Exam 3 Study Guide - Esophageal

Question 1

Factors tht Contribute to Dcrd LES Pressure

Answer 1

• Caffeinated beverages; coffee, tea, & soda
• Chocolate
• Citrus fruits
• Tomatoes & tomato products
• Smoking & use of tobacco products
• Calcum channel blockers
• Nitrates
• Peppermint, spearmint
• Alcohol
• Anticholinergic drugs
• High lvls of estrogen & progesterone
• Nasogastric tube placement

Question 2

Gastroesophageal Reflux - Diagnostic Assessment

Answer 2

• Definitive diagnostic test does not exist
• Barium Swallow
  > can’t confirm GERDm but can be helpful when used in combination w/ other diagnostic procedures
• Upper Endoscopy/EGD
  > look for abornmalities; biopsy can be taken; requires moderate sedation 
• pH Monitoring Examination
  > most accurate method of diagnosing GERD

Question 3

Gastroesophageal Reflux Disease

Answer 3

• GERD is most common UGI disorder in US
• Occurs most often in middle-aged & older adults
• GER occurs as a result of backward flow of stomach contents into esophagus
  > GERD arises from persistent GER
• Most common cause of GERD is excessive relaxation of lower esophageal spincter (LES)
  > allows reflux of gastric ontents into esophagus & exposure of esphageal mucosa to acidic gastric contents

Question 4

Hiatial Hernia

Answer 4

• Protrusion of stomach through esophagus hiatus of diaphragm into chest
• Asymptomatic or symps similar to those w/ GERD
• 2 Types:
  > Sliding Type: most common & treated medically
  > Large Tolling Type: can become strangulated or obstructed, early surgical repair is preferred

Question 5

Hiatial Hernia - Diagnostic Testing

Answer 5

• Barium swallow study w/ fluoroscopy is most specific diagnostic test
• EGD may be performed to visualize sliding hernias