The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy
Not a member yet
381 research outputs found
Sort by
Association between Severity of Dyspepsia and Urea Breath Test Results in Patients with Positive Helicobacter pylori Serology
Full text linkBackground: Active Helicobacter pylori infection is considered to cause more severe dyspepsia symptoms compared to inactive infection. This study was aimed to determine the association between severity of dyspepsia and urea breath test (UBT) results in subjects with positive H. pylori serology.Method: This study was a cross-sectional study in 60 subjects with positive H. pylori serology in Provincial General Hospital of West Nusa Tenggara. Severity of dyspepsia was measured using modified Glasgow Dyspepsia Severity Score (GDSS) questionnaire. Diagnosis of active H. Pylori infection was made using 14C UBT examination.Results: Proportion of active H. pylori infection in subjects with positive serology was 20%. The average of modified GDSS score in all patients was 1.95 (SD + 1.78), with minimal score of 0 and maximal score of 7. There was a statistically significant difference between average of modified GDSS score and positive and negative UBT results, (p=0.027). The cut-off point value of modified GDSS to diagnose positive UBT was 3.8. Results of diagnostic test with modified GDSS as a test and UBT results as the gold standard indicated sensitivity of 41.6% and specificity of 85.4%. Conclusion: There was a significant difference between modified GDSS score in patients and positive and negative H. pylori infection. In areas which did not have UBT examination, eradication in patients with positive serology and GDSS score of more than or equal to 4 could be considered.
Left-Sided Portal Hypertension: A Case Series
Full text linkLeft-sided portal hypertension is rarely found, but this condition may cause gastrointestinal tract bleeding and can be life-threatening. The exact incidence of left-sided portal hypertension is unknown as it is rarely found, approximately 1-5%, and most cases were misdiagnosed. We reported 3 cases of left-sided portal hypertension in male patient aged 34 years old, female patient aged 29 years old, and female patient aged 35 years old. Most diagnosis was made based on the clinical findings by excluding the diagnosis of cirrhotic portal hypertension. Splenic vein angiography remains the gold standard in diagnosing left sided portal hypertension. Left-sided portal hypertension is difficult to differentiate from cirrhotic portal hypertension because in these both abnormalities, varices can be present. Left-sided portal hypertension can be considered as a diagnosis in patient with upper gastrointestinal tract bleeding due to oesophageal varices, gastric varices, or portal hypertension gastropathy, accompanied with hypersplenism without the presence of hepatic abnormality or cirrhosis
Red Cell Distribution Width to Platelet Ratio: in a Search of Non-Invasive Liver Fibrosis Biomarker
Full text linkChronic Pancreatitis
Full text linkChronic 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
Signet-Ring Cell Carcinoma of the Ampulla of Vater
Full text linkSignet-ring cell carcinoma (SRCC) of the ampulla of Vater is a very rare case and only 28 cases have beed reported in the English literature. Herein, we report a 59-year-old woman with SRCC of the ampulla of Vater. She developed symptoms of obstructive jaundice at early stage of disease and underwent pylorus-preserving Whipple procedure as definitive treatment. Histopathology examination showed numerous tumor cells with intracytoplasmic mucin and eccentric nuclei. Her tumor has already invaded the serosa of duodenum, but no infiltration to the stomach, pancreas, and lymphovascular structure. Her surgical margins and regional lymph nodes were free of tumor. She was diagnosed with T2N0M0 SRCC of the ampulla of Vater. No adjuvant treatment was given and she has been doing well for five months after surgery
Cancer Stem Cells and Signaling Pathways in Colorectal Cancer
Full text linkColorectal cancer (CRC) is the third most common cancer in males, the second in females and is the second leading cause of cancer related death worldwide. Despite recent advances in chemotherapy, and targeted therapy for CRC, the prognosis for patients with advanced cancer has remained poor, due to drug resistance, metastasis and recurrence. A small fraction of cells possess tumor propagation abilities. These are termed “cancer stem cells (CSCs). A subset of colorectal cancer stem cells, may hold a key to controlling cancer. The cancer stem cell (CSC) model suggests that tumors are hierarchically organized, only CSCs possess cancer-promoting potential. The killing of CSCs is thought to be a critical component of effective antitumor therapies. A number of signaling pathways, most notably the Wingless related (Wnt), transforming growth factor-beta (TGF-β), Notch and Hedgehog signaling and other mechanisms have been found to be associated with CSCs in CRC. They play important roles in maintaining the growth and functional integrity of CSC. Many new molecules are now being studied to block theses pathways. Some of the molecules block the self-renewal and induction of apoptosis in CSCs. The design of CSC-targeted interventions is a rational target, and reduce local recurrence and metastasis. This review aims to summarize the issue on CSCs and signaling pathway relevant for CRC, which may lead to more effective therapeutic strategies for CRC
Correlation of Aerobic Exercise and High Nitrate Diet with Population of Eschericia coli in the Digestive Tract of Liver Cirrhosis Individuals
