Intestinal Research

Original Articles

Impact of stool transplantation and metformin on polyp reduction and inflammation in an APC Min mouse model: Yeon Ji Kim, Jiwon Lee, Eunmi Lee, Seun Ja Park, Jae Hyun Kim; Received January 30, 2025 Accepted March 18, 2025 Published online May 19, 2025; DOI: https://doi.org/10.5217/ir.2025.00011 [Epub ahead of print]

Abstract PDF PubReader ePub: Background/Aims
Familial adenomatous polyposis is a hereditary condition characterized by numerous adenomatous polyps in the colon and rectum, significantly increasing colorectal cancer risk. Current management strategies, such as prophylactic colectomy, are invasive and have long-term consequences, highlighting the need for alternative therapies. This study aimed to evaluate whether stool transplantation and metformin therapy synergistically reduce polyp formation and inflammation.
Methods
APC Min mice were divided into 4 groups: control, anti-control (antibiotic pretreatment), stool (stool transplantation), and stool+metformin. Polyp burden, bacterial abundance, inflammatory cytokines (interleukin [IL]-6, tumor necrosis factor [TNF]-α, IL-10), and tumorigenic markers (NF-κB, Cox2, c-myc, β-catenin) were assessed using messenger RNA (mRNA) and protein analyses of intestinal tissues, along with serum and fecal microbiota evaluations.
Results
Stool transplantation combined with metformin significantly reduced bacterial abundance and polyp burden. The anti-control group showed similar reductions, suggesting suppression of gut microbiota re-establishment. TNF-α and IL-10 levels remained unchanged, but a significant increase in IL-6 was observed in the stool+metformin group’s intestinal tissues, indicating localized immune activation. Intestinal Cox2 mRNA expression was reduced in the combination group, correlating with polyp suppression. Protein levels of NF-κB, Cox2, and β-catenin showed no significant changes in vivo, while in vitro experiments revealed a decrease in NF-κB and an increase in Cox2, suggesting complex regulation of inflammation-related pathways.
Conclusions
Stool transplantation combined with metformin reduces polyp burden in APC Min mice through gut microbiota modulation and localized immune activation. These findings support the therapeutic potential of this combination treatment for familial adenomatous polyposis.

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Endoscopy

Effect of gut microbiome on minor complications after a colonoscopy: Jae Hyun Kim, Youn Jung Choi, Hye Jung Kwon, Kyoungwon Jung, Sung Eun Kim, Won Moon, Moo In Park, Seun Ja Park; Intest Res 2021;19(3):341-348. Published online November 10, 2020; DOI: https://doi.org/10.5217/ir.2020.00057

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Minor complications that might occur after colonoscopy, including abdominal discomfort, bloating, diarrhea, and constipation, could a barrier for patients to undergo a screening colonoscopy. In this study, we aimed to identify the effect of gut microbial diversity and composition on minor complications after colonoscopy.
Methods
A total of 24 healthy subjects provided their stools before bowel preparation and on the 7th and 28th day after colonoscopy. On the 7th day after colonoscopy, the presence of minor complications was investigated using a questionnaire. We divided patients into 2 groups, the no complication group and complications group. The fecal microbial diversity, distribution, and composition were then compared between the groups.
Results
Five of the 24 subjects reported that they had undergone minor complications after colonoscopy. Most of the symptoms were mild and self-limited, but 1 patient needed medication. Interestingly, the Firmicutes/Bacteroidetes ratio of the initial stool samples before bowel preparation in the complication group was significantly higher than that in no complication group. After bowel preparation, the Firmicutes/Bacteroidetes ratio of the complication group decreased, but not in the no complication group. The microbial diversity of the no complication group decreased after bowel preparation, but not in the complication group.
Conclusions
The gut microbial composition and diversity before and after bowel preparation could be considered as one of the causes of minor complications after colonoscopy. Further studies are needed to delineate the role of gut microbiota in the occurrence of minor complications after colonoscopy.

