GERD (GASTROESOPHAGEAL REFLUX DISEASE)

HANYA satu persen masyarakat Indonesia yang memahami GERD, suatu gangguan kesehatan akibat meluapnya asam lambung yang diderita empat juta orang Indonesia. Asam lambung dalam jumlah cukup diperlukan agar tubuh dapat mencerna makanan dengan baik.

Namun, jika berlebihan, asam lambung yang seharusnya berdiam di dalam lambung dapat meluap hingga keluar dari katup lambung dan menyebar hingga ke organ-organ tubuh lainnya.

Spesialis penyakit dalam dari divisi Gastroenterologi Departemen Ilmu Penyakit Dalam FKUI/RSCM Jakarta, Dr H Ari Fahrial Syam SpPD KGEH MMB, mengungkapkan, penyakit akibat asam lambung umumnya mengenai tiga lokasi, yakni usus dua belas jari, lambung, dan kerongkongan.

Dyspepsia atau penyakit maag yang ditandai dengan rasa nyeri atau perih di lambung mungkin sudah populer di telinga masyarakat. Lain halnya dengan GERD (Gastroesophageal Reflux Disease) yang mungkin masih asing di telinga orang awam. Menurut Montreal Definition, GERD diartikan sebagai kondisi adanya aliran balik (reflux) dari isi lambung ke kerongkongan yang menyebabkan gejala mengganggu hingga terjadi komplikasi.

"Keluhan utamanya adalah rasa panas (heartburn) pada tulang belakang dada,yang terkadang disertai pahit atau enek seperti mau muntah akibat asam lambung yang naik ke kerongkongan," kata Ari dalam acara talkshow kesehatan tentang GERD yang diselenggarakan PT AstraZeneca Indonesia di Jakarta, Senin (4/5/2009).

Aliran balik tersebut tak hanya memicu sindrom GERD yang ditandai nyeri dada seperti terbakar tadi, melainkan juga menyebabkan luka pada kerongkongan (esofagitis). Imbas lainnya adalah atypical syndrome (seperti asthma reflux) yang dapat mengganggu aktivitas sehari-hari dan sulit diobati. Reflux esophagitis itu sendiri merupakan proses terjadinya erosi atau kerusakan pada dinding dalam kerongkongan akibat kerap terpapar asam lambung.

Jika tidak diterapi dengan baik, dapat menyebabkan komplikasi seperti penyempitan dan perdarahan pada kerongkongan, serta kondisi yang disebut Barrett's esophagus, yakni terjadi pembentukan jaringan pada dinding kerongkongan seperti yang ditemukan dalam usus.

"Perlukaan pada kerongkongan tadi jika terus berlanjut tanpa ditangani dalam jangka panjang berpotensi memicu terjadinya kanker kerongkongan," katanya.

Ari mengingatkan, GERD adalah penyakit kronis yang bisa mengarah pada komplikasi yang dapat menurunkan kualitas hidup pasien. Gejala GERD sangat samar dan umum, kendati ada beberapa yang bisa ditengarai sebagai kekhususan. Tak heran, sering kali pasien menyamakan pengobatan untuk kasus yang dialaminya dengan obat yang dijual bebas di pasaran (over the counter/OTC).

Demikian halnya gejala yang tersamar acap kali membuat pasien atau bahkan dokter salah menduga. Misalkan, seseorang yang mengalami suara serak tidak musti disebabkan infeksi saluran napas akibat virus misalnya, boleh jadi asam lambungnya yang bermasalah.

"Saat batuk atau pilek, asam lambung juga cenderung meningkat. Jika terdapat gejala seperti tiap pagi mulut terasa pahit, dada tidak nyaman, apalagi disertai penurunan berat badan, patut dicurigai kemungkinan Anda terkena GERD," papar Ari seraya mengungkapkan serangan GERD bisa terjadi beberapa kali dalam sehari, kendati produksi asam lambung biasanya memuncak pada pukul 22.00-23.00 (malam).

GERD dapat menyerang siapa pun tanpa mengenal kelompok usia. Namun, hingga kini angka prevalensi GERD belum diketahui secara pasti. Di negara-negara Barat sekitar 10 persen-20 persen populasi orang dewasa mengalami heartburn secara teratur setiap minggu. Sementara di Asia Timur angkanya berkisar dua persen-enam persen.

Sejumlah kalangan memperkirakan reflux esophagitis dirasakan oleh 50-65 persen penderita GERD. Saat ini di Indonesia juga belum ada angka pasti jumlah penderita GERD. Namun, menurut Ari, dari hospital base yang dapat ditelusuri, terdapat sekitar 20 persen dari total pasien yang berobat ke Departemen Ilmu Penyakit Dalam menyampaikan keluhan gejala GERD, mulai tingkat ringan hingga parah.

