Intestinal Research

Original Article

Evaluation of the Mayo endoscopic score in ulcerative colitis using a multimodal large language model: a human-blinded accuracy study: Antonietta Gerarda Gravina, Raffaele Pellegrino, Giuseppe Imperio, Michele Izzo, Ilaria De Costanzo, Fabio Landa, Stefano Pellegrino, Alessandro Federico; Received July 16, 2025 Accepted September 21, 2025 Published online February 12, 2026; DOI: https://doi.org/10.5217/ir.2025.00138 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Background/Aims
To date, some large language models (LLMs), such as Chat Generative Pre-trained Transformer 4-omni (ChatGPT-4o), can process images through visual transformer patching. An LLM analysis was conducted to assess the ability of ChatGPT-4o to assign the Mayo endoscopic score (MES).
Methods
A selection set of high-quality endoscopic frames was identified to compare 4 input models to select the most performant, confirmed in an extended set of 304 frames. Concordance with the evaluation by expert endoscopists was assessed.
Results
Only one of the pre-tested models demonstrated significant concordance (κ = 0.232, 95% confidence interval [CI] = 0.167 to 0.296, P= 0.003; ρ = 0.36, P= 0.011), with a mean bias of –0.26 ± 1.192 (95% CI, –2.596 to 2.076). This was confirmed in the extended set (κ = 0.260, 95% CI = 0.195 to 0.324, P< 0.001; ρ = 0.288, P< 0.001). The absolute concordance for the selected model was 44% and 45.3% in the selection and extended sets, respectively. For the identification of moderately-to-severely active disease, a sensitivity of 73% (95% CI, 60% to 82%), specificity of 60% (95% CI, 54% to 66%), positive predictive value of 32% (95% CI, 25% to 40%), and negative predictive value of 90% (95% CI, 84% to 93%) were identified.
Conclusions
ChatGPT-4o shows a mild potential in evaluating MES in endoscopic frames, but further refinements are mandatory.

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Reviews

Population-based screening colonoscopy in Korea: balancing benefits and limitations: Hyoung Il Choi, Jae Myung Cha; Received August 22, 2025 Accepted September 28, 2025 Published online January 2, 2026; DOI: https://doi.org/10.5217/ir.2025.00188 [Epub ahead of print]

Abstract PDF PubReader ePub: Population-based colonoscopy screening is considered one of the most effective strategies for reducing the incidence and mortality of colorectal cancer. Its major strength lies in its dual benefits: early detection of colorectal cancer and prevention via the removal of precancerous lesions. Colonoscopy has a high sensitivity and provides a full colonic evaluation in a single session, thereby reducing the need for frequent testing. However, this approach has notable limitations. Colonoscopy is an invasive procedure associated with rare but serious complications such as perforation and bleeding. Participation rates tend to be lower than those of noninvasive methods like fecal immunochemical tests. Additionally, implementing colonoscopy as a populationbased tool requires significant resources, including trained endoscopists, endoscopy facilities, and financial investments. The quality of colonoscopy may also vary depending on the operator’s skill and adherence to guidelines. Given these trade-offs, population-based colonoscopy screening must be carefully evaluated in terms of cost-effectiveness, feasibility, and public acceptance within each country’s healthcare system. Therefore, population-based colonoscopy screening should be approached with a balanced understanding of its benefits and limitations to ensure cost-effectiveness, feasibility, alignment with each country’s healthcare infrastructure, and integration with existing screening programs.

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Recent updates on the endoscopic treatment of rectal neuroendocrine tumor: Sunghyeok Ryou, Kwangwoo Nam; Received July 18, 2025 Accepted September 8, 2025 Published online November 27, 2025; DOI: https://doi.org/10.5217/ir.2025.00141 [Epub ahead of print]

Abstract PDF PubReader ePub

The incidence of rectal neuroendocrine tumors has been gradually increasing, primarily due to the widespread use of screening colonoscopy and growing awareness of the disease. Most rectal neuroendocrine tumors are small ( < 10 mm), well-differentiated, and low-grade lesions at the time of diagnosis, and they are usually asymptomatic. Given these characteristics, endoscopic resection is considered a feasible treatment option for early-stage lesions. However, due to their inherent malignant potential, a comprehensive initial diagnostic evaluation is essential. Lymph node or distal metastasis can be present at diagnosis or may develop long after apparently successful primary treatment. Therefore, achieving complete resection using the most optimal resection method is crucial. Modified endoscopic mucosal resection and endoscopic submucosal dissection are recommended over conventional forceps or snare polypectomy, which are associated with high incomplete resection rates. In case of incomplete resection, additional endoscopic resection can be a feasible option in selected cases. Furthermore, regular post-resection surveillance is needed, especially in patients with high-risk of recurrence such as poor pathologic result or incomplete resection.

Citations

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Endoscopic Resection of Rectal Neuroendocrine Tumors: Pathologic Risk Stratification and Surveillance Strategies
Ji Eun Kim
Journal of Digestive Cancer Research.2025; 13(3): 228. CrossRef

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1 Crossref

Endoscopy

Balancing safety and effectiveness in colonoscopy for older adults: a narrative review: Min-Jae Kim, Yuna Kim, Jie-Hyun Kim, Young Hoon Youn, Jaeyoung Chun; Intest Res 2025;23(4):443-454. Published online October 2, 2025; DOI: https://doi.org/10.5217/ir.2025.00092

Abstract PDF PubReader ePub: Colonoscopy is becoming more widely used in older adults for screening and diagnostic evaluation of colorectal cancer. While advanced age itself is not a contraindication, elderly patients often present unique challenges, including frailty, comorbidities and polypharmacy, which increase the risk of complications during the procedure. Rather than chronological age alone, frailty is important in risk assessment and clinical decision-making before performing a colonoscopy. This review summarizes recent evidence, particularly from large cohort studies and clinical guidelines, to provide a balanced evaluation of the advantages and disadvantages of performing colonoscopies on older adults. Ultimately, we emphasize the importance of judicious patient selection, customized bowel preparation and tailored sedation management to optimize the safety and effectiveness of colonoscopy in this vulnerable group.

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Original Articles

Tumor

The impact of the COVID-19 pandemic on clinical practices related to colorectal cancer and colonoscopy in South Korea: a nationwide population-based study: Jin Young Yoon, Moon Hyung Lee, Min Seob Kwak, Jae Myung Cha; Intest Res 2025;23(1):85-95. Published online November 29, 2024; DOI: https://doi.org/10.5217/ir.2024.00066

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Despite of the coronavirus disease 2019 (COVID-19) pandemic, there is little data regarding its impact on colorectal cancer (CRC)-related clinical practice. This study aimed to assess the changes in its impact during the COVID-19 pandemic.
Methods
This was a retrospective national population-based study using the Health Insurance Review and Assessment database from January 2019 to December 2021. The number of patients in 2020 and 2021 was compared with those in 2019 for the diagnostic and therapeutic colonoscopy, CRC-related operation, and any treatment for CRC.
Results
The annual number of patients undergoing diagnostic colonoscopies decreased by 6.9% in 2020 but increased 8.1% in 2021, compared to those in 2019; number of patients undergoing therapeutic colonoscopies increased by 6.0% and 37.7% in 2020 and 2021, respectively; number of patients operated for CRC decreased by 4.2% in 2020 and increased by 2.3% in 2021. The number of patients treated for CRC decreased by 2.8% in 2020 and increased by 4.4% in 2021. Diagnostic and therapeutic colonoscopies and any CRC-related treatment decreased by 43.8%, 37.5%, and 11.3% in March 2020, during the first surge of COVID-19, but increased by 26.0%, 58.1%, and 9.5% in June 2021, respectively. CRC-related operations decreased by 24.1% in April 2020 and increased by 12.6% in August 2021.
Conclusions
Negative impact of the COVID-19 pandemic on clinical practices related to CRC completely recovered within second year. It could be considered for the development of an optimal strategy on CRC management in response to the pandemic-driven crisis.

Citations

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The impact of COVID-19 on clinical practices of colorectal cancer in South Korea
Kwang Woo Kim, Hyoun Woo Kang
Intestinal Research.2025; 23(1): 6. CrossRef

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1 Web of Science
1 Crossref

Colorectal neoplasia

A survey of current practices in post-polypectomy surveillance in Korea: Jeongseok Kim, Tae-Geun Gweon, Min Seob Kwak, Su Young Kim, Seong Jung Kim, Hyun Gun Kim, Eun Ran Kim, Sung Noh Hong, Eun Sun Kim, Chang Mo Moon, Dae Seong Myung, Dong Hoon Baek, Shin Ju Oh, Hyun Jung Lee, Ji Young Lee, Yunho Jung, Jaeyoung Chun, Dong-Hoon Yang, on behalf of the Intestinal Tumor Research Group of the Korean Association for the Study of Intestinal Diseases (KASID); Intest Res 2024;22(2):186-207. Published online April 25, 2024; DOI: https://doi.org/10.5217/ir.2023.00109

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
We investigated the clinical practice patterns of post-polypectomy colonoscopic surveillance among Korean endoscopists.
Methods
In a web-based survey conducted between September and November 2021, participants were asked about their preferred surveillance intervals and the patient age at which surveillance was discontinued. Adherence to the recent guidelines of the U.S. Multi-Society Task Force on Colorectal Cancer (USMSTF) was also analyzed.
Results
In total, 196 endoscopists completed the survey. The most preferred first surveillance intervals were: a 5-year interval after the removal of 1–2 tubular adenomas < 10 mm; a 3-year interval after the removal of 3–10 tubular adenomas < 10 mm, adenomas ≥ 10 mm, tubulovillous or villous adenomas, ≤ 20 hyperplastic polyps < 10 mm, 1–4 sessile serrated lesions (SSLs) < 10 mm, hyperplastic polyps or SSLs ≥ 10 mm, and traditional serrated adenomas; and a 1-year interval after the removal of adenomas with highgrade dysplasia, >10 adenomas, 5–10 SSLs, and SSLs with dysplasia. In piecemeal resections of large polyps ( > 20 mm), surveillance colonoscopy was mostly preferred after 1 year for adenomas and 6 months for SSLs. The mean USMSTF guideline adherence rate was 30.7%. The largest proportion of respondents (40.8%–55.1%) discontinued the surveillance at the patient age of 80–84 years.
Conclusions
A significant discrepancy was observed between the preferred post-polypectomy surveillance intervals and recent international guidelines. Individualized measures are required to increase adherence to the guidelines.

Citations

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Chan Hyuk Park, Byung Wook Jung, Yoon Suk Jung
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Journal of Gastroenterology and Hepatology.2025; 40(12): 2944. CrossRef

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Review

Colorectal neoplasia

Summary and comparison of recently updated post-polypectomy surveillance guidelines: Yoon Suk Jung; Intest Res 2023;21(4):443-451. Published online October 26, 2023; DOI: https://doi.org/10.5217/ir.2023.00107

Abstract PDF PubReader ePub

Recently, updated guidelines for post-polypectomy surveillance have been published by the U.S. Multi‐Society Task Force (USMSTF), the British Society of Gastroenterology/Association of Coloproctology of Great Britain and Ireland/Public Health England (BSG/ACPGBI/PHE), the European Society of Gastrointestinal Endoscopy (ESGE), the Japan Gastroenterological Endoscopy Society (JGES), and the Korean Multi-Society Taskforce Committee. This review summarizes and compares the updated recommendations of these 5 guidelines. There are some differences between the guidelines for the recommended post-polypectomy surveillance intervals. In particular, there are prominent differences between the guidelines for 1–4 tubular adenomas < 10 mm with low-grade dysplasia (nonadvanced adenomas [NAAs]) and tubulovillous or villous adenomas. The USMSTF, JGES, and Korean guidelines recommend colonoscopic surveillance for patients with 1–4 NAAs and those with tubulovillous or villous adenomas, whereas the BSG/ACPGBI/PHE and ESGE guidelines do not recommend endoscopic surveillance for such patients. Surveillance recommendations for patients with serrated polyps (SPs) are limited. Although the USMSTF guidelines provide specific recommendations for patients who have undergone SPs removal, these are weak and based on very lowquality evidence. Future studies should examine this topic to better guide the surveillance recommendations for patients with SPs. For countries that do not have separate guidelines, we hope that this review article will help select the most appropriate guidelines as per each country’s healthcare environment.

Citations

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Demographic and Clinicopathologic Factors Associated With Colorectal Adenoma Recurrence
Usman Ayub Awan, Qingyuan Song, Kristen K. Ciombor, Adetunji T. Toriola, Jungyoon Choi, Timothy Su, Xiao-ou Shu, Kamran Idrees, Kay M. Washington, Wei Zheng, Wanqing Wen, Zhijun Yin, Xingyi Guo
JAMA Network Open.2026; 9(2): e2556853. CrossRef
Comparison between endoscopic resection and transanal surgery for treatment of rectal tumors: a systematic review and meta‑analysis
Chan Hyuk Park, Byung Wook Jung, Yoon Suk Jung
Intestinal Research.2026; 24(1): 38. CrossRef
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Hye Kyung Hyun, Ji Soo Park, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim
Journal of Gastroenterology and Hepatology.2025; 40(2): 433. CrossRef
Frequency and Risk Factors of Advanced Neoplasia in Korean Inflammatory Bowel Disease Patients with Low-grade Dysplasia
Yong Eun Park, Kyeong Ok Kim, Dong Hyun Kim, Soo-Kyung Park, Yoo Jin Lee, Chang Kyun Lee
The Korean Journal of Gastroenterology.2025; 85(1): 34. CrossRef
The impact of COVID-19 on clinical practices of colorectal cancer in South Korea
Kwang Woo Kim, Hyoun Woo Kang
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Annual Blood Tests Are an Acceptable form of Surveillance to Supplement Colonoscopies for Colorectal Cancer
Rishabh Goyal, Carlene J. Wilson, Ingrid H. Flight, Charles Cock, Graeme P. Young, Molla M. Wassie, Sarah Cohen-Woods, Erin L. Symonds, Maddison Dix
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Maddison Dix, Syme Aftab, Graeme P. Young, Carlene J. Wilson, Kalindra Simpson, Charles Cock, Erin L. Symonds
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Nanette S. Van roermund, Joep E.G. Ijspeert, Evelien Dekker
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Giovanna McGinty, Zeino Zeino
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Original Article

Colorectal neoplasia

The elderly population are more vulnerable for the management of colorectal cancer during the COVID-19 pandemic: a nationwide, population-based study: Hong Sun Kang, Seung Hoon Jeon, Su Bee Park, Jin Young Youn, Min Seob Kwak, Jae Myung Cha; Intest Res 2023;21(4):500-509. Published online August 29, 2023; DOI: https://doi.org/10.5217/ir.2023.00004

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
The impact of coronavirus disease 2019 (COVID-19) on the management of colorectal cancer (CRC) may worse in elderly population, as almost all COVID-19 deaths occurred in the elderly patients. This study aimed to evaluate the impact of COVID-19 on CRC management in the elderly population.
Methods
The numbers of patients who underwent colonoscopy, who visited hospitals or operated for CRC in 2020 and 2021 (COVID-19 era) were compared with those in 2019, according to 3 age groups (≥70 years, 50–69 years, and ≤49 years), based on the nationwide, population-based database (2019–2021) in South Korea.
Results
The annual volumes of colonoscopy and hospital visits for CRC in 2020 were more significantly declined in the old age group than in the young age group (both P<0.001). In addition, the annual volume of patients operated for CRC numerically more declined in old age group than in young age group. During the first surge of COVID-19 (March and April 2020), old age patients showed statistically significant declines for the monthly number of colonoscopies (–46.5% vs. –39.3%, P<0.001), hospital visits (–15.4% vs. –7.9%, P<0.001), CRC operations (–33.8% vs. –0.7%, P<0.05), and colonoscopic polypectomies (–41.8% vs. –38.0%, P<0.001) than young age patients, compared with those of same months in 2019.
Conclusions
Elderly population are more vulnerable for the management of CRC during the COVID-19 pandemic. Therefore, the elderly population are more carefully cared for in the management of CRC during the next pandemic.

