TEACHING UNIT ACTIVITIES

Improving Diet to Avoid Gastritis Disease

Submitted to fulfill the task of Health Education and Promotion courses

Compiled By :
Tjong Veren Veronica
220110170183
 NURSING FACULTY
PADJADJARAN UNIVERSITY
2018
 TEACHING UNIT PROGRAM
Topic : Improving Diet To Avoid Gastritis Disease

Subtopic : Improving Diet Using “panlasnam (delapan, duabelas, enam)” technic as a

form of prevention of gastritis.

Target/Audience: 3rd Semester Students of Nursing faculty in Padjadjaran University

Garut Region.

Date : Monday. November 5th 2018

Time : 1 x 60 minutes

8 PM - 9 PM

Venue : Padjadjaran University Garut Region’s hall

Interviewees: Tjong Veren Veronica

1. Audience characteristics/Learners

3rd Semester Students of Nursing faculty in Padjadjaran University Garut region with
the percentage of 75% female students and 25% male students. Most students do not
stay at home with parents, but in dormitories, boarding houses, rented houses etc. The
third semester students have lectures that are quite dense. In addition, students often
consume spicy and seasoned snacks.

2. Learning Objectives

After taking part in health education and promotion programs about improving
irregular eating patterns, students are expected to be able to change their behavior
from irrelugar eating to regular eating patterns accompanied by adequate nutrition for
the body. Students can adopt this behavior as a healthy habit.

3. Achievement of Learning
After attending health education and promotion on the topic of improving irregular
eating patterns, students are expected to be able to:

1. Students are able to explain the meaning of a well-organized diet within a 5-minute
evaluation session.

2. Students are able to correctly reiterate the schedule, frequency, and portion of
meals correctly within 5 minutes of the evaluation session.

3. Students are able to explain the reason for regular eating patterns correctly within 5
minutes of the evaluation session.

4. Students are able to correctly mention at least 3 nutritious food guidelines correctly
within 5 minutes of the evaluation session.

5. Students are able to correctly recite at least 5 samples of nutritious food within 5
minutes of the evaluation session.

6. Students are able to mention a minimum return of 3 due to an irregular diet

correctly within 5 minutes of the evaluation session.

7. Students are able to recite at least 3 tips so that they can continue to run a regular
diet correctly within 5 minutes of the evaluation session.

8. Students are able to practice again how to properly process food in a healthy
10-minute demonstration session.

9. Students can change the behavior of irregular eating habits to become regular with
the right technique after 60 minutes of counseling sessions.

4. Discussion Points

Improving Diet to Avoid Gastritis Disease.

5. Sub-topic of discussion

1. Definition of healthy and regular eating patterns

2. Schedule, frequency, and proper portion of food (“Panlasnam” technique)

3. The reason for the importance of regular eating patterns is important

4. Guidelines for nutritious food

5. Various nutritious foods

6. The impact of irregular eating patterns

7. Anticipation tips if students have a lot of schedules and assignments.

6.Teaching Material

(attached)

7. Learning strategies

Method :

- Lecture (Power Point)

- Discussion (Buzz Group)

- Demonstration

Media Usage :

- Infocus / projector

- Video

- Demonstration tool

7. Setting Place

The place I want to apply is the U-shaped seat model. The goal is students can see
videos, power points, demonstrations clearly so that they are expected to be able to
apply them in daily life. This position is also very good in the process of discussion
 between students and interviewees as well as between students and students because it
can attract all student attention in the future.

8.Teaching and Learning Activities

Stage Educator Activities Student Activities Methods Media Time

Allocation

Preparation A. Prepare the hall room A. Registration - - 5 minutes

(Pre-Activity) (place setting) (fill in attendance
list)
B. Prepare the media
B. Enter the room

Opening A. Greetings and introduce Answer, listen and - - 5 minutes

Activities yourself pay attention.

B. Explain the intent and

purpose

C. Do time contracts

D. Mention any material

that will be delivered

Material Explain the definition of Listen,pay A.Presentation -Projector 45 minutes

Description a healthy and regular diet. attention,submit
B.Demonstrati -Laptop
and answer
B. Explain the reasons on (healthy
questions. -Power point
why healthy and regular food and
eating patterns are drinks) -Food and

important. healthy
C. Discussion
drinks
C. Explain the right eating
D. (Questions (demonstratio
schedule
and Answers) n ingredients)
D. Describe the
 appropriate meal portions

E. Describe various kinds

of healthy foods and
drinks

F. Demonstrate how to
make healthy food

G. Explain the result of an

unhealthy and irregular
diet.

