to determine the effects of Ramadhan fasting on GERD symptoms.
a total of 130 GERD patients participated in this study. Patients were divided into two groups, i.e. those who performed Ramadhan ...fasting (n=66), and those who did not perform Ramadhan fasting (n=64). The evaluation was done using Indonesian version of GERD questionnaire (GERD-Q) between the two groups, and between Ramadhan month and non-Ramadhan month in the Ramadhan fasting group.
there was a statistically significant difference (p<0.01) in the median of GERD-Q score in Ramadhan-fasting group subjects and non-Ramadhan-fasting group subjects (0 vs. 4). Moreover, a statistically significant difference (p<0.01) was also found in the median of GERD-Q score in Ramadhan-fasting group subjects and non-fasting group subjects (p<0.01).
subjects in Ramadhan fasting group, GERD symptoms experienced less severe during fasting month (Ramadhan) than non-fasting month. During Ramadhan month, GERD symptoms were also milder in Ramadhan fasting group than those in non-fasting group subjects.
BackgroundClinician burnout is an important occupational hazard that may be exacerbated by the novel COVID-19 pandemic. Within Southeast Asia, burnout in gastroenterology is understudied. The primary ...objective of this study is to estimate the prevalence of burnout symptoms within gastroenterology, in member states of the Associations of Southeast Asian Nations (ASEAN), during and after the COVID-19 pandemic. The secondary objective is to identify work-related stressors that contribute to burnout in ASEAN gastroenterologists.Methods and analysisThis is an observational study that will use anonymised online surveys to estimate the prevalence of burnout symptoms at two time points: during the COVID-19 pandemic in 2020 and in 2022 (assumed to be after the pandemic). Gastroenterologists from Singapore, Malaysia, Thailand, Indonesia, Philippines and Brunei will be invited to participate in the online survey through their national gastroenterology and endoscopy societies. Burnout will be assessed using the Maslach Burnout Inventory-Human Services Survey tool. Supplementary questions will collect demographic and qualitative data. Associations between demographic characteristics and burnout will be tested by multiple regression.ResultsThe prevalence of burnout symptoms in gastroenterology during the COVID-19 pandemic, and the baseline prevalence after COVID-19, will be established in the above-mentioned countries. Work-related stressors commonly associated with burnout will be identified, allowing the introduction of preventative measures to reduce burnout in the future.Ethics and disseminationEthical approval was granted by the Singhealth Centralised Institutional Review Board (2020/2709). Results will be submitted for publication.
Dyspepsia is one of numerous general complaints, which is commonly encountered by doctors of various disciplines. In daily practice, the complaint is not only limited for gastroenterologists. ...Knowledge on pathophysiology of dyspepsia have been developing continuously since a scientific investigation has been started in 1980's, which considers Helicobacter pylori as one of key factor in managing dyspepsia, either it is associated with ulcer or non-ulcer. The management of dyspepsia cannot be separated from the management of H. pylori and there is an additional new knowledge associated with definition, pathophysiology, diagnosis and treatment of both dyspepsia and H. pylori infection.This consensus document on the management of dyspepsia and H. pylori infection in Indonesia has been developed using the evidence-based medicine principles; therefore, it can be used as a reference for doctors in dealing with dyspepsia and H. pylori infection cases in their daily practice. It is expected that with the new consensus, doctors can provide greater service to their patients who have dyspepsia and H. pylori infection.
Coronavirus disease-19 (COVID-19) is a respiratory disease caused by novel SARS-CoV-2. The disease has become a global pandemic since March 2020. Transmission of the disease is rapid and contagious ...through droplets and contaminated environments. Meanwhile, gastrointestinal endoscopy is a procedure that has a high risk of transmitting COVID-19. Proper strategies are needed to prevent transmission of the virus in the endoscopic unit. Some literature has published the guidelines for prevent COVID-19 in endoscopic units such as guidelines by AGA, APSDE, ESGE and ESGENA. These guidelines state that strategies for prevent the COVID-19 transmission in endoscopy unit must be done from before the procedure, during the procedure until after the procedure. These strategies must be followed by all patients and health care providers who working in endoscopy units.
