Digestive disorders in workers

Human digestive system consists of channels and digestive glands. The digestive tract is a channel through which food is passed. There are many diseases that can attack the digestive tract, either from biological sources such as foods containing viruses or bacteria or other microorganisms, chemical sources such as overdose of drugs, as well as mechanical effects such as temperature and environment.
digestion is very important for humans, because the performance of the digestive system will determine the absorbed nutrients and disposal of waste that is not needed by the body. The digestive system will also form a short chain essential amino acid (SCFA) that is useful in immune processes (immunity).
having a healthy digestion will strengthen the body's immune system that protects the body from various diseases, destroying and eliminating foreign microorganisms (bacteria, parasites, fungi, viruses, tumors) that enter the body. Nevertheless, awareness of digestive health in society today is felt still low. This can be seen from the daily diet of people who can trigger digestive system disorders. Even so on workers, there are still workers who have digestive problems.

According to Levy SB, complaints of digestive disorders often arise in shift workers / night work than in the morning workers / day workers. Existing reports indicate that of 34,047 people working with the shift work system, 2.5-15% suffer from indigestion, which also affects 10-30% of workers who previously worked in rotation before.
A study in Iceland shows that nurses who work 16 hours in the morning shift have more severe gastrointestinal symptoms, possibly due to a considerable lack of rest time between late night shifts and early morning. In the study of Hamid Reza and Ali Reza on nurses in Iran gastrointestinal complaints were obtained with a very high proportion of 81.9% in nurses with shifts work. This proportion is twice as large as reported in previous studies in Korea.
In addition, According to dr. Grace Judio-kahl, MSc, MH, CHt lifestyle care physician, at the clinic where she practices the LightHouse Clinic conducted a survey showing that 31% of patients had indigestion and 73% were working women. The main causes are unbalanced nutrition, irregular eating, and lack of fiber consumption in women in big cities. In addition, less exercise also contributes to this problem.
This is in accordance with the 2007 Basic Health Research Report shows that most of Indonesia's population is still less consumption of fiber from vegetables and fruits, lack of exercise and increase eating foods containing preservatives. This situation of course cause interference in the digestion with complaints that often arise, among others, bloated and can not defecate smoothly or constipation. From various studies it can be said that workers are still vulnerable to exposure to various diseases caused by indigestion.
A. Understanding Digestive Disorders
Digestive disorder is a common term that is often used in case of interference with the stomach or stomach or in other words disturbances in the digestion is the obstruction of digestive function or stomach failure in digesting food (Bangun, 2004).
Digestive disorder is also a condition where slow movement of food in a person's gastrointestinal tract, if the movement of food in the digestive tract becomes slow it will result in damage to the muscles of the stomach and colon. The damage occurs because the stomach and intestines are not able to function normally.
Digestive disorders are one of the most commonly reported health problems associated with rotational work. It is said that 20-30% of shift workers suffer from indigestion. There is much evidence to suggest that shifting work can cause indigestion. Shift workers may suffer from less appetite and other digestive disorders. Some of the causes are too much coffee, lots of fatty foods, rarely eat during the day but eat a lot at night, eat in a hurry, and lack of exercise. The economic and social costs of indigestion are enormous. Symptoms can be very disruptive to everyday life including work and can further cause stress (Desdiani, 2004).

B. Classification of Digestive Disorders
Digestive disorder is a collection of gastrointestinal disorders such as discomfort, heartburn, heartburn, nausea, vomiting, bloating, belching, full quickly, diarrhea, constipation, reduced appetite. In addition there are complaints of abdominal pain, flatus, irritable bowel syndrome, dyspepsia, and peptic ulcer (Desdiani, 2004).
As for all sorts of diseases digestive disorders commonly experienced by workers are:
1. Maag (gastriti()

