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Abstrak :
From the l9th of July to the l9?' of October 1999, we conducted a study to evaluate the diagnostic capabilities/benefits of the double contrast barium esophagogram in patients with esophagitis. The sample patients were taken from patients with reflux-type dyspepsia who visited the out patient clinic of the Sub-department of Gastroenterology ofthe Department of Internal Medicine of the Faculty of Medicine of the University of indonesia/Cipto Mangunkusumo Hospital, Jakarta. During the duration of study 32 patients fulfilled the criteria for inclusion, and did not fulfill the criteria for exclusion. All of the subjects underwent double contrast barium esophagogram, Bernstein lest, and endoscopy of the upper gastrointestinal tract, as well as biopsy of the lower third esophageal mucosa. The chief complaints for reflux type dyspepsia were found in the following order: pyrosis/heartburn (56.26%), acid/sour taste in the mouth (12.5%), chest pain (9.3 8%), swallowing disturbance (6.25%). breathing difficulties (6.25%), belching (6.25%), and palpitation (3.12%) From the 32 patients with reflux type dyspepsia that underwent double contrast barium esophagogram, 10 patients (3l. 25%) were found positive for esophagitis, and the remaining 22 patients were found to be negative (68.75%). Bernstein test found 11 patients (34.37%) positive and 21 (65.63%) negative, while endoscopy of the upper gastrointestinal tract showed positive esophagitis in 25 patients (78. 13%) and negative in 7 patients (2l.87%). The degree of accordance between double contrast barium esophagogram and the Bernstein test or even a combination of the two was unsatisfactory in diagnosing esophagitis in reflux type dyspepsia. Based on this, this study concludes that double contrast barium esophagogram and Bernstein are incapable of replacing endoscopic examination in establishing the diagnosis of esophagitis.

Abstrak :
Background: Esophagitis implies an organic damage of the esophagus due to several pathophysiologic factors, predominantly: (1) degree of gastric acid secretion (gastric pH), whereabouts are rapidly or slowly to be mucosal breaks onto esophagus were under the influe nced by: (a) gastric pH 54 and (b) the contact of gastric acid into esophageal mucosal. (2) Lower esophageal sphincter (LES) as a important lactor lor antifetlux mechanisms, which antireflux mechanism cannot senre as a barrier system whenever tone of LES comes down until 510 mml-lg that causes feeble resting LES pressure. Esophageal injuries are recognized endoscopicaliy by the presence of the Savary-Millers classification (1985), but there are not definitely which ones principally to pathophysiologic factor. Methods: This was a consecutive non-random sampling cross sectional study Thirty subject from 127 patients with dyspepsia undergoing elective upper-endoscopic examination with collecting of the gastric juice and biopsies of tower esophageal mucosal, also esophageal manometric examination. Before that, clinical inclusive and exclusive criterias until laboratory examination were performed. Significant interval was 95%. Analyzing data with Fisher?s Exact Test One-Tail to correlate between gastric pH and hypotonic LES into esophagitis. Results: Esophagilis prevalence was 22. 8%. Fisher's Exact Test One-Tail to correlate esophagitis with gastric pH E 4 was significant (p=0.013798), but with hypotonic LES (tones of LES S 10 mmHg) was not (p=0.60269). The combined roles or' gastric pH and tones of LES into esophagitis are included: (1) Frequency of roles of pH E 4 and hypotonic LES are 48.2% (2) Frequency of role of pH < 4 without hypotonic of LES are 33.3%. (3) Frequency of role of hypotonic LES without pH S4 are 11. 1% and (4) Frequency of esophagitis without roles of pH $4 and hypotonic ol LES are 7.4%. Conclusions: The sum of gastric pH 5 4 and hypotonic of LES together are more than each separate factor. Onto statistically was significant between esophagitis and gastric pH, but there is no correlation with tones ol LES. So, gastric pH plays a more important role than LES.

