Titong Sugihartono
Department Of Internal Medicine, Faculty Of Medicine, Universitas Airlangga, Dr. Soetomo Hospital, Surabaya, Indonesia

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Oxidative Stress and the Severity of Gastroesophageal Reflux Disease: Is There Any Correlation? Imro'ati, Tri Asih; Sugihartono, Titong; Widodo, Budi; Nefertiti, Eva Pravitasari; Wibawa, I Dewa Nyoman
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 25, No 3 (2024): VOLUME 25, NUMBER 3, December, 2024
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/253202445-52

Abstract

Background: Oxidative stress plays a crucial role in the inflammatory response of the oesophageal epithelium; hence, therapies that affect oxidative stress may be a new approach in GERD management.  The objective is to analyze and determine the correlation between Total Oxidant Status (TOS), Total Antioxidant Status (TAS), and Oxidative Stress Index (OSI) with severity of GERD.Methods: This is an observational analytic study using a cross-sectional design,that  conducted at the Endoscopic Unit of three hospitals in Surabaya, which held from June 2020 to March 2021. The 18 to 60 years old subjects who meet the GERD-Q score 8-18 and not meet the exclusion criteria undergo an endoscopic examination to determine the GERD severity and blood test. Data analysis was using the Spearman rank correlation test.Results: This study indicates that most subjects are women, with mean age 39.31±10.99 years, most are GERD grade A, the mean value of TOS, TAS, ISO respectively is 5.18±1.60, 1.58±0.18, and 3.36±1.35. The laboratory test results show insignificant different based on GERD degree.  There is a non-significant positive correlation between TOS and GERD severity, a significant negative correlation  between TAS and  GERD severity, and a significant positive correlation between OSI and GERD severity (respectively, r = 0.121, p = 0.266 vs r = -0.323, p = 0.044 vs r = 0.345, p = 0.033).Conclusion:  The TAS and OSI may be correlated to the GERD severity but still need further investigations. 
Self-Expandable Metallic Stent Placement for Radiation-Induced Esophageal Stricture: A Case Report Annisa Zahra Mufida; Amie Vidyani; Andi Ratna Kartika Maharani; Amal Arifi Hidayat; Titong Sugihartono
Asian Journal of Healthcare Analytics Vol. 5 No. 1 (2026): May 2026
Publisher : PT FORMOSA CENDEKIA GLOBAL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55927/ajha.v5i1.15847

Abstract

Radiation-induced esophageal stricture (RIES) represents a severe late complication in patients receiving radiotherapy, resulting in progressive dysphagia that can significantly impair quality of life. Several therapeutic options exist, including endoscopic dilation, injection therapy, incision, self-dilatation, surgical correction, and temporary stent placement. Among these, temporary esophageal stenting offers the potential advantage of providing sustained luminal expansion, stimulating tissue remodeling, and achieving long-term symptom relief. A 47-year-old woman with stage IV breast carcinoma and a prior history of radiotherapy presented with progressive difficulty swallowing. Over three months, her dysphagia worsened from solids to liquids. Endoscopic evaluation revealed a 4 cm esophageal stricture. Initial CRE balloon dilation improved her symptoms temporarily, but recurrence occurred, prompting a repeat endoscopy with adjunctive corticosteroid injection. Due to the relapse, a fully covered self-expandable metallic stent (SEMS) was placed to minimize the need for repeated dilations. The procedure was completed without complications. The management of benign esophageal strictures aims to reestablish luminal patency and alleviate dysphagia. SEMS placement represents an effective and reliable therapeutic option, particularly in cases of radiation-induced stricture where balloon dilation alone fails to achieve lasting results.