Intestinal Research

Original Articles

Gastrointestinal bleeding risk of non-vitamin K antagonist oral anticoagulants versus warfarin in general and after polypectomy: a population-based study with propensity score matching analysis: Jong Yop Pae, Eun Soo Kim, Sung Kook Kim, Min Kyu Jung, Jun Heo, Jang Hoon Lee, Min Ae Park; Intest Res 2022;20(4):482-494. Published online April 15, 2022; DOI: https://doi.org/10.5217/ir.2021.00161

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Background/Aims
Gastrointestinal bleeding (GIB) risk for non-vitamin K antagonist oral anticoagulants (NOACs) compared with warfarin is largely unknown. We aimed to determine the risk of overall and post-polypectomy GIB for NOACs and warfarin.
Methods
Using the Korean National Health Insurance database, we created a cohort of patients who were newly prescribed NOACs or warfarin between July 2015 and December 2017 using propensity score matching (PSM). Kaplan-Meier analysis with log-rank test was performed to compare the risk of overall and post-polypectomy GIB between NOACs (apixaban, dabigatran, and rivaroxaban) and warfarin. Post-polypectomy GIB was defined as bleeding within 1 month after gastrointestinal endoscopic polypectomy.
Results
Out of 234,206 patients taking anticoagulants (187,687 NOACs and 46,519 warfarin), we selected 39,764 pairs of NOACs and warfarin users after PSM. NOACs patients showed significantly lower risk of overall GIB than warfarin patients (log-rank P<0.001, hazard ratio, 0.86; 95% confidence interval, 0.78–0.94; P=0.001). Among NOACs, apixaban showed the lowest risk of GIB. In the subgroup of 7,525 patients who underwent gastrointestinal polypectomy (lower gastrointestinal polypectomy 93.1%), 1,546 pairs were chosen for each group after PSM. The NOACs group showed a high risk of post-polypectomy GIB compared with the warfarin group (log-rank P=0.001, hazard ratio, 1.97; 95% confidence interval, 1.16–3.33; P=0.012).
Conclusions
This nationwide, population-based study demonstrates that risk of overall GIB is lower for NOACs than for warfarin, while risk of post-polypectomy GIB is higher for NOACs than for warfarin.

Citations

Citations to this article as recorded by

Safety of cold snare resection techniques for removal of polyps in the small colon in patients taking clopidogrel and aspirin: a Korean Association for the Study of Intestinal Diseases prospective multicenter study
Tae-Geun Gweon, Hyun Gun Kim, Yunho Jung, Seong Ran Jeon, Soo-Young Na, Yoo Jin Lee, Tae Ho Kim
Gastrointestinal Endoscopy.2025; 101(4): 866. CrossRef
Updates on the Prevention and Management of Post-Polypectomy Bleeding in the Colon
Hisham Wehbe, Aditya Gutta, Mark A. Gromski
Gastrointestinal Endoscopy Clinics of North America.2024; 34(2): 363. CrossRef
Anticoagulant-related bleeding as a sign of underlying tumoural lesions in patients with atrial fibrillation: a nationwide cohort study
Kristiaan Proesmans, Maxim Grymonprez, Sylvie Rottey, Lies Lahousse, Magnus Bäck
European Heart Journal Open.2024;[Epub] CrossRef
Re-bleeding and all-cause mortality risk in non-variceal upper gastrointestinal bleeding: focusing on patients receiving oral anticoagulant therapy
Won Shik Kim, Seung Han Kim, Moon Kyung Joo, Jong-Jae Park, Beom Jae Lee, Hoon Jai Chun
Annals of Medicine.2023;[Epub] CrossRef
Nonvitamin K oral anticoagulants with proton pump inhibitor cotherapy ameliorated the risk of upper gastrointestinal bleeding
Parata Chaiyana, Karjpong Techathuvanan, Supatsri Sethasine
Scientific Reports.2023;[Epub] CrossRef

