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INDONESIA
The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
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 771 Documents
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Irritable Bowel Syndrome: Diagnosis and Treatment Muhammad Syafiq; Marcellus Simadibrata K; Murdani Abdullah; E. Mujaddid
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 4, NUMBER 1, April 2003
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/41200314-21

Abstract

Irritable bowel syndrome (IBS) is the most common functional disorder of the gastrointestinal tract. As a result of the lack of specific diagnostic testing and absence of circumscribed biology markers of the disease, its diagnosis is based on a myriad of symptoms. The term irritable bowel syndrome was probably first coined in 1944 by Peters and Bargen. In 1849, Cumming described the clinical manifestations of Irritable Bowel Syndrome. Irritable bowel syndrome is defined on the basis of the recently modified Rome criteria as the presence of at least 12 weeks (not necessarily consecutive) of abdominal discomfort or pain in the preceding 12 months that cannot be explained by structural or biochemical abnormalities, and that has at least two of the following three features: pain relieved with defecation, an onset associated with a change in the frequency of bowel movements (diarrhea or constipation), or an onset associated with a change in form of stool (loose, watery, or pellet-like). The syndrome can be divided into three subcategories according to the Modified Rome criteria II; those with a predominant symptom of diarrhea, constipation, or constipation alternating with diarrhea. There are several criteria for irritable bowel syndrome, one of which is the Manning criteria, applied in many epidemiological and clinical studies to identify irritable bowel syndrome. However, many investigators disagree with this criteria due to a seemingly poor validity in men. In an attempt to bring order to the specialty, consensus-based approach is adopted by a group of international experts, which led to the development of the Rome criteria for irritable bowel syndrome (Table 1). Extra-intestinal symptoms, including headache, backache, urinary and gynecologic symptoms, and fatigue, are more common in the constipation-predominant subgroup.
Role of Proton Pump Inhibitor in the Management of Acid-Related Disorders Elli Arsita; Achmad Fauzi
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 15, No 1 (2014): VOLUME 15, NUMBER 1, April 2014
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (5307.284 KB) | DOI: 10.24871/151201431-7

Abstract

Proton pump inhibitor (PPI) is the strongest inhibitor to gastric acid secretion. PPI is effective in all gastricacid disorders, such as: peptic ulcer, gastroesofageal reflux disease, non steroid anti inflammatory drugs (NSAIDs)gastropathy, and Zollinger-Ellison syndrome. Several studies comparing one PPI to another. Although somedifferences have been reported, there are small differences with unclear clinical importance.PPI has side effects that may be related to diarrhea due to Clostridium difficile, pneumonia, hip fracture, vitamin B12 deficiency, and IgE mediated allergic reaction. Several studies revealed strong association but havelimitation in design and sampel size. PPI therapy should be according to indication, dose, and appropriate period.Keywords: proton pump inhibitor, gastric acid disorder, indication, dose, period ABSTRAKPenghambat pompa proton (PPP) adalah inhibitor paling kuat terhadap sekresi asam lambung. PPPefektif untuk terapi semua gangguan asam lambung termasuk ulkus peptikum, penyakit gastroesofageal reflux,gastropati karena obat anti inflamasi non steroid (OAINS), dan sindrom Zollinger-Ellison. Beberapa penelitianmembandingkan beragam PPP satu dengan yang lainnya. Walaupun dilaporkan ada beberapa perbedaan,namun besaran perbedaannya kecil dan tidak jelas kepentingan klinisnya.PPP kemungkinan berkaitan dengan efek samping diare karena Clostridium difficile, pneumonia, frakturpanggul, defisiensi vitamin B12, dan reaksi alergi yang dimediasi IgE. Beberapa penelitian menunjukkanhubungan yang kuat namun memiliki keterbatasan desain dan besaran sampel. Terapi PPP harus sesuai denganindikasi, dosis, dan jangka waktu yang tepat.Kata kunci: penghambat pompa proton, gangguan asam lambung, indikasi, dosis, jangka waktu
Serum Zinc Level and Urinary Zinc Excretion in Liver Cirrhotic Patient Catharina Triwikatmani; Putut Bayupurnama; Sutanto Maduseno; Neneng Ratnasari; Fahmi Indrarti; Siti Nurdjanah
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 10, ISSUE 1, April 2009
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/10120092-6

