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All Journal Hemera Zoa Medika Alkhairaat : Jurnal Penelitian Kedokteran dan Kesehatan World Nutrition Journal Respiratory Science The Indonesian Journal of Community and Occupational Medicine The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Penyakit Dalam Indonesia

Ari Fahrial Syam

Division Of Gastroenterology, Department Of Internal Medicine, University Of Indonesia/Cipto Mangunkusumo Hospital, Jakarta

Author-ID : 399120

Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Medicine & Pharmacology Neuroscience Public Health

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Influence of Fucoidan in Mucus Thickness of Gastric Mucosa in Patients with Chronic Gastritis Kaka Renaldi; Marcellus Simadibrata; Ari Fahrial Syam; Abdul Aziz Rani; Ening Krisnuhoni
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 2, August 2011
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Chronic gastritis is commonly found with complains of dyspepsia, which may decrease work productivity. Imbalance between agressive and defensive factors is the cause of chronic gastritis. Therapy is mostly directed to the agressive factors, particularly gastric acid and very few studies are directed on defensive factors. Mucus is the first defense mechanism of gastric mucosa. Fucoidan is a phytopharmaca, which is thought to increase the thickness of gastric mucosa. The objective of this study was to know the thickness of gastric mucosa in patients with chronic gastritis and to evaluate the effect of fucoidan to the gastric mucosa thickness in patients with chronic gastritis. Method: In this double-blinded randomized clinical trial study, 41 patients in the Endoscopy Unit Cipto Mangunkusumo Hospital between October 2009 and October 2010 were enrolled consecutively. Selected patients were divided into 2 groups: a group was given fucoidan and another group was given placebo. Statistical analysis was done using T-test. Results: Of 41 chronic gastritis patients, only 34 patients completed this study. There was difference of mucus thickness of gastric mucosa in patients with chronic gastritis; in the antrum 42.59 µ m (± 8.67) and in the corpus 44.28 µ m (± 9.64). This study also showed that fucoidan administration increased the mucus thickness in the antrum by 7.42 µ m and in the corpus by 7.74 µ m compared to placebo significantly. Conclusion: Fucoidan increased the mucus thickness of gastric mucosa in patients with chronic gastritis. Keywords: mucus thickness, chronic gastritis, fucoidan

Effect of Coconut Milk Supplementation to Nutritional Status Parameters in Liver Cirrhosis Patients Suwito Indra; Rino Alvani Gani; Ari Fahrial Syam; Hamzah Shatri
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 16, No 2 (2015): VOLUME 16, NUMBER 2, August 2015
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Liver cirrhosis is on of health problems in Indonesia. Decreasing number of liver cells in cirrhosis cause some complications, one of which is malnutrition. In Indonesia, coconut milk is one of nutrients sources which quite popular. Coconut milk is thought to have hepatoprotective effect and be able to be eliminated by cirrhosis patients. A study about effect of coconut milk supplementation to nutritional status parameters in liver cirrhosis patients is really needed.Method: This study is a randomized controlled trial with parallel design. This study is conducted in Cipto Mangunkusumo Hospital Jakarta from February to March 2014. Patients are given late night snack (LNS) in form of agar that contained 25 grams of sugar and additional 50 cc coconut milk in group I (experimental group) and additional drink that contained 25 grams of sugar in group II (control group). Variables that measured to look changes in nutritional status between the two groups are triceps skinfold thickness (TSF), mid arm muscle circumference (MAMC), body mass index (BMI), body fat mass (BFM), prealbumin levels and serum albumin levels.Results: A total of 35 patients with liver cirrhosis in this study to the completion. There are three parameters of nutritional status that increasing better in the group receiving a LNS from combination of carbohydrates and coconut milk, compared to group receiving carbohydrates alone. Those three parameters are mean (SD) MAMC with amount of 9.41 (6.43) mm in group I and 4.68 (5.76) mm in group II, p = 0.028. Median (range) BFM changes 0.67 (-2.47-3.80) kg in group I and 0.21 (-4.96-1.99) kg in group II, p=0,373. Mean (SD) serum albumin level change 0.17 (0.31) g/dL in group I and 0.07 (0.41) g/dL in group II, p = 0,426. There is an increase in the TSF measurement in all subjects after one month of LNS supplementation, but not found any significant differences of TSF changes between the two groups. While the measurement of BMI and serum prealbumin did not show any significant changes after treatment in all subjects research.Conclusion: One month LNS 200 kkal supplementation with combination of carbohydrates and coconut milk have a better effect on the improvement of nutritional status in patients with liver cirrhosis, compared to carbohydrates alone. This shown by the better parameters of MAMC, BFM and increased serum albumin in group I, compared to group II.

