and white-plague sign (P= 0.013) were significantly exacerbated in the endoscopic active ulcer stage. Receiver operating characteristic curve analysis revealed that a bowel wall thickness of > 5.5 mm (sensitivity 89.7%, specificity 85.3%) was potentially useful for detecting active lesions. When compared with histopathological findings, an increase in bowel wall thickness reflected the ulcer marginal ridge, and the white-plaque sign reflected the ulcer bottom.
Conclusions
Intestinal ultrasound is useful for monitoring intestinal ulcer activity in intestinal Behçet disease.

Citations

Citations to this article as recorded by

Development and validation of a novel intestinal ultrasound score for predicting endoscopic activity of ileocecal ulcers in intestinal Behçet's disease
Katsuki Yaguchi, Reiko Kunisaki, Sho Sato, Serina Haruyama, Kazuki Kurimura, Yoshinori Nakamori, Masafumi Nishio, Kenichiro Toritani, Rongrong Wu, Hideaki Kimura, Toshiaki Ebina, Kazushi Numata, Shin Maeda
Journal of Gastroenterology.2026; 61(4): 410. CrossRef
Effectiveness and Tolerability of Anti-Tumor Necrosis Factor Alpha Therapy in Refractory Intestinal Behçet’s Disease: A Large Single-Center Study
Ji Young Chang, Jiwoo Kim, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jae Hee Cheon, Jihye Park
Gut and Liver.2026; 20(2): 305. CrossRef
Behçet's Syndrome
Yusuf Yazici, Gulen Hatemi
Current Rheumatology Reports.2026;[Epub] CrossRef
Elevated IL-6 levels in the intestinal mucosa of patients with gastrointestinal Behçet’s disease
Jihye Park, Arjun Ravi, Katharina Bruzelius, I Seul Park, Philippe Pinton, Jae Hee Cheon
Intestinal Research.2025; 23(4): 559. CrossRef

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IBD

Patient self-reported symptoms using visual analog scales are useful to estimate endoscopic activity in ulcerative colitis: Saya Tsuda, Reiko Kunisaki, Jun Kato, Mayu Murakami, Masafumi Nishio, Tsuyoshi Ogashiwa, Takeichi Yoshida, Hideaki Kimura, Masayuki Kitano; Intest Res 2018;16(4):579-587. Published online October 10, 2018; DOI: https://doi.org/10.5217/ir.2018.00021

Abstract PDF PubReader ePub

Background/Aims
In clinical practice, colonoscopy has been regarded as the gold standard for the evaluation of disease severity as well as mucosal healing in ulcerative colitis (UC). Some activity indices incorporating patient symptoms as parameters have been shown to reflect the endoscopic activity of UC. The aim of this study was to examine whether self-reported symptoms with visual analog scales (VAS) can predict endoscopic activity.
Methods
A cross-sectional study of 150 UC patients who underwent colonoscopy with submission of VAS scores of 4 symptoms: general condition, bloody stools, stool form, and abdominal pain (0: no symptoms, 10: the most severe symptoms). Each VAS score was compared with colonoscopic activity assessed with the Mayo endoscopic subscore (MES).
Results
All VAS scores were significantly correlated with the endoscopic severity (Spearman correlation coefficients of general condition, bloody stools, stool form, and abdominal pain: 0.63, 0.64, 0.58, and 0.43, respectively). Mucosal healing defined as MES 0 alone was predicted by VAS score <1.5 on general condition or 0 on bloody stools with sensitivity of 0.84 and 0.76 and specificity of 0.66 and 0.76, respectively. Additionally, VAS score <2.5 on stool form predicted active lesions in distal colorectum alone with sensitivity of 0.67 and specificity of 0.66, suggesting that this item could predict the indication of topical therapy.
Conclusions
Self-reported VAS scores on symptoms were correlated with endoscopic activity of UC. To clarify the relationship between VAS and mucosal healing, further validation studies are needed.

