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"Latar Belakang: Tuberkulosis (TB) merupakan masalah kesehatan utama di dunia, khususnya di Indonesia. Tuberkulosis umumnya menyerang paru (TB paru), namun bisa juga menyerang organ lain (TB ekstraparu), seperti kolitis TB. Diagnosis kolitis TB menjadi tantangan karena klinis dan hasil pemeriksaannya menyerupai penyakit lain, seperti inflammatory bowel disease (IBD). Studi ini bertujuan untuk mengetahui proporsi hasil PCR-TB feses pada pasien teduga kolitis TB dan uji diagnosis pemeriksaan PCR-TB feses jika dibandingkan dengan hasil kolonoskopi, histopatologi, dan evaluasi klinis. Metode: Dilakukan studi uji diagnostik pada 60 subjek terduga kolitis TB di RSCM yang menjalani pemeriksaan kolonoskopi pada bulan Februari-April 2019. Ekstraksi DNA dari feses dilakukan dengan menggunakan QIAamp® Fast Stool DNA Mini Kit dan PCR dilakukan dengan kit artus® M. tuberculosis RG dengan target gen 16s rRNA. Hasil pemeriksaan PCR-TB feses dibandingkan dengan hasil kolonoskopi, histopatologi, dan evaluasi klinis. Hasil: Terdapat 60 subjek terduga kolitis TB yang disertakan dan dianalisis dalam penelitian ini. Diperoleh 26 (43,3%) hasil PCR-TB feses positif, yang terdiri atas 7/8 subjek kolitis TB dan 19/52 subjek bukan kolitis TB. Dari hasil penelitian ini, didapatkan nilai diagnostik PCR-TB feses dibandingkan hasil kolonoskopi, histopatologi, dan evaluasi klinis memiliki sensitivitas 87,5%, spesifisitas 63,5%, NPP 26,9%, dan NPN 97,1%. Simpulan: Pemeriksaan PCR-TB feses memiliki sensitivitas baik namun spesifisitas yang rendah untuk diagnosis kolitis TB sehingga lebih baik sebagai pemeriksaan penyaring untuk kolitis TB.

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Background: Tuberculosis (TB) is a major health problem in the world, particularly in Indonesia. Tuberculosis commonly affects lung (pulmonary TB), but it can also affect other organs (extrapulmonary TB), such as TB colitis. The diagnosis of TB colitis has become a challenge because the clinical manifestation and its tests result can mimic other diseases, such as inflammatory bowel disease (IBD). This study was aimed to find the proportion of stool TB-PCR result in patients which suspected with TB colitis and the diagnostic value of stool TB-PCR if compared to colonoscopy, histopathology, and clinical evaluation. Methods: Diagnostic study was done in 60 subjects suspected for TB colitis in RSCM which underwent colonoscopy and histopathology examination in February-April 2019. The DNA extraction from the stool was done by using QIAamp® Fast Stool DNA Mini Kit and TB-PCR was done with artus® M. tuberculosis RG PCR kit which targeting 16s rRNA gene. The result of stool TB-PCR then was compared to the result of colonoscopy, histopathology, and clinical evaluation. Results: There were 60 subjects suspected with TB colitis recruited and analyzed in this study. There were 26 (43,3%) positive stool TB, consist of 7/8 subjects with TB colitis and 19/52 subjects with non-TB colitis. From this study, the diagnostic value of stool TB-PCR that was compared to combination of colonoscopy, histopathology, and clinical evaluation were: sensitivity 87,5%, specificity 63,5%, positive predictive value (PPV) 26,9% and negative predictive value (NPV) 97,1%. Conclusion: Stool TB-PCR has good sensitivity but low specificity for diagnosing TB colitis. Therefore, stool TB-PCR is better utilized for TB colitis screening."