Abstrak :
Latar belakang: Kanker esofagus dilaporkan sebagai penyebab kematian keenam dari seluruh jenis kanker yang ada di seluruh dunia. Salah satu faktor risiko terjadinya keganasan esofagus, terutama adenokarsinoma esofagus adalah gastroesophageal reflux disease (GERD). Diagnosis dini GERD sangat penting karena esofagitis refluks kronis merupakan faktor risiko utama terjadinya Barret esofagus, yang merupakan lesi prekursor terjadinya adenokarsinoma esofagus.Tujuan penelitian ini adalah untuk mengetahui ekspresi p53 dan Ki67 pada esofagitis refluks derajat ringan, esofagitis refluks derajat berat dengan kriteria Esohisto dan Barret esofagus. Bahan dan cara: Penelitian ini merupakan penelitian deskriptif dengan desain penelitian potong lintang, dengan melakukan pulasan imunohistokimia p53 dan Ki67 pada 76 kasus sampel yang terbagi menjadi 30 kasus esofagitis refluks derajat ringan, 14 kasus esofagitis refluks derajat berat, dan 32 kasus Barret esofagus di Departemen Patologi Anatomik Fakultas Kedokteran Universitas Indonesia/Rumah Sakit Cipto mangunkusumo (FKUI/RSCM) tahun 2016-2018. Hasil: Ekspresi p53 positif pada 54 kasus sampel (71,1%), terbanyak pada Barret esofagus sebanyak 28 kasus (51,9%). Ekspresi Ki67 tinggi pada 46 kasus (60,5%), terbanyak pada esofagitis refluks derajat berat sebanyak 12 kasus (85,7%) Kesimpulan: Ekspresi p53 dan Ki67 pada esofagitis refluks derajat berrat dan Barret esofagus lebih tinggi dibanding dengan esofagitis refluks derajat ringan. ......Background: Esophageal cancer is reported as the sixth leading cause of death from all types of cancer worldwide. One of the risk factors for esophageal malignancy, especially esophageal adenocarcinoma is gastroesophageal reflux disease (GERD). Early diagnosis of GERD is very important because chronic reflux esophagitis is a major risk factor for Barrett esophagus, which is a precursor lesion to esophageal adenocarcinoma. The aim of this study was to determine p53 and Ki67 expression in mild reflux esophagitis, severe reflux esophagitis with the criteria of Esohisto and Barrett esophagus. Materials and methods: This study is a descriptive study with a cross-sectional design, by performing immunohistochemical results of p53 and Ki67 in 76 sample cases which were divided into 30 cases of mild reflux esophagitis, 14 cases of severe reflux esophagitis, and 32 cases of Barret esophagus in the Department Anatomical Pathology, Faculty of Medicine, University of Indonesia / Cipto Mangunkusumo Hospital (FKUI / RSCM) 2016-2018. Results: P53 positive expression in 54 sample cases (71.1%), most in Barret esophagus as many as 28 cases (51.9%). Ki67 expression was high in 46 cases (60.5%), most in severe reflux esophagitis as many as 12 cases (85.7%) Conclusion: The expression of p53 and Ki67 in severe reflux esophagitis and Barrett esophagus was higher than in mild reflux esophagitis.

Abstrak :
latar belakang : Esofagitis refluks merupakan kondisi yang cukup sering ditemukan pada pasien usia lanjut. kejadian kanker esofagus, dimana esofagitis merupakan faktor resiko penting masih dianggap jarang di kebanyakan negara Asia. banyak faktor risiko lain penyebab kejadian kanker esofagus masih banyak belum diketahui. studi ini ditujukan untuk mencari prevalensi esofagitis refluks pada pasien usia lanjut faktor-faktor yang berhubungan. metode: studi ini adalah studi potong lintang pada kelompok usia lanjut yang menjalani prosedur pemeriksaan endoskopi saluran cerna atas. pasien yang sudah mendapatkan terapi penghambat pompa proton jangka panjang pasien dengan kegemasan saluran cerna, pasien yang baru saja mendapatkan obat kemoterapi, pasien dengan kelainan otak dan pembuluh darah dan juga pasien yang terbukti terdapat infeksi kuman H. pylori dieksklusi analisis statistik dilakukan dengan menggunakan program SPSS versi 17 (Chicago, IIlinois, USA). hasil : dari 238 pasien usia lanjut didapatkan esophagitis refluks sebanyak 22 (9,2%) pasien, rerata usia pasien adalah 69.8± 6.8 tahun. beberpa komorbiditas yang ditemukan seperti, diabetes, hipertensi, penyakit jantung korner, penyakit ginjal kronik, dan sirosis hari. satu-satunya faktor yang berhubungan dengan kejadian esofagitis refulks adalah adanya hernia hiatus esofagus (p = 0,038), tetai, esofagitis refulks cenderung ditemukan lebih banyak pada pasien usia lanjut yang memilki riwayat konsumsi obat yang bisa ,encetuskan kondisi refulks tanpa adanya perlindungan anti asam. simpulan: esofagitis refluks masih merupakan masalah besar pada pasien usia lanjut. terdapatnya hernia hiatus bisa memberikan pertimbangan penting untuk dilakukanya pemeriksaan penyaring endoskopi saluran cerna atas. tetapi hal ini masih menjadi perbedaan dengan mempertimbangkan beban biaya dan rendahnya kejadian kanker esofagus di sebagian besar negara Asia.

