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UPPER GI: GERD Group 5: Brooke Bevins, Lindsey Gamrat, Briana McKenney, Emily Mendel, Latifah Gray, Hannah Crist.

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Presentation on theme: "UPPER GI: GERD Group 5: Brooke Bevins, Lindsey Gamrat, Briana McKenney, Emily Mendel, Latifah Gray, Hannah Crist."— Presentation transcript:

1 UPPER GI: GERD Group 5: Brooke Bevins, Lindsey Gamrat, Briana McKenney, Emily Mendel, Latifah Gray, Hannah Crist

2 PATIENT HISTORY Joe is a 47 YO male who came in c/o intense burning sensation in his chest accompanied by nausea. He reports that he has also been belching frequently which gives him the sensation of regurgitation in his throat. Joe smokes ½ a pack of cigarettes per day and consumes moderate amounts of alcohol Dx with asthma at 14 YO Recently dx with hiatal hernia NKA to food Reports that he frequently get a burning sensation in chest after dinner Late dinner then watches TV in chair and goes to bed Symptoms worsen when he lays down Takes antacids occasionally which helps

3 PHYSICAL AND DIAGNOSTICS Nurse calculates BMI as 31.2 A BMI over 30 indicates a patient is obese A stool occult blood test is positive Indicative of bleeding somewhere in the GI tract Never had an endoscopy or acid probe test

4 PREVALENCE Occurs in both men and women Most common in those that are overweight

5 RISK FACTORS Obesity Hiatal hernia Pregnancy Smoking Dry mouth Asthma Diabetes Delayed stomach emptying

6 PATHOPHYSIOLOGY GERD- Gastroesophageal reflux disease (aka acid-reflux disease) is caused by excessive reflux occurring, either in frequency or volume, or if the esophagus fails to contract in response to stomach contents Common cause is a hiatal hernia Effective diets relax the lower esophageal sphincter and dont stimulate gastric secretions http://www.youtube.com/w atch?v=TdK0jRFpWPQ

7 SYMPTOMS AND RISKS Heart burn with pain occurring behind the sternum Pain can sometimes radiate to the neck and the back of the throat Those at risk include pregnant women and obese people In women, BMI may be associated with the symptoms of GERD for those who are normal or overweight. Moderate weight gain may aggravate the symptoms Smoking increases the risk of GERD

8 DIAGNOSIS X-ray of esophagus Chalky liquid that coats the GI tract and allows physician to see inside of tract and determine damage that has been done. Endoscopy Physician passes a flexible tube with a light and camera down the esophagus to view the stomach and esophagus

9 DIETARY INTERVENTIONS Loose weight if it is needed Avoid lying down for three hours after eating Eat frequent and smaller portioned meals Do not eat close to bed time Stay away from food that may worsen GERD symptoms: Citrus fruits, chocolate, caffeine, alcohol, fatty/fried foods, garlic, onions, spicy foods, tomato-based foods

10 NURSING INTERVENTIONS Educate client and family on importance of a healthy diet. Educate client about risks attached to smoking and how it perpetuates his condition. Promote regular exercise. Educate client foods that are harmful to his condition. *see dietary interventions Assist in obtaining resources to help track nutrient/calorie intake ChooseMyPlate.gov/SuperTracker https://www.choosemyplate.gov/SuperTracker/default.aspx

11 MEDICATIONS OTC: Antacids/any medicine that slows acid production and heals the esophagus Alka-Seltzer Prescription Strength: H-2 receptor Blockers (Pepcid, Zantac) Proton Pump Inhibitors (Prevacid, Prilosec) Surgery is a last resort treatment that occurs if the medications do not help in controlling GERD

12 ALTERNATIVE MEDICATIONS Not proven to treat or reverse damage, but are proven to provide some relief Acupuncture Relaxation Therapy Guided Imagery Progressive Muscle Relaxation Herbal remedies * Licorice, Slippery Elm, Chamomile, Marshmallow *May interfere with some medications

13 PATIENT GOALS Maintains a healthy weight Excess weight creates pressure on abdomen and acid will build up in the esophagus. Patient avoids food and drinks causing heartburn Fried foods, fast foods, soda, tomato sauce, onion, garlic, spicy foods, etc. Eats smaller meals Obese clients should work towards loosing weight and maintaining a healthier food diet. Doesnt lie down after eating Wait at least three hours to lie down.

14 OUTCOMES Weight loss for obese clients Healthier food diet Engage in weekly physical activities Smaller meal portions Stop/reduce smoking habits

15 LONG-TERM IMPLICATIONS Narrowing of the esophagus (esophageal stricture) An open sore in the esophagus (esophageal ulcer) Precancerous changes to the esophagus (Barretts esophagus)

16 QUESTIONS?

17 REFERENCES Fennerty, Brian. (2007, May). Heartburn, gastroesophageal reflux (ger), and gastroesophageal reflux disease (gerd). Retrieved from http://digestive.niddk.nih.gov/ddiseases/pubs/gerd/ http://digestive.niddk.nih.gov/ddiseases/pubs/gerd/ Longstreth, G. F. (2011, August 11). Gastroesophageal reflux disease. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001311/http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001311/ Center for Disease Control and Prevention. (2011, September 13). About bmi for adults. Retrieved from http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html Mayo Foundation for Medical Education and Research (MFMER). (1998- 2012). Retrieved from http://www.mayoclinic.com/health/gerd/DS00967/DSECTION=lifestyle-and- home-remedies http://www.mayoclinic.com/health/gerd/DS00967/DSECTION=lifestyle-and- home-remedies

18 REFERENCES Lutz, Carroll & Przytulski, Karen. (2011). Nutrition and Diet Therapy. Philadelphia, PA: F.A. Davis Company Mayo Clinic Foundation for Medical Education and Research. (2011). GERD. Mayo Clinic. Retrieved from http://www.mayoclinic.com/health/gerd/DS00967 http://www.mayoclinic.com/health/gerd/DS00967


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