Gastroesophageal Reflux Disease
Gastroesophageal Reflux Disease
Gastroesophageal Reflux Disease or GERD occurs when the reflux of stomach acid and contents has a “reflux” back into the esophagus.
- This is usually caused due to the weakness within the lower esophageal sphincter or LES.
- This acid, can affect the lining of the esophagus and eventually cause pain to the patient.
Assessment:
- Dysphagia
- HeartBurn (burning and stinging sensation in the upper midsternum.
- Belching (eructation)
- Flatulence
- Chest Pain
Diagnostic Tests:
- pH Monitoring is one of the accurate diagnostics (NG tube is used)
- A pH of less than 4 in the LES is a diagnosis of GERD
- Endoscopy
- Barium Swallow
Management:
- Avoid food that are irritants such as (spicy foods, chocolate, fats)
- Small frequent meals
- Not lie down 2-3 hours after eating.
- Avoid Alcohol
Medications:
- Antacids (Mylanta)
- Proton Pump Inhibitors (Protoix, Nexium)
- Histamine Blockers (Pepcid, Axid)
- Prokinetic Drugs (increases gastric emptying) (Reglan)
Procedures:
Stretta- inhibits the vagus nerve activity in the GI system.
♣ Laproscopic Nissen Fundoplication (LNF)– fundus of the stomach is wrapped around the esophagus to support the LES.
♣ Post Op:
- Elevate the head of bed to prevent respiratory problems.
- Monitor the NG tube
After the procedure: the stomach size is smaller.
– Long term reflux of the acid in GERD patients can cause Barrett’s Esophagus.
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