Exam 2 - Upper GI Flashcards
What is GERD?
Gastroesophageal reflux disease
- Backward flow of the acidic stomach contents into the esophagus and even the mouth
- Symptoms: Burning sensation after meals, heartburn, increased salivation, belching, esophageal spasm, asthma, hoarseness, dental corrosion
- pathophysiology: delayed gastric emptying, increased intraabdominal pressure, increased espohageal sensitivity
30% of population has GERD, 50% of infants (sphinter not fully formed)
What is esophagitis?
inflammation of the esophagus
- Inflammation, ulceration, erosions, scarring
- Acute from reflux, viral infection, intubation, ingestion of irritating agents, eosinophilic infiltration
- Chronic from prolonged contact with gastric acid
What is barrett’s esophagus?
- precancerous condition usually stemming from untreated prolonged GERD
- other risk factors: male gender, obesity, middle age, smoking, family history of BE
What are the MNT guidelines for GERD and esophagitis?
- Avoid large, high fat meals
- Avoid eating 2-3 hours before lying down
- Elevated the HOB
- Avoid smoking
- Avoid alcoholic beverages
- Avoid caffeine containing foods/beverages
- Wear loose fitting clothing around stomach
- Avoid acid and highly spiced foods
- Consume a healthy diet with adequate fiber
- Lose weight if overwt.
What is dysphagia?
- problems with swallowing
- associated with malnutrition and dehydration
- caused from obstruction, inflammation, abnormal UES function, MS, motility disorders
if patient mentions painful swallowing, must have referral to SLP
What is a modified barium swallow exam?
- swallow exam using barium that shows up on x-rays to watch a variety of textures while swallowing
What is IDDSI?
international dysphagia diet standardization initiative
- level 1-3
What is dyspepsia and MNT for it?
- epigastric discomfort following meals: abdominal pain, bloating, nausea, regurgitation, belching
- MNT: food logs to identify problem foods, reduce fat, limit alcohol, smaller meals
What is gastritis?
- inflammation of grastric mucosa
- H. pylori infection is the most common cause
- symptoms: nausea, vomiting, anorexia from non desire to eat, hemorrhage, epigastric pain
How is H pylori treated?
- using antibiotics
Peptic ulcer disease
- ulcerations of gastric or duodenal mucosa that penetrates submucose
- primary causes: H pylori, gastritis, NSAID use, coticosteroids, alcohol, smoking, stress
- symptoms: pain, burning sensation caused or relieved by eating
MNT for peptic ulcer disease?
- Protein buffers gastric acid (but stimulates gastrin, acid, and pepsin)
- Restrict foods that may increase acid secretion or cause irritation to gastric mucosa: Black, red pepper, chili, cayenne, and other spices. Caffeine, Coffee, Alcohol
- Overall good diet w/fiber, small/frequent meals
Protective foods against peptic ulcer disease?
- inhibit H pylori: caranberries, ginger, curcumin, sulforaphane, kimchi, green tea, black current oil, probiotics
What are the pharmaceutical treatments for excess acid secretion?
- antacids - acts to neutralize stomach acidity
- H2 receptor antagonists histamine blockers
- proton pump inhibitors - long term use can cause B12 and iron deficiences
Gastric cancer causes and treatment?
- Causes: H. Pylori (80% of cases), western diet (high in processed meats, fat, starches, and simple sugars), alcohol consumption, excess body weight, smoking, highly salted/pickled foods, inadequate micronutrients
- treatment: partial or total gastrectomy
- selenium has been shown to be protective against gastric cancer - comes from soil, found in fruits and vegetables