Abstract

Background: Zinc deficiency is commonly found in liver cirrhotic patient, and it is usually caused by excessive urinary excretion that is exaggerated by diuretic agents. The objective of this study is to know the differences of zinc serum concentration according to the Child-Turcotte-Pugh (CTP) score and clinical factors that influence zinc serum level and 24-hour urinary zinc excretion. Method: The design of this study was cross-sectional. In adult patients with liver cirrhosis, blood samples were collected after patients had fasted for at least 8 hours. Zinc levels were measured by the flame atomic absorption spectrophotometry method. Correlation test was performed among numeric variables, as well as Mann-Whitney U test to measure mean differences of zinc serum concentration and of 24-hours urinary zinc excretion according to clinical factors. The level of significance was p 0.05. Results: During the period of May 1st - September 30th 2007, there were 36 eligible patients. The mean value of zinc serum levels was 63.70 ± 24.85 µg/dL. There were 24 (66.67%) patients with hypozincemia. The mean value of 24-hour-urinary zinc excretion was 787.52 ± 570.20 µg. There were 19 (52.8%) patients with urinary zinc excretion 550 µg/24 hour. The results of mean difference test of zinc serum concentration between CTP score B and C showed no statistical significance (p = 0.052). Urinary zinc excretion correlated to urine volume (r = 0.638, p = 0.000), and it was higher in hospitalized patients compared to outpatients. It also was higher in men compared to women. There were no statistically significant differences in zinc serum level, zinc urinary level, and urinary zinc excretion on the administration of diuretic agents. Conclusion: There were no significant differences of fasting zinc serum concentration in cirrhotic patients between the CTP scores B and C. In liver cirrhotic patients, urinary zinc excretion positively correlates to urine volume.   Keywords: liver cirrhosis, serum zinc level, urinary zinc excretion
Factors Associated with Surveillance for Early Detection of Hepatocellular Carcinoma in Liver Cirrhosis Patients Ario Perbowo Putra; Andri Sanityoso Sulaiman; Juferdy Kurniawan; Kuntjoro Harimurti
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (167.745 KB) | DOI: 10.24871/1832017153-158

Abstract

Background: Minimal number of KHS patients diagnosed through surveillance is thought to be the cause of continued low survival. It is important knowing the proportion of surveillance for early detection of KHS in patients with liver cirrhosis and related factors.Objective: Determine the proportion of surveillance for early detection of KHS in patients with liver cirrhosis and related factors.Method: Cross-sectional study of patients with liver cirrhosis at RSCM from January to December 2013. Data obtained from medical records and reconfirmed by telephone. Surveillance is required for abdominal ultrasound with or without AFP at least once a year within 3 years after that period. Factors studied were gender, ethnicity, education level, income level, availability of medical assurance, location of residence, surveillance education, cirrhosis etiology, and severity of cirrhosis. Then logistic regression test is used in the multivariate analysis.Results: From 200 patients, 50 patients (25,0%) underwent surveillance, 150 patients (75,0%) did not. Bivariate analysis resulted in 4 variables with p 0.25, gender (p = 0,056), ethnicity (p = 0, 231), surveillance education (p = 0,005), and severity of cirrhosis (p = 0, 005). Multivariate analysis resulted risk factors for surveillance were surveillance education (OR = 2,598; CI 95% (1,325 - 5,094), p = 0,005) and severity of cirrhosis (OR = 1.815; CI 95% = 1,210-2,724; p = 0,004).Conclusion: Surveillance education and severity of cirrhosis are factors associated with surveillance for early detection of KHS in liver cirrhosis patients.
Non-endoscopic Examination as Predictor of Varices Degree in Liver Cirrhosis Patients Who have Experienced Esophageal Variceal Bleeding Paulus Kusnanto; Marcellus Simadibrata; Irsan Hasan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 1, April 2011
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/121201115-22

Abstract

Background: Standard diagnosis for determining the degree of varices is by endoscopy. However, sometimes there are obstacles in the implementation of endoscopy. Based on the factors, we need to know the parameters of non-endoscopic examination which include ascites, splenomegaly, thrombocytopenia, Child-Pugh, portal vein diameter as a predictor of the degree of liver cirrhosis patients with varices who have experienced esophageal variceal bleeding. Method: The study design was cross-sectional study. The study was conducted on hospitalized patients in Cipto Mangunkusumo hospital, Gatot Subroto hospital, and Kraton hospital from September 2008 to November 2009. The patients were liver cirrhosis patients with history of upper gastrointestinal bleeding, no present bleeding, and hemodynamically stable. Examination of predictor factors in the patients such as ascites, splenomegaly, thrombocytopenia, Child-Pugh and portal vein diameter were done. Statistical analysis was performed with student’s t-test, Mann-Whitney test, and stepwise multivariable logistic regression. Results: The study involved 44 patients with liver cirrhosis who have esophageal variceal bleeding. Based on the results of endoscopic examination, large varices (F3) were found in 21 (47.73%) patients, small varices (F1 F2) in 23 (52.27%) patients, located on the distal esophagus extending to the medial (86.4%), with red color sign present (54.5%). Results of non-endoscopic examination such as splenomegaly, ascites, thrombocytopenia, portal vein diameter and Child-Pugh score was known not to be associated with the degree of esophageal varices (p 0.05). Conclusion: Non-endoscopic examination was not related to the degree of varices in liver cirrhosis patients who have experienced esophageal variceal bleeding. Keywords: esophageal variceal bleeding, liver cirrhosis, predictor factors, endoscopic criteria
Prevalence of Helicobacter pylori infection in adult patients with dyspeptic symptoms in Abdi Waluyo Hospital Jakarta from January 2017 to December 2019 Maureen Irawati; Felix Aloysius Budimutiar; Guntur Darmawan; Deborah Theresia Budimutiar; Marcellus Simadibrata
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 22, No 1 (2021): VOLUME 22, NUMBER 1, April 2021
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (558.516 KB) | DOI: 10.24871/221202137-41

