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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 799 Documents
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Recurrent Variceal Bleeding Due to Non-Cirrhotic Portal Hypertension in a Patient with Primary Myelofibrosis: Case Report Sitorus, Debora; Anwar, Bariani; Dinakrisma, Anastasia Asylia
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 26, No 3 (2025): VOLUME 26, NUMBER 3, December, 2025
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2632025293-297

Abstract

Acute upper gastrointestinal bleeding may arise from variceal or non-variceal sources. Primary myelofibrosis, classified as a subtype of myeloproliferative neoplasms, represents an uncommon clinically significant etiology of non-cirrhotic portal hypertension. The authors reported a case of a 39-year-old woman with recurrent variceal bleeding for six years. She presented with progressive weight loss, splenomegaly, and severe anemia. One year before her first episode of hematemesis, a bone marrow biopsy revealed myelofibrosis grade 2, and JAK2 V617F mutation was positive, confirming primary myelofibrosis. The treatment was discontinued due to high expense. Abdominal ultrasonography showed portal hypertension and changes suggestive of cirrhosis. She underwent successful endoscopic variceal ligation to control active bleeding, and initiation of a JAK inhibitor (ruxolitinib) was recommended for outpatient management to address the underlying disease. This case highlights that in patients presenting with variceal bleeding and portal hypertension in the absence of cirrhosis, myeloproliferative neoplasms, such as primary myelofibrosis should be considered as a differential diagnosis. This study aimed to raise awareness of primary myelofibrosis as a rare cause of non-cirrhotic portal hypertension and emphasize the importance of early recognition and targeted therapy to prevent recurrent bleeding and disease progression.
Validity and Reliability of the Indonesian Short Form-Leeds Dyspepsia Questionnaire (SF-LDQ) Prasetya, Ignatius Bima; Anas, Desriyadi; Al-Idrus, Syarifah Nur E’zzati; Simatupang, Flouria Stefanny; Herardi, Ryan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 26, No 3 (2025): VOLUME 26, NUMBER 3, December, 2025
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2632025212-218

Abstract

Background: The severity of dyspepsia symptoms is often overlooked despite established definitions and diagnostic criteria. The Short Form-Leeds Dyspepsia Questionnaire (SF-LDQ) is a validated English-language tool designed to evaluate these symptoms. This research focuses on creating and validating an Indonesian version of the SF-LDQ.Methods: The SF-LDQ was translated into Indonesian following standard procedures, including forward-backward translation, cross-checking, and pilot testing. Unselected patients from Dabo Regional Hospital and Dabo Lama Community Health Center (Pusat Kesehatan Masyarakat, or Puskesmas) completed a questionnaire upon enrollment and again after three days via direct follow-up or blinded phone interviews. Reliability was measured through internal consistency (Cronbach’s α) and test-retest analysis (Spearman’s correlation). Meanwhile, validity was evaluated by comparing SF-LDQ scores with Rome IV Criteria-based diagnoses from blinded physicians and analyzing diagnostic performance with ROC curves.Results: A total of 204 participants were included. The Indonesian SF-LDQ exhibited excellent reliability, with Cronbach’s α of 0.875 and Spearman’s correlation of 0.984 (p 0.001). Validity analysis demonstrated an AUC of 0.946 (p 0.001, 95% CI = 0.913–0.978). A cut-off score of 6.5 yielded 87.0% sensitivity and 93.3% specificity.Conclusion: The Indonesian SF-LDQ is a dependable and valid tool for evaluating the frequency and severity of dyspeptic symptoms.
Comparison of Quality of Life in Chronic Liver Disease Patients Based on Indonesian Version of SF-36 Questionnaire Mustika, Syifa; Nuri, Sofia; Jauza, Nadia Alfiani; F, Sri Lestari; Nugroho, Rama Tiar; Kalal, Chetan Ramesh
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 26, No 3 (2025): VOLUME 26, NUMBER 3, December, 2025
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2632025255-262

