Marcellus Simadibrata
Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia/Dr. Cipto Mangunkusumo General National Hospital, Jakarta

Published : 238 Documents
Articles

Clinical Profile and Outcome of Non-Variceal Upper Gastrointestinal Bleeding in Relation to Timing of Endoscopic Procedure in Patients Undergoing Elective Endoscopy Siregar, Lianda; Rani, Abdul Aziz; Manan, Chudahman; Simadibrata, Marcellus; Makmun, Dadang
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 3, December 2011
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.24871/1232011140-145

Abstract

Background: Endoscopy is the most accurate method for diagnosing the source of upper gastrointestinal bleeding. This study was aimed to evaluate the correlation between the timing of elective endoscopy and the length of hospital stay, the amount of transfusion given and incidence of recurrent bleeding or patient mortality. Method: A retrospective study was conducted in all patients with non-variceal upper gastrointestinal bleeding who had experienced elective endoscopy at Cipto Mangunkusumo Hospital between January 2007 and August 2008. Identification of clinical risk using clinical Rockall score was performed at the emergency room. Persistent bleeding, recurrent bleeding, surgical treatment and death were the outcome variables. Statistical analysis was performed using Chi-square/fisher exact test and linear regression. Results: There were 40 eligible cases with mean age of 53 ± 13 years; the greatest occurrence was at the age group of 50-59 years (12%), male (52.5%) and those who had clinical symptom of melena (52.5%). Twenty seven (67.5%) patients had Rockall score of 1-3 points and 13 (32.5%) had 4-6 points. There was only one patient who had adherent clots (Forrest grade II B). Endoscopy results revealed that the most common cause of bleeding was gastric ulcer, which occurred in 12 (30%) patients. There was no correlation between the timing of endoscopic procedures and outcome variable; however the length of hospital stay had a significant correlation with timing of endoscopic procedures. Conclusion: Elective endoscopy does not affect the variables of mortality and recurrent bleeding; however, it affects the length of hospital stay. Further prospective studies are required to find causal relation between them. Keywords: non-variceal upper gastrointestinal bleeding, Rockall score, elective endoscopy, outcome variables
Potential interaction between proton pump inhibitor and clopidogrel Kurniawan, Indra; Simadibrata, Marcellus
Medical Journal of Indonesia Vol 22, No 1 (2013): February
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (308.348 KB) | DOI: 10.13181/mji.v22i1.520

Abstract

Clopidogrel is an anti-platelet agent commonly used in patients with atherosclerotic cardiovascular (CV) disease. Although formerly considered safe, several studies reported that the use of clopidogrel may cause a significant increase in the rate of gastrointestinal (GI) bleeding. This adverse effect could be minimized by coadministration of proton pump inhibitor (PPI). However, since PPI and clopidogrel share the same metabolic pathway, it has been hypothesized that the administration of PPI following clopidogrel therapy may cause a reduction in its anti-platelet effect, thereby increasing the risk of CV events. Recent studies found no significant inhibition in the activation of clopidogrel by CYP2C19 with administration of PPI in vitro. Pharmacokinetic and pharmacodynamic studies, as well as clinical studies, reported conflicting results regarding the potential interaction between PPI and clopidogrel. Until now, the available study investigated the PPI-clopidogrel interaction are primarily observational. The COGENT study is the only prospective, placebo-controlled trial examined the PPI-clopidogrel interaction. This study revealed no significant increase in CV events in patients receiving PPI following clopidogrel therapy, compared to the control group. Though remains controversial, current expert consensus recommended the administration of PPI in patients receiving clopidogrel, particularly in high-risk patients. (Med J Indones. 2013;22:57-62)Keywords: Cardiovascular, clopidogrel, gastrointestinal, proton pump inhibitor
The gastro-esophageal reflux disease questionnaire using Indonesian language: A language validation survey Simadibrata, Marcellus; Rani, Aziz; Adi, Pangestu; Djumhana, Ali; Abdullah, Murdani
Medical Journal of Indonesia Vol 20, No 2 (2011): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (38.269 KB) | DOI: 10.13181/mji.v20i2.442

