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The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy

jghe
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Published by The Indonesian Society for Digestive Endoscopy

ISSN : 14114801 EISSN : 23028181 DOI : -

Core Subject : Health,

Medicine & Pharmacology

The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy is an academic journal which has been published since 2000 and owned by 3 Societies: The Indonesian Society of Gastroenterology; Indonesian Association for the Study of the Liver; The Indonesian Society for Digestive Endoscopy. The aim of our journal is to advance knowledge in Gastroenterology, Hepatology, and Digestive Endoscopy fields. We welcome authors for original articles, review articles, and case reports in the fields of Gastroenterology, Hepatology, and Digestive Endoscopy.

Arjuna Subject : Kedokteran - Ilmu Pencernaan

Articles 12 Documents

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Search results for , issue "VOLUME 14, NUMBER 2, August 2013" : 12 Documents clear

Age and Alarm Symptoms Predict Upper Gastrointestinal Malignancy among Patients with Dyspepsia Hendra Koncoro; I Ketut Mariadi; Gde Somayana; IGA Suryadarma; Nyoman Purwadi; IDN Wibawa
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 2, August 2013
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Upper gastrointestinal (UGI) malignancy is one of the major causes of cancer related death. Endoscopy in dyspeptic patients above 45 years, or those with alarm symptoms may detect this condition. There were only limited data in Indonesia about age and alarm symptoms to predict UGI malignancy. This study was aimed to determine the prevalence of UGI malignancy among dyspepsia patients and to develop a simple clinical prediction model.Method: A cross-sectional study to 390 patients with dyspepsia underwent endoscopy in Endoscopy Unit of Sanglah Hospital Denpasar between July 2012 and June 2013 was conducted. Demography and alarm symptoms were documented. Chi-square and logistic regression test analysis were conducted to analyze variables associated with UGI malignancy.Results: Twenty (5.13%) of 390 patients with dyspepsia had UGI malignancy. Of the 20 patients, 65% were gastric cancer and 30% were esophageal cancer. The mean age was 59 ± 12 years. Variables associated with UGI malignancy were weight loss (OR = 8.2), dysphagia (OR = 6.2), age 45 years old (OR = 5.6), gastrointestinal bleeding (OR = 5.5), persistent vomiting (OR = 5.4), and anemia (OR = 4.9). Using a simplified rule of age 45 years and the presence of any alarm symptom, sensitivity was 85% and specificity was 67.57%.Conclusions: UGI malignancy was found in 5.13% of patients with dyspepsia who underwent endoscopy. Simple clinical prediction model states that age above 45 years and alarm symptoms may be used as a screening tool to predict UGI malignancy.Keywords: dyspepsia, alarm symptoms, upper GI malignancy, clinical prediction model

Update 2013: the Role of Probiotic in Non-alcoholic Fatty Liver Disease, an Evidence Based Approach Alvin Nursalim; Irsan Hasan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 2, August 2013
Publisher : The Indonesian Society for Digestive Endoscopy

During the last two decades, non-alcoholic fatty liver disease (NAFLD) has been a topic in many discussions. The major risk factors for NAFLD is metabolic syndrome, which include obesity, insulin resistance andhypertension. Beside insulin resistance, oxidative stress has been linked with the disease. There is accumulating evidence that intestinal bacterial overgrowth plays an important role in NAFLD pathogenesis. Intestinal bacteria influence the progression of NAFLD through endogenous ethanol production and cytokine that would eventually induce hepatic oxidative stress. Probiotic intervene pathogenic intestinal flora so it is a potential treatment for NAFLD. Many animal studies documented the beneficial effect of probiotic in NAFLD. Probiotic reduce hepatic inflammation, reduce hepatic steatosis and improve insulin resistance. There is still limited human studies upon this topic. However, preliminary result showed potential role of probiotic in NAFLD treatment. Probiotic is safe, cheap and widely available therefore it is a promising new approach for NAFLD therapy. Upcoming study would hopefully provide firm foundation regarding the use of probiotic for NAFLD on human.Keywords: NAFLD, probiotic, metabolic syndrome

