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"More than 95% colorectal cancers arise from neopiastic adenomatous polyps (adenomas). The malignant potential of polyps depends on size, amounts, histological type and degree of dysplasia. The prevalence of adenoma increases with age. Patient whose age more than 40 years old with rectal bleeding as presenting symptom should never be ascribed solely to coexisting haemorrhoids without a through evaluation of the colon and rectum.We reported a case of hematochezia due to colorectal polyps with coexisting hemorrhoids as suspected bleeding source. Colonoscopy examination demonstrated colorectal adenomatous polyps in rectum and sig-moid. Polypectomy was done and tissue biopsy result was tubular adenoma with mild dysplasia."

"Crolm's disease encompasses a spectrum of clinical and pathological patterns, affecting the gastrointestinal (GI) tract with potential systemic and extraintestinal complications. The disease can affect any age group, but the onset is most common in the second and third decade. Lower Gi bleeding is one of its clinical features. Surgical intervention is required in up to two-thirds of patients to treat intractable hemorrhage, perforation, obstruction or unresponsive fulminant disease.

We reported a case of Crohn's disease in young male who suffered from severe lower Gi bleeding (hematochezia) as the clinical features. Lower GI endoscopy revealed ulceration at the distal ileum surrounded by fibrotic tissue as a source of bleeding and a tumor mass at mesocolon. Upper GI endoscopy was unremarkable. Histopathologyc examination concluded multiple ulceration with chronic ischemic condition, appropriate to Crohn's disease. The patient underwent emergency surgical intervention (subtotal colectomy and ileustomy), and his condition was improved."

"Background: Some studies suggested that colorectal cancer at young age had a distinct biological characteristic: more advanced stage at time of diagnosis, poorer differentiated, and consisted of large proportion of mucin producing tumors.Aim of the study: To analyze clinical and histopathological differences between young aged colorectal cancer patients (< 40 years old) and the older patientsMethods: A cross-sectional retrospective study was conducted among our colorectal cancer patients in a general hospital between 1999-2004, using C.I8, C.I9, C20 ICD X code in medical record searching. It was requested that the patients had surgical treatment in Dr. Sardjito General Hospital. An inconclusive clinical staging and/or histological data were among the exclusion criteria. Chi-square, Fisher's exact test, T-test, and Mann Whitney U-test was performed to analyze the difference between patients < 40 years old and 40 years old, in respect to diagnostic staging, histological type, histological grade (differentiation), CEA level, hemoglobin, albumin, tumor location, and chief complain. With p < 0.05 was considered as significant.Results: Sixteen young aged (< 40 years old) and 72 older patients had been identified. No differences in gender proportion and mean of symptoms to diagnosis period between two groups. No statistical differences between young aged and the older patients in diagnostic staging, histological grade and type, CEA level, and hemoglobin. Young aged patients had higher albumin value at presentation (p = 0.014), all had left sided tumors (p = 0.035), more complain of anal pain (p < 0.001), and less change of bowel habits complain (p = 0.009)Conclusion: The study results had failed to confirm the difference in respect to diagnostic staging, histological type and grade, CEA level, and hemoglobin. Most of our young aged patients had left sided tumors with chief complain of anal pain, and less complain of change of bowel habits"

"Colon polyps can be a predisposing factor for colon cancer; they should be immediately removed once they are found. Most of colon cancer arises from adenoma. Most adenoma cases are asymptomatic. It is frequently detected at the first time when someone undergoes screening for colorectal cancer with the imaging modalities in the medical check-up. Approximately, 10-40% of patients without any symptoms with the positive result of occult blood test suffer from adenoma. By using colonoscopy, we can detect for adenoma cancer and adenoma polyps, so colonoscopic procedure is recommended for individuals with the high risk for colorectal cancer. Excision and polyp removal during colonoscopy is a treatment choice to lower the risk for developing colon cancer. Surgical intervention is usually required in the management of adenoma polyps for those with an extremely large size which cannot be resected through endoscopy. There are some suggestions for preventing of adenoma growing such as vegetable and fruit diet, limit intake of meat and fatty food. And finally do physical activities regularly and stay away from alcohol and cigarettes"

