PENERAPAN KUESIONER DISPEPSIA FUNGSIONAL ROMA III PADA PASIEN UNINVESTIGATED DYSPEPSIA

dr. Maya Um Husna, dr. Neneng Ratnasari, SpPD-KGEH

2014 | Tesis | S2 Ilmu Penyakit Dalam

Latar Belakang Penelitian. Dispepsia merupakan keadaan klinik yang sering dijumpai dalam praktek sehari-hari, dapat disebabkan kelainan organik, namun sebagian besar merupakan dispepsia fungsional. Rome Foundation menetapkan kriteria diagnostik berdasarkan gejala (symptom-based diagnostic criteria) untuk membantu mendiagnosis dispepsia fungsional. Belum terdapat penelitian tentang penerapan Kuesioner Dispepsia Fungsional Roma III di Yogyakarta. Tujuan Penelitian. Mengkaji penerapan Kuesioner Dispepsia Fungsional Roma III pada pasien uninvestigated dyspepsia untuk membantu mendiagnosis dispepsia fungsional, serta mengetahui sensitivitas dan spesifitasnya. Metode Penelitian. Penelitian cross-sectional atau studi potong lintang yang mengkaji penerapan Kuesioner Dispepsia Fungsional Roma III pada pasien-pasien uninvestigated dyspepsia. Subyek penelitian adalah penderita uninvestigated dyspepsia yang mendaftar pemeriksaan endoskopi di RSUP Dr. Sardjito dan RSU PKU Muhammadiyah Bantul Yogyakarta. Kriteria inklusi adalah pasien uninvestigated dyspepsia dengan usia lebih dari 18 tahun sampai dengan 55 tahun, tanpa alarm symptom, dan bersedia dilakukan pemeriksaan endoskopi. Kriteria eksklusi adalah terdapatnya alarm symptom dan penyakit komorbid. Dilakukan pengisian kuesioner sebelum pemeriksaan endoskopi. Hasil Peneltian. Terdapat 54 pasien uninvestigated dyspepsia, 22 pasien dieksklusi karena terdapat alarm symptom dan penyakit komorbid. Terdapat 32 pasien uninvestigated dyspepsia yang memenuhi kriteria inklusi. Berdasarkan pemeriksaan endoskopi didapatkan 16 (50%) pasien termasuk dispepsia fungsional dan 16 (50%) pasien termasuk dispepsia organik. Hasil pengisian kuesioner menunjukkan bahwa 7 (21,88%) pasien termasuk dalam EPS (Epigastric Pain Syndrome), 2 (6,25%) pasien termasuk PDS (Postprandial Distress Syndrome), 9 (28,12%) pasien memenuhi kriteria EPS dan PDS, sedangkan 14 (43,75%) pasien bukan EPS maupun PDS. Tidak terdapat perbedaan gejala dispepsia yang bermakna antara pasien dispepsia fungsional dan dispepsia organik (p=0,154). Nilai sensitivitas dan spesifitas kuesioner adalah 68,75% dan 56,25%. Kesimpulan. Kuesioner Dispepsia Fungsional Roma III belum dapat diterapkan untuk mendiagnosis dispepsia fungsional secara klinis karena tidak dapat membedakan gejala dispepsia antara xiii pasien dispepsia fungsional dan dispepsia organik, dengan nilai sensitivitas 68,75% dan spesifitas 56,25%.

BACKGROUND : Dyspepsia is a clinical condition which is often found in daily practice. It can be caused by organic abnormality but most cases are functional dyspepsia. Rome Foundation has developed symptom-based diagnostic criteria to assist health care professional in diagnosing functional dyspepsia. There hasn’t been a study about the application of Rome III Questionnaire for Functional Dyspepsia in Yogyakarta. The aim of this study is to evaluate the application of Rome III Questionnaire for Functional Dyspepsia in patients with uninvestigated dyspepsia to help in diagnosing functional dyspepsia and to discover both its sensitivity and specificity. METHODS : This is a cross sectional study to evaluate the application of Rome III Questionnaire for Functional Dyspepsia in patients with uninvestigated dyspepsia. Subjects of this study were patients with uninvestigated dyspepsia who applied for endoscopic examination in Dr. Sardjito Central General Hospital and PKU Muhammadiyah Bantul General Hospital in Yogyakarta. The inclusion criterias were age above 18 years to 55 years, without alarm symptoms, and agree to do endoscopic examination. Subjects with alarm symptoms and comorbid diseases were excluded. Questionnaire were filled before endoscopic examination. RESULTS : There were 54 subjects with uninvestigated dyspepsia, 22 subjects were excluded due to alarm symptoms and comorbid diseases. There were 32 subjects with uninvestigated dyspepsia who met inclusion criterias. According to endoscopic examination, there were 16 subjects (50%) with functional dyspepsia and 16 subjects (50%) with organic dyspepsia. The result of questionnaires showed 7 subjects (21,88%) with Epigastric Pain Syndrome (EPS), 2 subjects (6,25%) were categorized as Postprandial Distress Syndrome (PDS), 9 subjects (28,12%) met the criterias of EPS and PDS while 14 subjects (43,75%) were neither EPS nor PDS. There is no significant difference of dyspepsia symptoms in subjects with functional dysepsia and organic dyspepsia (p=0,154). The sensitivity and specificity of questionnaire are 68,75% and 56,25% respectively. xv CONCLUSIONS : This study suggests that Rome III Questionnaire for Functional Dyspepsia haven’t been able to be applied to diagnose functional dyspepsia clinically because it can’t differ the symptoms of dyspepsia in patients with functional dyspepsia and organic dyspepsia with 68,75% sensitivity and 56,25% specificity

Kata Kunci : uninvestigated dyspepsia, dispepsia fungsional, Epigastric Pain Syndrome (EPS), Postprandial Distress Syndrome (PDS), Kuesioner Dispepsia Fungsional Roma III, pemeriksaan endoskopi, sensitivitas, spesifitas