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Abstrak :
Backgrounds: Gastrointestinal bleeding such as hematemesis or melena are common conditions in clinical practice and endoscopic service. The mortality rate due to gastrointestinal bleeding is relatively high. In this study, we evaluate the causes of hematemesis melena for the last 5 years and the factors associated with the bleeding. Methods: The study was done retrospectively. We obtained data from medical record of patients that performed endoscopy of upper gastrointestinal tract in Division of Gastroenterology, Department of Internal medicine, Cipto Mangunkusumo hospital (Jakarta, Indonesia) during the period of 2001 to 2005. Results: Of 4.154 patients who underwent upper gastrointestinal tract endoscopy from 2001 to 2005, we found that 837 patients (20.1%) were due to upper gastrointestinal bleeding. They were 552 male (65.9%) and 285 female patients (34.1%). Mean age of male patients was 52.7 ± 15.82 years, while for female patients was 54.46 ± 17.6 years. Of 837 patients who came due to hematemesis were 150 patients (17.9%), melena were 310 patients (37.8%), both melena and hematemesis were 371 patients (44.3%), 557 cases (66.5 %) due to non varices. Endoscopic results showed that 280 cases (33.4%) were due to esophageal varices. In general, this study had demonstrated that esophageal varices was the most frequent cause of upper gastrointestinal bleeding. We found 229 cases of esophageal varices were coincidence with portal hypertensive gastropathy. While ulcer was found in 225 cases (26.9%) and most of them were gastric ulcer (51.1%). Of gastrointestinal bleeding caused by esophageal varices, most were grade HI in 138 cases (49.3%). The incidence of bleeding of bleeding were found more frequently in patients age group of 40 - 60 years (389 cases; 46.5%), > 60 years (305 cases; 36.2%), < 40 years (242 cases; 16.8%). The causes of bleeding in patients whose age > 60 years, most were caused by ulcer (37.4%). In this study, we also found that cancer as the cause of gastrointestinal bleeding in 26 cases (3.1%). Gastrointestinal cancer comprised of gastric cancer in 15 cases (57.7%), duodenal cancer in 7 cases (26.9%), and esophageal cancer in 4 patients (15.4%). Conclusion: The most frequent cause of upper gastrointestinal bleeding was esophageal varices and usually had reached stage HI. The non variceal cause of bleeding was gastric cancer. Upper gastrointestinal malignancy was also found to be the etiology of bleeding in this study.