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5 Crossref

IBD

Nonimmunity against hepatitis B virus infection in patients newly diagnosed with inflammatory bowel disease: Seong Jae Yeo, Hyun Seok Lee, Byung Ik Jang, Eun Soo Kim, Seong Woo Jeon, Sung Kook Kim, Kyeong Ok Kim, Yoo Jin Lee, Hyun Jik Lee, Kyung Sik Park, Yun Jin Jung, Eun Young Kim, Chang Heon Yang; Intest Res 2018;16(3):400-408. Published online July 27, 2018; DOI: https://doi.org/10.5217/ir.2018.16.3.400

Abstract PDF PubReader ePub

Background/Aims

This study aimed to elucidate the prevalence of hepatitis B virus (HBV) serologic markers in Korean patients newly diagnosed with, but not yet treated for inflammatory bowel disease (IBD).

Methods

We prospectively enrolled 210 patients newly diagnosed with IBD (109 with ulcerative colitis and 101 with Crohn's disease). Hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis B core antibody (anti-HBc) levels were measured and compared with those of 1,100 sex- and age-matched controls.

Results

The prevalence of chronic HBV infection (positive HBsAg, positive anti-HBc, and negative anti-HBs results) and past infection (negative HBsAg, positive anti-HBc, and positive or negative anti-HBs results) were not significantly different between the patients and controls (chronic HBV infection: IBD, 3.8% vs. control, 4.9%, P=0.596; past infection: IBD, 26.2% vs. control, 28.8%, P=0.625). The patients with IBD aged <20 years were at a higher susceptibility risk (nonimmune) for HBV infection than the controls (IBD, 41.5% vs. control, 22.4%; P=0.018). In the multivariate analysis, an age of <20 years (P=0.024) and symptom duration of ≥12 months before diagnosis (P=0.027) were identified as independent risk factors for nonimmunity against HBV infection.

Conclusions

The patients newly diagnosed with IBD were susceptible to HBV infection. The frequency of nonimmunity was high, especially in the patients aged <20 years and those with a longer duration of symptoms before diagnosis. Therefore, it is necessary to screen for HBV serologic markers and generate a detailed vaccination plan for patients newly diagnosed with IBD.

Citations

Citations to this article as recorded by

Prevalence of hepatitis B virus and hepatitis C virus infection in patients with inflammatory bowel disease: a systematic review and meta-analysis
Suprabhat Giri, Dhiraj Agrawal, Shivaraj Afzalpurkar, Sunil Kasturi, Amrit Gopan, Sridhar Sundaram, Aditya Kale
Intestinal Research.2023; 21(3): 392. CrossRef
Viral Hepatitis in Patients with Inflammatory Bowel Disease
Seung Hwan Shin, Sang Hyoung Park
The Korean Journal of Gastroenterology.2022; 80(2): 51. CrossRef
Vaccination strategies for Korean patients with inflammatory bowel disease
Yoo Jin Lee, Eun Soo Kim
The Korean Journal of Internal Medicine.2022; 37(5): 920. CrossRef
Management of hepatitis B virus infection in patients with inflammatory bowel disease under immunosuppressive treatment
Georgios Axiaris, Evanthia Zampeli, Spyridon Michopoulos, Giorgos Bamias
World Journal of Gastroenterology.2021; 27(25): 3762. CrossRef
Prevention and management of viral hepatitis in inflammatory bowel disease: a clinical practice guideline by the Korean Association for the Study of Intestinal Diseases
Soo-Kyung Park, Chang Hwan Choi, Jaeyoung Chun, Heeyoung Lee, Eun Sun Kim, Jae Jun Park, Chan Hyuk Park, Bo-In Lee, Yunho Jung, Dong-Il Park, Do Young Kim, Hana Park, Yoon Tae Jeen
Intestinal Research.2020; 18(1): 18. CrossRef
Evaluating Hepatitis B Seroprotection and Revaccination for Children With Inflammatory Bowel Disease
Erica J Brenner, Ravi Jhaveri, Michael D Kappelman, Ajay S Gulati
Inflammatory Bowel Diseases.2019; 25(9): e108. CrossRef
The importance of immunization in immune-mediated inflammatory disease cannot be overstated
Sang Hyoung Park
Intestinal Research.2018; 16(3): 325. CrossRef

