Intestinal Research

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Remission of diffuse ulcerative duodenitis in a patient with ulcerative colitis after infliximab therapy: a case study and review of the literature: Yong-Sung Choi, Jong Kyu Kim, Wan Jung Kim, Mi-Jung Kim; Intest Res 2019;17(2):273-277. Published online February 12, 2019; DOI: https://doi.org/10.5217/ir.2018.00122

Although ulcerative colitis (UC) is confined to colonic and rectal mucosa in a continuous fashion, recent studies have also demonstrated the involvement of upper gastrointestinal tract as diagnostic endoscopy becomes more available and technically advanced. The pathogenesis of UC is not well established yet. It might be associated with an inappropriate response of host mucosal immune system to gut microflora. Although continuous and symmetric distribution of mucosal inflammation from rectum to colon is a typical pattern of UC, clinical feature and course of atypically distributed lesions in UC might also help us understand the pathogenesis of UC. Herein, we report a case of duodenal involvement of UC which successfully remitted after infliximab therapy. Endoscopic and pathologic findings before and after administration of anti-tumor necrosis factor suggest that the pathogenesis of upper gastrointestinal involvement of UC may be similar to that of colon involvement.

Citations

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A case of relapsed pan-colonic ulcerative colitis accompanied with gastroduodenal lesions immediately after COVID-19
Katsuya Endo, Tomonori Satoh, Yuki Yoshino, Shiho Kondo, Yoko Kawakami, Daisuke Fukushi, Atsuko Takasu, Takayuki Kogure, Morihisa Hirota, Kennichi Satoh
Clinical Journal of Gastroenterology.2025; 18(3): 399. CrossRef
Gastroduodenitis Associated with Active Ulcerative Colitis Treated with Infliximab: Different Clinical Course in the Colon and Gastroduodenal Lesions
Tomoyuki Hayashi, Takeshi Terashima, Masaki Nishitani, Noriaki Orita, Masaki Miyazawa, Akihiro Seki, Hidetoshi Nakagawa, Kouki Nio, Noriho Iida, Shinya Yamada, Hajime Takatori, Tetsuro Shimakami, Taro Yamashita
Internal Medicine.2024; 63(7): 929. CrossRef
Severe Disease Activity May Predispose Patients to Post-colectomy Duodenitis Associated with Ulcerative Colitis
Akira Sonoda, Naoki Yoshimura, Minako Sako, Soh Okano, Satoshi Saito, Masakazu Takazoe, Satomi Furukawa, Kinya Okamoto, Tetsuo Yamana, Hisateru Tachimori, Masayuki Fukata
Internal Medicine.2024; 63(10): 1337. CrossRef
Concurrent occurrence of ulcerative duodenitis and ulcerative colitis displaying unique responses to golimumab and ustekinumab
Sho Masaki, Hajime Honjo, Masayuki Kurimoto, Natsuki Okai, Yasuo Otsuka, Yasuhiro Masuta, Ken Kamata, Kosuke Minaga, Masatoshi Kudo, Tomohiro Watanabe
Clinical Journal of Gastroenterology.2024; 17(5): 854. CrossRef
Upper Gastrointestinal Tract Involvement in Inflammatory Bowel Diseases: Histologic Clues and Pitfalls
Bence Kővári, Rish K. Pai
Advances in Anatomic Pathology.2022; 29(1): 2. CrossRef
Mucosal lesions of the upper gastrointestinal tract in patients with ulcerative colitis: A review
Yan Sun, Zhe Zhang, Chang-Qing Zheng, Li-Xuan Sang
World Journal of Gastroenterology.2021; 27(22): 2963. CrossRef
Clinical characteristics and prognosis of patients with ulcerative colitis that shows rectal sparing at initial diagnosis
Yong-Sung Choi, Jong-Kyu Kim, Wan-Jung Kim
World Journal of Gastrointestinal Endoscopy.2021; 13(9): 407. CrossRef
Upper Gastrointestinal Manifestations of Inflammatory Bowel Disease
Noam Harpaz, Alexandros D. Polydorides
Surgical Pathology Clinics.2020; 13(3): 413. CrossRef
Two Cases of Ulcerative Colitis-like Gastroduodenitis after Total Proctocolectomy for Intractable Ulcerative Colitis
Takahiro SHIMOYAMA, Takayuki YAMAMOTO, Yasuhiro INOUE, Satoru UMEGAE
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association).2019; 80(5): 904. CrossRef