Background: Low-dose aspirin is the most common drug used for prevention of cardiovascular and cerebrovascular events. Long-term aspirin therapy can induce gastroduodenal mucosal injury, even in a ...very low dose (10 mg daily). The frequency of gastroduodenal injuries among long-term low-dose aspirin users in Indonesia is currently unknown. The aim of this study is to determine the prevalence of gastroduodenal mucosal injury, endoscopic findings, and influencing factors among long-term low-dose aspirin users in Cipto Mangunkusumo Hospital.Method: This study was a cross-sectional study conducted in Cipto Mangunkusumo Hospital, Jakarta. Subjects were patients aged ≥ 18 years old who had been using low-dose aspirin (75-325 mg) for at least the preceding 28 days. Ninety-five subjects were recruited consecutively in the period of December 2015 – April 2016. History taking, upper endoscopic examination, and histopathology examination for Helicobacter pylori infection were performed in all subjects. Endoscopic findings such as erosions and ulcers were assessed as mucosal injuries. Data were analysed to find prevalence, bivariate analysis (Chi-square test), and multivariate analysis (logistic regression test).Results: Mucosal injury was found in 49 subjects (51.6%; 95% CI: 41.6–61.7%), mucosal erosion in 38 subjects (40%; 95% CI: 30.2–49.9%) and ulcers in 11 subjects (11.6%; 95% CI: 5.2–18.0%). Only 44.9% patients with mucosal injury had dyspepsia symptoms. Double antiplatelet therapy increased the risk of mucosal injury (OR = 3.3; 95% CI: 1.3–8.5). However, proton pump inhibitor (PPI) decreased the risk of mucosal injury (OR = 0,2; 95% CI: 0,04 – 0,60).Conclusion: Gastroduodenal mucosal injury was found in more than half of long-term low-dose aspirin users. Double antiplatelet therapy increased the risk of mucosal injury, while PPI effectively reduced the risk.
Diagnostic and Therapeutic Approach in Intestinal Tuberculosis Guno, Tri Hapsoro; Putra, Barry A; Kamelia, Telly ...
The Indonesian journal of gastroenterology, hepatology, and digestive endoscopy (Jakarta),
02/2017, Letnik:
17, Številka:
2
Journal Article
Odprti dostop
Tuberculosis was still a global health problem. Beside lung, tuberculosis also manifest in other organs, one among them is in abdominal organs. Abdominal tuberculosis was a complex disease with ...unspecific sign and symptoms so that its diagnostic procedure was not rarely inconclusive. We reported a 24 years old woman with chief complain of worsening abdominal pain in all region, accompanied by nausea, vomiting, bloating, and absent bowel movement. She also had a fresh bloody stool. She had an active pulmonary tuberculosis on initiation phase treatment. Physical examination suggest a bowel obstruction sign with distended abdomen and increase bowel sound. Colonoscopy procedure findings was a mass that obstruct bowel lumen in ileocaecal region, suggest for malignancy similar to computerized tomography (CT) scan result, but pathlogic result showed an active colitis without any sign of malignancy. Because of its contradiction, the second colonoscopy was performed and concluded as intestinal tuberculosis, matched with second pathologic examination. Although polymerase chain reaction (PCR) tuberculosis (TB) showed a negative result, a further clinical judgement concluded this as an intestinal tuberculosis case. Patient was finally treated as intestinal tuberculosis with first-line antituberculosis drugs and planned to have colonoscopy evaluation. After general condition was good and obstructive ileus sign was relieved, patient planned for outpatient care.
