1.Bowel preparation for colonoscopy in special populations: a practical and risk-stratified approach
Myung-Hun LEE ; Won MOON ; Kyoungwon JUNG ; Jae Hyun KIM ; Sung Eun KIM ; Moo In PARK ; Seun Ja PARK
Kosin Medical Journal 2026;41(1):9-18
Bowel preparation is a key determinant of colonoscopy quality; however, inadequate cleansing remains common among patients with overlapping clinical and logistical barriers. In routine practice, preparation failure may prolong procedures, reduce diagnostic confidence, and necessitate early repeat colonoscopy. We review major society guidelines and selected studies addressing bowel preparation in inflammatory bowel disease (IBD), chronic kidney disease (CKD), older adults, chronic constipation, and hospitalized patients. Across these settings, the most consistently supported measures include split-dose administration, completion of the final dose close to the time of colonoscopy in accordance with local fasting and sedation policies, and structured patient instructions reinforced through follow-up communication. A standardized assessment of preparation quality is recommended to support quality improvement and appropriate follow-up. Risk stratification can help identify patients who may benefit from intensified preparation pathways, including those with prior inadequate preparation, severe constipation, frailty, or inpatient status. Safety considerations are particularly important in CKD, in which oral sodium phosphate should be avoided and magnesium-containing agents used cautiously; polyethylene glycol-based solutions are generally preferred. In IBD, regimen selection should also consider endoscopic interpretability because sodium phosphate preparations have been associated with preparation-related mucosal abnormalities that may confound the assessment of subtle inflammatory findings. Among hospitalized patients, system-level barriers often predominate, and protocolized pathways may improve workflow and patient comfort while maintaining cleansing effectiveness. We propose a practical, risk-stratified approach to regimen selection, timing, rescue strategies, and safety monitoring that can be implemented in high-volume clinical practice.
2.Neoadjuvant Concurrent Chemoradiotherapy for Duodenal-invasive Ascending Colon Cancer: Case Series
Seong Hyun KOH ; Jae Hyun KIM ; Seun Ja PARK
Journal of Digestive Cancer Research 2026;14(1):109-114
Duodenal invasion by ascending colon cancer is an uncommon and challenging manifestation of locally advanced right-sided colon cancer. Its optimal management remains debatable, particularly regarding the use of neoadjuvant concurrent chemoradiotherapy (CCRT). We retrospectively reviewed seven patients (aged 63–80 years) with ascending colon adenocarcinoma with duodenal invasion who were treated with neoadjuvant CCRT between 2012 and 2025 at a single tertiary center. Clinical staging ranged from stage IIC to IVB. Treatment strategies included neoadjuvant CCRT followed by curative-intent surgery when feasible and palliative chemotherapy and/or radiotherapy in advanced or inoperable cases. Among the seven patients, five underwent curative surgery following CCRT. Of these, four achieved long-term, recurrencefree survival for 99 months or more (average 102.5 months). One experienced recurrence after initial treatment and died of progressive disease. The remaining two patients did not undergo surgery because of disease progression or poor response to initial therapy, resulting in death or loss to follow-up. Histology revealed moderately to poorly differentiated adenocarcinoma and signet ring cell carcinoma. Neoadjuvant CCRT is feasible and effective in some patients with ascending colon cancer and duodenal invasion, supporting en bloc resection while minimizing surgical morbidity. Prospective studies are warranted to establish optimal treatment protocols.
3.How to Achieve Diversity, Equity, and Inclusion in The Korean Society of Gastroenterology?
Nayoung KIM ; Kwangwoo NAM ; Ki-Nam SHIM ; Hyo Jung KIM ; Su Youn NAM ; Sae Kyung JOO ; Seun Ja PARK ; Yonghoon CHOI ; Yoon Ju JUNG ; Yong Sung KIM ; Ja Kyung KIM ; Seon Mee PARK
The Korean Journal of Gastroenterology 2025;85(1):22-30
With the increasing emphasis on diversity, equity, and inclusion (DEI) in organizations and institutions, academic societies in gastroenterology and hepatology are beginning to take actionable steps toward achieving DEI. The successful implementation of DEI initiatives leads to excellence in the field, improved patient outcomes, particularly in areas where health disparities are prevalent, and advances in the gastrointestinal discipline. Such implementation also results in a workforce that better reflects the growing diversity of the population. This review defines DEI and introduces the DEI policies and strategies adopted by the academic societies of gastroenterology in other countries. This paper proposes strategies to integrate DEI better into the Korean Society of Gastroenterology, emphasizing the importance of embedding DEI into the culture and strategic framework. The key strategies include establishing a DEI committee, setting clear targets, and conducting formal assessments to measure DEI progress. This study focused on enhancing workforce diversity, particularly among women and young doctors, and advocates for the need to support their academic development through male allyship and the promotion of equitable and inclusive academic cultures.