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Original Articles

Practice patterns and clinical significance of use of capsule endoscopy in suspected and established Crohn's disease: Yonghyun Kim, Seong Ran Jeon, Sang Myung Choi, Hyun Gun Kim, Tae Hee Lee, Jun-Hyung Cho, Yunho Jung, Wan Jung Kim, Bong Min Ko, Jin-Oh Kim, Joon Sung Lee, Moon Sung Lee; Intest Res 2017;15(4):467-474. Published online October 23, 2017; DOI: https://doi.org/10.5217/ir.2017.15.4.467

Abstract PDF PubReader ePub

Background/Aims

Although the role of capsule endoscopy (CE) in Crohn's disease (CD) has expanded, CE is not used routinely for diagnosing and evaluating CD in Korea. We aimed to investigate current patterns of practice and evaluate the clinical significance of the use of CE in CD in Korean patients.

Methods

Among 651 CE procedures performed for various indications, we retrospectively analyzed the medical records of patients who underwent CE in 57 cases of suspected CD (sCD) and 14 cases of established CD (eCD).

Results

In the sCD group, CE was most commonly used for the initial diagnosis of CD (54.4%). Capsule retention was found in only 1 patient in the eCD group (1/71, 1.4%). In the sCD group, 28.1% of patients were diagnosed with CD on the basis of CE findings; other diseases diagnosed included tuberculous enteritis (7.0%), non-steroidal anti-inflammatory drug-induced enteropathy (5.3%), and other enteritis (17.5%). Only 11.5% of patients with eCD (14/122) underwent CE. The indication for CE in the 14 patients with eCD was to assess disease extent and activity. The overall diagnostic yield of CE was 59.7%. Therapeutic strategies were changed in 70.2% of patients in the sCD group and 50% of those in the eCD group based on CE findings.

Conclusions

In clinical practice, CE was most commonly indicated for the initial diagnosis of CD and was not generally performed in patients with eCD. CE appears to be an effective diagnostic modality for evaluating sCD and is useful for determining therapeutic strategies for patients with sCD and those with eCD.

Citations

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Video capsule endoscopy in inflammatory bowel disease
Kenji J.L. Limpias Kamiya, Naoki Hosoe, Yukie Hayashi, Takaaki Kawaguchi, Kaoru Takabayashi, Haruhiko Ogata, Takanori Kanai
DEN Open.2022;[Epub] CrossRef
Enteroscopy in Crohn’s Disease: Are There Any Changes in Role or Outcomes Over Time? A KASID Multicenter Study
Seong Ran Jeon, Jin-Oh Kim, Jeong-Sik Byeon, Dong-Hoon Yang, Bong Min Ko, Hyeon Jeong Goong, Hyun Joo Jang, Soo Jung Park, Eun Ran Kim, Sung Noh Hong, Jong Pil Im, Seong-Eun Kim, Ja Seol Koo, Chang Soo Eun, Dong Kyung Chang
Gut and Liver.2021; 15(3): 375. CrossRef
Capsule Endoscopy in Crohn’s Disease—From a Relative Contraindication to Habitual Monitoring Tool
Adi Lahat, Ido Veisman
Diagnostics.2021; 11(10): 1737. CrossRef
Use of small bowel capsule endoscopy in clinical practice: how has it performed?
Seong Ran Jeon
The Korean Journal of Internal Medicine.2020; 35(4): 854. CrossRef
Pursuing therapeutic success in Crohn’s disease: A matter of definition, tools and longterm outcomes
Loredana Goran, Monica State, Ana Maria Negreanu, Lucian Negreanu
European Journal of Inflammation.2020; 18: 205873922096289. CrossRef
Capsule endoscopy: Current status and role in Crohn’s disease
Loredana Goran, Ana Maria Negreanu, Ana Stemate, Lucian Negreanu
World Journal of Gastrointestinal Endoscopy.2018; 10(9): 184. CrossRef
Role of capsule endoscopy in suspected or established Crohn's disease in real practice
Hyun Joo Jang
Intestinal Research.2017; 15(4): 431. CrossRef

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Double-Balloon Enteroscopy in Elderly Patients: Is It Safe and Useful?: Dae Han Choi, Seong Ran Jeon, Jin-Oh Kim, Hyun Gun Kim, Tae Hee Lee, Woong Cheul Lee, Byung Soo Kang, Jun-Hyung Cho, Yunho Jung, Wan Jung Kim, Bong Min Ko, Joo Young Cho, Joon Seong Lee, Moon Sung Lee; Intest Res 2014;12(4):313-319. Published online October 27, 2014; DOI: https://doi.org/10.5217/ir.2014.12.4.313

Abstract PDF PubReader ePub

Background/Aims

Providers may be hesitant to perform double-balloon enteroscopy (DBE) in the elderly because the increased number of co-morbidities in this population poses a greater risk of complications resulting from sedation. There are limited data on the use of DBE in the elderly. Here, we assessed the safety and efficacy of DBE in the elderly compared to those in younger patients.

