Upper GI Flashcards
what are the 3 common causes of dysphagia?
Mechanical obstruction, neuromuscular (ex: stroke), and people that have been intubated / trachs
List the common triggers for GERD:
- fatty foods
- spicy foods
- tomato based foods
- citrus
- caffeine
-large amounts of ETOH - cigs
- sleep position
- obesity
- pregnancy
- some drugs
what is dyspepsia?
Basically like indigestion - burning, bloating/gassy, nauseous
What are the mouth manifestations of GERD?
tooth decay, gingivitis, bad breath
True or false - GERD can manifest as an ear ache.
True
What are 3 pulmonary manifestations of GERD?
Chronic cough, worsening asthma, recurrent pneumonias
What is Barrett esophagus?
Development of abnormal metaplastic tissue in the esophagus. Places the patient at an increased risk of developing adenocarcinoma (cancer) of the esophagus. Overall survival rate is low. Monitor the patient for progression of this.
What is another name for a Type I hiatal hernia?
sliding hernia
What is another name for a Type II hiatal hernia?
paraesophageal hernia
What education can the nurse give to a patient with a hiatal hernia to help control symptoms?
small, frequent meals
avoid laying down after eating
avoid tight clothing
avoid abdominal supports
weight control if obese
antacids (GERD and esophagitis)
Where is the inflammation at with acute and chronic gastritis?
in the stomach lining
Where is the inflammation for gastroenteritis?
stomach lining and small intenstines
What are the 3 common causes of acute gastritis?
NSAIDS, ETOH, H. pylori
What are the 4 complications of chronic gastritis?
PUD, bleeding ulcers, anemia, gastric cancer
What are the 2 common causes of chronic gastritis?
H. pylori
Autoimmune attack of parietal cells
What type of environment is best for H. pylori?
acidic
How can H. pylori be transmitted?
Saliva, fecal matter, vomit, contaminated food or water
What are the 3 common causes of gastroenteritis?
viral infections (norovirus and rotavirus), bacterial infections (e. coli, salmonella, campylobacter), parasitic infections
Normal duration for gastroenteritis?
1-3 days, can last 10
What is the primary complication from gastroenteritis?
FVD
What are the common causes of PUD?
H. pylori, NSAIDs, ASA, ETOH, increased secretion of acid, smoking, family hx, stress (exacerbates NOT cause)
What is the patho behind PUD?
Mucosa is damaged causing histamine to be released. When histamine is released it increases the acid and pepsin secretion causing more irritation and damage to the lining. It also destroys blood vessels which explains why some patients may have bleeding.
What is the most common location of PUD and when?
duodenum, early adult hood
Why are older adults more at risk for gastric ulcers?
More use of NSAIDS, ASA, steroids, anticoags. Also generally more comorbidities.
Some patients with PUD may have burning pain in the middle of their stomach, when is this typically the worse?
When they have an empty stomach (nothing to protect the lining)
What is the typical onset of pain related to gastric ulcers?
1-2 hours after eating
What is the typical onset of pain related to duodenal ulcers?
2-4 hours after eating
What are the 3 major complications from PUD?
hemorrhage
obstruction
perforation and peritonitis
What factors are considered “aggressive” in relation to developing PUD?
H. pylori
NSAIDS
acid and pepsin
smoking
What factors are considered “defensive” factors in relation to developing PUD?
mucus
bicarbonate
blood flow
prostaglandins
What is GERD?
The lower esophageal sphincter not closing properly and allowing stomach contents to come back up. The stomach contents are highly acidic and cause irritation and inflammation in the esophagus.
What are the symptoms of GERD?
heartburn (pyrosis)
dyspepsia
regurgitation
chest pain (referred pain)
dysphagia
What are common complications from GERD?
ulceration
scarring
strictures
barrett esophagus
What is a hiatal hernia?
a defect in the diaphragm that allows part of the stomach to pass into the thorax
Which type of hernia usually is small and doesn’t need treatment?
type I / sliding hernia
What are the risk factors for hiatal hernias?
older age
injury or other damage that may weaken the diaphragm
repeatedly putting too much pressure on the abdominal muscles (severe coughing, vomiting, constipation / straining)
obesity
smoking (nicotine weakens abdominal muscles)
What are the common manifestations for a hiatal hernia?
can be asymptomatic
belching
dysphagia
chest / epigastric pain
Can a hiatal hernia and GERD coexist?
yes
What is duration difference between acute and chronic gastritis?
acute - 2-10 days
chronic - weeks - years
What are the clinical manifestations of acute and chronic gastritis?
vomiting
stomach burning
upset stomach
anorexia
N/V
postprandial discomfort
gas
hematemesis
tarry stools
anemia
What are the clinical manifestations of acute gastroenteritis?
watery diarrhea (may be bloody)
abdominal pain
N/V
fever
malaise
What are the risk factors for acute gastroenteritis?
older age
higher doses of NSAIDS (more frequent doses)
history of PUD
use of corticosteroids and anticoagulants long term
autoimmune disease
H. pylori
What are the clinical manifestations of PUD?
sometimes none - especially if they aren’t bleeding
N/V
anorexia
weight loss
bleeding
burning pain