H. Explain tips on
maintaining a regular diet.

I. Give students the

opportunity to ask
questions.

J. Evaluate student
understanding by giving
questions related to
material.

Closing B. Thank you for the A. Listen A. - - 5 minutes

willingness of the
B.Reply to B. -
participants
greetings
B. Say hello

Total 60 Minutes

9. Bibliography
Diatsa, B., Muhlisin, A., KM, S., & Yulian, V. (2016). Hubungan Pola Makan Dengan Kejadian
Gastritis Pada Remaja di Pondok AL-Hikmah, Trayon, Karanggede, Boyolali (Doctoral
dissertation, Universitas Muhammadiyah Surakarta).

Hartati, S., & Cahyaningsih, E. (2016). Hubungan Perilaku Makan dengan Kejadian
Gastritis pada Mahasiswa Akper Manggala Husada Jakarta Tahun 2013. Jurnal
Keperawatan, 6(1).

Shalahuddin, I. (2018). HUBUNGAN POLA MAKAN DENGAN GASTRITIS PADA REMAJA DI

SEKOLAH MENENGAH KEJURUAN YBKP3 GARUT. Jurnal Kesehatan Bakti Tunas Husada:
Jurnal Ilmu-ilmu Keperawatan, Analis Kesehatan dan Farmasi, 18(1), 33-44.

10.Evaluation

1. Process Evaluation

Evaluation during the learning process takes place.

- How many students are there?

- Are students enthusiastic about counseling material?

- Are activities running orderly?

- Are students active on asking questions?

2. Evaluating Results

An evaluation conducted at the end of a health education session.

 Can students explain the definition of regular eating patterns correctly?

 Can students mention the schedule (“Panlasnam” technique), the right portion and
frequency of eating correctly?

 Can students explain the reason why a regular diet is important right?

 Can students mention at least 3 nutritious food guidelines correctly?

 Can students mention at least 5 examples of nutritious food correctly?

 Can students mention at least 3 examples of the eating patterns not being properly
mixed?

 Can students mention at least 3 tips so that they can continue to run a regular diet
correctly?

 Are students able to practice again how to properly process food properly?

Background

Many schedules and coursework are inherent and inseparable from students. The
density of student activities, both academic and non-academic activities (UKM and
Organization), make students sometimes forget to take care of themselves. Students
tend to not be concerned with their own needs such as personal hygene and the main
thing is eating. Many of the students do not care about the eating schedule and good
food intake for their bodies. For them, what is important about food is cheap prices
and the food can be quickly served like instant food. Schedule of irregular eating turns
out without realizing it can cause some diseases / digestive problems, one of which is
gastritis / ulcer.

According to the Health Journal of Bakti Tunas Husada, entitled "The

relationship of eating patterns with gastritis in adolescents in vocational schools
Garut" states that the dietary pattern of the first semester X class YBKP3 Garut
students is 70.7%, gastritis is 65.7 %. And there is a significant relationship between
the diet of students with gastritis with p-value = 0.004. This proves that there is a very
strong correlation between a person's diet and the possibility of gastritis. This
certainly needs the attention of students, that it turns out that irregular eating habits
that might seem trivial, can cause a disease and if left unchecked can cause dangerous
complications. Not only diet, what kind of food consumed by students also needs
attention. Students should not overeat foods that are too acidic and spicy because they
can irritate the stomach. Based on research from the Gastroenterology division of the
Department of Internal Medicine FKUI, it was found that patients who experienced
indigestion in Indonesia during 2009 were 86.41% caused by gastritis, 12.59% had
ulcers, and 1% were caused by gastric cancer (Fahrizal, 2009) . the rate of gastritis
that occurs in Indonesia is quite high when compared to other digestive diseases. This
means that almost all ages and sexes can experience this disease. Therefore it is
necessary to improve diet and nutritional intake, especially for students because what
we know is that students often do not live with their parents (migrate) so there is no
role for parents to provide and control their children's food. This is where the role of
nurses is needed in the field of education and health promotion as providers of support
/ support to students. Through this health education program students are expected to
be able to change the behavior of those who previously had irregular eating habits but
after the program, can have a good and regular diet and healthy food intake.

