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MANAGEMEN GIZI

PADA GEH
ANDI FARADILAH
SKDI 2012 ( 3 - 4)

Esofagitis
Peritonitis
Refluks esofagus
Gastritis
Gastroenteritis
Refluks gastroesofagus
Ulkus (gaster dan duodenum)
Demam tifoid
Perdarahan GI
Malabsorpsi
Intoleransi Makanan
Alergi Makanan (HEMA IMUN)
Hepatitis
Kolesistitis
Divertikulosis
Kolitis
IBS

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PENYAKIT GEH
Esofagitis
Refluks esofagus
Gastritis
Gastroenteritis SALURAN CERNA ATAS

Refluks gastroesofagus
Ulkus (gaster dan duodenum)
Demam tifoid
Divertikulosis SALURAN CERNA BAWAH

Kolitis
Peritonitis
Perdarahan GI
Malabsorpsi HEPAR , BILLER

IBS
Hepatitis
Kolesistitis
TUJUAN PEMBELAJARAN

• Dapat menjelaskan mekanisme malnutrisi dan penyakit GEH

• Dapat menjelaskan manajemen gizi pada penyakit GEH


DIGESTIVE SYSTEM
DONEC QUIS NUNC

1. Ingestion
2. Peristaltik
3. Mechanical
4. Enzymatic
5. Absorption
6. Elimination
NUTRIENT ABSORPTION
DONEC QUIS NUNC
KAITAN MALNUTRISI DAN PENYAKIT GEH !
KAITAN MALNUTRISI DAN PENYAKIT GEH !

Jeejeebhoy KN, Duerksen DR, Malnutrition in Gastrointestinal DIsorders:


Detection and Nutritional Assessment, Gastroenterol Clin North AM, 2018
PENYAKIT SALURAN CERNA BAGIAN ATAS

Ex .
Esofagitis refluks
Refluks esofagus
Gastritis
GERD
Gastroesophageal Reflux Disease (GERD) 

• is defined as symptoms or complications resulting from the reflux of gastric con- tents into the
esophagus or beyond, and even into the oral cavity (including larynx) or lung

• Symptoms : heartburn, dysphagia

• Management :

• Do not lying down after eating

• Small feeding

• Frequent feeding

• Avoid exacerbated foods, dietary fat, alcohol

• Avoid tight uniform

• Reduce abdominal fatness


GASTRITIS/ PEPTIC ULCER

• Etiology : h.pylory, NSAIDs, stress, lifestyle

• Lihat manajemen GERD

• Diet Lambung (I- IV)

Tujuan :
Meringankan beban kerja saluran pencernaan
Membantu menetralisir kelebihan asam lambung dan memberikan makanan dengan zat gizi
adekuat dan tidak merangsang
Syarat :
Makanan dalam bentuk lunak dan mudah dicerna
Porsi kecil dan diberikan sering
Cara pengolahan makanan direbus, kukus, panggang dan tumis
Hindari makanan tidak merangsang lambung seperti asam, pedas
PENYAKIT SALURAN CERNA BAWAH

Ex.
Gastroenteritis
Divertikulosis
Kolitis
Konstipasi
KONSTIPASI/ DIVERTIKULOSIS

• Defined as hard stools, straining with defecation,


infrequent bowel movements
• Normal frequency ranges from one stool q 3 days to 3
times a day
• Etiology :
• Poor diet
• Medication
• Neurological diseases
• Lifestyle
CAUSES OF CONSTIPATION

•Side effect of medication, esp narcotics


•Metabolic Endocrine abnormalities, such as
hypothyroidism, uremia and hypercalcemia
•Lack of exercise
•Ignoring the urge to defecate
•Vascular disease of the large bowel
•Systemic neuromuscular disease leading to deficiency of
voluntary muscles
•Poor diet, low in fiber
•Pregnancy
CAUSES OF CONSTIPATION
DONEC QUIS NUNC

• Diseases of the upper gastrointestinal tract


• Celiac Disease
• Duodenal ulcer
• Diseases of the large bowel resulting in:
• Failure of propulsion along the colon
(colonic inertia)
• Failure of passage though anorectal structures (outlet obstruction)
• Irritable bowel syndrome
• Anal fissures or hemorrhoids
• Laxative abuse
MANAGEMENT OF CONSTIPATION

• Bowel training

• Increase mobility

• High fiber 25 gram/d : insoluble

• Fluid intake
DONEC QUIS NUNC
GASTROENTERITIS

• Diare
• Inflammatory disease
• Infections with fungal, bacterial, or viral agents
• Medications (antibiotics, elixirs)
• Overconsumption of sugars
• Insufficient or damaged mucosal absorptive surface
• Malnutrition
MANAGEMENT OF DIARRHEA

• Identify and treat the underlying problem


• Manage fluid and electrolyte replacement using oral glucose electrolyte
solutions (see WHO guidelines)
• Initiate minimum-residue diet
• Avoid large amounts of sugars and sugar alcohols
• Prebiotics in modest amounts including pectin, oligosaccharides, inulin,
oats, banana flakes
• Probiotics, cultured foods and supplements that are sources of beneficial
gut flora

• Diet rendah residu/serat


• Jenis makanan
• Konsistensi makanan
IRRITABLE BOWEL SYNDROME

Criteria consists of recurrent abdominal pain or discomfort for at 
least 3 days per month in the last 3 months with onset at least 6 
months before diagnosis and with 2 or more of the following:

1. Pain improvement with defecation 

2. Change in stool frequency at onset
ROME CRITERIA

3. Change in stool form or appearance at onset 
III
IRRITABLE BOWEL DISEASE
IRRITABLE BOWEL DISEASE

• Berdasarkan gejala yang ada


• Nyeri perut
• Konstipasi
• Diare
IRRITABLE BOWEL SYNDROME
PENYAKIT HATI

• Hati :

• fungsi metabolik KH, protein, lemak

• Tempat cadangan

• Pembentukan empedu

• MALNUTRISI

• Hepatitis/sirosis hepatic :

• Ikterus

• Anoreksia

• Fullness of stomach
PROGRESS PENYAKIT HATI
TERAPI GIZI MEDIK PADA HEPATITIS

• 35 - 40 kkal/hari

• Lemak utamakan medium chain trigliserida

• Porsi kecil —> hipoglikemia


PENYAKIT KANDUNG EMPEDU

• Fungsi : metabolisme dan digesti lemak

• Kolelitiasis

• Kolesistitis


TERAPI GIZI MEDIK PENYAKIT KANDUNG EMPEDU

• Rendah lemak —> cegah kontraksi (kondisi akut)

• Obesitas —> diet rendah kalori


DEMAM TIFOID

• Tifoid —> perforasi gaster

• Edukasi ?

• Fase akut

• Post acute phase

• Komplikasi perforasi gaster


TAKE HOME MESSAGES

• Konsekuensi malnutrisi pada penyakit saluran cerna

• Penanganan level primer : edukasi adalah kunci penting

• Ingat management fase akut dan post akut


DONEC QUIS NUNC

Reflux Esophagitis
GERD
Nausea/vomiting
Dispepsia
Gastritis
Peptic ulcer
Dumping syndrome
Constipation
Diarrhea
Coeliac Disease
Diverticular disease
Irritable Bowel Syndrome
Inflammatory Bowel Disease
Ulcerative colitis
Crohn’s disease
Liver disease
Bladder disease
Pancreas disease
TERIMA KASIH