Intestinal Research最新文献

{"title":"To overcome medical gap in screening and surveillance of colorectal cancer during the COVID-19 pandemic.","authors":"Yoo Min Han","doi":"10.5217/ir.2023.00144","DOIUrl":"10.5217/ir.2023.00144","url":null,"abstract":",","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71423575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The elderly population are more vulnerable for the management of colorectal cancer during the COVID-19 pandemic: a nationwide, population-based study.","authors":"Hong Sun Kang,&nbsp;Seung Hoon Jeon,&nbsp;Su Bee Park,&nbsp;Jin Young Youn,&nbsp;Min Seob Kwak,&nbsp;Jae Myung Cha","doi":"10.5217/ir.2023.00004","DOIUrl":"10.5217/ir.2023.00004","url":null,"abstract":"<p><strong>Background/aims: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10111664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of primary sclerosing cholangitis combined with inflammatory bowel disease.","authors":"You Sun Kim, Edward H Hurley, Yoojeong Park, Sungjin Ko","doi":"10.5217/ir.2023.00039","DOIUrl":"10.5217/ir.2023.00039","url":null,"abstract":"<p><p>Primary sclerosing cholangitis (PSC) is a progressive cholestatic, inflammatory, and fibrotic disease that is strongly associated with inflammatory bowel disease (IBD). PSC-IBD represents a unique disease entity and patients with this disease have an increased risk of malignancy development, such as colorectal cancer and cholangiocarcinoma. The pathogenesis of PSC-IBD involves genetic and environmental factors such as gut dysbiosis and bile acids alteration. However, despite the advancement of disease characteristics, no effective medical therapy has proven to have a significant impact on the prognosis of PSC. The treatment options for patients with PSC-IBD do not differ from those for patients with PSC alone. Potential candidate drugs have been developed based on the pathogenesis of PSC-IBD, such as those that target modulation of bile acids, inflammation, fibrosis, and gut dysbiosis. In this review, we summarize the current medical treatments for PSC-IBD and the status of new emerging therapeutic agents.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9900547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How the COVID-19 pandemic affected the severity and clinical presentation of diverticulitis.","authors":"Sara S Soliman,&nbsp;Rolando H Rolandelli,&nbsp;Grace C Chang,&nbsp;Amanda K Nemecz,&nbsp;Zoltan H Nemeth","doi":"10.5217/ir.2022.00042","DOIUrl":"10.5217/ir.2022.00042","url":null,"abstract":"<p><strong>Background/aims: </strong>Single-institution studies showed that patients presented with more severe diverticulitis and underwent more emergency operations during the coronavirus disease 2019 (COVID-19) pandemic. Therefore, we studied this trend using nationwide data from the American College of Surgeons National Surgical Quality Improvement Program database.</p><p><strong>Methods: </strong>Patients (n = 23,383) who underwent a colectomy for diverticulitis in 2018 (control year) and 2020 (pandemic year) were selected. We compared these groups for differences in disease severity, comorbidities, perioperative factors, and complications.</p><p><strong>Results: </strong>During the pandemic, colonic operations for diverticulitis decreased by 13.14%, but the rates of emergency operations (17.31% vs. 20.04%, P< 0.001) and cases with a known abscess/perforation (50.11% vs. 54.55%, P< 0.001) increased. Likewise, the prevalence of comorbidities, such as congestive heart failure, acute renal failure, systemic inflammatory response syndrome, and septic shock, were higher during the pandemic (P< 0.05). During this same period, significantly more patients were classified under American Society of Anesthesiologists classes 3, 4, and 5, suggesting their preoperative health states were more severe and life-threatening. Correspondingly, the average operation time was longer (P< 0.001) and complications, such as organ space surgical site infection, wound disruption, pneumonia, acute renal failure, septic shock, and myocardial infarction, increased (P< 0.05) during the pandemic.</p><p><strong>Conclusions: </strong>During the pandemic, surgical volume decreased, but the clinical presentation of diverticulitis became more severe. Due to resource reallocation and possibly patient fear of seeking medical attention, diverticulitis was likely underdiagnosed, and cases that would have been elective became emergent. This underscores the importance of monitoring patients at risk for diverticulitis and intervening when criteria for surgery are met.