Management of Paralytic Ileus Elizabeth Merry Wintery; Ari Fahrial Syam; Marcellus Simadibrata; Chudahman Manan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 4, ISSUE 3, December 2003
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/43200380-88

Ileus is a pathophysiologic state of inhibited motility in the gastrointestinal tract due to a physical/ anatomic obstruction in the lumen (obstructive ileus) or due to cessation of smooth muscle motor activity in the small intestine and colon. In Internal Medicine, paralytic ileus is most commonly caused by peritonitis, which is most often caused by acute pancreatitis. To establish a diagnosis, several diagnosis evaluation procedures may need to be performed such as laboratory evaluation, radiologic examination, ultrasonography and CT examination. Management of paralytic ileus is aimed at the underlying disease and supportive therapy. With this management paralytic ileus will spontaneously remit. Keywords: paralytic ileus, pathogenesis, diagnosis, management

Long Term Risks of Proton Pump Inhibitor Administration: A Literature Review Andi Kristanto; Randy Adiwinata; Josephin Rasidi; Beatrice Belinda Phang; Sheila Adiwinata; Timoteus Richard; Willy Brodus Uwan; Ari Fahrial Syam
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 18, No 3 (2017): VOLUME 18, NUMBER 3, DECEMBER 2017
Publisher : The Indonesian Society for Digestive Endoscopy

Proton pump inhibitor (PPI) has become drug of choice for acid related disease. However, PPI tend to be overprescribed and becoming one of the highest burden for health cost. Some studies showed that PPI are prescribed unnecessarily. Recent evidences showed raised concerns over long term effects of PPI consumption. Several long term side effects such as increased incidence of gastric polyps, micronutrient absorption disorders, infections, and osteoporosis have been yearly discussed. In recent years there has been increased attention to new side effects such as dementia, chronic renal failure, and cardiovascular disorders. Therefore, some health associations had issued warning and guidance regarding long term PPI prescription.

Diagnostic Problem and Management of Intestinal Tuberculosis Ryan Ranitya; Ari Fahrial Syam; Marcellus S Kolopaking; Vera Yoewono
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 2, NUMBER 3, December 2001
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/23200125-27

Intestinal tuberculosis, without any evidence of pulmonary or tuberculous infection elsewhere in the body, is still a rare case. Sometimes it is very difficult to make an early and prompt diagnosis for this, because clinical manifestations are varied, unspecific, and mimic other diseases. Examinations, including chest x-ray, tuberculin test, acid-fast stained smear, endoscopic and histological findings may still be inconclusive. Thus, therapeutic trials of anti- tuberculous drugs are advised. We report a case of intestinal tuberculosis with a chief clinical manifestation of chronic diarrhea. There was no evidence of tuberculous infection elsewhere in the body Endoscopic appearance and histological findings were atypical and unspecific. The patient was given anti- tuberculous drugs and responded very well clinically within 2 weeks. Keywords: Intestinal tuberculosis, difficult diagnosis, management

Imaging Modalities Role inRecurrent Acute Pancreatitis Diagnosis Andreas Pekey; Rio Zakaria; Leonard Nainggolan; Ari Fahrial Syam; Dadang Makmun
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 15, No 3 (2014): VOLUME 15, NUMBER 3, December 2014
Publisher : The Indonesian Society for Digestive Endoscopy

Recurrent acute pancreatitis (RAP) is a potentially life-threatening pancreatic disorder. Itrequires a combination of medical and interventional skills to diagnose, determine the etiology, and treat the condition. Recurrencesoccur in 25-30% of all acute pancreatitis cases. The most common cause of RAP is gallstone (microlithiasis). Imaging modalities become an important aspect to evaluate multiple microlithiasis. In this case, we report a 52 years oldoverweight female with RAP and fatty liver ofunknown etiology.We suspected gallstone as the cause of RAP. Physical examination considered normal. Ultrasound and abdominal CT scan wasperformed in whichfatty liver were founded. Since the gallstone is not clearly found with radiologic imaging, we decide to undergoEndoscopic Retrograde Cholangiopancreatography(ERCP)procedure to evaluatea possibility of microlithiasis. ERCPresult showed a multiple microlithiasis, thus we evacuate the stones. Clinical outcome post ERCP and evacuationprocedure was good. We concluded that the best imaging modalities to evaluate microlithiasis in RAP with normal ultrasound and abdominal CT scan is ERCP. Keywords:recurrent acute pancreatitis (RAP), microlithiasis, endoscopic retrograde cholangiopancreatography (ERCP).