Abstract

Background: Liver cirrhosis is a chronic progressive disease associated with substantial morbidity and mortality. Although clinical management often emphasizes physical outcomes, assessment of health-related quality of life (HRQoL) provides a more comprehensive evaluation of patient well-being. A validated multidimensional instrument for HRQoL assessment is SF-36 (36-Item Short Form Health Survey). Therefore, this study aims to compare HRQoL among patients with chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma (HCC) using Indonesian version of SF-36. There are limited data from Indonesia comparing HRQoL across different stages of chronic liver disease, particularly including patients with chronic hepatitis.Methods: A cross-sectional study was conducted at Gastroenterohepatology Clinic of Saiful Anwar General Hospital, Malang, using 273 patients including 156 with chronic hepatitis, 88 with liver cirrhosis, and 29 with HCC. HRQoL was assessed using SF-36 questionnaire, which evaluated eight domains. Data were analyzed through Kruskal–Wallis test followed by Mann–Whitney post hoc analysis.Results: The results showed that HRQoL differed significantly across all SF-36 domains among the three groups (p 0.001), with the lowest scores observed in patients with HCC. Post hoc analysis showed a progressive decline in quality of life with increasing disease severity. However, no significant difference was found between cirrhosis and HCC groups in role limitations due to emotional problems (p 0.05).Conclusion: Advanced stages of chronic liver disease are associated with poorer HRQoL. Emotional role limitations appear less dependent on disease severity, signifying the need for psychological support across all stages.
Thrombospondin-2 as a Biomarker of Advanced Liver Fibrosis in Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) Budyono, Catarina; Ahda, Fatikha Rudia
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 26, No 3 (2025): VOLUME 26, NUMBER 3, December, 2025
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2632025263-267

Abstract

Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) is a highly prevalent liver disorder associated with obesity and metabolic syndrome, replacing the term Non-Alcoholic Fatty Liver Disease (NAFLD). The diagnosis of MAFLD is established based on the presence of hepatic steatosis accompanied by metabolic abnormalities such as overweight/obesity, type 2 diabetes mellitus, or metabolic dysregulation. Although liver biopsy remains the gold standard for diagnosis, its invasive nature underscores the need for practical, non-invasive biomarkers. This review aims to summarize the current evidence regarding thrombospondin-2 (TSP-2) as a potential biomarker of hepatic fibrosis in MAFLD. Recent data indicate that serum TSP-2 levels correlate with the severity of steatosis, inflammation, and fibrosis. TSP-2 also shows promise in distinguishing simple steatosis from steatohepatitis and in identifying patients at risk of advanced fibrosis. While these findings highlight the potential role of TSP-2 in diagnosis and disease monitoring, further clinical validation is required before its routine implementation in clinical practice.
Correlation of Neutrophil-Lymphocyte Ratio, Alpha-Fetoprotein, and PIVKA-II with Staging of HCC Related HBV at Dr. Mohammad Hoesin Hospital, Palembang Rahmayani, Febry; Suyata, Suyata; ., Legiran
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 26, No 3 (2025): VOLUME 26, NUMBER 3, December, 2025
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2632025219-227

Abstract

Background: The staging of Hepatocellular carcinoma (HCC) requires evaluating the tumor size and number, liver function, physical performance, tumor invasion, extrahepatic metastasis, and clinical symptoms. Biomarkers such as neutrophil-lymphocyte ratio (NLR), alpha-fetoprotein (AFP), and protein induced by the absence of vitamin K or antagonist-II (PIVKA-II) have been identified as valuable diagnostic and prognostic tools for HCC. This study aims to investigate the correlation between NLR, AFP, and PIVKA-II and HCC stages.Methods: This observational study was conducted at the Department of Internal Medicine, Dr. Mohammad Hoesin Hospital, Palembang, from April to July 2024. HCC stages were classified using the Barcelona Clinic Liver Cancer (BCLC) system. NLR, AFP, and PIVKA-II levels were measured using  ELISA method. Data were analyzed susing one-way ANOVA or the Kruskal-Wallis test.Results: A total of 38 patients with HCC who met the inclusion criteria were included in the study. There was a weak positive correlation between NLR and HCC stage (r = 0.334; p = 0.040), a moderate positive correlation between AFP and HCC stage (r = 0.499; p = 0.001), and a strong positive correlation between PIVKA-II and HCC stage (r = 0.797; p = 0.000). PIVKA-II and AFP were found to have a significant sequential effect on the BCLC stage.Conclusion: PIVKA-II and AFP are significant indicators for assessing BCLC stages, offering valuable support for the diagnosis and management of HCC.
Hepatoprotective Effects of Glibenclamide, Catechin, and Ethanolic Neem Leaf Extract in Alloxan-Induced Diabetic Rats Oyesola, Olusoji A.; Olayemi, Oluwaseye Emmanuel; Soetan, Olaniyi A.; Ogungbenle, Temitope E.; Adebanjo, Solomon O.; Ojo-Adebayo, Eunice O.
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 27, No 1 (2026): VOLUME 27, NUMBER 1, April, 2026
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/271202627-36

