Intestinal Research

Original Articles

IBD

Knowledge and perspectives towards the use of histology in inflammatory bowel disease by gastroenterologists across the Asia-Pacific region: Thanaboon Chaemsupaphan, Aviv Pudipeddi, Huiyu Lin, Hsin-Yun Wu, Julajak Limsrivilai, Wee Chian Lim, Shu-Chen Wei, Rupert W. Leong; Intest Res 2025;23(3):338-346. Published online December 2, 2024; DOI: https://doi.org/10.5217/ir.2024.00086

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Recently, histological mucosal assessment has gained momentum as a potential new treatment target for patients with inflammatory bowel disease (IBD) in the Asia-Pacific region. This study aimed to evaluate and compare the knowledge and acceptability of histological assessment among gastroenterologists across the region.
Methods
A cross-sectional survey among gastroenterologists in the Asia-Pacific region was conducted and compared against a previous Australian survey. The questionnaire assessed knowledge and attitude towards the role and application of histology in IBD practice. Statistical analyses were employed to compare scores and identify predictors.
Results
A total of 221 gastroenterologists from 12 countries, including 77 (34.8%) from Australia, responded to questionnaire, with 185 (83.7%) completing the survey. The mean knowledge score was 9.8 ± 3.3 (51.6%). There was no significant difference in the average score among countries (P= 0.53). IBD specialist (P< 0.01), doctoral degree (P= 0.02), and regular participation in IBD multidisciplinary meetings (P= 0.01) were associated with higher scores. Most respondents (90.7%) agreed on the importance of histology in IBD. While 54.6% of Australians perceived the role of histology as established, only 37.0% of Asians respondents considered this similarly (P= 0.02). Histological activity alone minimally influences treatment escalation in patients with endoscopic remission, but achieving combined histo-endoscopic remission often leads to therapy de-escalation.
Conclusions
Although gastroenterologists in the Asia-Pacific region are aware of the role of histology in IBD, their knowledge remains limited, and its clinical utility is not widely adopted. There is a need to promote the routine use of standardized histological assessment in IBD practice.

Citations

Citations to this article as recorded by

Comparison of the performance between an AI-based vision transformer and human endoscopists in predicting the endoscopic and histologic activities of ulcerative colitis
Yuan-Yen Chang, Han-Po Yang, Yang-Yuan Chen, Hsu-Heng Yen
DIGITAL HEALTH.2026;[Epub] CrossRef
Asia Pacific association of gastroenterology consensus statements on histopathological evaluation of inflammatory bowel diseases
Rupert W. Leong, Thanaboon Chaemsupaphan, Huiyu Lin, Wee Chian Lim, Choon Jin Ooi, John D. Chetwood, Ren Mao, Hsin Yun Wu, Shu Chen Wei, Govind Makharia, Vineet Ahuja, Rupa Banerjee, Raja Atreya, Julajak Limsrivilai, Satimai Aniwan, Pises Pisespongsa, Ida
Therapeutic Advances in Gastroenterology.2025;[Epub] CrossRef

3,452 View
184 Download
2 Web of Science
2 Crossref

IBD

Histologic healing and clinical outcomes in ulcerative colitis: Raymond Fueng-Hin Liang, Huiyu Lin, Cora Yuk-Ping Chau, Wee Chian Lim; Intest Res 2025;23(2):182-192. Published online September 19, 2024; DOI: https://doi.org/10.5217/ir.2024.00058

Abstract PDF PubReader ePub

Background/Aims
Growing evidence suggests histologic healing (HH) improves clinical outcomes in ulcerative colitis (UC) patients beyond endoscopic healing (EH). We hypothesize that HH is associated with better clinical outcomes in Asian UC patients, for whom data is lacking.
Methods
We performed a retrospective study of UC patients in clinical remission (CR) with a follow-up colonoscopy and minimum 1-year follow-up post-colonoscopy. Primary outcome was clinical relapse (CRL), defined as either a Simple Clinical Colitis Activity Index score of > 2, medication escalation, hospitalization or colectomy. Predictors of CRL and HH were assessed.
Results
One hundred patients were included with a median follow-up of 22 months. At index colonoscopy, 80 patients were in EH. On follow-up, 41 patients experienced CRL. Of 80 patients in EH, 34 (42.5%) had persistent histologic activity (Nancy Index ≥ 2) and 29 (36.3%) relapsed during the follow-up period. Amongst patients in CR and EH, those with HH had lower CRL rate (26.1% vs. 50.0%, P= 0.028) and longer CRL-free survival (mean 46.1 months vs. 31.5 months, P= 0.015) than those with persistent histologic activity. On bivariable analysis of 100 patients in CR, HH, and Mayo endoscopic score (MES) of 0 were significantly associated with lower risk of CRL. On multivariable analysis, only MES 0 remained predictive of lower CRL risk.
Conclusions
Above and beyond CR and EH, achieving HH improves clinical outcomes in Asian UC patients. However, HH may not confer incremental benefit if MES 0 has been achieved. Further prospective studies evaluating the benefit of histologically guided therapeutic decisions are needed.

Citations

Citations to this article as recorded by

The therapeutic mechanism of bornyl acetate in alleviating ulcerative colitis by regulating the intestinal flora
Bingqing Shang, Minghui Yang, Liduan Yin, Suyuan Lv, Tong Wang, Qiu Wu, Yue Geng
Food & Function.2026; 17(3): 1500. CrossRef
KASID and Intestinal Research journal: a central academic hub for research of intestinal diseases in the Asia-Pacific region
Jae Hee Cheon, Hye Kyung Hyun, You Sun Kim, Dong Il Park, Tae Il Kim, Dong Soo Han
Intestinal Research.2026; 24(1): 6. CrossRef
Correlation between clinical and histopathological scoring systems in Egyptian patients with ulcerative colitis (single center study)
Randa Ahmed El Garhy, Faten Wagdi Ragheb, Nermine Mohamed Abd Raboh, Hagar Elessawy, Fatma S. Hafez
The Egyptian Journal of Internal Medicine.2025;[Epub] CrossRef

5,482 View
188 Download
3 Web of Science
3 Crossref

First
Prev
Page of 1
Next
Last

Search