Current Diagnostic Approach of Inflammmatory Bowel Disease Stephanie, Anggilia; Makmun, Dadang
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy,
04/2014, Letnik:
15, Številka:
1
Journal Article, Book Review
Inflammatory bowel disease (IBD) has begun to emerge in Indonesia. The disease is further classifiedinto two types, ulcerative colitis (UC) and Crohn's disease (CD). Diagnosis of IBD is initiated ...from symptomfindings such as diarrhea, abdominal pain, bleeding diarrhea, and weight loss, and supported by physicalexamination and additional tests. The options for additional examinations of IBD are mainly endoscopy (esophagogastroduodenoscopy, colonoscopy, and also intestinal endoscopy), imaging techniques, and laboratory examinations either from blood or feces. The application of these modalities should be prompted by sufficientclinical suspicion to promote their efficiency as well as prevent underdiagnosis or overdiagnosis. In primaryhealth care settings, patients with IBD are expected to be recognized for therapy or to use appropriate referralsystem to warrant a proper treatment.Keywords: inflammatory bowel disease, diagnosis terkini, kolitis ulseratif, penyakit Crohn ABSTRAKInflammatory bowel disease (IBD) mulai banyak ditemukan di Indonesia. Penyakit ini terbagi atas dua jenisyaitu kolitis ulseratif (KU) dan penyakit Crohn (PC). Diagnosis IBD dimulai dari gejala yang ditemukan sepertidiare, nyeri perut, buang air besar berdarah dan penurunan berat badan, serta didukung oleh pemeriksaan fisikdan pemeriksaan penunjang. Pilihan pemeriksaan penunjang untuk IBD secara garis besar adalah endoskopi(esofagogastroduodenoskopi, kolonoskopi maupun endoskopi usus halus), pencitraan, dan pemeriksaanlaboratorium, baik dari darah atau feses. Penggunaan berbagai modalitas ini harus didahului adanya kecurigaanyang cukup secara klinis agar tepat guna, mencegah under- atau overdiagnosed. Pada tingkat layanan primer,pasien IBD juga diharapkan dapat ditemukan untuk diterapi atau menggunakan sistem rujukan yang tepat agar ditatalaksana dengan baik.Kata kunci: inflammatory bowel disease, diagnosis terkini, kolitis ulseratif, penyakit Crohn
Gastrointestinal Amyloidosis: Diagnostic Approach and Treatment Budyono, Catarina; Fauzi, Achmad; Makmun, Dadang
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy,
12/2015, Letnik:
16, Številka:
3
Journal Article, Book Review
Odprti dostop
Amyloidosis is a disease marked by deposition of misfolded proteins, known as amyloids, in the extracellular space, including gastrointestinal tract. According to the precursor protein, amyloidosis ...is classified into six types; all of which can be involved in the gastrointestinal tract. Amyloidosis has weight loss and gastrointestinal bleeding as the most frequent symptoms. Gastrointestinal tract biopsy is diagnostic in most cases of amyloidosis and Congo red stain is used to confirm the amyloid proteins deposit. Treatment of amyloidosis consists of controlling symptoms, terminating protein formation and deposit, and treating the underlying diseases. Chemotherapy might be applied depends on the type of amyloidosis.
Background: Inflammatory bowel disease diagnosis was still based on invasive examination, such as endoscopy and histopathology. Fecal calprotectin was a non-invasive intestinal inflammation marker, ...but several study give a different result in its diagnostic value and correlation to inflammatory bowel disease. This research was aimed to prove that fecal calprotectin examination has a high diagnostic value in diagnosing inflammatory bowel disease, and also correlate to its clinical stages.Method: This is a cross sectional study to do a diagnostic test in several hospital in Jakarta, from September 2014 to February 2015. Receiver operating characteristic (ROC) curve was made to get fecal calprotectin diagnostic level and Krusskal Wallis test was performed to identify fecal calprotectin difference among each inflammatory bowel disease clinical stages.Results: A total of 71 patients with inflammatory bowel disease was invoved in this research, based on colonoscopic examination result. Among them, 57 patients was confirmed to have intestinal inflammation based on histopathology result. Fecal calprotectin level was found to be higher in patients with inflammatory bowel disease than patients without intestinal inflammation (553,8 µg/g vs. 76,95 µg/g, p 0,001). A cut off point of 179,3 µg/g was gathered, with 96% sensitivity (95% CI: 0,88-0,99), 93% specificity (95% CI: 0,69-0,99), and 99,5% area under curve (AUC) 99,5% (95% CI: 0,98-1,00). A significant difference was found between fecal calprotectin in each inflammatory bowel disease clinical stages (p 0,001).Conclusion: Fecal calprotectin has a high diagnostic value for inflammatory bowel disease (IBD) and strongly correlate to its disease clinical stages.
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