Methods

We retrospectively analyzed the medical records of 158 patients who underwent 218 DBEs. Patients were divided into an elderly group (age ≥65 years; mean 71.4±5.4; n=34; 41 DBEs) and a younger group (age <65 years; mean 39.5±13.5; n=124; 177 DBEs).

Results

In both groups, the most common indication for DBE was obscure gastrointestinal bleeding. Mucosal lesions (33.3% vs. 60.9%; P=0.002) were the most common finding in both groups, followed by tumors (30.8% vs. 14.1%; P=0.036). The elderly were more likely to receive interventional therapy (51.3% vs. 23.5%; P=0.001). The diagnostic yield of DBE was slightly higher in the elderly group (92.3% vs. 86.5%; P=0.422), but was not statistically significant. The therapeutic success rate of DBE was 100% in the elderly group compared to 87.5% in the younger group (P=0.536). The overall DBE complication rate was 1.8% overall, and this rate did not differ significantly between the groups (2.6% vs. 1.7%; P=0.548).

Conclusions

DBE is safe and effective in the elderly, and has a high diagnostic yield and high therapeutic success rate.

Citations

Citations to this article as recorded by

Clinical outcomes in frail elderly patients undergoing small-bowel capsule endoscopy
Rebecca K Grant, Alexander R Robertson, Kirsty A Lennon, Eksha Gupta, Ursula E Walton, Ross J Porter, Niall T Burke, Solomon Ong, Atul Anand, Sarah Douglas, Alice Corbett, William M Brindle, Rahul Kalla, John N Plevris
Frontline Gastroenterology.2025; 16(1): 30. CrossRef
Outcomes of Double Balloon-Enteroscopy in Elderly vs. Adult Patients: A Retrospective 16-Year Single-Centre Study
Margherita Trebbi, Cesare Casadei, Silvia Dari, Andrea Buzzi, Mario Brancaccio, Valentina Feletti, Alessandro Mussetto
Diagnostics.2023; 13(6): 1112. CrossRef
Enteroscopy in the Elderly: Review of Procedural Aspects, Indications, Yield, and Safety
Ana Catarina Ribeiro Gomes, Rolando Pinho, Adélia Rodrigues, Ana Ponte, João Carvalho
GE - Portuguese Journal of Gastroenterology.2020; 27(1): 18. CrossRef
Device assisted enteroscopy in the elderly — A systematic review and meta-analysis
Stefania Chetcuti Zammit, David S. Sanders, Reena Sidhu
Digestive and Liver Disease.2019; 51(9): 1249. CrossRef
Double-balloon enteroscopy: Indications, approaches, diagnostic and therapeutic yield, and safety. Early experience at a single center
J.J.E. García-Correa, J.J. Ramírez-García, L.F. García-Contreras, C. Fuentes-Orozco, L. Irusteta-Jiménez, L.R. Michel-Espinoza, A.S. Carballo Uribe, J.A. Torres Chávez, A. González-Ojeda
Revista de Gastroenterología de México (English Edition).2018; 83(1): 31. CrossRef
Enteroscopia de doble balón: indicaciones, abordajes, eficacia diagnóstica y terapéutica y seguridad. Experiencia temprana de un solo centro
J.J.E. García-Correa, J.J. Ramírez-García, L.F. García-Contreras, C. Fuentes-Orozco, L. Irusteta-Jiménez, L.R. Michel-Espinoza, A.S. Carballo Uribe, J.A. Torres Chávez, A. González-Ojeda
Revista de Gastroenterología de México.2018; 83(1): 31. CrossRef
Device-assisted enteroscopy in the UK: description of a large tertiary case series under conscious sedation
Vijay Pattni, David J Tate, Ana Terlevich, Peter Marden, Steve Hughes
Frontline Gastroenterology.2018; 9(2): 122. CrossRef
Paradigm shift: should the elderly undergo propofol sedation for DBE? A prospective cohort study
Hey-Long Ching, Federica Branchi, David S Sanders, David Turnbull, Reena Sidhu
Frontline Gastroenterology.2018; 9(3): 192. CrossRef
Efficacy and Safety of Single-Balloon Enteroscopy in Elderly Patients
Chen-Wang Chang, Ching-Wei Chang, Wei-Chen Lin, Chia-Hsien Wu, Horng-Yuan Wang, Tsang-En Wang, Cheng-Hsin Chu, Ming-Jen Chen
International Journal of Gerontology.2017; 11(3): 176. CrossRef
Diagnostic yield and safety of double balloon-assisted enteroscopy in the elderly: A systematic review and meta-analysis
Y. Chen, G. Liu, T. Zhang, K. Yang, H. Yu, Y. Tie, J. Liang, J. Zhou, H. Gan
European Geriatric Medicine.2017; 8(4): 354. CrossRef
Clinical outcome after enteroscopy for small bowel angioectasia bleeding: A Korean Associateion for the Study of Intestinal Disease (KASID) multiceter study
Seong Ran Jeon, Jeong‐Sik Byeon, Hyun Joo Jang, Soo Jung Park, Jong Pil Im, Eun Ran Kim, Ja Seol Koo, Bong Min Ko, Dong Kyung Chang, Jin‐Oh Kim, Su Yeon Park
Journal of Gastroenterology and Hepatology.2017; 32(2): 388. CrossRef
Systematic review: Safety of balloon assisted enteroscopy in Crohn’s disease
Ahilan Arulanandan, Parambir S Dulai, Siddharth Singh, William J Sandborn, Denise Kalmaz
World Journal of Gastroenterology.2016; 22(40): 8999. CrossRef
Current status and future perspectives of capsule endoscopy
Hyun Joo Song, Ki-Nam Shim
Intestinal Research.2016; 14(1): 21. CrossRef
Author's Reply
Seong Ran Jeon
Intestinal Research.2015; 13(1): 99. CrossRef
Clinical Characteristics and Treatment Outcomes of Cryptogenic Multifocal Ulcerous Stenosing Enteritis in Korea
Sook Hee Chung, Sang Un Park, Jae Hee Cheon, Eun Ran Kim, Jeong-Sik Byeon, Byong Duk Ye, Bora Keum, Ki-Nam Shim, Sung-Ae Jung, Jin-Oh Kim, Seong Ran Jeon, Hyun Joo Song, Jeong Seop Moon, Dong Kyung Chang
Digestive Diseases and Sciences.2015; 60(9): 2740. CrossRef
Questions About Sedation Protocols for Double-Balloon Enteroscopy
Dong-Hoon Yang
Intestinal Research.2015; 13(1): 97. CrossRef