Citations

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Alteration in gut microbiota after colonoscopy: proposed mechanisms and the role of probiotic interventions
Hyeong Ho Jo, Moon Young Lee, Se Eun Ha, Dong Han Yeom, Yong Sung Kim
Clinical Endoscopy.2025; 58(1): 25. CrossRef
Depressive Symptoms and Gut Microbiota after Bowel Preparation and Colonoscopy: A Pre–Post Intervention Study
Amelia J. McGuinness, Martin O’Hely, Douglas Stupart, David Watters, Samantha L. Dawson, Christopher Hair, Michael Berk, Mohammadreza Mohebbi, Amy Loughman, Glenn Guest, Felice N. Jacka
Microorganisms.2024; 12(10): 1960. CrossRef
Benefits of Probiotic Pretreatment on the Gut Microbiota and Minor Complications after Bowel Preparation for Colonoscopy: A Randomized Double-Blind, Placebo-Controlled Pilot Trial
Dooheon Son, Youn Jung Choi, Min Young Son, Won Moon, Seun Ja Park, Sanghyun Lim, Jae Hyun Kim
Nutrients.2023; 15(5): 1141. CrossRef
Key determinants of success in fecal microbiota transplantation: From microbiome to clinic
Serena Porcari, Nicolas Benech, Mireia Valles-Colomer, Nicola Segata, Antonio Gasbarrini, Giovanni Cammarota, Harry Sokol, Gianluca Ianiro
Cell Host & Microbe.2023; 31(5): 712. CrossRef
Colonoscopy: body and psyche. Can psychiatry contribute to the quality of the examination?
Adam Zaczek, Robert Pudlo
Current Problems of Psychiatry.2023; 24: 253. CrossRef
CO2 Is Beneficial to Gut Microbiota Homeostasis during Colonoscopy: Randomized Controlled Trial
Xue Yang, Wen-Bo Xiu, Jin-Xia Wang, Liang-Ping Li, Chong He, Cai-Ping Gao
Journal of Clinical Medicine.2022; 11(18): 5281. CrossRef
Novel frontiers of agents for bowel cleansing for colonoscopy
Milena Di Leo, Andrea Iannone, Monica Arena, Giuseppe Losurdo, Maria Angela Palamara, Giuseppe Iabichino, Pierluigi Consolo, Maria Rendina, Carmelo Luigiano, Alfredo Di Leo
World Journal of Gastroenterology.2021; 27(45): 7748. CrossRef

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Functional bowel disorders

Is stool frequency associated with the richness and community composition of gut microbiota?: Hye Jung Kwon, Jong Hyun Lim, Dongmin Kang, Sanghyun Lim, Seun Ja Park, Jae Hyun Kim; Intest Res 2019;17(3):419-426. Published online February 7, 2019; DOI: https://doi.org/10.5217/ir.2018.00149

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Recently, a number of studies have reported that the gut microbiota could contribute to human conditions, including obesity, inflammation, cancer development, and behavior. We hypothesized that the composition and distribution of gut microbiota are different according to stool frequency, and attempted to identify the association between gut microbiota and stool frequency.
Methods
We collected fecal samples from healthy individuals divided into 3 groups according to stool frequency: group 1, a small number of defecation (≤2 times/wk); group 2, normal defecation (1 time/day or 1 time/2 day); and group 3, a large number of defecation (≥2–3 times/day). We evaluated the composition and distribution of the gut microbiota in each group via 16S rRNA-based taxonomic profiling of the fecal samples.
Results
Fecal samples were collected from a total of 60 individuals (31 men and 29 women, aged 34.1±5.88 years), and each group comprised 20 individuals. The microbial richness of group 1 was significantly higher than that of group 3 and tended to decrease with increasing number of defecation (P<0.05). The biological community composition was fairly different according to the number of defecation, and Bacteroidetes to Firmicutes ratio was higher in group 1 than in the other groups. Moreover, we found specific strains at the family and genus levels in groups 1 and 3.
Conclusions
Bacteroidetes to Firmicutes ratio and the abundance of Bifidobacterium were different according to the stool frequency, and specific bacteria were identified in the subjects with large and small numbers of defecation, respectively. These findings suggest that stool frequency might be associated with the richness and community composition of the gut microbiota.

