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GERD
Gastroesophageal reflux (GER) occurs when stomach acid or bile
flows into the esophagus, leading to the development of
esophagitis. Gastroesophageal reflux disease (GERD) is
diagnosed when GER is chronic, more severe, and causes
complications over time. GERD is caused by abnormalities in
the lower esophageal sphincter function, esophageal
motility, or gastric emptying.
S/S of GERD
Pyrosis (heartburn), regurgitation, retrosternal burning, bitter
taste, belching, dysphagia, excessive salivation, occurs at night or
in recumbent position, relieved by sitting up
Pharmacologic management of GERD
- Antacids: TUMS
- Histamine antagonists (H2 blockers)
- Proton pump inhibitors (-prazole)
- Promotility drugs
- Endoscopy
elevate HOD, diet modifications, wt loss, smoking cessation,
avoid tight clothing
Risk factors for esophageal stricture
, GERD, stomach acid and digestive enzymes may repeatedly
back up into the lower part of the esophagus, leading to
inflammation and irritation. Prolonged inflammation can result in
the formation of scar tissue, causing the esophagus to narrow.
Esophagitis, ingestion of caustic substances, radiation
therapy
Hiatal hernia treatment
Surgery- Repair of Hiatal Hernia, small frequent meals, avoid
recumbent position after eating
Medications (Same as GERDS):
-Antacids -neutralizes acid in the stomach-PRN,
-H2-Receptor blockers (↓amount of acid [mild symptoms]);
Zantac, Pepcid AC, Tagamet- DAILY,
-PPI (MOST powerful!! Med to treat GERD); Omeprazole
(Prilosec), prevacid, pantoprazole/protonix -DAILY
Pathophysiology of appendicitis
obstruction leads to stasis of fluid and mucus-->bacterial growth--
>inflammation
Distention of appendix compromises blood supply, ischemia leads
to infarction and necrosis; necrosis leads to perforation and
peritonitis
Symptoms of appendicitis
Pain in the lower, right abdomen, loss of appetite, nausea,
vomiting, abdominal swelling, fever. REBOUND TENDERNESS/
GUARDING
, Diagnosing appendicitis via lab work
Complete blood count (CBC): An elevated white blood cell count
(WBC) is suggestive of inflammation, though it is not specific to
appendicitis.
Urinalysis: A urinalysis can be performed to rule out a urinary tract
infection.
C-reactive protein (CRP): An elevated CRP level can indicate an
inflammatory response, supporting the suspicion of appendicitis.
Risks for appendectomy in adults
higher risk for development of IBD and more severe complications
from C. diff infections.
-increased risk for colon CA after appe, among individuals aged
50-54
Peptic ulcer disease (PUD) pathophysiology
Erosion of the stomach lining. The bacteria Helicobacter pylori (H.
Pylori).
A peptic ulcer is an ulceration in the mucosal lining of the lower
esophagus, stomach, or duodenum. As a result, inflammation can
occur and penetrate the submucosa.
Risk factors for PUD
H. pylori, NSAIDs, stress, obesity, genetics, alcohol
consumptions, gastronomes and Zollinger ellison syndrome
(increased gastric acid secretion diseases)
gastric ulcers
gastric ulcers are similar to duodenal ulcers except the pain of
gastric ulcers occurs immediately after eating. Individuals with