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Clinical Comparison for Colon Polyps between Right and Left Colon in Koreans: Wook Hyun Um, Hyun Gun Kim, Seong Ran Jeon, Tae Hee Lee, Wan Jung Kim, Bong Min Ko, Jin-Oh Kim, Joo Young Cho, Joon Seong Lee, Moon Sung Lee; Intest Res 2012;10(4):372-378. Published online October 31, 2012; DOI: https://doi.org/10.5217/ir.2012.10.4.372

Abstract PDF

Background/Aims
Comparative studies of colon polyps between right and left colon in Korean population are limited. We investigated the clinical characteristics of the patients according to polyp location and compared the results of the morphological and histological analysis of right and left colon polyps. Methods: The study was performed prospectively for the patients who underwent colon polypectomy for health check-ups in a single tertiary center. The patients were classified into three groups by the location of the polyps: right group (from the cecum to the splenic flexure), left group (from the descending colon to the anus), and total group. The size, the morphology, the location and the pathology of the polyps were evaluated. Results: From June 2010 to June 2011, Overall 2596 polyps from 950 patients (male=646) were analyzed. Colon polyps were right side-shift with increased patients age (P<0.001). The incidence of polyps was most common in sigmoid colon (26.5%). Polyps less than 5 mm size were more common in left colon (P<0.001) and flat polyps larger than 1 cm in right colon (P=0.006), respectively. In histopathological findings, the distribution of advanced adenoma was not different according to the location, however tubular adenomas and serrated adenomas (P<0.001) were more common in right colon. Female was more distributed in right group, respectively (P<0.001). Conclusions: In a single center study, colon polyps were more distributed in right colon with age and in females. Also flat polyps larger than 1cm, tubular adenoma and serrated adenoma were found in larger proportion in right colon. (Intest Res 2012;10:372-378)

