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Divisi Gastroenterologi, Departemen Ilmu Penyakit Dalam, FKUI/RSUPN Dr. Cipto Mangunkusumo, Jl. Diponegoro No. 71 Jakarta 10430 Indonesia
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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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Effectivity of Extracorporeal Shock Wave Lithotripsy (ESWL) and Stenting vs. Stenting Only for Difficult Common Biliary Duct Stones: A Retrospective Analysis Maulahela, Hasan; Rumagesan, Djahalia; Abdullah, Murdani; Makmun, Dadang; Renaldi, Kaka; Simadibrata, Marcellus; Shatri, Hamzah; Fauzi, Achmad; Tandan, Manu
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: 10.24871/241202323-29

Abstract

Background: Endoscopic retrograde cholangiopancreatography (ERCP) alone may not be sufficient for treating difficult common bile duct stones. To address this challenge, several other modalities exist, including extracorporeal shock wave lithotripsy (ESWL) and biliary stent placement. This study aims to investigate the effectiveness of ESWL following biliary stent placement, in comparison to biliary stent placement alone , in the treatment of difficult common bile duct stones.Methods: A retrospective cohort study was conducted using medical record data from the Gastrointestinal Endoscopy Center Registry of Dr. Cipto Mangunkusumo General National Hospital. This study evaluated 126 subjects with difficult bile stones, who were divided into two groups: one group received biliary stent placement alone, while the other underwent extracorporeal shock wave lithotripsy (ESWL) following biliary stent placement. The effectiveness of each treatment was assessed based on the rate of complete clearance of bile stones.Results: Of the total participants, 72 underwent ESWL following biliary stent placement, while 54 received biliary stent placement alone. The rate of complete stone clearance was 69.1% in the ESWL group and 64.8% in the stent-only group. However, the addition of ESWL as an adjuvant therapy did not result in a statistically significant improvement (p = 0.703; 95% CI: 0.816–1.351). Normal body mass index was a factor that influences the effectiveness of ESWL after biliary stent placement (p = 0.002).Conclusion: The ESWL procedure as adjuvant therapy following biliary stent placement has the same level of effectiveness as biliary stent placement alone.
Diagnosis and Management of Chylous Ascites Prihastuti, Putu Shely; Wibawa, I Dewa Nyoman
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: 10.24871/241202363-71

Abstract

Chylous ascites (CA) is a rare form of ascites that results from the leakage of lipid-rich lymph into the peritoneal cavity. This usually occurs due to trauma and rupture of the lymphatics or increased peritoneal lymphatic pressure secondary to obstruction. The underlying etiologies for CA have been classified as traumatic, congenital, infectious, neoplastic, postoperative, cirrhotic or cardiogenic. Since malignancy and cirrhosis account for about two-thirds of all the cases of CA in Western countries. The diagnosis of CA is based on the distinct characteristic of the ascitic fluid which includes a milky appearance and a triglyceride level of 200 mg/dL. The management consists of identifying and treating the underlying disease process, dietary modification, and diuretics. Treatment with nutritional optimization and management of the underlying etiology are the cornerstones of therapy. When conservative measures fail, other interventions such as octreotide/somatostatin analogues, surgical ligation, embolization and transjugular intrahepatic portosystemic shunt in patients with cirrhosis can be considered.
The Plausible Use of Mango (Mangifera indica) Peel Isoquercitrin as Adjuvant Therapy for Colorectal Cancer: Translating Research from Bench to Bedside Habiburrahman, Muhammad; Sutopo, Stefanus; Rahadiani, Nur
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: 10.24871/241202354-62

