Colonoscopic surveillance is currently recommended after polypectomy owing to the risk of newly developed colonic neoplasia. However, few studies have investigated colonoscopy surveillance in Asia. This multicenter and prospective study was undertaken to assess the incidence of advanced adenoma based on baseline adenoma findings at 3 years after colonoscopic polypectomy.
A total of 1,323 patients undergoing colonoscopic polypectomy were prospectively assigned to 3-year colonoscopy surveillance at 11 tertiary endoscopic centers. Relative risks for advanced adenoma after 3 years were calculated according to baseline adenoma characteristics.
Among 1,323 patients enrolled, 387 patients (29.3%) were followed up, and the mean follow-up interval was 31.0±9.8 months. The percentage of patients with advanced adenoma on baseline colonoscopy was higher in the surveillance group compared to the non-surveillance group (34.4% vs. 25.7%). Advanced adenoma recurrence was observed in 17 patients (4.4%) at follow-up. The risk of advanced adenoma recurrence was 2 times greater in patients with baseline advanced adenoma than in those with baseline non-advanced adenoma, though the difference was not statistically significant (6.8% [9/133] vs. 3.1% [8/254],
A colonoscopy surveillance interval of 3 years in patients with baseline advanced adenoma can be considered appropriate.
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Several studies have found that the measurement of fecal calprotectin is useful for the early diagnosis of inflammatory bowel disease (IBD). We compared the effectiveness of three different fecal calprotectin kits for initial diagnosis in patients with suspected IBD.
We enrolled 31 patients with IBD (18 Crohn's disease [CD], 11 ulcerative colitis [UC], and two intestinal Behçet's disease), five with irritable bowel syndrome (IBS), and five with other colitis (four infectious colitis and one intestinal tuberculosis). Diagnosis was based on clinical, laboratory, and endoscopic examinations. Fecal samples were obtained at the first diagnosis and calprotectin levels were measured using three different kits (Quantum Blue® Calprotectin, EliA™ Calprotectin, and RIDASCREEN® Calprotectin).
The overall accuracy for differentiating IBD from IBS or other colitis was 94% and 91%, respectively, for Quantum Blue® (cutoff, 50 µg/g); 92% and 89%, respectively, for EliA™ (cutoff, 50 µg/g); and 82% and 76%, respectively, for RIDASCREEN® (cutoff, 50 µg/g). In patients with CD, the results of Quantum Blue® Calprotectin and EliA™ Calprotectin correlated significantly with levels of the Crohn's disease activity index (Spearman's rank correlation coefficient, r=0.66 and r=0.49, respectively). In patients with UC, the results of EliA™ Calprotectin correlated significantly with the Mayo score (r=0.70).
Fecal calprotectin measurement is useful for the identification of IBD. The overall accuracies of the three fecal calprotectin kits are comparable.
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Gastric pathology and
Among 492 patients with CD receiving upper gastrointestinal (GI) endoscopic evaluation in 19 Korean hospitals, we evaluated the endoscopic findings and gastric histopathologic features of 47 patients for our study. Histopathologic classification was performed using gastric biopsy tissues, and
There were 36 men (76.6%), and the median age of patients at the time of upper GI endoscopy was 23.8 years (range, 14.2–60.5). For CD phenotype, ileocolonic disease was observed in 38 patients (80.9%), and non-stricturing, non-penetrating disease in 31 patients (66.0%). Twenty-eight patients (59.6%) complained of upper GI symptoms. Erosive gastritis was the most common gross gastric feature (66.0%). Histopathologically,
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Vaccinations in patients with inflammatory bowel disease (IBD) are recommended to prevent infectious diseases. However, there are few reports of vaccination in IBD patients in Korea. The frequency of complementary and alternative medicine (CAM) use is high despite its uncertain effectiveness. This study aimed to identify the rates of vaccination and use of CAM in patients with IBD.
A total of 219 patients attended an education session for IBD patients held at Severance Hospital on March 23, 2013. We conducted a survey on vaccination and CAM use in IBD patients; 120 patients completed the questionnaire.
The influenza vaccination rate was 44.2% and pneumococcal vaccination rate was 4.2%. Thirty-one (66%) patients were aware of the importance of vaccination. The vaccination rate was higher in patients who were aware of the importance of vaccination compared with that in patients who were unaware of the importance of vaccination (70.1% vs. 41.7%,
Awareness of the importance of vaccination and actual vaccination rates were low in IBD patients. Despite insufficient evidence on the effectiveness of CAMs in IBD patients, many patients used CAMs. We believe that repeated education and promotion of vaccination are important. Further large-scale studies to investigate the efficacy and safety of CAMs are warranted in patients with IBD.
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