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DIGESTIVE SYSTEM EXAMINATION PANEL
Thu, 8 Dec 2022
When you experience complaints of the digestive system, the doctor will try to explore the history of your symptoms and narrow down on several possible diagnoses.
In some conditions, further investigation is required.
The following are some of the checks that can be carried out:
A. Laboratory Examination:
1. Liver function
Parameters commonly used to determine liver function include:
Serum Glutamic Oxaloacetic Transaminase (SGOT) or now better known as Aspartate Aminotransferase (AST) is an enzyme that can be found in the heart, liver, skeletal muscle, kidneys, brain, spleen, pancreas and lungs. Normal SGOT/AST values range from 5-35 U/L. If there is an increase, it can be caused by disorders of these organs or consumption of certain drugs.
Serum Glutamic Pyruvate Transaminase (SGPT) or now better known as Alanine Aminotransferase (ALT) is found in the liver. But it is also found in muscles, kidneys and heart. SGPT/ALT is more specific as a parameter of liver function compared to SGOT/AST. Normal SGOT/AST values range from 5-35 U/L.
In addition, there are several other parameters that can be used to support liver function tests, such as Alkaline Phosphatase (ALP), Gamma Glutamyl Transferase (GGT), direct/indirect bilirubin, albumin and globulin. The examination is based on medical indications and the doctor's consideration.
2. Serological examination of Hepatitis Virus
To make a diagnosis of hepatitis, there are many serological tests that can be done according to the suspicion of the type of hepatitis you are suffering from, such as:
• Hepatitis A: IgM/IgG anti HAV
• Hepatitis B: HbsAg, IgM/IgG Anti HBc, AntiHBs, HBV DNA quantitative (PCR), HBeAg, AntiHBe
• Hepatitis C: IgM/IgG anti-HCV, quantitative HCV RNA
3. Digestive enzymes
• Amylase
Amylase is an enzyme produced by saliva (salivary glands), pancreas, liver and fallopian tubes. This enzyme functions to convert starch into sugar so that it can be digested further. Normal values range from 20-123 U/L. Increases occur in cases of inflammation of the pancreas, stomach ulcers, inflammation of the salivary glands and others.
• Lipase
The main producer of lipase is the pancreas. This enzyme functions to break down fatty acids into glycerol. Normal levels between 10-140 U/L. Elevated lipase values also refer to pancreatic inflammation and in other cases of digestion.
4. Urea Breath Test (UBT)
In cases of stomach ulcers caused by Helicobacter pylori, there are several tests that can be done to make a diagnosis. One of them is the Urea Breath Test. Helicobacter pylori bacteria has the ability to break down the urea enzyme into ammonia and carbon dioxide, so it is hoped that it can be detected through this test. The patient will be asked to swallow urea, 30 minutes later the patient will be asked to exhale in a special place that has a carbon trap. This examination is non-invasive so it is more preferred.
B. Non-Laboratory Examination:
Ultrasound of the Upper and Lower Abdomen
Ultrasound examination utilizes ultrasound waves to detect any abnormalities in the body. Ultrasound examination is often done because it is effective, non-invasive and has minimal side effects. Ultrasound examination of the abdomen consists of 2 parts, namely the upper (top) and lower (bottom). The main organs on an ultrasound examination of the upper abdomen consist of: Liver, gallbladder, pancreas, spleen, right and left kidney, abdominal blood vessels (abdominal aorta) and so on. While the examination of the lower abdomen includes: bladder, intestines, especially the appendix, prostate gland in men, ovaries and uterus in women. If you are planning to have an abdominal ultrasound examination, the doctor will recommend fasting for 8-12 hours, because undigested food can interfere with the examination.
Author : dr. Eta Auria Latiefa, Medical Consultant Doctor of PRAMITA Clinical Laboratory Jl. Miss Di Tiro No. 17 Yogyakarta.
BIBLIOGRAPHY
• Mayo Clinic (2020). Tests & Procedures. Ultrasound.
• RI Ministry of Health (2011). Guidelines for Interpreting Clinical Data
• Ricci C, Holton J, Vaira D. Diagnosis of Helicobacter pylori: invasive and non-invasive tests. Best Practice & Research: Clinical Gastroenterology 2007;21(2):299–313
In some conditions, further investigation is required.