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Bowel movement alterations predict the severity of diverticular disease and the risk of acute diverticulitis: a prospective, international study
Antonio Tursi, Daniele Piovani, Giovanni Brandimarte, Francesco Di Mario, Walter Elisei, Marcello Picchio, Gisella Figlioli, Gabrio Bassotti, Leonardo Allegretta, Maria Laura Annunziata, Mauro Bafutto, Maria Antonia Bianco, Raffaele Colucci, Rita Coniglia
Intestinal Research.2025; 23(1): 96. CrossRef
Efficacy of Three Doses of Halquinol on Growth Performance, Diarrhea Incidence, Nutrient Digestibility, and Fecal Microbiome of Weaned Pigs
Panumas Kongpanna, Uttra Jamikorn, Thitima Tripipat, Angkana Tantituvanont, Rakthai Ngampak, Dachrit Nilubol
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Personalized probiotic strategy considering bowel habits: impacts on gut microbiota composition and alleviation of gastrointestinal symptoms via Consti-Biome and Sensi-Biome
Uigi Min, Yoo-Jeong Jin, You Jin Jang, Jonghyun Lim, Byung-Yong Kim
Frontiers in Nutrition.2024;[Epub] CrossRef
Deciphering the Impact of Defecation Frequency on Gut Microbiome Composition and Diversity
Gwoncheol Park, Seongok Kim, WonJune Lee, Gyungcheon Kim, Hakdong Shin
International Journal of Molecular Sciences.2024; 25(9): 4657. CrossRef
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Nicola Procházková, Gwen Falony, Lars Ove Dragsted, Tine Rask Licht, Jeroen Raes, Henrik M Roager
Gut.2023; 72(1): 180. CrossRef
Gut Microbiome Analysis for Personalized Nutrition: The State of Science
Marie‐Christine Simon, Christian Sina, Paola G. Ferrario, Hannelore Daniel
Molecular Nutrition & Food Research.2023;[Epub] CrossRef
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Stefanie Malan-Müller, Mireia Valles-Colomer, Tomás Palomo, Juan C. Leza
Gut Microbes.2023;[Epub] CrossRef
Fecal microbiota transplantation in Parkinson's disease—A randomized repeat-dose, placebo-controlled clinical pilot study
Herbert L. DuPont, Jessika Suescun, Zhi-Dong Jiang, Eric L. Brown, Heather T. Essigmann, Ashley S. Alexander, Andrew W. DuPont, Tehseen Iqbal, Netanya S. Utay, Michael Newmark, Mya C. Schiess
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Ju Young Eor, Chul Sang Lee, Sung Ho Moon, Ju Young Cheon, Duleepa Pathiraja, Byeonghyeok Park, Min Jae Shin, Jae-Young Kim, Sangjong Kim, Youngbae Noh, Yunhan Kim, In-Geol Choi, Sae Hun Kim
Food Science of Animal Resources.2023; 43(4): 659. CrossRef
Efficacy of washed microbiota transplantation for therapeutic targets of refractory functional constipation and the influencing factors: a single-center, retrospective, 24-week follow-up study
Liquan Wu, Qingfen Yuan, Lihao Wu, Harry Hua-Xiang Xia, Muxiao Zhong, Tao Liu, Xiaoyan Ye, Danping Luo, Jiating Xu, Wenrui Xie, Xingxiang He, Jieyi Cai
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Hyunji Park, Na-Young Park, Ara Koh
BMB Reports.2023; 56(9): 469. CrossRef
Frequency of Bowel Movements and Risk of Diverticulitis
Manol Jovani, Wenjie Ma, Kyle Staller, Amit D. Joshi, Po-Hong Liu, Long H. Nguyen, Paul Lochhead, Yin Cao, Idy Tam, Kana Wu, Edward L. Giovannucci, Lisa L. Strate, Andrew T. Chan
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Sarah J. Eustis, Michael W. McCall, E. Angela Murphy, Michael D. Wirth
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Diet and Gut Microbiome and the “Chicken or Egg” Problem
Hannelore Daniel
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Hyun-Seok Oh, Uigi Min, Hyejin Jang, Namil Kim, Jeongmin Lim, Mauricio Chalita, Jongsik Chun
Journal of Microbiology.2022; 60(5): 533. CrossRef
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Lidy Pelsser, Tim Stobernack, Klaas Frankena
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Differences in gut microbiota correlate with symptoms and regional brain volumes in patients with late-life depression
Chia-Fen Tsai, Chia-Hsien Chuang, Yen-Po Wang, Ya-Bo Lin, Pei-Chi Tu, Pei-Yi Liu, Po-Shan Wu, Chung-Yen Lin, Ching-Liang Lu
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A Clinical Outcome of the Anti-PD-1 Therapy of Melanoma in Polish Patients Is Mediated by Population-Specific Gut Microbiome Composition
Bernadeta Pietrzak, Katarzyna Tomela, Agnieszka Olejnik-Schmidt, Łukasz Galus, Jacek Mackiewicz, Mariusz Kaczmarek, Andrzej Mackiewicz, Marcin Schmidt
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Boštjan Jakše, Stanislav Pinter
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Daiki Watanabe, Haruka Murakami, Harumi Ohno, Kumpei Tanisawa, Kana Konishi, Kikue Todoroki-Mori, Yuta Tsunematsu, Michio Sato, Yuji Ogata, Noriyuki Miyoshi, Naoto Kubota, Jun Kunisawa, Keiji Wakabayashi, Tetsuya Kubota, Kenji Watanabe, Motohiko Miyachi
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Aruna Shrestha, Barbara U. Metzler-Zebeli, Hamadi Karembe, Daniel Sperling, Simone Koger, Anja Joachim
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The Microbiota Profile in Inflamed and Non-Inflamed Ileal Pouch–Anal Anastomosis
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Colorectal neoplasia

