The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
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.
Articles
771 Documents
Esophagus and Its Function Related to Gastro-esophageal Reflux
Badriul Hegar;
Aldo Reynaldo;
Yvan Vandenplas
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 3, Desember 2012
Publisher : The Indonesian Society for Digestive Endoscopy
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DOI: 10.24871/1332012166-173
ABSTRACTThe main function of the esophagus is to transport food from the mouth into stomach. Anatomical structures, innervations and blood supplies are needed in order to transport the food into stomach. Mastication stimulates the parasympathetic nerves that regulate salivary, gastric and pancreatic secretion. Saliva secretion stimulates swallowing and increases primary esophageal peristalsis, helps in clearing the esophagus from refluxed material. Swallowing induces peristaltic of esophagus that propulses a solid bolus down the esophagus into the stomach. Innervations are important for esophagus to do its function. One of the most important is coordination between the various reflexes. Delayed clearance of acid from the esophageal and decreased pressure of the lower sphincter esophagus (LES) are the major mechanisms involved in the development of esophagitis. The resistance of the mucosa to the noxious effect of the refluxed material (acid, pepsin, chymotrypsin and trypsin, bile, etc.) is different from person to person. The LES pressure is a defense mechanisms to prevent gastro-esophageal reflux disease (GERD). The LES pressure decreases postprandially. The frequency of postprandinal GER is related to the meal size. Gastric bolus feeding is related to greater intragastric pressure causes more of transient LES relaxations. Osmolality and volume of the feeding slow gastric emptying and incrase postprandial GER. The occurrence of GERD is associated with whether or not the preventive factors are functioning. Other preventive factors for GERD are esophageal peristalsis, secretion and mucosal resistance, gravity and position, the LES tone and angle of his. Patient with GERD should be searched for any disturbances on those factors. Keywords: gastroesophageal reflux diseases, lower esophageal sphincter, esophagitis, peristaltic
A 17-Years Old Man of Colitis Tuberculosis with Fistula Perianal
Paulus Kusnanto;
Marcellus Simadibrata;
Ari Fahrial Syam;
Achmad Fauzi;
Murdani Abdullah;
Dadang Makmun;
Chudahman Manan;
Daldiyono Daldiyono;
Abdul Aziz Rani;
Ening Krisnuhoni
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 9, ISSUE 3, December 2008
Publisher : The Indonesian Society for Digestive Endoscopy
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DOI: 10.24871/932008103-106
Tuberculosis (TB) remains to be one of the most common problems in developing countries such as Indonesia. It can involve many organs including gastrointestinal tracts. Colonic tuberculosis is an ancient disease and has long been recognized. However, it is sometimes difficult to make early diagnosis due to its nonspecific signs and symptoms. Perianal granulomas or perianal fistula presents some degree of diagnostic difficulty. A spectrum of diseases can produce granulomas in perianal region and perineum. Most are infectious or inflammatory diseases. Standard histological diagnosis often less significant to clarify the etiology and treatment will vary from one to another disease entity. In this report, we present a case 17-years old man with colitis TB and fistula perianal, in which the initial diagnostic workup suggested Crohn’s disease. Mantoux test, Acid Fast Bacilli test on fecal examination and polymerase chain reaction analysis revealed negative result. The chest X-ray was normal; while the fistulography X-ray: revealed 2 orifices in rectosigmoid area. The colonoscopy revealed mucosa edema with ulceration in rectosigmoid and pedincular polyp in the caecum. Initial colonoscopy diagnosis was Crohn’s disease with differential diagnosis colitis ulcerative, colitis