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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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Tranexamic Acid in the Management of Non-variceal Upper Gastrointestinal Bleeding Reza, Muhammad; Nursyirwan, Saskia Aziza
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 25, No 1 (2024): VOLUME 25, NUMBER 1, April, 2024
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/251202483-93

Abstract

Background: Non-variceal upper gastrointestinal bleeding (UGIB) is a common case of emergency in daily clinical practice with a fairly high mortality rate. The use of tranexamic acid, which has been recommended in managing trauma bleeding, may serve as an alternative pharmacological therapy to manage bleeding in non-variceal UGIB. This evidence-based case report aims to evaluate the impact of tranexamic acid on managing bleeding, risk of mortality, and thromboembolic event in non-variceal UGIB patients.Methods: A systematic literature search was conducted on 4 databases: CDSR, EMBASE, PubMed, and Scopus for meta-analyses. Studies were selected based on inclusion and exclusion criteria formulated a-priori with subsequent critical appraisal according to the OCEBM critical appraisal tools. Result: Meta analyses by Kamal, et al (2020) and Twum-Barimah, et al (2020) were included in our report. Kamal, et al shows no significant difference in mortality in tranexamic acid use compared to placebo (RR 0.84; 95%CI 0.63–1.11; I2=2%). Similarly, although Twum-Barimah reported tranexamic acid reduced risk of mortality compared to placebo (RR 0.45; 95%CI 0.23–0.88; p=0.02; I2 = 0%), none of the RCTs included shows significant result when observed individually. In addition, Kamal, et al also reported increased risk of vein thromboembolic events in high-dose tranexamic acid administration (RR 2.21; 95%CI 1.32–3.69; I2=0%) compared to low-dose administration, in UGIB patients.Conclusion: Tranexamic acid is not recommended to be used in managing bleeding in patients non-variceal UGIB patients and may increase the risk of thromboembolic event.
Association between Anxiety and Dyspepsia among Outpatients at Atma Jaya Hospital Heryadi, Samantha Yaffa; Tenggara, Riki; Suryani, Eva; Widjaja, Nelly Tina; Hardi, Nicholas
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 25, No 1 (2024): VOLUME 25, NUMBER 1, April, 2024
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/251202421-26

Abstract

Background: Anxiety is a psychological condition characterized by excessive fear and worry that occurs continuously and is difficult to control. Anxiety play a significant role in causing dyspepsia through the Brain-Gut Axis mechanism. Although, there are many cases of anxiety and dyspepsia in Indonesia, there is still a lack of research on the relationship between anxiety and dyspepsia in Indonesia, especially in the clinic. Therefore, this study aimed to determine the relationship between anxiety and dyspepsia among outpatients at Atma Jaya Hospital.Method: This cross-sectional study was conducted on outpatients at Atma Jaya Hospital to investigate the relationship between anxiety and dyspepsia. The demographic and patient characteristic data, including gender, age, highest level of education, and habits, such as eating spicy food, drinking coffee, alcohol consumption, smoking, and NSAID used were collected. The GAD-7 and SF-LDQ questionnaires, which have been validated in Indonesian, were used in this study. Spearman correlation test was used to analyze the data to find the relationship between anxiety and dyspepsia.Results: This study obtained 158 participants. The age range of participants who experienced dyspepsia the most is 19-44 years(77.53%). The majority of those who experienced dyspepsia are female (79.12%). The highest education level of the participants who experienced dyspepsia is a Master’s degree (100%). Participants who consumed spicy food accounted for 61.39% while 54.43% consumed coffee, 6.96% consumed alcohol, 12.66% smoked, and 1.90% used NSAIDs. Additionally, 105 participants (66.46%) experienced both anxiety and dyspepsia. The Spearman correlation test results showed a significant relationship between anxiety and dyspepsia (p-value = 0.000) and a moderate correlation (rs = 0.450). Conclusion: There is a moderate correlation between anxiety and dyspepsia. Keywords: Anxiety, Dyspepsia, GAD-7, Heartburn, SF-LDQ.
Prevalence and Determinants of Gastroesophageal Reflux Disease in a Regional Indonesian Hospital Gastroesophageal Reflux Disease: Patterns and Risk Factors in a West Java Hospital Setting Fatimah, Liliana Surya; Wikarta, Dwi Bayu; Lee, Yeong Yeh; Gisrianti, Reina Syafira
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 25, No 2 (2024): VOLUME 25, NUMBER 2, August, 2024
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2522024329