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71423563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malnutrition and inflammation status in nonobese patients with inflammatory bowel disease are associated with nonalcoholic fatty liver disease: a retrospective study.","authors":"Takahiro Nagata,&nbsp;Sadahiro Funakoshi,&nbsp;Daisuke Morihara,&nbsp;Satoshi Shakado,&nbsp;Keiji Yokoyama,&nbsp;Kazuhide Takata,&nbsp;Takashi Tanaka,&nbsp;Atsushi Fukunaga,&nbsp;Ryo Yamauchi,&nbsp;Hiromi Fukuda,&nbsp;Hiroki Matsuoka,&nbsp;So Imakiire,&nbsp;Hideto Sakisaka,&nbsp;Satoshi Matsuoka,&nbsp;Nobuaki Kuno,&nbsp;Koichi Abe,&nbsp;Hideki Ishibashi,&nbsp;Shinya Ashizuka,&nbsp;Fumihito Hirai","doi":"10.5217/ir.2023.00035","DOIUrl":"10.5217/ir.2023.00035","url":null,"abstract":"<p><strong>Background/aims: </strong>The frequency and details of nonalcoholic fatty liver disease (NAFLD) complications in patients with inflammatory bowel disease (IBD) remain unclear. This study aimed to clarify characteristics of NAFLD in patients with IBD.</p><p><strong>Methods: </strong>We retrospectively identified and enrolled patients with IBD diagnosed with or without NAFLD by undergoing abdominal computed tomography (CT) at our institution between 2005 and 2020. The primary endpoint was the complication rate of NAFLD in patients with IBD. Secondary endpoints were the clinical characteristics of nonobese patients with IBD and comorbid NAFLD and their association with nutritional and inflammatory parameters.</p><p><strong>Results: </strong>Twenty-one (21.9%) of 96 eligible patients with IBD also had NAFLD. In nonobese patients (defined as patients with a body mass index <25 kg/m2), C-reactive protein (CRP; P<0.001) and alanine aminotransferase (P=0.018) levels were higher and the albumin level (P=0.005) and prognostic nutritional index (PNI; P=0.002) values were lower in patients with NAFLD than in those without NAFLD. The PNI value was positively correlated (P<0.001) and the CRP level was negatively correlated (P=0.001) with the hepatosplenic ratio. However, in the NAFLD combined group, PNI (P<0.05) and CRP values (P<0.001) were improved over time after CT imaging by continuing IBD treatment.</p><p><strong>Conclusions: </strong>Worsening nutritional and inflammatory status in IBD patients is associated with complications of NAFLD. Diagnosis of NAFLD in IBD patients using CT imaging might be useful not only for early detection of NAFLD but also in assessing the need for therapeutic intervention for IBD.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9966886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Summary and comparison of recently updated post-polypectomy surveillance guidelines.","authors":"Yoon Suk Jung","doi":"10.5217/ir.2023.00107","DOIUrl":"10.5217/ir.2023.00107","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71423574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional variations in the prevalence of primary sclerosing cholangitis associated with inflammatory bowel disease.","authors":"Kwang Woo Kim,&nbsp;Hyoun Woo Kang","doi":"10.5217/ir.2023.00133","DOIUrl":"10.5217/ir.2023.00133","url":null,"abstract":"Ulcerative colitis (UC) and Crohn’s disease (CD) are types of inflammatory bowel disease (IBD), characterized as chronic, relapsing bowel disorder causing a significant impact on the personal health. 1,2 Many studies have reported various mechanisms in genetic, immunologic, microbial, environmental fields and experimental models for IBD have suggested essential components in the pathogenesis. 3 One of the pathologic characteristics of IBD is presenting various extraintestinal manifestations. 4","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71423565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut microbiome on immune checkpoint inhibitor therapy and consequent immune-related colitis: a review.","authors":"Sung Wook Hwang,&nbsp;Min Kyu Kim,&nbsp;Mi-Na Kweon","doi":"10.5217/ir.2023.00019","DOIUrl":"10.5217/ir.2023.00019","url":null,"abstract":"<p><p>Immune checkpoint inhibitors have dramatically revolutionized the therapeutic landscape for patients with advanced malignancies. Recently, convincing evidence has shown meaningful influence of gut microbiome on human immune system. With the complex link between gut microbiome, host immunity and cancer, the variations in the gut microbiota may influence the efficacy of immune checkpoint inhibitors. Indeed, some bacterial species have been reported to be predictive for cancer outcome in patients treated with immune checkpoint inhibitors. Although immune checkpoint inhibitors are currently proven to be an effective anti-tumor treatment, they can induce a distinct form of toxicity, termed immune-related adverse events. Immune-related colitis is one of the common toxicities from immune checkpoint inhibitors, and it might preclude the cancer therapy in severe or refractory cases. The manipulation of gut microbiome by fecal microbiota transplantation or probiotics administration has been suggested as one of the methods to enhance anti-tumor effects and decrease the risk of immune-related colitis. Here we review the role of gut microbiome on immune checkpoint inhibitor therapy and consequent immune-related colitis to provide a new insight for better anti-cancer therapy.