part 3 Flashcards
What are the respiratory complications from GERD?
- irritation of upper airway by secretions
- cough
- bronchospasm
- laryngospasm
- crichopharyngeal spasm
- aspiration: asthma, pneumonia
- dental erosion
What are some lifestyle modifications we need to teach about GERD?
- avoid alcohol, caffeine, and smoking
- weight loss, exercise, stress management
- avoid triggers, don’t eat late at night
- elevate HOB
- wait 2-3 hours after eating before you lay down
- medication information
What foods decrease LES pressure?
chocolate peppermint tomatoes coffee tea
What are the medications for GERD?
- proton pump inhibitors (PPIs): promote esophageal healing - prilosec
- histamine 2 receptor blockers: decrease secretion of HCL - cimetidine
- acid protective: cytoprotective properties - sucralfate
- cholinergic: increases LES pressure - urecholine
- prokinetic: promotes gastric emptying - reglan
- antacids: neutralize HCL - mylanta
When should antacids (Maalox, Mylanta) be taken?
1-3 hours after meals/at bedtime
Surgical therapy is reserved for those with what complications related to GERD?
- failure of conservation therapy
- medication intolerance
- Barrett’s metaplasia
- esophageal stricture/stenosis
- chronic esophagitis
What are the 2 fundoplication surgeries for complications related to GERD?
Nissen
Toupet
Fundus of stomach is wrapped around the distal esophagus and the funds is sutured to itself.
Nissen fundoplication
After a surgery for GERD what types of food should be avoided?
-avoid gas forming foods
What is a hiatal hernia?
-portion of the stomach pushed into the esophagus through an opening in the diaphragm
What are the 2 types of hiatal hernia?
- sliding: happens when the pt lays down and goes back when they stand (most common)
- paraesophageal: (rolling) forms a pocket alongside the esophagus, this is an emergency