Abstract

Background: Gastroesophageal reflux disease (GERD) is increasing prevalent in Indonesia. However, epidemiology data remain limited, particularly in developing regions such as Karawang. Therefore, this study aims to examine the prevalence, risk factors, and clinical characteristics of GERD within the population of Karawang, West Java.Methods: This study employed a cross-sectional design. Patients aged 18 years who visited the Karawang Regional Public Hospita, were recruited sequentially. Data were collected using a standardized questionnaire. Univariable and multivariable analyses were performed, with a p-value 0.05 considered stastically significant.Results: The prevalence of GERD was 55.6%, with a higher prevalence in women compared to men (58% vs. 42%, p = 0.263). Significant factors associated with GERD included age 40 years (OR = 0.126; 95% CI: 0.043-0.369; p = 0.001), frequent consumption of spicy foods (OR = 5.002; 95% CI: 2.534-9.877; p = 0.001); and NSAIDs consumption (OR = 2.002; 95% CI =2 1.049-3.821; p = 0.035).Conclusion: GERD is prevalent in the Karawang region. Key factors associated with its occurrence include younger age, frequent consumption of spicy foods, and the use NSAIDs.
Drug-induced Myelotoxicity in Patients with Crohn’s Disease Renaldi, Kaka; Hosea, Fransiscus Nikodemus
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 25, No 2 (2024): VOLUME 25, NUMBER 2, August, 2024
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2522024%p

Abstract

As a chronic granulomatous disease, Crohn’s disease (CD) poses a significant insinuation on morbidity and low quality of life. Long-term treatment is needed to control the disease activity. Observation and evaluation of disease activity are principal practices in treating CD, and sometimes clinicians tend to overlook the adverse effects of therapy that may occur and resemble disease progression.Hereby, we presented a 76-year-old female with a 10-year history of Crohn’s disease who came to our emergency room with general weakness one week before admission. She complained of hematochezia and abdominal pain in the last month. She had been taking mesalazine 2x500 mg PO and azathioprine 2x50 mg PO in the previous three years. She was diagnosed with lung cancer six months before admission and had been prescribed erlotinib 1x150 mg PO in the last six weeks. Upon admission, pancytopenia was found in the blood study. Hematochezia, along with anemia and abdominal pain, might occur due to either disease activity or the adverse effects of the medication.Thorough observation and clinical evaluation regarding disease activity and side effects are required to manage Crohn’s disease comprehensively. 
Transforming Screening, Risk Stratification, and Treatment Optimization in Chronic Liver Disease Through Data Science and translational Innovation Addissouky, Tamer A.
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 25, No 1 (2024): VOLUME 25, NUMBER 1, April, 2024
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/251202453-62

Abstract

Background: Chronic liver diseases continue to face challenges in prognosis, treatment selection, disease mechanisms, screening, and therapeutic optimization. Promising innovations could address these gaps through data integration and novel analytic approaches.Main Body: MAPS-CRAFITY integrating clinical variables, AFP, and CT/MRI findings, and transformer modeling of RFA data improve HCC outcome prediction to guide management. Analyses revealing IL21R as a PBC susceptibility gene and implicating dysfunctional VWF processing in portal hypertension deliver mechanistic insights. Quantifying childhood MAFLD informs screening needs, while supporting use of G6PD deficient liver donors enables transplantation access expansion through risk stratification. Updating Baveno criteria enhances PBC prognosis, and an HCC prognostic score identifies optimal RFA candidates to maximize treatment efficacy.Conclusion: Recent research leverages diverse data types, genetics, imaging, and machine learning to develop integrated predictive systems that allow more personalized therapy selection. Elucidating molecular pathways provides therapeutic targets and prognostic biomarkers. Evidence-based screening and risk models facilitate delivering tailored interventions. Optimization of current modalities through prognostic validation and patient selection improves real-world effectiveness. Multifaceted modern research approaches promise to address unmet needs and transform hepatology care.
The Role of Gut Microbiota and Probiotics in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis Leong, Xue Bin; Tang, Chuan Zhe; Lee, Chloe Zi Ying; Lee, Zoe Ling Hui; Koo, Thai Hau
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 25, No 2 (2024): VOLUME 25, NUMBER 2, August, 2024
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2522024319