Abstrak :
Latar Belakang: Disfungsi saluran cerna berhubungan dengan luaran klinis yang lebih buruk pada pasien sakit kritis. Kadar albumin serum yang rendah merupakan salah satu faktor yang dapat meningkatkan risiko disfungsi saluran cerna. Hubungan kadar albumin dengan disfungsi saluran cerna masih inkonklusif karena pendekatan diagnostik disfungsi saluran cerna yang belum terstandarisasi dengan baik. Gastrointestinal dysfunction score (GIDS) instrumen dengan subjektivitas minimal dan reproduktifitas maksimal, diharapkan dapat menegakkan diagnosis disfungsi saluran cerna dengan objektivitas yang lebih baik. Penelitian ini dilakukan untuk mengetahui hubungan antara kadar albumin saat admisi dengan terjadinya disfungsi saluran cerna yang dinilai menggunakan GIDS. Metode: Penelitian ini merupakan penelitian kohort prospektif pada subjek berusia ≥18 tahun yang dirawat di ruang rawat intensif Rumah Sakit Umum Pusat Nasional (RSUPN) dr. Cipto Mangunkusumo dan Rumah Sakit Universitas Indonesia (RSUI). Karakteristik subjek penelitian berupa usia, jenis kelamin, status gizi, penyakit komorbid, diagnosis admisi intensive care unit (ICU), waktu inisiasi pemberian nutrisi oral atau enteral, kebiasaan mengonsumsi alkohol, dan skor sequential organ failure assessment (SOFA). Dilakukan analisis bivariat untuk menilai hubungan kadar albumin saat admisi dengan disfungsi saluran cerna. Hasil: Diperoleh 64 subjek, kelompok kadar albumin rendah 32 subjek dan kelompok kadar albumin normal 32 subjek. Rerata usia subjek 50,2±15,7, laki-laki 64,1%, 26,6% subjek dengan status gizi berat badan normal berdasarkan indeks massa tubuh (IMT), 50% subjek dengan malnutrisi secara klinis,  21,9% subjek dengan diagnosis komorbid diabetes melitus dan 3,1% subjek dengan parkinson, 34,4 % subjek dengan diagnosis admisi bedah, 95,3% subjek mendapatkan nutrisi oral atau enteral ≤ 48 jam, median skor SOFA 3 (0-12). Rerata kadar albumin  subjek dengan disfungsi saluran cerna 2,7±0,6 g/dL, rerata kadar albumin  subjek tidak disfungsi saluran cerna 3,7±0,7 g/dL. 31,3% subjek mengalami disfungsi saluran cerna. Terdapat hubungan signifikan secara statistik antara kadar albumin saat admisi dengan disfungsi saluran cerna RR 9 (95%CI 2,3-35,6; p <0,001) dan skor GIDS, p<0,001. Kesimpulan: Terdapat hubungan bermakna antara kadar albumin saat admisi dengan disfungsi saluran cerna. Pemeriksaan kadar albumin saat admisi ICU idealnya dilakukan secara rutin dan diikuti dengan koreksi kadar albumin apabila ditemukan kondisi hipoalbuminemia. ......Background: Gastrointestinal dysfunction is associated with worse clinical outcomes in critically ill patients. Low serum albumin levels are one factor that can increase the risk of gastrointestinal dysfunction. The relationship between albumin levels and gastrointestinal dysfunction is still inconclusive because the diagnostic approach to gastrointestinal dysfunction is not yet well standardized. Gastrointestinal dysfunction score (GIDS) is an instrument with minimal subjectivity and maximum reproducibility, which is expected to provide a diagnosis of gastrointestinal dysfunction with better objectivity. This research was conducted to determine the relationship between albumin levels at admission and the occurrence of gastrointestinal dysfunction as assessed using GIDS. Methods: This study is a prospective cohort study of subjects aged ≥18 years who were treated in the intensive care unit at RSUPN dr. Cipto Mangunkusumo and RSUI. Characteristics of research subjects included age, gender, nutritional status, comorbid diseases, ICU admission diagnosis, time of initiation of oral or enteral nutrition, alcohol consumption habits, and SOFA score. Bivariate analysis was carried out to assess the relationship between albumin levels at admission and gastrointestinal dysfunction. Results: There were 64 subjects, 32 subjects in the low albumin level group and 32 subjects in the normal albumin level group. Mean age of subjects 50.2 ± 15.7, 64.1% male, 26.6% subjects with normal weight nutritional status based on BMI, 50% subjects with clinical malnutrition, 21.9% subjects with comorbid diagnosis of diabetes mellitus and 3.1%  subjects with Parkinson's, 34.4%  subjects with surgical admission diagnosis, 95.3% subjects received oral or enteral nutrition ≤ 48 hours, median SOFA score 3 ( 0-12). The mean albumin level of subjects with gastrointestinal dysfunction was 2.7 ± 0.6 g/dL, the mean albumin level of subjects without gastrointestinal dysfunction was 3.7 ± 0.7 g/dL. 31.3% of subjects experienced gastrointestinal dysfunction. There was a statistically significant relationship between albumin levels at admission and gastrointestinal dysfunction RR 9 (95%CI 2.3-35.6; p <0.001) and GIDS score, p<0.001. Conclusion: There is a significant relationship between albumin levels at admission and gastrointestinal dysfunction. Albumin levels examination during ICU admission should ideally be carried out routinely and followed by correction of albumin levels if hypoalbuminemia is found.

Abstrak :
Gangguan pencernaan merupakan isu global dengan hasil  studi epidemiologi lebih dari 40% orang diseluruh dunia mengalami gangguan pencernaan. Salah satu faktor diet yang berhubungan dengan gangguan pencernaan yaitu jenis makanan yang dikonsumsi. Masyarakat Minahasa memiliki kebiasaan mengkonsumsi makanan berempah dan pedas. Tujuan penelitian ini adalah untuk mengidentifikasi hubungan antara mengonsumsi makanan minahasa berempah dan pedas dengan gejala gangguan pencernaan. Penelitian ini merupakan penelitian cross-sectional yang melibatkan 212 sampel berusia 18-60 tahun yang sesuai dengan kriteria inklusi dan eksklusi. Pengambilan sampel menggunakan teknik consecutive sampling. Hasil penelitian menunjukkan bahwa setelah dikontrol dengan variabel perancu, terdapat hubungan antara konsumsi makanan berempah dan pedas dengan gejala gangguan pencernaan (nilai p 0.015<0.05) OR 2.523 (95% CI: 1.197-5.319). Pasien yang mengonsumsi makanan berempah dan pedas berisiko 2.523 kali mengalami gejala gangguan pencernaan. Peneliti merekomendasikan perawat untuk melakukan asuhan keperawatan secara komperhensif sebagai educator dan fasilitator untuk mengoptimalkasn kesehatan masyarakat yang mengonsumsi makanan berempah dan pedas serta faktor lainnya yang berisiko  dengan gejala gangguan pencernaan. Bagi pelayanan kesehatan dan pemerintah daerah dapat menyusun rencana strategi dalam upaya pencegahan maupun penanganan gangguan pencernaan terkait konsumsi makanan berempah dan pedas dengan tetap melestarikan kekhasan budaya setempat. ......Gastrointestinal disorders are a global issue with the epidemiology study results of more than 40% of people around the world experiencing digestive disorders. A dietary factor associated with indigestion is the type of food consumed. Minahasa people habitually consume spicy foods. The aim of this study was to identify the relationship between consuming spicy Minahasan food and symptoms of indigestion. This study was a cross-sectional study involving 212 samples aged 18-60 years who complied with the inclusion and exclusion criteria. Consecutive sampling technique was used. After control for confounding variables, there was an association between consuming spicy foods and gastrointestinal symptoms (p value 0.015<0.05) OR 2.523 (95% CI: 1.197-5.319). Patients who consume spicy foods are at risk of 2.523 times to experience gastrointestinal symptoms. Furthermore, Researchers recommend nurses to provide comprehensive nursing care as educators and facilitators to optimize the health of people who consume spicy foods and other risk factors associated with gastrointestinal symptoms. For health services and government can establish a strategic plan in preventing and treating gastrointestinal disorders related to the consumption of spicy food while preserving the characteristics of local culture.