Citations

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The impact of COVID-19 on clinical practices of colorectal cancer in South Korea
Kwang Woo Kim, Hyoun Woo Kang
Intestinal Research.2025; 23(1): 6. CrossRef
To overcome medical gap in screening and surveillance of colorectal cancer during the COVID-19 pandemic
Yoo Min Han
Intestinal Research.2023; 21(4): 418. CrossRef

5,543 View
205 Download
2 Web of Science
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Review

Cancer

Korean Guidelines for Postpolypectomy Colonoscopic Surveillance: 2022 revised edition: Su Young Kim, Min Seob Kwak, Soon Man Yoon, Yunho Jung, Jong Wook Kim, Sun-Jin Boo, Eun Hye Oh, Seong Ran Jeon, Seung-Joo Nam, Seon-Young Park, Soo-Kyung Park, Jaeyoung Chun, Dong Hoon Baek, Mi-Young Choi, Suyeon Park, Jeong-Sik Byeon, Hyung Kil Kim, Joo Young Cho, Moon Sung Lee, Oh Young Lee, Korean Society of Gastrointestinal Endoscopy, Korean Society of Gastroenterology, Korean Association for the Study of Intestinal Diseases; Intest Res 2023;21(1):20-42. Published online January 31, 2023; DOI: https://doi.org/10.5217/ir.2022.00096

Abstract PDF Supplementary Material PubReader ePub

Colonoscopic polypectomy is effective in decreasing the incidence and mortality of colorectal cancer (CRC). Premalignant polyps discovered during colonoscopy are associated with the risk of metachronous advanced neoplasia. Postpolypectomy surveillance is the most important method for managing advanced metachronous neoplasia. A more efficient and evidence-based guideline for postpolypectomy surveillance is required because of the limited medical resources and concerns regarding colonoscopy complications. In these consensus guidelines, an analytic approach was used to address all reliable evidence to interpret the predictors of CRC or advanced neoplasia during surveillance colonoscopy. The key recommendations state that the high-risk findings for metachronous CRC following polypectomy are as follows: adenoma ≥10 mm in size; 3 to 5 (or more) adenomas; tubulovillous or villous adenoma; adenoma containing high-grade dysplasia; traditional serrated adenoma; sessile serrated lesion containing any grade of dysplasia; serrated polyp of at least 10 mm in size; and 3 to 5 (or more) sessile serrated lesions. More studies are needed to fully comprehend the patients who are most likely to benefit from surveillance colonoscopy and the ideal surveillance interval to prevent metachronous CRC.

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Clinical Efficacy of Real-Time Artificial Intelligence-Assisted Colonoscopy in Colorectal Polyp Detection: A Prospective Multicenter Randomized Controlled Trial
Han Jo Jeon, Bora Keum, Eui Sun Jeong, Seong-Eun Kim, Chang Mo Moon, Bomee Lee, Sanghyun Kim, Hyuk Soon Choi, Jae Min Lee, Eun Sun Kim, Yoon Tae Jeen
Gut and Liver.2026; 20(1): 97. CrossRef
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Chan Hyuk Park, Byung Wook Jung, Yoon Suk Jung
Intestinal Research.2026; 24(1): 38. CrossRef
Survey of the Actual Practices Used for Endoscopic Removal of Colon Polyps in Korea: A Comparison with the Current Guidelines
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Seongwoo Choi, Yunho Jung
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Jin-Dong Wang, Guo-Shuai Xu, Xin-Long Hu, Wen-Qiang Li, Nan Yao, Fu-Zhou Han, Yin Zhang, Jun Qu
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Yunho Jung, Hyun Gun Kim, Dong-Hoon Yang, Hyoun Woo Kang, Jae Jun Park, Dong Hoon Baek, Jaeyoung Chun, Tae-Geun Gweon, Hyeon Jeong Goong, Min Seob Kwak, Hyun Jung Lee, Soo-Kyung Park, Jong Hoon Lee
Journal of Korean Medical Science.2024;[Epub] CrossRef
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Jong Yoon Lee
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Su Young Kim
The Korean Journal of Medicine.2023; 98(3): 102. CrossRef
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Yoon Suk Jung
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Original Article

Miscellaneous

Characteristics and usefulness of transabdominal ultrasonography in immune-mediated colitis: Kensuke Sakurai, Takehiko Katsurada, Mutsumi Nishida, Satomi Omotehara, Shinya Fukushima, Shinsuke Otagiri, Kazunori Nagashima, Reizo Onishi, Ryo Takagi, Yoshito Komatsu, Naoya Sakamoto; Intest Res 2023;21(1):126-136. Published online July 22, 2022; DOI: https://doi.org/10.5217/ir.2021.00166

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
The usefulness of ultrasonography (US) in diseases of the gastrointestinal tract has been reported recently. This prospective study aimed to determine the features of US findings in immune-mediated colitis (IMC), an adverse event induced by immune checkpoint inhibitor, and examine the correlation between US findings, colonoscopy (CS) findings, and severity of colitis.
Methods
We studied patients examined using CS and US upon suspicion of IMC in Hokkaido University Hospital between April 2018 and February 2021. Endoscopic findings of IMC were assessed using the Ulcerative Colitis Endoscopic Index of Severity (UCEIS). The severity of US findings in IMC was evaluated using US grade, which is the ultrasonographic grading scale in ulcerative colitis. Bowel wall thickness and the intensity of the color Doppler signal were also analyzed. Severity of colitis was evaluated using Common Terminology Criteria for Adverse Events (CTCAE) grade version 5.
Results
Fourteen patients with IMC were enrolled. The US findings were bowel wall thickening, loss of stratification, ulceration and increased blood flow signal. The US grade was moderately correlated with the UCEIS (r=0.687, p=0.009) and CTCAE grade (r=0.628, p=0.035). Bowel wall thickness and UCEIS (r=0.628, p=0.020), as well as color Doppler signal grade and CTCAE grade (r=0.724, p=0.008), were significantly correlated.
Conclusions
US findings in IMC were mainly similar to those of ulcerative colitis, but there were some findings that were characteristic only of IMC. Significant correlation was found between US findings, CS findings, and severity of colitis. Hence, US could be useful for the evaluation of IMC.

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Rena Mei, Emily Pepe, David Y Oh, Katy K Tsai, Rishika Chugh, Michael G Kattah
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Sung Wook Hwang, Min Kyu Kim, Mi-Na Kweon
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Perspective

IBD

Endoscopy for assessment of mucosal healing in ulcerative colitis: time bound or response guided?: Ajit Sood, Ramit Mahajan, Arshdeep Singh, Vandana Midha, Varun Mehta; Intest Res 2022;20(3):297-302. Published online February 8, 2022; DOI: https://doi.org/10.5217/ir.2021.00099

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The timing of colonoscopy in patients with active ulcerative colitis (UC) lacks coherence. The published guidelines and recommendations advocate time-bound colonoscopy in patients with active UC to assess for mucosal healing. However, the practice of performing colonoscopies at fixed time frames lacks reasoning. The time to achieve mucosal healing in UC is not uniform across the patient populations and is influenced by the disease severity and efficacy and time to therapeutic response of the drugs being used. Additionally, with the availability of sensitive noninvasive inflammatory biomarkers such as fecal calprotectin, that parallel the disease activity and correlate with mucosal healing, the notion of performing colonoscopy at fixed intervals sounds unjustifiable. The authors express their view that a response-guided colonoscopy (driven by normalization of clinical symptoms and inflammatory biomarkers), rather than a time-bound colonoscopy, would be more logical, apart from being cost-effective and patient-friendly.

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Beyond conventional endoscopy: Image-enhanced techniques in quiescent ulcerative colitis assessment
Vedran Tomašić, Petra Ćaćić, Neven Baršić, Alen Bišćanin
World Journal of Gastrointestinal Endoscopy.2026;[Epub] CrossRef
Applicability of colon capsule endoscopy for monitoring ulcerative colitis: a systematic review
Mathilde Simone Rasmussen, Lea Østergaard Hansen, Ulrik Deding, Mark Bremholm Ellebæk, Jens Kjeldsen, Thomas Bjørsum-Meyer
Scandinavian Journal of Gastroenterology.2025; 60(4): 336. CrossRef
Seeing Is Believing: Does Red Dichromatic Imaging (RDI) Predict Histological Remission and Clinical Outcomes in Ulcerative Colitis Patients?
Vedran Tomašić
Digestive Diseases and Sciences.2025; 70(7): 2254. CrossRef
Comments on Oral Sulfate Solution Is as Effective as Polyethylene Glycol with Ascorbic Acid in a Split Method for Bowel Preparation in Patients with Inactive Ulcerative Colitis: A Randomized, Multicenter, and Single-Blind Clinical Trial
Ji Eun Kim
Gut and Liver.2024; 18(1): 192. CrossRef
Ischemia-modified albumin: a novel blood marker of endoscopic mucosal healing in inflammatory bowel disease
Seung Bum Lee, Hyun-Ki Kim, Sang Hyuk Park, Ji-Hun Lim, Sang Hyoung Park
Intestinal Research.2024; 22(1): 75. CrossRef
A novel serum biomarker of endoscopic mucosal healing in inflammatory bowel disease
Hyoun Woo Kang
Intestinal Research.2024; 22(1): 3. CrossRef
Management of ulcerative colitis in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease updated in 2023
Hsu-Heng Yen, Jia-Feng Wu, Horng-Yuan Wang, Ting-An Chang, Chung-Hsin Chang, Chen-Wang Chang, Te-Hsin Chao, Jen-Wei Chou, Yenn-Hwei Chou, Chiao-Hsiung Chuang, Wen-Hung Hsu, Tzu-Chi Hsu, Tien-Yu Huang, Tsung-I Hung, Puo-Hsien Le, Chun-Che Lin, Chun-Chi Lin
Intestinal Research.2024; 22(3): 213. CrossRef
Histologic improvement predicts endoscopic remission in patients with ulcerative colitis
Ji Eun Kim, Minjee Kim, Min-Ji Kim, Eun Ran Kim, Sung Noh Hong, Dong Kyung Chang, Sang Yun Ha, Young-Ho Kim
Scientific Reports.2024;[Epub] CrossRef
Practical management of mild-to-moderate ulcerative colitis: an international expert consensus
Ferdinando D’Amico, Fernando Magro, Axel Dignass, Sameer Al Awadhi, Ana Gutierrez Casbas, Natália Sousa Freitas Queiroz, Grażyna Rydzewska, Byong Duk Ye, Zhihua Ran, Ailsa Hart, Vipul Jairath, Gionata Fiorino, Laurent Peyrin-Biroulet, Silvio Danese
Expert Review of Gastroenterology & Hepatology.2024; 18(8): 421. CrossRef
Predictive Value of PHRI for Recurrence within One Year after UC Treatment: A Retrospective Study
Kun Zhang, Jianlan Xie, Jianmin Zhao, Mei Jia
British Journal of Hospital Medicine.2024; : 1. CrossRef
Molecular Activity of Inflammation and Epithelial-Mesenchymal Transition in the Microenvironment of Ulcerative Colitis
Yu Kyung Jun, Nayoung Kim, Hyuk Yoon, Ji Hyun Park, Hyung Kyung Kim, Yonghoon Choi, Ji Ae Lee, Cheol Min Shin, Young Soo Park, Dong Ho Lee
Gut and Liver.2024; 18(6): 1037. CrossRef
Comparison of Two Types of 1-L Polyethylene Glycol-ascorbic Acid as Colonoscopic Bowel Preparation: A Prospective Randomized Study
Suh Hyun Choi, Won Eui Yoon, Seung Hyuk Kim, Hee Jun Myung, Seo Hyun Kim, Soon Oh So, Se Hun Kim, Hyun Mi Lee, Yeoun Jung Oh, Jeong Seop Moon, Tae Yeong Park, You Sun Kim
The Korean Journal of Gastroenterology.2022; 80(2): 85. CrossRef

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Original Articles

Colorectal neoplasia

Postgastrectomy gastric cancer patients are at high risk for colorectal neoplasia: a case control study: Tae-Geun Gweon, Kyu-Tae Yoon, Chang Hyun Kim, Jin-Jo Kim; Intest Res 2021;19(2):239-246. Published online November 13, 2020; DOI: https://doi.org/10.5217/ir.2020.00009

Abstract PDF PubReader ePub

Background/Aims
Several studies have shown that colorectal neoplasms (CRN) including colorectal cancer (CRC) may be prevalent in patients with gastric cancer. However, in most of these studies, colonoscopy to investigate the prevalence of CRN was performed prior to surgery. We aimed to investigate whether CRN was more prevalent in postgastrectomy gastric cancer patients than in healthy individuals.
Methods
We reviewed the medical records of those patients within a cohort of gastric cancer patients with gastrectomy who underwent colonoscopy between 2016 and 2017. Controls age- and sex-matched with gastric cancer patients at a 2:1 ratio were identified among those who underwent colonoscopy at a health-promotion center. The frequencies of CRN, advanced CRN (ACRN), and CRC among patients with gastrectomy were compared with those in the control subjects. A total of 744 individuals (gastric cancer, 248; control, 496) were included.
Results
The rates of CRN and ACRN in the gastric cancer group were higher than those in the healthy individuals (CRN, 47.6% vs. 34.7%, P< 0.001; ACRN, 16.9% vs. 10.9%, P= 0.020). The rate of CRC was comparable between the 2 groups (2.0% vs. 0.6%, P= 0.125). Multivariate analysis identified previous gastrectomy for gastric cancer and male sex as significant risk factors for (A)CRN.
Conclusions
CRN and ACRN were more prevalent in patients who underwent surgery for gastric cancer than in the control group. Regular surveillance colonoscopy at appropriate intervals is indicated after gastrectomy.

