Esophogeal Disorders Flashcards
Chronic syndrome of mucosal damage due to reflux of stomach acid into lower esophagus
Gastroesophageal Reflux Disease (GERD)
Primary Factor of GERD
Incompetent LES
Factors affecting LES pressure
Food & Drugs
Obesity
Smoking
Hiatal hernia
Etiology for GERD
Acidic gastric contents overwhelm esophageal defenses, causes irritation and inflammation
Most common manifestation of GERD
♡burn (pyrosis)
Complications of GERD
Esophagitis
Barret’s esophagus (BE)
Respiratory
Dental erosion
Patient care for GERD
i. Low-fat diet; small meals
ii. Avoid alcohol, caffeine and smoking
iii. Upright position 2 to 3 hours after meals; avoid tight clothing at waist or bending over after eating
iv. Avoid eating 3 hours before bed
v. HOB increased on 4 to 6” blocks
vi. Weight reduction
vii. Drug therapy
Foods to avoid with GERD
- Chocolate, peppermint, orange juice, coffee/tea
ii. Avoid milk and eating before bedtime
obtain biopsy to determine cancer
Endoscopic mucosal resection (EMR)
Hiatal Hernia
Herniation of part of the stomach into the esophagus through and opening in the diaphragm
weakened muscle in diaphragm and esophagogastric opening
Structural hiatal hernia
Clinical manifestations of hernias
i. Heartburn (pyrosis), dyspepsia (indigestion), regurgitation, respiratory symptoms, chest pain
Diagnostic studies of hernia
Barium swallow or endoscopy
Management of hernia: conservative, surgical
i. Conservative: Reduce intraabdominal pressure
ii. Surgical: reduce hernia, optimize LES pressure, and prevent movement of gastroesophageal junction
iii. Herniotomy, herniorrhaphy, fundoplication, gastropexy
c. First sign may be severe hernia
esophageal bleeding or aspiration
