Intestinal Research

Original Article

Colon Transit Time May Predict Inadequate Bowel Preparation in Patients With Chronic Constipation: Hong Jun Park, Myeong Hun Chae, Hyun-Soo Kim, Jae Woo Kim, Moon Young Kim, Soon Koo Baik, Sang Ok Kwon, Hee Man Kim, Kyong Joo Lee; Intest Res 2015;13(4):339-345. Published online October 15, 2015; DOI: https://doi.org/10.5217/ir.2015.13.4.339

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

We evaluated whether colonic transit time (CTT) can predict the degree of bowel preparation in patients with chronic constipation undergoing scheduled colonoscopy in order to assist in the development of better bowel preparation strategies for these patients.

Methods

We analyzed the records of 160 patients with chronic constipation from March 2007 to November 2012. We enrolled patients who had undergone a CTT test followed by colonoscopy. We defined patients with a CTT ≥30 hours as the slow transit time (STT) group, and patients with a CTT <30 hours as the normal transit time (NTT) group. Boston Bowel Preparation Scale (BBPS) scores were compared between the STT and NTT groups.

Results

Of 160 patients with chronic constipation, 82 (51%) were included in the STT group and 78 (49%) were included in the NTT group. Patients with a BBPS score of <6 were more prevalent in the STT group than in the NTT group (31.7% vs. 10.3%, P=0.001). Multivariate analysis showed that slow CTT was an independent predictor of inadequate bowel preparation (odds ratio, 0.261; 95% confidence interval, 0.107-0.634; P=0.003). The best CTT cut-off value for predicting inadequate bowel preparation in patients with chronic constipation was 37 hours, as determined by receiver operator characteristic (ROC) curve analysis (area under the ROC curve: 0.676, specificity: 0.735, sensitivity: 0.643).

Conclusions

Patients with chronic constipation and a CTT >30 hours were at risk for inadequate bowel preparation. CTT measured prior to colonoscopy could be useful for developing individualized strategies for bowel preparation in patients with slow CTT, as these patients are likely to have inadequate bowel preparation.

Citations

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Case Report

Adenocarcinoma Originating From a Completely Isolated Duplication Cyst of the Mesentery in an Adult: Seung Yong Shin, Mee Yon Cho, Hoon Ryu, Jae Woo Kim, Hyun-Soo Kim, Jung Min Kim, An Na Ko, Tae-Sun Yu, Hong Jun Park; Intest Res 2014;12(4):328-332. Published online October 27, 2014; DOI: https://doi.org/10.5217/ir.2014.12.4.328

Abstract PDF PubReader ePub

Alimentary tract duplications are uncommon congenital abnormalities that usually have an anatomical connection with some part of the gastrointestinal tract and have a common blood supply with the adjacent segment of intestine. A completely isolated duplication cyst (CIDC) is a very rare type of gastrointestinal duplication that does not communicate with the normal bowel segment and possesses its own exclusive blood supply. Only 5 CIDC cases in adults have been reported in the English medical literature. Additionally, only 1 case of mucinous cystadenoma from an infected CIDC of the ileum has been reported. This report describes a 52-year-old male patient with a peritoneal CIDC, which upon curative excision was found to have given rise to an adenocarcinoma. The latter was lined internally with malignant glandular cells and contained a smooth muscular outer layer as determined by microscopic examination of the tissue. We believe that this is the first reported case of an adenocarcinoma originating from a CIDC in an adult.

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Original Articles

Prevalence and Risk Factors of Colorectal Neoplasms according to Coronary Artery Obstructive Disease: Ki Tae Suk, Hyun Soo Kim, Hyun Jun Min, Hong Jun Park, Hyo Keun Jeon, Moon Young Kim, Jae Woo Kim, Soon Koo Baik, Sang Ok Kwon; Intest Res 2011;9(2):112-117. Published online August 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.2.112

Abstract PDF: Background/Aims
Both colorectal neoplasm (CN) and coronary artery obstructive disease (CAOD) are prevalent and major leading causes of death in Korea. Although CN and CAOD share similar risk factors such as male gender, smoking, hyperlipidemia, diabetes mellitus, and obesity, few studies of both CN and CAOD have been reported. In this study, we evaluated clinical correlations between CN and CAOD. Methods: Between June 2003 and December 2007, 176 patients (Male: 101, average age: 62.1±9.7 yr) who underwent colonoscopy after or before coronary angiography were retrospectively enrolled. The colonoscopic findings (normal, adenoma, or cancer) of patients as well as clinical and laboratory data according to the extent of CAOD (normal, minimal CAOD, or CAOD) were compared. Results: CAOD negative, minimal CAOD, and CAOD patients totaled 36, 40, and 100, respectively. The presence of CN (adenoma and adenocarcinoma) in CAOD negative, minimal CAOD, and CAOD cases was 42%, 48%, and 63%, respectively, which was significantly different (P＜0.05). In multivariate analysis, old age (≥60 yr; P=0.03, odds ratio 2.47) and the presence of CAOD (P=0.02, odds ratio 4.11) were associated with the presence of CN. Conclusions: The prevalence of CN increased in proportion to the severity of CAOD. Colorectal cancer screening by fecal occult blood tests or colonoscopy should be a priority in patients with CAOD, particularly the elderly. (Intest Res 2011;9:112-116)

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Clinicopathological Characteristics of Colorectal Cancer according to Microsatellite Instability: Ki Tae Suk, Hyun Soo Kim, Jin Hyung Lee, Bo Ra Kim, Moon Young Kim, Jae Woo Kim, Soon Koo Baik, Sang Ok Kwon, Yosep Chong, Mee Yon Cho; Intest Res 2009;7(1):14-21. Published online June 30, 2009

Abstract PDF: Background/Aims
Microsatellite instability (MSI) is associated with mutations in the DNA mismatch repair system and accounts for 10-15% of all cases of sporadic colorectal cancer (CRC). However, the characteristics and role of MSI as a marker for predicting the prognosis and therapeutic effect on CRC remain unclear. Methods: Between June 2003 and December 2007, 259 patients (males, 159 [61%]; age, 63 [±11] years) who underwent surgery for CRC were retrospectively enrolled. The clinicopathologic characteristics of patients with high-frequency MSI (MSI-H) CRC were reviewed and compared to patients with low-frequency MSI or microsatellite stable CRC. The patient characteristics and MSI-related data were recorded for the following variables: gender, age, clinicopathologic findings, chemotherapy response, recurrence, and survival. Results: MSI-H CRC was diagnosed in 30 patients (12%), low-frequency MSI CRC was diagnosed in 10 patients (4%), and microsatellite stable CRC in was diagnosed in 219 patients (84%). The MSI-H group exhibited the following characteristics: large size, right colon location, positive response to chemotherapy, low recurrence, longer survival, less neural invasion, poor differentiation, diffuse lymphoid reaction, and mucin pool formation. However, in the chemotherapy group (n=180), MSI-H was not a marker of longer survival. Based on Cox-regression analysis, stage IV CRC (OR=6.66; 95% CI, 2.24-53.00), MSI-H (OR=0.17; 95% CI, 0.04-0.73), and a positive response to chemotherapy (OR=0.02; 95% CI, 0.01-0.11) were related to mortality. Conclusions: MSI-H CRC had less neural invasion and diffuse lymphoid reaction. Further studies regarding the relationship between those pathologic findings and survival are needed. (Intest Res 2009;7:14-21)

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