Learning Strategies

DEFINITION OF HEALTHY AND REGULAR EATING PATTERNS

Dietary habit

Diet is often interpreted as a person's eating habits every day. According to

Baliwati (2004), diet is a composition of the type and amount of food consumed by a
person or group of people at a certain time. The formation of a person's diet is based
on certain factors in the surrounding environment. Expert opinion states that diet is a
way taken by a person or group of people to choose food and consume it as a reaction
to physiological, psychological, cultural and social influences (Harper, 1986). Diet is
also a variety of information that gives an idea of the type and amount of food
consumed by each person and is a characteristic of a particular community group
(Ranti and Soegeng, 2004). Based on the above explanation, it can be concluded that
diet is a way or habit carried out by a person or group in terms of eating food carried
out repeatedly at certain times over a long period of time and is a reaction to
physiological, psychological, cultural and social influences in surrounding
environment.

Healthy diet

It is a way or effort in regulating the number and type of food with certain
intentions such as maintaining health, nutritional status, preventing or helping to cure
illness. On a daily diet, a person must maintain and relate to his daily habits.

Explanation of the components of the diet are explained as follows:

1. Food Supply

Food intake is the amount of food consumed by individuals in a day. Assessment of

food intake is usually seen through the amount of nutrients consumed. Nutrients that
enter consist of macronutrients namely carbohydrates, proteins and fats and
micronutrients which consist of vitamins and minerals.

2. Types of food

In nature there are various types of food both vegetable and animal foods. Among the
various types of food, there are those that are rich in one type of nutrient and some
that lack certain nutrients. Therefore humans need various kinds of food to ensure that
all the nutrients that the body needs can be fulfilled in sufficient quantities. The type
of food we consume must contain carbohydrates, protein, fat and specific nutrients.
Food is divided into two types, namely food and main foods. Intermediate food is
food consumed on the sidelines of the main meal. The main food consists of staple
foods, animal and vegetable side dishes, vegetables, fruit and drinks.
Further explanation of the two types of food is explained below:

1) Main Food The main food is food consumed by someone in the form of breakfast,
lunch, and dinner which consists of staple foods, such as rice, side dishes, vegetables,
fruit, and drinks. The staple food is food that is considered to play an important role in
the arrangement of dishes. In general, food serves as a source of energy (calories) in
the body and gives a sense of satiety. (Soediaoetama, 2004).

2) Intermediate Food Intermediate food is a snack made alone or sold in front of the
house or in a shop or supermarket. Intermediate food according to its form consists of:
a. Dry food such as banana chips, cassava chips, egg beans, pop corn and so on. b.
Wet-shaped interlude foods such as lemper, semar, mendem, tofu contents, pastels,
fried bananas and so on. c. Sauce-shaped interlude food such as meatballs, chicken
noodles, “empek-empek”, rice noodles and so on.

3. Frequency of eating

is the amount of time to eat in a day includes full food (full meat) and eating (snacks).
University of North Sumatra's 12 full meals are usually given three times a day
(breakfast, lunch and dinner), while the usual snack is between breakfast and lunch
and between lunch and dinner. The frequency of eating that can trigger the emergence
of an ulcer is the frequency of eating less than the recommended frequency, namely
eating three times a day. Naturally, food is processed in the body through digestive
organs starting from the mouth to the small intestine. Duration of food in the stomach
depends on the nature and type of food. If on average, the stomach is empty between
3-4 hours. Then this meal schedule must adjust to the empty stomach.

4. Eating Schedules

On a daily diet, the habit of eating schedules is often irregular, such as being late for
eating, delaying eating time and not even eating, causing the stomach to experience
emptiness for a long time. Schedule of irregular eating will certainly attack the
stomach and risk causing gastritis. The frequency of meals in a day consists of three
main meals, namely breakfast, lunch, and dinner. The daily meal schedule is divided
into breakfast (before 9 am), lunch (12 am- 1 pm), and dinner (6 pm -7 pm). This
eating schedule is adjusted to the time of emptying the stomach which is 3-4 hours so
that a good meal time is in this time span so that the stomach is not left empty
especially for a long time (Oktavani, 2011). Based on this schedule, in implementing
this program I want to apply the panlasnam technique, which stands for eight, twelve
and six. This means breakfast is served at 8 am, lunch at 12 noon and dinner at 6 pm. I
created this technique / abbreviation so that students are easier to catch the right time /
schedule of meals every day so that they are expected to be able to change student
eating habits that are not regularly organized.