Citations

Citations to this article as recorded by

Management of Post-Colonoscopy Syndrome with a Nutraceutical Intervention Based on Hericium erinaceus: A Retrospective Two-Arm Multicentre Analysis
Antonio Tursi, Alessandro D’Avino, Giovanni Brandimarte, Giammarco Mocci, Raffaele Pellegrino, Alessandro Federico, Edoardo Vincenzo Savarino, Antonietta Gerarda Gravina
Nutrients.2025; 17(19): 3152. CrossRef
Defining Comprehensive Disease Control for Use as a Treatment Target for Ulcerative Colitis in Clinical Practice: International Delphi Consensus Recommendations
Stefan Schreiber, Silvio Danese, Axel Dignass, Eugeni Domènech, Massimo C Fantini, Marc Ferrante, Jonas Halfvarson, Ailsa Hart, Fernando Magro, Charlie W Lees, Salvo Leone, Marieke J Pierik, Michele Peters, Polly Field, Helen Fishpool, Laurent Peyrin-Biro
Journal of Crohn's and Colitis.2024; 18(1): 91. CrossRef
Anxiety and care experiences in adolescents with chronic health conditions: an international, longitudinal study across the transfer of care
Anna Alanen, Mira Kallio, Evelyn Culnane, Mari Koivisto, Miko Pasanen, Sanna Salanterä, Susan Sawyer, Silja Kosola
BMJ Paediatrics Open.2024; 8(1): e002836. CrossRef
Bridge study protocol: an international, observational cohort study on the transition of healthcare for adolescents with chronic conditions
Silja Kosola, Evelyn Culnane, Hayley Loftus, Anna Tornivuori, Mira Kallio, Michelle Telfer, Päivi J Miettinen, Kaija-Leena Kolho, Kristiina Aalto, Taneli Raivio, Susan Sawyer
BMJ Open.2021; 11(6): e048340. CrossRef
Efficacy of a Preparation Based on Calcium Butyrate, Bifidobacterium bifidum, Bifidobacterium lactis, and Fructooligosaccharides in the Prevention of Relapse in Ulcerative Colitis: A Prospective Observational Study
Gian Paolo Caviglia, Federico De Blasio, Marta Vernero, Angelo Armandi, Chiara Rosso, Giorgio Maria Saracco, Elisabetta Bugianesi, Marco Astegiano, Davide Giuseppe Ribaldone
Journal of Clinical Medicine.2021; 10(21): 4961. CrossRef
Similar Clinical Outcomes of Early and Late Anti-TNF Initiation for Ulcerative Colitis: A Nationwide Population-Based Study
Minkyung Han, Yoon Suk Jung, Jae Hee Cheon, Sohee Park
Yonsei Medical Journal.2020; 61(5): 382. CrossRef
Systematic Review of Development and Content Validity of Patient-reported Outcome Measures in Inflammatory Bowel Disease: Do We Measure What We Measure?
Emma M van Andel, Brechtje D M Koopmann, Femke Crouwel, Casper G Noomen, Nanne K H de Boer, Dirk P van Asseldonk, Lidwine B Mokkink
Journal of Crohn's and Colitis.2020; 14(9): 1299. CrossRef
The Usefulness of Microencapsulated Sodium Butyrate Add-On Therapy in Maintaining Remission in Patients with Ulcerative Colitis: A Prospective Observational Study
Marta Vernero, Federico De Blasio, Davide Giuseppe Ribaldone, Elisabetta Bugianesi, Rinaldo Pellicano, Giorgio Maria Saracco, Marco Astegiano, Gian Paolo Caviglia
Journal of Clinical Medicine.2020; 9(12): 3941. CrossRef
Prediction of treatment outcome and relapse in inflammatory bowel disease
Jun Kato, Takeichi Yoshida, Sakiko Hiraoka
Expert Review of Clinical Immunology.2019; 15(6): 667. CrossRef

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