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10166090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and risk factors related to polyposis recurrence and advanced neoplasm development among patients with non-hereditary colorectal polyposis.","authors":"Jihun Jang,&nbsp;Jihye Park,&nbsp;Soo Jung Park,&nbsp;Jae Jun Park,&nbsp;Jae Hee Cheon,&nbsp;Tae Il Kim","doi":"10.5217/ir.2022.00139","DOIUrl":"10.5217/ir.2022.00139","url":null,"abstract":"<p><strong>Background/aims: </strong>Patients with more than 10 cumulative polyps might involve a greater genetic risk of colorectal neoplasia development. However, few studies have investigated the risk factors of polyposis recurrence and development of advanced neoplasms among patients with non-hereditary colorectal polyposis.</p><p><strong>Methods: </strong>This study included patients (n=855) with 10 or more cumulative polyps diagnosed at Severance Hospital from January 2012 to September 2021. Patients with known genetic mutations related to polyposis, known hereditary polyposis syndromes, insufficient information, total colectomy, and less than 3 years of follow-up were excluded. Finally, 169 patients were included for analysis. We collected clinical data, including colonoscopy surveillance results, and performed Cox regression analyses of risk factors for polyposis recurrence and advanced neoplasm development.</p><p><strong>Results: </strong>The 169 patients were predominantly male (84.02%), with a mean age of 64.19±9.92 years. The mean number of adenomas on index colonoscopy was 15.33±8.47. Multivariable analysis revealed history of cancer except colon cancer (hazard ratio [HR], 2.23; 95% confidence interval [CI], 1.23-4.01), current smoking (HR, 2.39; 95% CI, 1.17-4.87), and detection of many polyps (≥15) on index colonoscopy (HR, 2.05; 95% CI, 1.21-3.50) were significant risk factors for recurrence of polyposis. We found no statistically significant risk factors for advanced neoplasm development during surveillance among our cohort.</p><p><strong>Conclusions: </strong>The presence of many polyps (≥15) on index colonoscopy, history of cancer except colon cancer, and current smoking state were significant risk factors for polyposis recurrence among patients with non-hereditary colorectal polyposis.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9540282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative outcomes of acute colonic diverticulitis in immunocompromised versus immunocompetent patients: a systematic review and meta-analysis.","authors":"Jae Gon Lee,&nbsp;Yong Eun Park,&nbsp;Ji Young Chang,&nbsp;Hyun Joo Song,&nbsp;Duk Hwan Kim,&nbsp;Young Joo Yang,&nbsp;Byung Chang Kim,&nbsp;Shin Hee Lee,&nbsp;Myung-Won You,&nbsp;Seong-Eun Kim","doi":"10.5217/ir.2023.00005","DOIUrl":"10.5217/ir.2023.00005","url":null,"abstract":"<p><strong>Background/aims: </strong>Immunocompromised patients with acute colonic diverticulitis are at high risk for complications and failure of non-surgical treatment. However, evidence on the comparative outcomes of immunocompromised and immunocompetent patients with diverticulitis is lacking. This systematic review and meta-analysis investigated the outcomes of medical treatment in immunocompromised and immunocompetent patients with diverticulitis.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in PubMed, Embase, and the Cochrane Library. Studies comparing the clinical outcomes of immunocompromised and immunocompetent patients with diverticulitis were included.</p><p><strong>Results: </strong>A total of 10 studies with 1,946,461 subjects were included in the quantitative synthesis. The risk of emergency surgery and postoperative mortality after emergency surgery was significantly higher in immunocompromised patients than in immunocompetent patients with diverticulitis (risk ratio [RR], 1.76; 95% confidence interval [CI], 1.31-2.38 and RR, 3.05; 95% CI, 1.70-5.45, respectively). Overall risk of complications associated with diverticulitis was non-significantly higher in immunocompromised than in immunocompetent patients (RR, 1.24; 95% CI, 0.95-1.63). Overall mortality irrespective of surgery was significantly higher in immunocompromised than in immunocompetent patients with diverticulitis (RR, 3.65; 95% CI, 1.73-7.69). By contrast, postoperative mortality after elective surgery was not significantly different between immunocompromised and immunocompetent patients with diverticulitis. In subgroup analysis, the risk of emergency surgery and recurrence was significantly higher in immunocompromised patients with complicated diverticulitis, whereas no significant difference was shown in mild disease.</p><p><strong>Conclusions: </strong>Immunocompromised patients with diverticulitis should be given the best medical treatment with multidisciplinary approach because they had increased risks of surgery, postoperative morbidity, and mortality than immunocompetent patients.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9533697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}