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"Dyspepsia is one of numerous general complaints, which is commonly encountered by doctors of various disciplines. In daily practice, the complaint is not only limited for gastroenterologists. Knowledge on pathophysiology of dyspepsia have been developing continuously since a scientific investigation has been started in 1980s, which considers Helicobacter pylori as one of key factor in managing dyspepsia, either it is associated with ulcer or non-ulcer. The management of dyspepsia cannot be separated from the management of H. pylori and there is an additional new knowledge associated with definition, pathophysiology, diagnosis and treatment of both dyspepsia and H. pylori infection.

This consensus document on the management of dyspepsia and H. pylori infection in Indonesia has been developed using the evidence-based medicine principles; therefore, it can be used as a reference for doctors in dealing with dyspepsia and H. pylori infection cases in their daily practice. It is expected that with the new consensus, doctors can provide greater service to their patients who have dyspepsia and H. pylori infection."

"Background: The prevalence of Helicobacter pylori (H. pylori) infection in the world is quite high, especially in developing countries. Usually the patient shows no specific symptoms and chronic gastritis therefore becomes chronically infected The complication of the injéction is the development of peptic ulcer; which is a predisposing factor for gastric carcinoma. Early diagnosis is an important step to avoid these complications by providing immediate accurate therapy. Methods: In this study the CLO, MIU (Motility Indole Urease) tests and culture were conducted on 131 biopsy samples of the stomach antrum mucous tissue taken from chronic dyspepsia patients from several hospitals in Jakarta. In the CLO test, biopsy tissue was put in a small well agar to be incubated at room temperature. In the MIU test the biopsy tissue sample was submerged in the small MlU tube agar with a depth of approximately 2/3 rds from the surface, and then incubated at room temperature. Another piece of biopsy tissue was cultured micro-aerophylicalty The CLO and MlU tests are considered positive if the color changes from yellow to red and are considered negative if there is no color change within 24 hours. Results: Compared to culture, the CLO test demonstrated 38% sensitivity; 96% specificity, 94% positive predictive value and 52% negative predictive value, whereas the results of the MIU test against culture method showed 76% sensitivity 89% specificity 88% positive predictive value, and 78% negative predictive value. Conclusion: The MIU test that showed high sensitivity and specyficity and thus could be further developed as an alternative diagnostic method for H. pylori infection."

"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."

"Background: The aim of the treatment for Helicobacter pylori (H. pylor) infection in any therapeutic context is the eradication of the organism from the fore gut. Triple or quadruple therapy has been widely accepted by many concensus as an eradication treatment in patients with ulcer or HC pylori positive dyspep- sia, but in our experience, especially in Malang successful eradication with a combination of amoxycillin, clarithromycin, metronidazole and PPI was only found in l5-20% of patients, showing an inadequacy in the use of a combination of triple or quadruple drugs. This failure may be due to multi resistant H. pylori. Thus, we must look for another agent for successful eradication. Ascorbic acid is known to play a role in inhibiting H. pylori activities. Objective: To evaluate the eject of the fleroxacine and ascorbic acid combination on H. pylori dyspeptic patients. Design: Single blind randomized clinical trial. Setting: Out-patients from The Gastro-Hepatologic Clinic, Internal Department Medical Faculty Unibraw/Dr: Sahhil Anwar Hospital, Malang, East Java, Indonesia. Patient: 30 patients were enrolled with a history of more than 3 months of ayspeptic symptoms with prior treatment using amoxycillin 500 t. id, metronidazole 500 :ng t. i.d, and landsoprazole 30 mg and persistent H. pylori after therapy. Method: We administered a combination ofjleroxacine 400 mg, ascorbic acid 1000 mg and lansoprazole to patients who had formerly taken amoxicillin, rnetronidazole and lansoprazole. These drugs were given for I4 days. Evaluation was performed 8 weeks after therapy The pre-elementary study showed that H. pylori strains in Malang, East Java, Indonesia were multi-resistant to many antibiotics. Result: After 2 weeks of treatment and 8 weeks after termination' of therapy 96, 6% of patients treated with fleroxacine, ascorbic acid and PPI demonstrated an absence of ayspeptic symptoms. The culture turned out negative and the treatment was found effective in eradicating H pylori in 28 patients (93,3%). Conclusion: Fleroxacine in combination with hexoxaene, ascorbic acid and lansoprazole was efficacious in the treatment of H. pylori dyspeptic patients in Malang East Java, Indonesia."