Characteristic Profiles of Parasitic and Fungal Infections in Acute Diarrhea Marcellus Simadibrata; Suzana Ndraha; Tjahjadi Robert Tedjasaputra; Ari Fahrial Syam; Achmad Fauzi; Murdani Abdullah; Abdul Aziz Rani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 3, December 2011
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Diarrhea has been widely encountered in developing countries, including Indonesia. This study aimed to investigate the incidence of parasites and fungal infections, which also constitutes the etiologies of acute diarrhea. Method: A cross-sectional study was performed involving 93 patients. Patients with chief complaint of acute diarrhea were recruited at five hospitals in Jakarta, Indonesia during the period of November 2008 until May 2009. Acute diarrhea was defined as passing watery or soft stools with frequency of more than three times per day, weighted more 200 g per day, and occurred in less than 15 days duration. They were asked to collect their stool to the laboratory for further parasites and fungal detection. Results: This study showed that 41 out of 93 patients (44.09%) were found to be infected with parasites or fungi. The most common microorganism found was Candida albicans in 18 (19.35%) patients. Other parasites encountered in the stool samples were Blastocystis hominis, Entamoeba histolytica, Entamoeba coli, Giardia lamblia. The presenting clinical symptoms of the patients were fever (44.87%), bloating (41.03%), nausea (39.74%), oliguria (39.74%), cephalgia (35.90%), vomiting (24.36%), and tenesmus (19.23%). Conclusion: The incidence of parasitic and fungal infections in patients with acute diarrhea constitutes nearly half of all cases of infection-caused diarrhea. The most commonly encountered microorganism is Candida albicans. Keywords: parasites, fungi, acute diarrhea

The Pathogenic Triad of Chronic Cough: Postnasal Drip Syndrome, Asthma, and Gastroesophageal Reflux Disease Wulyo Rajabto; Ari Fahrial Syam; Heru Sundaru
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 8, ISSUE 1, April 2007
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/81200720-23

Chronic cough, lasting for 3 weeks or more, is one of the most common symptoms for which adult patients seek medical attention. The pathogenic triad of chronic cough is Postnasal Drip Syndrome (PNDS), Asthma, and Gastroesophageal Reflux Diseases (GERD) are the vast majority etiology of chronic cough in non-smoker adult with normal chest X-ray. The clinical investigations that should be performed are spirometry pre-post bronchodilator and bronchoprovocation testing for asthma; plain sinus radiograph and or computed tomographic imaging of the sinus for PNDS due to sinusitis; gastro-intestinal investigation 24 hours oesophageal pH monitoring and upper gastrointestinal endoscopy for GERD. Keywords: chronic cough, postnasal drip syndrome, asthma, gastroesophageal reflux disease

Tuberculous Peritonitis Presenting Acute Recurrent Pancreatitis Birry Karim; Afifah Is; Ikhwan Rinaldi; Ari Fahrial Syam; Murdani Abdullah; Ceva Wicaksono Pitoyo
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 10, NUMBER 3, December 2009
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/1032009125-130

Tuberculosis (TB), one of the oldest diseases known to affect humans, is a major cause of death worldwide. TB is still a major problem in Indonesia. This disease, which is caused by bacteria of the Mycobacterium tuberculosis, usually affects the lungs, although other organs are involved in up to one- third of cases. Approximately 95% cases of TB and 98% death because of TB occur in developing country. Gastrointestinal tuberculosis is uncommon, making up 3.5% of extrapulmonary cases in the United States. This kind of TB may involve gastrointestinal tract, peritoneal, lymph nodes, or solid intraabdominal organs (viscera). A 17 years old male admitted to hospital with TB peritonitis presenting unusual clinical manifestation. At the first admission patients was diagnosed with acute pancreatitis based on elevation of amylase and lipase level up to 285 and 2,046 U/L and after finishing further examination, patients suffered from tuberculous peritonitis which based on literature manifested some gastrointestinal disorders. Diagnostic confirmation was accomplished by conducting serum-ascites albumin gradient (SAAG) of 1.1 g/dL, peritoneal thickening and the presence of ascites with fine mobile septations on ultrasound, positive polymerase chain reaction (PCR) TB from ascitic fluid. Patients received conventional antitubercular therapy for 12 months of rifampicin, isoniazid, pyrazinamide, and ethambutol. The addition of corticosteroids for the first two or three months of treatment may reduce the incidence of late complications arising from adhesive disease, such as small bowel obstruction. Keywords: mycobacterium tuberculosis, tuberculous peritonitis, PCR, serum-ascites albumin gradient

