Jurnal Penyakit Dalam Indonesia (Mar 2020)
Level of Plasma Cortisol in Functional Dyspepsia with Psychosomatic Disorder
Abstract
Introduction. Increasing of cortisol will stimulate the production of gastric acid and can inhibit prostaglandin E which is an inhibitor of the enzyme adenyl cyclase in parietal cells that is protective of gastric mucosa. High value of plasma cortisol is associated with psychological stress which can trigger the complaints of dyspepsia. This study aims to find out the level of plasma cortisol in dyspepsia functional Methods. An analytic descriptive - cross sectional study with nonrandom consecutive sampling was conducted among dyspepsia patients. After diagnosis of functional dyspepsia, depression, anxiety and both of depression – anxiety, all subjects were examined for gastroscopy and plasma cortisol in the morning and evening. Results. There were 40 patients with dyspepsia and psychosomatic disorders and 10 patients with dyspepsia without psychosomatic symptom as control group with an age range of 20 – 40 years old. The mean value of cortisol level in the morning among subjects with psychosomatic disorder was 322.33 nmol/L (SD 166.92 nmol/L) whereas in the normal group was 188.82 nmol/L (SD 103.14 nmol/L). The median value of cortisol level in the evening among subjects with psychosomatic disorder was 136.25 nmol/L (range 17.8-494.1 nmol/L) whereas in the normal group was 91.40 nmol/L (range 10.6-291.6 nmol / L). Statistical analysis showed that there was a significant increased in the morning cortisol between sujects with depression (mean value = 338.82 nmol/L (SD 166.82 nmol/L) compared to normal group (p value=0.013). Meanwhile, there difference in afternoon cortisol between subjects with psychosomatic disorder and the normal group was not statistically significant (p>0.05). Conclusion. The level of morning plasma cortisol in functional dyspepsia with psychosomatic patients (depression) was significantly higher than patients without psychosomatic disorder.
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