"Penyakit gastroenterologi masih merupakan masalah kesehatan utama di Indonesia, dengan kolitis menempati urutan kelima dari sepuluh penyakit terbanyak pada pelayanan rawat jalan. Kesamaan gambaran klinis dan hasil pemeriksaan diagnostik kolitis TB dan Inflammatory Bowel Disease (IBD) menyebabkan kesulitan diagnosis. Studi ini bertujuan untuk mengetahui peran diagnostik Interferon-Gamma Release Assay (IGRA) metode Elispot pada pasien terduga kolitis tuberkulosis di Indonesia. Dilakukan studi potong lintang dan acak dengan penyajian data deskriptif analitik. Subjek penelitian merupakan 60 pasien terduga kolitis tuberkulosis yang mengunjungi poliklinik gastroenterologi di RSUPNCM bulan April-Oktober 2018. Sampel yang digunakan adalah darah vena. Hasil uji diagnostik IGRA metode Elispot dengan baku emas pemeriksaan histopatologi adalah sensitivitas 83,3%, spesifisitas 57,4%, NPP 17,3%, dan NPN 96,9%. Hasil uji diagnostik IGRA metode Elispot dengan baku emas pemeriksaan kolonoskopi adalah sensitivitas 53,9%, spesifisitas 55,3%, NPP 25%, dan NPN 81,3%. Hasil uji diagnostik IGRA metode Elispot dengan baku emas pemeriksaan kolonoskopi dan histopatologi adalah sensitivitas 57,1%, spesifisitas 60,5%, NPP 28,6%, dan NPN 81,3%. Hasil uji diagnostik IGRA metode Elispot dengan baku emas pemeriksaan histopatologi, kolonoskopi, dan evaluasi klinis akhir adalah sensitivitas 100%, spesifisitas 59,3%, NPP 21,3%, dan NPN 100%. Tes IGRA Metode Elispot dapat digunakan sebagai pemeriksaan penapisan.

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Gastroenterology diseases are still a major health problem in Indonesia, with colitis ranks fifth among the top ten diseases in outpatient care. The similarity of clinical features and diagnostic results of TB and Inflammatory Bowel Disease causes difficulties in diagnosis. This study is aimed to determine the diagnostic value of Interferon-Gamma Release Assay (IGRA) with Elispot Method in patients with suspected tuberculous colitis in Indonesia. It is a cross sectional and randomized study, shown as an analytic descriptive report. There were 60 patients with suspected tuberculosis colitis, visiting gastroenterology polyclinic at RSCM from April-October 2018. The sample was venous blood.  Diagnostic results of IGRA with Elispot Method with histopathology test as the gold standard are sensitivity 83,3%, specificity 57,4%, PPV 17,3%, and NPV 96,9%. As with colonoscopy as the gold standard are sensitivity 53,9%, specificity 55,3%, PPV 25%, dan NPV 81,3%. Meanwhile, with colonoscopy and histopathology test as the gold standard are sensitivity 57,1%, specificity 60,5%, PPV 28,6%, dan NPV 81,3%. And, diagnostic results  of IGRA with Elispot Method with colonoscopy, histopathology test, and final clinical judgement as the gold standard are sensitivity 100%, specificity 59,3%, PPV 21,3%, dan NPV 100%. IGRA with Elispot Method can be used as screening test."

"The term "Inflammatory Bowel Disease" (IBD) is frequently used to denote two diseases, ulcerative colitis (UC) and Crohn's disease (CD). This condition is frequently recorded in the West, and along with development of diagnostic facilities, is beginning to be more commonly found in Indonesia.The etiology of this disease is still unclear, but it is suspected that environmental, geographic, and genetic factors are involved. Cytokines play a great role in the pathogenesis of IBD, where in IBD there is an unbalance of pro-inflammatory cytokines and inhibitor cytokines. In IBD, there is an increase in pro-inflammatory cytokines, such as IL-1, IL-2, IL-6, IL-8, and alpha TNF in the intestinal mucosa. Such increase significantly correlates with the activity of ulcerative colitis through endoscopic examination,At this moment, forms of therapy for IBD associated with cytokines are being developed, such as ways to inhibit cytokine synthesis, cytokine release, cytokine activity and the cytokine signaling pathway in the target cell."

