Effects of Chili Treatment on Gastrointestinal and Rectal Sensation in Diarrhea-predominant Irritable Bowel Syndrome: A Randomized, Double-blinded, Crossover Study

( Satimai Aniwan ),( Sutep Gonlachanvit ) 대한소화기기능성질환·운동학회 2014 Journal of Neurogastroenterology and Motility (JNM Vol.20 No.3

Background/Aims Whether, chronic chili ingestion can desensitize transient receptor potential vanilloid type 1 receptors in gastrointestinal (GI) tract leading to decrease GI symptoms and sensation in diarrhea-predominant irritable bowel syndrome (IBS-D) patients has not been well explored. The aim of this study was to determine the effects of 6-week chili treatment on postprandial GI symptoms and rectal sensation in response to balloon distention in IBS-D patients. Methods Sixteen IBS-D patients received placebo or chili capsules before meals 3 times/day for 6 weeks in a randomized, double-blinded, crossover fashion with 4-week washout period. Postprandial GI symptoms were evaluated. All patients underwent a rectal barostat study to evaluate rectal sensory threshold at the end of each treatment. Results The maximum postprandial abdominal burning scores were similar between both treatments at baseline (1.4 [0.0-2.0] vs. 1.1 [0.0-2.8], P > 0.05) but were significantly decreased after chili (0.0 [0.0-0.5] vs. 0.3 [0.0-1.6], P < 0.05) at the end of treatment. The chili treatment significantly increased sensory threshold for the first rectal sensation (median [interquartile range]:16 [12-16] mmHg vs. 8 [8-16] mmHg, P < 0.05) however, there was no significant effect on rectal compliance (7.3 ± 1.0 vs. 7.1 ± 1.8 mL/mmHg). Other postprandial GI symptoms did not vary significantly between both treatments at baseline and the end of treatment. Conclusions In IBS-D patients, 6-week chili ingestion significantly decreased postprandial abdominal burning and increased the rectal sensory threshold. These findings suggest a desensitization effect of chili ingestion on transient receptor potential vanilloid type 1 receptors in the proximal gut and rectum. (J Neurogastroenterol Motil 2014;20:400-406)

Fecal Calprotectin as a Surrogate Marker for Mucosal Healing After Initiating the Therapeutic Anti-Tubercular Trial

Satimai Aniwan 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.2

COMMENTARY

Temporal trend in the natural history of ulcerative colitis in a country with a low incidence of ulcerative colitis from 2000 through 2018

( Satimai Aniwan ),( Julajak Limsrivilai ),( Supot Pongprasobchai ),( Nonthalee Pausawasdi ),( Piyapan Prueksapanich ),( Natanong Kongtub ),( Rungsun Rerknimitr ) 대한장연구학회 2021 Intestinal Research Vol.19 No.2

Background/Aims: The incidence of ulcerative colitis (UC) in Thailand (crude incidence rate of 0.28 per 100,000 persons) is much lower than in the West. The burden of UC varies in different populations. The aim of this study was to evaluate the natural history of UC over the two decades in Bangkok, Thailand. Methods: This retrospective study included patients who were diagnosed with UC between 2000 and 2018 in 2 university hospitals. To evaluate changes in the disease course, we stratified patients into 2000-2009 cohort and 2010-2018 cohort. The cumulative probability of endoscopic healing, UC-related hospitalization and colectomy was estimated using the Kaplan-Meier method. Results: A total of 291 UC patients were followed for total of 2,228 person-years. Comparison between 2 cohorts, there were no differences in disease pattern and severity whereas an increase in the combination use of oral and topical mesalamine and the early use of thiopurine was observed. Only 1% of patients for each cohort required biologic agent at 5 years. The rate of achieving mucosal healing increased from 15% to 46% at 3 years (P<0.01). The rate of UC-related hospitalization decreased from 30% to 21% at 5 years (P<0.05). The rate of colectomy decreased from 6% to 2% at 5 years (P<0.05). Conclusions: The natural history of UC in a low incidence country was less aggressive than the West. Over the past two decades, the rates of UC-related hospitalization and colectomy have been decreasing which were similar to the West. (Intest Res 2021;19:186-193)

Current Status of Colorectal Cancer and Its Public Health Burden in Thailand

Kasenee Tiankanon,Satimai Aniwan,Rungsun Rerknimitr 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.4

Colorectal cancer (CRC) accounts for approximately 10.3% of new cancer cases in Thailand and is currently the 3rd most prevalentcancer found among the Thai population. Starting in 2017, the Thai government announced the national CRC screening program asa response to this important issue. Among the 70 million people currently residing in Thailand, 14 million require screening, whilethere are approximately a total of 1,000 endoscopists available to perform colonoscopy. Due to the limited resources and shortage ofendoscopists in Thailand, applying a population-based one-step colonoscopy program as a primary screening method is not feasible. To reduce colonoscopy workload, with the help of others, including village health volunteers, institution-based health personnel,reimbursement coders, pathologists, and patients due for CRC screening, a two-step approach of one-time fecal immunochemicaltest (FIT), which prioritizes and filters out subjects for colonoscopy, is chosen. Moreover, additional adjustments to the optimal FITcutoff value and the modified Asia-Pacific Colorectal Screening risk score, including body weight, were proposed to stratify thepriority of colonoscopy schedule. This article aims to give an overview of the past and current policy developmental strategies andthe current status of the Thailand CRC screening program.