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A Double-Blind, Randomized, Active Drug Comparative, Parallel-Group, Multi-Center Clinical Study to Evaluate the Safety and Efficacy of Probiotics (Bacillus licheniformis, Zhengchangsheng® capsule) in Patients with Diarrhea: Jun Heo, Sung Kook Kim, Kyung Sik Park, Hye Kyung Jung, Joong Goo Kwon, Byung Ik Jang; Intest Res 2014;12(3):236-244. Published online July 25, 2014; DOI: https://doi.org/10.5217/ir.2014.12.3.236

Abstract PDF PubReader ePub

Background/Aims

Bacillus Licheniformis, a probiotic used in the treatment of diarrhea, has been shown to suppress the growth of pathologic bacteria. This study was performed to assess the therapeutic efficacy and safety of Zhengchangsheng® (Bacillus Licheniformis) in comparison with another probiotic, Bioflor® (Saccharomyces Boulardii) for the treatment of diarrhea.

Methods

Patients with diarrhea (n=158) were randomized to receive Zhengchangsheng® or Bioflor® for 5 days. The existence or non-existence of formed feces, changes in daily stool frequency, improvement of subjective symptoms, and changes in the severity of diarrhea were compared.

Results

Of the 158 full analysis set (FAS) patient population, 151 patients comprised the per protocol (PP) analysis. The rates of recovered to formed feces in the Bacillus and Saccharomyces groups were 91.0% vs. 95.0% in the FAS (P=0.326) and 90.5% vs. 96.1% in the PP analysis (P=0.169), respectively. The mean duration of diarrhea changing to formed feces was 3.15±1.10 days in the Bacillus group and 3.22±1.01 in the Saccharomyces group (P=0.695, FAS). The frequency of defecation, subjective symptoms, and degree of severe diarrhea were improved in both groups, however, there were no statistically significant differences between the 2 groups. Analysis of the 95% confidence intervals for the differences in the rate of recovery to formed feces between the 2 groups met the criteria for non-inferiority of Bacillus compared to Saccharomyces. No significant adverse events were observed during the study period.

Conclusions

Zhengchangsheng® is not inferior to Bioflor® in therapeutic efficacy and is a safe and useful therapeutic agent for the treatment of diarrhea.