Colonoscopic Findings in Patients with Chronic Diarrhea at Mohammad Hoesin Hospital Palembang Imam Supriyanto; Suyata Suyata; Syadra Bardiman Rasyad; Fuad Bakry
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 2, August 2013
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Chronic diarrhea is a common problem encountered by clinicians. Colonoscopy is a tool with high accuracy and sensitivity to depict abnormalities and has the advantage in distinguishing the abnormalities that cause chronic diarrhea. Nevertheless, the colonoscopic findings in patients with chronic diarrhea vary by age. The objective of this study is to observe abnormalities found in lower gastrointestinal tract in patients withchronic diarrhea who underwent colonoscopy and its relationship with age.Method: An observational analytic study, data retrieved from medical record of outpatient and inpatient with chronic diarrhea at Mohammad Hoesin Hospital Palembang from January 2011 until December 2012. Chronic diarrhea diagnosis was based on clinical findings, laboratory result, and colonoscopy procedure. Patients were then divided into groups based on age ( 40 and 40). Data were analyzed with SPSS 12.0.Results: There were 92 patients consisted of 56 (60.9%) male and 36 (39.1%) female. Mean age was 47.67 ± 16.83 with age interval 15-85 years. Group I of 35 (38%) patients, whereas group II of 57 (62%) patients. The colonoscopic findings were ulcerative colitis 33 (35.9%), normal 27 (29.3%), colon tumor 20 (21.7%), colitis tuberculosis 5 (5.4%), Crohn’s disease 3 (3.3%) and polyp 4 (4.3%). Based on age, the incidence of ulcerative colitis was most frequently encountered in both groups, whereas normal colon and colon tumors were encountered most in group II. No correlation was found between age and colon abnormality (p = 0.87).Conclusion: The most common finding was ulcerative colitis followed by normal colon and colon tumor. There was no correlation between age and colon abnormalities.Keywords: chronic diarrhea, colonoscopy, age

Approach for Diagnostic and Treatment of Achalasia Andree Kurniawan; Marcellus Simadibrata; Prima Yuriandro; Lie Khie Chen
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 2, August 2013
Publisher : The Indonesian Society for Digestive Endoscopy

Achalasia is a rare motor disorder of the esophagus and lower esophageal sphincter. The incidence is approximately 1/100,000 per year and the prevalence rate is 10/100,000. Achalasia is quite difficult to establishbecause the symptoms might be insidious and therefore not many people come to seek medical attention until it deteriorates to final stage of the disease. There are several modalities that can be used as diagnostic toolssuch as manometry, barium esophagogram, esophagoduodenoscopy, esophageal CT-scan, until the recent one, high-resolution manometry that can classify achalasia into three different types. The treatment options are the pharmacologic intervention, endoscopic treatment, minimal invasive surgery, and radical surgery.We reported a case of 20 year old female with achalasia who came with dysphagia symptom since three years before. The diagnosis was made by historytaking, physical examination and barium meal and esophagogastroduodenoscopy. The patient underwent pneumatic dilatation and since then the symptom was relieved.Keywords: achalasia, diagnostic, treatment

Impaired Glucose Metabolism in Liver Cirrhosis Suzanna Ndraha; Fendra Wician; Marshel Tendean; Ivan DP Sunardi; Mardi Santoso
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 2, August 2013
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Approximately 30% of patients who suffer cirrhosis maybe diabetic, called hepatogenous diabetes (HD). Insulin resistance seems to be the pathophysiologic basis for HD. Aims of this study were to evaluate the glucose metabolism disorders in liver cirrhosis patients and to observe the insulin resistance in HD.Method: This study was conducted from February-July 2013 in Koja Hospital Jakarta. In the first phase, with observational design, inclusion criteria were liver cirrhosis and exclusion was an acute complication. We recorded their oral glucose tolerance test (OGTT). Patients who met the HD criteria were continued to the second phase, using analytic design, and were compared with type 2 diabetes mellitus (T2DM) patients as control. Mean differences of 2-hours postprandial plasma glucose/fasting plasma glucose (2hPPG/FPG) ratio, as well as fasting insulin levels between both groups were assessed.Results: Twenty four patients were included in our study. Normal glucose tolerance test were noted in 7 (29%) patients, impaired glucose tolerance (IGT) in 6 (25%) patients and HD in other 11 (46%) patients. In the second phase, we obtained the ratio of 2hPPG/FPG in HD was 2 ± 0.5 and T2DM was 1.5 ± 0.4 (p = 0.01). Mean fasting insulin levels in HD was 10.8 ± 4.2 μIU/mL, while T2DM was 9.3 ± 5.3 μIU/mL (p = 0.5). The ratio of 2hPPG/FPG was higher in HD compared to T2DM, assuming the role of insulin resistance in HD.Conclusion: There were impaired glucose metabolism in liver cirrhosis patients, as well as hepatogenous diabetes. Insulin resistance and hyperinsulinemia appeared to play role in HD.Keywords: hepatogenous diabetes, type 2 diabetes mellitus, 2hPP/FPG ratio, fasting insulin level

