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RAPID SURVEY OF GASTRICAL SYMPTOMS IN THE STUDENTS OF THE FACULTY OF PUBLIC HEALTH, UNIVERSITAS
MUHAMMADIYAH JAKARTA IN 2022
1Amira Mhuthia Adila, 2Munaya Fauziah, 3Thresya Febrianti, 4Istianah Surury
1-4Public Health Study Program, Faculty of Public Health, Universitas Muhammadiyah Jakarta K.H. Ahmad Dahlan St., Ciputat, Cireundeu, South Jakarta, Special Capital Region of Jakarta 15419.
Email: [email protected]
ABSTRACT
Gastritis is one of the non-communicable diseases which is a public health problem. According to data from the Indonesian Ministry of Health (2018), the incidence of gastritis in Indonesia is 40.8%. South Tangerang recorded as many as 8,432 (10.43 percent) people reported experiencing gastritis symptom syndrome; this makes gastritis one of the ten most common diseases in South Tangerang. This study aimed to determine the association between sex, frequency of eating, mealtime, frequency of irritating eating and stress with gastritis symptoms. The method used in this study is a rapid survey of 210 samples determined through two-stage cluster sampling and then tested univariately and bivariate using Chi- Square with α=0.05. The results showed that there was no association between sex (p-value = 0.087) and mealtime (p-value = 0.273) with gastritis recurrence. There is a relationship between eating frequency (p-value = 0.009), risk eating frequency (p-value = 0.000), and stress (p-value = 0.000) with gastritis symptoms. This study concludes that the factors associated with gastritis symptoms include the frequency of eating, the frequency of eating irrittation and stressful. Meanwhile, gender and meal times were not associated with gastritis symptoms. Suggestions that for teenagers to pay attention to the frequency of eating, reduce the frequency of eating irritating and do meditation and strengthen faith in order to avoid stress that can trigger gastritis symptoms.
Keywords: Gastritis symptom, students, diet, stress
INTRODUCTION
Gastritis is one of the non-communicable diseases which is a public health problem. Gastritis or commonly known as an ulcer, is characterized by the appearance of symptoms such as heartburn, nausea, vomiting, and a feeling of fullness felt by a person affected by this disease. Gastritis caused by Helicobacter Plyori bacteria triggers inflammation (inflammation) in the stomach lining(1).
Globally, gastritis is a problem in both developed and developing countries. In developing countries alone there are 50.8% of gastritis sufferers while in developed countries, 34.7% of the population are gastritis sufferers(2). In developing countries, the overall prevalence of H. pylori varies depending on geographic area and socioeconomic conditions, being about 69% in Africa, 78% in South America, and 51% in Asia (3).
According to data from The Indonesian Ministry of Health (2018), The incidence of gastritis in Indonesia is 40.8%. The incidence of gastritis in several areas in Indonesia itself is pretty high, with a percentage prevalence of 274,396 cases from 238,452,952 population(4). The Indonesian Health Profile also notes gastritis as one of the top ten most common diseases that become inpatient clients at Indonesian Hospitals(5).
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In South Tangerang City in 2022 recorded, That as many as 8,432 (10.43%) people reported experiencing gastritis symptom syndrome; this makes gastritis one of the ten most common diseases in South Tangerang (6).
Factors that influence the incidence of gastritis include gender, eating patterns consisting of frequency of eating, meal times, types of food, and stress levels (7)(8). The incidence of gastritis if not treated starting from the risk factors, will result in complications such as upper gastrointestinal bleeding and fluid and electrolyte disturbances which can even lead to death (9).
Researchers conducted a preliminary study on February 22, 2022 through several question items on 50 FKM UMJ students to see a rough picture of the incidence of gastritis, the results showed that there were (60%) students had a history of stomach pain and (76%) experienced pain or discomfort.
Uncomfortable in the gut.
Based on the description above, the researchers are interested in conducting further in-depth and systematically with the title "Rapid Survey of Gastritis Symptoms in Students of the Faculty of Public Health, Universitas Muhammadiyah Jakarta in 2022". Thiss study aimed to describe the symptoms of gastritis and the factors that influence it.
