Esophageal and Stomach Disorders Flashcards
proximal dysphagia can occur from?
stroke
what is aspiration pneumonia?
Aspiration pneumonia is bronchopneumonia that develops due to the entrance of foreign materials into the bronchial tree, usually oral or gastric contents (including food, saliva, or nasal secretions).
distal dysphagia occurs from ?
obstructions from inflammation, tumor, or achalasia
what is achalasia?
a condition in which the muscles of the lower part of the esophagus fail to relax, preventing food from passing into the stomach.
distal dysphagia mimics?
angina
what does GERD stand for?
gastroesophageal reflux disease
what is GERD?
chronic symptom of mucosal damage caused by stomach acid coming up from the stomach into the esophagus.
S/S of GERD?
Heartburn
Reflux
Dysphagia
Painful swallowing
Chest pain (especially when lying down)
Coughing, asthma, wheezing, sore throat, hoarseness
how is GERD diagnosed?
History
Endoscopy
Barium Radiography
H. pylori
how is GERD treated?
Small frequent meals
Meds
Acid-suppressing inhibitors
Surgery
what are PT implications for GERD?
Lifestyle modifications
Right side lying allows gastric juices to flow more easily due to gravity
Supine: avoid position immediately after eating
what are S/S of Barrett’s Esophagus?
Dysphagia Esophagitis Ulceration Bleeding Adenocarcinoma
what is Barrett’s Esophagus?
refers to an abnormal change (metaplasia) in the cells of the lower portion of the esophagus. When the normal stratified squamous epithelium lining of the esophagus is replaced by simple columnar epithelium with goblet cells (cells usually found lower in the gastrointestinal tract), Barrett’s esophagus is diagnosed
what is the treatment for Barrett’s Esophagus?
Control GERD
Endoscopic ablation therapy
porton pump inhibition to control acid secretions
what is Esophageal varices?
extremely dilated sub-mucosal veins in the lower third of the esophagus.
how is Esophageal varicose treated?
Variceal hemorrhage stops on its own
Prophylactic treatment
Stent to reduce pressure (between hepatic vein and portal vein)
Liver transplant
PT implication for Esophageal Varices?
Avoid activities increasing intra-abdominal pressure
what is hiatus?
opening in the diaphragm
in hiatal hernias, the _____ ____ becomes enlarged?
cardiac sphincter
in hiatal hernia, the _____ pushes though the hiatus and into the ______
stomach
esophagus
how do hiatal hernia’s usually form?
weakening of the diaphragm
enlargement of the hiatus
true or false
histal hernia can only be acquired?
false
May be congenital or acquired
Born with weakness of the diaphragm, trauma aging, surgery, anything increasing intraabdominal pressure
risk factors for Hiatal Hernia include?
over 50
obese
smokes
S/S and Hiatal Hernias include?
Heart burn
Chest pain
Reflux, belching
Nausea
how is Hiatal hernias diagnosed?
Ultrasonography
Barium swallow
Endoscopy
treatment for Hiatal hernias include?
antiacids
elevate the head of the bed
what are the PT implications of Hiatal hernias?
avoid supine
Avoid exercises that increase intra-abdominal pressure
what are peptic ulcers?
Break in the protective mucosal lining
exposes the submucosal areas to gastric secretions
chronic peptic ulcers damages the ______ _____ and replaces it with _____ ______. It can also damage _____ _____.
muscular layer
scar tissue
blood vessels (hemorrhage)
what are 3 types of ulcers?
Gastric
Duodenal
Esophageal
90% of peptic ulcers are due to
Helicobacter Pylori Infections
risk factors of peptic ulcers include
Helicobacter Pylori Infection (90% of ulcers) Long term NSAID use Tobacco and alcohol Physiologic changes Genetics Gastrinoma Systemic mastocytosis Malignant tumors
S/S of peptic ulcer include?
Epigastric pain Midline pain in thoracic spine Melena Nausea Hematemesis Loss of appetite --> weight loss Bleeding Occur 3-4 days to weeks, subside and reappear months later
complications of peptic ulcers include?
Hemorrhage
Perforation
Obstruction
Unremitting pain
how are peptic ulcers diagnosed?
S/S and History Upper GI X-Ray Blood test Breath test Stool antigen test Gastroscopy
how is peptic ulcers prevented/treated?
Avoid prolonged NSAIDS
Antimicrobials
Acid blockers
Cabbage
Coffee
Exercise
Surgery
gastric ulcers heal within _______ _____
3 months
duodenal and gastric ulcers have _____ course with _____ and _____
chronic
remissions
exacerbations
peptic ulcers: massive ________ or ______ may cause mortality
hemorrhage or perforation
curing __________ usually results in curing the peptic ulcer disease
H. Pylori