Diabetes Mellitus Due to Liver Cirrhosis in 33-Year-Old Female Henny Tanadi Tan; Suzanna Ndraha; Helena Fabiani; Fendra Wician; Mardi Santoso; Marshell Tendean
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 2, August 2013
Publisher : The Indonesian Society for Digestive Endoscopy

Impaired glucose metabolism can occur in patient with chronic liver disease, either it is impaired glucose tolerance or diabetes mellitus (DM). DM due to liver cirrhosis is known as hepatogenous diabetes (HD). HDis different from type 2 DM in clinical signs and management.A 33-year-old female came with chief complaint of fatigue since three days before admission. Patient also complained of nausea, vomiting, and increased abdominal circumference since one year ago. Patient wasdiagnosed with DM two months ago. From physical examination, anemic and ascites without signs of cirrhosis were obtained. Laboratory test showed mild anemia with hemoglobin levels 6.5 g/dL, elevated serum bilirubinand liver enzymes, decreased serum albumin, prolonged prothrombin time and elevated random blood glucose. Serologic test showed chronic hepatitis B with HBV DNA 1.61 x 104 copy/mL. The abdominal ultrasound resultshowed liver cirrhosis with ascites.The patient was diagnosed with hepatogenous diabetes in liver cirrhosis due to chronic hepatitis B infection and anemia of chronic disease. The management of this patient was quite complex especially in administrationof oral antidiabetic agent which could affect the liver function.Keywords: hepatogenous diabetes, liver cirrhosis, diabetes mellitus, chronic hepatitis B infection

S-Index and APRI Score to Predict Liver Fibrosis Chronic in Hepatitis B and C Patients Elias Tarigan; Leonardo Basa Dairy; Juwita Sembiring; Mabel Sihombing; Gontar Alamsyah Siregar; Lukman Hakim Zain
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 2, August 2013
Publisher : The Indonesian Society for Digestive Endoscopy

Background: A great interest has been dedicated to the development of non invasive predictive models in recent years to substitute liver biopsy for fibrosis assessment and follow-up. The aim of this study was to comparethe accuracy between S-index and aspartate aminotransferase to platelet ratio index (APRI) to FibroScan for predicting liver fibrosis in chronic hepatitis B and C patients.Method: A cross-sectional study was conducted in 40 patients with chronic hepatitis B and C between January 2010 - May 2011 at Division of Gastroentero-hepatology, Department of Internal Medicine, Adam Malik Hospital, Medan. Patients underwent laboratory examination and FibroScan, then used predictive values to assess the accuracy of S-index scores and APRI compared to FibroScan. The analysis was performed using SPSS 15.0.Results: S-index identified significant fibrosis in 87.5% patients with sensitivity (Se) 87.5% and specificity (Sp) 100%. About 67.5% of 40 patients could be identified correctly. S-index also could accurately predict the absence or presence of cirrhosis in 87.5% of the total 40 patients, with NPV 91.7% and PPV 81.25%, respectively. APRI for significant fibrosis has Se 85.7%, Sp 88%, PPV 88.8%, NPV 69.2%; while Se 53%, Sp 88%, PPV 72.7%, NPV 75.8% for liver cirrhosis. AUROC value for S-index was higher than APRI in predicting significant fibrosis and cirrhosis, i.e. 0.938 vs. 0.917 and 0.873 and 0.707, respectively.Conclusion: The S-index has a higher accuracy than APRI in predicting significant fibrosis and cirrhosis in patients with chronic hepatitis B virus and hepatitis C virus infection.Keywords: S-index, APRI score, FibroScan, chronic hepatitis B and C

Combination Therapy of Sorafenib and Transarterial Chemoembolization in Management of Hepatoma Bhanu S Kumar; Andri Sanityoso; Ari Fahrial Syam; Rino Alvani Gani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 2, August 2013
Publisher : The Indonesian Society for Digestive Endoscopy