Clinical significance of carcinoembryonic antigen in peritoneal fluid detected during operation in stage I–III colorectal cancer patients: Jae Hyun Kim, Seunghun Lee, Seung Hyun Lee, Byung Kwon Ahn, Sung Uhn Baek, Won Moon, Seun Ja Park; Intest Res 2018;16(3):467-474. Published online July 27, 2018; DOI: https://doi.org/10.5217/ir.2018.16.3.467

Abstract PDF PubReader ePub

Background/Aims

Early diagnosis of peritoneal metastases in patients with colorectal cancer (CRC) can influence patient prognosis. The aim of this study was to identify the clinical significance of carcinoembryonic antigen (CEA) in peritoneal fluid detected during operation in stage I–III CRC patients.

Methods

Between April 2009 and April 2015, we reviewed medical records from a total of 60 stage I–III CRC patients who had peritoneal fluid collected during operation. Patients who had positive cytology in the assessment of peritoneal fluid were excluded. We evaluated the values of CEA in peritoneal fluid (pCEA) to predict the long-term outcomes of these patients using Kaplan-Meier curves and Cox regression models.

Results

The median follow-up duration was 37 months (interquartile range, 21–50 months). On receiver operating characteristic analysis, pCEA had the largest area under the curve (0.793; 95% confidence interval, 0.635–0.950; P=0.001) with an optimal cutoff value of 26.84 (sensitivity, 80.0%; specificity, 76.6%) for predicting recurrence. The recurrence rate was 8.1% in patients with low pCEA (<26.84 ng/mL, n=37), and 52.2% in patients with high pCEA (≥26.84 ng/mL, n=23). In multivariate Cox regression analysis, high pCEA (≥26.84 ng/mL) was a risk factor for poor cancer-free survival (CFS) in stage I–III patients.

