Dyspepsia and Helicobacter Pylori Infection

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The Prevalence and Risk Factors of GERD Among Indonesian Medical Doctors

Background: Based on our knowledge, the study of gastrointestinal reflux disease (GERD) among certain profession has never been conducted. The aim of this study is to determine the prevalence and risk factors of GERD among Indonesian doctors. Methods: A consecutive study involving 515 doctors was conducted in October 2015. The GerdQ score was used to the diagnosis of GERD and determined its impact on daily life. All possible risk factors were also analysed. Results: A total of 515 subjects completed the questionnaire. The mean age of them was 41.37 ± 11.92 years old. Fifty-five percent of them were male and 60.6% general practitioners. The prevalence of GERD was 27.4% of which 21.0% was had GERD with low impact on daily life, and 6.4% was GERD with high impact on daily life. The statistically significant risk factors of GERD was found in age >50 y.o (p = 0.002; OR = 2.054), BMI >30 kg/m2 (p = 0.016; OR = 2.53), and smokers (p = 0.031; OR = 1.982). Sex and education level were not found significant statistically as the risk factors of GERD. Conclusions: The prevalence of GERD among Indonesian physician was 27.4%. We found that age over 50 y.o, obesity and smoking habit were the risk factors of GERD in Indonesian doctors.&nbsp

Common Bile Duct Stricture Post Open Cholecystectomy

Common bile duct stricture is a common complication following open cholecystectomy. Approximately 80% of benign strictures occur following injury during a cholecystectomy. We report a female aged 70 years old, with a history of open cholecystectomy due to gallbladder stones. She was admitted to Cipto Mangunkusumo Hospital with symptoms and signs of obstructive jaundice. Endoscopy retrograde cholangio-pancreaticography (ERCP) examination revealed proximal common bile duct (CBD) stricture. She underwent open laparotomy, during which, a narrowing of proximal CBD was seen due to a fibrosis involving part of the duodenum. The patient then underwent a hepatic-duodenostomy bypass surgery. The symptoms and signs of obstructive jaundice were relieved after surgery

Impact of Low Fiber Diet on Gastrointestinal Disorders

Fiber is not digested or absorbed in the small intestine. The main site of action of fiber is in the colon. In the colon, fiber will increase stool output and frequency, increase stool water, dilute the colonic content, reduce the toxins, bile acid, increase colonic fermentation and also stimulate probiotic growth. Some meta-analysis of observational epidemiologic and case control studies have found a protective effect of dietary fiber against colon cancer that increase with intake. Therefore, the high fiber diet is healthy recommendation to prevent various gastrointestinal disorders

Current Diagnosis and Management of Helicobacter Pylori

Helicobacter pylori (H. pylori) is a microbe which cause chronic infection in human. Currently, the prevalence in developed countries continue to decrease, but the same does not happen in developing countries. Orofecal transmission and its connection with environmental condition is assumed to be its cause.Impact of H. pylori infection in gastric mucosa is influenced by the bacteria pathogenesis which is able to survive in acid condition and causes inflammatory reaction. The diagnosis is differentiated through endoscopy or non-endoscopy depends on the alarm symptoms, local prevalence, pre-test probability, availability, cost and aim of examination.Management of H. pylori depends on the high rate of clarithromycin resistence. In area with resistency prevalence below 20% triple therapy can still be used, while in increasing resistency area, use of four times daily therapy or other antibiotics such as levofloxacin and furazolidone can be considered

Difficulties in Making Diagnosis of Inflammatory Bowel Disease: Several Cases Analysis

Inflammatory bowel disease (IBD) is rarely found in clinical practice. However, the incidence of IBD seems to have increased recently. Generally, the patients will come to hospital with chief complaint of chronic diarrhea with or without hematochezia. We reported two cases of IBD in which they had been misdiagnosed as colitis tuberculosis based on colonoscopy examination. Treatment of anti tuberculosis drugs had made no clinical improvement. Further evaluation suggested the diagnosis of IBD. They responded very well clinically after treated as IBD. This case report reminds us to consider the diagnosis of IBD in patient with chronic diarrhea and ulceration in colonic mucosa at colonoscopy

Clinical Improvement of Dyspepsia Symptoms Following Eradication Treatment for Helicobacter Pylori

The prevalence of Helicobacter pylori in patients with peptic ulcer in Indonesia is very high. It ranges between 90-100%. In general, patients with gastritis and peptic ulcer usually have dyspepsia symptoms. The pathophysiology of dyspepsia symptoms caused by Helicobacter pylori has not been clearly understood. However, it is assumed that the symptoms are correlated to various factors including inflammation, apoptosis damage, and increased secretion of gastric acid, atrophy and non-atrophy gastritis as well as the development of peptic ulcer. The main objective of treatment for Helicobacter pylori infection is elimination of Helicobacter pylori bacteria. Triple therapy has 80% success rate with no significant adverse events and minimal effect in inducing resistance to antibiotics. The success rate of eradication treatment in patients with peptic ulcer is 90%; while an evaluation on improvement of duodenal ulcus following eradication treatment with one month proton pump inhibitor treatment reveals 90% success rate