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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
Gastric Cancer and Microbiota: Exploring the Microbiome’s Role in Carcinogenesis and Treatment Strategies
Daniela-Cornelia Lazăr, Sorin-Dan Chiriac, George-Andrei Drăghici, Elena-Alina Moacă, Alexandra Corina Faur, Mihaela-Flavia Avram, Vladiana-Romina Turi, Mihaela-Roxana Nicolin, Adrian Goldiș, Matin Asad Salehi, Radu Jipa
Life.2025; 15(7): 999. CrossRef
Analysis of the risk of metachronous colorectal cancer and long-term prognosis in patients following gastrectomy for gastric cancer
Jun He, Bixian Luo, Hongming Liu, Dong Cao, Weihua Gong
Scientific Reports.2025;[Epub] CrossRef
Effect of bowel preparation completion time on bowel cleansing efficacy: Prospective randomized controlled trial of different bowel preparation completion times precolonoscopy
Hye Min Kim, Hyo Suk Kim, Young Eun An, Jae Hyuck Chang, Tae Ho Kim, Chang Whan Kim, Tae‐Geun Gweon
Digestive Endoscopy.2024; 36(12): 1347. CrossRef
Calcium, Vitamin D, and Colorectal Cancer
Young-Jo Wi, Soo-Young Na
The Korean Journal of Gastroenterology.2023; 82(2): 47. CrossRef
Comparison of 2 L Polyethylene Glycol Plus Ascorbic Acid and 4 L Polyethylene Glycol in Elderly Patients Aged 60–79: A Prospective Randomized Study
Sung Hoon Jung, Chul-Hyun Lim, Tae-Geun Gweon, Jinsu Kim, Jung Hwan Oh, Kyu-Tae Yoon, Jee Young An, Jeong‑Seon Ji, Hwang Choi
Digestive Diseases and Sciences.2022; 67(10): 4841. CrossRef
Colonoscopy Insertion in Patients with Gastrectomy: Does Position Impact Cecal Intubation Time?
Jae Hyun Kim, Youn Jung Choi, Hye Jung Kwon, Gyu Man Oh, Kyoungwon Jung, Sung Eun Kim, Won Moon, Moo In Park, Seun Ja Park
Digestive Diseases and Sciences.2022; 67(9): 4533. CrossRef
Early gastric neoplasms are significant risk factor for colorectal adenoma: A prospective case-control study
Seong-Jung Kim, Jun Lee, Dae Youb Baek, Jun Hyung Lee, Ran Hong
Medicine.2022; 101(32): e29956. CrossRef
Colorectal Neoplasia in CDH1 Pathogenic Variant Carriers: A Multicenter Analysis
Peter P. Stanich, Dareen Elgindi, Elena Stoffel, Erika Koeppe, Ajay Bansal, Rachel Stetson, Debra L. Collins, Dana Farengo Clark, Eve Karloski, Beth Dudley, Randall E. Brand, Michael J. Hall, Yana Chertock, Brian A. Sullivan, Charles Muller, Alice Hinton,
American Journal of Gastroenterology.2022; 117(11): 1877. CrossRef

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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.

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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
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Effects of Brown Rice, Meal Replacements, and Anti-Obesity Drugs on Mitochondria in Obese Rats
Dian Handayani, Anisa Handayani, Achmad Rudijanto, Puspita Nuraissa, Widya Rahmawati, Xu-Feng Huang
Diabetes, Metabolic Syndrome and Obesity.2025; Volume 18: 3151. CrossRef
Fecal Microbiota Transplantation for Inflammatory Bowel Disease: Where We Stand and What Is Next
Dai Ishikawa, Xiaochen Zhang, Kei Nomura, Akihito Nagahara
Inflammatory Intestinal Diseases.2025; 10(1): 371. 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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Colorectal neoplasia

Microvascular density under magnifying narrow-band imaging endoscopy in colorectal epithelial neoplasms: Takahiro Gonai, Keisuke Kawasaki, Shotaro Nakamura, Shunichi Yanai, Risaburo Akasaka, Kunihiko Sato, Yousuke Toya, Kensuke Asakura, Jun Urushikubo, Yasuko Fujita, Makoto Eizuka, Noriyuki Uesugi, Tamotsu Sugai, Takayuki Matsumoto; Intest Res 2020;18(1):107-114. Published online November 4, 2019; DOI: https://doi.org/10.5217/ir.2019.00061

Abstract PDF PubReader ePub

Background/Aims
Magnifying endoscopic classification systems, such as the Japan narrow-band imaging (NBI) Expert Team (JNET) classification, have been widely used for predicting the histologic diagnosis and invasion depth of colorectal epithelial tumors. However, disagreement exists among observers regarding magnifying endoscopic diagnosis, because these classification systems are subjective. We herein investigated the utility of endoscopic microvascular density (eMVD) calculated from magnifying NBI endoscopic images in colorectal tumors.
Methods
We reviewed magnifying NBI endoscopic images from 169 colorectal epithelial tumors (97 adenomas, 72 carcinomas/high-grade dysplasias) resected endoscopically or surgically. The eMVD on magnifying NBI endoscopic images was evaluated using image-editing software, and relationships between eMVD and clinical, endoscopic, and pathological findings were retrospectively analyzed.
Results
The eMVD in carcinomas (0.152 ± 0.079) was significantly higher than that in adenomas (0.119 ± 0.059, P< 0.05). The best cutoff value for distinguishing carcinoma from adenoma was 0.133. Sensitivity, specificity, and accuracy were 56.9%, 67.0%, and 62.7%, respectively. In addition, JNET type 2B tumors showed significantly higher eMVD (0.162 ± 0.079) compared to type 2A tumors (0.111 ± 0.050, P< 0.05).
Conclusions
The eMVD as determined by magnifying NBI endoscopy is considered to be a possible objective indicator for differentiating colorectal carcinomas from adenomas.

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Novel physiological analysis using blood flow velocity for colonic polyps: Pilot study
Eiji Kamba, Takashi Murakami, Naoki Tsugawa, Kei Nomura, Keiichi Haga, Yoichi Akazawa, Hirofumi Fukushima, Hiroya Ueyama, Kenshi Matsumoto, Tomoyoshi Shibuya, Takeshi Terai, Takashi Yao, Akihito Nagahara
Endoscopy International Open.2024; 12(06): E781. CrossRef
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Kwangwoo Nam, Noseong Park, Seunghun Lee, Suil Jeon, Jungbin Lee, Seung‐Mo Hong, Sung Wook Hwang, Sang Hyoung Park, Dong‐Hoon Yang, Byong Duk Ye, Jeong‐Sik Byeon, Suk‐Kyun Yang, Jeong Hoon Lee, Do Hoon Kim, Ki Hean Kim, Seung‐Jae Myung
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Zugang Yin, Chenhui Yao, Limin Zhang, Shaohua Qi
Frontiers in Medicine.2023;[Epub] CrossRef
Chicken skin mucosa surrounding small colorectal cancer could be an endoscopic predictive marker of submucosal invasion
Ying-Jie Zhang, Wu Wen, Fan Li, Yi Jian, Chuan-Ming Zhang, Meng-Xia Yuan, Ye Yang, Feng-Lin Chen
World Journal of Gastrointestinal Oncology.2023; 15(6): 1062. CrossRef
A review on self-healing featured soft robotics
Md. Ariful Islam, Labanya Talukder, Md. Firoj Al, Subrata K. Sarker, S. M. Muyeen, Prangon Das, Md. Mehedi Hasan, Sajal K. Das, Md. Manirul Islam, Md. Robiul Islam, Sumaya Ishrat Moyeen, Faisal R. Badal, Md. Hafiz Ahamed, Sarafat Hussain Abhi
Frontiers in Robotics and AI.2023;[Epub] CrossRef
Emergence of a New Optical Marker for Colorectal Neoplasms: To What Extent Should We Accept It?
Han Hee Lee
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Endoscopic diagnosis and treatment of early colorectal cancer
Seung Wook Hong, Jeong-Sik Byeon
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Colonic Chicken Skin Mucosa Surrounding Colon Polyps Is an Endoscopic Predictive Marker for Colonic Neoplastic Polyps
Yu Mi Lee, Kyung Ho Song, Hoon Sup Koo, Choong-Sik Lee, Inseok Ko, Sang Hyuk Lee, Kyu Chan Huh
Gut and Liver.2022; 16(5): 754. CrossRef
Artificial intelligence-based colorectal polyp histology prediction using narrow-band image-magnifying colonoscopy: a stepping stone for clinical practice
Ji Young Chang
Clinical Endoscopy.2022; 55(5): 699. CrossRef
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Istvan Racz, Andras Horvath, Zoltán Horvath
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Photoacoustic endoscopy: A progress review
Heng Guo, Ying Li, Weizhi Qi, Lei Xi
Journal of Biophotonics.2020;[Epub] CrossRef
Diagnostic efficacy of the Japan Narrow-band-imaging Expert Team and Pit pattern classifications for colorectal lesions: A meta-analysis
Yu Zhang, Hui-Yan Chen, Xiao-Lu Zhou, Wen-Sheng Pan, Xin-Xin Zhou, Hang-Hai Pan
World Journal of Gastroenterology.2020; 26(40): 6279. CrossRef

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Endoscopy

Clinical comparison of low-volume agents (oral sulfate solution and sodium picosulfate with magnesium citrate) for bowel preparation: the EASE study: Jeeyeon Kim, Hyun Gun Kim, Kyeong Ok Kim, Hyung Wook Kim, Jongha Park, Jeong-Sik Byeon, Sung-Wook Hwang, Hyun Deok Shin, Jeong Eun Shin, Hyo-Joon Yang, Hyun Seok Lee, Yunho Jung, Young-Seok Cho, Young Eun Joo, Dae-Seong Myung, Kyu Chan Huh, Eu Mi Ahn; Intest Res 2019;17(3):413-418. Published online April 8, 2019; DOI: https://doi.org/10.5217/ir.2018.00156

Abstract PDF PubReader ePub

Background/Aims
This study compared the efficacy, compliance, and safety of bowel preparation between sodium picosulfate with magnesium citrate (SPMC) and oral sulfate solution (OSS).
Methods
A prospective randomized multicenter study was performed. Split preparation methods were performed in both groups; the SPMC group, 2 sachets on the day before, and 1 sachet on the day of the procedure, the OSS group, half of the OSS with 1 L of water on both the day before and the day of the procedure. The adenoma detection rate (ADR), adequacy of bowel preparation using the Boston Bowel Preparation Scale (BBPS) score, patient satisfaction on a visual analog scale (VAS), and safety were compared between the 2 groups.
Results
This study analyzed 229 patients (121 in the SPMC group and 108 in the OSS group). ADR showed no differences between 2 groups (51.7% vs. 41.7%, P> 0.05). The mean total BBPS score (7.95 vs. 8.11, P> 0.05) and adequate bowel preparation rate (94.9% vs. 96.3%, P> 0.05) were similar between the 2 groups. The mean VAS score for taste (7.62 vs. 6.87, P=0.006) was significantly higher in the SPMC group than in the OSS group. There were no significant differences in any other safety variables between the 2 groups except nausea symptom (36.1% vs. 20.3%, P=0.008).
Conclusions
Bowel preparation for colonoscopy using low volume OSS and SPMC yielded similar ADRs and levels of efficacy. SPMC had higher levels of satisfaction for taste and feeling than did OSS.

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Efficacy and safety of split-dose ultra-low-volume polyethylene glycol with ascorbic acid versus sodium picosulfate with magnesium citrate for bowel preparation: a systematic review and meta-analysis.
Abdallfatah Abdallfatah, Ahmed W. Hageen, Dania Albader, Abdulaziz Al-Tamimi, Khalid Alsalumi, Abdulrahman Alzmmam, Mahdi Abdullah, Laith Alreshaid, Saleh Aldhuwayhi, Nourah Almarri, Wala Fallatah, Abdullah Altamimi
European Journal of Gastroenterology & Hepatology.2026;[Epub] CrossRef
Comments on Oral Sulfate Solution Is as Effective as Polyethylene Glycol with Ascorbic Acid in a Split Method for Bowel Preparation in Patients with Inactive Ulcerative Colitis: A Randomized, Multicenter, and Single-Blind Clinical Trial
Ji Eun Kim
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Oral Sulfate Solution Is as Effective as Polyethylene Glycol with Ascorbic Acid in a Split Method for Bowel Preparation in Patients with Inactive Ulcerative Colitis: A Randomized, Multicenter, and Single-Blind Clinical Trial
Ji Min Lee, Kang-Moon Lee, Ho Suk Kang, Ja Seol Koo, Hyun Seok Lee, Seok-Hoo Jeong, Jung Ho Kim, Dae Bum Kim
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Quality indicators in colonoscopy: the chasm between ideal and reality
Su Bee Park, Jae Myung Cha
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Comparison of the efficacy and safety between oral sulfate tablet and polyethylene glycol for bowel preparation before colonoscopy according to age
Jae Hyun Kim, Yong Eun Park, Tae Oh Kim, Jongha Park, Gyu Man Oh, Won Moon, Seun Ja Park
Medicine.2022; 101(27): e29884. CrossRef
Efficacy, safety and tolerability of oral sulphate tablet for bowel preparation in patients with inflammatory bowel disease: A multicentre randomized controlled study
Kyeong Ok Kim, Eun Young Kim, Yoo Jin Lee, Hyun Seok Lee, Eun Soo Kim, Yun Jin Chung, Byung Ik Jang, Sung Kook Kim, Chang Heon Yang
Journal of Crohn's and Colitis.2022; 16(11): 1706. CrossRef
Comparison of Two Types of 1-L Polyethylene Glycol-ascorbic Acid as Colonoscopic Bowel Preparation: A Prospective Randomized Study
Suh Hyun Choi, Won Eui Yoon, Seung Hyuk Kim, Hee Jun Myung, Seo Hyun Kim, Soon Oh So, Se Hun Kim, Hyun Mi Lee, Yeoun Jung Oh, Jeong Seop Moon, Tae Yeong Park, You Sun Kim
The Korean Journal of Gastroenterology.2022; 80(2): 85. CrossRef
Correlation between Surrogate Quality Indicators for Adenoma Detection Rate and Adenoma Miss Rate in Qualified Colonoscopy, CORE Study: KASID Multicenter Study
Jae Hee Han, Hyun Gun Kim, Eu Mi Ahn, Suyeon Park, Seong Ran Jeon, Jae Myung Cha, Min Seob Kwak, Yunho Jung, Jeong Eun Shin, Hyun Deok Shin, Young-Seok Cho
Gut and Liver.2022; 16(5): 716. CrossRef
How to Choose the Optimal Bowel Preparation Regimen for Colonoscopy
Ji Eun Na, Eun Ran Kim
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Optimal Laxatives for Oral Colonoscopy Bowel Preparation: from High-volume to Novel Low-volume Solutions
Soo-Young Na, Won Moon
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No inferioridad entre dos agentes de bajo volumen (Picosulfato de Sodio/Citrato de Magnesio vs. Sulfato de Sodio/Potasio/Magnesio) en la preparación de colon para procedimientos diagnósticos: estudio observacional
Erika D. Pérez-Riveros, Margarita Rey R., Belén Mendoza De Molano, Juan Carlos Robayo, Jaime Solano Mariño, Rafael García Duperly, Andrés Gómez, Renzo Pinto Carta, Gerardo Ardila, Jose De la Hoz-Valle, Fernando Sierra-Arango
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Endoscopy

The current capacity and quality of colonoscopy in Korea: Jae Ho Choi, Jae Myung Cha, Jin Young Yoon, Min Seob Kwak, Jung Won Jeon, Hyun Phil Shin; Intest Res 2019;17(1):119-126. Published online October 10, 2018; DOI: https://doi.org/10.5217/ir.2018.00060

Abstract PDF PubReader ePub

Background/Aims
Little is known for the capacity and quality of colonoscopy, and adherence to colonoscopy surveillance guidelines in Korea. This study aimed to investigate the present and potential colonoscopic capacity, colonoscopic quality, and adherence to colonoscopy surveillance guidelines in Korea.
Methods
We surveyed representative endoscopists of 72 endoscopy units from June to August 2015, using a 36-item questionnaire regarding colonoscopic capacity, quality, and adherence to colonoscopy surveillance guidelines of each hospitals.
Results
Among the 62 respondents who answered the questionnaire, 51 respondents were analyzed after exclusion of 11 incomplete answers. Only 1 of 3 of endoscopy units can afford to perform additional colonoscopies in addition to current practice, and the potential maximum number of colonoscopies per week was only 42. The quality of colonoscopy was variable as reporting of quality indicators of colonoscopy were considerably variable (29.4%–94.1%) between endoscopy units. Furthermore, there are substantial gaps in the adherence to colonoscopy surveillance guidelines, as concordance rate for guideline recommendation was less than 50% in most scenarios.
Conclusions
The potential capacity and quality of colonoscopy in Korea was suboptimal. Considering suboptimal reporting of colonoscopic quality indicators and low adherence rate for colonoscopy surveillance guidelines, quality improvement of colonoscopy should be underlined in Korea.

