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Background: Inflammatory bowel disease (IBD) is idiopathic disease characterized by chronic inflammation of the gastrointestinal tract. Polysaccharide peptide of Ganoderma lucidum mycelium extract (PPGL) is considerably a good option for adjunctive therapy of IBD. This study aims to evaluate the benefit of PPGL in patients treated with 5-ASA. Method: A retrospective observational cohort study was conducted to examine the medical records of 124 ulcerative colitis patients. There were 80 patients in intervention group who were treated with a combination of 5-ASA and PPGL, and there were 44 patients in the control group who were treated with 5-ASA only. Clinical and laboratory endpoints were observed at the baseline and after 30, 60, and 90 days. Clinical endpoints included abdominal pain, bloody diarrhea, aphthous stomatitis, and polyarthritis; meanwhile, laboratory endpoints included hemoglobin level, ESR, CRP, fecal calprotectin, M2-pyruvate kinase (MP2K), fecal culture, C. difficile culture, and colonoscopy results. Clinical trials conducted after patient enrollment with registry number ClinicalTrials.gov NCT04029649. Results: On day-30 there was a significant difference between intervention group 45.6% and control group 2.3% in abdominal pain complaints (p 0.001). Moreover, laboratory parameters of fecal calprotectin (p 0.001), fecal MP2K (p = 0.015), and hemoglobin (p 0.001) were considerably better in intervention group on day-30. These differences were consistently found on day 60 and 90. Conclusion: The study implies potential correlation between PPGL administration and improvement of clinical and laboratory endpoints up to 90 days. A larger randomized, blinded, prospective study is required to confirm these effects in ulcerative colitis.

Ulcerative colitis (UC) is an idiopathic inflammatory disease that affects the colon. Current pharmacological modalities to treat UC have various side effects; therefore, there is a demand to develop a new alternative medicine that can reduce side effects and increase drug efficacy. One candidate for alternative therapy is Polysaccharide Peptide which is extracted from Ganoderma lucidum mycelium. This Polysaccaharide has an active compound of Β-1,3/1,6-D-Glucan which has strong immunomodulatory and anti-inflammatory properties. Various studies have reported that Ganoderma lucidum polysaccharides can reduce inflammatory markers such as TNF-α, IFN-γ, and IL-17A, which is produced by colonic mucosal inflammation. In addition, β-1,3/1,6-D-Glucan has shown improvements in inflammatory parameters and intestinal immunological barrier function animal studies with artificial colitis and requires further research in humans before clinical applications.

Hospital malnutrition is common in Indonesia and other developing countries. In Asia, the prevalence of hospital malnutrition ranges between 27-39%. The causes of malnutrition in hospital care include insufficient food intake and increased catabolic processes due to underlying causes such as metabolic disease, infection, and malignancy. Several studies have demonstrated that malnutrition increases the morbidity and mortality of hospitalized patients, prolongs hospital stay, and delays recovery. Therefore, healthcare providers must recognize malnutrition early by conducting nutritional screening and assessment to prevent worsening of malnutrition and administer the optimal nutritional therapy to patients. Apart from giving a standard diet, high-protein food supplementation in liquid form remains a suitable alternative for patients, especially since it is easily digestible. A high protein diet is associated with a better mortality rate, better weight gain, and improved SGA score in patients.