Intestinal Research

Functional bowel disorder

An Asian perspective on irritable bowel syndrome: Kee Wook Jung, Seung-Jae Myung; Intest Res 2023;21(2):189-195. Published online May 31, 2022; DOI: https://doi.org/10.5217/ir.2021.00136

Irritable bowel syndrome (IBS) is a prevalent chronic disorder, and its epidemiology depends on the diagnostic criteria used. Recently, the Rome IV criteria for IBS were published by changing the frequency of abdominal pain and excluding abdominal discomfort from the previously used Rome III criteria. However, the recent Asian consensus on IBS recommends the inclusion of abdominal discomfort and abdominal pain as diagnostic criteria. The low fermentable oligo-, di-, mono-saccharides, and polyols (FODMAP) diet has been proven to be effective in Western patients. Moreover, recent well-designed studies reported its effectiveness and the microbial changes after implementing it in Asian patients with IBS. However, traditional Korean foods including kimchi, one of representative FODMAP-rich food, exhibited a poor correlation with the food-related symptoms of IBS. Therefore, the low FODMAP diet protocol should be cautiously applied to IBS patients, especially to Korean patients with IBS. In Asian countries, there are lots of traditional herbal medicines and treatments for IBS; however, these studies have limitations including the heterogeneity of herbal mixtures and relatively small sample size. Therefore, well-designed studies based on large samples are required to validate complementary and alternative medicine in the treatment of Asian patients with IBS.

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The Role of Diet in the Management of Irritable Bowel Syndrome: A Comprehensive Review
Maleesha Jayasinghe , Vinuri Karunanayake, Ali Mohtashim, Dilushini Caldera , Piyalka Mendis , Omesh Prathiraja, Fatemeh Rashidi, John A Damianos
Cureus.2024;[Epub] CrossRef
Downregulated APOD and FCGR2A correlates with immune infiltration and lipid-induced symptoms of irritable bowel syndrome
Yamei Ran, Kangqi Wu, Chenglin Hu, Renzheng Liang, Li Zhang, Juan Xiao, Yongmei Peng, Wenjing Sun
Scientific Reports.2023;[Epub] CrossRef
Technical Feasibility of Quantitative Measurement of Various Degrees of Small Bowel Motility Using Cine Magnetic Resonance Imaging
Ji Young Choi, Jihye Yun, Subin Heo, Dong Wook Kim, Sang Hyun Choi, Jiyoung Yoon, Kyuwon Kim, Kee Wook Jung, Seung-Jae Myung
Korean Journal of Radiology.2023; 24(11): 1093. CrossRef
Letter to the Editor: Survey-Based Analysis of Clinical Treatment Status of Irritable Bowel Syndrome in Korea: Suggestions for Future Research
Ji Young Chang
Journal of Korean Medical Science.2023;[Epub] CrossRef
Effectiveness of Medilac-S as an Adjuvant to Conventional Irritable Bowel Syndrome Treatments: A Systematic Review with Meta-Analysis
Annie Tremblay, Xiaoyu Xu, James Colee, Thomas A. Tompkins, Sylvie Binda
Gastroenterology Insights.2023; 14(4): 491. CrossRef
Comments on Efficacy of a Synbiotic Containing Lactobacillus paracasei DKGF1 and Opuntia humifusa in Elderly Patients with Irritable Bowel Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial
Kwang Woo Kim
Gut and Liver.2023; 17(6): 954. CrossRef

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A Case of Cronkhite-Canada Syndrome Showing Spontaneous Remission: Dong-Uk Kang, Dong-Hoon Yang, Yunsik Choi, Ji-Beom Kim, Ho-Su Lee, Hyo Jeong Lee, Sang Hyoung Park, Kee Wook Jung, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim; Intest Res 2013;11(4):317-322. Published online October 30, 2013; DOI: https://doi.org/10.5217/ir.2013.11.4.317