4.Rapidly Growing Gastrointestinal Stromal Tumor on the Esophagus
Ji Hye PARK ; Sung Eun KIM ; Seun Ja PARK ; Moo In PARK ; Won MOON ; Jae Hyun KIM ; Kyoungwon JUNG ; Myung Hun LEE
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2025;25(1):64-69
Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms that mainly occur in the stomach and small intestine; those arising in the esophagus are rarer. A 54-year-old woman was referred to our hospital with a one-month history of dysphagia. Esophagogastroduodenoscopy (EGD), performed approximately five months earlier, had not revealed any specific findings. However, an EGD performed in our hospital showed the presence of a round, protruding lesion (approximately 40×30 mm in size), with a normal overlying mucosal surface, 35–39 cm from the upper incisor. Chest computed tomography (CT) revealed a large esophageal mass. Enucleation was performed on the esophageal mass, and a GIST was diagnosed using immunochemical staining. Imatinib mesylate administration was initiated two months postoperatively. The patient was stable, without any evident recurrence in the 8-month postoperative follow-up EGD and chest CT examinations. Therefore, physicians should consider that patients with worsening dysphagia may have an underlying organic condition, such as an acute increase in size of an esophageal GIST, even if recent examinations were unremarkable.
5.How to Achieve Diversity, Equity, and Inclusion in The Korean Society of Gastroenterology?
Nayoung KIM ; Kwangwoo NAM ; Ki-Nam SHIM ; Hyo Jung KIM ; Su Youn NAM ; Sae Kyung JOO ; Seun Ja PARK ; Yonghoon CHOI ; Yoon Ju JUNG ; Yong Sung KIM ; Ja Kyung KIM ; Seon Mee PARK
The Korean Journal of Gastroenterology 2025;85(1):22-30
With the increasing emphasis on diversity, equity, and inclusion (DEI) in organizations and institutions, academic societies in gastroenterology and hepatology are beginning to take actionable steps toward achieving DEI. The successful implementation of DEI initiatives leads to excellence in the field, improved patient outcomes, particularly in areas where health disparities are prevalent, and advances in the gastrointestinal discipline. Such implementation also results in a workforce that better reflects the growing diversity of the population. This review defines DEI and introduces the DEI policies and strategies adopted by the academic societies of gastroenterology in other countries. This paper proposes strategies to integrate DEI better into the Korean Society of Gastroenterology, emphasizing the importance of embedding DEI into the culture and strategic framework. The key strategies include establishing a DEI committee, setting clear targets, and conducting formal assessments to measure DEI progress. This study focused on enhancing workforce diversity, particularly among women and young doctors, and advocates for the need to support their academic development through male allyship and the promotion of equitable and inclusive academic cultures.
6.Rapidly Growing Gastrointestinal Stromal Tumor on the Esophagus
Ji Hye PARK ; Sung Eun KIM ; Seun Ja PARK ; Moo In PARK ; Won MOON ; Jae Hyun KIM ; Kyoungwon JUNG ; Myung Hun LEE
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2025;25(1):64-69
Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms that mainly occur in the stomach and small intestine; those arising in the esophagus are rarer. A 54-year-old woman was referred to our hospital with a one-month history of dysphagia. Esophagogastroduodenoscopy (EGD), performed approximately five months earlier, had not revealed any specific findings. However, an EGD performed in our hospital showed the presence of a round, protruding lesion (approximately 40×30 mm in size), with a normal overlying mucosal surface, 35–39 cm from the upper incisor. Chest computed tomography (CT) revealed a large esophageal mass. Enucleation was performed on the esophageal mass, and a GIST was diagnosed using immunochemical staining. Imatinib mesylate administration was initiated two months postoperatively. The patient was stable, without any evident recurrence in the 8-month postoperative follow-up EGD and chest CT examinations. Therefore, physicians should consider that patients with worsening dysphagia may have an underlying organic condition, such as an acute increase in size of an esophageal GIST, even if recent examinations were unremarkable.
7.How to Achieve Diversity, Equity, and Inclusion in The Korean Society of Gastroenterology?