Abstrak :
Penelitian ini bertujuan mengidentifikasi gambaran kejadian masalah gastrointestinal pada mahasiswa asing di Universitas Indonesia. Desain penelitian deskriptif dengan pendekatan potong lintang, melibatkan 64 sampel yang dipilih dengan teknik convenient sampling. Instrumen yang digunakan ialah kuesioner yang dimodifikasi dari penelitian sebelumnya. Analisis data univariat distribusi frekuensi. Hasil penelitian menunjukkan 82,8% mahasiswa asing di Universitas Indonesia pernah mengalami masalah gastrointestinal selama berada di Indonesia. 46,3% responden menyatakan sering mengalami keluhan sakit perut, yang merupakan manifestasi umum pada berbagai jenis gangguan gastrointestinal. Penelitian lebih lanjut diperlukan untuk mengeksplorasi berbagai faktor pola makan dan gaya hidup yang memengaruhi kejadian masalah gastrointestinal pada mahasiswa asing di Universitas Indonesia. ......This study aimed to identify the description of gastrointestinal problems on foreign students in Universitas Indonesia. Descriptive study with a cross-sectional design, involving 64 samples whom were selected with convenient sampling method. A questionnaire which was modified from previous research was used. The result showed that 82,8% foreign students of Universitas Indonesia had experienced gastrointestinal problems during in Indonesia, which indicates high prevalence. 46,3% respondents often experience abdominal discomfort which is the common manifestation of various gastrointestinal disorders. A further research is needed to explore and elaborate the related factors such as consumption pattern and lifestyle which significantly affect the gastrointestinal problems finding on foreign students in Universitas Indonesia.

Abstrak :
Gangguan gastrointestinal merupakan sebagain besar penyakit yang menyebabkan penderitanya mencari pertolonganmedis. Salah satu contohnya adalah mual dan muntah. Mual merupakan sensasi tidak menyenangkan dari keinginanuntuk muntah atau perasaan di tenggorokan atau daerah epigastrum yang memperingatkan seseorang bahwa muntah akansegera terjadi. Sedangkan muntah merupakan ekspulsi paksa isi lambung melalui mulut sebagai refleks proteksi dari tubuh untuk mengeluarkan zat berbahaya dari GIT sebelum dapat diserap. ......Gastrointestinal disorder are the majority of disease that cause sufferes to seek medical help. One examples is nausea and vomiting. Nausea is the unpleasant sensation of wanting to vomit or a feeling in the throat or epigastrum area that warns a person that vomiting is imminent. Meanwhile, vomiting is the forced expulsion of stomach contents through the mouth as a protective reflex from the body to remove harmful substances from the GIT before they can be absorbed.

Abstrak :
This atlas will illustrate the distribution and morphological features of interstitial cells of cajal (ICC) which are the key cells to understanding of the regulatory mechanism of gastrointestinal motility, since ICC act as both pacemaker and as intermediates in neural transmission, and since ICC show specific distribution patterns depending on their anatomical positions. All subtypes of ICC located in the different tissue layers and different levels of the gastrointestinal tract will be revealed by immunohistochemistry for Kit receptors and nerves by using mainly whole-mount stretch preparation of the guinea-pig tissues. Three-dimensional reconstruction of confocal images will particularly help the readers to understand the peculiar arrangement of ICC networks in situ and the correlation between ICC and nerves. Electron micrographs will help illustrate the characteristic features of ICC and their ultrastructural differences from fibroblasts, smooth muscles and other interstitial cells.