"Colostomy adalah sebuah ostomy (lubang) yang dibuat di kolon dengan tujuan untuk pengeluaran feses atau meningkatkan penyembuhan. Pembuatan lubang ini memberikan dampak baik fisik maupun psikososial dalam kehidupan. Penelitian ini bertujuan untuk mendapatkan pemahaman yang mendalam tentang pengalaman pasien hidup dengan colostomy dan bagaimana pasien memaknai pengalaman tersebut. Desain penelitian ini adalah fenomenologi deskriptif dengan metode wawancara mendalam. Partisipan adalah individu dengan kanker kolorektal yang menggunakan colostomy, diambil dengan cara purposive sampling. Data yang dikumpulkan berupa rekaman hasil wawancara dan catatan lapangan yang dianalisis dengan menerapkan teknik Collaizi. Penelitian ini mengidentifikasi 5 tema, yaitu 1) menjadi berbeda dengan orang normal dalam pemenuhan kebutuhan sehari-hari pasca tindakan colostomy; 2) mempunyai colostomy menimbulkan berbagai ketidaknyamanan fisik dan psikososial dalam menjalani kehidupan sehari-hari; 3) menjadi tidak sebebas dulu, setelah tindakan colostomy; 4) berbagai respon tahapan berduka ketika pertama kali menjalani kehidupan pasca tindakan colostomy; dan 5) setiap pasien dengan colostomy membutuhkan pelayanan kesehatan yang profesional. Hasil penelitian memperlihatkan bahwa hidup dengan colostomy sebenarnya bukan merupakan suatu masalah tetapi hanya "berubah" bila dibandingkan dengan orang normal. Perubahan ini memerlukan modifikasi gaya hidup dari pasien dengan colostomy. Hasil penelitian ini diharapkan dapat memberikan pemahaman tentang pentingnya pemberian informasi bagi pasien sehingga perlu dibuatkan panduan khusus bagi pasien yang akan menjalani operasi colostomy.

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Colostomy is an ostomy made in colon intended to evacuate the fecal or promote healing process. The formation of stoma can affect a person’s life both physical and psychosocial aspects. The aims of this study were to explore patient experiences living with colostomy and how they takes the meaning from this experience. This study employed descriptive phenomenology design and data were collected by in-depth interview. Partisipants were individual with colostomy caused by colorectal cancer collected by purposive sampling. Data gathered were in interview recording and field note form, then transcribed and analyzed by Collaizi’s analysis method.

This study identified 5 themes includes : 1) differ from others in daily need; 2) having colostomy result in physical and psychosocial discomfort in daily living; 3) not free as usual after colostomy; 4) grieving process after colostomy; and 5) patient with colostomy need a professional health care.

The results revealed that living with colostomy in fact is not a problem but just a "change" compared to normal condition. The cange needs a life style modification from patient with colostomy. This result hoped to give an understanding about the important of information for patient, therefor it is needed to develop a guideline for patient who will have a colostomy."

"Kanker kolorektal menempati urutan ketiga dari seluruh jenis kanker di dunia. Salah satu penanganan  untuk memperbaiki kualitas hidup pasien dengan kanker kolorektal adalah stoma. Efektifitas stoma masih belum banyak dipahami oleh pasien, karena kekhawatiran akan dampak yang ditimbulkan. Tujuan penelitian ini adalah untuk mendeskripsikan dan menginterpretasikan secara mendalam, pengalaman pasien kanker kolorektal dalam pengambilan keputusan persetujuan tindakan pembuatan stoma. Penelitian menggunakan metode kualitatif dengan pendekatan fenomenologi yang melibatkan 11 partisipan pada Komunitas Ostomate Indonesia, dengan teknik purposive sampling. Tiga tema besar pada penelitian ini yaitu proses yang sulit untuk menyetujui tindakan pembuatan stoma, pengetahuan yang tidak adekuat mengenai stoma, dan stoma sebagai pilihan terakhir. Keputusan untuk menyetujui pembuatan stoma adalah keputusan yang sulit bagi pasien dan keluarga. Persiapan pasien yang baik melalui edukasi, advokasi dan konseling mengenai fungsi, efektifitas, komplikasi yang mungkin terjadi, dan adaptasi dengan stoma, adalah peran penting perawat dalam proses ini.

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Colorectal cancer is the third most common in all types of cancer in the world. One treatment to improve the quality of life of patients with colorectal cancer is stoma. The effectiveness of the stoma is still not widely understood by patients, because of concerns about the impact. The purpose of this study was to describe and interpret in depth, the experience of coloprectal cancer patients in making decisions regarding the approval of stoma-making actions. The study used a qualitative method with a phenomenological approach involving 11 participants at the Komunitas Ostomate Indonesia, with a snow ball sampling technique. Three major themes in this study are the difficult process to approve the stoma-making action, inadequate knowledge about the stoma, and in the end the patient resigns to the stoma-making procedure. Agreeing with stoma making is a difficult decision for patients and families. Preparation of good patients by providing education, advocacy and counseling regarding function, effectiveness, possible complications, and adaptation to stoma, is important for nurses to do in this process."

"Kanker kolorektal adalah penyakit neoplasma ganas yang tumbuh dan berkembang pada saluran usus besar dan atau rektum. Terapi anti EGFR menggunakan agen biologis antibodi monoklonal cetuximab dan panitumumab diketahui memberikan tingkat penyembuhan yang baik pada pasien kanker kolorektal. Pasien dengan mutasi pada gen NRAS dan KRAS cenderung resisten terhadap terapi anti EGFR, sehingga penting dilakukan pemeriksaan kedua gen tersebut sebelum pemberian terapi. Pemeriksaan gen NRAS belum tersedia di Indonesia karena minimnya data mengenai mutasi gen tersebut pada populasi Indonesia. Penelitian dilakukan untuk mengetahui profil mutasi pasien gen NRAS pada 58 sampel pasien kanker kolorektal di Jakarta. Pemeriksaan mutasi dilakukan pada exon 2(codon 12 & 13) dan exon 3 (codon 61) gen NRAS menggunakan metode sekuensing. Analisis elektroferogram sekuensing menunjukan mutasi gen NRAS ditemukan pada 6,9% (n=58) sampel uji. Hasil uji statistik fischer exact test dua arah menunjukan tidak adanya asosiasi mutasi gen dengan kelompok usia pasien dan jenis kelamin. Gen NRAS ditemukan termutasi pada codon 12 (1,7 %) dan codon 61 (5.2%). Tidak ditemukan adanya mutasi pada codon 13 gen NRAS.