s) Disorders of digestion, by the community is often referred to as ulcer disease. In general, ulcer disease or stomach function disorder is caused by high levels of acid in the stomach. Under normal circumstances, the mucous layer or mucous membrane protects the stomach wall against the effects of acids and enzymes normally found in gastric juices. If the layer is damaged, acid will damage the wall of the stomach and cause ulcers or wounds (Build, 2004). High levels of gastric acid are caused by excessive acid production. The ulcer disease caused by excessive stomach acid production can be exacerbated by the following conditions: a. Irregular meal times. Type of food that is less suitable or difficult to digest. The amount of food is too much or too littled. Nutrition or poor quality of food. The habit of smoking and drinking alcoholf. Stress and lack of rest. In addition, according to Saydam in Mawaddah Rahmah in 2013 states that Gastritis is an inflammation (swelling) of the gastric mucosa caused by irritation and infection factors. The danger of gastritis if left continuously will damage the function of the stomach and may increase the risk for stomach cancer to cause death. Various studies have concluded that complaints of pain in gastritis disease are most common due to functional gastritis, which reaches 70-80% of all cases. Functional Gastritis is a pain that is not caused by disorders of the stomach organs but is more often triggered by an inappropriate diet, psychological factors and anxiety. According to data from World Health Organization (WHO), Indonesia ranks fourth with the highest number of gastritis patients after the country America, Britain and Bangladesh which amounted to 430 million people with gastritis. Incidence of gastritis in Southeast Asia is about 583,635 of the population every year (Kemenkes RI, 2008). The signs of ulcer disease are uncomfortable, pain in the pit of the stomach, nausea, vomiting, bloating, full quickly and decreased appetite. This ulcer disease arises due to irregular eating patterns, stress and helicobacter pylory bacteria. From the results of research on nurse shift workers found that there are 55.6% of nurses who suffer from gastritis. Where the most cause is an irregular diet of 66.7% .2. Constipation Every person's bowel habit is different. Constipation or constipation occurs when bowel movements are inhibited unusually. Constipation is a condition or symptom of food movement restriction in the digestive tract so the bowel movement can not be smooth and regular. Under normal circumstances, every 24 hours, the colon (colon) will be emptied periodically. A person is considered constipated if he can not defecate for two days or more. In general, the cause of constipation is lack of drinking or fiber. Less activity and exercise, also causes the intestinal work becomes sluggish. The habit of delaying the desire to defecate because it does not want to interfere with work activities can also be a trigger of constipation. In the elderly, generally the elasticity or activity of the colon (colon) has also been reduced so that it can cause constipation (Bangun, 2004). In English, as one of the developed countries, annually issued five million recipes for the purchase of laxatives and watering big. While 40,000 gallons of liquid paraffin are drunk by the English population. Constipation is a delay and difficulty in emptying the contents of the stomach occurs due to too loud feces or the volume of stool is too small. In most cases, constipation has nothing to do with organic disease but is more due to long-standing habits and less fiber-rich foods. Due to the lack of fiber, the volume of the stool is not sufficient to induce a peristalsis movement that induces feces effectively. This situation resulted in increased activity of colonic muscles, colonic spasm and chronic constipation (Beck, 2000). In Saptawati Bardosono's study of 210 female workers from two selected government offices in Jakarta, where data were collected by interview methods and anthropometric measurements, defecation, fiber intake, and nutritional status of the subjects obtained prevalence of constipation ranging from 47.6% (fatigue during defecation) to 63.8% (digestive complaints for 3 days / week). While in the study in Iran found nurses who suffered constipation of 60 nurses (37%) of the 160 nurses who were respondents (Saberi, 2010) .3. Peptic ulcer Peptic ulcer is an ulceration of the mucous membranes or deeper structures of the stomach and duodenum. This is caused by acid and pepsin imbalance. Often occurs in men, users of NSAID (Non Steroid Anti Inflammatory Drugs) drugs, occurring at age 25 to 50 years with a peak age of 40 years. The cause is due to decreased ability of the digestive mucosa to shelter from pepsin and acid. Helicobacter pylori (H. pylori) also has a major effect on the occurrence of the disease (Desdiani, 2004). According to Mary E. Beck, ulceration that occurs in the upper part of the alimentary tract caused by acidic gastric acid is called peptic ulcer or gastric ulcers. Factors that cause peptic ulcers are not fully understood. It is estimated that the condition occurs due to the digestion process of the gastric mucosa by gastric and pepsin sap, which is often accompanied by a disturbance in the mechanism of protection of the mucous membrane. Excessive secretion of hydrochloric acid is a contributing factor. Peptic ulcer is sometimes associated with emotional stress. In the study of pietrocti et al., It was found out that the prevalence of peptic ulcers was higher in shift workers (29/101) or 28.7% compared with ordinary workers (23/247) or 9.3%. 4. DyspepsiaDefinition of dyspepsia to date agreed by experts in the field of gastroenterology is a collection of complaints / symptoms of clinical (syndrome) discomfort or pain that is felt in the upper abdominal area accompanied by other complaints of a feeling of heat in the chest and abdomen, regurgitas, bloating, stomach feels full, full quickly, belching, anorexia, nausea, vomiting and lots of acid gas emitted from the mouth. Dyspepsia syndrome is usually suffered for several weeks / months that are missing or persistent. The cause of dyspepsia is Helicobacter pylori. Where Helicobacter pylori can infect and damage the gastric mucosa. Helicobacter pylori is a type of germ found in the stomach and associated with gastric malignancy. The important thing of Helicobacter pylori is its lifelong nature, always active and can be transmitted if not eradicated. Helicobacter is believed to damage the host defense mechanism and damage the tissues. Helicobacter pylori can stimulate the gastric mucous gland to more actively produce gastrin resulting in hyperglastrinemia. In general, patients with dyspepsia are cigarette consumption, excessive alcohol drinking, drinking large amounts of coffee and eating acidic foods. In a study conducted by Sander, Guilherme et al found that of 850 patients with dyspepsia, 628 were women (73, 9%). 387 (45.5%) are active workers. Among the active workers, 32.2% mentioned that dyspepsia had caused absenteeism from work during the previous week and 78% reported reducing labor productivity.C. Causes of digestive disorders There are various causes of indigestion, among others: diet, food type, stress, and drugs (Gondosari, 2010) .1. Eat irregularly or eat late. Eat into human need to get intake that will be converted into energy to perform activities or activities. Normally our body works for 10 to 12 hours every day. If the diet is not regular then the body that continues to work will be disrupted. With no food intake coming in, then nothing will be consumed, whereas the digestive system will still work. The impact of the digestive system will injure the digestive organs themselves. Disease that often arises if the diet is not regular is an ulcer. This is caused by the organ of our stomach does not work according to the time. Stomach will be very unfamiliar with the diet that keeps changing. As a result, the stomach can not adjust the working time, so it can damage the stomach itself. In addition, irregular eating patterns such as eating at midnight will be associated with increased blood fat levels. Eating at the low point of circadian rhythm is related to the metabolism response. The eating rules are closely related to daily feeding times. Naturally food is processed in the body through the digestive organs ranging from the mouth to the small intestine. If the average stomach is empty between 3-4 hours, then this meal schedule also adjusts to the empty of the stomach (Okviani, 2011). Irregular eating patterns make the stomach sensitive when stomach acid increases. Excessive production of HCl can cause friction in the wall of the stomach and small intestine, causing pain in the epigastrum. Friction will be more severe if the stomach is empty due to irregular eating, will eventually cause bleeding in the stomach. The results showed that eating regularity is a risk factor for gastritis with OR = 1.85. Where the risk of gastritis incidence for respondents who eat irregular 1.85 times greater suffer from gastritis compared with those who eat regularly.