Conformity Between Ileoscopy Appearance with Terminal Ileum Histopathology Appearance in Normal Colonoscopy Chronic Diarrhea Patients

Background: Chronic diarrhea is one of the most common problem in gastroenterology cases. Ileoscopy is one of the modalities to determine the etiology of chronic diarrhea by normal colonoscopy appearance. Recently, there is still controversy in the need of this examination in normal macroscopic appearance. The aim of this study is to study the conformity of histopathology abnormalities with ileoscopy appearance in chronic diarrhea patients with normal colonoscopy.Methods: This study uses cross sectional study design by collecting 60 medical record data in several hospitals in Jakarta in the period of 1 January 2005 to 31 December 2011. Diagnostic test between ileoscopy and histopathology is performed by histopathology examination as a gold standard.Results: Study results revealed conformity between both examinations for 93.33%. Sensitivity value of ileoscopy examination compared to histopathology as a gold standard was 94%, specificity 90%, positive predictive value 97.9%, and negative predictive value 75%.Conclusion: Ileoscopy examination in chronic diarrhea patients and normal colonoscopy showed similar results with histopathology examination

National Consensus on the Use of Sedation Drugs in the Gastrointestinal Endoscopic Procedures

Gastrointestinal endoscopy is rapidly developing and several gastrointestinal endoscopy equipment are available for both diagnostic and therapeutic purposes. Proper sedation is critical in performing endoscopic procedures, both for patients and physicians. This consensus is used as a guideline and not as a legal standard in performing endoscopic services. This consensus explained the definition, indication, contraindication, and complication prevention during sedation. Factors affecting the need of sedation is patient factors, procedure factors, and sedation level. Diagnostic or therapeutic upper gastrointestinal tract endoscopy which not complicated can be performed with minimal sedation or moderate sedation, while deep sedation can be considered for longer and more complex procedures. Furthermore, assessment and selection of sedation was explained, followed by the guide to choose pharmacological sedation and analgesics. Currently, diazepam, midazolam, propofol, fentanyl, and pethidine is the most likely used sedation during gastrointestinal endoscopy, with midazolam as the preferred medication of choice. This consensus also explained the antidote of each drug and the recovery after procedure. This consensus aimed to improve gastrointestinal endoscopic procedure services in Indonesia