Gastric Amyloidosis Achmad Fauzi; Fajar Raditya; Ari Fahrial Syam; Abdul Aziz Rani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 7, ISSUE 3, December 2006
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/73200686-89

Amyloidosis occurs as secondary to rheumatoid arthritis, inflammatory bowel disease and other diseases and also associated with familial Mediterranean fever. Outcomes are worse if there are cardiac or gastrointestinal manifestations. A 57 year-old female was admitted to our hospital with clinical manifestations of nausea, vomiting, epigastric pain, odynophagia, dysphagia and chronic diarrhea. She has also history of rheumatoid arthritis for 10 years. Upper gastrointestinal endoscopy revealed hyperemia in the whole region of gastric mucosa and lower gastrointestinal endoscopy showed hyperemia with erosion in colonic and ileal mucosa. Histopathologic examination of the gastric biopsy showed the deposition of amyloid materials in the mucosa. We report a case of gastric amyloidosis secondary to rheumatoid arthritis. Keywords: gastric amyloidosis, rheumatoid arthritis, dyspepsia

Co-Authors -, Arles - -, Suhendro - -, Suhendro - A.A. Ketut Agung Cahyawan W Aan Santi Aan Santi Abdul Aziz Rani Abdul Aziz Rani Abdul Aziz Rani Abdul Aziz Rani ACHMAD FAUZI Achmad Fauzi Achmad Fauzi Achmadsyah, Armand Adiwinata, Sheila Adjeg Tarius Afifah Is Agasjtya Wisjnu Wardhana Agnes Kurniawan Agustinus, Taolin Ahani, Ardhi Rahman Ahimsa, Titos Ahimsa, Titos Ahmad Aulia Ahmad Fauzi Ali Imron Yusuf Alkindi Bahar Amanda Pitarini Utari Andi Kristanto Andreas Pekey Andreas Pekey, Andreas Andree Kurniawan Andri Sanityoso Andri Sanityoso Andri Sanityoso Anggie Indari Anggilia Stephanie Anggilia Stephanie, Anggilia Anis Karuniawati Ari, Franciscus Arles - - Armen Muchtar Armen Muchtar Arya Govinda Aryanto Basuki Awang, Iqbal I Aziz Rani Bambang Pontjo Priosoeryanto Bambang Setyohadi Beatrice Belinda Phang Bhanu S Kumar Birry Karim Bona Adhista Bradley Jimmy Waleleng Bradley Jimmy Waleleng Budi Tan Oto C Martin Rumende C Rinaldi A Lesmana Caputra, Hadyanto Catarina Budyono Catarina Budyono, Catarina Ceva W. Pitoyo Christy Efiyanti Chudahman Manan Chudahman Manan Chudahman Manan Chyntia Olivia MJ Cindy Rahardja Cleopas Martin Rumende Dadang Makmun Daldiyono Daldiyono Daldiyono Daldiyono Daldiyono Hardjodisasto Daldiyono Hardjodisastro Daniel Gunawan Dante Saksono Harbuwono Deddy Gunawanjati Dedy Gunawanjati Sudrajat Dharmika Djojoningrat Diah Rini Handjari Diah Rini Handjari Diany N Taher Didi Kurniadhi Didi Kurniadhi Djulzasri Albar Dwi Suseno E Mudjaddid E Mudjaddid, E E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Eka Ginanjar Ekowati Rahajeng Ekowati Rahajeng Elizabeth Merry Wintery Ellen Susanti Elli Arsita Elli Arsita Elza Febria Sari Elza Febria Sari Endang Susalit Endang Susalit Ening Krisnuhoni Esthika Dewiasty, Esthika Euphemia Seto, Euphemia Evita H Effendi Evy Yunihastuti Fajar Raditya Fauzi Ahmad Muda Feriadi Suwarna FJW Ten Kate Florentina Caroline Puspita Franciscus Ari Futihati Ruhama Zulfa Gerie Amarendra Ginova Nainggolan Ginova Nainggolan GNJ Tytgat Grace Nami Sianturi Gunawanjati Sudrajat Hadyanto