GERD Flashcards
Common disorder marked by backflow of gastric or duodenal contents into the esophagus
GASTRO-ESOPHAGEAL REFLUX DISEASE (GERD)
What is the main reason or cause of GERD
WEAKENING OF LOWER ESOPHAGEAL SPHINCTER (LES)
GERD can result to inflammatory process in the lining of esophagus known as
REFLUX ESOPHAGITIS
What is the other name of GERD
REFLUX ESOPHAGITIS
HallmarK of GERD
REFLUX ESOPHAGITIS
Common risk factor of GERD wherein↑Abdominal fat tissues result in↑ pressure in the abdomen and thus leads to reflux
OBESITY
Common risk factor of GERD wherein The protrusion of a portion of the stomach through the hiatus can affect the normal mechanisms of esophageal clearance, making it easier for stomach contents, including acid, to reflux into the esophagus
HIATAL HERNIA
Common risk factor wherein ↑pressure in the abdomen due to growing baby can cause reflux
PREGNANCY
Common risk factor which is also a complication of Diabetes
DIABETIC GASTROPATHY
Refers to a condition wherein due to prolonged high level of blood sugar, tissues of stomach are affected thus resulting to the damage in the gastric walls leading to delayed gastric emptying and weakened LES
DIABETIC GASTROPHY
Common risk factor that has the tendency to relax the LES
ASTHMA
Results to cutaneous and GI damages + Impair swallowing
Connective tissue Disorder (RHEUMATOID ARTHRITIS)
Characterized by presence of acid-producing tumors in the stomach
ZOLLINGER-ELLISON SYNDROME
Common risk factor wherein Growing tumors that can produce acid can cause excess acid and result to reflux
ZOLLINGER-ELLISON SYNDROME
Narrowing of pylorus (Pyloric sphincter)
PYLORIC STENOSIS
Common risk factor wherein the gastric content cannot go to small intestine due to the narrowing of pyloric sphincter
PYLORIC STENOSIS
Common risk factor wherein it causes slow, decrease, or absent movement of esophagus and small intestine
MOTILITY DISORDER
This position increases possibility of reflux
BENDING OR STOOPING
Foods that relaxes LES
(FSC)
FATTY FOODS
SPICY FOODS
CAFFEINE
Drugs that can relax LES
(BBCNX)
BENZODIAZEPINE
BETA BLOCKER
CALCIUM CHANNEL BLOCKER
NITRATES
XANTHINES
Foods that can increase acid production
(ACT)
ALCOHOL
COFFEE
TOBACCO
Is high predisposing factor to gastritis, PUD, and GERD
HELICOBACTER PYLORI
A condition wherein the cell of the esophagus changes from squamous to columnar lined epithelium due to constant exposure to acid. It is usually a premalignant state and a predisposing factor to esophageal cancer
BARRETT’s ESOPHAGUS (SYNDROME)
Hall mark symptom of GERD
PYROSIS (HEARTBURN)
Symptoms of GERD that is characterize by Diffiulty swallowing
DYSPHAGIA
Symptom of GERD that is characterize by Painful swallowing
ODYNOPHAGIA
An imaging test that uses barium and X-rays to create images of the upper gastrointestinal (GI) tract
BARIUM SWALLOW
used to evaluate damage to the esophageal mucosa and rule out strictures and hernias
BARIUM SWALLOW
Visualization of the esophagus, stomach, and duodenum using a camera held on to a flexible tube called endoscope
ENDOSCOPY (ESOPHAGOGASTRODUODENOSCOPY)
Gold standard for the diagnosis of GERD
AMBULATORY PH MONITORING
involves transnasal catheter placement or endoscopic wireless capsule
placement for approximately 24 -36 hours
AMBULATORY PH MONITORING
monitor spikes of regurgitation
AMBULATORY PH MONITORING
done to reproduce the pain (heartburn) when the lower esophagus is irrigated with an acid (Mild hydrochloric acid + saline or salt ) solution in people with GERD
BERNSTEIN TEST (ACID PERFUSION TEST)
How long is the Bernstein test
30 mins
How long is the Ambulatory Ph monitoring
24-36 hrs
How many time should client with GERD eat?
4-6 TIMES/DAY
Client with GERD should elevate the head of the bed at
6-8 INCHES
Client with GERD should sleep in what position
LEFT LATERAL POSITION
What is the diet of clients with GERD
↓PROTEIN AND FATS
What should patient with GERD avoid in their diet
SPICY, ACIDIC, CARBONATED FOODS
Client with GERD should stop eating snacks how many hours prior to bed
3 HOURS
Pharmaological management for GERD that neutralizes Acid
ANTACID
Examples of Antacid
(CAMA)
CALCIUM CARBONATE
ALUMINUM HYDROXIDE
MAGNESIUM HYDROXIDE
ALGINATE
Pharmacological Management for GERD that decrease gastric acid production
HISTAMINE 2 RECEPTOR ANTAGONIST
Example of histamine 2 receptor antagonist
(FCR)
FAMOTIDINE
CITIMIDINE
RANITIDINE
Pharmacologic management for GERD that accelerate gastric emptying
PROKINETIC AGENT (PROMOTILITY)
Example of prokinetic (promotility) agent
(MD)
METOCLOPRAMIDE
DOMPERIDONE
Pharmacological Management that decreases gastric acid production that takes longer to effect than H2 receptor agonist
PROTON PUMP INHIBITOR
Example of Proton Pump Inhibitor
(PO)
PANTOPRAZOLE
OMEPRAZOLE
Potential risk of gastric acid suppression is the
LOSS OF PROTECTIVE FLORA
INCREASE RISK FOR INFECTION
Infection associated with gastric acid supression
CLOSTRIDIUM DIFFICILE
What are the Pharmacological management for GERD
AHPP
ANTACID
H2 RECEPTOR AGONIST
PROKINETIC (PROMOTILITY)
PROTON PUMP INHIBITOR
a minimally invasive, outpatient procedure designed to relieve symptoms of GERD
STRETTA PROCEDURE
involves using a tube with a balloon or electrodes to apply controlled heat (radiofrequency energy) to the muscles around the lower esophageal sphincter and the gastric cardia
STRETTA PROCEDURE
In this procedure, the energy heats the tissue, ultimately causing it to swell and stiffen inhibits the activity of the vagus nerve thus reducing discomfort of client
STRETTA PROCEDURE
involves injecting a biocompatible polymer into the lower esophageal sphincter to tighten it and create a barrier against acid reflux
ENTERYX PROCEDURE
What is it called to something that is injected in the Enteryx Procedure
BIOCOMPATIBLE POLYMER
is a medical device that uses sutures to cinch and tighten the lower esophageal sphincter
BARD ENDOCINCH SUTURING SYSTEM (BESS)
gold standard for surgical management of GERD
OPEN OR LAPAROSCOPIC NISSEN FUNDOPLICATION
involves wrapping (360 degrees) of a portion of the gastric fundus around the
sphincter area of the esophagus
OPEN OR LAPAROSCOPIC NISSEN FUNDOPLICATION
Complications of Nissen Fundoplication
- Small bowel obstruction
- Retching
- Gas-bloat syndrome
- Dumping syndrome
- Temporary dysphagia
- Atelectasis
- Obstructed NGT
Complications of GERD
ESOPHAGITIS
ASPIRATION PNEUMONIA
BARRETT’s SYNDROME
large bubble of gas in the stomach that causes SOB
GAS-BLOAT SYNDROME
rapid emptying of the gastric content to small intestine
DUMPING SYNDROME
involuntary effort to vomit
RETCHING