Abstract

Background: Helicobacter pylori infection is a global public health problem and may be present in more than half of the world’s population  Prevalence in developing country higher compared to developed country. However, in Indonesia prevalence of Helicobacter pylori infection is still low compare to other Asian countries. This study aims to determine the prevalence of Helicobacter pylori infection in Abdi Waluyo Hospital Jakarta from January 2017 to December 2019.Method: In this cross sectional study, a total of 772 adult patients were tested using Urea Breath Test-14C for detection of isotopic carbon produced by Helicobacter pylori ability to broke down urea.Results: Prevalence of Helicobacter pylori infection in Abdi Waluyo hospital between January 2017 – December 2019 was 20.98% with endoscopic findings as follows: 17.48% with gastritis,  3.24% with gastric ulcers , 0.26% with gastric cancerConclusion: Increase prevalence of Helicobacter pylori infection every year in Abdi Waluyo hospital. It is suggested to perfom Urea Breath Test for adult patients with dyspeptic symptoms to screened Helicobacter pylori infection. 
Risk Factors for Recurrent Upper Gastrointestinal Tract Bleeding after Esophageal Varices Ligation on Patients with Liver Cirrhosis Syarif Hidayat; Dharmika Djojoningrat; Nurul Akbar; Nanang Sukmana; Sabarinah Prasetyo
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 5, ISSUE 3, December 2004
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/53200479-88

Abstract

Background: Upper gastrointestinal tract (GIT) bleeding on liver cirrhosis patients will increase morbidity and mortality. Recurrent bleeding’s risk rise after the first episode of variceal bleeding. The mortality risk also rises on each bleeding. Purpose: This study was done in order to identify the risk factors for the first episode of recurrent bleeding of upper GIT on liver cirrhosis patient. Evaluation of risk factors was based on preliminary data prior to ligation. Method: Evaluation of the upper GIT bleeding was done using anamnesis on the patients or their relatives by letter, home visits or telephone. The data on recurrent bleeding was obtained from medical records. They were evaluated on the 3rd month then 1st year after ligation. This study was a cross sectional study with retrospective data and a consecutive sampling method. Result: Bivariate analysis revealed the 3rd month’s risk factors for first episode of upper GIT bleeding were ascites, total bilirubin level of 2 mg/dL, hepatoma, Child-Pugh C classification of the liver function and red color sign on esophageal varices. The risk factors for the first episode of upper GIT bleeding on first year were age £ 60 years old, hepatoma, and red color sign (RCS) on esophageal varices. The differences between risk factors on upper GIT bleeding on the 3rd month and 1st year were likely due to intervention, collateral para-esophageal varices, medication that irritated GIT, physical activities, and differences on variceal obliteration rate related to variceal ligation. Conclusion: Risk factors for recurrent upper GIT bleeding that could be minimized were ascites, total bilirubin level, Child-Pugh classification and RCS. It was expected with parascentesis, diuretics, hepatoprotector medications and drugs that lowers portal hypertension (such as propranolol and isosorbid mononitrate), might improve those risk factors thus decreasing the risk for recurrent upper GIT bleeding. Keywords: Upper gastrointestinal tract, esophageal varices, liver cirrhotic
Gastric Mucous Atrophy and Metaplasia in Patient with Helicobacter pylori Infection Nikko Darnindro; Ari Fahrial Syam; Diah Rini Handjari; Dadang Makmun
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 16, No 1 (2015): VOLUME 16, NUMBER 1, April 2015
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (121.166 KB) | DOI: 10.24871/161201513-16