Abstract

Background: The aims of this study were to test the usefulness of the Gastro-esophageal Reflux Disease Questionnaire (GERDQ) in the diagnosis of GERD, to validate the GERDQ written in Indonesian language, and to evaluate the reliability of the GERDQ for use in Indonesian-speaking GERD patients (Virginia study).Methods: This was a prospective survey of 40 patients diagnosed with GERD, based on an endoscopic examination, in 3 cities in Indonesia (Jakarta, Bandung, and Surabaya) from 15 January to 15 May 2009. Patients were asked to complete the GERDQ, and the validity and reliability of the questionnaire were assessed.Results: The percentages of respondents who reported symptoms lasting 4–7 days were as follows: 68% had a burning sensation behind the breastbone (heartburn); 65% had stomach content (fluid) move upwards to the throat or mouth (regurgitation); 70% had a pain in the centre of the upper abdomen; 58% had nausea; 63% had difficulty sleeping because of the heartburn and/or regurgitation; and 63% took additional medication for heartburn and/or regurgitation. Cronbach’s alpha was 0.83, indicating that all of the questions in the Indonesian-language GERDQ are valid and reliable for Indonesian GERD patients.Conclusions: This study achieved the primary objectives and showed that the GERDQ is valid and reliable for use with Indonesian-speaking GERD patients. The results were consistent with those of the DIAMOND study, which showed that the GERDQ can be used to diagnose GERD on the basis of the reported symptoms. (Med J Indones 2011; 20:125-30)Keyword: GERD, GERDQ, Reliability test, Validity test, Virginia study
The role of probiotics to improve gut health in the elderly Kurniawan, Indra; Simadibrata, Marcellus
Medical Journal of Indonesia Vol 20, No 3 (2011): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (96.102 KB) | DOI: 10.13181/mji.v20i3.457

Abstract

Recent studies have reported that there is a group of microbiota, which have been shown to bring beneficial effects on human’s health. They are called probiotics. Probiotics have been defined as live, non pathogenic microorganisms that, when administered in adequate amounts, confer a health benefi t on the host. The administration of probiotics can change the composition of the gut microbiota. Several probiotics preparations seem to have a role in the prevention of certain diseases as well as treatment of various conditions. Probiotics have been shown to be helpful in relieving constipation, promoting recovery from diarrhea, reducing the risks of colorectal cancer, normalizing nutritional status, and improving the symptoms of irritable bowel syndrome, inflammatory bowel disease, and lactose intolerance. However, the benefits associated with probiotics are strain specific. Therefore, the use of probiotics to confer health benefits should indicate the dosage regimens of each probiotics strain, based on adequate clinical trials. Although probiotics are generally regarded as safe, careful monitoring should be performed on the use of probiotics in the elderly patients. (Med J Indones 2011; 20:226-31)Keywords: elderly, health, probiotics
Endoscopical appearances of nonsteroidal anti inflammatory drug (NSAID)- enteropathy Simadibrata, Marcellus; Tytgat, G. N.J.; Lesman, L. A.; Daldiyono, Daldiyono; Ariawan, Iwan
Medical Journal of Indonesia Vol 14, No 4 (2005): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (156.426 KB) | DOI: 10.13181/mji.v14i4.200

