Tesis

Faktor Risiko Terjadinya Penyakit Refluks Gastroesofagus Pada Anak Usia 10—12 Tahun: Studi Kasus Di SDN Kenari Menggunakan Kuesioner Frequency Scale For The Symptomps Of Gastro Esophageal Reflux Diseases = Gastroesophageal Reflux Diseases and Its Risk Factor in children10—12 years: Case Study in SDN Kenari Using Frequency Scale For The Symptomps Of Gastro Esophageal Reflux Diseases

Latar belakang: Penyakit refluks gastroesofagus (PRGE) adalah kejadian refluks
gastroesofagus yang telah disertai gangguan kualitas hidup atau komplikasi.
Angka kejadian PRGE di seluruh dunia sangat beragam dan dipengaruhi oleh
distribusi usia. Penyakit gastrointestinal fungsional melatar belakangi terjadinya
PRGE. Angka kejadian PRGE pada usia 10—12 tahun yang merupakan masa
awal remaja serta hubungan PRGE dengan kejadian gastrointestinal di Indonesia
belum pernah dilaporkan.
Metode: Studi potong lintang yang dilanjutkan dengan studi kasus kontrol
dilakukan terhadap seluruh siswa kelas 4—6 SD, SDN Kenari 1—12, Jakarta
pada bulan Mei—Juli 2014. Penegakkan diagnosis PRGE menggunakan
kuesioner frequency scale for the symptoms of gastroesofageal reflux disorder
(FSSG) dengan melalui translasi kuesioner. Kolik infantil dan gumoh ditegakkan
sesuai kriteria ROME III. Sakit perut berulang ditegakkan sesuai kriteria Apley.
Hasil penelitian: Validasi kuesioner hasil translasi ke bahasa Indonesia
menunjukkan validitas (seluruh pertanyaan memiliki r > 0,3 dengan p < 0,05) dan
reabilitas (Cronbach alpha 0,853 dengan item reability index setiap pertanyaan
> 0,3) yang baik. Angka kejadian PRGE 404 (44,6%) dari 905 orang anak usia
10—12 tahun dengan interval kepercayaan 95% (IK 95%) 41,4% sampai 47,9%.
Odd ratio PRGE pada lelaki dibandingkan perempuan 0,841 (IK 95% 0,646
sampai 1,095; p = 0,198). Kejadian kolik infantil, gumoh, dan sakit perut berulang
berturut-turut 23,3%, 16,9%, dan 3%. Tidak ditemukan hubungan bermakna
antara jenis kelamin (p = 0,299), kelompok usia (p = 0,902), kolik (p = 0,226),
dan sakit perut berulang (p = 0,353) dengan kejadian PRGE. Hasil analisis
multivariat menunjukkan gumoh dan riwayat orang tua dengan PRGE
berhubungan dengan kejadian PRGE pada anak usia 10—12 tahun dengan odd
ratio berturut-turut 2,166 (IK 95% 1,226 sampai 3,827) dan 3,069 (IK 95% 1,233
sampai 7,637).
Simpulan: Angka kejadian PRGE pada anak usia 10—12 tahun di Indonesia
adalah 44,6%. Regurgitasi pada masa bayi dan riwayat PRGE pada orang tua
berhubungan dengan kejadian PRGE pada anak usia 10—12 tahun. Tidak
ditemukan hubungan bermakna antara kolik infantil dan riwayat sakit perut
berulang terhadap kejadian PRGE.


Introduction: Gastroesophageal reflux disease (GERD) is an event of
gastroesophageal reflux followed by certain disruption in quality of life or one of
which cause some complications. Prevalence of GERD varies greatly worldwide
and influenced by age distribution. Functional gastrointestinal disorders are
responsible for GERD. GERD prevalence in children aged 10—12 years old,
which is an early adolescence phase, as well as correlation between GERD and
other gastrointestinal disorder were never been reported in Indonesia.

Method: A cross sectional study followed by a case control study were done to
all elementary students grade 4—6 who studied in SDN Kenari 1—12, from May
to July 2014. Diagnosis of GERD was established using frequency scale for
symptoms of gastroesophageal reflux disorder (FSSG), which was translated into
Indonesian language. Infantile colic and regurgitation were diagnosed according
to ROME III criteria while recurrent abdominal pain according to Apley criteria.

Result: Validation of the translated FSSG questionnaire showed that it was valid
(all question had r > 0.3 with p < 0.05) and reliable (Cronbach alpha 0.853 with
item reliability index on each question > 0.3). Prevalence of GERD was 404
(44.6%) out of 905 children aged 10—12 years old wih confidence interval of
95% (95% CI, 41.4% to 47.9%). Odd ratio (OR) of GERD in males compared to
females was 0.841 (95% CI, 0.646 to 1.095; p = 0.198). Prevalence of infantile
colic, regurgitation, and reccurent abdominal pain were 23.3%, 16.9%, and 3%
respectively. There were no significant correlation in GERD prevalence with sex
(p = 0.299), age group (p = 0.902), infantile colic (p = 0.226), and recurrent
abdominal pain (p = 0.353). Multivariate analysis showed that GERD prevalence
correlated with regurgitation (OR 2.166; 95% CI, 1.226 to 3.827) and parental
history of GERD (OR 3.069; 95% CI, 1.233 to 7.637).

Conclusion: GERD prevalence in children aged 10—12 years old in Indonesia
was 44.6%. Infant regurgitation and parental history of GERD correlated with the
event of GERD in children aged 10—12 years old. There is no significant
correlation between infantile colic and history of reccurent abdominal pain with
GERD prevalence.