5. Eating Portions

Amount or portion is a measure or measure of food consumed at each meal. The

amount (portion) of food according to food recommendations for adolescents
according to Hudha (2006). Standard number (portion) for adolescents 6 includes:
staple food in the form of rice, fresh bread and instant noodles. The amount or portion
of staple food includes: 100 grams of rice, 50 grams of fresh bread, instant noodles for
a large size of 100 grams and a small size of 60 grams. Side dishes have two classes
of vegetable and animal side dishes, the amount or portion of food includes: 50 grams
of meat, 50 grams of eggs, 50 grams of fish, 50 grams of tempe (two pieces), 100
grams of tofu (two pieces). Vegetables are food ingredients derived from plants, the
amount or portion of vegetables from various types of vegetable dishes include: 100
grams of vegetables. Fruit is a dish that is served after the main food functions as a
dessert. The number of servings of fruit size of 100 grams, the size of pieces is 75
grams.

REASONS FOR THE IMPORTANCE OF GOOD AND ORDERLY EATING

If a person's diet is irregular, for example longer than the schedule that should be done,
then it means that the stomach is left empty for a long time. Empty stomach causes
increased acid levels so that it can irritate the stomach and cause various complaints
of gastric symptoms / gastritis. In addition, the type of food consumed should be
foods that do not cause excessive stomach acid expenditure and eating schedules must
be regular, it is better to eat small amounts but often and regularly rather than eating
in large portions but irregular (Almatsier, 2010). Dinner schedules also should not be
too close to bedtime. Cristina-Maria Kastorini, MSc, a nutritionist from the University
of Ioannina in Greece, said that if a person goes to bed immediately after dinner, the
person is susceptible to gastric acid reflux. This condition causes stomach acid to rise
into the esophagus and trigger discomfort.

NUTRITIOUS FOOD GUIDELINES

The general guidelines for a healthy diet for the people that are often used are the Five
Perfect Healthy Four guidelines, Triguna Foods, and the most recently introduced
guidelines are 13 Basic Balanced Nutrition Messages. The definition of triguna food
is that daily food or diet must contain:

1) carbohydrates and fats as energy substances;

2) protein as a builder substance;

3) vitamins and minerals as regulatory substances (Dirjen Binkesmas Depkes RI

(1997)) Guideline 13 Basic Message of Balanced Nutrition delivers messages to
prevent multiple nutritional problems and achieve balanced nutrition to produce a
reliable quality of human resources. The outline of the messages as explained by the
Director General of Community Health of the Ministry of Health of the Republic of
Indonesia (1997) includes:

4. Eat a variety of foods. Diverse foods must contain carbohydrates, fats, proteins,
vitamins, minerals, and even dietary fiber in balanced amounts and proportions
according to the needs of each group (infants, toddlers, children, adolescents,
pregnant and lactating mothers, adults and the elderly )

5. Eat food to meet energy needs. Energy can be obtained from food sources of
carbohydrates, fats and proteins. Energy is needed for basic metabolism (such as to
produce body heat and work the organs of the body) and for daily activities such as
learning, working and exercising. Excess energy will result in obesity, while lack of
energy can cause malnutrition such as marasmus.

6. Eat carbohydrate sources half of your energy needs. Simple carbohydrates, such as
sugar and sugary foods, should be consumed with due regard to the principle of
timely, exact indication and exact amount. This food should be eaten during the day
when we will or are doing activities and the amount does not exceed 3-4 tablespoons
of sugar / day. Complex carbohydrates should be consumed with foods that are a
source of other nutritional elements such as protein, fat / oil, vitamins and minerals.
50-60% of energy needs should be obtained from complex carbohydrates.

7. Limit consumption of fat and oil to a quarter of energy sufficiency. Consumption of

excessive fat and oil, especially saturated fats / oils from animals, can be at risk of
obesity or dyslipidemia in people who have 18 tendencies in that direction.
Dyslipidemia or increased levels of fat (cholesterol or triglycerides) in the blood is a
factor for the occurrence of coronary heart disease and stroke. The consumption of fat
/ oil is recommended not to exceed 20% of the total calories and keep in mind that
this nutrient element also has its own role as a source of essential fatty acids and also
helps the absorption of some fat-soluble vitamins.

8. Use iodized salt. The use of iodized salt can prevent Iodine Deficiency Disorders
(IDD). However, excessive use of salt is also not recommended because salt contains
sodium which can increase blood pressure. Salt consumption should not exceed 6
grams or 1 teaspoon per day.

