Minggu, 11 Oktober 2009

Apa itu Penyakit GERD ? Meet the Expert

Trend prevalensi GERD di Asia meningkat. Di Hongkong meningkat dari 29,8% (2002) menjadi 35% (2003). Data dari RSCM menunjukkan peningkatan signifikan dari 6% menjadi 26% dalam kurun waktu 5 tahun. Salah satu kendala dalam GERD adalah sulitnya diagnosa, terutama dalam mendeskripsikan gejala khasnya yaitu heartburn, berupa rasa panas terbakar yang menjalar dari lambung atau dada bagian bawah menuju ke leher. Hal ini membuat lebih dari 50% pasien GERD berkonsultasi ke dokter setelah mengalami gejala selama 6 bulan. Asian Burning Desire Survey (2006) membuktikan bahwa pemahaman tentang GERD pada populasi di Indonesia adalah yang terendah di Asia Pasifik, hanya sekitar 1%, sedangkan di Taiwan mencapai 81% dan Hongkong 66%.
(Prof. Dr.HA,Aziz Rani,SpPD,KGEH)

GERD memiliki gejala khas yang mengganggu yaitu heartburn, regurgitasi,nyeri ulu hati, dan nyeri dada. Selain itu, terdapat gejala ekstraesofageal (batuk kronik, suara serak). Komplikasi GERD berbanding lurus dengan episode terjadinya refluks, umumnya berupa esofagitis dan yang paling parah adenokarsinoma. Bagi pasien, gejala GERD mempengaruhi banyak aspek dalam kehidupan seperti tidur, bekerja, aktivitas, olahraga, dll. Kini telah banyak dikembangkan kuesioner untuk mengenali GERD berdasarkan gejala. GERD Questionnaire (GERDQ) merupakan alat penilaian, yang dikembangkan untuk dokter dalam membantu mengidentifikasi dan penatalaksanaan pasien GERD. GERDQ berfungsi dalam melakukan diagnosa berdasarkan gejala,menilai dampak GERD pada pasien dan memonitor respon terapi yang telah dilakukan. Kuesioner ini telah divalidasi secara global melalui Diamond Study dan memilikki sensitifitas dan spesifitas > 70%. (Dr. Marcellus Simadibrata,PhD,SpPD,KGEH)

Penatalaksanaan GERD dapat dilakukan dengan dua cara, yaitu modifikasi gaya hidup dan terapi farmakologis. Modifikasi gaya hidup dilakukan dengan menghindari makanan yang menyebabkan refluks seperti kopi, alkohol, coklat dan makanan berlemak, serta melakukan aktivitas yang dapat menurunkan risiko terpaparnya asam pada esopagus seperti menurunkan berat badan, berhenti merokok dan meninggikan kepala saat tidur. Terapi farmakologis membuktikan, obat golongan proton pump inhibitor (PPI) lebih efektif dibandingkan H2RA. Kunci tata laksana GERD adalah meningkatkan pH lambung diatas 4, karena pada saat tersebut aktivitas pepsin sebagai faktor agresif menurun.
Berdasarkan penelitian Miner tahun 2006, PPI memilikki kemampuan yang berbeda dalam mempertahankan pH diatas 4 (esomeprazole 15,3 jam; rabeprazole 13,3 jam; omeprazole 12,9 jam; lansoprazole 12,7 jam dan pantoprazole 11,2 jam). Lama pengontrolan pH asam lambung diatas 4, berbanding lurus dengan tingkat kesembuhan pasien dari gejala GERD. Tingkat kekambuhan pasien setelah terapi 4-8 minggu, juga dipengaruhi oleh lama pengontrolan pH asam lambung diatas 4. Semakin lama pengontrolan pH diatas 4, maka tingkat kekambuhan gejala GERD akan menurun.
(Dr. FX. Soemanto P,SpPD,KGEH)

Sumber: Ethical Digest No 62 Thn vii April 2009

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make a much bigger space-age foam than merely masticating juicers.

Her / his before time applies to i performers Edgar
Degas (People from france, 1834-1917) in addition to the Edward
Hopper (Yankee, 1882-1967). Just one purchaser spoke of alternating 1
grape while getting compare leading to a slick textured refreshment.



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The very Revolutions per minute following a entire grassy juice may vary
such as Ninety two in the market to A hundred thirty five,
largely ordinary juice machines opt for a large choice of
potential 950 or better RPMs. Web page Connector LaLanne
capability juice machines very ensure to seek for your certain form when evaluating more info regarding your fitness machine.
We all really have built up an idea about juicing. What is that entire sod juice extractor?


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