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"Bile reflux: gastropathy is a disease caused by reflux of duodenal fluid to the gaster: This fluid contains pancreatic juices and duodenal secretion. The manifestations that occur depend on the frequency amount, and duration of reflux. This disorder is quite rarely recognized in daily clinical practice. Endoscopy of the upper gastrointestinal tract is required to establish the diagnosis of this disorder: This paper will give a brief view ofthe pathogenesis and diagnostic method for this disorder."

"Gastropathy refers to the damage of the epithelial cells of the gastric mucosa and disturbance of epithelial cell regeneration unaccompanied by inflammation. Gastropathy occurs due to irritation by chemical agents (such as non-steroidal anti inflammatory drugs - NSAIDs and alcohol), bile reflux, hypovolemic conditions, and chronic obstruction.NSAIDs in general are chemical agents that cause irritation of the upper gastrointestinal tract through direct and indirect topical effects and by inhibiting prostaglandin synthesis through inhibition of COX-1 and COX-2. There are many data that demonstrates that the anti-inflammatory function of NSAIDs is mainly through inhibition of COX-2, while many of their side effects are due to inhibition of COX-1.In general, there is a correlation between the influence of NSAID and the administered dose. The higher the dose, the higher the risk for upper gastrointestinal tract disorder. NSAID users who frequently switch drugs have a risk twice higher than those only receiving one kind of NSAID. Those who use NSAID with corticosteroids have 15 times the risk. Use ofNSAID simultaneously with anticoagulants increases the risk of bleeding from ulcer 13 times compared to control subjects. NSAID use in a patient with history of bleeding from the gastrointestinal tract is 17.2 times non-users. Smoking also increases the percentage of gastroduodenal ulcer due to NSAID.Clinical symptoms ofNSAID gastropathy are often only dyspepsia syndrome. There is no correlation between symptoms and endoscopic findings.The first step in the therapy ofNSAID gastropathy is termination ofNSAID administration. To treat and prevent risks of gastropathy due to NSAID, mucosal protection agents may be used. Out of the various kinds of medicine available, proton-pump inhibitors turn out to be more effective compared to H2 receptor antagonists or cytoprotectiveagents."

"Non steroidal anti-inflammatory drugs (NSAIDS) are now commonly used in clinical practice. On the other hands, this drug could result severe complication such as bleeding and perforation. In such condition, proton pump inhibitor can be used to stop bleeding than H, antagonists. We reported one cases of upper gastrointestinal bleeding due to NSAID gastropathy that was unresponsive to Ranitidine. The treatment was suitable to proton pump inhibitor that could overcome upper gastrointestinal bleeding."

"Latar belakang. Studi pH lambung pada pasien sirosis hati masih kontroversi Penelitian ini bertujuan untuk mengetahui adanya perbedaan pH lambung pada pasien sirosis hati dengan gastropati hipertensi portal GHP ringan dan berat. Metode Penelitian. Potong lintang dengan cara konsekutif pada pasien yang datang ke poliklinik gastro enterologi dan hepatologi RSCM pada periode Maret - Mei 2014 sebanyak enam puluh dua pasien sirosis hati dengan GHP dilakukan pemeriksaan endoskopi untuk menilai derajat gastropati sesuai klasifikasi McCormack dan pemeriksa pH lambung dengan menggunakan pH meter. Hasil. Dari 62 subjek didapatkan 50 subjek 80 6 berjenis kelamin laki laki dan perempuan 12 subjek 19 4 GHP paling banyak disebabkan oleh hepatitis C 56 5 hepatitis B 32 3 non hepatitis 8 1 dan alkohol 3 2 Rerata pH lambung pada seluruh pasien sirosis hati dengan GHP adalah 2 13 Rerata pH lambung pada pasien sirosis hati dengan GHP ringan 2 00 lebih rendah dibandingkan kelompok GHP berat 2 25 dengan perbedaan yang bermakna.

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Background. Studies show gastric pH in cirrhosis patient still in controversy Aim of this study to know differences of gastric pH in liver cirrhosis patient withmild and severe portal hypertensive gastropathy

Methods. Cross sectional method with consecutive to all liver cirrhotic patientwho came to gastroenterology and hepatology clinic in Ciptomangunkusumo hospital Sixty two liver cirrhosis patients with portal hypertensive gastropathyunderwent endoscopy to measure degree of gastropathy based on McCormack classification and measured mean basal gastric pH with pH metry.

Result. There are 50 male subject 80 6 and 12 female subject 19 4 participating in this research Portal hypertensive gastropathy mostly caused by hepatitis C 56 5 hepatitis B 32 3 non hepatitis 8 1 and alcohol 3 2 Mean of gastric pH in all liver cirrhosis patient with portal hypertensive gastropathy was 2 13. The mean gastric pH in liver cirrhosis patient with mildportal hypertensive gastropathy 2 00 mEq L lower than the gastric pH in severeportal hypertensive gastropathy 2 25 mEq L with significant differences."

"Non-steroidal anti-inflammatory drugs (NSAIDs) is a group of drugs used to treat pain, inflammation, and fever. High consumption of NSAIDs associated with high gastrointestinal side effects. Common complaint from patients, which ranging from mild heartburn to the onset of gastrointestinal bleeding, often complicates the adequate administration of NSAIDs. Various methods have been developed to reduce the likelihood of gastroenteropathy complication. Early diagnosis, appropriate prompt treatment, as well as adequate monitoring will reduce morbidity and mortality from complications due to NSAIDs. This paper will discuss the diagnosis and management of gastro-enteropathy NSAID through approaching the underlying pathophysiology."