9. Eat food sources of iron. Foods such as green vegetables, nuts, liver, eggs and meat
contain a lot of iron and need to be consumed in sufficient quantities to prevent
nutritional anemia.
10. Eat breakfast. Breakfast with a variety of foods will meet the nutritional needs to
maintain the freshness of the body and increase productivity in work. In students,
breakfast will facilitate the concentration of learning so that learning achievements
can be improved.

11. The amount of clean, safe and sufficient amount of water. Drinking water must be
clean and free of germs. Drink up to 2 liters of clean water per day so that your body's
metabolism can run smoothly because water is needed as a nutrient solvent for
metabolic purposes. adequate water consumption can avoid dehydration and will
reduce the risk of infection and kidney stones.

12. Perform physical activity or regular exercise. The activity will help maintain
normal weight while increasing the body's freshness, improving blood flow and
preventing osteoporosis, especially in the elderly.

13. Avoid drinking alcoholic beverages. Alcohol together with cigarettes and other
illegal drugs must be avoided because it can carry risks for various degenerative,
vascular and cancer diseases.

14. Eat foods that are safe for health. Foods that are not polluted, do not contain
germs or other parasites, do not contain harmful chemicals and foods that are
processed well so that the nutrients and taste are not damaged, is a food that is safe for
health.

15. Read labels on packaged foods. Labels on packaged foods must contain
expiration dates, nutrient content and active ingredients used. Consumers who are
careful and pay attention to these labels will avoid damaged, non-nutritious and
dangerous foods. In addition, consumers can judge whether or not the food is halal
(Dirjen Binkesmas Depkes RI, 1997)
A. EXAMPLES OF NUTRITIOUS FOOD

1. Carbohydrates

One or several chemical compounds including sugar, starch, and fiber containing C, H
and O atoms with the chemical formula Cn (H2O) n. Carbohydrates are the main
energy source for the human body, if 80% of them are derived from carbohydrates.

Plants, such as rice, corn, potatoes, wheat and cassava.

2. Protein

Chemical compounds that contain amino acids, arranged or atoms C, H, O and N.

Proteins come from the word proteos which means occupying the first place.

Proteins are distinguished from vegetable protein (plants), for example legumes, tofu,
tempeh, soybeans and wheat, animal protein such as meat, eggs, milk, cheese, fish
and others.

3. Fat

Salt that occurs from the union of fatty acids with organic alcohols called glycerol or
glycerin. contained in side dishes (fatty meat) and oil (cooking oil).

4. Vitamin

Organic compounds needed by the body in small amounts to regulate specific body
functions such as: normal growth, maintaining health and reproduction. Vitamins
cannot be produced by the body, so they must be obtained from consuming food
ingredients. It is found in fruits, vegetables and nuts.

5. Minerals

Organic substances are needed by the body in small amounts to help the body's
functional reactions, for example to maintain metabolic order.

There are many side dishes or vegetables, such as Fe (iron) found in spinach, kale,
and katuk, eggs and other green vegetables.

6. Water
is the largest component of the structure of the human body approximately 60-70% of
adult body weight in the form of water, so that water is needed by the body, especially
for those who do sports or strenuous activities. Dietary fiber including complex
carbohydrates that cannot be digested, plays a role in maintaining the normal function
of the digestive tract.

A. THE DUE TO EAT PATTERN IS NOT REGULATED

1. Gastritis Disease

Gastritis comes from the word gaster which means stomach and itching which
means inflammation / inflammation. Gastritis is inflammation of the gastric wall,
especially in the gastric mucous layer (Hadi, 1999). Inflammation of the stomach is
caused by excessive production of stomach acid. According to Ardiansyah (2012),
Gastritis is an inflammation of the gastric mucosa that is acute, chronic, diffuse or
local, with characteristics of anorexia, feeling full in the stomach (middle), discomfort
in the epigastrium, nausea, and vomiting. Gastritis or commonly known as "stomach
ulcer" is an inflammation of the gastric mucosa that is most often caused by dietary
irregularities, such as eating too much 18 due to improper dietary patterns. While
chronic gastritis is prolonged gastric mucosal inflammation caused by benign or
malignant ulcers of the stomach and Helicobacter Pylori bacteria (Brunner and
Suddart, 2002). Based on the definitions of various experts above, it can be concluded
that gastritis is an inflammation or bleeding in the gastric mucosa caused by irritation,
infection, and irregularities in diet. Irregularities in eating patterns such as improper
eating schedules, inappropriate food intake, and eating foods that trigger an increase
in stomach acid such as too much seasoning, gas, coconut milk and spicy.