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Colorectal neoplasia

Rates of metachronous adenoma after curative resection for left-sided or right-sided colon cancer: Yuk Fai Lam, Wai Kay Seto, Teresa Tong, Ka Shing Cheung, Oswens Lo, Ivan FN Hung, Wai Lun Law, Wai K Leung; Intest Res 2018;16(4):619-627. Published online October 10, 2018; DOI: https://doi.org/10.5217/ir.2018.00013

Abstract PDF PubReader ePub

Background/Aims
We determined the rates of metachronous colorectal neoplasm in colorectal cancer (CRC) patients after resection for right (R)-sided or left (L)-sided cancer.
Methods
Consecutive CRC patients who had undergone surgical resection for curative intent in our hospital between 2001 and 2004 were identified. R-sided colonic cancers refer to cancer proximal to splenic flexure whereas L-sided cancers include rectal cancers. Patients were included only if they had a clearing colonoscopy performed either before or within 6 months after the operation. Findings of surveillance colonoscopy performed up to 5 years after colonic resection were included in the analysis.
Results
Eight hundred and sixty-three CRC patients underwent curative surgical resection during the study period. Three hundred and twenty-seven patients (107 R-sided and 220 L-sided) fulfilled the inclusion criteria and had at least 1 postoperative surveillance colonoscopy performed. The proportion of patients who had polyp and adenoma on surveillance colonoscopy was significantly higher among patients with L-sided than R-sided cancers (polyps: 30.9% vs. 19.6%, P=0.03; adenomas: 25.5% vs. 13.1%, P=0.01). The mean number of adenoma per patient on surveillance colonoscopy was also higher for patients with L-sided than R-sided tumors (0.52; 95% confidence interval [CI], 0.37–0.68 vs. 0.22; 95% CI, 0.08–0.35; P<0.01). Multivariate analysis showed that L-sided cancers, age, male gender and longer follow-up were independent predictors of adenoma detection on surveillance colonoscopy.
Conclusions
Patients with Lsided cancer had a higher rate of metachronous polyps and adenoma than those with R-sided cancer on surveillance colonoscopy.

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DMMR status and synchronous lesions predicts metachronous lesions after curative resection for rectal cancer
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Endoscopy

Difficult colonoscopy: air, carbon dioxide, or water insufflation?: Alisha Chaubal, Vikas Pandey, Ruchir Patel, Prateik Poddar, Aniruddha Phadke, Meghraj Ingle, Prabha Sawant; Intest Res 2018;16(2):299-305. Published online April 30, 2018; DOI: https://doi.org/10.5217/ir.2018.16.2.299

Abstract PDF Supplementary Material PubReader ePub

Background/Aims

This study aimed to compare tolerance to air, carbon dioxide, or water insufflation in patients with anticipated difficult colonoscopy (young, thin, obese individuals, and patients with prior abdominal surgery or irradiation).

Methods

Patients with body mass index (BMI) less than 18 kg/m² or more than 30 kg/m², or who had undergone previous abdominal or pelvic surgeries were randomized to air, carbon dioxide, or water insufflation during colonoscopy. The primary endpoint was cecal intubation with mild pain (less than 5 on visual analogue scale [VAS]), without use of sedation.

Results

The primary end point was achieved in 32.7%, 43.8%, and 84.9% of cases with air, carbon dioxide and water insufflation (P<0.001). The mean pain scores were 5.17, 4.72, and 3.93 on the VAS for air, carbon dioxide, and water insufflation (P<0.001). The cecal intubation rate or procedure time did not differ significantly between the 3 groups.

Conclusions

Water insufflation was superior to air or carbon dioxide for pain tolerance. This was seen in the subgroups with BMI <18 kg/m² and the post-surgical group, but not in the group with BMI >30 kg/m².

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Endoscopy

Prospective analysis of factors associated with inadequate bowel preparation for colonoscopy in actual clinical practice: Dae Hyung Woo, Kyeong Ok Kim, Da Eun Jeong, Yoon Jeong Nam, Si Hyung Lee, Byung Ik Jang, Tae Nyeun Kim; Intest Res 2018;16(2):293-298. Published online April 30, 2018; DOI: https://doi.org/10.5217/ir.2018.16.2.293

Abstract PDF PubReader ePub

Background/Aims

Inadequate bowel preparation can result in prolonged procedure time and increased missed lesion and complication rates. This prospective study aimed to evaluate bowel preparation quality and identify the predictive factors for inadequate bowel preparation in actual clinical practice.

Methods

We included 399 patients who underwent colonoscopy between June 2015 and July 2016. Using the Aronchick bowel preparation scale, we defined a score ≤2 as adequate preparation and a score >2 as inadequate preparation.

Results

Mean patient age was 58.38±12.97 years; 60.6% were male. Indications for colonoscopy included screening (69.7%) and surveillance after polyp removal (21.3%). A split-dose regimen was prescribed to 55.4% of patients. The inadequate bowel preparation rate was 28.1%. Overall, the median time between the last bowel preparation agent dose and start of colonoscopy was 5.0 hours (range, 1.5–16.0 hours); that of the adequate group was 5.0 hours (range, 1.5–16.0 hours); and that of the inadequate group was 5 hours (range, 2–23 hours). The mean bowel preparation scale score of the ascending colon (1.94±0.25) was significantly higher than that of other colon segments. On multivariate analysis, elderly age, history of cerebrovascular disease, history of gastrectomy or appendectomy, and total preparation solution uptake <2 L were the independent predictors of inadequate bowel preparation.

Conclusions

The inadequate bowel preparation rate was 28.1%. Risk factors included elderly age and history of cerebrovascular disease or abdominal surgery. Patients with these risk factors require special care and education.

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Review

Endoscopy

Quality is the key for emerging issues of population-based colonoscopy screening: Jin Young Yoon, Jae Myung Cha, Yoon Tae Jeen; Intest Res 2018;16(1):48-54. Published online January 18, 2018; DOI: https://doi.org/10.5217/ir.2018.16.1.48

Abstract PDF PubReader ePub

Colonoscopy is currently regarded as the gold standard and preferred method of screening for colorectal cancer (CRC). However, the benefit of colonoscopy screening may be blunted by low participation rates in population-based screening programs. Harmful effects of population-based colonoscopy screening may include complications induced by colonoscopy itself and by sedation, psychosocial distress, potential over-diagnosis, and socioeconomic burden. In addition, harmful effects of colonoscopy may increase with age and comorbidities. As the risk of adverse events in population-based colonoscopy screening may offset the benefit, the adverse events should be managed and monitored. To adopt population-based colonoscopy screening, consensus on the risks and benefits should be developed, focusing on potential harm, patient preference, socioeconomic considerations, and quality improvement of colonoscopy, as well as efficacy for CRC prevention. As suboptimal colonoscopy quality is a major pitfall of population-based screening, adequate training and regulation of screening colonoscopists should be the first step in minimizing variations in quality. Gastroenterologists should promote quality improvement, auditing, and training for colonoscopy in a population-based screening program.

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Original Articles

Endoscopy

Three-year colonoscopy surveillance after polypectomy in Korea: a Korean Association for the Study of Intestinal Diseases (KASID) multicenter prospective study: Won Seok Choi, Dong Soo Han, Chang Soo Eun, Dong Il Park, Jeong-Sik Byeon, Dong-Hoon Yang, Sung-Ae Jung, Sang Kil Lee, Sung Pil Hong, Cheol Hee Park, Suck-Ho Lee, Jeong-Seon Ji, Sung Jae Shin, Bora Keum, Hyun Soo Kim, Jung Hye Choi, Sin-Ho Jung; Intest Res 2018;16(1):126-133. Published online January 18, 2018; DOI: https://doi.org/10.5217/ir.2018.16.1.126

Abstract PDF PubReader ePub

Background/Aims

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.

Methods

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.

Results

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], P=0.09). Advanced adenoma recurrence was observed only in males and in subjects aged ≥50 years. In contrast, adenoma recurrence was observed in 187 patients (48.3%) at follow-up. Male sex, older age (≥50 years), and multiple adenomas (≥3) at baseline were independent risk factors for adenoma recurrence.

Conclusions

A colonoscopy surveillance interval of 3 years in patients with baseline advanced adenoma can be considered appropriate.

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High C-reactive protein level is associated with high-risk adenoma: Hyae Min Lee, Jae Myung Cha, Jung Lok Lee, Jung Won Jeon, Hyun Phil Shin, Kwang Ro Joo, Jin Young Yoon, Joung Il Lee; Intest Res 2017;15(4):511-517. Published online October 23, 2017; DOI: https://doi.org/10.5217/ir.2017.15.4.511

Abstract PDF PubReader ePub

Background/Aims

There is substantial evidence supporting a role of inflammation in the pathogenesis of colorectal cancer; however, little is known about the association between serum C-reactive protein (CRP) and the risk of colorectal adenoma. This study was conducted to investigate the association between serum CRP and colorectal adenoma risk.

Methods

A retrospective cross-sectional study was performed on first-time screening colonoscopies in asymptomatic subjects who also had their serum CRP level measured during a routine health check-up between September 2006 and September 2009 in Korea. Serum CRP level was compared between high-risk and low-risk adenoma groups and independent predictors of high-risk adenoma were analyzed using multivariate regression analysis.

Results

Among the 3,309 eligible patients, the high-risk adenoma group had higher serum CRP levels than the low-risk adenoma group (P=0.000). In addition, patients with a high-risk adenoma were more frequently included in the high CRP group than in the low CRP group (8.6% vs. 4.0%, P<0.001). The prevalence of high-risk adenoma was 3.5 times higher in the highest quartile of CRP level (P=0.000) compared with that in the lowest quartile. In logistic regression analysis, a higher quartile CRP level was found to be an independent risk factor for high-risk adenoma (odds ratio, 1.8; 95% confidence interval, 1.3–2.5; P=0.000).

Conclusions

High CRP level is associated with high-risk adenoma in both men and women. Our data may support the association between chronic inflammation and colorectal neoplasia, which warrants further investigation.

Citations

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Review

Sedation for routine gastrointestinal endoscopic procedures: a review on efficacy, safety, efficiency, cost and satisfaction: Otto S. Lin; Intest Res 2017;15(4):456-466. Published online October 23, 2017; DOI: https://doi.org/10.5217/ir.2017.15.4.456

Abstract PDF PubReader ePub

Most gastrointestinal endoscopic procedures are now performed with sedation. Moderate sedation using benzodiazepines and opioids continue to be widely used, but propofol sedation is becoming more popular because its unique pharmacokinetic properties make endoscopy almost painless, with a very predictable and rapid recovery process. There is controversy as to whether propofol should be administered only by anesthesia professionals (monitored anesthesia care) or whether properly trained non-anesthesia personnel can use propofol safely via the modalities of nurse-administered propofol sedation, computer-assisted propofol sedation or nurse-administered continuous propofol sedation. The deployment of non-anesthesia administered propofol sedation for low-risk procedures allows for optimal allocation of scarce anesthesia resources, which can be more appropriately used for more complex cases. This can address some of the current shortages in anesthesia provider supply, and can potentially reduce overall health care costs without sacrificing sedation quality. This review will discuss efficacy, safety, efficiency, cost and satisfaction issues with various modes of sedation for non-advanced, non-emergent endoscopic procedures, mainly esophagogastroduodenoscopy and colonoscopy.

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Original Articles

Colonic dysmotility and morphological abnormality frequently detected in Japanese patients with irritable bowel syndrome: Takeshi Mizukami, Shinya Sugimoto, Tatsuhiro Masaoka, Hidekazu Suzuki, Takanori Kanai; Intest Res 2017;15(2):236-243. Published online April 27, 2017; DOI: https://doi.org/10.5217/ir.2017.15.2.236

Abstract PDF PubReader ePub

Background/Aims

Colonoscopy and computed tomography (CT) are used primarily to exclude organic diseases in patients with irritable bowel syndrome (IBS), rather than to assess the pathophysiology of IBS. We aimed to evaluate colonic dysmotility and morphology in Japanese patients with IBS.

Methods

One hundred eighty-four patients with IBS and 49 asymptomatic controls who underwent colonoscopy in combination with CT colonography or barium enema were retrospectively reviewed between 2008 and 2012. Water-aided colonoscopy was performed without sedation by a single endoscopist. The duration and pattern of colonic movement and cecal intubation time were recorded. To assess colonic morphology, barium enema or CT colonography were performed immediately after colonoscopy.

Results

Colonic dysmotility was more frequent in the IBS group (28.8% vs. 2.0% in controls, P<0.001), especially in cases of IBS with diarrhea (IBS-D) (IBS with constipation [IBS-C] 28.8% vs. IBS-D 60.0% vs. mixed IBS [IBS-M] 5.1%, P<0.001). Colonic morphological abnormality was more frequent in the IBS group than in the control group (77.7% vs. 24.5%, P<0.001), especially in IBS-M and IBS-C groups (IBS-C 77.5% vs. IBS-D 48.9% vs. IBS-M 100%, P<0.001). Most patients with IBS with colonic dysmotility had experienced stress related to their symptoms. Cecal intubation time was significantly longer in the IBS group than in the control group (12.1±6.9 minutes vs. 4.6±1.9 minutes, P<0.001).

Conclusions

Unsedated colonoscopy, combined with radiographic findings, can detect colonic dysmotility and morphological abnormality. Technical difficulties observed during cecal intubation may partially explain the pathophysiology of IBS.

Citations

Citations to this article as recorded by

Ultrasound Imaging Equipment for Evaluating Chronic Constipation in Home Healthcare: A Review Article
Yohei Okawa
Gastrointestinal Disorders.2025; 7(1): 12. CrossRef
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Reo Kobayashi, Ken Inoue, Satoshi Sugino, Ryohei Hirose, Toshifumi Doi, Akihito Harusato, Osamu Dohi, Naohisa Yoshida, Kazuhiko Uchiyama, Takeshi Ishikawa, Tomohisa Takagi, Hideyuki Konishi, Yasuko Hirai, Katsura Mizushima, Yuji Naito, Yoshito Itoh
Biological and Pharmaceutical Bulletin.2024; 47(2): 373. CrossRef
Diagnostic Ability of Ultrasonography Compared with Computed Tomography for Assessing Rectal Feces
Noboru Misawa, Masaru Matsumoto, Momoko Tsuda, Shigeki Tamura, Tsutomu Yoshihara, Keiichi Ashikari, Takaomi Kessoku, Hidenori Ohkubo, Takuma Higurashi, Hiromi Sanada, Mototsugu Kato, Atsushi Nakajima
Journal of the Anus, Rectum and Colon.2024; 8(2): 126. CrossRef
Evidence-Based Clinical Guidelines for Chronic Constipation 2023
Eikichi Ihara, Noriaki Manabe, Hidenori Ohkubo, Naotaka Ogasawara, Haruei Ogino, Kazuki Kakimoto, Motoyori Kanazawa, Hidejiro Kawahara, Chika Kusano, Shiko Kuribayashi, Akinari Sawada, Tomohisa Takagi, Shota Takano, Toshihiko Tomita, Toshihiro Noake, Mari
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The Keio Journal of Medicine.2023; 72(4): 95. CrossRef
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Shin Fukudo, Toshikatsu Okumura, Masahiko Inamori, Yusuke Okuyama, Motoyori Kanazawa, Takeshi Kamiya, Ken Sato, Akiko Shiotani, Yuji Naito, Yoshiko Fujikawa, Ryota Hokari, Tastuhiro Masaoka, Kazuma Fujimoto, Hiroshi Kaneko, Akira Torii, Kei Matsueda, Hiro
Journal of Gastroenterology.2021; 56(3): 193. CrossRef
NUTRITIONAL STATUS, QUALITY OF LIFE AND LIFE HABITS OF WOMEN WITH IRRITABLE BOWEL SYNDROME: A CASE-CONTROL STUDY
Ana Paula Monteiro de MENDONÇA, Luciana Miyuki YAMASHITA, Esther Dantas SILVA, Isabela SOLAR, Larissa Ariel Oliveira SANTOS, Ana Carolina Junqueira VASQUES
Arquivos de Gastroenterologia.2020; 57(2): 114. CrossRef

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Clinical outcome of endoscopic management in delayed postpolypectomy bleeding: Jeong-Mi Lee, Wan Soo Kim, Min Seob Kwak, Sung-Wook Hwang, Dong-Hoon Yang, Seung-Jae Myung, Suk-Kyun Yang, Jeong-Sik Byeon; Intest Res 2017;15(2):221-227. Published online April 27, 2017; DOI: https://doi.org/10.5217/ir.2017.15.2.221

Abstract PDF PubReader ePub

Background/Aims

The clinical course after endoscopic management of delayed postpolypectomy bleeding (DPPB) has not been clearly determined. This study aimed to assess clinical outcomes after endoscopic hemostasis of DPPB and evaluate risk factors for rebleeding after initial hemostasis.