Abstract PDF

Cronkhite-Canada syndrome (CCS) is a rare, noninherited gastrointestinal polyposis syndrome associated with ectodermal changes such as alopecia, nail dystrophy, and cutaneous hyperpigmentation. The etiology and pathogenesis of CCS are not known, but diarrhea, malnutrition, gastrointestinal bleeding, and infection may occur in the affected patient; moreover, this condition could be fatal. However, previous reports have described several cases of spontaneous remission. We report a 60-year-old man who was incidentally found to have colonic polyposis, alopecia, and hypogeusia and was diagnosed to have CCS. However, this patient experienced spontaneous remission, including regrowth of body hair and alleviation of bowel inflammation, without any specific medications such as steroids, antibiotics, or proton pump inhibitors. (Intest Res 2013;11:317-322)

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Cronkhite-Canada Syndrome Showing Good Early Response to Steroid Treatment
Woohee Cho, Kwangwoo Nam, Ki Bae Bang, Hyun Deok Shin, Jeong Eun Shin
The Korean Journal of Gastroenterology.2018; 71(4): 239. CrossRef

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Endoscopic Resection for Rectal Carcinoid Tumor: Efficacy and Clinical Results of Follow-up: Gwang Un Kim, Byong Duk Ye, Jeong-Sik Byeon, Hwan Sung Park, Tae Jin Ok, Dong-Hoon Yang, Kee Wook Jung, Kyung Jo Kim, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim; Intest Res 2011;9(3):217-224. Published online December 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.3.217

Abstract PDF

Background/Aims
With the growing volume of screening colonoscopies, the incidence of rectal carcinoids and the number of endoscopic resections for rectal carcinoids are also increasing. However, the prognosis including recurrence and metachronous lesions after endoscopic resection is unclear. Methods: The medical records of 255 patients who had undergone endoscopic resection for rectal carcinoids between October 1999 and April 2010 were retrospectively reviewed. Results: The number of males was 150 (58.8%), and the mean age was 54.1 years (range, 27-85 years). Mean tumor size was 6.9 mm. In total, 162 cases (63.5%) were treated with endoscopic mucosal resection and 93 (36.5%) were treated with endoscopic submucosal dissection. Although endoscopic complete resections were achieved in all cases, the histological examination showed 47 cases with a positive resection margin (18.4%) and three with lymphovascular invasion (1.2%). In the 54 patients with a free resection margin, who were followed for more than 12 months, abdominopelvic computed tomography and endoscopy did not show recurrence after a median of 30.5 and 36 months, respectively. Three patients with lymphovascular invasion did not show recurrence during follow-up period of 13, 30, and 37 months, respectively. Metachronous rectal carcinoids were detected in four patients at 23, 58, 61, and 89 months, respectively, after initial endoscopic resection, leading to a second endoscopic treatment. Conclusions: Small rectal carcinoids completely resected grossly and pathologically without lymphovascular invasion appear to have low probability of short-term recurrence. However, considering the slow growth rate of carcinoids, long-term follow-up for recurrence and metachronous carcinoids is required. (Intest Res 2011;9:217-224)

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Clinical outcomes and risk factors associated with poor prognosis after endoscopic resection of 10–20 mm rectal neuroendocrine tumors: a multicenter, retrospective study of 10-year experience
Ja Jun Goo, Dong Hoon Baek, Hyung Wook Kim, Hong Sub Lee, Jong Yoon Lee, Su Bum Park, Geun Am Song, Sang Heon Lee, Jong Hoon Lee
Surgical Endoscopy.2023; 37(7): 5196. CrossRef
Risk Factors for Lymph Node Metastasis and Oncologic Outcomes in Small Rectal Neuroendocrine Tumors with Lymphovascular Invasion
Seung-Joo Nam, Byung Chang Kim, Hee Jin Chang, Han Ho Jeon, Junho Kim, Su Young Kim
Gut and Liver.2022; 16(2): 228. CrossRef
Multiple small, rectal neuroendocrine tumors with numerous micronests
Sung Sil Park, Nayoung Han, Jihyeon Lee, Hee Jin Chang, Jae Hwan Oh, Dae Kyung Sohn
Journal of Digestive Diseases.2018; 19(9): 572. CrossRef
Clinical outcomes of endoscopic mucosal resection for rectal neuroendocrine tumor
Jihye Kim, Jee Hyun Kim, Joo Young Lee, Jaeyoung Chun, Jong Pil Im, Joo Sung Kim
BMC Gastroenterology.2018;[Epub] CrossRef
Are Small Rectal Neuroendocrine Tumors Safe?
Jae Ho Choi, Jae Myung Cha
Intestinal Research.2015; 13(2): 103. CrossRef
Appendiceal Neuroendocrine Tumor with Lymph Node Metastasis in a Teenager
Keun Young Kim, Won Cheol Park
The Korean Journal of Gastroenterology.2015; 65(2): 127. CrossRef