Hal senada dikemukakan Medical Affair PT AstraZeneca Indonesia, dr Mary Josephine. Menurut dia, pemahaman GERD di Indonesia memang masih sangat rendah, yakni hanya satu persen. Angka ini jauh lebih kecil dibanding negara Asia lainnya seperti Filipina (17 persen) dan Taiwan (13 persen). Padahal, saat ini sekitar empat juta orang Indonesia terserang GERD, tanpa mengetahui bagaimana metode penatalaksanaan gejala yang efektif.
http://lifestyle.okezone.com

Food Selection for Gastric Bypass Patients

Dieters who dejectedly complain they are figuratively “stuck” with their excess fat may be surprised to learn there is a scientifically-accurate truth to their statement. Fat cells -- which are created when the body is unable to convert excess calories to energy -- are permanent. Fat cells cannot be removed by any diet known to humanity [1]. They can, however, be reduced in size. This is the experience enjoyed by people who lose weight [i].

There is, however, an increasingly popular – and controversial – method to eliminate fat cells permanently via an external, non-diet method. Scientifically referred to as a Gastric Bypass Operation, but more popularly known as “stomach stapling”, this procedure literally staples part of the stomach together. The result is that food intake becomes severely restricted, and the body begins the process of malabsorption, or a decreased ability to absorb nutrients. In addition, the duodenum [2] is bypassed to prevent the absorption of nutrients that could cause excess calories, and as such, the creation of additional fat cells [ii].

In addition to this, a more complex and less frequent procedure called Extensive Gastric Bypass or “biliopancreatic diversion” involves the removal stomach parts, and the circumvention of the duodenum and jejunum – or in laypersons terms, the circumvention of the first part of the small intestine, and the middle portion the small intestine. The result is an even greater malabsorption capacity.

The bulk of concern surrounding stomach-stamping procedures is emanating from the medical community. Some experts are worried that individuals opting for this rather dramatic surgery are not prepared to make post-procedure lifestyle changes. They point out that since stomach stapling reduces the size of the stomach, and therefore the amount of food that a person can digest is severely reduced, an individual must be fully equipped to eat wisely after the procedure. This “wise eating” must include both the volume of post-procedure food that is eaten, and the number of calories that are eaten on a daily basis [iii].

These experts are also quick to point out that the failure to adequately prepare people for post-procedure wise eating habits often leads to various forms of malnutrition. These include anemia due to Iron and B12 deficiencies, hair loss, calcium deficiencies, nausea, vomiting, excessive sweating, diarrhea, and the loss of water-soluble essential vitamins such as C, Niacin, and B1, B2, B3, B5, B6, Biotin, and Folic Acid [iv].

The jury on whether stomach stapling is a “fair” choice, or one that is driven by unhealthy body-image stereotypes propagated by the media and elsewhere, is hotly debated and will continue to dominate conversations about this controversial procedure. Yet what cannot be lost in this debate is that, everyday, real human beings are facing an uphill battle after their stomach stapling surgery. For these people, whether they chose to have the surgery due to body image issues or not, the rationale is rather academic once the surgery is over. What they clearly need at this point are nutritional supplement solutions that cater to their new eating limits and framework.

Profect, which is a nutritional supplement created by Protica Research, does not support the proliferation of unhealthy body image expectations that people are inundated with each day; especially impressionable youth. Yet with this being said, Profect has been engineered to provide those who have opted for this dramatic weight-loss surgery with an ideal source of post-procedure food.

Each serving of Profect is contained in 2.7 fluid ounces, which is significantly smaller than most other nutritional supplements. It is therefore aptly suited for those who must limit their volume of food intake. At the same time, each serving of Profect contains only 100-calories – none of which are from fat -- and as such will not lead to runaway caloric intake.

What is clearly the most appreciated medical quality, however, is Profect’s protein configuration. Each 2.7 fluid ounce serving of Profect contains 25 grams of protein. This is the densest protein available on the market. As such, individuals who are obliged to eat very small food portions can easily ingest 100% of the U.S. Recommended Daily Intake of protein in less than six fluid ounces.

In addition, each serving of Profect contains 50% to 100% of all nine water-soluble vitamins. These vitamins help consumers replenish the vitamin stores that they may be losing due to the post-procedure side effects noted above, such as diarrhea, vomiting, and sweating. In the long-term, daily usage of Profect provides the body with the critically important constant flow of water-soluble vitamins.

Indeed, the controversy surrounding stomach stapling, which also includes its hefty price tag, will continue; and it is important to hear all views. Yet what must also continue is quality education and awareness. People must be adequately informed that while their weight may seemingly “disappear” overnight thanks to stomach stapling, there is still a challenging road ahead. This road includes an eating regimen that will require conscientious food selections, much smaller portions, and careful monitoring of protein and vitamin intake.
by: Protica Nutritional Research