Conclusions

In this study, we determined that high pCEA (≥26.84 ng/mL) detected during operation was helpful for the prediction of poor CFS in patients with stage I–III CRC.

Citations

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Research Progress of Drainage Fluid Biomarkers in Predicting Anastomotic Leakage after Colorectal Surgery
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Advances in Clinical Medicine.2025; 15(02): 1772. CrossRef
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Nicola Natalizi, Elisabetta Marino, Luigina Graziosi, Annibale Donini
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Prognostic Significance of Preoperative Serum Carcinoembryonic Antigen Varies with Lymph Node Metastasis Status in Colorectal Cancer
Jing Jia, MinZhe Li, Wenhao Teng, Lin Wang, Weidong Zang, Jun Xiao, Ying Chen, Dan Zhao
Journal of Oncology.2021; 2021: 1. CrossRef

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Clinical features of Crohn's disease in Korean patients residing in Busan and Gyeongnam: Eun Ji Lee, Tae Oh Kim, Geun Am Song, Jong hun Lee, Hyung Wook Kim, Sam Ryong Jee, Seun Ja Park, Hyun Jin Kim, Jong Ha Park; Intest Res 2016;14(1):30-36. Published online January 26, 2016; DOI: https://doi.org/10.5217/ir.2016.14.1.30

Abstract PDF PubReader ePub

Background/Aims

Crohn's disease (CD) is a chronic inflammatory bowel disease that presents with variable features and repeated disease aggravation. The incidence of CD is increasing in Korea. We evaluated the clinical features of CD in a study population in Busan and Gyeongnam, Korea.

Methods

A hospital-based analysis included 619 patients diagnosed with CD between March 1986 and February 2013 from seven tertiary care hospitals in Busan and Gyeongnam. Individual case records were reviewed with regard to age at diagnosis, sex, disease location, disease behavior, and medical and surgical treatments received during the follow-up period.

Results

The cumulative frequency of patients diagnosed with CD revealed a continued increase in the number of cases reported yearly. The male-to-female ratio was 2.5:1 and the median age at diagnosis was 24 years. At diagnosis, 114 (18.4%) had isolated small bowel disease, 144 (23.3%) had isolated colonic disease, and 358 patients (57.8%) presented with disease in the small bowel and colon. The number of patients presenting with stricturing or penetrating disease behavior was 291 (47%) at the final evaluation. In total, 111 (17.9%) patients underwent intestinal resections.

Conclusions

A continued increase in the number of patients diagnosed with CD was found in Busan and Gyeongnam as observed in other regions. We report results similar to that of other Korean studies in terms of sex distribution, age, and location of disease.

Citations

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Association between inflammatory bowel disease and osteoporosis in European and East Asian populations: exploring causality, mediation by nutritional status, and shared genetic architecture
Jian Kang, Xize Wu, Yue Li, Shuangli Zhao, Shixuan Wang, Dongdong Yu
Frontiers in Immunology.2024;[Epub] CrossRef
Inflammatory bowel disease in Korea: epidemiology and pathophysiology
Jung Won Lee, Chang Soo Eun
The Korean Journal of Internal Medicine.2022; 37(5): 885. CrossRef
NF-kappa B activation correlates with disease phenotype in Crohn’s disease
Yoo Min Han, Jaemoon Koh, Ji Won Kim, Changhyun Lee, Seong-Joon Koh, ByeongGwan Kim, Kook Lae Lee, Jong Pil Im, Joo Sung Kim, Gernot Sellge
PLOS ONE.2017; 12(7): e0182071. CrossRef
Are there interregional differences in the epidemiology and clinical characteristics of Crohn's disease in the Asia-Pacific region?
Sinwon Lee, Byong Duk Ye
Intestinal Research.2016; 14(1): 2. CrossRef
Changing epidemiological trends of inflammatory bowel disease in Asia
Wee Khoon Ng, Sunny H. Wong, Siew C. Ng
Intestinal Research.2016; 14(2): 111. CrossRef