TB, colitis infection. results of direct or post homogenizes examination (Ziel–Nielsen staining) revealed that no acid-fast bacilli was found. Multiple biopsies were done, which indicated mucosa edema with ulceration in rectosigmoid area, pedincular polyp in the caecum, and surrounded by fistula perianal; while histopathological examination showed inflammatory-caseating-epithelioid-granulomas and giant cells (Langhans datia cell) caused by tuberculosis. It highlights the need for awareness of intestinal TB along with the differential diagnosis of chronic intestinal disease. Standard regimen of antituberculosis treatment was given and the patient showed good clinical response. Keywords: Crohn’s disease, caseating epithelioid granuloma, giant cell, colitis TB, perianal fistula
High Incidence of Hepatitis B Virus Infection in Hemodialysis Patients at Sanglah General Hospital and It’s Risk Factors
Cokorda Agung Wahyu Purnamasidhi;
I Ketut Mariadi;
I Dewa Nyoman Wibawa;
Yenny Kandarini
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 17, No 3 (2016): VOLUME 17, NUMBER 3, December 2016
Publisher : The Indonesian Society for Digestive Endoscopy
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DOI: 10.24871/1732016155-161
Background: Patients receiving maintenance hemodialysis (HD) are at higher risk for Hepatitis B Virus (HBV) infections than in general population. Strict infection control is essential to prevent nosocomial transmission. We aimed to investigate the incidence of HBV infection in the HD population in Sanglah General Hospital as well as risk factors acquired HBV infection.Method: All adult patients receiving maintenance HD (n=267) in 3 dialysis units at Sanglah Hospital were studied between March to June 2016. In this study, medical record of patients on maintenance hemodialysis were reviewed and the patients were interviewed by the researchers to collect data regarding the serology status of these patients before and during HD, and potential risk factors which could be associated with HBV acquisition.Results: Participant mean age was 54.07 ± 0.80 years and 154 (57.7%) were male.We found 21 patients (7.8%) were sero-positive for HBV (HBsAg positive) with mean titer was 9.26±1.85. Of the sero-positive patients,1 patient (4.8%) were known to be infected before the initiation of HD and 20 patients (95.2%) were infected during HD. Incidence of HBV infection during HD was 7.5% (20/266). Sero-positive patients were younger with mean age was 51.81±2.76 years, had longer time on dialysis and had previous blood transfusions. Risk factors, which significant associated with hepatitis B infection were history of transfusion (p0.01; OR: 2.49; 95%CI: 1.29-8.18) and duration of hemodialysis (p 0.01; OR: 1.07; 95% CI: 1.03-3.74).Conclusion: Patients on maintenance HD in Sanglah General Hospital have a high incidence of HBV infection. The factors associated with HBV infection are highly suggestive of nosocomial transmission within HD units. History of transfusion and duration of hemodialysis were significant risk factors for HBV infection in patients receiving maintenance HD.
Chronic Pancreatitis
Indira Kemalasari;
Murdani Abdullah;
Marcellus Simadibrata
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
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DOI: 10.24871/1922018107-117
Chronic pancreatitis is a progressive inflammation in pancreas results in fibrosis and irreversible damage lead to loss of exocrine and endocrine function. Mortality and complication rate is high. Appropriate management of chronic pancreatitis begin from accurate diagnosis to adequate treatment. Diagnosis is still a challenge for clinician, mostly in early-stage disease. Several diagnostic modalities such computed tomography scan, magnetic resonance cholangiopancreaticography, endoscopic ultrasound, endoscopic retrograde cholangiopancreaticography, and direct-indirect pancreatic function test help diagnosis establishment. Endoscopic approach has an important role, both during diagnosis and treatment.