Incidence of hepatocellular carcinoma (HCC) continues to increase in developing countries and rank 5th in male and 7th in female. Main cause being reported is chronic hepatitis B in Asian region. Treatment of choice for HCC is liver resection, however it is oftenly not possible to be performed as the disease has entered advanced stage. Due to the less choice of treatment in HCC, one of the several other alternatives has been considered is transarterial chemoembolization (TACE) which is applied in patients who cannot undergo resection or ablation therapy, failure of therapy. However limitation of TACE is very high recurrence rate of HCC. Sorafenib is ananti-angiogenic medicine approved as first systemic drug in HCC therapy. Several studies stated the benefits of combination therapy of TACE and Sorafenib administration to prevent HCC recurrence. Success rate of thiscombination therapy reaches control disease rate of 100% based on response evaluation criteria in solid tumors (RECIST) from European Association for the Study of the Liver (EASL).Keywords: TACE, sorafenib, liver cancer, HCC

Prolonged Cholestatic as a Typical Manifestation of Hepatitis A Infection: Diagnosis and Management Nikko Darnindro; Rinaldi A Lesmana
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 2, August 2013
Publisher : The Indonesian Society for Digestive Endoscopy

Hepatitis A virus (HAV), a positive-strand RNA virus, is stable at moderate temperature and low pH level. These characteristics allow the virus to survive in the environment and be transmitted through fecal-oral route.Twenty-year-old male came with jaundice and itchy skin since one month before admission. He was diagnosed as hepatitis A cholestasis type according to his history taking, physical examination, and laboratory result. Blood test showed elevated total bilirubin 27.4 g/dL, direct bilirubin 21.2 g/dL, indirect bilirubin 6.2 g/dL, alanin aminotransferase (ALT) 95 U/L, aspartate transaminase (AST) 134 U/L, alkaline phosphatase (ALP) 221 U/L, and gamma-glutamyltransferase (gGT) 17 U/L. His ultrasound results showed mild, non-specific hepatomegaly without common bile duct dilatation. The patient got symptomatic therapy with ursodeoxycholic acid (UDCA) 300 mg twice daily for his itchy skin and steroid therapy 0.5-1 mg/kg per day on the tenth day. He did not vomit or feel nausea anymore. After five days of steroid therapy, his total bilirubin level became 10.83 g/dL. He was discharged home with steroid therapy and steroid was tapered off during follow-up in the clinic.Prolonged cholestasis is one of atypical manifestation of hepatitis A which is rarely found. Cholestasis increases morbidity and prolongs hospitalization. Steroid therapy decreased bilirubin level and gave clinicalimprovement to the patient.Keywords: hepatitis A, prolonged cholestasis, steroid therapy

Detecting Liver Fibrosis: a Non-Invasive Era Putut Bayupurnama
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 2, August 2013
Publisher : The Indonesian Society for Digestive Endoscopy

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Murdani Abdullah

Contact Email
ina.jghe@gmail.com

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+6285891498517

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ina.jghe@gmail.com

Editorial Address
Divisi Gastroenterologi, Departemen Ilmu Penyakit Dalam, FKUI/RSUPN Dr. Cipto Mangunkusumo, Jl. Diponegoro No. 71 Jakarta 10430 Indonesia

Location
Kota adm. jakarta pusat,

Dki jakarta

INDONESIA

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Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name Murdani Abdullah

Contact Email ina.jghe@gmail.com

Phone +6285891498517

Journal Mail Official ina.jghe@gmail.com

Editorial Address Divisi Gastroenterologi, Departemen Ilmu Penyakit Dalam, FKUI/RSUPN Dr. Cipto Mangunkusumo, Jl. Diponegoro No. 71 Jakarta 10430 Indonesia

Location Kota adm. jakarta pusat, Dki jakarta INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

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Abstract

Contact Name
Murdani Abdullah

Contact Email
ina.jghe@gmail.com

Phone
+6285891498517

Journal Mail Official
ina.jghe@gmail.com

Editorial Address
Divisi Gastroenterologi, Departemen Ilmu Penyakit Dalam, FKUI/RSUPN Dr. Cipto Mangunkusumo, Jl. Diponegoro No. 71 Jakarta 10430 Indonesia

Location
Kota adm. jakarta pusat,

Dki jakarta

INDONESIA