Nayoung KIM ; Kwangwoo NAM ; Ki-Nam SHIM ; Hyo Jung KIM ; Su Youn NAM ; Sae Kyung JOO ; Seun Ja PARK ; Yonghoon CHOI ; Yoon Ju JUNG ; Yong Sung KIM ; Ja Kyung KIM ; Seon Mee PARK
The Korean Journal of Gastroenterology 2025;85(1):22-30
With the increasing emphasis on diversity, equity, and inclusion (DEI) in organizations and institutions, academic societies in gastroenterology and hepatology are beginning to take actionable steps toward achieving DEI. The successful implementation of DEI initiatives leads to excellence in the field, improved patient outcomes, particularly in areas where health disparities are prevalent, and advances in the gastrointestinal discipline. Such implementation also results in a workforce that better reflects the growing diversity of the population. This review defines DEI and introduces the DEI policies and strategies adopted by the academic societies of gastroenterology in other countries. This paper proposes strategies to integrate DEI better into the Korean Society of Gastroenterology, emphasizing the importance of embedding DEI into the culture and strategic framework. The key strategies include establishing a DEI committee, setting clear targets, and conducting formal assessments to measure DEI progress. This study focused on enhancing workforce diversity, particularly among women and young doctors, and advocates for the need to support their academic development through male allyship and the promotion of equitable and inclusive academic cultures.
8.Rapidly Growing Gastrointestinal Stromal Tumor on the Esophagus
Ji Hye PARK ; Sung Eun KIM ; Seun Ja PARK ; Moo In PARK ; Won MOON ; Jae Hyun KIM ; Kyoungwon JUNG ; Myung Hun LEE
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2025;25(1):64-69
Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms that mainly occur in the stomach and small intestine; those arising in the esophagus are rarer. A 54-year-old woman was referred to our hospital with a one-month history of dysphagia. Esophagogastroduodenoscopy (EGD), performed approximately five months earlier, had not revealed any specific findings. However, an EGD performed in our hospital showed the presence of a round, protruding lesion (approximately 40×30 mm in size), with a normal overlying mucosal surface, 35–39 cm from the upper incisor. Chest computed tomography (CT) revealed a large esophageal mass. Enucleation was performed on the esophageal mass, and a GIST was diagnosed using immunochemical staining. Imatinib mesylate administration was initiated two months postoperatively. The patient was stable, without any evident recurrence in the 8-month postoperative follow-up EGD and chest CT examinations. Therefore, physicians should consider that patients with worsening dysphagia may have an underlying organic condition, such as an acute increase in size of an esophageal GIST, even if recent examinations were unremarkable.
9.How to Achieve Diversity, Equity, and Inclusion in The Korean Society of Gastroenterology?
Nayoung KIM ; Kwangwoo NAM ; Ki-Nam SHIM ; Hyo Jung KIM ; Su Youn NAM ; Sae Kyung JOO ; Seun Ja PARK ; Yonghoon CHOI ; Yoon Ju JUNG ; Yong Sung KIM ; Ja Kyung KIM ; Seon Mee PARK
The Korean Journal of Gastroenterology 2025;85(1):22-30
With the increasing emphasis on diversity, equity, and inclusion (DEI) in organizations and institutions, academic societies in gastroenterology and hepatology are beginning to take actionable steps toward achieving DEI. The successful implementation of DEI initiatives leads to excellence in the field, improved patient outcomes, particularly in areas where health disparities are prevalent, and advances in the gastrointestinal discipline. Such implementation also results in a workforce that better reflects the growing diversity of the population. This review defines DEI and introduces the DEI policies and strategies adopted by the academic societies of gastroenterology in other countries. This paper proposes strategies to integrate DEI better into the Korean Society of Gastroenterology, emphasizing the importance of embedding DEI into the culture and strategic framework. The key strategies include establishing a DEI committee, setting clear targets, and conducting formal assessments to measure DEI progress. This study focused on enhancing workforce diversity, particularly among women and young doctors, and advocates for the need to support their academic development through male allyship and the promotion of equitable and inclusive academic cultures.
10.Rapidly Growing Gastrointestinal Stromal Tumor on the Esophagus
Ji Hye PARK ; Sung Eun KIM ; Seun Ja PARK ; Moo In PARK ; Won MOON ; Jae Hyun KIM ; Kyoungwon JUNG ; Myung Hun LEE
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2025;25(1):64-69
Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms that mainly occur in the stomach and small intestine; those arising in the esophagus are rarer. A 54-year-old woman was referred to our hospital with a one-month history of dysphagia. Esophagogastroduodenoscopy (EGD), performed approximately five months earlier, had not revealed any specific findings. However, an EGD performed in our hospital showed the presence of a round, protruding lesion (approximately 40×30 mm in size), with a normal overlying mucosal surface, 35–39 cm from the upper incisor. Chest computed tomography (CT) revealed a large esophageal mass. Enucleation was performed on the esophageal mass, and a GIST was diagnosed using immunochemical staining. Imatinib mesylate administration was initiated two months postoperatively. The patient was stable, without any evident recurrence in the 8-month postoperative follow-up EGD and chest CT examinations. Therefore, physicians should consider that patients with worsening dysphagia may have an underlying organic condition, such as an acute increase in size of an esophageal GIST, even if recent examinations were unremarkable.

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