Abstract

Background: Diabetes mellitus is a systemic disorder that causes hepatic damage, primarily through oxidative stress and inflammation. This study evaluated the hepatoprotective effects of glibenclamide, catechin, and ethanolic neem leaf extract in alloxan-induced diabetic male rats.Methods: Fifty Sprague-Dawley rats were allocated into five groups: normal control, diabetic control, and three treatment groups receiving glibenclamide (5 mg/kg), catechin (40 mg/kg), or neem extract (250 mg/kg) orally for 14 days after diabetes induction (alloxan, 150 mg/kg i.p.). Diabetes was confirmed by a fasting blood glucose level ≥200 mg/dL after 72 h. Liver function biomarkers (AST, ALT, ALP, albumin, bilirubin, and total protein), oxidative stress markers (MDA, SOD, CAT, and GSH), lipid profiles, and liver histopathology were evaluated.Results: Diabetic rats exhibited marked hyperglycaemia, elevated liver enzyme levels, lipid peroxidation, and hepatocellular damage. All treatments significantly improved glycaemic control, reduced hepatic enzyme levels and MDA, and enhanced antioxidant enzyme activities. Neem-treated rats demonstrated the most significant biochemical recovery and near-normal liver histology with preserved Kupffer cells.Conclusion: These findings suggest that neem leaf extract exerts robust hepatoprotective effects, likely because of its high polyphenolic content and antioxidant properties, making it a promising candidate for mitigating liver injury in diabetes mellitus
Pseudomyxoma Peritonei Mimicking Liver Cirrhosis: A Case Report and Literature Review Paramita, Diah Pradnya; Somayana, Gde
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 27, No 1 (2026): VOLUME 27, NUMBER 1, April, 2026
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/271202688-94

Abstract

Pseudomyxoma peritonei (PMP) is a rare condition caused by rupture of a primary mucinous tumor, followed by dissemination of tumor cells within the peritoneal cavity and excessive mucin production. The signs and symptoms are generally nonspecific, making early diagnosis difficult. We present a man, age 57, who showed abdominal distention accompanied by nausea and vomiting for approximately four months, which was referred to as liver cirrhosis. Carcinoembryonic antigen level was elevated and postoperative histology revealed low-grade peritoneal mucinous neoplasia. The signs and symptoms of PMP are generally nonspecific, making it difficult to diagnose earlier and leading to delayed appropriate treatment. Computed tomography (CT) scan is the preferred imaging modality for determining the extent of the disease preoperatively. Elevated tumor marker level, especially CEA, CA19-9, and CA-125, is usually suggestive of the diagnosis of PMP. Immunohistochemistry was used to determine the origin of primary malignancy. PMP management needs to be individualized; therefore, discussion among multidisciplinary teams is needed. Currently, the most common treatment option is cytoreductive surgery (CRS) in conjunction with hyperthermic intraperitoneal chemotherapy (HIPEC) and has been associated with improved survival in several studies. However, if there are limitations in therapeutic modalities or patient populations, alternative therapies can be used. This case report aims to highlight the diagnostic challenges of pseudomyxoma peritonei presenting as ascites that mimics liver cirrhosis.
From Diagnosis to Treatment: A Literature Review on Hiatal Hernia Management Hartanto, Darius; Waleleng, Bradley Jimmy; Rotty, Luciana; Gosal, Fandy; Winarta, Jeanne; Waleleng, Andrew
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 27, No 1 (2026): VOLUME 27, NUMBER 1, April, 2026
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/271202680-87

