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All Journal The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Simadibrata, Daniel Martin
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Medicine & Pharmacology

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The Effectiveness of a High-Protein Liquid Dietary Supplementation in Improving Nutritional Status of Malnourished Patients in Hospital Care: a Preliminary Study Simadibrata, Marcellus; Abdullah, Murdani; Witjaksono, Fiastuti; Muzellina, Virly Nanda; Utari, Amanda Pitarini; Wulandari, Yohannessa; Wijayanti, Ari; Mustikarani, Dewi; Haloho, Raja Mangatur; Rachman, Aditya; Simadibrata, Daniel Martin; Mutiara, Rizka; Renaldi, Kaka
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 23, No 1 (2022): VOLUME 23, NUMBER 1, April 2022
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (671.108 KB) | DOI: 10.24871/231202243-51

Abstract

Background: Malnutrition is a very common problem in hospitalized patients. Based on studies conducted in various countries, the prevalence of hospital malnutrition ranges from 20-45%. Hospital malnutrition can occur as a result of insufficient nutrient intake, impaired absorption of nutrients in the gastrointestinal (GI) tract, loss of nutrients due to disease, or increased metabolic requirement during illness. Nutrition is the basis for the healing process as it requires good nutrients through various enzymatic reactions. Some studies have shown that hospital malnutrition increases morbidity, mortality, prolongs the duration of hospitalization, and delays recovery. To improve nutritional status, a high-protein diet can be given. Liquid diet is one of the alternative forms of nutrition because it is easier to swallow.Method: This study was a double-blind randomized controlled trial conducted to assess the effectiveness of high protein liquid dietary supplementation in malnourished hospitalized patients. The patients were assessed for their nutritional status based on ESPEN 2015 criteria. Patients who experienced malnutrition will be divided into 2 groups, namely the control group which was given normal protein liquid diet, while the intervention group was given high protein liquid diet supplementation as much as 2 bottles (200 mL) per day for 7-10 days. Furthermore, the nutritional status of the patient was assessed.Results: By administering high-protein liquid diet supplementation, there was a tendency to increase the strength of the right handgrip in 3 subjects (50%), the tendency to increase body mass index (BMI) in 3 subjects (50%), Subjective Global Assessment (SGA) score improved in 2 subjects with mild/moderate malnutrition (33.3%) and 1 subject with normal nutrition (16.7%), and the tendency to increase the fat-free mass in 3 subjects (50%).Conclusion: The administration of high protein liquid dietary supplementation tended to increase the strength of the right handgrip, BMI, SGA score, and body fat-free mass index.
Combination Treatment in Ulcerative Colitis using 5-Aminosalysilic Acid (5-ASA) and Polysaccharide Peptide of Indonesian Ganoderma lucidum Mycelium Extract Simadibrata, Marcellus; Rachman, Aditya; Budimutiar, Felix; Simadibrata, Paulus; Abdullah, Murdani; Haloho, Raja Mangatur; Wijaya, Anthony Eka; Bisuk, Batara; Maharani, Shabrina; Mustikarani, Dewi; Simadibrata, Daniel Martin; Sugita, Peter
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 24, No 1 (2023): VOLUME 24, NUMBER 1, April, 2023
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/24120232-11

Abstract

Background:  Inflammatory bowel disease (IBD) is idiopathic disease characterized by chronic inflammation of the gastrointestinal tract. Polysaccharide peptide of Ganoderma lucidum mycelium extract (PPGL) is considerably a good option for adjunctive therapy of IBD. This study aims to evaluate the benefit of PPGL in patients treated with 5-ASA.Method: A retrospective observational cohort study was conducted to examine the medical records of 124 ulcerative colitis patients. There were 80 patients in intervention group who were treated with a combination of 5-ASA and PPGL, and there were 44 patients in the control group who were treated with 5-ASA only. Clinical and laboratory endpoints were observed at the baseline and after 30, 60, and 90 days. Clinical endpoints included abdominal pain, bloody diarrhea, aphthous stomatitis, and polyarthritis; meanwhile, laboratory endpoints included hemoglobin level, ESR, CRP, fecal calprotectin, M2-pyruvate kinase (MP2K), fecal culture, C. difficile culture, and colonoscopy results. Clinical trials conducted after patient enrollment with registry number ClinicalTrials.gov NCT04029649.Results: On day-30 there was a significant difference between intervention group 45.6%  and control group 2.3% in abdominal pain complaints (p 0.001). Moreover, laboratory parameters of fecal calprotectin (p 0.001), fecal MP2K (p = 0.015), and hemoglobin (p 0.001) were considerably better in intervention group on day-30. These differences were consistently found on day 60 and 90.Conclusion: The study implies potential correlation between PPGL administration and improvement of clinical and laboratory endpoints up to 90 days. A larger randomized, blinded, prospective study is required to confirm these effects in ulcerative colitis.
Co-Authors Aditya Rachman, Aditya Amanda Pitarini Utari Ari Wijayanti Bisuk, Batara Budimutiar, Felix Fiastuti Witjaksono Haloho, Raja Mangatur Kaka Renaldi Maharani, Shabrina Marcellus Simadibrata Murdani Abdullah Mustikarani, Dewi Mutiara, Rizka Muzellina, Virly Nanda Paulus Simadibrata Sugita, Peter Wijaya, Anthony Eka Wulandari, Yohannessa