Abstract

A deadly and debilitating disease, colorectal cancer (CRC), is rapidly becoming a significant threat to public health. However, current therapeutic approaches are still hampered by various side effects. Due to its benefits and remarkable apoptotic impact on cancer cells, plant-derived flavonoids now garner interest as candidates for cancer therapy. Isoquercitrin, a flavonoid commonly found in fruit plants, especially mangoes, is notable due to its ability to inhibit cancer development through various mechanisms. This review aims to highlight the use of isoquercitrin extracted from mango peels in inhibiting CRC carcinogenesis. A literature search was done on Pubmed, Proquest, and Google Scholar using inclusion and exclusion criteria, and a narrative review was synthesised using the evidence gathered. Validity assessment was done through the the Office of Health Assessment and Translation (OHAT) and Oxford Center for Evidence-Based Medicine (CEBM) critical assessment tools. Evidence suggested that isoquercitrin is promising as adjuvant therapy in CRC. It may inhibit overaccumulation of cytoplasmic β-catenin and its translocation into the nucleus, thus downregulating the expression of target proto-oncogenes leading to carcinogenesis of colon crypts. Isoquercitrin concentration in mango peel is abundant, 557.7 mg/kg in dried mango peel and 31.0 mg/kg in pure extracts. A pharmacology study approved that a daily intake of 5.4 mg/kgBW of isoquercitrin has an effective anticancer effect. This substance has good oral bioavailability and is well-tolerated but inhibits the metabolising enzymes CYP1A1 and CYP1B1. In conclusion, isoquercitrin is a potential adjuvant in inhibiting CRC growth with minimum costs and side effects.
Spleen and Liver Stiffness as Noninvasive Predictors of Varices in HBV Cirrhosis Siahaan, Billy Stinggo; Kurniawan, Juferdy; Simadibrata, Marcellus; Rizka, Aulia; Sanityoso, Andri; Rumende, Cleopas Martin; Rachman, Andhika; Shatri, Hamzah
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 24, No 2 (2023): VOLUME 24, NUMBER 2, August, 2023
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2422023137-142

Abstract

Background: Esophageal varices (EV) are the most frequent complication of portal hypertension in patients with liver cirrhosis. Due to many reasons, esophagogastroduodenoscopy remains impractical for routine surveillance in everyday practice. Hence, ongoing studies into reliable non-invasive test for predicting EV are still important.Methods: A total of 71 patients with liver cirrhosis due to hepatitis B who underwent endoscopy, spleen stiffness measurement (SSM), and liver stiffness measurement (LSM) between January and April 2023 were enrolled in this study. Diagnostic applicability was assessed using the area under the receiver-operator curve (AUC) to measure and compare the performance of each measurement and combination for predicting EV, as well as to obtain the corresponding optimal prediction value.Results: This study included 71 patients with liver cirrhosis. Among them, 74.6% (53 patients) were classified as Child-Pugh A, 22.5% (16 patients) as Child-Pugh B, and 2.8% (2 patients) as Child-Pugh C. The prevalence of esophageal varices (EV) within the cohort was 71.8%. This study showed that SSM with a cut-off of 38.8 kPa had AUC 0.867 (95% CI: 0.774–0.960) (sensitivity 78.4%, specificity 80%), and LSM with a cut-off of 10.55 kPa had AUC 0.822 (95% CI: 0.701–0.943) (sensitivity 88.2%, specificity 65%).Conclusion: Spleen and liver stiffness measurements demonstrate good performance in predicting EV in patients with liver cirrhosis caused by hepatitis B.
Selective Serotonin Reuptake Inhibitors and Risk of Gastrointesinal Bleeding In Dyspepsia: An Evidence-Based Case Report Shatri, Hamzah; Zulkifly, Steven; Putranto, Rudi; Makmun, Dadang; Fauzi, Achmad; Maulahela, Hasan; Faisal, Edward; Irvianita, Vinandia; Ardani, Yanuar
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 24, No 2 (2023): VOLUME 24, NUMBER 2, August, 2023
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2422023182-191

Abstract

Aim: This evidence-based case report aims to provide the latest evidence about the risk of gastrointesinal (GI) bleeding in selective serotonin reuptake inhibitor (SSRI) users with dyspepsia.Method: The literature search was conducted in four major electronic databases (PubMed, Cochrane, Scopus, ProQuest). The selected articles were sorted through screening abstract based on the inclusion and exclusion criteria. Critical appraisal was performed by using validated critical appraisal tool.Results: Of 247 records from extensive literature searching, three eligible studies (one randomized clinical trial and two cohort studies) were obtained to answer the clinical question. All studies showed SSRIs did not increase the risk of GI bleeding in patients with functional dyspepsia and peptic ulcer. However, the adverse event of SSRIs might be under-reported.Conclusion: According to the evidence, the risk of GI bleeding in SSRIs users with dyspepsia is still unclear. Larger size of sample of controlled trial study is recommended to be conducted to calculate the precise risk of GI bleeding in SSRI users with dyspepsia.
Prevalence and Association of Helicobacter Pylori Infection in Bowel Disease at Dr. Cipto Mangunkusumo General National Hospital 2010–2021 Simadibrata, Marcellus; Mustikarani, Dewi
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 24, No 3 (2023): VOLUME 24, NUMBER 3, December, 2023
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2432023222

