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Abstrak :
Inflammatory bowel disease (IBD) in rarely found in clinical practice. However, the incidence of IBD seems to have increased recently. Generally, the patients will come to hospital with chief complain! of chronic diarrhea with or without hematochezia. We reported two cases of IBD in which they had been misdiagnosed as colitis tuberculosis based on colonoscopy examination. Treatment of anti tuberculosis drugs had made no clinical improvement. Further evaluation suggested the diagnosis of IBD. They responded very well clinically after treated as IBD. This case report reminds us to consider the diagnosis of IBD in patient with chronic diarrhea and ulceration in colonic mucosa at colonoscopy.

Abstrak :
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.

Abstrak :
Pemantauan terapi secara berkala mengenali interaksi obat gejala efek samping lebih awal dapat mencegah reaksi obat yang tidak dikehendaki (ROTD) pada pengobatan pasien. Anemia dapat terjadi karena perdarahan baik akut maupun kronis mengakibatkan penurunan total sel darah merah. Pendarahan saluran gastrointestinal bagian bawah dengan keluarnya darah segar sewaktu buang air besar disebut hematochezia. Tuberkulosis ekstra paru perlu diwaspadai pada orang hidup dengan HIV/AIDS(ODHA) karena kejadiannya lebih sering dibandingkan TB dengan HIV negatif. Pemberian antibiotik pada pasien suspek TB paru sebagai alat bantu diagnosis TB paru tidak direkomendasikan lagi karena hal ini dapat menyebabkan keterlambatan diagnosis TB dengan konsekuensi keterlambatan pengobatan TB sehingga meningkatkan risiko kematian. Klasifikasi PCNE (Pharmaceutical Care Network Europe) dapat membantu tenaga kesehatan profesional untuk mendokumentasikan informasi-informasi mengenai DRPs (Drug Related Problem) yang terjadi dalam proses asuhan kefarmasian. Pada pasien Hematochezia dengan Anemia, TB Paru, dan SIDA perlu dilakukan kultur resistensi antibiotik untuk melihat antibiotik yang tepat untuk pengobatan pasien. Tahapan tatalaksana pemberian terapi hematochezia, TB terlebih dahulu kemudian dijeda dengan pemberian ARV juga dinilai sudah tepat. ......therapy to recognize drug interactions early side effects can prevent unwanted drug reactions (ROTD) in patient treatment. Anemia can occur due to both acute and chronic bleeding resulting in a decrease in total red blood cells. Bleeding in the lower gastrointestinal tract with the release of fresh blood during bowel movements is called hematochezia. Extrapulmonary tuberculosis needs to be watched out for in people living with HIV/AIDS (PLWHA) because it occurs more frequently than TB with HIV negative. Giving antibiotics to patients with suspected pulmonary TB as a tool for diagnosing pulmonary TB is no longer recommended because this can cause a delay in the diagnosis of TB with consequent delays in TB treatment, thereby increasing the risk of death. The PCNE (Pharmaceutical Care Network Europe) classification can help health professionals to document information about DRPs (Drug Related Problems) that occur in the process of pharmaceutical care. In Hematochezia patients with Anemia, Pulmonary TB, and SIDA, it is necessary to carry out antibiotic resistance cultures to determine the appropriate antibiotic for treating the patient. The stages of management of giving hematochezia therapy, TB first and then stopping it with giving ARVs are also considered appropriate.