No full textBackground: In liver cirrhosis, the population of E coli is increased. conditions such as reduced intestinal). Escherichia coli with 2 enzyme nitrate reductase (NRF and Nir) reduce nitrate to nitrite and subsequently converted to ammonia (99%) and nitric oxide (1%) in anaerobic condition. Regular aerobic exercise 2-3 times/week for 30 minutes resulted in increased 2,3-DPG which reduces the activity of E. coli to reduce nitrate to nitrite and ammonia, which only works on the anaerobic state. High Nitrate Diets lead to increased nitrate reducing bacteria such as E. coli resulting in the reduction of nitrate excess produce nitrite and ammonia in large quantities. Probiotic Lactobacillus spp. can suppress the growth of bacterial endotoxins and pathogens such as E. coli and other Enterobacteriaceae. This study aimed to determine the correlation of aerobic exercise and a high nitrate diet in gastrointestinal populations of Escherichia coli gastrointestinal tract in patient with liver cirrhosis.Method: This was a descriptive-experimental study in liver cirrhosis patients Child Pugh A/B in outpatient clinic Saiful Anwar Hospital in August 2015. Respondents were asked to fill out a questionnaire with information about the demographic data, the nitrate diet, aerobic exercise, other medical data and sanitation, and stool samples were taken for faecal culture. Eta Correlation statistical test was used to determine the correlation of aerobic exercise and a high nitrate diet high in population of E. coli. The significant difference are indicated by p < 0.005.Results: A total of 36 patients diagnosed with liver cirrhosis Child Pugh A/B, 14 (39%) underwent aerobic exercise 3x /week, as many as 25 (70%) consume a high nitrate diet. There was a strong relationship between aerobic exercise and high nitrate diet with population of E. coli (Ƞ = 0.725; p < 0.05).Conclusion: There was a strong relationship between aerobic exercise and high nitrate diet with a population of E. coli in liver cirrhosis. Giving probiotics in patients with liver cirrhosis suppressed the population of E. coli
Overview of Serum Interleukin-18 (IL-18) Levels in Liver Cirrhosis Patients and Their Correlation to Hepatic Encephalopathy
Full text linkBackground: The inflammatory process has an important role in the pathophysiology of hepatic encephalopathy (HE) in liver cirrhosis. IL-18 is a key mediator who plays a role in neuroinflamation processes that can lead to symptoms of HE. This study aimed to determine serum IL-18 levels in liver cirrhosis patients and to assess the association of serum IL-18 levels with HE.Method: A total of 52 subjects (32 patients with liver cirrhosis and 20 healthy controls) were enrolled in this study. 32 patients with liver cirrhosis will be assessed for HE based on West-Haven criteria. All subjects were examined for serum IL-18 levels which is measured by ELISA method. We performed a comparative analysis between serum IL-18 levels of liver cirrhosis patients and healthy controls, a correlation analysis between serum IL-18 levels and HE, and a comparative analysis of serum IL-18 levels among degrees of HE.Results: Mean serum IL-18 levels in the liver cirrhosis group were 688.5 ± 674.3 pg/ml, and in the healthy controls group were 163.9 ± 100 pg/mL with p value = 0.01 (p < 0.05). There was a significant correlation between IL-18 and HE (r = 0.85, p = 0.00). Serum IL-18 levels in covert and overt HE groups were significantly higher than those without HE (p < 0.05).Conclusion: Serum IL-18 levels were significantly higher in liver cirrhosis patients than in healthy controls. There was a positive correlation between IL-18 and HE. Serum IL-18 levels in liver cirrhosis patients with HE were significantly higher than those without HE
The Role of Biologics Agent in the Treatment of Inflammatory Bowel Disease
Full text linkInflammatory bowel disease (IBD), with major manifestations as Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic intestinal inflammatory disorder with an unknown etiology which pathogensis involving multifactorial immune disorder characterized by chronic relapsing inflammation of the intestine. Management of IBD depends on stage and location of the inflammation consist of the classic conventional treatment and the more new treatment with biologics agent. Biologics agent refers to monoclonal antibodies with activity directed against specific targets involved in the pathogenesis of chronic inflammatory conditions. Advances in the understanding of the specific mechanisms of pathogenesis IBD led to the development of targeted treatment. Today there are six biologics agent approved and used as therapy and there still many other biologics agent on research progress. Many reports show positive report about efficacy for the biological therapy compared with placebo and conventional treatment for the IBD. Limited by their cost and adverse effect that possibly happened, biologics agent is still promising therapy that change the course of IBD treatment.
The Comparison of Tnf α (Tumor Necrosis Factor α) Serum Levels Between Cytotoxin - Associated Gene A (Caga) Positive and Negative in Patients with Gastritis Helicobacter pylori
No full textBackground: Helicobacter pylori (H. pylori) infection is the common cause of chronic gastritis in the world that is around 80% in addition to other causes such as autoimmune diseases, drugs, idiopathic and others. The pathogenesis of H. pylori associated with virulence factors consisting of cytotoxin - associated gene A (CagA) and vacuolating cytotoxin A (Vaca). In the case of gastritis occurred acute and chronic inflammatory responses and activation cytokines that cause inflammation of mucous which TNF-α levels increased in patients gatritis H. pylori. Levels of serum TNF-α was found higher in patients infected with H. pylori with CagA positive. The purpose of this study is to investigate the comparison between TNF-α serum level in H. pylori gastritis patients with Cag A (+) and CagA (-).Method: The study was conducted with a cross-sectional design in 30 patients with dyspepsia, using PADYQ score. We performed gastroscopy, biopsy, and CLO test to prove the existence of H. pylori. Furthermore, we used PCR to assess CagA (+) and CagA (-), and ELISA method to measure TNF-α serum level.Results: From 30 subjects, 18 men (60%), 12 women (40%), and the mean age was 53.5 years, the majority of the ethnic was Bataknese (53.3%), patients with H. pylori gastritis with CagA (+) were 21 (70%) and patients with H. pylori gastritis with CagA (-) were 9 (30%). We found the mean serum levels of TNF-α was higher (3.48) in H. pylori gastritis with CagA (+) than the CagA (-) (1.29) with p value was 0.001.Conclusion: We found increased serum levels of TNF-α in patients with CagA (+) compared to Cag A (-) H. pylori gastritis