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A Case of Isolated Ileal Ganglioneuroma: Ju Hyung Song, Byong Duk Ye, Yong Sik Yoon, Mi-Jung Kim, Dong-Hoon Yang, Kee Wook Jung, Kyung-Jo Kim, Jung-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim; Intest Res 2011;9(1):46-50. Published online April 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.1.46

Abstract PDF

Ganglioneuromas of the gastrointestinal tract are rare, but have an established association with genetic disorders, such as the multiple endocrine neoplasia (MEN) syndrome (type 2b) and neurofibromatosis (type 1). However, solitary ganglioneuromas are not associated with an increased risk for MEN 2b, neurofibromatosis type 1, or any other systemic conditions. Ganglioneuromas of the gastrointestinal tract have been reported to predominantly involve the colon and rectum, and are thereby occasionally detected during colonoscopy or surgery. Although there are no characteristic symptoms of solitary ganglioneuromas, symptoms can be induced by solitary ganglioneuromas, such as abdominal pain, bleeding, or obstruction, depending on the location and size. Herein we report a case of a solitary ganglioneuroma of the ileum. A 34-year-old man sought evaluation at our hospital for anemia. The medical and family histories were benign and there was no history of genetic disorders. The evaluation for anemia revealed iron-deficiency anemia and CT enterography revealed a single mass in the ileum. Laparoscopic resection of the lesion was performed and the pathologic examination confirmed an ileal ganglioneuroma. (Intest Res 2011;9: 11-50)

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A Case of Duodenal Ganglioneuroma Manifesting as a Subepithelial Tumor
Dong Chan Joo, Gwang Ha Kim, Chul Byung Chae, So Jeong Lee, Do Youn Park
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2018; 18(4): 271. CrossRef

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Response to Biofeedback Therapy for Patients with Rectal Hyposensitivity: Kee Wook Jung, Seung-Jae Myung, Jeong-Sik Byeon, In Ja Yoon, Jung Eun Ko, So Young Seo, Soon Man Yoon, Mi Young Do, Do Hoon Kim, Benjamin Kim, Seunghyun Kwon, Byong Duk Ye, Hwoon-Yong Jung, Suk-Kyun Yang, Jin-Ho Kim; Intest Res 2008;6(1):56-69. Published online June 30, 2008

Abstract PDF: Background/Aims
Rectal hyposensitivity (RH) has been treated with conventional biofeedback therapy (BFT), whereas the effectiveness and long term results of this therapy are not known. We aimed to investigate the effectiveness of BFT for patients with RH by conducting a retrospective review of prospectively collected data. Methods: From June 2004 to March 2007, we enrolled those RH patients who underwent BFT. BFT was performed two or three times every week. Six months after BFT, the clinical response was evaluated by subjective and objective parameters. Results: A total of 82 RH patients underwent BFT. Fifty three patients finished BFT and the other 29 patients dropped out during BFT. Thirty six patients (67.9%) showed responsiveness (R) to BFT and 17 (31.5%) showed non-responsiveness (NR). The characteristics between the two groups showed no difference, except for the "desire to defecate" volume (116.1±25.2 in the R group vs. 140.0±43.9 in the NR group, p value ＜0.05) and the rectoanal inhibitory reflex (RAIR) (15.6±0.5 in the R group R vs. 27.6±18.2 in the NR group, p value ＜0.05). The R group showed a shorter colon transit time compared to NR group. At six months after BFT, a total of 20 patients were interviewed; 15 patients answered that they still had responsiveness (75%). Conclusions: The patients with RH showed a similar BFT response to that of the constipated patients. However, the patients with a more hyposensitive rectum and a longer colonic transit showed NR to BFT, suggesting RH is an important factor in BFT responsiveness. (Intest Res 2008;6:56-69)

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