METHOD
This research is a quantitative study with a rapid survey design carried out from March to June 2022 at the Muhammadiyah University, Jakarta. The sample in this study is 30 X 7 (30 clusters/village, each cluster consisting of 7 respondents), which is sufficient to see cases that often occur in the rapid survey method. Sampling was done by two-stage cluster sampling, in the first stage the probability proportionate to size. Then the second stage of sample selection, with sample selection in each cluster conducted by random sampling. Data analysis carried out descriptively and analytically, descriptively to see the description of the dependent variable (gastritis symptoms) and independent (gender, frequency of eating, eating time, frequency of risky eating, and stress).
RESULTS AND DISCUSSION
Based on Table 1. Distribution of Respondents by Age, the average age of respondents is 20.7, with a median of 21 and a variation of 1.41 years. The age of the youngest respondent is 18 years, and the oldest respondent is 27 years.
Table 1. Characteristics of Respondents by Age
Mean Median SD Min - Max
Age 20.77 21 1.41 18-27
Based on Table 2. Respondents who do not routinely experience gastritis symptoms are 106 (50.5%) people, while the number of respondents who regularly experience gastritis symptoms is 104
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people (49.5%). Most of the respondents were female, as many as 172 (81.9%) people, and male respondents as many as 38 (18.1%) people. Respondents have a excellent eating frequency of as many as 117 (55.7%) people, while respondents have a bad eating frequency of as many as 93 people (44.3%).
Respondents with good meal times are 122 (58.1%) people, while respondents with bad meal times are 88 (41.9%) people. Respondents who regularly eat irritating food are 136 people (64.8%), while respondents who consume foods that do not regularly eat irritating as many as 74 (35.2%) people.
Respondents experienced stress as many as 177 people (84.3%), while respondents did not experience stress as many as 33 people (15.7%).
Table 2. Characteristics of Respondents based on Gastritis Symptoms, Gender, Frequency of Eating, Meal Time, Frequency of Irritating Eating, and Stress
Variable n (%)
Symptoms of Gastritis
Routine 104 49.5
Not a routine 106 50.5
Gender
Woman 172 81.9
Male 38 18.1
Feeding Frequency
Not good 93 44.3
Well 117 55.7
Eating time
Not good 88 41.9
Well 122 58.1
Irritating Eating Frequency
Routine 136 64.8
Not a routine 74 35.2
Stress
Yes 177 84.3
Not 33 15.7
The results of the chi-square test analysis on the gender variable obtained a p-value = 0.087 so that H0 is accepted; it can be interpreted that there is no relationship between gender and gastritis recurrence in FKM UMJ students. In the variable frequency of eating, the p-value = 0.009, so that H0 is rejected, it can be interpreted that there is a significant relationship between the frequency of eating and the symptoms of gastritis. In addition, the OR was 2.17, which means that a person with a poor eating frequency will have the opportunity to experience a recurrence of gastritis as much as 68%. In the mealtime variable, p-value = 0.273, then H0 is accepted, meaning there is no relationship between mealtime and gastritis symptoms. In the variable frequency of irritating eating, p-value = 0, 000 then H0 is rejected, meaning there is a significant relationship between the type of food and the symptoms of gastritis. In addition, an OR of 4.8 means that someone who consumes irritating foods has an 82%
risk of routinely experiencing gastritis symptoms. The test results on the stress variable obtained p value
= 0.000 so that H0 is rejected, meaning there is a significant relationship between stress and gastritis symptoms. In addition, an OR value of 5.58 means that someone who is stressed has an 83% risk of
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routinely experiencing gastritis symptoms. 0.000 so that H0 is rejected, meaning there is a significant relationship between stress and gastritis symptoms. In addition, an OR value of 5.58 means that someone who is stressed has an 83% risk of routinely experiencing gastritis symptoms. 000 so that H0 is rejected, meaning there is a significant relationship between stress and symptoms of gastritis. In addition, an OR value of 5.58 means that someone who is stressed has an 83% risk of routinely experiencing gastritis symptoms.
