Indexed In : Science Citation Index Expanded(SCIE), MEDLINE,
Pubmed/Pubmed Central, Elsevier Bibliographic, Google Scholar,
Databases(Scopus & Embase), KCI, KoreaMed, DOAJ
Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut atnd Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology. +MORE
| Yong Chan Lee |
Professor of Medicine Director, Gastrointestinal Research Laboratory Veterans Affairs Medical Center, Univ. California San Francisco San Francisco, USA |
| Jong Pil Im | Seoul National University College of Medicine, Seoul, Korea |
| Robert S. Bresalier | University of Texas M. D. Anderson Cancer Center, Houston, USA |
| Steven H. Itzkowitz | Mount Sinai Medical Center, NY, USA |
All papers submitted to Gut and Liver are reviewed by the editorial team before being sent out for an external peer review to rule out papers that have low priority, insufficient originality, scientific flaws, or the absence of a message of importance to the readers of the Journal. A decision about these papers will usually be made within two or three weeks.
The remaining articles are usually sent to two reviewers. It would be very helpful if you could suggest a selection of reviewers and include their contact details. We may not always use the reviewers you recommend, but suggesting reviewers will make our reviewer database much richer; in the end, everyone will benefit. We reserve the right to return manuscripts in which no reviewers are suggested.
The final responsibility for the decision to accept or reject lies with the editors. In many cases, papers may be rejected despite favorable reviews because of editorial policy or a lack of space. The editor retains the right to determine publication priorities, the style of the paper, and to request, if necessary, that the material submitted be shortened for publication.
Split Viewer
Ji Eun Kim 
Correspondence to: Ji Eun Kim
ORCID https://orcid.org/0000-0003-2149-7979
E-mail happyjinny0706@gmail.com
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Gut Liver 2024;18(1):192-193. https://doi.org/10.5009/gnl230355
Published online November 30, 2023, Published date January 15, 2024
Copyright © Gut and Liver.
To the Editor:
We extend our congratulations on the study conducted by Lee et al.,1 which demonstrated the efficacy of oral sulfate solution (OSS) administration in patients with ulcerative colitis (UC) based on the results of colonoscopic procedures. While there have been numerous reports within the scientific community regarding the usefulness and efficiency of OSS in patients with UC, this study is the first publication in the literature to emphasize the advantages of such findings. Through this paper, we hope to provide a hopeful message to patients suffering from UC, who have been experiencing difficulty undergoing periodic colonoscopies2 due to the discomfort associated with the procedure of bowel preparation.
Colonoscopy is primarily conducted periodically for cancer surveillance, with the most crucial step to ensure its efficiency being bowel preparation. Furthermore, with the heightened rigor in treatment goals for patients with inflammatory bowel diseases following the release of the Selecting Therapeutic Targets in Inflammatory Bowel Disease II guidelines,3 the assessment of mucosal healing has gained importance. In the case of UC, the state of colonic mucosal healing, allowing direct visual inspection of a patient's inflammatory activity, holds substantial importance.4
UC is a condition that causes inflammation of the colon due to various etiologies.5 UC has prompted ongoing concerns about safety, as it encompasses a variety of components with the development of new bowel preparations over time. To substantiate this, comparative studies between 2-L polyethylene glycol (PEG) and 4-L PEG have been conducted,6 and in the case of a low-volume agent at 1 L, it also demonstrated noninferiority in terms of safety and efficacy.7 This establishes the need for bowel preparation designs that consider not only efficacy but also compliance and safety.
In their study, Lee et al. demonstrated the safety of OSS through evaluations encompassing differences in various electrolytes from blood tests pre- and postendoscopy, as well as changes in the activity index, represented by the partial Mayo score. However, this evaluation pertains to acute complications, and longitudinal tracking of baseline intestinal inflammatory states provoked by bowel preparation might also be necessary. In clinical practice, instances of ischemic colitis have been reported following the use of OSS,8 but the underlying mechanisms remain elusive, necessitating further investigation into direct causality. This is particularly important due to the known effect of OSS in stimulating colon motility, potentially leading to bowel hypoperfusion.9
An aspect of disappointment within the study findings is the lack of difference between the two groups in terms of nausea or bloating. This conclusion contrasts with the anticipation that OSS administration would result in fewer instances. A previous study comparing OSS to sodium picosulfate with magnesium citrate found that patient satisfaction was actually higher in the sodium picosulfate with magnesium citrate group, and statistically, the OSS group exhibited greater levels of nausea.10 Consequently, there remains a need for future large-scale prospective studies to establish the superiority of OSS.
OSS not only allows for consumption with minimal fluid intake but also enhances compliance due to its palatability, thereby aiding in bowel preparation.11 Furthermore, its inclusion of simethicone facilitates effective gas removal. An ideal bowel preparation should swiftly clear all fecal matter without inducing histological changes in the colonic mucosa, while ensuring patient comfort and safety. In this regard, the authors' conclusion that OSS is noninferior to PEG with ascorbic acid for bowel preparation in patients with UC is agreed upon. However, to sufficiently establish its safety, long-term data collection is needed. Ultimately, since the goal is to safely prepare the colon, even in cases of active UC, additional research is necessary to address any potential concerns.