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Colorectal cancer is a neoplasm disease that arise in inner lining of colon or rectum. Anti EGFR therapy such as cetuximab and panitumumab were widely used to suppress metastases colorectal cancer in patient and decided as gold standard therapy. Mutation either KRAS or NRAS gene will reduced effectifity of anti EGFR therapy, hence genotyping of KRAS and NRAS gene must be executed before. NRAS genotyping test not yet available in Indonesia due to lack of information about this gene. This study was subjected to understanding profile of NRAS gene mutation in Jakartans colorectal cancer patient. Mutation screening was perform by sequencing method, notably exon 2 (codon 12&13) and exon 3 (codon 61). Electropherograms analysis shows that NRAS mutation found in 6,9% samples (n=58). NRAS mutation found in codon 12 (1,7%), codon 61 (5,2%), and there was no mutation found in codon 13. Fischer exact test statistical analysis summarized that there was no significant association of NRAS mutation with both sex and age."

"[ABSTRAK Kanker kolorektal merupakan kanker yang muncul di sekitar kolon dan rektum. Salah satu dampak kanker kolorektal adalah kekurangan nutrisi atau malnutrisi. Padahal asupan nutrisi yang adekuat sangat diperlukan untuk meningkatkan sistem imun melawan sel kanker dan mempersiapkan jaringan dalam proses penyembuhan pasca pembedahan. Kebersihan mulut dan perawatan bibir dengan madu menjadi salah satu implementasi keperawatan yang dapat dilakukan untuk memperbaiki status nutrisi pasien kanker kolorektal. Hasil implementasi selama kurang lebih dua minggu menunjukkan dampak yang positif terhadap status nutrisi pasien yang ditunjukkan dengan peningkatan nafsu makan dan perbaikan manifestasi klinis yang berhubungan dengan status nutrisi. Kebersihan mulut dan perawatan bibir dengan madu dapat direkomendasikan untuk implementasi keperawatan pada pasien kanker kolorektal terutama yang mengalami malnutrisi.;ABSTRACT Cancer colorectal is cancer that located at around colon and rectum, one of effect cancer colorectal is malnourished. Adequat nutrition is very important to enhance immunity systems to against cancer cells and heal the wound after surgery. Oral hygiene and lip care with honey liquid can be done to repaire the nutritional status. The results of these implementations showed the positive impact which indicated by enhancement of appetite and improvement of clinical manifestations related to nutritional status for two weeks. So, oral hygiene and lip care with honey are recommended to repaire the nutritional status for patient cancer colorectal.;Cancer colorectal is cancer that located at around colon and rectum, one of effect cancer colorectal is malnourished. Adequat nutrition is very important to enhance immunity systems to against cancer cells and heal the wound after surgery. Oral hygiene and lip care with honey liquid can be done to repaire the nutritional status. The results of these implementations showed the positive impact which indicated by enhancement of appetite and improvement of clinical manifestations related to nutritional status for two weeks. So, oral hygiene and lip care with honey are recommended to repaire the nutritional status for patient cancer colorectal.;Cancer colorectal is cancer that located at around colon and rectum, one of effect cancer colorectal is malnourished. Adequat nutrition is very important to enhance immunity systems to against cancer cells and heal the wound after surgery. Oral hygiene and lip care with honey liquid can be done to repaire the nutritional status. The results of these implementations showed the positive impact which indicated by enhancement of appetite and improvement of clinical manifestations related to nutritional status for two weeks. So, oral hygiene and lip care with honey are recommended to repaire the nutritional status for patient cancer colorectal.;Cancer colorectal is cancer that located at around colon and rectum, one of effect cancer colorectal is malnourished. Adequat nutrition is very important to enhance immunity systems to against cancer cells and heal the wound after surgery. Oral hygiene and lip care with honey liquid can be done to repaire the nutritional status. The results of these implementations showed the positive impact which indicated by enhancement of appetite and improvement of clinical manifestations related to nutritional status for two weeks. So, oral hygiene and lip care with honey are recommended to repaire the nutritional status for patient cancer colorectal., Cancer colorectal is cancer that located at around colon and rectum, one of effect cancer colorectal is malnourished. Adequat nutrition is very important to enhance immunity systems to against cancer cells and heal the wound after surgery. Oral hygiene and lip care with honey liquid can be done to repaire the nutritional status. The results of these implementations showed the positive impact which indicated by enhancement of appetite and improvement of clinical manifestations related to nutritional status for two weeks. So, oral hygiene and lip care with honey are recommended to repaire the nutritional status for patient cancer colorectal.]"