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Reviews

Variable Clinical Classifications and Diagnostic Coding Systems of Colorectal Neuroendocrine Tumor: Byung Chang Kim, Cheol Hee Park, Tae Il Kim, Suck-Ho Lee, Jin-Oh Kim, Hyun Soo Kim, Dong-Hoon Yang, Bora Keum, Sung Pil Hong, Seong-Eun Kim, Hyun Gun Kim, Jeong Eun Shin, Jae Myung Cha, Young Eun Joo, Dong Il Park, Hwang Choi, Kyu Chan Huh, Seung-Jae Myung, Dong Kyung Chang, Seun Ja Park; Intest Res 2013;11(1):14-22. Published online January 31, 2013; DOI: https://doi.org/10.5217/ir.2013.11.1.14

Abstract PDF

The incidence of colorectal carcinoid tumor is recently increasing as screening colonoscopy increased. Traditional carcinoid tumor had been known as low grade, malignant neuroendocrine cell orign tumor. In 2000, World Health Organization (WHO) suggested that carcinoid was called well-differentiated neuroendocrine tumor (NET). It recently updated in 2010 by WHO; according to the differentiation and malignant potential, NET classified with NET Grade 1, Grade 2, and neuroendocrine carcinoma. They suggested that NET had malignant potential in accordance with histopathologic characteristics. Therefore, WHO recommended the behavior code of NET as malignant. However, European Neuroendocrine Tumor Society (ENETS) proposed the behavior of NET to four grades based on the histopathologic features; benign, benign or low grade malignant, low grade malignant, and high grade malignant. Also, American Joint Committee on Cancer (AJCC) suggested that topography codes of NET were defined as malignant. Korean Standard Classification of Diseases (KCD) described the different codings of carcinoid (NET). The discrepancies of behavior code or coding system exist among WHO, ENETS, AJCC and KCD. Also, there were differences in the perception for topographic coding system between clinicians and pathologists. NETs of colorectum were reported with the variable clinical characteristics (especially, metastasis) and long term prognosis from many studies. Especially, risk of metastasis and long term prognosis of small sized NET (<1 cm) had some discrepancies and should be investigated prospectively. Therefore, the consensus about topographic codes of NET should be needed with multidisplinary approach among gastroenterologists, pathologists and surgeons. (Intest Res 2013;11:14-22)

Citations

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Efficacy of Precut Endoscopic Mucosal Resection for Treatment of Rectal Neuroendocrine Tumors
Hoonsub So, Su Hyun Yoo, Seungbong Han, Gwang-un Kim, Myeongsook Seo, Sung Wook Hwang, Dong-Hoon Yang, Jeong-Sik Byeon
Clinical Endoscopy.2017; 50(6): 585. CrossRef
Diagnostic Coding for Intramucosal Carcinoma and Neuroendocrine Tumor in the Colorectum: Proposal for Avoiding Confusing Coding in Korea
Dong Soo Han, Jin Hee Sohn, Jeong-Sik Byeon, Hwang Choi, Joon Mee Kim
Clinical Endoscopy.2015; 48(3): 216. CrossRef
Highlights from the 50th Seminar of the Korean Society of Gastrointestinal Endoscopy
Eun Young Kim, Il Ju Choi, Kwang An Kwon, Ji Kon Ryu, Seok Ho Dong, Ki Baik Hahm
Clinical Endoscopy.2014; 47(4): 285. CrossRef