Abstract

Non Steroidal Anti Inflammatory Drugs (NSAID) have been associated with a sudden and sustained rise in the incidence of gastrointestinal ulcer complications. The aim of the study was to reveal the endoscopical abnormalities found in the duodenum & proximal jejunum due to NSAID. Thirty eight patients taking NSAID for their arthritis or rheumatism were included in this study. Gastro-duodeno-jejunoscopy was done with Olympus PCF-10. The endoscopical appearances of NSAID entero gastropathy were evaluated with a scoring system. The NSAID-entero-gastropathy appearances were endoscopically seen as hyperemia, erosion and ulcer. From all patient recruited, 7.9% complaint of diarrhea and 71.1% complaint of dyspepsia. Endoscopically, in the duodenal bulb we found 79% cases of hyperemia, 39.5% cases of erosion and 7.9% cases of ulcer. In the second part (descending part) of the duodenum we found 28.9% cases of hyperemia, 15.8% cases of erosion and 2.6% case of ulcer. In the jejunum, we found 7.9% cases of hyperemia, 2.6% case of erosion and no ulcer. It is concluded that the most frequent abnormal endoscopical appearances in NSAID- enteropathy was hyperemia. The most frequent site of NSAID-enteropathy abnormal findings was in the duodenal bulb. (Med J Indones 2005; 14: 225-9)Keywords: NSAID-enteropathy, endoscopical appearances.
Approach to the Patient with Accidentally Swallowing a Needle Sijabat, Hotmen; Sudjatmika, Budiman; Simadibrata, Marcellus
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 9, ISSUE 2, August 2008
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/92200870-73

Abstract

People are capable of ingesting, inserting, or injecting themselves or others with all manner of foreign objects. Ingested or inserted foreign bodies may cause bowel obstruction or perforation; which lead to severe hemorrhage, abscess formation, or septicemia; or distant embolization. Fortunately, once a foreign body has reached the stomach, it has an 80-90% chance of passage. All sharp foreign bodies should be removed before they pass from the stomach because 15-35% of these will cause intestinal perforation, usually in the area of the ileocecal valve. The abdominal radiograph should be made and repeated to confirm the location of foreign bodies. If a sharp foreign body does not progress for three consecutive days, surgical intervention should be considered and, if the patient becomes symptomatic, surgical intervention will be necessary. In this case, the patient had accidentally swallowed needle 2 days prior to admission, with no complaint any symptoms of abdominal discomfort, and no bloody stools. Observation is the treatment of choice for this case, since needle had passed stomach and reached colon, and it is hoped that the needle pass through without any complication. Keywords: sharp foreign bodies, needle, swallowing
Epstein-Barr Virus Infection as One of the Predisposition Factor for Colorectal Cancer Simadibrata, Marcellus
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 1, April 2012
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.24871/13120121-

Abstract

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Upper Gastrointestinal Abnormalities in Esophagogastroduodenoscopy Examination: Descriptive Study in PSUPAU Endoscopic Unit Pribadi, Julwan; Sedijono, Sedijono; Suryantini, Suryantini; Simadibrata, Marcellus; Syam, Ari Fahrial; Abdullah, Murdani; Fauzi, Achmad; Makmun, Dadang; Manan, Chudahman; Daldiyono, Daldiyono; Rani, Abdul Aziz
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 9, ISSUE 3, December 2008
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.24871/93200882-85

Abstract

Background: The Endoscopy Unit of Indonesian Air Force Central Hospital Dr. Esnawan Antariksa, Jakarta, Indonesia, has just been established in late 2004 and it is still in developing process. This study was aim to depict the profile of patients who underwent esophagogastroduodenoscopy procedure in the unit. Method: This study was a retrospective study that analyzed data in endoscopic registry of patients who underwent esophagogastroduodenoscopy (EGD) examination from September 2004 to December 2007. Result: Total of 108 patients underwent EGD examination, comprised of 66 (61%) males and 42 (39%) females, with average age of 45.4 years old (range 16-77 years old). The most frequent indication for EGD was dyspepsia 63%, followed by hematemesis-melena 26% and dysphagia 5.5%. Among patients with dyspepsia, EGD revealed organic abnormalities in 71% patients, with descriptions of erosive gastritis 35%, gastritis 18%, bile reflux 7%, esophagitis 5% and gastric ulcer 3%. Among patients with hematemesis-melena, EGD revealed abnormalities, which were described as erosive gastritis 48%, esophageal varices bleeding 22%, gastric ulcer 18%, caustic injury 4%, and esophagitis 4%. Conclusions: EGD is an important procedure to ascertain the occurence of organic abnormalities in patient with gastrointestinal symptoms and signs e.g. dyspepsia and gastrointestinal bleeding. More than half of patients with dyspepsia showed organic abnormalities. Among patients with hematemesis-melena, erosive gastritis is more common than variceal bleeding. Keywords: esophagogastroduodenoscopy, dyspepsia, upper gastrointestinal bleeding, hematemesis melena
Eosinophilic Esophagitis Pramana, T Yuli; Simadibrata, Marcellus
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 8 ISSUE 2 August 2007
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