"Latar Belakang : Kolitis merupakan penyakit gastrointestinal yang banyak ditemukan dan menjadi masalah utama di negara berkembang termasuk Indonesia. Zinc, trace element penting dengan berbagai fungsi diantaranya antimikrobial mukosa intestinal, meningkatkan fungsi barrier gastrointestinal, dan fungsi imun. Kolitis menyebabkan perubahan anatomis saluran gastrointestinal, dianggap dapat menyebabkan defisiensi zinc akibat gangguan penyerapan dan peningkatan ekskresi. Penelitian ini bertujuan mengetahui profil zinc darah dan analisa tinja pada pasien kolitis di RSUPN dr. Cipto Mangunkusumo. Metode : Dilakukan penelitian potong lintang pada bulan Agustus 2019-November 2019. Subjek kolitis diperoleh secara konsekutif dari pasien yang kontrol di poliklinik gastroenterologi atau menjalani kolonoskopi di Pusat Endoskopi Saluran Cerna RSUPN. dr. Cipto Mangunkusumo. Pemeriksaan sampel zinc darah secara spektrofotometri dan analisa tinja subjek kolitis untuk menilai profil zinc darah dan analisa tinja. Kadar zinc darah subjek kolitis dibandingkan dengan kadar zinc darah subjek sehat. Hasil : Terdapat 40 subjek kolitis dan 16 subjek sehat yang disertakan untuk dianalisis pada penelitian ini. Diperoleh 45% pasien kolitis yang defisiensi zinc dengan rerata kadar zinc kelompok kolitis adalah 10,9 ± 1,9 µmol/L dan rerata kadar zinc subjek sehat 12,3 ± 1 µmol/L. Profil analisa tinja kelompok kolitis ditemukan konsistensi lembek 90%, BAB berlendir 17,5%, peningkatan jumlah eritrosit 60%, peningkatan jumlah leukosit 5%, positif amilum 20%, positif lemak 7,5%, pH asam 97,5%, positif darah samar tinja 37,5%, dan jamur di tinja 7,5%. Simpulan : Kadar zinc pada kelompok kolitis lebih rendah bermakna dibanding kadar zinc pada kelompok sehat. Perlu dilakukan penelitian lebih lanjut untuk mempertimbangkan pemberian terapi zinc pada pasien kolitis dengan defisiensi zinc.

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Background: Colitis is a common gastrointestinal disease that is a major problem in developing countries including Indonesia. Zinc, an important trace element with various functions including antimicrobial intestinal mucosa, improves gastrointestinal barrier function, and immune function. Colitis causes anatomical changes in the gastrointestinal tract, considered to cause zinc deficiency due to impaired absorption and increased excretion. This study aims to determine the profile of blood zinc and fecal analysis in colitis patients at RSUPN Dr. Cipto Mangunkusumo. Methods: A cross-sectional study was conducted on 40 colitis and 16 healthy subjects in August 2019-November 2019. Colitis subjects were obtained consecutively from patients who were in the gastroenterology outpatient clinic or underwent colonoscopy at the Gastroenterological Endoscopy Center of RSUPN. dr. Cipto Mangunkusumo. Spectrophotometric examination of blood zinc samples and fecal analysis of colitis subjects to assess blood zinc profile and stool analysis. The level of colitis in the subjects' blood zinc was compared with the level of zinc in the healthy subject. Results: There were 40 colitis subjects and 16 healthy subjects included for analysis in this study. 45% of colitis patients who were deficient in zinc with a mean zinc level in the colitis group were 10.9 ± 1.9 μmol / L and the mean zinc level in healthy subjects was 12.3 ± 1 μmol / L. Fecal analysis profile of colitis group found 90% soft stool consistency, 17.5% slimy stool, increase in erythrocyte count 60%, increase in leukocyte count 5%, positive starch 20%, positive fat 7.5%, acid pH 97.5%, positive Fecal blood feces 37.5%, and fungi in feces 7.5%.

Conclusion: Zinc levels in the colitis group were significantly lower than zinc levels in the healthy group. Further research needs to be done to consider giving zinc therapy to colitis patients with zinc deficiency."

"Peptic ulcer is a clearly marginated ulceration in mucosal membran that can penetrate until muscularis layer and resulted from imbalance between aggressive factor (gastric acid and pepsin) and defensive factor (gastric mucous, bicarbonate and prostaglandin, mucosal blood flow, and cell replacement). Factors that can act as aggressive factor include H. pylori, NSAID, and smoking. Duodenal ulcer is frequently associated with H. pylori, in which Helicobacter pylori is found in 95 - 100% of duodenal ulcer patients..It was reported, a 39 years old female patient with cirrhosis hepatis who suffered from melena in which endoscopic examination revealed duodenal ulcer as a source of bleeding.The re was no H. pylori, based on serologic examination (IgG antiHP) and culture. The ulcer is suspected caused by NSAID based on history of using traditional medicine that may contain NSAID. Treatment with proton pump inhibitor and sucralfate can heal the ulcer after two week treatment."

"Latar belakang: panduan tatalaksana untuk kolitis ulseratif (KU) belum tersedia. Saat ini, mesalazine, kortikosteroid, dan imunomodulator merupakan pilihan terapi untuk KU. Namun, obat-obatan tersebut memiliki efek samping yang tidak menyenangkan, misalnya mual, muntah, sakit kepala, hepatitis, dan infertilitas pria. Curcumin terdapat dalam tanaman Kunyit (Curcuma longa L.) yang memiliki aktivitas anti inflamasi dan antioksidan."