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Clinical Classification of Colorectal Epithelial Tumors and Proposal for Diagnostic Coding: Hyun Gun Kim, Jin-Oh Kim, Suck-Ho Lee, Chang Kyun Lee, Hyun Soo Kim, Hwang Choi, Dong-Hoon Yang, Bora Keum, Sung Pil Hong, Seong-Eun Kim, Byung Chang Kim, Jeong Eun Shin, Cheol Hee Park, Chang Soo Eun, Tae Il Kim, Dong Il Park, Kyu Chan Huh, Dong Kyung Chang, Seun Ja Park; Intest Res 2011;9(1):1-11. Published online April 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.1.1

Abstract PDF

The Korean Standard Classification of Diseases (KCD), which reflects the International Classification of Diseases (ICD), is a fundamental coding system for the diagnosis of colorectal epithelial tumors. The KCD coding of colorectal lesions is entirely up to the clinician and is based on pathologic reports. However, coding discrepancies have arisen among physicians using the KCD and pathologists using the ICD for Oncology-3 (ICD-O-3). The Korean Society of Pathologists recently proposed a standardized pathology-reporting format and guidelines for the coding of colorectal cancer to decrease these discrepancies among pathologists. However, ICD and ICD-O are simple classification codes based on pathologic reports, and are neither intended nor suitable for indexing of distinct clinical entities. For appropriate diagnostic coding using the KCD, a corrected coding principle based upon pathologic reports is required, and unified coding between KCD and ICD-O is necessary. A standardized pathologic report format and communication with understanding between physicians and pathologists should be established. Additionally, the private medical insurance system for colorectal cancer should be revised to reduce conflicts among patients, clinicians, and insurance companies over the medical coding system. (Intest Res 2011;9: 2-11)

Citations

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Diagnostic Coding for Intramucosal Carcinoma and Neuroendocrine Tumor in the Colorectum: Proposal for Avoiding Confusing Coding in Korea
Dong Soo Han, Jin Hee Sohn, Jeong-Sik Byeon, Hwang Choi, Joon Mee Kim
Clinical Endoscopy.2015; 48(3): 216. CrossRef
Diminutive and Small Colorectal Polyps: The Pathologist's Perspective
Yun Kyung Kang
Clinical Endoscopy.2014; 47(5): 404. CrossRef
Early Colorectal Epithelial Neoplasm in Korea: A Multicenter Survey of Pathologic Diagnosis
Yun Kyung Kang, So-Young Jin, Mee Soo Chang, Jung Yeon Kim, Gyeong Hoon Kang, Hye Seung Lee, Jin Hee Sohn, Ho Sung Park, Kye Won Kwon, Mi Jin Gu, Young Hee Maeng, Jong Eun Joo, Haeng Ji Kang, Hee Kyung Kim, Kee-Taek Jang, Mi Ja Lee, Hee Kyung Chang, Joon
Korean Journal of Pathology.2013; 47(3): 245. CrossRef
Update on the Proposal for Creating a Guideline for Cancer Registration of the Gastrointestinal Tumors (I-2)
Eun Sun Jung, Yun Kyung Kang, Mee-Yon Cho, Joon Mee Kim, Won Ae Lee, Hee Eun Lee, Sunhoo Park, Jin Hee Sohn, So-Young Jin
Korean Journal of Pathology.2012; 46(5): 443. CrossRef

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Original Article

Comparison of Bowel Preparation Depending on Completion Time of Polyethylene Glycol Ingestion and Start Time of Colonoscopy: Jang Hyuk Yoon, Dong Il Park, Jeong Eun Shin, Seong Eun Kim, Sung Ae Jung, Suck Ho Lee, Dong Kyung Chang, Chang Soo Eun, Dong Soo Han, Hyun Soo Kim, Seun Ja Park, Il Hyun Baek, Bora Keum, Yoon Tae Jeen; Intest Res 2010;8(1):24-29. Published online June 30, 2010; DOI: https://doi.org/10.5217/ir.2010.8.1.24