Citations

Citations to this article as recorded by

Clinicopathological features of colorectal polyps in 2002 and 2012
Yoon Jeong Nam, Kyeong Ok Kim, Chan Seo Park, Si Hyung Lee, Byung Ik Jang
The Korean Journal of Internal Medicine.2019; 34(1): 65. CrossRef

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Capsule Endoscopy for Suspected Small Bowel Bleeding in Patients with Portal Hypertension: Gang Il Cheon, Jin Oh Kim, Sung Wook Hong, Seong Ran Jeon, Tae Hee Lee, Hyun Gun Kim, Won Young Cho, Wan Jung Kim, Min Jeong Kim, Sung Won Jeong, Jae Young Jang, Bong Min Ko, Joo Young Cho, Joon Seong Lee; Intest Res 2011;9(2):129-138. Published online August 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.2.129

Abstract PDF: Background/Aims
In Korea, limited data are available on small bowel bleeding in patients with portal hypertension. This study reports on the use of capsule endoscopy in cases of suspected small bowel bleeding in patients with portal hypertension. Methods: Capsule endoscopy was used at our hospital to evaluate small bowel disease in 501 cases from July 2003 to June 2010. Of those cases, nine patients with portal hypertension due to liver cirrhosis with suspected small bowel bleeding were selected for the study. A retrospective analysis was performed using data from medical records. Results: Six of the nine (66.7%) patients were males with an average age of 53.4 years. The average hemoglobin level was 8.1 g/dL. Abnormalities noted during capsule endoscopy included portal hypertensive enteropathy in all nine cases (100%), jejunal varices in four (44.4%), jejunal and ileal angiodysplasia in five (55.5%), multiple small bowel erosions in one (11.1%), granularity of the jejunal mucosa in one (11.1%), and small bowel erythema in three (33.3%). Active bleeding from jejunal varices was detected in two patients (22.2%). Despite having no obvious active bleeding during the capsule endoscopy, four patients (44.4%) were diagnosed with portal hypertensive enteropathy with obscure small bowel bleeding. Conclusions: Capsule endoscopy is a useful diagnostic tool for the evaluation of small bowel bleeding in patients with portal hypertensive enteropathy. Additional prospective and multicenter studies on the use of capsule endoscopy are needed to evaluate the incidence and clinical importance of portal hypertensive enteropathy. (Intest Res 2011;9:129-138)

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Molecular Characterization of hSRBC, a Candidate Tumor Suppressor Gene anda Upstream Regulator of p53 in Human Colon Cancer: Wan Jung Kim, Hyo Jong Kim, Sung-Gil Chi, Jin Oh Kim, Joo Young Cho, Chan Sup Shim; Intest Res 2007;5(2):131-143. Published online December 30, 2007

Abstract PDF: Background/Aims
hSRBC [human Serum deprivation response (sdr)-Related gene product that Binds to c-kinase] was identified using PKCδ or BRCA1 as a probe and located at 11p15.5-p15.4 region. Expression of hSRBC protein was also decreased in a number of breast, lung, and ovarian cancer cell lines, suggesting that hSRBC might be a putative tumor suppressor gene. Methods: The expression status of hSRBC was analyzed in 50 primary colon tumors and their adjacent 50 normal tissues, and 20 colon cancer cell lines. Transcript and protein expression of hSRBC was studied by quantitative RT-PCR and Western blot, respectively. siRNA-mediated knockdown of hSRBC expression was utilized to investigate its association with p53. Results: The mRNA expression of hSRBC was decreased in 60% (12/20) of colon cancer cell lines and 44% (22/50) of patient's colon cancer tissues. Expression of hSRBC mRNA was significantly decreased in tumors compared to non-cancerous cells, while genomic level of hSRBC was not decreased in tumors. hSRBC expression was increased by 5-aza-2’-deoxycytidine treatment and hypermethylation of CpG sites was strongly associated with decreased expression. Ectopic transfection of hSRBC suppressed RKO cell count and hSRBC knockdown by siRNA augmented HCT116 cell numbers. Flow cytometry showed G1 arrest and apoptosis of colon cancer cells by restoration of hSRBC expression in RKO cells. Both basal and etoposide-mediated p53 expression was decreased when hSRBC expression was knockdowned with siRNA. Conclusions: hSRBC expression is frequently decreased by promoter CpG site hypermethylation. hSRBC down-regulates p53 expression in G1 phase and might be a novel upstream regulator of p53. (Intest Res 2007;5:131-143)

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