The frequency of eosinophilic esophagitis (EE) cases is increasing along with increased understanding among doctors about EE. In the beginning, EE is mostly found in children population. It was first reported in adults by Landres on 1978. The prominent EE symptoms in adults are dysphagia and solid food impaction. Endoscopic examination reveals mucous ring of esophagus, white plaque on the mucosa. The diagnosis is supported by positive result of eosinophils, which forms infiltration on the mucosaof > 20 eosinophils/ high power field in the distal or middle esophagus. Treatment by using diet and corticosteroid, either topical or systemic, shows adequate results. Immunomodulator treatment is promising, but it needs further investigation with larger sample. No consensus have been reached for EE, therefore it may affect the diagnosis, treatment and epidemiology data.   Keywords: esophagus, eosinophil, dysphagia, ring of esophagus
The Role of Fecal Occult Blood Test in Screening of Colorectal Cancer and Inflammatory Bowel Disease Simadibrata, Marcellus
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 1, April 2010
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Colorectal cancer (CRC) and inflammatory bowel disease (IBD) are a quite common colon disease in the world. The World Gastroenterology Organization (WGO) recommends screening test to detect colorectal cancer, i.e. fecal occult blood test (FOBT) and colonoscopy. Diagnosis of CRC is established based on a good history taking, clinical manifestation, physical examination and laboratory examination. Other supporting laboratory tests include routine laboratory test of hemoglobin for detecting anemia, examination of bleeding stool either macroscopically or microscopically. Radiographic examination, either colon in loop or colonoscopy (if such modalities are available), shall be performed to confirm the occurrence of cancer mass in the colon. Moreover, biopsy examination is carried out to obtain the histopathological feature of tumor mass or the type of cancers. WGO has made a guideline for CRC screening, which consists of 6 cascades, which depend on the risk of colorectal cancer and local facilities available. There are several kinds of FOBT, but the most frequently used include three methods, i.e.: the FOBT guaiac base/traditional, the fecal immunochemical test (FIT) and the FOB + transferrin rapid test (OT 102c & OT 103c). FIT and FOB + transferrin rapid test have a quite high sensitivity and specificity in detecting the lower gastrointestinal tract bleeding caused by colorectal cancer and IBD. Keywords: FOBT, colorectal cancer, IBD