Abstract PDF

Background/Aims
Polyethylene glycol (PEG) solution is the most widely used bowel preparation agent for colonoscopy because of its safety and efficacy in colon cleansing. It has been hypothesized that the timing of colon preparation may influence the quality of colon cleansing, and therefore affect the diagnostic yield of colonoscopy. The aim of this study was to determine the optimal interval of time between complete ingestion of PEG and performing colonoscopy. Methods: We prospectively enrolled 1,355 patients who had undergone a PEG-based bowel preparation on the day of colonoscopy in 11 tertiary hospitals in Korea between March 2008 and February 2009. All colonoscopies were performed in the afternoon. The start time of PEG ingestion, completion time of PEG ingestion, dose of PEG ingested, start time of colonoscopy, and the quality of bowel cleansing were recorded. Results: There was no difference of cleansing quality of bowel preparation between three groups of less than 7 hours of elapsed time (2≤ and <3 hours, 3≤ and <5 hours, 5≤ and <7 hours). However, group of more than 7 hours of elapsed time presented poor cleansing quality than others (P<0.01). Conclusions: If >7 hours elapses after ingestion of PEG, the quality of bowel preparation is poor. Therefore, depending on the time colonoscopy is scheduled, the start time of PEG ingestion may need to be adjusted. (Intest Res 2010;8:24-29)

Citations

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The optimal bowel preparation intervals before colonoscopy: A randomized study comparing polyethylene glycol and low-volume solutions
Vladimir Kojecky, Jan Matous, Radan Keil, Milan Dastych, Zdena Zadorova, Michal Varga, Radek Kroupa, Jiri Dolina, Miroslav Misurec, Ales Hep, Martin Griva
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Comparative Study on Bowel Preparation Efficacy of Ascorbic Acid Containing Polyethylene Glycol by Adding Either Simethicone or 1 L of Water in Health Medical Examination Patients: A Prospective Randomized Controlled Study
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Review

Multimodality Treatment of Colorectal Cancer: Seun Ja Park; Intest Res 2007;5(2):122-130. Published online December 30, 2007

Abstract PDF: Polyps that contain carcinomatous changes that are confined to the mucosa (carcinoma-in-situ or severe dysplasia) do not have metastatic potential and are adequately treated with complete polypectomy or endoscopic mucosal resection. If deep invasion into the stalk has occurred or if adverse features (such as lymphatic invasion, or positive margins) are present, then en bloc colectomy is indicated. For lesions in the mid to upper rectum, a low anterior resection is the treatment of choice. To decrease the risk of local recurrence, patients should undergo optimal pelvic dissection with sharp mesorectal excision. Patients with pathologic lymph node-negative T3 or T4 lesions or any lymph node-positive cancer should receive preoperative or postoperative combined modality therapy. A major goal of preoperative therapy is to decrease the volume of the primary tumor and thus enhance sphincter preservation. For resectable colon cancer, the surgical procedure of choice is colectomy with en bloc removal of the regional lymph nodes. Laparoscopic colectomy has been advanced as an approach to the surgical management of colon cancer. Recently, the outcomes of cancer from a randomized trial comparing laparoscopically assisted and open surgery for curable colon cancer was reported. After a median of 4.4 years follow-up, similar cancer recurrence rates were observed in the two groups. The current management of disseminated metastatic colon cancer uses various active drugs, both in combination and as single agents: 5-FU/leucovorin, irinotecan, oxaliplatin, capecitabine, bevacizumab, and cetuximab. The choice of therapy is based on consideration of the type and timing of the prior therapy that has been administered and the differing toxicity profiles of the constituent drugs. As primary therapy for metastatic disease in a patient with good tolerance to intensive therapy, combination therapy consisting of fluoropyrimidines: FOLFOX (oxaliplatin, infusional fluorouracil, and leucovorin) or FOLFIRI (irinotecan, infusional fluorouracil, and leucovorin), with or without bevacizumab; bolus 5-FU/leucovorin/irinotecan with bevacizumab; 5-FU/leucovorin with bevacizumab were recommened. (Intest Res 2007;5:122-130)

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