Background Although associations between various single nutrients and exacerbation of inflammatory bowel disease (IBD) have been reported, more recent attention has focused on overall dietary patterns and quality rather than a single nutrient. This study was to investigate the association of dietary inflammatory potential and dietary quality with disease severity in young adult Crohn’s disease (CD) patients. Methods Non-consecutive 3-day food records were investigated in 25 patients with CD aged 19-40 years. Patients with moderate or severe active disease were excluded to investigate their usual dietary habits. A survey on dietary behavior was conducted and clinical data including the disease progress were collected. To investigate potential pro-inflammatory dietary habits in a patient's usual diet, food-based index of dietary inflammatory potential score (FBDI), glycemic index (GI), and glycemic load (GL) were calculated. Diet quality was evaluated using a tool called Diet Quality Index-international (DQI). Results Although most patients showed adequate caloric intake, 72% of the enrolled patients had a potential pro-inflammatory pattern identified as FBDI. The FBDI was significantly associated with intake of mixed coffee and sweeten drinks, beef, and pork (P < 0.05). Patients who had a serious clinical course such as history of surgery or the use of biologics, tended to have a higher FBDI (6.45 vs 2.44, P = 0.08), and showed a higher proportion with a low DQI (53% vs 20%, P = 0.06). Only 30% of the high FBDI group showed deep remission after 12 to 18 months of follow-up endoscopic or image study, whereas 72.7% of the low FBDI group showed deep remission (P =0.05). A significantly positive correlation was derived between FBDI and GL (r =0.452, P = 0.02). Conclusion For the care of patients with CD, it is necessary to evaluate the dietary quality as well as the total nutrient intake, and we need to educate the patients that dietary habits can affect the disease prognosis.

Background It has been suggested that changes in gut microbiota have an important effect on the development of inflammatory bowel disease (IBD). In studies using germ-free mice, it has been reported that the absence of microbiota rarely causes dextran sulfate sodium (DSS)-colitis. This study was to investigate whether the changes in DSS-colonic inflammation in mice treated with antibiotics were comparable to the results in germ-free mice. Methods Ampicillin + enrofloxacin were treated in six 9-week-old C57BL/6 mice for initial 3 days and stools were sampled daily to measure the total amount of bacterial 16S rRNA. The time of loss and restoration of gut microbiota was investigated after repeated antibiotics. The severity of colitis and barrier damage were compared between the following groups: (i) control group, (ii) DSS group, and, and (iii) DSS + antibiotics group. The DSS group was allowed to drink 3% DSS from day 5 and maintained for 7 days, and colon tissues were obtained from all groups on day 12. The inflammatory markers (IL-1α, IL-6, IL-17, tumor necrosis factor (TNF)-α) and gut barrier markers (Zonular occludens (ZO)-1, occludin, claudin-1, claudin-4) in colon tissues were comparatively analyzed between groups. Results Bacterial 16S rRNA was not detected from day 4 after the antibiotics, and restoration started from day 11. After repeated antibiotics, microbial depletion was re-confirmed on day 14, but restoration appeared on day 18, confirming faster recovery. The expression levels of IL-1α, IL-17, and TNF-α in the DSS + antibiotics group did not differ from the control but were significantly lower than the DSS group (all p < 0.01). However, the expression of ZO-1 and claudin-4 was significantly lower in the DSS + antibiotics treatment group than in the control group (p < 0.05). Conclusion The antibiotic cocktail could dramatically reduce gut microbiota over a period, but the effect would decrease as it is repeated. Depletion of gut microbiota after antibiotics would dramatically reduce DSS-colonic inflammation but could damage the gut barrier or at least not prevent barrier dysfunction.

Background/Aims: Esophageal perforation is associated with high mortality and morbidity in patients presenting to the emergency department (ED) with esophageal injury. We investigated the effectiveness of initial CT scan in patients with esophageal injury to determine the risk factors for complications. Methods: Patients admitted through the ED for evaluation of esophageal injuries between January 2001 and May 2020, were investigated. Demographic data, etiological factors, comorbidities, treatment administered, and outcomes were collected. Esophageal injury was graded based on the following CT criteria: (a) normal, (b) pneumomediastinum, (c) mediastinitis, fluid collection, abscess, or overt esophageal wall injury, and (d) pleural effusion, subcutaneous emphysema, or pneumothorax. Grade 2 was defined as microperforation and grades 3 and 4 as overt perforation. Results: Of 281 patients with esophageal injury, 38 had CT-documented overt perforations and 20 had microperforations. Foreign body-induced injury (n=37), Boerhaave syndrome (n=12), and chemical injury (n=3) were common causes of esophageal injury. Complications occurred in 24 (8.5%) patients. Risk factors for complications were age ≥65 years (

No abstract