Gastritis Classification

Broadly speaking, gastritis can be divided into several types based on clinical
manifestations, typical histopathological features, anatomical distribution, and
possible pathogenesis of gastritis. Based on clinical manifestations, gastritis can be
divided into acute and chronic. It must be remembered that even though the division
is acute and chronic, the two are not interconnected. Acute gastritis is a clinical
disorder that is clearly the cause with typical symptoms, usually found in acute
inflammatory cells and neutrophils. While chronic gastritis is an inflammation of the
chronic gastric mucous surface caused by ulcers and associated with the bacterium
Helicobacter Pylori (Mansjoer, 2001).

a. Acute arthritis

Acute gastritis is a disease that is often found and is usually benign and fully cured
(Suratum, 2010). Acute gastritis is inflammation of the gastric mucosa which causes
erosion and bleeding of the gastric mucosa due to exposure to irritant substances.
Erosion that occurs in acute gastritis does not reach the lining of the stomach muscles.
The hardest causes of acute gastritis are strong acidic or alkaline foods that can cause
the mucosa to become gangrene or perforation. Formation of scar tissue can occur due
to obstruction of the pylorus. One form of acute gastritis whose clinical
manifestations can take the form of severe disease is erosive gastritis or hemorrhagic
gastritis. It is called hemorrhagic gastritis because in this disease there will be
bleeding of the gastric mucosa in various degrees and erosion that occurs means the
loss of continuity of the gastric mucosa in several places, accompanied by
inflammation of the gastric mucosa.

b. Chronic arthritis

Chronic gastritis is an chronic inflammation of the gastric mucosa. Chronic gastritis

is often associated with peptic ulcer and gastric carcinoma, but the causal relationship
between the two is unknown. Chronic gastritis affects people who have an incurable
gastritis. Initially already had gastritis and was not cured, then gastritis became
chronic and difficult to cure. Chronic gastritis infiltration of inflammatory cells in the
lamina propria and intra-epithelial region consists mainly of chronic inflammatory
cells namely lymphocytes and plasma cells. Chronic gastritis is defined histologically
as an increase in the number of lymphocytes and plasma cells in the gastric mucosa.
The mild degree of chronic gastritis is chronic superficial gastritis that affects the
sub-epithelial portion around the stomach basin. More severe cases also affect the
deeper mucous glands and this is usually associated with glandular atrophy (chronic
atrophic gastritis) and intestinal metaplasia. Most cases of chronic gastritis are one of
two types, namely type A which is an autoimmune gastritis with antibodies to parietal
cells which can eventually lead to gastric mucosal atrophy, 95% of patients with
pernicious anemia and 60% of patients with chronic atrophic gastritis. Usually this
condition is a tendency to occur Ca Gastric in the fundus or corpus. Type B is a
gastritis that occurs due to Helicobacter Pylory which has inflammation that diffuses
in the mucous layer to the muscularis so that it often causes bleeding and erosion
(Suratum, 2010). According to Misnadiarly (2009) gastritis is classified into several
forms, namely:

a) Gastropathic gastritis with common complaints of heartburn, nausea, vomiting and

diarrhea. The causes of drugs such as aspirin, alcohol, trauma to the stomach such as
laser treatment, abnormal blood vessels in the stomach and injuries due to surgery.

b) Specific gastritis, namely pain in the pit of the stomach, nausea and vomiting. The
cause is due to bacterial infections, viruses, fungi, parasites, nematodes and the
presence of diseases of the digestive tract. When caused by toxins usually
accompanied by diarrhea, abdominal pain, the body becomes hot, shivering, and
muscle spasms.

c) Chronic gastritis. Complaints in chronic gastritis are generally not specific in the
form of an unpleasant feeling in the pit of the stomach accompanied by nausea,
vomiting and feeling full of heart. The causes include: C.Pylori infection, reactive
gastropathy, autoimmune, presence of tumors in the stomach and stress factors.

Gastritis Symptoms

Gastritis or often called ulcer is quite commonly known by the public. However,
many of the people have not fully understood the symptoms of gastritis. The basic
diagnosis of general gastritis is a history of repeated discomfort in the pit of the
stomach ½ to 1 hour after eating (digestion) and arises especially in the early hours.
The pain will disappear by being fed or antacid, at least temporarily. Nausea and
vomiting often accompany pain in the pit of the stomach.