"Latar belakang: Dispepsia merupakan gangguan kesehatan yang sering ditemuierologi dan urin (RAPIRUN) dibandingkan dengan UBT sebagai baku emas dalam mengetahui infeksi H. pylori. Penelitian dilakukan pada pasien rawat jalan Puskesmas Kecamatan Koja Kotamadya Jakarta Utara. Yang dinilai adalah sensitivitas, spesivisitas, positive predictive value (PPV), negative predictive value (NPV) tes tersebut. Tujuan: Mengetahui akurasi diagnostik pemeriksaan non-invasif (serologi dan urin) dibandingkan dengan UBT (urea breath test) sebagai baku emas untuk mendeteksi infeksi H. pylori pada pasien dengan sindroma dispepsia. Metode: Penelitian yang digunakan adalah studi potong lintang untuk mengetahui akurasi pemeriksaan non-invasif yaitu s H. pylori menunjukkan hasil positif pada 36,5% subyek, sedangkan pada pemeriksaan serologi (Mataram, Biomedika) didapatkan hasil positif sebanyak 32,4%. Pemeriksaan RAPIRUN (Rapid Urine Test, Otsuka) menunjukkan hasil positif pada 24,3% subyek. Pada serologi didapatkan sensitivitas 74%, spesifitas 91%, PPV 83%, NPV 86%. Sedangkan pada RAPIRUN didapatkan sensitivitas 63%, spesifitas 98%, PPV 94%, NPV 82%. Hasil: Selama kurun waktu April 2015 sampai Juni 2015, 74 subyek, dengan mayoritas perempuan (82,4%), dengan rerata umur 45,05 tahun menjalani pemeriksaan non-invasif. Pemeriksaan UBT sebagai baku emas diagnosis infeksi di pelayanan kesehatan. Infeksi Helicobacter pylori adalah salah satu penyebab dispepsia. Diagnosis infeksi H.pylori dapat dilakukan melalui pemeriksaan invasif dan non invasif. Pemeriksaan non invasif lebih mampu laksana, murah dan memiliki risiko yang lebih sedikit. Simpulan: RAPIRUN lebih unggul dalam hal spesifisitas dibanding serologi.

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Background: Dyspepsia is the common problem in the population. The main etiology of dyspepsia is Helicobacter pylori infection. The diagnosis of H. pylori infection is based on invasive examination and non-invasive examination. The non-invasive examination could be easier to do and have less risk than invasive examination.

Objective: To evaluate the diagnostic accuracy of the non-invasive test (serology and RAPIRUN) compared to UBT as gold standard examination to detect H. pylori infection in patients with dyspepsia syndrome.

Methods: A cross-sectional study for diagnostic H. pylori by using serology and Rapid Urine test (RAPIRUN) is conducted to evaluate the diagnostic accuracy of non-invasive test compared to UBT as gold standard examination in patients with dyspepsia syndrome. This study was conducted at outpatient Community Health Center in Koja District North Jakarta from middle April 2015 until Middle June 2015. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) were used to evaluate the diagnostic accuracy.

Results: From mid-April 2015 to Mid-June 2015, 74 subjects, with the majority of patients was female (82.4%), and the mean of age was 45.05 years old, had undergone non-invasive test The UBT test as the gold standard examination for H. pylori infection showed positive result in 36.5% patients while the serology test resulting positive in 32.4%. The RAPIRUN test resulting positive in 32.4% patients. The sensitivity of serology test was 74%, specificity 91%, PPV 83%, NPV 86%, meanwhile the RAPIRUN test was resulting as sensitivity 63%, specificity 98%, PPV 94%, NPV 82%.

Conclusion: RAPIRUN has a high diagnostic value for H. pylori in specificity than serology."

"Latar Belakang: Diagnosis definitif Helicobacter pylori H.pylori hingga kini masih merupakan masalah. Biakan untuk isolasi dan identifikasi bakteri ini sulit. Uji cepat urease direkomendasikan sebagai uji diagnostik lini pertama pasien dispepsia. Tujuan: Mengembangkan komposisi medium biakan dan deteksi cepat H.pylori pada spesimen biopsi lambung pasien dispepsia. Metode: Desain penelitian merupakan studi potong lintang dan eksperimental laboratorium. Sampel diambil dengan cara consecutive sampling sebanyak 68 spesimen biopsi lambung 34 antrum, 34 korpus, masing-masing untuk biakan dan uji MIU. Sebagai pembanding digunakan histopatologi dan PCR. Mula-mula dilakukan optimasi medium biakan dan MIU konsentrasi merah fenol, pH, urea dan suhu inkubasi. Selanjutnya kondisi optimal yang diperoleh diaplikasikan pada spesimen biopsi pasien dispepsia. Hasil: Medium biakan agar darah Columbia ditambah vankomisin 5 mg / 500 mL dan darah domba 7 belum optimal, namun dapat digunakan untuk isolasi dan identifikasi. Hasil MIU modifikasi sebagai berikut: konsentrasi merah fenol 0,001 ; urea 4 ; pH medium 7; Suhu inkubasi optimal 35-370 C. Proporsi positif hasil uji MIU sebesar 35,29 12/34, biakan 32,35 11/34, PCR 32,35 11/34 dan histopatologi 20,59 7/34. Kesimpulan: Pemeriksaan MIU meningkatkan positivitas hasil pemeriksaan sebesar 14,7 bila dibandingkan dengan histopatologi.