The following are some of the checks that can be carried out:
A. Laboratory Examination:
1. Liver function
Parameters commonly used to determine liver function include:
Serum Glutamic Oxaloacetic Transaminase (SGOT) or now better known as Aspartate Aminotransferase (AST) is an enzyme that can be found in the heart, liver, skeletal muscle, kidneys, brain, spleen, pancreas and lungs. Normal SGOT/AST values range from 5-35 U/L. If there is an increase, it can be caused by disorders of these organs or consumption of certain drugs.
Serum Glutamic Pyruvate Transaminase (SGPT) or now better known as Alanine Aminotransferase (ALT) is found in the liver. But it is also found in muscles, kidneys and heart. SGPT/ALT is more specific as a parameter of liver function compared to SGOT/AST. Normal SGOT/AST values range from 5-35 U/L.
In addition, there are several other parameters that can be used to support liver function tests, such as Alkaline Phosphatase (ALP), Gamma Glutamyl Transferase (GGT), direct/indirect bilirubin, albumin and globulin. The examination is based on medical indications and the doctor's consideration.
2. Serological examination of Hepatitis Virus
To make a diagnosis of hepatitis, there are many serological tests that can be done according to the suspicion of the type of hepatitis you are suffering from, such as:
• Hepatitis A: IgM/IgG anti HAV
• Hepatitis B: HbsAg, IgM/IgG Anti HBc, AntiHBs, HBV DNA quantitative (PCR), HBeAg, AntiHBe
• Hepatitis C: IgM/IgG anti-HCV, quantitative HCV RNA
3. Digestive enzymes
• Amylase
Amylase is an enzyme produced by saliva (salivary glands), pancreas, liver and fallopian tubes. This enzyme functions to convert starch into sugar so that it can be digested further. Normal values range from 20-123 U/L. Increases occur in cases of inflammation of the pancreas, stomach ulcers, inflammation of the salivary glands and others.
• Lipase
The main producer of lipase is the pancreas. This enzyme functions to break down fatty acids into glycerol. Normal levels between 10-140 U/L. Elevated lipase values also refer to pancreatic inflammation and in other cases of digestion.
4. Urea Breath Test (UBT)
In cases of stomach ulcers caused by Helicobacter pylori, there are several tests that can be done to make a diagnosis. One of them is the Urea Breath Test. Helicobacter pylori bacteria has the ability to break down the urea enzyme into ammonia and carbon dioxide, so it is hoped that it can be detected through this test. The patient will be asked to swallow urea, 30 minutes later the patient will be asked to exhale in a special place that has a carbon trap. This examination is non-invasive so it is more preferred.
B. Non-Laboratory Examination:
Ultrasound of the Upper and Lower Abdomen
Ultrasound examination utilizes ultrasound waves to detect any abnormalities in the body. Ultrasound examination is often done because it is effective, non-invasive and has minimal side effects. Ultrasound examination of the abdomen consists of 2 parts, namely the upper (top) and lower (bottom). The main organs on an ultrasound examination of the upper abdomen consist of: Liver, gallbladder, pancreas, spleen, right and left kidney, abdominal blood vessels (abdominal aorta) and so on. While the examination of the lower abdomen includes: bladder, intestines, especially the appendix, prostate gland in men, ovaries and uterus in women. If you are planning to have an abdominal ultrasound examination, the doctor will recommend fasting for 8-12 hours, because undigested food can interfere with the examination.
Author : dr. Eta Auria Latiefa, Medical Consultant Doctor of PRAMITA Clinical Laboratory Jl. Miss Di Tiro No. 17 Yogyakarta.
BIBLIOGRAPHY
• Mayo Clinic (2020). Tests & Procedures. Ultrasound.
• RI Ministry of Health (2011). Guidelines for Interpreting Clinical Data
• Ricci C, Holton J, Vaira D. Diagnosis of Helicobacter pylori: invasive and non-invasive tests. Best Practice & Research: Clinical Gastroenterology 2007;21(2):299–313
