Disorders of the Upper GI Tract

Question 1

What is dysphagia?

Answer 1

difficulty swallowing

Question 2

The act of swallowing occurs in two stages what are the two stages?

Answer 2

1st stage : oropharyngeal - transfer of food from the mouth and pharynx to the esophagus

2nd stage : esophageal - the bolus goes from the esophagus to the stomach

Question 3

what are the S/S of oropharyngeal dysphagia?

Answer 3

inability to swallow, coughing during or after swallowing, NASAL regurgitation, bad breath, gurgling noise after swallowing, a hoarse or “wet” voice, speech disorder

Question 4

What are the S/S of esophageal dysphagia?

Answer 4

food ‘sticking” in the esophagus (difficulty passing bolus through the esophagus into the stomach

usually from an obstruction in the esophagus or to a motility disorder

Question 5

What disorders do we suggest pureed foods for?

Answer 5

dysphagia and mouth ulcers

Question 6

What is aspiration?

Answer 6

food or liquid entering the trachea or lungs

Question 7

what is choking?

Answer 7

food in the trachea BLOCKING the airway

Question 8

what is Sitophobia?

Answer 8

the fear of eating (usually from previous choking experience)

Question 9

what is Reflux esophagitis?

Answer 9

• Gastroesophageal Reflux Disease (GERD)
• inflammation of the esophagus
• regurgitation of stomach contents into the esophagus

Question 10

what is a Hiatal Hernia?

Answer 10

portion of the stomach in the chest cavity

Question 11

What are the S/S of Dyspepsia?

Answer 11

general symptoms of indigestion

-stomach pain, heartburn, early satiety, vomiting, bloating

Question 12

What are the causes of Dyspepsia?

Answer 12

Medical Conditions:
-peptic ulcers, GERD, motility disorders, malabsorpative disorders, gallbladder disease, abdominal tumors

Systemic Disorders:
-Diabetes mellitus, renal disease, thyroid disease, heart failure

Medications

Dietary supplements/ Type of Food

Question 13

What are the treatments for Dyspepsia?

Answer 13

small meals, eat slowly, take antacids, don’t use straw(air can worsen symptoms)

Question 14

What are the side effects of Antacids?

Answer 14

Na (hypertension)
Ca (kidney stones)
Al (depletion of phosphorus, constipation, and weak bones)

Question 15

Why are ulcers seen a lot in the Elderly?

Answer 15

because they have less acid in their stomachs

Question 16

What is Gastritis?

Answer 16

inflammation of the stomach mucosa

acute and chronic

causes:
- infection : bacterial, viral, fungal
- esp. H. Pylori
- Checmicals : alcohol, cocain
- Drugs : aspirin

Question 17

What are Peptic Ulcers?

Answer 17

erosion of the stomach lining

Cause: H. Pylori, Zollinger-Ellison Syndrome (excessive acid secretion)

A lot of people are asymptomatic or mild discomfort

S/S
-hunger pain, burning pain in stomach region, sometimes aggravated by food

Question 18

What can Peptic Ulcers cause?

Answer 18

GI bleeding, perforation of the stomach or duodenum

Question 19

Define Gastrectomy

Answer 19

partial or total removal of the stomach

Question 20

What is Zollinger-Ellison Syndrome?

Answer 20

excessive acid secretion

Question 21

What are the two types of Partial Gastrectomies?

Answer 21

Gastroduodenostomy

Gastrojejunostomy

Question 22

What is a total Gastrectomy?

Answer 22

complete removal of the stomach, the intestine is attached to the esophagus

Question 23

What two types of gastrectomies could result in a blind loop( part of the intestine left over after the attachment where food will not pass through).

Answer 23

Gastrojejunostomy or Total Gastrectomy

Question 24

What is the postgastrectomy diet?

Answer 24

Carbohydrate-Controlled : slow the passage of food

Prevent hypoglycemia and dumping syndrome

fluids and food withheld until some healing has occurred

small, frequent meals and snacks, mostly soft, low-fat foods

liquids limited during meals (1/2 cup) : too much liquid will increase the passage of food

Question 25

Why don’t you want a postgastrectomy patient to have food pass quickly through their intestines?

Answer 25

because the stomach has been removed fully or partially they will have to rely more on their intestines to digest the food. if too fast absorption will be lessened

Question 26

What is blind loop syndrome?

Answer 26

Blind Loop: left over section of intestines after stomach surgeries

overgrows bacteria: stagnate, static condition…. leads to… deficiency in Vitamin B12, folate and bile

Question 27

What is dumping syndrome?

Answer 27

when you have rapid emptying of undigested food into the small intestines

water moves (flooded) into the intestines

usually common after stomach surgery

Question 28

When do early symptoms of dumping syndrome occur and what are they?

Answer 28

30 mins after eating

cramps, diarrhea, dizziness, nausea and vomiting, rapid heartbeat

Question 29

When do late symptoms of dumping syndrome occur and what are they?

Answer 29

1-3 hours of eating

anxiety, confusion, headache, hunger, palpations, sweating

Question 30

What is the suggestion for patients who experience dumping syndrome?

Answer 30

smaller meals, eat slowly, limit fluid intake, avoid excessive sugar

Question 31

T/F Dumping syndrome can occur with the gastric band surgery.

Answer 31

FALSE. it can occur with a Gastric Bypass though (where the stomach is partially removed for weight loss)

Question 32

Why is it suggested that those who have gastrectomies avoid excessive sugar?

Answer 32

because sugar attracts water just like salt and you don’t want the food to move too fast through the intestines