Abstract

A hiatal hernia is a medical disorder where the upper part of the stomach, or occasionally other intraabdominal organs, abnormally protrudes through the diaphragmatic hiatus. The occurrence of this disorder ranges from asymptomatic to severe symptoms, depending on the extent of herniation and associated complications. The development of a hiatal hernia is associated with repeated acid exposure, shortening of the muscles, and proximal displacement of the esophagus. Based on the American Foregut Society (AFS) endoscopic classification, hiatal hernia is divided into types I–IV, which guide clinical evaluation and management. Moreover, management strategies vary according to symptom severity and progression, as treatment is usually not required in asymptomatic patients. For mild to moderate cases, non-pharmacological management is recommended, such as avoidance of smoking, weight reduction, and avoidance of trigger foods and beverages. Proton pump inhibitors (PPIs) are the first-line options in pharmacological treatment, while surgical intervention is the sole method capable of repositioning herniated organs back into the abdominal cavity and addressing the functional defects related to a hiatal hernia. Therefore, this review aimed to provide a comprehensive overview of hiatal hernia management, from initial diagnosis to therapeutic selection.
Clinicopathological Characteristics of Hepatocellular Carcinoma at a Tertiary Hospital: A Retrospective Study Rasfa, Rum Affida; Hilbertina, Noza; Asri, Aswiyanti; -, Yenita; Devianti, Loli
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 27, No 1 (2026): VOLUME 27, NUMBER 1, April, 2026
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/271202637-44

Abstract

Background: Hepatocellular carcinoma (HCC) is the sixth most common cancer globally and shows significant regional variations in clinicopathological characteristics. Limited data exist on HCC patterns in Indonesia, particularly in West Sumatra. This study aimed to characterize the clinicopathological features of HCC at Dr. M. Djamil Hospital, Padang, from 2021to2024.Methods: A descriptive retrospective study was conducted using medical records and histopathological re-evaluation of 46 HCC cases. Specimens were examined for demographic data, tumor characteristics, histopathological subtypes according to the WHO 2019 classification, differentiation grade, lymphovascular invasion, and background liver pathology.Results: The median age was 56 years, with male predominance (60.9%). Most specimens were resection specimens (60.9%) with tumor size ≥4 cm in 47.8% of cases and single nodules in 52.1%. Clear cell (39.1%) and macrotrabecular massive (37.0%) were the predominant subtypes, contrasting with global data showing NOS predominance. Most tumors were moderately differentiated (63.0%), with lymphovascular invasion present in 65.2% and cirrhotic background in 58.7% of casesConclusion: HCC in West Sumatra demonstrates distinct histopathological patterns, with a predominance of clear cell and macrotrabecular massive subtypes and high rates of lymphovascular invasion. These finding suggest histopathological features associated with aggressive tumor behavior (particularly macrotrabecular massive subtype and lymphovascular invasion), although no clinical outcome or survival analysis was performed.
Colonic Leiomyoma Presenting as Sigmoid Volvulus in a Young Male Digambiro, Reza Aditya; Amarendra, Gerie; Ilona, Florinda; Chendrasari, Julian; Kehinde, Samuel Abiodun
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 27, No 1 (2026): VOLUME 27, NUMBER 1, April, 2026
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/271202695-100

Abstract

Colonic leiomyomas are rare tumors that originate from the smooth muscle layer of the colon and are infrequently observed in young individuals. This case report represents a 21-year-old male who presented with a 2-month history of progressive abdominal distension, persistent vomiting, early satiety, and bloating. Computed tomography (CT) of the abdomen suggested sigmoid volvulus with associated bowel obstruction. However, exploratory laparotomy revealed a well-defined, firm intramural mass in the sigmoid colon, leading to segmental resection and primary anastomosis. Histopathological analysis showed intersecting fascicles of bland spindle cells with eosinophilic cytoplasm and cigar-shaped nuclei without atypia or mitotic activity. Immunohistochemistry confirmed positivity for smooth muscle actin (SMA) and negativity for CD117, supporting a diagnosis of colonic leiomyoma and excluding gastrointestinal stromal tumor (GIST). The patient’s postoperative course was uneventful, with complete resolution of obstructive symptoms and restoration of normal bowel function. This case highlights the diagnostic challenge of differentiating colonic leiomyoma from other causes of bowel obstruction, particularly when presenting with features mimicking sigmoid volvulus. It also emphasizes the critical role of histopathology and immunohistochemistry in establishing a definitive diagnosis. Clinicians should consider rare benign tumors in the differential diagnosis of young patients with signs of bowel obstruction.

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