Table 3. Relationship of Gender, Frequency of Eating, Meal Time, Frequency of Irritating and Stressful Eating with Gastritis Symptoms in FKM UMJ Students in 2022
Variable
Symptoms of Gastritis
Total OR
(95% CI) P Value Routine Not a routine
n % n % N %
Gender
Woman 84 48.8 88 51.2 172 100 0.859
(0.42-1.73) 0.087
Man 20 52.6 18 47.4 38 100
Feeding Frequency
Not good 56 60.2 37 39.8 93 100 2,176
(1.24-3.79) 0.009
Well 43 41.0 69 59.0 117 100
Eating time
Not good 48 54.5 40 45.5 88 100 1.414
(0.81-2.45) 0.273
Well 56 45.9 66 54.1 122 100
Irritating Eating Frequency
Routine 85 62.5 51 37.5 136 100 4,825
(2.57-9.02) 0.000
Not a routine 19 25.7 55 74.3 74 100
Stress
Yes 96 55.4 79 44.6 177 100 5.582
(2.19-14.1) 0.000
Not 6 18.2 27 81.8 33 100
Gender is a nature that is a provision of God, this can be distinguished biologically because it is physically attached to each sex, both male and female, as a means of reproduction (10). The results of a rapid survey conducted on 210 active students at FKM UMJ showed that the proportion of women who experienced gastritis symptoms was more significant than that of men. The relationship test between the two variables was obtained (p-value = 0.087), so this study showed no significant relationship between gender and gastritis recurrence.
This is not in line Rantung and Malonda (2019), research where gender is related to the incidence of gastritis(11). However, the results of this study are in line with research conducted by Sunarmi (2018) and Maidartati, et al (2021)where gender is not significantly associated with gastritis symptoms(12)(13). Men and women have different eating patterns. A woman is more concerned and concerned about her weight and appearance, so women try to lose weight by regulating the frequency, amount and type of food consumption as much as possible so as not to become fat (14).
Based on the study’s result, there was no significant relationship between gender and gastritis symptoms, and the researchers assumed that male and female students of the Faculty of Public Health had the same diet. The women tend to like spicy and sour food. In contrast, men tend to consume
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caffeine often, so there is no significant relationship between gender and gastritis symptoms in the Faculty of Public Health students.
Eating frequency is a picture of how many times you eat in a day including breakfast, lunch, dinner, and snacks (15). A rapid survey of 210 FKM UMJ students showed that there were 93 respondents had a poor eating frequency, meaning less than recommended. When tested further, among respondents with poor eating frequency, 56 (60.2%) respondents who routinely experienced gastritis symptoms. The correlation test also showed that the frequency of eating was statistically associated with gastritis symptoms (p-value = 0.009); someone who had a poor eating frequency had a 68% chance of developing gastritis symptoms on a regularly basis.
This study’s results align with research Sari (2021) and Setyaningsih (2021) that the frequency of eating affects the incidence of gastritis(16)(17). Students majoring in health tend to have a diet that is less than recommended; this can be due to physiological, psychological, cultural, and social factors(18). Irregular eating frequency makes it difficult for the stomach to adapt, so stomach acid increases Increased stomach acid will irritate the gastric mucosal wall, causing gastritis(14).
Based on the results of this study, the researchers assumed that the frequency of eating of FKM UMJ students was related to the appearance of gastritis symptoms. This is caused by the frequency of eating students who are not good enough to increase stomach acid so that students often feel the gastritis symptoms.
Meal time is related to the eating schedule according to the empty time of the stomach with an average of 3-4 hours, so a good meal time is in the morning (before 09.00), noon (12.00-13.00), and evening (before 19.00)(19). The results showed that there 41.9% of respondents with still had poor meal times. When asked about the distance to eat, many respondents still have a very long mealtime lag of up to 8-9 hours and skip breakfast, however, in this study, when a more in-depth analysis of the relationship between mealtime and the incidence of gastritis showed that the incidence of gastritis was not influenced by mealtime.