No potential conflict of interest relevant to this article was reported.
Gut and Liver 2024; 18(1): 192-193
Published online January 15, 2024 https://doi.org/10.5009/gnl230355
Copyright © Gut and Liver.
Ji Eun Kim
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Correspondence to:Ji Eun Kim
ORCID https://orcid.org/0000-0003-2149-7979
E-mail happyjinny0706@gmail.com
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
To the Editor:
We extend our congratulations on the study conducted by Lee et al.,1 which demonstrated the efficacy of oral sulfate solution (OSS) administration in patients with ulcerative colitis (UC) based on the results of colonoscopic procedures. While there have been numerous reports within the scientific community regarding the usefulness and efficiency of OSS in patients with UC, this study is the first publication in the literature to emphasize the advantages of such findings. Through this paper, we hope to provide a hopeful message to patients suffering from UC, who have been experiencing difficulty undergoing periodic colonoscopies2 due to the discomfort associated with the procedure of bowel preparation.
Colonoscopy is primarily conducted periodically for cancer surveillance, with the most crucial step to ensure its efficiency being bowel preparation. Furthermore, with the heightened rigor in treatment goals for patients with inflammatory bowel diseases following the release of the Selecting Therapeutic Targets in Inflammatory Bowel Disease II guidelines,3 the assessment of mucosal healing has gained importance. In the case of UC, the state of colonic mucosal healing, allowing direct visual inspection of a patient's inflammatory activity, holds substantial importance.4
UC is a condition that causes inflammation of the colon due to various etiologies.5 UC has prompted ongoing concerns about safety, as it encompasses a variety of components with the development of new bowel preparations over time. To substantiate this, comparative studies between 2-L polyethylene glycol (PEG) and 4-L PEG have been conducted,6 and in the case of a low-volume agent at 1 L, it also demonstrated noninferiority in terms of safety and efficacy.7 This establishes the need for bowel preparation designs that consider not only efficacy but also compliance and safety.
In their study, Lee et al. demonstrated the safety of OSS through evaluations encompassing differences in various electrolytes from blood tests pre- and postendoscopy, as well as changes in the activity index, represented by the partial Mayo score. However, this evaluation pertains to acute complications, and longitudinal tracking of baseline intestinal inflammatory states provoked by bowel preparation might also be necessary. In clinical practice, instances of ischemic colitis have been reported following the use of OSS,8 but the underlying mechanisms remain elusive, necessitating further investigation into direct causality. This is particularly important due to the known effect of OSS in stimulating colon motility, potentially leading to bowel hypoperfusion.9
An aspect of disappointment within the study findings is the lack of difference between the two groups in terms of nausea or bloating. This conclusion contrasts with the anticipation that OSS administration would result in fewer instances. A previous study comparing OSS to sodium picosulfate with magnesium citrate found that patient satisfaction was actually higher in the sodium picosulfate with magnesium citrate group, and statistically, the OSS group exhibited greater levels of nausea.10 Consequently, there remains a need for future large-scale prospective studies to establish the superiority of OSS.
OSS not only allows for consumption with minimal fluid intake but also enhances compliance due to its palatability, thereby aiding in bowel preparation.11 Furthermore, its inclusion of simethicone facilitates effective gas removal. An ideal bowel preparation should swiftly clear all fecal matter without inducing histological changes in the colonic mucosa, while ensuring patient comfort and safety. In this regard, the authors' conclusion that OSS is noninferior to PEG with ascorbic acid for bowel preparation in patients with UC is agreed upon. However, to sufficiently establish its safety, long-term data collection is needed. Ultimately, since the goal is to safely prepare the colon, even in cases of active UC, additional research is necessary to address any potential concerns.
No potential conflict of interest relevant to this article was reported.
pISSN 1976-2283
eISSN 2005-1212
Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut atnd Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology. +MORE
| Yong Chan Lee |
Professor of Medicine Director, Gastrointestinal Research Laboratory Veterans Affairs Medical Center, Univ. California San Francisco San Francisco, USA |
| Jong Pil Im | Seoul National University College of Medicine, Seoul, Korea |
| Robert S. Bresalier | University of Texas M. D. Anderson Cancer Center, Houston, USA |
| Steven H. Itzkowitz | Mount Sinai Medical Center, NY, USA |
All papers submitted to Gut and Liver are reviewed by the editorial team before being sent out for an external peer review to rule out papers that have low priority, insufficient originality, scientific flaws, or the absence of a message of importance to the readers of the Journal. A decision about these papers will usually be made within two or three weeks.
The remaining articles are usually sent to two reviewers. It would be very helpful if you could suggest a selection of reviewers and include their contact details. We may not always use the reviewers you recommend, but suggesting reviewers will make our reviewer database much richer; in the end, everyone will benefit. We reserve the right to return manuscripts in which no reviewers are suggested.
The final responsibility for the decision to accept or reject lies with the editors. In many cases, papers may be rejected despite favorable reviews because of editorial policy or a lack of space. The editor retains the right to determine publication priorities, the style of the paper, and to request, if necessary, that the material submitted be shortened for publication.
PDF
Standard view
Export citation
Share 