Abstrak :
Latar Belakang: Resistensi insulin telah dilaporkan lebih tinggi pada populasi subjek dengan penyakit refluks gastroesofageal GERD dibandingkan subjek tanpa GERD serta berhubungan langsung terhadap adanya esofagitis erosif. Adanya perbedaan ras dan metode pengukuran pada penelitian sebelumnya, mendorong perlunya penelitian di Indonesia untuk dapat mengetahui resistensi insulin pada populasi GERD, khususnya pada erosi esofagus. Tujuan: Mempelajari perbedaan resistensi insulin pada penyakit refluks gastroesofageal dengan erosi dan tanpa erosi esofagus. Metode: Penelitian ini menggunakan metode potong lintang terhadap 84 pasien dewasa dengan gejala GERD yang berobat di poliklinik gastroenterologi RSCM pada bulan Januari hingga April 2017. Perekrutan subjek dilakukan secara konsekutif menggunakan kuesioner GERDQ. Nilai HOMA-IR digunakan untuk evaluasi resistensi insulin. Adanya erosi esofagus dinilai menggunakan pemeriksaan esofagogastroduodenoskopi EGD. Data diolah menggunakan analisis Mann Whitney untuk memperoleh beda median nilai HOMA-IR antara kelompok tanpa erosi dan kelompok dengan erosi esofagus. Hasil penelitian: Nilai median HOMA IR pada seluruh subjek dengan gejala GERD adalah 1,46 0,32-13,85 . Uji Mann Whitney menunjukkan adanya perbedaan nilai HOMA-IR yang signifikan p= 0,015 dengan nilai median HOMA IR yang lebih tinggi pada kelompok erosi esofagus, yaitu 1,74 0,35-13,85 dibandingkan dengan subjek tanpa erosi esofagus, yaitu 1,21 0,32-10,78. Kesimpulan: Resistensi insulin, yang dinilai dengan HOMA-IR, lebih tinggi secara bermakna pada pasien refluks gastroesofageal dengan erosi esofagus dibandingkan tanpa erosi esofagus. ......Background: Insulin resistance had been reported higher in GERD patients, particularly in patients with erosive esophagitis. Differences in subjects rsquo characteristics and measurement used in previous studies encourage the need to assign the study in Indonesia learn about insulin resistance among GERD patients especially in esophagitis erosive. Aim: To learn the difference of insulin resistance between erosive and non erosive reflux disease in GERD patients. Methods: A cross sectional study of 84 adult patients with GERD symptoms was conducted. The subjects were recruited consecutively between January 2017 and April 2017 at Cipto Mangunkusumo National Hospital in Jakarta. GERDQ questionnaire was used for subject recruitment. Homeostatic model assessment insulin resistance HOMA IR index was used to evaluate insulin resistance. Esophageal erosions were diagnosed using upper gastrointestinal endoscopy. Mann whitney analysis was used to determine HOMA IR median difference between esophagitis and non esophagitis group. Results: The median of HOMA IR in all subjects was 1.46 0.32 13.85 . Using Mann Whitney test, HOMA IR index was significantly higher in esophagitis patients p 0.015 than in non erosive patients, with the median of HOMA IR index were 1.74 0.35 13.85 and 1.21 0.32 10.78 respectively. Conclusion Insulin resistance, using HOMA IR index, is significantly higher in gastroesophageal reflux disease patients with esophageal erosion.