Abstract

Background: Helicobacter pylori (H. pylori) is one of the most common bacteria found in human and cause chronic infection. Recent study conducted in one of private hospitals in Jakarta shows that there is a trend of declining prevalance of H. pylori from 12.5% in 1998 to 2.9% in 2005. The aim of this study is to obtain` the prevalance of gastric atrophy and metaplasia in patients with H. pylori infection based on histopathology.Method: This was a case control study between June to August 2014 with 69 cases and 71 controls using medical records datas and histopathology results. Control sample was taken consecutively from patient undergone esophagogastroduodenoscopy procedure in 2013.Results: The average age for patient with H. pylori was 51 years slightly higher than patient with negative H. pylori (p 0.05). Generally, the prevalence rate among males was slightly lower than females (p 0.05). From Histopathology findings, active chronic gastritis was found in 62.3% patients with positive H. pylori than only 12.7% in patient with negative H. pylori (95% CI = 4.86-26.7; OR = 11.31). Mild and moderate  atrophy was higher among H. pylori positive (p = 0.09). gastric mucous metaplasia was also higher (10% vs. 1.4%) among positive H. pylori patient (p = 0.03).Conclusion: H. pylori infection can cause atrophy and metaplasia in gastric mucosa. Prevalence of gastric metaplasia caused by H. pylori infection is lower in this study compared to the same study abroad.
Factors Found on the First Variceal-Bleeding Episode in Liver Cirrhosis Patients with Portal Hypertension Arnold Hasahatan Harahap; Dadang Makmun; Irsan Hasan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 1, April 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/111201015-18

Abstract

Background: The dietary protein restriction that was commonly recommended to hepatic encephalopathy (HE) patients, often leads to malnutrition, whereas malnutrition can deteriorate cirrhosis prognosis. The aims of this study were to find out encephalopathy improvement that was measured by critical flicker frequency (CFF) test and nutritional status by measuring prealbumin level after L-Ornithine L-Aspartate (LOLA) treatment with adequate calories and protein intake in patients with HE. Method: Patients with liver cirrosis who visited Cipto Mangunkusumo hospital on June-October 2009 was evaluated by CFF test using HEPAtonormTM device. Encephalopathy was defined when CFF 39 Hz. Nutritional status was measured by the mid-arm muscle circumference (MAMC) and was stated as malnutrition when the MAMC was below the 15th percentile. Patients had been treated by 3 x 6 mg LOLA granules for 2 weeks, and adequate calories and protein intake with branched-chain amino acid (BCAAs) substitution. The change of encephalopaty was evaluated by the CFF test and the nutritional status by measuring prealbumin blood level. Results: There were 17 patients with liver cirrhosis who fulfilled the inclusion criteria. The mean CFF Result increased from 34.1 ± 2.5 Hz to 36.5 ± 2.9 Hz after LOLA treatment with the adequate calories and protein intake including BCAAs substitution, which was statistically significant (p 0.001) compared to before treatment. The prealbumin level also increased significantly compared before treatment, i.e. from 5.4 ± 2.1 mg/dL to 6.4 ± 2.6 mg/dL, p = 0.008. Conclusion: HE patients with malnutrition could be given adequate calorie and protein with BCAAs substitution to improve their nutritional  status,  and  LOLA  granules for the improvement of HE. Keywords: minimal hepatic encephalopathy, malnutrition, CFF, LOLA, prealbumin, BCAAs
Signet-Ring Cell Carcinoma of the Ampulla of Vater Lianda Siregar; Imelda M Loho; Agus Sudiro Waspodo; Dwi Sri Rejeki; Fajar Firsyada; Rahmanandika Swadari; Getty Inash Nandika; Muhammad Iqbal Siregar
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 19, No 2 (2018): VOLUME 19, NUMBER 2, August 2018
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1108.537 KB) | DOI: 10.24871/1922018126-129

Abstract

Signet-ring cell carcinoma (SRCC) of the ampulla of Vater is a very rare case and only 28 cases have beed reported in the English literature. Herein, we report a 59-year-old woman with SRCC of the ampulla of Vater. She developed symptoms of obstructive jaundice at early stage of disease and underwent pylorus-preserving Whipple procedure as definitive treatment. Histopathology examination showed numerous tumor cells with intracytoplasmic mucin and eccentric nuclei. Her tumor has already invaded the serosa of duodenum, but no infiltration to the stomach, pancreas, and lymphovascular structure. Her surgical margins and regional lymph nodes were free of tumor. She was diagnosed with T2N0M0 (stage IB) SRCC of the ampulla of Vater. No adjuvant treatment was given and she has been doing well for five months after surgery.

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