Methods

We reviewed medical records of 198 patients who developed DPPB and underwent endoscopic hemostasis between January 2010 and February 2015. The performance of endoscopic hemostasis was assessed. Rebleeding negative and positive patients were compared.

Results

DPPB developed 1.4±1.6 days after colonoscopic polypectomy. All patients achieved initial hemostasis. Clipping was the most commonly used technique. Of 198 DPPB patients, 15 (7.6%) had rebleeding 3.3±2.5 days after initial hemostasis. The number of clips required for hemostasis was higher in the rebleeding positive group (3.2±1.6 vs. 4.2±1.9, P=0.047). Combinations of clipping with other modalities such as injection methods were more common in the rebleeding positive group (67/291, 23.0% vs. 12/17, 70.6%; P<0.001). Multivariate analysis showed a large number of clips and combination therapy were independent risk factors for rebleeding. All the rebleeding cases were successfully managed by repeat endoscopic hemostasis.

Conclusions

Endoscopic hemostasis is effective for the management of DPPB because of its high initial hemostasis rate and low rebleeding rate. Endoscopists should carefully observe patients in whom a large number of clips and/or combination therapy have been used to manage DPPB because these may be related to the severity of DPPB and a higher risk of rebleeding.

Citations

Citations to this article as recorded by

Delphi consensus statement for the management of delayed post-polypectomy bleeding
Enrique Rodríguez de Santiago, Sandra Pérez de la Iglesia, Diego de Frutos, José Carlos Marín-Gabriel, Carolina Mangas-SanJuan, Raúl Honrubia López, Hugo Uchima, Marta Aicart-Ramos, Miguel Ángel Rodríguez Gandía, Eduardo Valdivielso Cortázar, Felipe Ramos
Therapeutic Advances in Gastroenterology.2025;[Epub] 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
The Use of Clips to Prevent Post-Polypectomy Bleeding: A Clinical Review
Matthew A. O’Mara, Peter G. Emanuel, Aaron Tabibzadeh, Robert J. Duve, Jonathan S. Galati, Gregory Laynor, Samantha Gross, Seth A. Gross
Journal of Clinical Gastroenterology.2024; 58(8): 739. CrossRef
Is endoscopic hemostasis safe and effective for delayed post-polypectomy bleeding?
Jae-Yong Cho, Yunho Jung, Han Hee Lee, Jung-Wook Kim, Kee Myung Lee, Hyun Lim, Geun-Hyuk Choi, Seong Woo Choi, Bo-In Lee
International Journal of Gastrointestinal Intervention.2024; 13(4): 122. CrossRef
Endoscopic management of delayed bleeding after polypectomy of small colorectal polyps: two or more clips may be safe
Xue-Feng Guo, Xiang-An Yu, Jian-Cong Hu, De-Zheng Lin, Jia-Xin Deng, Ming-Li Su, Juan Li, Wei Liu, Jia-Wei Zhang, Qing-Hua Zhong
Gastroenterology Report.2022;[Epub] CrossRef
Management and Outcomes of Bleeding Within 30 Days of Colonic Polypectomy in a Large, Real-Life, Multicenter Cohort Study
Enrique Rodríguez de Santiago, Maria Hernández-Tejero, Liseth Rivero-Sánchez, Oswaldo Ortiz, Irene García de la Filia-Molina, Jose Ramon Foruny-Olcina, Hector Miguel Marcos Prieto, Maria García-Prada, Almudena González-Cotorruelo, Miguel Angel De Jorge Tu
Clinical Gastroenterology and Hepatology.2021; 19(4): 732. CrossRef
Clinical Features of Re-Colonoscopy after Bleeding after Intestinal Polypectomy
慧敏翟
Advances in Clinical Medicine.2021; 11(11): 5151. CrossRef
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A. Rajendran, S. Pannick, S. Thomas‐Gibson, S. Oke, C. Anele, N. Sevdalis, A. Haycock
Colorectal Disease.2020; 22(9): 1085. CrossRef
Child-Pugh B or C Cirrhosis Increases the Risk for Bleeding Following Colonoscopic Polypectomy
Hosim Soh, Jaeyoung Chun, Seung Wook Hong, Seona Park, Yun Bin Lee, Hyun Jung Lee, Eun Ju Cho, Jeong-Hoon Lee, Su Jong Yu, Jong Pil Im, Yoon Jun Kim, Joo Sung Kim, Jung-Hwan Yoon
Gut and Liver.2020; 14(6): 755. CrossRef
Post-polypectomy Visible Vessel
Matthew Woo, Robert Bechara
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Tae-Geun Gweon, Jinsu Kim
International Journal of Gastrointestinal Intervention.2018; 7(3): 123. CrossRef

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Clinical outcomes of sigmoid colon volvulus: identification of the factors associated with successful endoscopic detorsion: Tomoya Iida, Suguru Nakagaki, Shuji Satoh, Haruo Shimizu, Hiroyuki Kaneto, Hiroshi Nakase; Intest Res 2017;15(2):215-220. Published online April 27, 2017; DOI: https://doi.org/10.5217/ir.2017.15.2.215

Abstract PDF PubReader ePub

Background/Aims

Although multiple treatment options exist for the management of sigmoid colon volvulus, no study has examined the factors associated with successful endoscopic detorsion. This study aimed to examine the clinical course of patients with sigmoid colon volvulus and to identify factors related to successful endoscopic detorsion.

Methods

This study included 30 cases (21 patients) of sigmoid volvulus from among 545 cases of intestinal obstruction at a single center. We retrospectively examined the clinical course and the factors associated with the possibility of endoscopic detorsion of sigmoid colon volvulus.

Results

The rate of laxative use among the study participants was 76.2%; the rate of comorbid neuropsychiatric disorders was 61.9%; and 57.1% of patients had a history of open abdominal surgery. All patients were initially treated with endoscopic detorsion, and this procedure had a 61.9% success rate. The recurrence rate after detorsion was as high as 46.2%, but detorsion during revision endoscopy was possible in all cases. Statistical analysis revealed that the absence of abdominal tenderness (P=0.027), the use of laxatives (P=0.027), and a history of open abdominal surgery (P=0.032) were factors predictive of successful endoscopic detorsion.

Conclusions

The results of our study are consistent with previous reports with respect to the success rate of endoscopic detorsion, the subsequent recurrence rate, and the proportion of patients requiring surgical treatment. In addition, we identified the absence of abdominal tenderness, the use of laxatives, and history of open abdominal surgery as factors predicting successful endoscopic detorsion of sigmoid colon volvulus.

Citations

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American Society for Gastrointestinal Endoscopy guideline on the role of endoscopy in the management of acute colonic pseudo-obstruction and colonic volvulus
Mariam Naveed, Laith H. Jamil, Larissa L. Fujii-Lau, Mohammad Al-Haddad, James L. Buxbaum, Douglas S. Fishman, Terry L. Jue, Joanna K. Law, Jeffrey K. Lee, Bashar J. Qumseya, Mandeep S. Sawhney, Nirav Thosani, Andrew C. Storm, Audrey H. Calderwood, Mouen
Gastrointestinal Endoscopy.2020; 91(2): 228. CrossRef
Endoscopic Decompression of Recurrent Sigmoid Volvulus in Pregnancy
Nathaly Cortez, Manuel Berzosa, Kiranmayi Muddasani, Kfir Ben-David
Journal of Investigative Medicine High Impact Case Reports.2020;[Epub] CrossRef
Endoscopic Management of Sigmoid Volvulus in a Debilitated Population: What Relevance?
Manuel Coelho da Rocha, Tiago Capela, Mário Jorge Silva, Gonçalo Ramos, João Coimbra
GE - Portuguese Journal of Gastroenterology.2020; 27(3): 160. CrossRef
Author's Reply
Tomoya Iida, Hiroyuki Kaneto, Hiroshi Nakase
Intestinal Research.2017; 15(4): 554. CrossRef
Comments on clinical outcomes of sigmoid colon volvulus: identification of the factors associated with successful endoscopic detorsion
Sabri Selcuk Atamanalp
Intestinal Research.2017; 15(4): 552. CrossRef

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Determining the optimal surveillance interval after a colonoscopic polypectomy for the Korean population?: Jung Lok Lee, Jae Myung Cha, Hye Min Lee, Jung Won Jeon, Min Seob Kwak, Jin Young Yoon, Hyun Phil Shin, Kwang Ro Joo, Joung Il Lee, Dong Il Park; Intest Res 2017;15(1):109-117. Published online January 31, 2017; DOI: https://doi.org/10.5217/ir.2017.15.1.109

Abstract PDF PubReader ePub

Background/Aims

Western surveillance strategies cannot be directly adapted to the Korean population. The aim of this study was to estimate the risk of metachronous neoplasia and the optimal surveillance interval in the Korean population.

Methods

Clinical and pathological data from index colonoscopy performed between June 2006 and July 2008 and who had surveillance colonoscopies up to May 2015 were compared between low- and high-risk adenoma (LRA and HRA) groups. The 3- and 5-year cumulative risk of metachronous colorectal neoplasia in both groups were compared.

Results

Among 895 eligible patients, surveillance colonoscopy was performed in 399 (44.6%). Most (83.3%) patients with LRA had a surveillance colonoscopy within 5 years and 70.2% of patients with HRA had a surveillance colonoscopy within 3 years. The cumulative risk of metachronous advanced adenoma was 3.2% within 5 years in the LRA group and only 1.7% within 3 years in the HRA group. The risk of metachronous neoplasia was similar between the surveillance interval of <5 and ≥5 years in the LRA group; however, it was slightly higher at surveillance interval of ≥3 than <3 years in the HRA group (9.4% vs. 2.4%). In multivariate analysis, age and the ≥3-year surveillance interval were significant independent risk factors for metachronous advanced adenoma (P=0.024 and P=0.030, respectively).

Conclusions

Patients had a surveillance colonoscopy before the recommended guidelines despite a low risk of metachronous neoplasia. However, the risk of metachronous advanced adenoma was increased in elderly patients and those with a ≥3-year surveillance interval.

Citations

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Risk of developing metachronous colorectal neoplasia after the resection of proximal versus distal adenomas
Yoon Suk Jung, Nam Hee Kim, Youngwoo Kim, Dong Il Park
Digestive and Liver Disease.2022; 54(4): 537. CrossRef
Post-polypectomy surveillance interval and advanced neoplasia detection rates: a multicenter, retrospective cohort study
Amanda J. Cross, Emma C. Robbins, Kevin Pack, Iain Stenson, Matthew D. Rutter, Andrew M. Veitch, Brian P. Saunders, Stephen W. Duffy, Kate Wooldrage
Endoscopy.2022; 54(10): 948. CrossRef
Comparison of Risk of Metachronous Advanced Colorectal Neoplasia in Patients with Sporadic Adenomas Aged < 50 Versus ≥ 50 years: A Systematic Review and Meta-Analysis
Yoon Suk Jung, Jung Ho Park, Chan Hyuk Park
Journal of Personalized Medicine.2021; 11(2): 120. CrossRef
British Society of Gastroenterology/Association of Coloproctology of Great Britain and Ireland/Public Health England post-polypectomy and post-colorectal cancer resection surveillance guidelines
Matthew D Rutter, James East, Colin J Rees, Neil Cripps, James Docherty, Sunil Dolwani, Philip V Kaye, Kevin J Monahan, Marco R Novelli, Andrew Plumb, Brian P Saunders, Siwan Thomas-Gibson, Damian J M Tolan, Sophie Whyte, Stewart Bonnington, Alison Scope,
Gut.2020; 69(2): 201. CrossRef
Urine-NMR metabolomics for screening of advanced colorectal adenoma and early stage colorectal cancer
Eun Ran Kim, Hyuk Nam Kwon, Hoonsik Nam, Jae J. Kim, Sunghyouk Park, Young-Ho Kim
Scientific Reports.2019;[Epub] CrossRef
A Comparison of the Cumulative Incidences of Metachronous Colorectal Adenoma and Cancer According to the Initial FindingsAmong Colonoscopically Followed-up Patients
Seiji Kimura, Masanori Tanaka, Shinsaku Fukuda
Nippon Daicho Komonbyo Gakkai Zasshi.2019; 72(6): 395. CrossRef
Impact of obesity and metabolic abnormalities on the risk of metachronous colorectal neoplasia after polypectomy in men
Nam Hee Kim, Yoon Suk Jung, Jung Ho Park, Dong Il Park, Chong Il Sohn
Journal of Gastroenterology and Hepatology.2019; 34(9): 1504. CrossRef
Risk of developing metachronous advanced colorectal neoplasia after colonoscopic polypectomy in patients aged 30 to 39 and 40 to 49 years
Nam Hee Kim, Yoon Suk Jung, Jung Ho Park, Dong Il Park, Chong Il Sohn
Gastrointestinal Endoscopy.2018; 88(4): 715. CrossRef
Quality is the Key for Emerging Issues of Population-Based Colonoscopy Screening
Jin Young Yoon, Jae Myung Cha, Yoon Tae Jeen
Clinical Endoscopy.2018; 51(1): 50. CrossRef
Histologic discrepancy between endoscopic forceps biopsy and endoscopic mucosal resection specimens of colorectal polyp in actual clinical practice
Moon Joo Hwang, Kyeong Ok Kim, A Lim Kim, Si Hyung Lee, Byung Ik Jang, Tae Nyeun Kim
Intestinal Research.2018; 16(3): 475. CrossRef
Quality is the key for emerging issues of population-based colonoscopy screening
Jin Young Yoon, Jae Myung Cha, Yoon Tae Jeen
Intestinal Research.2018; 16(1): 48. CrossRef

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A wide variation of the quality of colonoscopy reporting system in the real clinical practice in southeastern area of Korea: Jung Min Lee, Yu Jin Kang, Eun Soo Kim, Yoo Jin Lee, Kyung Sik Park, Kwang Bum Cho, Seong Woo Jeon, Min Kyu Jung, Hyun Seok Lee, Eun Young Kim, Jin Tae Jung, Byung Ik Jang, Kyeong Ok Kim, Yun Jin Chung, Chang Hun Yang; Intest Res 2016;14(4):351-357. Published online October 17, 2016; DOI: https://doi.org/10.5217/ir.2016.14.4.351

Abstract PDF PubReader

Background/Aims

Establishment of a colonoscopy reporting system is a prerequisite to determining and improving quality. This study aimed to investigate colonoscopists' opinions and the actual situation of a colonoscopy reporting system in a clinical practice in southeastern area of Korea and to assess the factors predictive of an inadequate reporting system.