Diagnostic Approach and Treatment of Choledocholithiasis
Indah Gianawati;
Ali Sulaiman;
L A Lesmana;
Toar JM Lalisang;
Arman A Abdullah
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 5, ISSUE 2, August 2004
Publisher : The Indonesian Society for Digestive Endoscopy
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DOI: 10.24871/52200471-75
Choledocolithiasis may cause acute cholangitis which is life-threatening condition. It has non specific clinical signs from mild to severe condition such as septicemia. Diagnostic and treatment modalities had developed a great deal recently. Therapeutic options include endoscopic retrograde cholangio pancreatography (ERCP),common bile duct exploration (CBDE), laparoscopic CBDE and stone retrieval. The important thing is to choose the appropriate method for each patient. We reported a case of choledocolithiasis in 40 years old, male patients who was clinically diagnosed as acute cholangitis. Diagnostic approach to find the etiology was done. Abdominal USG and CT were performed and showed multiple stones in gallbladder and intrahepatic biliary duct, suspected mass at caput of the pancreas and hepatomegaly. The ERCP showed dilatation of intra and extra hepatic biliary ducts with multiple stone in common bile duct (CBD), hepatic duct and gallbladder. The stent was placed for biliary drainage. The patient underwent cholecystectomy per laparoscopy, but further evaluation of the cholangiography still showed the presence of stones in intrahepatic biliary duct. Laparotomy exploration of CBD was done and it revealed multiple stones and dilatation of distal CBD. Surgical treatment selected for this case was choledocojejunostomy. Keywords: Choledocolithiasis, CBD, diagnostic approach
Upper Gastrointestinal Bleeding in Critically Ill Patient: Literature Review
William Faisal;
Luciana Rotty
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 22, No 3 (2021): VOLUME 22, NUMBER 3, December 2021
Publisher : The Indonesian Society for Digestive Endoscopy
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DOI: 10.24871/2232021226-233
Critically ill patients are at risk for stress ulcers in the upper digestive tract. Various risk factors have been associated with this condition. Patients who are critically ill are at risk of bleeding due to stress related mucosal disease (SRMD). Upper gastrointestinal tract problems usually occur as a result of severe physiological stress. Patients may develop gastric erosion and develop stress ulcers with severe gastrointestinal bleeding which can be fatal. Routine pharmacological use of stress ulcer prophylaxis (SUP) does not reduce overall mortality in intensive care patients. This increases the risk of infectious complications, particularly nosocomial pneumonia and Clostridium difficile-associated diarrhea. Early enteral nutrition has been shown to be effective in preventing stress ulceration of the upper gastrointestinal tract in critically ill patients. Routine use of stress ulcer prophylaxis in all critically ill patients may be dangerous and does not appear to be cost-effective. SUP administration must follow an algorithm that clearly balances risks and benefits.
The Use of Immunochemical Fecal Occult Blood Test as Colorectal Cancer Screening Tool in Asymptomatic Population in Indonesia
Murdani Abdullah;
Hayatun Nufus;
Ari Fahrial Syam;
Dadang Makmun;
Marcellus Simadibrata;
Abdul Aziz Rani
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
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DOI: 10.24871/151201415-9
Background: Colorectal cancer is the fourth leading cause of cancer-related mortality worldwide. Earlydetection of colorectal cancer is necessary in term of increasing survival. Immunochemical fecal occult bloodtest (I-FOBT) is one of the simple and inexpensive screening modality that can be used widely. No data has been available yet regarding the usage of I-FOBT in Indonesia. This study is a prevalence study of I-FOBT in asymptomatic population in Indonesia. Method: A cross sectional study was conducted in asymptomatic population visiting five public health service centers in Depok district, West Java, Indonesia. This study was performed from January to March 2012. Casereport form and I-FOBT kit were used to assess and screen the patients. Statistic analysis was performed usingChi-square test. Results: The prevalence of positive I-FOBT was almost equally distributed among age group. Femaledominated whole patients 202 (72.7%). Most of them had middle to low education level 116 (41.7%). As manyas 50.7% patients had normal body mass index. We had 11 (4%) patients with positive result of I-FOBT. Conclusion: Prevalence of positive result of I-FOBT in asymptomatic population in Indonesia was 4%.Further studies were needed to confirm sensitivity and specifity of I-FOBT in Indonesia.Keywords: colorectal cancer, immunochemical fecal occult blood test (I-FOBT), early detection
Result Comparison of Fecal Occult Blood Test between FOBT Hb and FOBT Hb tambah Tranferrin in Detecting Upper Gastrointestinal Tract Bleeding
Anik Widijanti;
Sri Sulistiandari;
Tony Hariyanto;
Rahma Triliana
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 1, April 2010
Publisher : The Indonesian Society for Digestive Endoscopy