Abstract

Probiotics have emerged as a promising treatment for inflammatory bowel diseases (IBD). Moreover, the efficacy and safety of gut microbiota should be comprehensively studied. This systematic review and meta-analysis aim to study randomized controlled trials (RCTs) of IBD patients using probiotics, compared to conventional drugs or placebo. Eligible RCTs involving adult IBD patients were identified using MEDLINE, EMBASE, and the Cochrane Controlled Trials Register until May 2024. Fixed-effects modeling was used to calculate risk ratio (RRs) with 95% confidence intervals (CIs) based on adverse event data due to low-moderate heterogeneity. The search yielded 2392 articles, including seven RCTs that met the criteria. On the other hand, concerning effectiveness outcomes, probiotics had an overall RR of 1.52 (95% CI: 1.08–2.13, p=0.02) compared to the controls. The comparable risk was demonstrated by the overall RR of 1.05 (95% CI: 0.59–1.86, p=0.87), which showed no apparent difference in the rate of adverse events between the groups on probiotics and the control group. Three studies were not included because their RR was non-estimable. Nevertheless, these three studies upheld the safety and tolerability of the probiotics. Though the number is small, and despite differences in types and schedules of probiotics, it can be suggested that probiotics enhance therapy responses in IBD patients. Further research with larger sample sizes and a broader range of demographics is necessary to shed more light on the effectiveness of probiotics.
Metastatic Cervical Cancer Presenting as a Sessile Polyp in the Ascending Colon Loho, Imelda Maria; Siregar, Lianda; Iriani, Dewi; Faatinah, Tiyas Hasnaa
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 25, No 1 (2024): VOLUME 25, NUMBER 1, April, 2024
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/251202494-97

Abstract

Patients with metastatic cervical cancer, particularly hematogenous metastasis, have a worse prognosis compared to those with localized cervical cancer. Gastrointestinal involvement of cervical cancer occurs in approximately 8% of cases and most lesions are located in the recto-sigmoid area due to direct extension of the disease. Here, we present a case of cervical adenocarcinoma spreading to the ascending colon as a sessile polyp and mimicking a hyperplastic polyp. Histopathological evaluation followed by immunohistochemistry analysis is needed to confirm the diagnosis.
Correlation of Simple Laboratory Result Parameters to CTP and MELD Scores, and the Diagnostic Role of Simple Laboratory Indexes to Cirrhosis Decompensation Dewi, Ni Nyoman Gita Kharisma; Dewi, Ni Luh Putu Yunia; Dewi, Putu Itta Sandi Lesmana; Pamungkas, Kadek Mercu Narapati; Sindhughosa, Dwijo Anargha; Mariadi, I Ketut
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 25, No 1 (2024): VOLUME 25, NUMBER 1, April, 2024
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/251202427-33