Methods

Physicians who performed colonoscopies in the Daegu-Gyeongbuk province of Korea and were registered with the Korean Society of Gastrointestinal Endoscopy (KSGE) were interviewed via mail about colonoscopy reporting systems using a standardized questionnaire.

Results

Of 181 endoscopists invited to participate, 125 responded to the questionnaires (response rate, 69%). Most responders were internists (105/125, 84%) and worked in primary clinics (88/125, 70.4%). Seventy-one specialists (56.8%) held board certifications for endoscopy from the KSGE. A median of 20 colonoscopies (interquartile range, 10–47) was performed per month. Although 88.8% of responders agreed that a colonoscopy reporting system is necessary, only 18.4% (23/125) had achieved the optimal reporting system level recommended by the Quality Assurance Task Group of the National Colorectal Cancer Roundtable. One-third of endoscopists replied that they did not use a reporting document for the main reasons of "too busy" and "inconvenience." Non-endoscopy specialists and primary care centers were independent predictive factors for failure to use a colonoscopy reporting system.

Conclusions

The quality of colonoscopy reporting systems varies widely and is considerably suboptimal in actual clinical practice settings in southeastern Korea, indicating considerable room for quality improvements in this field.

Citations

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Association of Poor Differentiation or Positive Vertical Margin with Residual Disease in Patients with Subsequent Colectomy after Complete Macroscopic Endoscopic Resection of Early Colorectal Cancer
Ki Ju Kim, Hyun Seok Lee, Seong Woo Jeon, Sun Jin, Sang Won Lee
Gastroenterology Research and Practice.2017; 2017: 1. CrossRef
Derivation and validation of a risk scoring model to predict advanced colorectal neoplasm in adults of all ages
Hyo‐Joon Yang, Sungkyoung Choi, Soo‐Kyung Park, Yoon Suk Jung, Kyu Yong Choi, Taesung Park, Ji Yeon Kim, Dong Il Park
Journal of Gastroenterology and Hepatology.2017; 32(7): 1328. CrossRef
Screening strategy for colorectal cancer according to risk
Dong Soo Han
Journal of the Korean Medical Association.2017; 60(11): 893. CrossRef

8,672 View
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3 Crossref

Characteristics and outcomes of endoscopically resected colorectal cancers that arose from sessile serrated adenomas and traditional serrated adenomas: Ji Yeon Seo, Seung Ho Choi, Jaeyoung Chun, Changhyun Lee, Ji Min Choi, Eun Hyo Jin, Sung Wook Hwang, Jong Pil Im, Sang Gyun Kim, Joo Sung Kim; Intest Res 2016;14(3):270-279. Published online June 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.3.270

Abstract PDF PubReader ePub

Background/Aims

The efficacy and safety of endoscopic resection of colorectal cancer derived from sessile serrated adenomas or traditional serrated adenomas are still unknown. The aims of this study were to verify the characteristics and outcomes of endoscopically resected early colorectal cancers developed from serrated polyps.

Methods

Among patients who received endoscopic resection of early colorectal cancers from 2008 to 2011, cancers with documented pre-existing lesions were included. They were classified as adenoma, sessile serrated adenoma, or traditional serrated adenoma according to the baseline lesions. Clinical characteristics, pathologic diagnosis, and outcomes were reviewed.

Results

Overall, 208 colorectal cancers detected from 198 patients were included: 198 with adenoma, five with sessile serrated adenoma, and five with traditional serrated adenoma. The sessile serrated adenoma group had a higher prevalence of high-grade dysplasia (40.0% vs. 25.8%, P<0.001) than the adenoma group. During follow-up, local recurrence did not occur after endoscopic resection of early colorectal cancers developed from serrated polyps. In contrast, two cases of metachronous recurrence were detected within a short follow-up period.

Conclusions

Cautious observation and early endoscopic resection are recommended when colorectal cancer from serrated polyp is suspected. Colorectal cancers from serrated polyp can be treated successfully with endoscopy.

Citations

Citations to this article as recorded by

Association of lifestyle and dietary preferences with precancerous serrated polyps: a hospital-based case-control study in Guangzhou, China
Shaoyu Cheng, Liji Chen, Shujun Liu, Haiyan Zhang, Cailing Zhong, Tianwen Liu
BMC Gastroenterology.2025;[Epub] CrossRef
Small sessile serrated polyps might not be at a higher risk for future advanced neoplasia than low-risk adenomas or polyp-free groups
Eun Hyo Jin, Ji Yeon Seo, Jung Ho Bae, Jooyoung Lee, Ji Min Choi, Yoo Min Han, Joo Hyun Lim
Scandinavian Journal of Gastroenterology.2022; 57(1): 99. CrossRef
The incidence and risk factors of sessile serrated adenomas in left side colon cancer patients after curative surgery
Myung Hee Kim, Hee Seok Moon, In Sun Kwon, Ju Seok Kim, Sun Hyung Kang, Jae Kyu Sung, Eaum Seok Lee, Seok Hyun Kim, Byung Seok Lee, Hyun Yong Jeong
Medicine.2020; 99(29): e20799. CrossRef
Improved Real-Time Optical Diagnosis of Colorectal Polyps Following a Comprehensive Training Program
Jung Ho Bae, Changhyun Lee, Hae Yeon Kang, Min-Sun Kwak, Eun Young Doo, Ji Yeon Seo, Ji Hyun Song, Sun Young Yang, Jong In Yang, Seon Hee Lim, Jeong Yoon Yim, Joo Hyun Lim, Goh Eun Chung, Su Jin Chung, Eun Hyo Jin, Boram Park, Joo Sung Kim
Clinical Gastroenterology and Hepatology.2019; 17(12): 2479. CrossRef
Clinical outcomes of surveillance colonoscopy for patients with sessile serrated adenoma
Sung Jae Park, Hyuk Yoon, In Sub Jung, Cheol Min Shin, Young Soo Park, Na Young Kim, Dong Ho Lee
Intestinal Research.2018; 16(1): 134. CrossRef
Surveillance colonoscopy in patients with sessile serrated adenoma
Ji Hyung Nam, Hyoun Woo Kang
Intestinal Research.2018; 16(3): 502. CrossRef
Identification of risk factors for sessile and traditional serrated adenomas of the colon by using big data analysis
Jeung Hui Pyo, Sang Yun Ha, Sung Noh Hong, Dong Kyung Chang, Hee Jung Son, Kyoung‐Mee Kim, Hyeseung Kim, Kyunga Kim, Jee Eun Kim, Yoon‐Ho Choi, Young‐Ho Kim
Journal of Gastroenterology and Hepatology.2018; 33(5): 1039. CrossRef
Endoscopic Resection of Cecal Polyps Involving the Appendiceal Orifice: A KASID Multicenter Study
Eun Mi Song, Hyo-Joon Yang, Hyun Jung Lee, Hyun Seok Lee, Jae Myung Cha, Hyun Gun Kim, Yunho Jung, Chang Mo Moon, Byung Chang Kim, Jeong-Sik Byeon
Digestive Diseases and Sciences.2017; 62(11): 3138. CrossRef
Is colorectal cancer screening necessary before 50 years of age?
Yoon Suk Jung
Intestinal Research.2017; 15(4): 550. CrossRef
Derivation and validation of a risk scoring model to predict advanced colorectal neoplasm in adults of all ages
Hyo‐Joon Yang, Sungkyoung Choi, Soo‐Kyung Park, Yoon Suk Jung, Kyu Yong Choi, Taesung Park, Ji Yeon Kim, Dong Il Park
Journal of Gastroenterology and Hepatology.2017; 32(7): 1328. CrossRef
Risk factors of missed colorectal lesions after colonoscopy
Jeonghun Lee, Sung Won Park, You Sun Kim, Kyung Jin Lee, Hyun Sung, Pil Hun Song, Won Jae Yoon, Jeong Seop Moon
Medicine.2017; 96(27): e7468. CrossRef

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Do we need colonoscopy verification in patients with fundic gland polyp?: Hee Sook Lee, Younjeong Choi, Ja Young Jung, Young-Jun Sung, Dong Won Ahn, Ji Bong Jeong, Byeong Gwan Kim, Kook Lae Lee, Seong-Joon Koh, Ji Won Kim; Intest Res 2016;14(2):172-177. Published online April 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.2.172

Abstract PDF PubReader ePub

Background/Aims

The aim of this study was to evaluate the prevalence of colorectal neoplasia in subjects with fundic gland polyps (FGPs) and the relationship between FGPs and colorectal neoplasia in Korea.

Methods

We analyzed 128 consecutive patients with FPGs who underwent colonoscopy between January 2009 and December 2013. For each case, age- (±5 years) and sex-matched controls were identified from among patients with hyperplastic polyps, gastric neoplasms, and healthy controls. Clinical characteristics were reviewed from medical records, colonoscopic findings, pathologic findings, and computed tomography images. The outcome was evaluated by comparison of advanced colonic neoplasia detection rates.

Results

Of the 128 patients, seven (5.1%) had colon cancers and seven (5.1%) had advanced adenomas. A case-control study revealed that the odds of detecting a colorectal cancer was 3.8 times greater in patients with FGPs than in the age- and sex-matched healthy controls (odds ratio [OR], 3.80; 95% confidence interval [CI], 1.09–13.24; P =0.04) and 4.1 times greater in patients with FGPs than in healthy controls over 50 years of age (OR, 4.10; 95% CI, 1.16–14.45; P =0.04). Among patients with FGPs over 50 years old, male sex (OR, 4.83; 95% CI, 1.23–18.94; P =0.02), and age (OR, 9.90; 95% CI, 1.21–81.08; P =0.03) were associated with an increased prevalence of advanced colorectal neoplasms.

Conclusions

The yield of colonoscopy in colorectal cancer patients with FGPs was substantially higher than that in average-risk subjects. Colonoscopy verification is warranted in patients with FGPs, especially in those 50 years of age or older.

Citations

Citations to this article as recorded by

Current Guidelines and Advances in the Management of Fundic Gland Polyps
Majed Ali, Lynn Srour, Mustapha Bitar, Karam Karam, Ihab I. El Hajj, Elias Fiani
Journal of Gastroenterology and Hepatology.2025; 40(6): 1374. CrossRef
Cold snare polypectomy for fundic gland polyps
Chi‐Hung Chen, Jen‐Chieh Huang, Jeng‐Shiann Shin
Advances in Digestive Medicine.2022; 9(1): 17. CrossRef
Clinical features of fundic gland polyps and their correlation with colorectal tumors
Xue-Mei Yang, Hong Xu
World Chinese Journal of Digestology.2020; 28(20): 1036. CrossRef
Parietalzellhypertrophie und Drüsenkörperzysten
M. Venerito, A. Canbay, M. Vieth
Der Gastroenterologe.2018; 13(2): 90. CrossRef

8,686 View
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5 Web of Science
4 Crossref

Case Report

Refractory pseudomembranous colitis that was treated successfully with colonoscopic fecal microbial transplantation: Jun Young Shin, Eun Jung Ko, Seung Ho Lee, Jong Bum Shin, Shin Il Kim, Kye Sook Kwon, Hyung Gil Kim, Yong Woon Shin, Byoung Wook Bang; Intest Res 2016;14(1):83-88. Published online January 25, 2016; DOI: https://doi.org/10.5217/ir.2016.14.1.83

Abstract PDF PubReader ePub

Pseudomembranous colitis (PMC) is a nosocomial and opportunistic infection caused by Clostridium difficile. PMC is related to the use of antibiotics leading to intestinal dysbiosis and an overgrowth of C. difficile. Metronidazole or vancomycin is considered to be the standard therapy for the management of PMC. However, PMC has a 15%–30% recurrence rate and can be refractory to standard treatments, resulting in morbidity and mortality. Here we describe a patient who experienced refractory PMC who was treated with fecal microbiota transplantation. A 69-year-old woman was admitted to the hospital with consistent abdominal pain and diarrhea, which had been present for 5 months. She was diagnosed with PMC by colonoscopy and tested positive for C. difficile toxin. Even though she took metronidazole for 10 days, followed by vancomycin for 4 weeks, her symptoms did not improve. Because of her recurrent and refractory symptoms, we decided to perform fecal microbiota transplantation. Fifty grams of fresh feces from a donor were obtained on the day of the procedure, mixed with 500 mL of normal saline, and then filtered. The filtered solution was administered to the patient's colon using a colonoscope. After the procedure, her symptoms rapidly improved and a follow-up colonoscopy showed that the PMC had resolved without recurrence.

Citations

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Fecal microbiota transplantation: present and future
Ra Ri Cha, Irene Sonu
Clinical Endoscopy.2025; 58(3): 352. CrossRef
Fecal Microbiota Transplantation for Fulminant Clostridioides Difficile Infection: A Combined Medical and Surgical Case Series
Ellen J Spartz, Mina Estafanos, Reema Mallick, Wolfganag Gaertner, Victor Vakayil, Cyrus Jahansouz, Rishav Aggarwal, Sayeed Ikramuddin, Alexander Khoruts, James V Harmon
Cureus.2023;[Epub] CrossRef
Efficacy and Safety of Fecal Microbiota Transplantation for Clearance of Multidrug-Resistant Organisms under Multiple Comorbidities: A Prospective Comparative Trial
Jongbeom Shin, Jung-Hwan Lee, Soo-Hyun Park, Boram Cha, Kye Sook Kwon, Hyungkil Kim, Yong Woon Shin
Biomedicines.2022; 10(10): 2404. CrossRef
The evaluation of fecal microbiota transplantation vs vancomycin in a Clostridioides difficile infection model
Qiaomai Xu, Shumeng Zhang, Jiazheng Quan, Zhengjie Wu, Silan Gu, Yunbo Chen, Beiwen Zheng, Longxian Lv, Lanjuan Li
Applied Microbiology and Biotechnology.2022; 106(19-20): 6689. CrossRef
The gut microbiota and gut disease
Sasha R. Fehily, Chamara Basnayake, Emily K. Wright, Michael A. Kamm
Internal Medicine Journal.2021; 51(10): 1594. CrossRef
RecurrentClostridium difficileInfection: Risk Factors, Treatment, and Prevention
Jung Hoon Song, You Sun Kim
Gut and Liver.2019; 13(1): 16. CrossRef
Clostridium difficile in Asia: Opportunities for One Health Management
Deirdre A. Collins, Thomas V. Riley
Tropical Medicine and Infectious Disease.2018; 4(1): 7. CrossRef
Current challenges in the treatment of severe Clostridium difficile infection: early treatment potential of fecal microbiota transplantation
Yvette H. van Beurden, Max Nieuwdorp, Pablo J. E. J. van de Berg, Chris J. J. Mulder, Abraham Goorhuis
Therapeutic Advances in Gastroenterology.2017; 10(4): 373. CrossRef
Fecal microbiota transplant in severe and severe-complicatedClostridium difficile: A promising treatment approach
Monika Fischer, Brian Sipe, Yao-Wen Cheng, Emmalee Phelps, Nicholas Rogers, Sashidhar Sagi, Matthew Bohm, Huiping Xu, Zain Kassam
Gut Microbes.2017; 8(3): 289. CrossRef
Fecal Microbiota Transplantation for Refractory and RecurrentClostridium difficileInfection: A Case Series of Nine Patients
Byoung Wook Bang, Jin-Seok Park, Hyung Kil Kim, Yong Woon Shin, Kye Sook Kwon, Hea Yoon Kwon, Ji Hyeon Baek, Jin-Soo Lee
The Korean Journal of Gastroenterology.2017; 69(4): 226. CrossRef

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Original Articles

Colon Transit Time May Predict Inadequate Bowel Preparation in Patients With Chronic Constipation: Hong Jun Park, Myeong Hun Chae, Hyun-Soo Kim, Jae Woo Kim, Moon Young Kim, Soon Koo Baik, Sang Ok Kwon, Hee Man Kim, Kyong Joo Lee; Intest Res 2015;13(4):339-345. Published online October 15, 2015; DOI: https://doi.org/10.5217/ir.2015.13.4.339

Abstract PDF PubReader ePub

Background/Aims

We evaluated whether colonic transit time (CTT) can predict the degree of bowel preparation in patients with chronic constipation undergoing scheduled colonoscopy in order to assist in the development of better bowel preparation strategies for these patients.