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DOI: 10.24871/11120102-6
Background: Immunological fecal occult blood test (FOBT) using anti human hemoglobin (Hb) has a low sensitivity in detecting upper gastrointestinal (GI) bleeding, due to Hb degradation. Transferrin (Tf) is more stable in stool when compared to Hb, provides an alternatives on diagnosing upper GI bleeding. This study aim to determine the advantage of FOBT Hb + Tf in detecting upper GI bleeding compared with FOBT Hb alone. Method: This study was conducted by comparing the diagnostic value of Rapid Immunochromatographic FOBT that use anti-human Hb alone, with the one using combination of anti human Hb Tf simultaneously in detecting upper GI bleeding. Stool sample from 48 patients with upper GI bleeding and 29 controls (without any upper GI bleeding) were collected then tested with both FOBT Methods. Endoscopy study was used as gold standard endoscopy to determine test’s diagnostic value. Result: In detecting upper GI bleeding, the sensitivity of FOBT Hb + Tf (85.42%) was higher than FOBT Hb (29.17%). The specifity of both Methods were accurate at 89.66% and 93.10% respectively. Positive predictive values (PPV) for both Methods were also good at 93.18% and 87.50% while negative predictive value (NPV) FOBT Hb + Tf (78.79%) were higher than FOBT Hb (44.26%). Conclusion: Between these two test Methods on detecting upper GI bleeding, FOBT Hb + Tf has higher sensitivity, PPV and NPV value compared to FOBT Hb. It is advisable to use FOBT Hb + Tf for upper GI bleeding screening. Keywords: FOBT, immunochromatography, hemoglobin, transferrin, upper GI bleeding
Gastric Mucosa Plasma Cells is Unspecific for Diagnosing Helicobacter pylori Infection
Gilda Hartecia;
Willy Sandhika;
Ummi Maimunah;
Muhammad Miftahussurur
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 20, No 2 (2019): VOLUME 20, NUMBER 2, August 2019
Publisher : The Indonesian Society for Digestive Endoscopy
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DOI: 10.24871/202201982-86
Background: A high density of Helicobacter pylori is believed to trigger an accumulation of plasma cells in the gastric mucosa. This accumulation stimulated the production of antibodies, causing high antibodies titer being circulated in the blood. The aims of this study is to identify the correlation between the number of plasma cells and H. pylori density in gastric mucosa.Method: This observational analytic study was performed with cross-sectional approach. The samples were the paraffin blocks which consisted of endoscopic gastric biopsy tissues of chronic gastritis patient in Anatomic Pathology Laboratory Dr. Soetomo General Hospital Surabaya in 2017 period. A total of 30 samples were purposively collected. Endoscopic gastric biopsy tissues were stained by two stains, Haematoxylin-Eosin and Modified Giemsa. The examination was performed by experienced pathologist. The correlation between total plasma cells and H. pylori density in gastric mucosa and the difference of total plasma cells between gastric mucosae with different density of H. pylori were determined.Results: There was no significant correlation between total plasma cells and H. pylori density in gastric mucosa. And there was no significant difference of the number of plasma cells found with different density of H. pylori.Conclusion: The number of plasma cells in the gastric mucosa is unspecific for diagnosing H. pylori infection. Other causes associated with plasma cells need to be assessed in further studies.
Colitis Tuberculosis
Budi Tan Oto;
Ahmad Fauzi;
Ari Fahrial Syam;
Marcellus Simadibrata;
Murdani Abdullah;
Dadang Makmun;
Chudahman Manan;
Abdul Aziz Rani;
Daldiyono Daldiyono
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 3, December 2010
Publisher : The Indonesian Society for Digestive Endoscopy
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DOI: 10.24871/1132010143-149
Tuberculosis (TB) is a significant public health problem worldwide. Indonesia is a country with the third highest prevalence of TB in the world after China and India. TB infection can attack all organs of the human body. TB in digestive system is one of the extrapulmonary TB manifestations and comprises of 3- 16% of all extrapulmonary TB cases. This type of TB may affect digestive system, peritoneum, mesentery lymphatic glands, liver, and spleen. Digestive system is affected in 66-75% of patients with abdominal TB. The ileocaecal region is most commonly affected. The manifestation of abdominal TB is not specific. Precise diagnostic approach and supporting results are needed to determine final diagnosis. However, there is no single examination adequate enough to diagnose abdominal TB. If the diagnosis can be established early, this disease could then be managed with conventional anti-TB drugs. Treatment for both 6-9 months period and 18-24 months period has been proven effective in management of extrapulmonary TB. In countries with high abdominal TB prevalence, initiation of anti-TB therapy is allowed if there are the clinical features present. Diagnosis can be determined when the patient has therapeutic response against the the anti-TB treatment. Keywords: tuberculosis, colitis, extrapulmonary, antituberculosis drugs