Pengaruh mengunyah permen karet xylitol terhadap timbulnya motilitas usus pasca operasi dengan general anestesi

Xylitol gum chewing to achieve early postoperative restoration of bowel motility after surgery under general anesthesiaBackground: The problem that is often encountered in the use of general anesthesia in major surgery is the Post-Operative Ileus (POI). POI is a temporary loss of gastrointestinal propulsion activity characterized by no sounding of bowel sounds and abdominal discomfort and distension. Providing nutrition oral or enteral when bowel sounds begin to sound has a weakness where it was reported that in this intervention the incidence of bloating, nausea and vomiting was mostly experienced by patients who were intolerant of the presence of food in their stomach.Purpose: Knowing the effect of Xylitol gum chewing to achieve early postoperative restoration of bowel motility after surgery under general anesthesiaMethod: A quasi-experimental method with pre-test and post-test in two groups of 20 patients as participants at A. Dadi Tjokro Dipo Hospital Bandar Lampung City recruited and taken by purposive sampling technique, 10 participants as intervention group (treat by chewing xylitol gum) and other of 10 participants as control group.Results: Finding that by a treat of Xylitol gum chewing in postoperative restoration of bowel motility after surgery under general anesthesia took after 2.3 hours while the patients who did not chew xylitol gum occurred 6.8 hours. T-Test showed that p-value was 0.00 that indicated the p-value < 0.05.Conclusion: There was a difference in the occurring time of the intestine motility between control and experiment groups. It is gained that difference is 4.39 hours with p-value = 0.00 which indicated p < 0.05, that there was an effect of chewing gum containing xylitol on the occurrence of post-operative intestine motility after general anesthesia surgery at A Dadi Tjokor Dipo Hospital of Bandar Lampung City. The present study suggests chewing gum is an alternative method to stimulate intestine motility for early post-operation feeding as a low-cost, safe, and tolerable treatment when without contra indication.Keywords: Xylitol gum chewing; Postoperative restoration; Bowel motility; Surgery; General anesthesiaPendahuluan: Masalah yang sering dijumpai dalam penggunaan general anestesi pada pembedahan mayor yaitu Post-Operative Ileus (POI). POI adalah hilangnya aktivitas daya dorong saluran cerna untuk sementara yang ditandai dengan tidak terdengarnya bising usus dan rasa tidak nyaman serta distensi abdomen. Memberikan nutrisi secara oral maupun enteral pada saat bising usus mulai terdengar merupakan memiliki kelemahan dimana dilaporkan bahwa pada intervensi ini kejadian kembung, mual dan muntah paling banyak dialami oleh pasien yang tidak toleran terhadap adanya makanan dalam lambungnyaTujuan: Diketahuinya pengaruh mengunyah permen yang mengandung xylitol terhadap timbulnya motilitas usus pada pasien pasca operasi dengan general anestesi.Metode: Penelitian eksperimen semu dengan pre-test dan post-test group. Jumlah pasien yang akan menjalani operasi elektif dengan menggunakan anestesi umum sebanyak 20 pasien di RSUD A. Dadi Tjokro Dipo Kota Bandar Lampung. Sampel diambil dengan teknik purposive sampling, 10 pasien pasca operasi mengunyah permen karet xylitol dan 10 pasien pasca operasi tidak mengunyah permen karet xylitol.Hasil: Didapatkan motilitas usus timbul 2,3 jam setelah mengunyah permen karet dan 6,8 jam bila tidak mengunyah. Hasil uji t-test didapatkan bahwa p value=0,00 yang berarti nilai p<0,05.Simpulan: Terdapat perbedaan waktu timbulnya motilitas usus pada kelompok kontrol dan kelompok eskperimen sebesar 4,39 jam dan didapatkan nilai p=0,00 yang berarti nilai p<0,05 sehingga Ho ditolak. Oleh karena itu dapat disimpulkan bahwa ada pengaruh pemberian permen karet yang mengandung xylitol terhadap timbulnya motilitas usus pasca operasi dengan general anestesi di RSUD A. Dadi Tjokro Dipo Kota Bandar Lampung. Penelitian ini menunjukkan bahwa mengunyah permen karet adalah metode alternatif untuk merangsang motilitas usus untuk pemberian makan pasca operasi awal sebagai pengobatan yang berbiaya rendah, aman, dan dapat ditoleransi..

STANDARISASI SPESIFIK DAN NON-SPESIFIK SIMPLISIA DAN EKSTRAK ETANOL RIMPANG KUNYIT (Curcuma domestica Val.)