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Background: Until now, definitive diagnostic of H.pylori is still a problem. Culture for isolation and identification of this pathogen is difficult. Rapid urease test is recommended as a first line diagnostic test.

Aim: To obtain optimal composition for culture medium and Motility Indol Urease MIU test for the detection of H. pylori in dyspeptic patient biopsy specimens.

Method: A cross sectional and experimental laboratory study was performed. Sixty eight gastric biopsy samples 34 antrum, 34 corpus were collected by consecutive sampling method for culture and MIU test. Histopathology and PCR were conducted for comparison. Initially, we performed the optimation of culture medium and MIU test phenol red and urea concentration, pH, and temperature. The optimal condition obtained was then applied to the specimens.

Result: Columbia agar supplemented with vancomycin 5 mg 500 mL and 7 sheep blood was unable to create an optimal condition, but it can be used for isolation and identification. Modified MIU was performed by this following condition phenol red 0,001 urea 4 pH 7 incubation temperature 35 37oC. Positive proportion of MIU was 35.29 12 34, culture 32.35 11 34, PCR 32,35 11 34 and histopathology 20.59 7 34.

Conclusion: MIU test was able to improve the positivity rate by 14,7 compared to histopathology."

"ABSTRACTBackground: early detection of H. pylori is essential to prevent the development of infections into gastric malignancies. The coccoid form of H. pylori is difficult to detect either by culture or histopathology; however, it can be detected using molecular methods, such as real-time PCR. The study was expected to provide new information on the development of H. pylori detection. Methods: a cross-sectional study was conducted at the Gastrointestinal Endoscopy Center of Cipto Mangunkusumo Hospital between October 2016 and August 2017. The sampling method used was consecutive sampling. Biopsy from gastric antrum and corpus were performed in 64 patients. We collected 2 specimens from each site to be examined using real-time PCR and histopathology. Initially, we conducted real-time PCR optimization followed by application of clinical samples from gastric biopsy. Data analysis using McNemars χ2 and Kappa tests. Results: the real-time PCR showed 25% positivity, while the positive proportion of histopathological examination was 14%. Real-time PCR has a sensitivity and specificity 88.9% dan 85.5%, respectively. The McNemars x2 test showed that there is significantly different (p=0.039) between the two tests; kappa value (p=0.561). Conclusion: the real-time PCR examination is more sensitive than histopathology. This technique can improve diagnosis by 11% compared to histopathological examination."

"Recurrent abdominal pain (RAP) is a very common presenting complaint in pediatric population. There is still a debate regarding the role of Helicobacter pylori (H. pylori) infection as an etiology of RAR Typically the inflammatory process in the gastric mucosa of infected individuals is chronic gastritis. Serologic and histologic examination are widely used for the diagnosis. This study was aimed to determine the role of H.pylori infection in Indonesian children with RAR The presence of serum IgG antibody to H. pylori and upper gastrointestinal endoscopy were performed on the 101 children with RAR Mztcosal biopsies were obtained for histologic analysis. The prevalence of H. pylori infection indicated by serology was 32.7% and by histology was 27. 7%. Histologic evidence of gastritis was present in 94.1 % children and 45% of them had chronic atrophic and active gastritis. Seventy percent children with H. pylori positive were found abnormal through endoscopy and all of the infected children were revealed abnormal through histological examination. Forty eight percent of seropositive children were found H. pylori positive and 80% of seronegatives children were found to be H pylori negative through histologic examination. Conclusion: H. pylori infection can be a cause of RAP in children. Work up for H. pylori infection should be performed when symptoms are suggestive of organic disease. Larger prospective studies are needed to be perforated for a longer time of period to clarify this issue."

"Helicobacter pylori adalah patogengastrointestinal yang penting yang berkaitan dengan gastritis,ulkus peptikum, dan peningkatan risiko kanker lambung. Studiini bertujuan mencari hubungan patogen ini dengan berbagaikelainan gastrointestinal."