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Digestion Exemplar: GERD
GERD Reflux of gastric contents into esophagus
Risk Factors • Obesity
• Excess ETOH consumption
• Smoking
• Hiatal hernia
• Pregnancy
Prevention
-Behavior & routine changes
-Small, frequent meals
-Avoid food that stimulate acid production or gastric irritation
• Spicy foods
Non
Non--
• Acidic foods
pharmacological
-Avoid eating close to bedtime
intervention à
-Elevate HOB
-Avoid tight clothes
-Avoid smoking & ETOH consumption
-Maintain ideal body weight (obesity is a risk factor)
Factors that Increased gastric volume
affect digestion Postural (certain body positions-lying flat)
Pressure (from obesity or tight clothes)
GERD Large meals, high-fat, spicy or consumed often with ETOH causes relaxation in the esophageal
Pathology sphincter à reflux of gastric contents ((hcl
hcl acid & pepsin) into esophagus
Hoarseness
Esophagus damaged by gastric acid à inflammation, edema & scarring (over time)
Etiology -transient relaxation of sphincter
-incompetent lower esophageal sphincter
-increased pressure in stomach à from increased gastric volume, certain postures, obesity or tight
clothing
S/S (clinical
manifestations) • Chest pain w/in 1 hr of eating Complications
• Discomfort worse when lying down • Esophagitis (esophageal
• pyrosis (heartburn) strictures, dysphagia, ulceration)
• sore throat • Barrett esophagus (precancer
• tooth enamel erosion lesionàincrease cancer risk)
• dyspepsia (pain when swallowing)
• regurgitation of sour material into mouth
• atypical chest pain
Diagn
Diagnostics
ostics
Barium Swallow -Xray study, imaging to evaluate esophagus
(Esophagram) -First test used for pt w/dysphagia
(Esophagram) NPO 8
8--12 HR
This is an X-ray **good for dx of stricture or obstruction **
procedure,
fluoroscopy.
Digestion Exemplar: GERD
GERD Reflux of gastric contents into esophagus
Risk Factors • Obesity
• Excess ETOH consumption
• Smoking
• Hiatal hernia
• Pregnancy
Prevention
-Behavior & routine changes
-Small, frequent meals
-Avoid food that stimulate acid production or gastric irritation
• Spicy foods
Non
Non--
• Acidic foods
pharmacological
-Avoid eating close to bedtime
intervention à
-Elevate HOB
-Avoid tight clothes
-Avoid smoking & ETOH consumption
-Maintain ideal body weight (obesity is a risk factor)
Factors that Increased gastric volume
affect digestion Postural (certain body positions-lying flat)
Pressure (from obesity or tight clothes)
GERD Large meals, high-fat, spicy or consumed often with ETOH causes relaxation in the esophageal
Pathology sphincter à reflux of gastric contents ((hcl
hcl acid & pepsin) into esophagus
Hoarseness
Esophagus damaged by gastric acid à inflammation, edema & scarring (over time)
Etiology -transient relaxation of sphincter
-incompetent lower esophageal sphincter
-increased pressure in stomach à from increased gastric volume, certain postures, obesity or tight
clothing
S/S (clinical
manifestations) • Chest pain w/in 1 hr of eating Complications
• Discomfort worse when lying down • Esophagitis (esophageal
• pyrosis (heartburn) strictures, dysphagia, ulceration)
• sore throat • Barrett esophagus (precancer
• tooth enamel erosion lesionàincrease cancer risk)
• dyspepsia (pain when swallowing)
• regurgitation of sour material into mouth
• atypical chest pain
Diagn
Diagnostics
ostics
Barium Swallow -Xray study, imaging to evaluate esophagus
(Esophagram) -First test used for pt w/dysphagia
(Esophagram) NPO 8
8--12 HR
This is an X-ray **good for dx of stricture or obstruction **
procedure,
fluoroscopy.