Methods

We analyzed the records of 160 patients with chronic constipation from March 2007 to November 2012. We enrolled patients who had undergone a CTT test followed by colonoscopy. We defined patients with a CTT ≥30 hours as the slow transit time (STT) group, and patients with a CTT <30 hours as the normal transit time (NTT) group. Boston Bowel Preparation Scale (BBPS) scores were compared between the STT and NTT groups.

Results

Of 160 patients with chronic constipation, 82 (51%) were included in the STT group and 78 (49%) were included in the NTT group. Patients with a BBPS score of <6 were more prevalent in the STT group than in the NTT group (31.7% vs. 10.3%, P=0.001). Multivariate analysis showed that slow CTT was an independent predictor of inadequate bowel preparation (odds ratio, 0.261; 95% confidence interval, 0.107-0.634; P=0.003). The best CTT cut-off value for predicting inadequate bowel preparation in patients with chronic constipation was 37 hours, as determined by receiver operator characteristic (ROC) curve analysis (area under the ROC curve: 0.676, specificity: 0.735, sensitivity: 0.643).

Conclusions

Patients with chronic constipation and a CTT >30 hours were at risk for inadequate bowel preparation. CTT measured prior to colonoscopy could be useful for developing individualized strategies for bowel preparation in patients with slow CTT, as these patients are likely to have inadequate bowel preparation.

Citations

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Seoul Consensus on Clinical Practice Guidelines for Functional Constipation
Kyung Ho Song, Young Sin Cho, Jeong Eun Shin, Hye-Kyung Jung, Seon-Young Park, Seung Joo Kang, Jung-Wook Kim, Yoo Jin Lee, Hyun Chul Lim, Hee Sun Park, Seong-Jung Kim, Ra Ri Cha, Ki Bae Bang, Chang Seok Bang, Sung Kyun Yim, Seung-Bum Ryoo, Bong Hyeon Kye,
The Korean Journal of Gastroenterology.2025; 85(3): 319. CrossRef
Advanced intestinal regulation improves bowel preparation quality in patients with constipation: A systematic review and network meta-analysis
Liang Ding, JinNan Duan, Tao Yang, ChaoQiong Jin, Jun Luo, Ahuo Ma
Frontiers in Pharmacology.2023;[Epub] CrossRef
Factors affecting cecal intubation time during colonoscopy
Ke Wang, Wen-Tao Xu, Wen-Jing Kou, Xing-Shun Qi
World Chinese Journal of Digestology.2023; 31(3): 105. CrossRef
Factors affecting the quality of bowel preparation for colonoscopy in hard-to-prepare patients: Evidence from the literature
Endrit Shahini, Emanuele Sinagra, Alessandro Vitello, Rocco Ranaldo, Antonella Contaldo, Antonio Facciorusso, Marcello Maida
World Journal of Gastroenterology.2023; 29(11): 1685. CrossRef
The effect of kiwi berry (Actinidia arguta) on preventing and alleviating loperamide-induced constipation
Jiyue Zhang, Dongnan Li, Qilin Tian, Yumeng Ding, Hanqian Jiang, Guang Xin, Shunchang Cheng, Siyi Tang, Chenyu Jin, Jinlong Tian, Bin Li
Food Innovation and Advances.2023; 2(1): 1. CrossRef
A Systematic Review of Exercise Therapy for Bowel Preparation
Yuan-Yuan Zhang, Ramoo Vimala, Ping Lei Chui, Ida Normiha Hilmi
Gastroenterology Nursing.2023; 46(5): 393. CrossRef
2022 Seoul Consensus on Clinical Practice Guidelines for Functional Constipation
Young Sin Cho, Yoo Jin Lee, Jeong Eun Shin, Hye-Kyung Jung, Seon-Young Park, Seung Joo Kang, Kyung Ho Song, Jung-Wook Kim, Hyun Chul Lim, Hee Sun Park, Seong-Jung Kim, Ra Ri Cha, Ki Bae Bang, Chang Seok Bang, Sung Kyun Yim, Seung-Bum Ryoo, Bong Hyeon Kye,
Journal of Neurogastroenterology and Motility.2023; 29(3): 271. CrossRef
Taking a Long and Hard Look at Quality Predictors of Bowel Preparation for Colonoscopy
Yunho Jung
Digestive Diseases and Sciences.2023; 68(11): 4069. CrossRef
Factors Influencing the Quality of Intestinal Preparation before Colonoscopy in Special Population
瑶童
Advances in Clinical Medicine.2023; 13(11): 17129. CrossRef
Rectal Evacuation Disorders are Associated With Poor Bowel Preparation in Patients With Chronic Constipation
Mythili P. Pathipati, Casey J. Silvernale, Kenneth G. Barshop, Jasmine B. Ha, James M. Richter, Kyle D. Staller
Journal of Clinical Gastroenterology.2022; 56(5): 438. CrossRef
Combination of bisacodyl suppository and 1 L polyethylene glycol plus ascorbic acid is a non‐inferior and comfortable regimen compared to 2 L polyethylene glycol plus ascorbic acid
Sun Hwa Kim, Eun Ran Kim, Kyunga Kim, Tae Jun Kim, Sung Noh Hong, Dong Kyung Chang, Young‐Ho Kim
Digestive Endoscopy.2020; 32(4): 600. CrossRef
Modelling characteristics of inadequate bowel preparations for colonoscopy
Scott L. Cornella, Brian J. Wentworth, Charles Orton, Bethany J. Horton, Steven M. Powell
GastroHep.2020; 2(2): 72. CrossRef
Usefulness of Personal Bowel Habits as a Predictive Factor for Inadequate Bowel Preparation for Colonoscopy: A Prospective Questionnaire-Based Observational Study
Namyoung Paik, Eun Ran Kim, Tae Jun Kim, Sung Noh Hong, Dong Kyung Chang, Young-Ho Kim
Gut and Liver.2019; 13(2): 169. CrossRef
Prediction of Inadequate Bowel Preparation Using Total and Segmental Colon Transit Time in Patients with Chronic Constipation: Some Different Outcomes
Chunying Zhai, Qiyang Huang, Ningli Chai, Wengang Zhang, Enqiang Linghu
Gastroenterology Research and Practice.2019; 2019: 1. CrossRef
Gut microbiota alterations from different Lactobacillus probiotic-fermented yoghurt treatments in slow-transit constipation
Chen-Jian Liu, Xiao-Dan Tang, Jie Yu, Hai-Yan Zhang, Xiao-Ran Li
Journal of Functional Foods.2017; 38: 110. CrossRef
The management of ‘hard-to-prepare’ colonoscopy patients
Daniele Mandolesi, Leonardo Frazzoni, Franco Bazzoli, Lorenzo Fuccio
Expert Review of Gastroenterology & Hepatology.2017; 11(8): 731. CrossRef
Bowel preparation for colonoscopy
Theodor Voiosu, Andrei Voiosu, Radu Voiosu
Current Opinion in Gastroenterology.2016; 32(5): 385. CrossRef

11,529 View
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17 Crossref

Is Retroflexion Helpful in Detecting Adenomas in the Right Colon?: A Single Center Interim Analysis: Hyun Seok Lee, Seong Woo Jeon; Intest Res 2015;13(4):326-331. Published online October 15, 2015; DOI: https://doi.org/10.5217/ir.2015.13.4.326

Abstract PDF PubReader ePub

Background/Aims

Colonoscopy is less effective at screening for colorectal cancer in the right side of the colon. Retroflexion during colonoscopy is expected to improve the detection rate of colorectal adenomas. The aim of the present study was to evaluate the usefulness of retroflexion in the right-sided colon.

Methods

From April to November 2013, a total of 398 patients were enrolled in this study. For each patient, a cap-assisted colonoscopic examination was performed. After cecal intubation, a forward view examination from the cecum up to the hepatic flexure was performed and all identified polyps were removed. The colonoscope was reinserted to the cecum, and a careful second forward view examination of the cecum to the hepatic flexure was performed, with removal of additionally identified polyps. The colonoscope was then reinserted to the cecum and retroflexed; a third colonoscopic examination was then performed to the hepatic flexure in retroflexion with removal of additional polyps. Total polyp numbers and characteristics were compared between the two forward view examinations and the retroflexion examination.

Results

A successful retroflexion was performed in 90.2% of patients. A total of 213 polyps and 143 adenomas were detected in the right-sided colon using the routine method of examining the right colon twice in forward view. An additional 35 polyps and 24 adenomas were detected on retroflexion. Of these 35 polyps, 27 (77.1%) were small-sized polyps (≤5 mm) and 24 (71.4%) were adenomas. Finding additional adenomas using the retroflexion technique was associated with older age.

Conclusions

Colonoscopic retroflexion is helpful in the detection of cecum and ascending colon adenomas, especially small-sized adenomas (≤5 mm). It is particularly useful in older patients.

Citations

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Colonic Chicken Skin Mucosa is an Independent Endoscopic Predictor of Advanced Colorectal Adenoma: Eun Ju Chung, Ji Young Lee, Jaewon Choe, Hye-Sook Chang, Jongcheol Kim, Dong Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Kyung-Jo Kim, Suk-Kyun Yang, Jin-Ho Kim, Seung-Jae Myung; Intest Res 2015;13(4):318-325. Published online October 15, 2015; DOI: https://doi.org/10.5217/ir.2015.13.4.318

Abstract PDF PubReader ePub

Background/Aims

Chicken skin mucosa (CSM), surrounding colorectal adenoma, is an endoscopic finding with pale yellow-speckled mucosa; however, its clinical significance is unknown. This study aimed to evaluate the prevalence and clinical characteristics of CSM, and the association between colorectal carcinogenesis and CSM.

Methods

This cross-sectional study was performed in 733 consecutive patients who underwent endoscopic polypectomy for colorectal adenoma after the screening of colonoscopy at the Asan Health Promotion Center between June 2009 and December 2011. The colonoscopic and pathological findings of colorectal adenoma including number, size, location, dysplasia, morphology, and clinical parameters were reviewed.

Results

The prevalence of CSM was 30.7% (225 of 733 patients), and most CSM-related adenomas were located in the distal colon (93.3%). Histological analysis revealed lipid-laden macrophages in the lamina propria of the mucosa. Multivariate analyses showed that CSM was significantly associated with advanced pathology, including villous adenoma and high-grade dysplasia (odds ratio [OR], 2.078; 95% confidence interval [CI], 1.191-3.627; P=0.010), multiple adenomas (i.e., ≥2 adenomas; OR, 1.692; 95% CI, 1.143-2.507; P=0.009), and a protruding morphology (OR, 1.493; 95% CI, 1.027-2.170; P=0.036). There were no significant differences in polyp size or clinical parameters between patients with and without CSM.

Conclusions

CSM-related adenoma was mainly found in the distal colon, and was associated with advanced pathology and multiple adenomas. CSM could be a potential predictive marker of the carcinogenetic progression of distally located colorectal adenomas.

Citations

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Risk Factors for Delayed Post-Polypectomy Bleeding: Min Jung Kwon, You Sun Kim, Song I Bae, Young Il Park, Kyung Jin Lee, Jung Hwa Min, Soo Yeon Jo, Mi Young Kim, Hye Jin Jung, Seong Yeon Jeong, Won Jae Yoon, Jin Nam Kim, Jeong Seop Moon; Intest Res 2015;13(2):160-165. Published online April 27, 2015; DOI: https://doi.org/10.5217/ir.2015.13.2.160

Abstract PDF PubReader

Background/Aims

Among the many complications that can occur following therapeutic endoscopy, bleeding is the most serious, which occurs in 1.0-6.1% of all colonoscopic polypectomies. The aim of this study was to identify risk factors of delayed post-polypectomy bleeding (PPB).

Methods

We retrospectively reviewed the data of patients who underwent colonoscopic polypectomy between January 2003 and December 2012. We compared patients who experienced delayed PPB with those who did not. The control-to-patient ratio was 3:1. The clinical data analyzed included polyp size, number, location, and shape, patient' body mass index (BMI), preventive hemostasis, and endoscopist experience.

Results

Of 1,745 patients undergoing colonoscopic polypectomy, 21 (1.2%) experienced significant delayed PPB. We selected 63 age- and sex-matched controls. Multivariate logistic regression analysis showed that polyps >10 mm (odds ratio [OR], 2.605; 95% confidence interval [CI], 1.035-4.528; P=0.049), a pedunculated polyp (OR, 3.517; 95% CI, 1.428-7.176; P=0.045), a polyp located in the right hemicolon (OR, 3.10; 95% CI, 1.291-5.761; P=0.013), and a high BMI (OR, 3.681; 95% CI, 1.876-8.613; P=0.013) were significantly associated with delayed PPB.

Conclusions

Although delayed PPB is a rare event, more caution is needed during colonoscopic polypectomies performed in patients with high BMI or large polyps, pedunculated polyps, or polyps located in the right hemicolon.

Citations

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Patient Descriptions of Rectal Effluents May Help to Predict the Quality of Bowel Preparation With Photographic Examples: Hoonsub So, Sun-Jin Boo, Hyungil Seo, Ho-Su Lee, Hyojeong Lee, Sang Hyoung Park, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim, Seungbong Han, Dong-Hoon Yang; Intest Res 2015;13(2):153-159. Published online April 27, 2015; DOI: https://doi.org/10.5217/ir.2015.13.2.153

Abstract PDF PubReader

Background/Aims

Previous studies have suggested a weak correlation between self-reported rectal effluent status and bowel preparation quality. We aim to evaluate whether photographic examples of rectal effluents could improve the correlation between patient descriptions of rectal effluents and bowel preparation quality.

Methods

Before colonoscopy, patients were asked to describe the nature of their last three rectal effluents. Photographic examples of rectal effluents were provided as a reference for scoring. Bowel preparation was subsequently assessed by a single endoscopist using a global preparation assessment scale. Preparation outcomes were grouped into two levels (excellent to good vs. fair to inadequate). Both univariate and multivariate logistic regression models were used to find any association between bowel preparation quality and patient characteristics.

Results

A total of 138 patients completed the questionnaires. The mean age was 56.5±10.4 years. The mean sum of the last three rectal effluent scores was 5.9±2.0. Higher rectal effluent scores (odds ratio [OR], 0.82; P=0.043) and the presence of diverticula (OR, 0.16; P<0.001) were risk factors for suboptimal preparation.

Conclusions

Photographic example-guided patient descriptions of rectal effluents showed a statistically significant association with bowel preparation quality. However, clinical significance seemed to be low. The presence of diverticula was an independent predictive factor for suboptimal bowel preparation quality.

