The document provides a concept map about gastroesophageal reflux disease (GERD). GERD is defined as backflow of gastric or duodenal contents into the esophagus, causing troublesome symptoms or mucosal injury. It is usually caused by an incompetent lower esophageal sphincter or motility disorders. Risk factors include old age, irritable bowel syndrome, obstructive airway disorders, smoking, coffee/alcohol consumption, and H. pylori infection. Signs and symptoms include heartburn, dyspepsia, regurgitation, and cough. Diagnostic tests include endoscopy and pH monitoring. Treatment involves lifestyle changes, medications like PPIs, and possibly antireflux
The document provides a concept map about gastroesophageal reflux disease (GERD). GERD is defined as backflow of gastric or duodenal contents into the esophagus, causing troublesome symptoms or mucosal injury. It is usually caused by an incompetent lower esophageal sphincter or motility disorders. Risk factors include old age, irritable bowel syndrome, obstructive airway disorders, smoking, coffee/alcohol consumption, and H. pylori infection. Signs and symptoms include heartburn, dyspepsia, regurgitation, and cough. Diagnostic tests include endoscopy and pH monitoring. Treatment involves lifestyle changes, medications like PPIs, and possibly antireflux
The document provides a concept map about gastroesophageal reflux disease (GERD). GERD is defined as backflow of gastric or duodenal contents into the esophagus, causing troublesome symptoms or mucosal injury. It is usually caused by an incompetent lower esophageal sphincter or motility disorders. Risk factors include old age, irritable bowel syndrome, obstructive airway disorders, smoking, coffee/alcohol consumption, and H. pylori infection. Signs and symptoms include heartburn, dyspepsia, regurgitation, and cough. Diagnostic tests include endoscopy and pH monitoring. Treatment involves lifestyle changes, medications like PPIs, and possibly antireflux
The document provides a concept map about gastroesophageal reflux disease (GERD). GERD is defined as backflow of gastric or duodenal contents into the esophagus, causing troublesome symptoms or mucosal injury. It is usually caused by an incompetent lower esophageal sphincter or motility disorders. Risk factors include old age, irritable bowel syndrome, obstructive airway disorders, smoking, coffee/alcohol consumption, and H. pylori infection. Signs and symptoms include heartburn, dyspepsia, regurgitation, and cough. Diagnostic tests include endoscopy and pH monitoring. Treatment involves lifestyle changes, medications like PPIs, and possibly antireflux
gastric or duodenal contents into the esophagus that causes troublesome symptoms and/or mucosal injury to the esophagus.
Caused by: Contributed by risk factors:
Usually due to incompetent • Old age lower esophageal sphincter, • Patients with irritable bowel pyloric stenosis or motility syndrome disorder • Patients with obstructive airway disorders, ulcer disease, and angina • Tobacco use • Coffee drinking • Alcohol consumption • Gastric infection with H. Pylori • Less physical activity at work • Eating habits
Pathophysiology
GERD is a result of gastric juices overcoming the lower
esophageal sphincter (LES) pressure and re-entering the esophagus. Other factors include delayed gastric emptying, decreased salivation, sliding and para- esophageal hiatal hernia, increase or decrease of intra- abdominal pressure. Assessment
• Appetite? Decrease • Pain? Yes, mid epigastric As manifested by signs and symptoms burning sensation in chest • Dry cough • Pyrosis (heartburn, specifically more commonly described as a • Occasional regurgitation burning sensation in the • Does change in position esophagus) affect the discomfort? Yes, • Dyspepsia pain worsens when lying flat and after eating. Pain is • Regurgitation relived when in a sitting • Dysphagia position and taking OTC • Hypersalivation medications. • Esophagitis • postprandial fullness and • Dental erosion early satiety • Ulcerations in the pharynx and • Waking up from pain and esophagus burning, with a sore throat • Laryngeal damage and hoarse voice. • Esophageal strictures • The patient reports • Adenocarcinoma associated mid-thoracic, • Pulmonary complications bilateral back pain that occurs during the episodes.
Diagnostic test:
• Endoscopy Nursing Diagnosis • Barium swallow • Gastric ambulatory pH analysis • Imbalanced nutrition: less • Bilirubin monitoring than body requirements reduced food intake secondary to GERD • Risk for aspiration related to difficulty swallowing. • Acute pain related to irritated esophageal mucosa. • Anxiety related to deficient knowledge about the esophageal disorder. Medical Management Surgical Pharmacologic Nursing Management Management Management • Lifestyle changes Promotive/Preventive such as weight • Antireflux Antacids/Acid • Encouraging loss. Avoidance of surgery neutralizing agent: adequate carbonated, • calcium nutritional intake caffeine intake, and alcoholic carbonate by asking patient beverages. • aluminum to eat slowly and hydroxide to chew all food Avoiding spicy thoroughly so that and citrus foods. Histamine 2 receptor it can pass easily Maintaining low analgesics in the stomach. fat diet, elevating the head of the • pepcide • Decreasing risk of bed, and avoid • ranitidine aspiration by keeping patient in eating several • cimetidine hours before a semi fowler going to bed. Prokinetic agents position. • • Providing patient Administering • Metodopramide medications for education to severe symptoms Protein Pump Inhibitors ensure patient is or persistent prepared • Omeprazole physically and symptoms. • Nexium psychologically for Reflux inhibitors all tests and treatments. • urecholine Curative/Restorative
• Relieving pain by encouraging to small, frequent feedings. • Advice patient to avoid any activities that increase pain and to remain upright for 1 to 4 hours after each meal