This is in line with research conducted by Sari (2021) where the pause to eat or mealtime affects the incidence of gastritis(16). However, this is not in line with other studies by Li, et al (2020) where mealtimes or meal breaks were statistically associated with the incidence of gastritis because eating at irregular mealtimes was a key factor mainly associated with abdominal pain and nausea (20).
Breakfast time is also necessary because when the body wakes up after sleeping for 8 to 9 hours, it experiences a decrease in glucose levels, so if the stomach is not filled with food, it will cause weakness all day. Students who are on a diet are still recommended to have breakfast because breakfast food will become energy for daily activities, so they will burn again (21).
Based on the results above, the researcher assumed that mealtime was not statistically related to gastritis symptoms. This is caused by the habit of students who already often skip meals long enough
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to make the stomach accustomed to empty. Many students are also used to skipping breakfast so that often gastritis symptoms do not appear in students with poor meal times.
The types of irritating foods in this study were coffee, tea, soft drinks, acidic foods and spicy foods. As much as 64.8% of respondents often consume irritating foods. After statistical tests were carried out in this study, it was found that irritating foods affect the incidence of gastritis. Someone who consumes irritating foods has an 82% chance of developing gastritis symptoms.
This stud’s results align with research conducted by Handayani and Thomy (2018), where the incidence of gastritis is influenced by irritating foods consumed by respondents(22). Spicy foods hurt the stomach, acidic and gaseous foods such as soft drinks stimulate the increase in stomach acid so that it produces excess gas that makes the stomach feel bloated, and also the caffeine contained in coffee and tea affects the central nervous system to increase the production of stomach acid(23).
Based on the study’s result above, the researchers assumed that there was a relationship between the frequency of irritating eating and the symptoms of gastritis. This is because FKM UMJ students mostly consume irritating foods that trigger an increase in gastric acid production, so students who regularly consume irritating foods often experience symptoms of gastritis.
Stress is a person's physical and emotional reaction (mentally/psychically) when a change in the environment requires a person to adapt (24). research on stress levels in students is often carried out, which is no exception. In this study, even 83.4% of student respondents experienced stress. When testing the relationship to the incidence of gastritis, it found that statistically, both are related to each other. Students who experience stress are 5.5 times more likely to get gastritis.
This is in line with research conducted by Nisa (2018) where stress affects the incidence of gastritis in health students at a private Islamic university(25). The nervous system of the brain is directly related to the stomach, and when a student experiences stress, this causes a hormone that triggers the release of excess stomach acid so that if it lasts a long time, it will cause gastritis symptoms to appear (26).
Gastritis due to stress is a decrease in mucosal resistance from toxic radicals. The body's stress response causes a reduction in gastric renewal, which leads to the atrophy of the gastric mucosa. Blood flow to the stomach is reduced and makes the stomach more susceptible to acid-pepsin ulceration and hyperacid secretion. In stressful situations, there is an excess of acid in the system, and the protective layer of mucus in the lining is damaged, which makes it more susceptible to damage(27).
Based on the results of this study, the researchers assumed a significant relationship between the incidence of stress and gastritis symptoms of FKM UMJ students. Like students in general, FKM UMJ students feel stress or pressure due to problems both academically on campus and in the campus environment. This triggers the body's physiology in times of stress to increase the production of stomach acid. So, often stressed students experience symptoms of gastritis.
388 CONCLUSIONS AND SUGGESTIONS
Based on the research results above, it can conclude that the factors related to the symptoms of gastritis include the frequency of eating, the type of food, and stress in students. Meanwhile, the variables of gender and meal times did not significantly affect the occurrence of gastritis.
Some suggestions that can recommend for students include:
1) Paying attention to the frequency of eating and the type of food consumed, make it a habit to eat at least three times a day and interspersed with snacks until the main meal.
2) Reduce consumption of foods that can irritate the stomach, such as coffee, tea, soft drinks, acidic foods, and spicy foods that can trigger an increase in stomach acid.
3) Strengthening faith by increasing religious activities so the heart is calm and avoids stress.
4) Exercise regularly, and have time for rest and self-care, and meditation.
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