Co-Authors -, Selfie -, Selfie Aan Santi Abdul Aziz Rani Achmad Fauzi Adang Bachtiar Adeputri Tanesha Idhayu Adiwinata, Sheila Adjeg Tarius Agi Satria Putranto Agustinus, Taolin Ahmad Fauzi Ahmad Soefyani Ali Djumhana Ali Imron Yusuf Amanda P Utari, Amanda P Ana Mira Lubis Andree Kurniawan Andri Sulaiman Angga Pramudita Anna Mira Lubis Anwar Jusuf Ari F Syam Ari Fahrial Syam Arief Hakiki Armen Armen Arnold Hasahatan Harahap Arshita Auliana Arya Govinda Axel, Benvenuto Ayundini, Gratcia Aziz Rani Badriul Hegar Bambang Sutopo Benedicta Mutiara Suwita, Benedicta Mutiara Bona Adhista Bradley Jimmy Waleleng Budi Tan Oto Budiman Sudjatmika Budimutiar, Felix Aloysius Ceva W Pitoyo Chudahman Manan Dadang Makmun Daldiyono Daldiyono Daldiyono Hardjodisasto Daldiyono Hardjodisastro Daniel Gunawan Dasril Nizam David Reinhard Sumantri Samosir Deddy Gunawanjati Deskian Kostermans, Deskian Dharmika Djojoningrat Diah Rini Handjari Diana Aulia Diany N Taher Dicky Levenus Tahapary Didi Kurniadhi Djulzasri Albar Dolly Dolven Kansera Drupadi Harnopidjati Singh Dillon Dyah Purnamasari Dyah Ratna Budiani Edi Mulyana, Edi Ekowati Rahajeng Elizabeth Merry Wintery Elli Arsita Endang Susalit Ening Krisnuhoni Epistel Pangujian Simatupang Feri, Rose FJW Ten Kate Fransiska Hardi G. N.J. Tytgat Gerie Amarendra GNJ Tytgat Guno, Tri Hapsoro Guntur Darmawan Halimkesuma, Christopher Christian Hamzah Shatri Haryanto Surya Hasan Maulahela, Hasan Hayatun Nufus Helsi Helsi Herdiman T Pohan Hery Djagat Purnomo Hotmen Sijabat Ikawari, Dina Ilham Ahmadi Ilone, Stella Imam Subekti Ina Susianti Timan Indah Suci Widyahening Indra Kurniawan Indra Marki Irfan Maulani Irsan Hasan Iskandar A Ivo Novita Sah Bandar Iwan Ariawan Jacobus Albertus Jane Estherina Jeffri Gunawan Jeffry Beta Tenggara Joseph JY Sung Juferdy Kurniawan Julwan Pribadi Kaka Renaldi Katharina Setyawati Kemalasari, Indira Kemalasari, Indira Kharia Utia Kie Chen L A Lesmana L. A. Lesman Laras Budiyani, Laras Laura A Siahaan, Laura A Laurentika, Ira Laurentius Lesmana Lianda Siregar Lie Khie Chen Lies Luthariana Loli J Simanjuntak Lusy Erawati Lydia D Simatupang M Purnomo Isnaeni Marcevianto, Kevin Varian Mesanti, Oska Moch Ikhsan Mokoagow Mulia Mulia Murdani Abdulah Murdani Abdullah Nata Pratama Nisan Soeheri Noto Dwimartutie Novie Rahmawati Zirta Nur Chandra Bunawan Nur Rasyid Nurmiati Amir Pamela Abineno Pangestu Adi Parlindungan Siregar Paulus Kusnanto Paulus Simadibrata Poerniati Koes Andrijani Prima Yuriandro Rabbinu Rangga Pribadi Raden Nur Ista Ralph Girson Gunarsa Randy Adiwinata, Randy Ratu Ratih Kusumayanti Riadi Wirawan Riahdo Saragih Rino A Gani Rino Alvani Gani Rizki Yaruntradhani Rolan Sitompul Rudolf Simadibrata Rudy Hidayat Ruswhandi -, Ruswhandi Ryan Ranitya Salius Silih Sedijono Sedijono Selfie, Selfie Seri Mei Maya Ulina Simatupang, Emerson Patulahon Simon Salim Siti Setiati Stephanie Chandra, Stephanie Steven Sumantri Suhendro Suhendro Suryantini Suryantini Suzana Ndraha Suzanna Ndraha T Yuli Pramana Teguh Karyadi Timan, Ina Sutanto Tjahjadi Robert Tedjasaputra Toman L Toruan Tommy P Sibuea Tony Loho Tri Juli Edi T Unggul Budihusodo Vera D Yoewono Vera Yuwono Willy Brodus Uwan, Willy Brodus Zakiah Zakiah