Caputra Hamzah Shatri Hamzah Shatri Hantoro, Ibnu Fajariyadi Haris Widita Haris Widita Haryanto Rahardjo Hasan Maulahela Hasan Maulahela Hasan Maulahela, Hasan Hayatun Nufus Hayatun Nufus Helsi Helsi Heru Sundaru Hery Djagat Purnomo Hery Djagat Purnomo Hotmen Sijabat I Gusti Bagus Wiksuana Ikhwan Rinaldi Ilham Ahmadi Ilum Anam Ilum Anam, Ilum Ina Susianti Timan Indra Marki Indra Marki Indra Marki Indra, Suwito Iqbal I Awang Ira Laurentika Irsan Hasan Ivo Novita Sah Bandar Iwan Ariawan Jacobus Albertus Jeffri Gunawan Joseph JY Sung Josephin Rasidi Julwan Pribadi Jumhana Atmakusuma Kaka Renaldi Karmel Tambunan Katharina Setyawati Khaira Utia Yusrie Kharia Utia Khie Chen L A Lesmana Laksmi, Purwita W. Laurentika, Ira Laurentius A Pramono Laurentius A Pramono, Laurentius A Laurentius Aswin Pramono Laurentius Aswin Pramono Laurentius Lesmana Laurentius Lesmana Leonard Nainggolan Leonard Nainggolan Leonita Ariesti Putri Listya, Luh Putu Luciana Budiati Sutanto Luciana Budiati Sutanto Luh Putu Listya Lusy Erawati Lusy Erawati Lydia D Simatupang M Purnomo Isnaeni Marcellus S Kolopaking Marcellus S. Kolopaking Marcellus Simadibrata Marcellus Simadibrata Marcellus Simadibrata Marcellus Simadibrata Marcellus Simadibrata K Marcellus Simadibrata Kolopaking Marthino Robinson Mazni, Yarman Menaldi Rasmin Moch Ikhsan Mokoagow Murdani Abdulah Murdani Abdullah Murdani Abdullah Murdani Abdullah Murdani Abdullah Murdani Abdullah Nata Pratama Nikko Darnindro Nikko Darnindro Nikko Darnindro Novie Rahmawati Zirta Nugroho, Prionggodigdo Nunung Ainur Rahmah Nur Rasyid Nur Rasyid Nurul Akbar Nurul Akbar Oktaramdani, Tessa Paulus Kusnanto Phang, Beatrice Belinda Pringgodigdo Nugroho, Pringgodigdo Prionggodigdo Nugroho Purwita W Laksmi, Purwita W Puspita, Florentina Caroline Putri, Leonita Ariesti Rabbinu Rangga Pribadi Radhiyatam Mardhiyah Radhiyatam Mardhiyah, Radhiyatam Rahardja, Cindy Ralph Girson Ralph Girson Gunarsa Randy Adiwinata Randy Adiwinata, Randy Ranty, Stefanus Satrio Rasco Sandy Sihombing, Rasco Sandy Rasidi, Josephine Resti Mulya Sari Riadi Wirawan Riadi Wirawan Riahdo Saragih Rino A Gani Rino A Gani Rino Alvani Gani Rino Alvani Gani Rino Alvani Gani Rino Alvani Gani Rio Zakaria Rio Zakaria Rio Zakaria Rolan Sitompul Rudi Putranto Ryan Herardi Ryan Ranitya Sari, Cut Yulia Indah Sayid Ridho Sedijono Sedijono Seri Mei Maya Ulina Sheila Adiwinata Simon Salim Siti Setiati Siti Setiati Stefanus Satrio Ranty Stella Evangeline Bela Stephanie Dewi, Stephanie Steven Sumantri Suhendro - - Suhendro Suhendro Suhendro Suhendro Suhendro Suwarto, Suhendro Sumaryono Sumaryono Sumaryono Sumaryono Suryantini Suryantini Suryantini Suryantini Suwito Indra Suzana Ndraha Syafruddin A. R. Lelosutan Taufiq Taufiq Taufiq Taufiq Teguh Hardjono Tena Djuartina, Tena Tessa Oktaramdani Timoteus Richard Timoteus Richard, Timoteus Tito Ardi Titos Ahimsa Tjahjadi Robert Tedjasaputra Toman L Toruan Tommy P Sibuea Tri Isyani Tungga Dewi Vera D Yoewono Vera Yoewono Vera Yuwono Wardhana, Agasjtya Wisjnu Willy Brodus Uwan Willy Brodus Uwan, Willy Brodus Wina Sinaga Wirasmi Marwoto Wirasmi Marwoto Wulyo Rajabto

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