Citations

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Manuel Antonio Lescano Lescano, Rodrigo Strehl Machado, Maria Rachel Rohr, Sender Jankiel Miszputen
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A Randomized Controlled Trial Comparing Colonoscopic Enema With Additional Oral Preparation as a Salvage for Inadequate Bowel Cleansing Before Colonoscopy
Hyo-Joon Yang, Dong Il Park, Soo-Kyung Park, Sunyong Kim, Taeheon Lee, Yunho Jung, Chang Soo Eun, Dong Soo Han
Journal of Clinical Gastroenterology.2019; 53(8): e308. CrossRef
Comparison of Bowel Cleansing Efficacy, Safety, Bowel Movement Kinetics, and Patient Tolerability of Same-Day and Split-Dose Bowel Preparation Using 4 L of Polyethylene Glycol: A Prospective Randomized Study
Myeongsook Seo, Tae-Geun Gweon, Cheal Wung Huh, Jeong Seon Ji, Hwang Choi
Diseases of the Colon & Rectum.2019; 62(12): 1518. CrossRef
Randomized trial comparing oral sulfate solution with 4‐L polyethylene glycol administered in a split dose as preparation for colonoscopy
Hyo‐Joon Yang, Soo‐Kyung Park, Jee Hyun Kim, Jong Pil Im, Dong Han Yeom, Geom Seog Seo, Dong Il Park
Journal of Gastroenterology and Hepatology.2017; 32(1): 12. CrossRef
Patient Description of Rectal Effluents With Photographic Examples as a Predictive Indicator for the Quality of Bowel Preparation
Hyoun Woo Kang
Intestinal Research.2015; 13(4): 362. CrossRef
Author's Reply
Hoonsub So, Seungbong Han, Dong-Hoon Yang
Intestinal Research.2015; 13(4): 364. CrossRef

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Case Report

Anaphylactic Shock Caused by Ingestion of Polyethylene Glycol: Sun Hee Lee, Jae Myung Cha, Joung Il Lee, Kwang Ro Joo, Hyun Phil Shin, Il Hyun Baek, Jung Won Jeon, Jun Uk Lim, Jung Lok Lee, Hyae Min Lee, Young-Hak Cho; Intest Res 2015;13(1):90-94. Published online January 29, 2015; DOI: https://doi.org/10.5217/ir.2015.13.1.90

Abstract PDF PubReader

Colonoscopy is the current standard method for evaluation of the colon. The diagnostic accuracy and therapeutic safety of colonoscopy depend on the quality of colonic cleansing and preparation. Generally, all these preparations have been demonstrated to be safe for use in healthy individuals without significant comorbid conditions. Based on safety and efficacy concerns, polyethylene glycol (PEG) is most commonly utilized as a bowel preparation solution for colonoscopy. Adverse events in patients receiving PEG are mostly clinically non-significant. However, fatal adverse events rarely have been shown to occur in the few individuals who experience vomiting or aspiration. Anaphylactic shock associated with ingestion of PEG electrolyte solution is an extremely rare fatal complication, and reported mainly in Western countries. Here, we report the first case of anaphylactic shock following the ingestion of PEG solution in Korea.

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Reviews

Would You Recommend Screening Colonoscopy for the Very Elderly?: Jae Myung Cha; Intest Res 2014;12(4):275-280. Published online October 27, 2014; DOI: https://doi.org/10.5217/ir.2014.12.4.275

Abstract PDF PubReader ePub

Life expectancy in Korea has increased, and the number of screening colonoscopies in the elderly has also dramatically increased. The net benefit of colonoscopy in the very elderly (≥80 years of age as defined by the World Health Organization) may be reduced because of the competing risk of mortality due to other diseases. Therefore, the decision to perform screening colonoscopy may be more complex in this age group. As the potential increase in life expectancy due to screening colonoscopy is significantly reduced in the very elderly, this procedure should be limited to those among the very elderly who have substantial life expectancies. Furthermore, considering the common major complications associated with colonoscopy, poor bowel preparation, and the possibility of incomplete colonoscopies in the very elderly, the performance of screening colonoscopy in the very elderly may not be an ideal recommendation. In terms of providing the greatest benefit to the most number of people, patients with the highest potential gain in terms of life expectancy, relative to the diagnostic yield, should be targeted for colonoscopy screening. This review addresses the unique considerations regarding screening colonoscopy in the very elderly and the individualized approach, which involves the weighing of the risks and benefits for each individual with consideration of their overall health status.

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Safety and Efficacy of Low-Volume Preparation in the Elderly: Oral Sulfate Solution on the Day before and Split-Dose Regimens (SEE SAFE) Study
Min Seob Kwak, Jae Myung Cha, Hyo-Joon Yang, Dong Il Park, Kyeong Ok Kim, Jun Lee, Jeong Eun Shin, Young-Eun Joo, Jongha Park, Jeong-Sik Byeon, Hyun Gun Kim
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Impact of Sigmoidoscopy and Colonoscopy on Colorectal Cancer Incidence and Mortality: An Evidence-Based Review of Published Prospective and Retrospective Studies: Otto S. Lin, Richard A. Kozarek, Jae Myung Cha; Intest Res 2014;12(4):268-274. Published online October 27, 2014; DOI: https://doi.org/10.5217/ir.2014.12.4.268

Abstract PDF PubReader ePub

Screening for colorectal cancer (CRC) using sigmoidoscopy or colonoscopy is now common in many developed countries. This concise, evidence-based review looks at the impact of sigmoidoscopy or colonoscopy screening on CRC incidence, CRC mortality and overall mortality. Data from controlled retrospective and prospective (observational or randomized) studies have generally shown that sigmoidoscopy and colonoscopy, whether for diagnostic, screening or surveillance purposes, are associated with a significant reduction in CRC incidence and CRC mortality. The data on their impact on overall mortality is much more limited, with most studies unable to report a reduction in overall mortality. The results of three meta-analyses have confirmed these conclusions. As expected, sigmoidoscopy has a predominant effect on left-sided CRC, although some studies have shown modest effects on right-sided colon cancer as well. Most studies on colonoscopy have demonstrated that the protective effect applies to both right and left-sided cancer, although the protection seemed better on the left side. Despite the introduction of other screening and diagnostic modalities for the colon, such as computed tomography colonography and colonic capsule endoscopy, lower endoscopy will continue to be an important mode of screening for CRC and evaluating the colon.

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Risk Factors Such as Male Sex, Smoking, Metabolic Syndrome, Obesity, and Fatty Liver Do Not Justify Screening Colonoscopies Before Age 45
Yoon Suk Jung, Kyung Eun Yun, Yoosoo Chang, Seungho Ryu, Dong Il Park
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Original Article

Is Colonoscopy Necessary after Computed Tomography Diagnosis of Acute Diverticulitis?: Min Jung Kim, Young Sik Woo, Eun Ran Kim, Sung Noh Hong, Dong Kyung Chang, Poong-Lyul Rhee, Jae J. Kim, Soon Jin Lee, Young-Ho Kim; Intest Res 2014;12(3):221-228. Published online July 25, 2014; DOI: https://doi.org/10.5217/ir.2014.12.3.221

Abstract PDF PubReader ePub

Background/Aims

A diagnosis of acute diverticulitis is based on computed tomography (CT). Colonoscopy is commonly performed after the acute event to exclude other diagnoses. This study aimed to determine whether colonoscopy is necessary and what additional information is gained from a colonoscopy after acute diverticulitis.

Methods

Acute diverticulitis was diagnosed by clinical criteria and characteristic CT findings. We analyzed the number of patients in whom colorectal cancers were diagnosed and other incidental findings of polyps and other diseases.

Results

A total of 177 patients were analyzed retrospectively. The mean age was 43.3±15.3 years (range, 13-82 years) and 97 patients (54.8%) were male. Sixty-one patients had undergone a colonoscopy within 1 year of the acute attack. Advanced adenomatous lesions and colonic malignancy were not detected. Nineteen patients (31.1%) had ≥1 polyp and 11 patients (18.0%) had an adenomatous polyp. No new or different diagnosis was made after colonoscopy. None of the 116 patients who did not undergo colonoscopy within a year after acute diverticulitis had a diagnosis of colorectal cancer registered with the Korea Central Cancer Registry.

Conclusions

Routine colonoscopy yields little benefit in patients with acute diverticulitis diagnosed by typical clinical symptoms and CT. The current practice of a colonoscopy after acute diverticulitis needs to be reevaluated.

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Review

Colonoscopy Quality is the Answer for the Emerging Issue of Interval Cancer: Jae Myung Cha; Intest Res 2014;12(2):110-116. Published online April 29, 2014; DOI: https://doi.org/10.5217/ir.2014.12.2.110

Abstract PDF PubReader

Colonoscopy is currently regarded as the gold standard and preferred screening method for colorectal cancer (CRC). Recently, however, a limitation of colonoscopy in the prevention of CRCs has been identified, particularly in the right-sided colon, and the problem of so-called interval cancers has emerged. The prevalence of interval cancer is estimated to be between 4% and 8% of CRCs detected. Although the exact etiology of interval cancer remains unknown, factors implicated in the development of interval cancers include missed lesions at the time of colonoscopy, incomplete resection of previous neoplastic lesions, different tumor biology, and serrated pathway of carcinogenesis. However, recent evidence suggests that interval cancers are related to the training of the endoscopist and quality of the colonoscopy rather than tumor biology. Therefore, the importance of adequate training and continuous monitoring of the colonoscopy quality, which are amenable to improvement, cannot be overstated in order to prevent the risk of interval cancers. In this study, the current literature regarding the prevalence and potential factors related to interval cancers and colonoscopy quality-related issues are reviewed.

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Original Articles

The Effect of Indigocarmine on Improvement of the Polyp Detection Rate during Colonoscopic Examination with Hood Cap: Sang Chang Kwon, Sung Won Choi, Seong Ho Choi, Hee Seung Park, Seung Heon Lee, Bong Gun Kim, Eun Hee Seo, Mun Jang, Seung Min Ryu, Dong Hyun Kim, Young Hoon Kim, Jun Ouk Ha, Jae Seung Lee; Intest Res 2014;12(1):60-65. Published online January 28, 2014; DOI: https://doi.org/10.5217/ir.2014.12.1.60

Abstract PDF PubReader

Background/Aims

Hood cap-assisted chromocolonoscopy using indigocarmine is expected to improve the detection rate of colorectal polyps, especially adenomatous polyps. Therefore, aim of the present study was to evaluate the usefulness of hood cap-assisted chromocolonoscopy in routine colonoscopic examinations.

Methods

From January, 2013 through March, 2013, a total of 86 patients were enrolled (M:F=33:53, mean age=60 years). For each patient, hood cap-assisted colonoscopic examination was performed, followed by hood cap-assisted chromocolonoscopy using 0.2% indigocarmine from the cecum to the hepatic flexure. Total numbers and characteristics of polyps were compared before and after indigo carmine dye spraying.

Results

Prior to dye spraying, 48 polyps were found in 37 patients, and after dye spraying, 53 additional polyps were found in 34 patients. Of these undetected polyps, 45 (85%) were small sized polyps (≤0.5 cm). Histologically, 19 (36%) were adenomatous polyps, and of these, 15 (28%) were tubular adenomas and 4 (8%) were serrated adenomas. As for the polyp detection rate, there was no difference between the expert and the non-expert groups.

Conclusion

Hood cap-assisted chromocolonoscopic examination using indigocarmine was helpful in detecting cecum and ascending colon polyps, especially small sized polyps (<0.5 cm) and neoplastic polyps.

Citations

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Tae-Geun Gweon, Sung Hoon Jung, Sang Woo Kim, Kang-Moon Lee, Dae Young Cheung, Bo-In Lee, Hwang Choi
BMC Gastroenterology.2019;[Epub] CrossRef
A prospective randomized comparative study of cold forceps polypectomy by using narrow-band imaging endoscopy versus cold snare polypectomy in patients with diminutive colorectal polyps
Soo-kyung Park, Bong Min Ko, Jae Pil Han, Su Jin Hong, Moon Sung Lee
Gastrointestinal Endoscopy.2016; 83(3): 527. CrossRef
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Hyun Seok Lee, Seong Woo Jeon
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Comparison of the Efficacy and Tolerability between Same-day Picosulfate and Split-dose Polyethylene Glycol Bowel Preparation for Afternoon Colonoscopy: A Prospective, Randomized, Investigator-blinded Trial: Mi Seon Kang, Tae Oh Kim, Eun Hee Seo, Da Kyung Jung, Mo Se Kim, Nae Yun Heo, Jong Ha Park, Seung Ha Park, Young Soo Moon; Intest Res 2014;12(1):53-59. Published online January 28, 2014; DOI: https://doi.org/10.5217/ir.2014.12.1.53

Abstract PDF PubReader

Background/Aims

In the present study, we evaluated the efficacy and tolerability between same-day bowel preparation protocols using 2 sachets of Picosulfate and a 4 L split-dose polyethylene glycol (PEG) bowel preparation for afternoon colonoscopy.

Methods

The study had a single-center, prospective, randomized, and investigator-blinded, non-inferiority design. We evaluated bowel preparation quality according to the Ottawa scale, patient tolerability, compliance, incidence of adverse events, sleep quality, and polyp/adenoma detection rate.

Results

Among the 196 patients analyzed (mean age, 55.3 years; 50.3% men), 97 received the same-day regimen of 2 sachets of picosulfate (group A) and 99 received the 4 L split-dose PEG regimen (group B). The Ottawa score of the total colon was 4.05±1.56 in group A and 3.80±1.55 in group B (P=0.255). The proportion of patients having adequate bowel preparation in the same-day picosulfate group (61.5%) was slightly less than the 4 L PEG group (71.3%); however, the difference was not statistically significant (P=0.133). Tolerability of the group A regimen was superior to that of the group B regimen (P<0.000). The same-day picosulfate regimen was associated with fewer adverse events, such as abdominal bloating (P=0.037) and better sleep quality (P<0.000).

Conclusions

The same-day picosulfate regimen and the 4 L split-dose PEG regimen had similar efficacy in bowel preparation for afternoon colonoscopy. However, the same-day picosulfate regimen was easier to administer, produced fewer adverse events, and enabled better sleep quality.

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Association of Gallbladder Polyp with the Risk of Colorectal Adenoma: Jung Won Jeun, Jae Myung Cha, Joung Il Lee, Kwang Ro Joo, Hyun Phil Shin, Jun Uk Lim; Intest Res 2014;12(1):48-52. Published online January 28, 2014; DOI: https://doi.org/10.5217/ir.2014.12.1.48

Abstract PDF PubReader

Background/Aims

Gallbladder polyps and colorectal adenomas share many common risk factors; however, their association has never been studied. The aim of this study was to investigate this association in asymptomatic healthy subjects.

Methods

Consecutive asymptomatic subjects who underwent both screening colonoscopy and abdominal ultrasonography at Kyung Hee University Hospital in Gang Dong between July 2010 and April 2011 were prospectively enrolled. The prevalence of colorectal adenoma was compared between subjects with or without gallbladder polyps. Furthermore, a logistic regression analysis was performed to determine the independent risk factors for colorectal adenoma in these subjects.

Results

Of the 581 participants, 55 presented with gallbladder polyps and 526 did not have gallbladder polyps. Participants with gallbladder polyps showed a trend toward a higher prevalence of colorectal adenoma than those without gallbladder polyps (52.7% vs. 39.2%, P=0.051). Although the result was not statistically significant, gallbladder polyps were found to be a possible risk factor for colorectal adenoma (odds ratio=1.796, 95% confidence interval=0.986-3.269, P=0.055), even after adjusting for potential confounding factors. There was no difference observed in colorectal adenoma characteristics between the two groups.

Conclusions

Our results suggest a possible association between gallbladder polyps and colorectal adenomas. Future studies with larger cohorts are warranted to further investigate this matter.

Citations

Citations to this article as recorded by

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