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Abstrak :
Background: Chronic diarrhea is common in Indonesia. The chronic non-infective diarrhea cases seem to be increasing recently. The aim of this study is to reveal the pattern of diseases that can cause chronic non-infective diarrhea. Materials & Methods: We examined all patients suffering from chronic non-infective diarrhea over a six years period. The patients underwent physical examination and performed laboratory tests, colon enema X-ray, colonoscopy, ileoscopy, upper gastrointestnal endoscopy and small bowel X-ray. Result: Chronic non-infective diarrhea was observed in 107 (51.7%) cases from 207 chronic diarrhea cases respectively. The frequently found abnormalities that had caused chronic non-infective diarrhea were carbohydrate maldigestion (62.61%), colorectal cancer (14.01%), Crohn's disease (11.21%), ulcerative colitis (9.34%), irritable bowel syndrome (8.41%), colorectal polyp (8.41%) etc. Conclusion: The most frequent abnormality found in chronic non-infective diarrhea was maldigestion.

Abstrak :
Background: The diagnosis and treatment of chronic diarrhea is sometimes difficult. Orocaecal transit time may explained some pathogenesis mechanism in chronic diarrhea. Materials & Methods: Twenty six chronic diarrhea patients and 35 normal adult subjects were included in this study. After fasting for at least 10 hours, subjects were asked to drink 20 ml (13.3 g) lactulose, then performed the breath hydrogen test. If there were an increment of H2 concentration 10 ppm in '/2 -1 hour, the subject was considered as rapid transit time, ff an increment of H2 concentration 10 ppm in 1 - 2 hour, the subject was considered as normal transit time. If an increment of H2 concentration 10 ppm in 2 - 3 hour,the subject was considered as delayed transit time Results: In the chronic diarrhea group, 10 (38.4%) had rapid OCTT, 15 (57.6%) had normal OCTT and only 1 (4%) had delayed OCTT. In the normal adults group, 2 (5.7%) had rapid OCTT, 22 (62.9%) had normal OCTT and 11 (31.4%) had delayed OCTT. The difference was statistically significant (p < 0.001). The mean value of OCTT in chronic diarrhea and normal adults were 84.23 ± 39.82 min vs. 114.00 ± 51.35 min (p = 0.027). Conclusions: The rapid OCTT was more likely to be found in the chronic diarrhea patients compare to normal adults significantly. The mean OCTT in chronic diarrhea was shorter than the mean OCTT in normal adults.

Abstrak :
The abnormality or disease of ihe small intestine may cause chronic diarrhea. The tests required to investigate the abnormality of the small intestine are difficult and expensive. In this study we studied the small intestine in chronic diarrhea cases, to discover any abnormality. The chronic diarrhea patients presenting from 1996 to 2000(5 years) at Cipto Mangunkusumo General Central National Hospital were included in the study. Patients were excluded if unable to co-operate. All of the patients were given blood and stool lexis in addition to colonoscopy, ileoscopy and duodeno-jejunoscopy with biopsy. Small intestinal examination could only be performed on 78patients witii chronic diarrhea. The most frequent characteristic were: aged 30-39 or 50-59 years (25.6% of all canes in the study), male(57.7%), non-bloody non steatorrhoeic tvpe of diarrhea(74.4%), and 4 to 48 weeks-duration of diarrhea(68.0%). Small intestine abnormalities were endoscopically and/or histopathologically found in 65 cases(S2.6%), while the rest of the patients were found to have normal small intestine. The abnormalities were found to he infective non-tuberculosis ileitis (in 20 patients, or 26% of all cases), Infective non-tuberculosis duodenitis(20 or 26%), non-infective jejtinitixf 14, or 18.2%), villous aft phy of the jejunum(3, or 3.9%), lymphoid nodular/follii hyperplasia of the terminal Heutn(l2, or 15.6%) etc. LOT intestinal abnormalities were found in 67 or S3.7% of t chronic diarrhea cases. The frequent small intestinal abnormalities were infe tive ileitis, duodenitis and lymphoid nodular/follicle hype plasiaofthe terminal ileum. The small intestinal abnormal ties were found less than the large intestinal abnormalitie

Abstrak :
Background: One of the causes of chronic diarrhea is pancreatic exocrine insufficiency. Chronic diarrhea cases are commonly encountered in Indonesia. Materials & Methods: All patients with chronic diarrhea at hospitals in Jakarta were included in this study and dyspeptic patients were used as control subjects. The study and control subjects must submit their stool for fecal pancreatic elastase-1 examination at a private laboratory in Jakarta. Mild/moderate pancreatic exocrine insufficiency was defined if the concentration was between 100 - 200 [ig El/g stool. Severe pancreatic exocrine insufficiency was defined if the concentration was below 100 [ig El/g stool. The data was analyzed using Fisher or Kruskal-Wallis tests. Results: There were 32 chronic diarrhea patients with a male to female ratio of 19/13 (59.38%/40.62%). The most frequent age range was 50-59 years old (39.5%). The characteristics (sex, age and race) of chronic diarrhea patients were matched with the characteristics of dyspeptic patients as control subjects (p > 0.05). The fecal elastase-1 results in chronic diarrhea displayed greater pancreatic exocrine insufficiency (< 200 fig El/g stool) than in dyspepsia (control) (>_ 200 fj,g El/g stool, p < 0.001). The mean fecal elastase-1 result in chronic diarrhea and in dyspepsia were 316.29 ±_ 195.44 vs. 475.93 +. 65.33 fig El/g stool (p < 0.001). Six patients (18.74%) were established as having severe pancreatic exocrine insufficiency. Seven patients (21.88%) were found with mild/moderate pancreatic exocrine insufficiency. Conclusion: Pancreatic exocrine insufficiency was found frequently in chronic diarrhea.