Turmeric is a plant that included in Zingiberaceae. Turmerics often used as a traditional medicine to heal wounds, antibacterial, reduces intestine motility, reduce unpleasant body odor, treats fever, diarrhea, and many more. Standardization is performed by examining turmeric rhizome simpicia and extract. Standardization is carried out to guarantee the quality of traditional raw materials and requirements for reproducibility of pharmaceutical and therapeutic qualities. Parameters that have been used in this research are macroscopic test, microscopic test, total ash content test, acid insoluble ash content test, water soluble simplicia content test, ethanol soluble simplicia content test, shrinkage drying test, and Phytochemistry screening qualitatively. From the results, turmeric simplicia has met the requirements, while turmeric extract has not eligible in requirements, because its acid insoluble ash content are not eligible. This expected because of the impurities which contamine the extract are silica and sand. Silica can cuts the mucosa of the throat when used it orally. Turmeric extract in this research does not eligible and cannot be used for the next step.

IMUNOKIMIAWI PGE2 USUS ILEUM YANG KEKURANGAN ENERGI PROTEIN

Diarrhoeal disease mortality which suffered by children less than five years due to protein energy deficiency is increased significantly.The pathological mechanisms are not known in detail yet. The objective of this research was able to explain the intestine motility inprotein energy deficiency of mice Balb/c. Hormonal mechanism that regulates the intestine motility is roled by prostaglandine E2 hormone(PGE2). The observed variable was the immunity component of PGE2. The measurement was performed using immunohistochemistrymethod with monoclonal antibody against PGE2 to the ileum mice tissue. The result of this study showed that protein energy deficiencymice had much reduced PGE2 (reduction from 1492 to 145, p = 0.000 ). In conclusion, the marked decrease of ileum PGE2 will decreaseintestine motility and it may be one cause of the high diarrhoeal mortality due to protein energy deficiency.

Spasmolytic and Anti-Secretory Activities of Water/Ethanol Crinum jagus Extract

The present study was undertaken to determine the potential anti-secretory and spasmolytic mechanism ofCrinum jaguswater/ethanol extract (25, 50 and 100 mg/kg, po). Anti-secretory activities were evaluated using castor oil and PGE2-induced enteropooling models in rats. Spasmolytic activities were conducted on small intestinal transit, on carbachol, 5-HT-induced intestine motility as well as on naloxone-pretreated intestine transit.C.jagusextract 25, 50 and 100 mg/kg bw has significantly (p<0.01) reduced in dose-dependent manner the castor oil-induced intestine secretion with inhibition rate of-59.7, -78.7 and-78.2% respectively.C jagus25, 50 and 100 mg/kg bw water/ethanol extract induced significant (p< 0.01) dose-dependent reduction of PGE2-induced fluid accumulation, with inhibition rate of-16.9, -57.7 and-66.2% respectively. On intestine transit, as on carbachol and on serotonin-induced intestine motility, the extract significantly (P< 0.01) reduced the distance covered by the charcoal. The spasmolytic effect ofC jagusextract was inhibited by the naloxone. These findings show thatC jagusmay reduce intestine secretion by the blockage of prostaglandins receptors. The spasmolytic effect could result from the blockage of muscarinic and/or serotonergic receptors, and by involving opiate receptors. These results support the traditional use ofC jagusin gastrointestinal disorders treatment.

Effects of serotonin on the physiology of the rabbit small intestine

Serotonin has been shown to alter the intestinal transport of ions and intestinal motility. These effects may interfere with each other, modulating the whole physiology of the intestine. We have previously shown that serotonin also alters the transport of nutrients. Thus, the aims of the present work were to determine the possible interference between the secretagogue effect of serotonin and the mechanism by which serotonin inhibits the absorption of nutrients, and to study the effect of serotonin on the digestive activity of nutrients of the brush border membrane jejunum enterocyte in the rabbit. The results show that the secretagogue effect of serotonin neither affects the inhibitory effect of serotonin on the intestinal absorption of the nutrients, nor affects the activity of Na+/K+-ATPase. The activity of sucrase and aminopeptidase N was also not affected by serotonin in the rabbit jejunum. Finally, we also studied different parameters of the motility in the rabbit small intestine. Serotonin seemed to stimulate the motility of the rabbit small intestine by increasing integrated mechanical activity and tone of muscle fibers in duodenum, jejunum, and ileum. In conclusion, serotonin might alter or modulate the whole intestinal physiology. Key words: serotonin, small intestine, motility, absorption, rabbit.