Citations

Citations to this article as recorded by

Common protein networks for various drug regimens of major depression are associated with complement and immunity
Seungyeon Lee, Sora Mun, Jiyeong Lee, Hee-Gyoo Kang
Journal of Psychopharmacology.2024; 38(9): 798. CrossRef
Baseline gut microbiome impacts probiotics Bacillus licheniformis CMCC63516 in modulating the gut microbiome and preventing antibiotic‐associated diarrhea: A double‐blind, randomized controlled trial
Qian Zhou, Wenkui Dai, Yanmin Bao, Jing Chen, Xiaohua Han, Changshan Liu, Meijie Hou, Huisheng Yao, Changsuo Hao, Shuaicheng Li, Yuejie Zheng
Clinical and Translational Medicine.2023;[Epub] CrossRef
Weizmannia coagulans: an Ideal Probiotic for Gut Health
Shiqi Zhang, Pinglan Li, Suwon Lee, Yu Wang, Chunming Tan, Nan Shang
Food Science and Human Wellness.2023; : 1. CrossRef
Bacillus licheniformis prevents and reduces anxiety-like and depression-like behaviours
Siyuan Feng, Chen Meng, Yiyuan Liu, Yue Yi, Axin Liang, Yingyu Zhang, Zikai Hao
Applied Microbiology and Biotechnology.2023; 107(13): 4355. CrossRef
Bacteremia caused by accidental injection of Bacillus licheniformis microbiota modulator through the central venous catheter
Chuan Zhong, Fen Wang, Haining Zhou, Jiarui Liu, Jiewei Hu, Yongjun Chen
Medicine.2022; 101(4): e28719. CrossRef
Bacillus licheniformis Reshapes the Gut Microbiota to Alleviate the Subhealth
Siyuan Feng, Chen Meng, Zikai Hao, Hong Liu
Nutrients.2022; 14(8): 1642. CrossRef
The effect of multispecies probiotics on cognitive reactivity to sad mood in patients with Crohn’s disease
Lipei Wu, Fujun Shen, Weiwei Wang, Chunrun Qi, Chunbin Wang, Anquan Shang, Shihai Xuan
Journal of Functional Foods.2021; 82: 104431. CrossRef
Bacillus licheniformis Zhengchangsheng® Inhibits Obesity by Regulating the AMP-Activated Protein Kinase Signaling Pathway
Xiaojie Lu, Yue Jing, Xiaofei Zhou, Naisheng Zhang, Jiandong Tai, Yongguo Cao
Probiotics and Antimicrobial Proteins.2021; 13(6): 1658. CrossRef
Oral Supplements of Combined Bacillus licheniformis Zhengchangsheng® and Xylooligosaccharides Improve High‐Fat Diet‐Induced Obesity and Modulate the Gut Microbiota in Rats
Yuyuan Li, Man Liu, He Liu, Xiaoqing Wei, Xianying Su, Ming Li, Jieli Yuan, Zongbao K. Zhao
BioMed Research International.2020;[Epub] CrossRef
Bacillus licheniformis Zhengchangsheng® attenuates DSS-induced colitis and modulates the gut microbiota in mice
Y. Li, M. Liu, J. Zhou, B. Hou, X. Su, Z. Liu, J. Yuan, M. Li
Beneficial Microbes.2019; 10(5): 543. CrossRef
Broad Prebiotic Potential of Non-starch Polysaccharides from Oats (Avena sativa L.): an in vitro Study
VANDA SARGAUTIENE, ILVA NAKURTE, VIZMA NIKOLAJEVA
Polish Journal of Microbiology.2018; 67(3): 307. CrossRef
Effect of Bacillus subtilis C-3102 on loose stools in healthy volunteers
M. Hatanaka, K. Yamamoto, N. Suzuki, S. Iio, T. Takara, H. Morita, T. Takimoto, T. Nakamura
Beneficial Microbes.2018; 9(3): 357. CrossRef
Rapid and simple detection of endospore counts in probiotic Bacillus cultures using dipicolinic acid (DPA) as a marker
Xiao-Sheng Liang, Chun Liu, Zhu Long, Xiao-Hua Guo
AMB Express.2018;[Epub] CrossRef
Gut Microbiota in Health and Probiotics in Functional Bowel Disease
Jai Hyun Rhyou
The Ewha Medical Journal.2017; 40(1): 22. CrossRef
Separation and determination of peptide metabolite of Bacillus licheniformis in a microbial fuel cell by high-speed capillary micellar electrokinetic chromatography
Wei Wang, Ruiguang Bai, Xiaoyu Cai, Ping Lin, Lihong Ma
Journal of Separation Science.2017; 40(22): 4446. CrossRef
Evaluation of chitosan hydrochloride-alginate as enteric micro-probiotic-carrier with dual protective barriers
Qing-Xi Wu, Xin Xu, Qiu Xie, Wang-Yu Tong, Yan Chen
International Journal of Biological Macromolecules.2016; 93: 665. CrossRef

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Case Report

A Pityrosporum Fungal Infection Following Infliximab Therapy in a Crohn's Disease Patient: Keun Young Shin, Jun Heo, Min Kyu Jung, Seong Woo Jeon, Sung Kook Kim; Intest Res 2010;8(2):177-180. Published online December 30, 2010; DOI: https://doi.org/10.5217/ir.2010.8.2.177

Abstract PDF: Crohn's disease (CD) is a chronic immune-mediated inflammatory disorder. Treatment strategies for CD are targeted toward various components of the proinflammatory mediators and subsequent immune response. Recently, the anti-tumor necrosis factor (TNF) monoclonal antibody, infliximab has been used in patients with CD. However, uncommon and unusual infections have been reported during anti-TNF-Ձ therapy and immunomodulator. Here, we report a case of pityriasis versicolor occurring in a patient with CD receiving infliximab treatment. The patient was successfully treated with topical ketoconazole. (Intest Res 2010;8:177-180)

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