Abstrak :
Insidens diare kronik di Asia berkisar antara 0,8 ? 1,0%. Lokasi penyakit dan kelainan yang menimbulkan diare kronik dapat dibagi atas 3 kelompok yaitu usus halus, usus besar dan ekstra intestinal. Penyakit-penyakit pada usus halus terdiri dari infeksi dan non-infeksi. Penyakit-penyakit infeksi antara lain yaitu infeksi bakterial, infeksi parasit dll. Penyakit-penyakit non-infeksi yang menimbulkan diare kronik a.l. penyakit Crohn, ?Celiac sprue?, enteropati OAINS, intoleransi laktose, tumor jinak, tumor karsinoid, karsinoma, komplikasi pasca bedah, obat laksatif dll. Pendekatan diagnosis terdiri dari anamnesis riwayat penyakit yang baik, pemeriksaan fisik yang teliti, laboratorium penunjang, laboratorium penunjang yang lebih spesifik termasuk foto rontgen kolon, foto rontgen ?esofagogastroduodenum follow-through?, ?enteroclysis?, pemeriksaan ileo-kolonoskopi dan endoskopi saluran cerna atas termasuk usus halus dengan biopsi untuk pemeriksaan histopatologi. Pengobatan diare kronik dibagi atas pengobatan suportif dan kausal. (Med J Indones 2002; 11: 179-89)

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The incidence of chronic diarrhea in Asia is between 0.8 ? 1.0%. The diseases and abnormalities according to the location, which can cause chronic diarrhea, are divided into three locations: the small bowel, the large bowel and extraintestinal. The small bowel diseases include infectious and non-infectious diseases. The infectious diseases are bacterial infections, parasitic infections etc. The non-infectious diseases include of Crohn?s disease, Celiac sprue, NSAID enteropathy, lactose intolerance, benign tumor, carcinoid tumor, carcinoma, post surgery complications, laxative etc. The approaches to diagnosis include good anamnesis, careful physical examination, supporting laboratory tests, more specialized supporting examinations including X-ray of the colon, esophagogastroduodenum follow-through, enteroclysis, ileo-colonoscopy and endoscopy on the upper portion of the digestive tract including the small intestine with biopsy for histopathology examinations. The treatment for chronic diarrhea is divided into supportive and causal therapy. (Med J Indones 2002; 11: 179-89)

Abstrak :
Indonesia is one of the most populous developing countries in the world. Similar with other developing countries, Indonesia has been suffered from the high incidence of gastroenterology diseases that mainly due to infection. In the recent years, Indonesia had also increased number of non-infectious gastroenterology diseases cases such as inflammatory bowel disease, gastroesophageal reflux disease, and colorectal cancer. Nevertheless, the developments of diagnostic and therapeutic modality along with the cooperation between sectors have undergone rapid progress as an effort in improving digestive health in Indonesia.

Abstrak :
Background: The incidence of chronic non-infectious diarrhea cases is increasing in line with the developments of medical technology and science. The objective of this study was to uncover the histopathologic abnormalities of the small bowel in cases of chronic non-infectious diarrhea. Materials and Methods: All chronic non-infectious diarrhea patients in Cipto Mangunkusumo Hospital from 1996 until 2000 were included in this study. For the control group, we used 37 endoscopically-normal patients with junctional dyspepia with the some characteristics (sex and age). All of the patients underwent gastroduodeno-jejunoscopic and ileocolonoscopic examinations. Patients with infection were excluded from this study. Biopsies were taken from the duodenal bulb, descending duodenum, jejenum near the Treitz ligament, terminal ileum, and colon. Histopathological tests were performed on all of the biopsies. Result: Histopathological examination was carried out on 31 patients and 37 control patients. In the duodenal bulb, the width of villi, lymphocyte infiltration, cosinophil infiltration, stage of inflammation, and polymorphonuclear cells infiltration were all lower in the chronic non-infectious diarrhea group than in the control group (p< 0.0l). ln the descending part of duodenum and jejunum, lymphocyte infiltration, the stage of inflammation, and polymorphonuclear cell infiltration were found to be higher in the chronic non-infectious diarrhea group than in the control group (p< 0.01). Within the terminal ileum, lymphocyte infiltration, the stage of inflammation and lymphoid follicle hyperlasia were found to be higher in the chronic non-infectious diarrhea group than in the control group (p< 0.01). Conclusion: Histopathologically, increased lymphocyte infiltration, inflammation and lymphoid follicle hyperplasia were discovered in specified areas of small intestine in chronic non-infectious diarrhea patients.

Abstrak :
Latar belakang: panduan tatalaksana untuk kolitis ulseratif (KU) belum tersedia. Saat ini, mesalazine, kortikosteroid, dan imunomodulator merupakan pilihan terapi untuk KU. Namun, obat-obatan tersebut memiliki efek samping yang tidak menyenangkan, misalnya mual, muntah, sakit kepala, hepatitis, dan infertilitas pria. Curcumin terdapat dalam tanaman Kunyit (Curcuma longa L.) yang memiliki aktivitas anti inflamasi dan antioksidan.