Adherence to Surveillance Guidelines after the Removal of Colorectal Polyps: A Multinational, Multicenter, Prospective Survey

( Chang Kyo Oh ),( Satimai Aniwan ),( Panida Piyachaturawat ),( Zhiqin Wong ),( Thida Soe ),( Bayasgalan Luvsandagva ),( Quang Trung Tran ),( Achmad Fauzi ),( Jeong-sik Byeon ),( Young-seok Cho ) 대한간학회 2021 Gut and Liver Vol.15 No.6

Background/Aims: As the number of colonoscopies and polypectomies performed continues to increase in many Asian countries, there is a great demand for surveillance colonoscopy. The aim of this study was to investigate the adherence to postpolypectomy surveillance guidelines among physicians in Asia. Methods: A survey study was performed in seven Asian countries. An email invitation with a link to the survey was sent to participants who were asked to complete the questionnaire consisting of eight clinical scenarios. Results: Of the 137 doctors invited, 123 (89.8%) provided valid responses. Approximately 50% of the participants adhered to the guidelines regardless of the risk of adenoma, except in the case of tubulovillous adenoma ≥10 mm combined with high-grade dysplasia, in which 35% of the participants adhered to the guidelines. The participants were stratified according to the number of colonoscopies performed: ≥20 colonoscopies per month (high volume group) and <20 colonoscopies per month (low volume group). Higher adherence to the postpolypectomy surveillance guidelines was evident in the high volume group (60%) than in the low volume group (25%). The reasons for nonadherence included concern of missed polyps (59%), the low cost of colonoscopy (26%), concern of incomplete resection (25%), and concern of medical liability (15%). Conclusions: A discrepancy between clinical practice and surveillance guidelines among physicians in Asia was found. Physicians in the low volume group frequently did not adhere to the guidelines, suggesting a need for continuing education and appropriate control. Concerns regarding the quality of colonoscopy and complete polypectomy were the main reasons for nonadherence. (Gut Liver 2021;15:878-886)

Performance comparison between two computer-aided detection colonoscopy models by trainees using different false positive thresholds: a cross-sectional study in Thailand

Kasenee Tiankanon,Julalak Karuehardsuwan,Satimai Aniwan,Parit Mekaroonkamol,Panukorn Sunthornwechapong,Huttakan Navadurong,Kittithat Tantitanawat,Krittaya Mekritthikrai,Salin Samutrangsi,Peerapon Vate 대한소화기내시경학회 2024 Clinical Endoscopy Vol.57 No.2

Background/Aims: This study aims to compare polyp detection performance of “Deep-GI,” a newly developed artificial intelligence (AI) model, to a previously validated AI model computer-aided polyp detection (CADe) using various false positive (FP) thresholds and determining the best threshold for each model. Methods: Colonoscopy videos were collected prospectively and reviewed by three expert endoscopists (gold standard), trainees, CADe (CAD EYE; Fujifilm Corp.), and Deep-GI. Polyp detection sensitivity (PDS), polyp miss rates (PMR), and false-positive alarm rates (FPR) were compared among the three groups using different FP thresholds for the duration of bounding boxes appearing on the screen. Results: In total, 170 colonoscopy videos were used in this study. Deep-GI showed the highest PDS (99.4% vs. 85.4% vs. 66.7%, p<0.01) and the lowest PMR (0.6% vs. 14.6% vs. 33.3%, p<0.01) when compared to CADe and trainees, respectively. Compared to CADe, Deep-GI demonstrated lower FPR at FP thresholds of ≥0.5 (12.1 vs. 22.4) and ≥1 second (4.4 vs. 6.8) (both p<0.05). However, when the threshold was raised to ≥1.5 seconds, the FPR became comparable (2 vs. 2.4, p=0.3), while the PMR increased from 2% to 10%. Conclusions: Compared to CADe, Deep-GI demonstrated a higher PDS with significantly lower FPR at ≥0.5- and ≥1-second thresholds. At the ≥1.5-second threshold, both systems showed comparable FPR with increased PMR.

The association between new generation oral contraceptive pill and the development of inflammatory bowel diseases

Santosh Sanagapalli,Yanna Ko,Viraj Kariyawasam,Siew C Ng,Whitney Tang,Hithanadura Janaka de Silva,Minhu Chen,Kaichun Wu,Satimai Aniwan,Ka Kei Ng,David Ong,Qin Ouyang,Ida Hilmi,Marcellus Simadibrata,Pi 대한장연구학회 2018 Intestinal Research Vol.16 No.3

Background/Aims: To examine the association between use of oral contraceptive pills (OCPs) and the risk of developing inflammatory bowel diseases (IBD), in a modern cohort. Methods: A prospective nested case-control study across sites in the Asia-Pacific region was conducted; involving female IBD cases and asymptomatic controls. Subjects completed a questionnaire addressing questions related to OCP use. Primary outcome was the risk of development of IBD of those exposed to OCP versus non-exposure. Secondary outcomes were development of Crohn’s disease (CD) versus ulcerative colitis (UC), and whether age of first use of OCP use may be associated with risk of IBD. Results: Three hundred and forty-eight female IBD cases (41% CD, median age: 43 years) and 590 female age-matched controls were recruited. No significant association was found between OCP use and the risk of IBD (odds ratio [OR], 1.65; 95% confidence interval, 0.77–3.13; P=0.22), CD (OR, 1.55) or UC (OR, 1.01). The lack of association persisted when results were adjusted for age and smoking. IBD cases commenced OCP use at a younger age than controls (18 years vs. 20 years, P=0.049). Conclusions: In this large cohort of subjects from the Asia-Pacific region, we found a modest but not significantly increased risk of developing IBD amongst OCP users.