According to Mansjoer (2001), gastritis is a disease of sores or abrasions in the gastric

mucosa. Someone suffering from gastritis will experience complaints of pain in the
stomach, nausea, vomiting, weakness, bloating, and feeling tight, pain in the pit of the
stomach, no appetite, pale face, rising body temperature, cold sweat, dizziness or
belching and can also occur gastrointestinal bleeding.

Pain in the stomach is something that is often referred to as a general sign of gastritis.
In fact, the symptoms of gastritis / ulcer do not have to be sore, but the discomfort in
the stomach / solar plexus followed by nausea or bloating and frequent belching or
feeling full quickly. Another symptom is the bitter taste that is felt in the mouth. This
bitter taste arises because excessive stomach acid pushes up the esophagus so that
sometimes sour or bitter taste arises in the esophagus and mouth. Here's a deeper
explanation of these symptoms:

a.Burping

Burping / belching is the release of gas from the digestive tract (esophagus and
stomach) to the mouth accompanied by sound and sometimes smell.

b. Bloated

To understand bloating there are two things that must be known: 1) Symptoms /
bloating: is a feeling (subjective) stomach as bigger than normal, so it is a sign or
symptom of discomfort, which is lighter than distention. 2) Sign / distention: is the
result of a physical examination (objective) where it is found that the abdomen is
bigger than normal, can be obtained from observation when using clothes so that the
narrowness and stomach is clearly bigger than usual.

c. Flatus

Flatus is the release of gas in the gastrointestinal tract through the anus originating
from air that is ingested or produced by bacteria. But the occurrence of flatus is more
often caused by the production of bacteria in the gastrointestinal tract or large
intestine in the form of consuming lots of sugar content and polysaccharides.
Examples of sugar are lactose (milk sugar), sorbitol as a low-calorie sweetener, and
fructose sweetener which is usually used in sweets.

According to Misnadiarly (2009), the symptoms of gastritis or stomach ulcers include

discomfort in the digestive tract, especially the upper part, nausea, vomiting, solar
ulcers, stomach feeling full, bloating, belching, full satiety, rumbling stomach and
frequent farting and wounds on the stomach wall. These symptoms can be acute,
recurrent and chronic. It is called chronic if the symptoms last more than one month
continuously. Based on the classification of gastritis namely acute gastritis and
chronic gastritis, the signs and symptoms of gastritis can be divided into:

A. Signs and symptoms of Acute Gastritis

The most common symptoms in patients with gastritis are complaints of pain,
heartburn, abdominal discomfort, nausea, vomiting, bloating, frequent exhaustion, full
satiety, feeling full in the stomach, burning sensation and frequent belching
(Puspadewi, 2012).

B. Signs and Symptoms of Chronic Gastritis

According to Sunday (2014) the signs and symptoms of chronic gastritis are plasma
cell gastritis, pain that persists in the epigastric region, mausea to vomiting, dyspepsia,
anorexia, decreased body weight, and complaints related to anemia.

Causes of Gastritis

Etiology of Gastritis according to Hadi, (2013) Causes of gastritis include:

a) Communication of digitalis chemical drugs (Acetamenophen / Aspirin,

corticosteroid steroids). Acetamenofen and cortico-steroids can cause irritation to the
gastric mucosa.

b) Alcohol consumption can cause damage to the gastric mucosa.

c) Radiation therapy, bile reflux, corrosive substances (vinegar and pepper) can cause
gastric mucosal damage and cause edema and bleeding.

d) Stressed or stressed conditions (burns, chemotherapy, and damage to the central

nervous system) stimulate increased production of gastric acid (gastric acid).

e) Infection by bacteria, such as Helicobacter pylori, Esobericia Coli, Salmonella, and

others.

Gastritis Manifestation according to Smeltzer, (2010).

The manifestations of acute and chronic gastritis are:

a) Anorexia

b) Pain in the epigastrium

c) Nausea and vomiting

d) Gastrointestinal bleeding (Melena Hematemesis)

e) Anemia (further signs)

f) Naucea

Risk factor

Gastritis Risk Factors according to Smeltzer, (2010) Risk factors that often cause
gastritis include:

a) Diet

People who have an irregular diet are susceptible to this disease. When the stomach
has to be filled, but left empty or delayed filling, stomach acid will digest the gastric
mucous layer resulting in pain.

b) Helicobacter Pylori

Helicobacter pylori is a gram negative bacterium, a curved basil and Helicobacter

pylori stem is a bacterium that causes inflammation of the chronic stomach lining
(gastritis) in humans. Helicobacter pylori infection is often known as the main cause
of peptic ulcer and causes of gastritis.