Abstract

BSTRACT[WU1] [DM2] Background: Recent studies showed contrasting associations between Helicobacter pylori infection and organic bowel disorders, where positive associations were reported in colorectal carcinoma (CRC) and colorectal polyp, while a protective association was observed in patients with inflammatory bowel diseases (IBD). We aim to determine the association between H. pylori infection and CRC, colorectal polyps, and IBD in Indonesian tertiary Hospital.Method: We retrospectively collected data from patients referred to Dr. Cipto Mangunkusumo General National Hospital from 2010 to 2021 with a complete H. pylori test from electronic medical records. We performed a chi-square analysis and logistic regression with a significant p-value of 0.05.Results: Three hundred and fourteen patients were enrolled. Overall, the prevalence of H. pylori infection in organic bowel disease was 61.7% (n = 194), with 9.9% (n = 31) of them having CRC, 20.3% having colorectal polyps (n = 64), and 31.5% (n = 99) having IBD. A proven association between H. pylori infection and IBD was observed (RR = 0.36; 95% CI: 0.18‒0.70; p = 0.000). However, no significant association was found between H. pylori infection and CRC (RR = 0.60; 95% CI: 0.22–1.66; p = 0.31) and colon polyps (RR = 0.59; 95% CI: 0.30–1.15; p = 0.10).Conclusion: Our study suggested an association between H. pylori infection and IBD patients. However, an insignificant association was observed between H. pylori infection, CRC, and colorectal polyps. Keywords: Helicobacter pylori, inflammatory bowel disease, colorectal cancer, colorectal polyps 
Relationship between Absolute Lymphocyte Count and Ascites in Patients with Liver Cirrhosis Riyadi, Nathasya Rizkyana; Carmelita, Austin Bertilova; Sasmithae, Lia; Kahanjak, Donna Novina; Putra S, Ravenalla Abdurrahman Al Hakim Sampurna
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 24, No 3 (2023): VOLUME 24, NUMBER 3, December, 2023
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2432023195

Abstract

Background: Cirrhosis is the final stage of liver disease characterized by fibrosis and irreversible nodule formation due to chronic inflammation. The most common liver cirrhosis complication is ascites, where pathological fluid accumulates in the peritoneal cavity. In cirrhosis, lymphocytes infiltrate the liver and contribute to stellate cell activation, differentiation, and the fibrogenic response. Many recent studies have not studied a relationship between the absolute lymphocyte count and ascites in liver cirrhosis. Therefore, it is important to investigate the relationship between lymphocytes and ascites in liver cirrhosis.Method: This is an observational study with a cross-sectional design study. Held in August–October 2022 at Dr. Doris Sylvanus Hospital's Medical Record Installation. 64 samples were selected based on inclusion and exclusion criteria. Meanwhile, absolute lymphocyte count were measured from the patient's blood tests or by calculation. Ascites were diagnosed by physical examination and radiology. The relationship between absolute lymphocyte count and ascites was analyzed using the chi-square test, with the results considered statistically significant when the p-value 0.05.Result: The medical records from April 2019 to April 2022, there were 64 samples, of which 15 and 49 were without and with ascites. Based on the chi-square test results, there was a significant relationship between absolute lymphocyte count and the incidence of ascites, with p = 0.02.Conclusion: This study concluded that there is a relationship between absolute lymphocyte count and ascites in patients with liver cirrhosis, where absolute lymphocyte count tends to decrease.
The Prevalence, Characteristics, and Relationship of Risk Factors in Upper GI Tract Bleeding Patients Undergoing Endoscopy in Dr. Doris Sylvanis General Regional Hospital in 2019–2020 Syahridho, Muhammad Andrean; Sasmithae, Lia; Carmelita, Austin Bertilova
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 24, No 2 (2023): VOLUME 24, NUMBER 2, August, 2023
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2422023107-115