Abstract

BackgroundCirrhosis of the liver is a final condition of all chronic liver diseases. Liver cirrhosis is the leading cause of increasing morbidity and mortality in adults worldwide. Systemic inflammation has been suggested to play an important role in causing progressive liver damage and is one of the leading causes of compensated and decompensated liver cirrhosis.Aim of StudyEvaluate the correlation of neutrophil-lymphocyte ratio (NLR), albumin-bilirubin ratio (ABR), albumin-bilirubin score (ALBI), aspartate aminotransferase to platelet ratio (APRI), albumin-creatinine ratio (ACR), lymphocyte-monocyte ratio (LMR), de ritis ratio to the severity of liver cirrhosis as assessed by CTP score and MELD score. In addition, this study also evaluated the diagnostic ability of NLR, ABR, ALBI, APRI, ACR, LMR, de ritis ratio, and CTP and MELD scores in predicting decompensated liver cirrhosis.MethodWe conducted a cross-sectional study involving patients diagnosed with liver cirrhosis at Prof DR IGNG Ngoerah General Hospital. All patients were diagnosed based on clinical history, physical examination, and investigations. This study enrolled 96 cirrhotic patients regardless of etiology. Laboratory examination results recorded platelets, neutrophils, lymphocytes, monocytes, AST, ALT, albumin, and creatinine. Then NLR, ACR, APRI, LMR, de raitis, ALBI, and ABR are calculated. CTP and MELD scores were calculated by taking data from the patient's medical recordResultOf the 96 patients tested in our study, the majority were male (66). The study found a significant moderate to very strong relationship to the MELD score between ACR, APRI, ALBI, ABR, LMR, WBC, sodium, and albumin. Neutrophil to lymphocyte ratio, ACR, De ritis, APRI, LMR, ALBI, ABR, sodium levels, and albumin have a moderate to very strong significant relationship to CTP score. ACR, De ritis, APRI, LMR, ALBI, ABR, WBC, sodium, and albumin levels with respective cut-offs £ 3.6; ≥ 1.5; ≥ 0.3; £ 2.8; ≥ 0.7; £1.6; ≥ 6.7, £ 136.50, and £ 3.0 can be used to help predict decompensated cirrhosisConclusionIn addition to using the CTP score and MELD score as a tool to predict the severity of liver cirrhosis, data from laboratory examination results in the form of albumin and ABR levels can help establish the diagnosis of decompensated cirrhosis. The sensitivity and specificity of ABR were 96.8% and 75.4% with a cut-off of £  1.6, while albumin levels were 93.5% and 81.5% with an amount off of £  3.0.
Gluten and Celiac Disease Utari, Amanda Pitarini
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 25, No 2 (2024): VOLUME 25, NUMBER 2, August, 2024
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2522024279

Abstract

Association Between Bile Reflux and Gastric Mucosal Damage Severity in Patients with Dyspepsia Saturti, Tjokorda Istri Anom; Mariadi, I Ketut; Triyanayasa, I Nyoman; Sindhughosa, Dwijo Anargha; Kuwai, Toshio
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 25, No 2 (2024): VOLUME 25, NUMBER 2, August, 2024
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2522024295

Abstract

Background: Bile acid reflux stands out as a notable risk factor for dyspepsia. Among patients with bile acid reflux, common endoscopic findings include mucosal erythema, the presence of bile acid on the mucosa, erosions, hyperrugosity, and gastric mucosal atrophy. This study aims to elucidate the association between bile acid levels in gastric fluid and the degree of gastric mucosal damage.Methods: This cross-sectional study involved dyspeptic patients who underwent endoscopic examination at Prof. Dr. I.G.N.G. Ngoerah Denpasar Hospital. Bile acid analysis was conducted through the enzymatic calorimetric method, while assessment of mucosal damage relied on the Lanza score, evaluated independently by two observers. Mucosal damage severity was categorized as either mild (score 0-2) or severe (score 3-5). Statistical analyses included Cohen’s kappa for interobserver agreement, bivariate analysis, and logistic regression.Results: Of the 99 subjects involved in the study, 58.6% were male. H. pylori antibodies were detected in 21% of the participants, while 48% exhibited a pH below 2.77. Additionally, 48% reported a history of NSAID consumption. The mean bile acid level in gastric fluid was 156.07 μmol/L, with a median of 170.09 μmol/L (categorized as high if ≥ 170.09 μmol/L, and low if 170.09 μmol/L). During endoscopic examination, mild mucosal damage was observed in 61%, and severe damage in 39% (kappa 1, P 0.001). A statistically significant relationship between gastric f luid bile acid levels and mucosal damage was evident (P 0.05).Conclusion: This study concludes that there was a relationship between the level of bile acid in gastric fluid and the degree of mucosal damage.

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