c) Too late to eat

Naturally the stomach will continue to produce stomach acid every time in small
amounts, after 4-6 hours after eating usually the glucose level in the blood has been
absorbed and used a lot so that the body will feel hungry and at that time the amount
of stomach acid is stimulated. If someone is late to eat for 2-3 hours, the stomach acid
produced is more and more excessive so that it can irritate the gastric mucosa and
cause pain around the epigastrium (Sediaoetama, 2010).
d) Spicy Food

Consuming spicy foods in excess will stimulate the digestive system, especially the
stomach and intestine contractions. This will cause a burning sensation and pain in the
pit of the stomach accompanied by nausea and vomiting. These symptoms make the
sufferer less appetite. If the habit of consuming spicy food> l x in 1 week for a
minimum of 6 months is allowed to continue can cause irritation to the stomach called
gastritis (Sediaoetama, 2010).

2. Intestinal Irritation Syndrome

Irritable bowel syndrome or irritable bowel syndrome? This is one of the major risks
of disease that can occur as an effect of irregular eating. Most people do eat
irregularly because they are busy, but others think that skipping or delaying meal time
is a solution to weight loss.

You should stop thinking like that if it really occurred to you that delaying or skipping
meals is an effective diet. In fact, regular eating is actually the most beneficial for the
intestine. If symptoms of irritable bowel syndrome such as cramps in the stomach,
stomach feels full and this happens too often, then also often abdominal pain, diarrhea
or constipation, beware of irritable bowel disease.

3.Gastric ulcer

Gstric ulcer is a condition in which the lining on the stomach wall is eroded. The main
symptom that is usually felt is pain in the abdomen that can spread to the back, navel
and neck. When the stomach has not been filled with anything, the pain will be felt
even more.

For several days the condition of pain that was complained of could recur
continuously, coupled with complaints of nausea, decreased appetite, and heartburn
that became painful. Late eating is the trigger, so immediately improve your meal
time to be more regular as well as immediately go to the doctor to deal with gastric
ulcer appropriately.

4.Diabetes
Blood sugar levels can increase much more easily when you often eat irregularly. The
messy meal hour actually affects the rising glucose levels and increases the potential
for diabetes.

This is caused by insulin resistance when you eat irregularly and this happens in the
long run. In conditions of insulin resistance, insulin is still produced by the pancreas
but the process of absorption of glucose by the cells of the body experiences
resistance so that it triggers glucose to accumulate in the blood and causes diabetes,
aka type 2 diabetes.

5. Food Absorption

The digestive tract can experience interference in the process of absorption of fluids
and nutrients from foods that enter the body. This certainly does not necessarily just
happen, because when the intestine has a problem such as experiencing inflammation,
trauma or infection, it is easy for you to later develop this condition.

Problems with the intestine can be triggered by irregular eating initially, but you leave
it alone without any intention of returning to eating more regularly. If symptoms such
as chronic diarrhea, flatulence, pungent stools and bright colors, anemia, until dry hair
and fall out, go to the doctor immediately to determine if you have food
malabsorption.

6.Gastric Acid

Gastric acid is also known as GERD or stands for Gastroesophageal Reflux Disease.
Frequent late eating or irregular eating in the long run can cause this disease to occur
to you. A common complaint that has the potential as a symptom is a burning
sensation in the chest and a painful heartburn.

In conditions that are far more serious, sufferers can even get dysphagia or have
difficulty swallowing. Usually a change in diet is the best solution given by a doctor,
but if it is serious enough, the symptom relievers should be taken, especially
long-term medications when stomach acid has recurred.

To avoid various ailments due to the terrible irregular eating, it is necessary to have
the willingness and awareness of oneself to change in terms of diet. Get used to eating
3 times a day, and you can ask family members to remind you of certain meals so you
don't forget.

E. KEEP A GOOD EAT PATTERN AND REGULATE TIPS

In order for a diet to be formed properly, here are tips on forming and maintaining a
healthy diet,

1. Don't eat other foods before you eat the main food (morning, afternoon and
evening)

2. Don't start getting used to consuming appetizers or high-calorie (sweet) interludes;

3. Try to consume 4 healthy foods perfectly every day;

4. Familiarize the varied menu, so that you are familiar with various flavors;

5. Looking for role models in applying a regular diet.

6. Getting used to breakfast so as to avoid snacking habits;

7. If you don't have to, don't get used to eating ready-to-eat food because the nutrition
of this food is not balanced (too much fat and calories);