Abstract

Background: Upper gastrointestinal bleeding occurs in the lumen from the proximal section of the Treitz ligament. Furthermore, it is divided into variceal and non-variceal bleeding based on the etiology. The risk factors include age, smoking, alcohol, portal hypertension, hepatitis, and medications. Upper GI bleeding manifests as hematemesis and melena. This study aims to determine the prevalence, characteristics, and relationship of risk factors with upper GI bleeding in patients undergoing endoscopy in Dr. Doris Sylvanus General Regional Hospital Palangka Raya in 2019–2020.Method: An analytical observational study with a cross-sectional design is conducted using the patient’s medical record data.Results: The results showed that there were 72 patients with upper gastrointestinal bleeding, including 44 males and 28 females, accounting for 61.11% and 38.89%, respectively. About 47 patients had the highest age group, making up 65.28%, and the peptic ulcer was the most common etiology, occurring in 43 patients (59.72%). Also, the highest clinical manifestations and risk factors were melena in 47 patients (65.28%) and smoking in 32 patients (44.4%). The results of the bivariate analysis showed a significant relationship between upper GI bleeding and risk factors for certain drugs, portal hypertension, and hepatitis with a p-value of 0.013, 0.000, and 0.002.Conclusion: In this study, upper GI bleeding was the most common is a non-variceal bleeding, in men, age group under 60 years, with clinical manifestations of melena and there was a significant relationship between UGIB  with certain drugs, portal hypertension, and hepatitis.
The Role of Gut Microbiota Dysbiosis as a Potential Factor in Early Diagnosis, Prognosis and Therapeutic Strategy of COVID-19 Patients Tandarto, Kevin; Suyandi, Kadek Ari; Chandrawati, Lily
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 24, No 3 (2023): VOLUME 24, NUMBER 3, December, 2023
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2432023242

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused the most widespread global pandemic since the 1918 influenza pandemic. The consequences of the coronavirus disease 2019 (COVID-19) are devastating and become the current world major public health issue. Not only SARS-CoV-2 attack the respiratory system, but also can affect multiple organs. Clinical manifestation varies from asymptomatic to severe multiorgan dysfunctions. COVID-19 is typically associated with a set of comorbidities such as hypertension, diabetes, obesity, and/or advanced age, which significantly exacerbates the consequences of infection. During the early stages of the disease, SARS-CoV-2 can also cause gastrointestinal symptoms such as vomiting, diarrhea, or abdominal pain. Intestinal dysfunction alters intestinal microbes and increases inflammatory cytokines. As a result, diagnosing gastrointestinal symptoms that procede respiratory problems during COVID-19 infection may be required for better early diagnosis and treatment. Discovering the composition of the microbiota and its metabolic products in the context of COVID-19 can aid in the identification of novel disease biomarkers and therapeutic targets. In the context of COVID-19, elucidating changes to the microbiome as reliable biomarkers represents an overlooked piece of the disease puzzle that requires further investigation.
Evaluation of Efficacy and Tolerability of Fixed Dose Combination of Rifaximin and Metronidazole in The Management of Acute Diarrhea Faruqui, Arif Ahmad
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 24, No 2 (2023): VOLUME 24, NUMBER 2, August, 2023
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2422023122-126

Abstract

Background: Infectious diarrhea is endemic in many parts of the world. It is generally mixed in etiology involving virus, bacteria, and parasite. Antibiotics belonging to fluoroquinolones class are most commonly used but are beneficial only in certain types of acute diarrhoea with side-effects like tendinopathy, arthropathy, neuropathy, arrhythmia, hypoglycemia, and hyperglycemia. Rifaximin with its unique mechanism, along with established metronidazole is proposed as a treatment option for acute diarrhea caused due to mixed gastrointestinal infections. The aim of this study is to evaluate the efficacy and tolerability of a fixed dose combination of rifaximin and metronidazole in the empirical management of acute diarrhea.Method: An open-label, non-comparative, non-randomized, multicenter trial was conducted in 238 patients presenting with acute diarrheal episodes involving various etiologies. Patients were given fixed dose combination tablet containing rifaximin 200 mg and metronidazole 400 mg twice a day for 5 days. Primary outcomes were change from baseline in number of soft or watery stools, fever, nausea, vomiting, abdominal pain, and gas/flatulence at day 5.Results: In final analysis 150 patients were included, as 88 patients lost to follow up. After 5 days of therapy, mean number of watery stools per day were reduced from 7.133 ± 2.055 to 0.733 ± 0.833 (p 0.0001). Minor incidences of gastritis, nausea, and metallic taste were reported.Conclusion: Combination of rifaximin and metronidazole significantly reduces number of watery stools and associated symptoms and is a clinically effective and safe option in the empirical management of acute diarrhea of various etiologies.

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