GI Disorders

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Anonymous
ID:
161885
Filename:
GI Disorders
Updated:
2012-07-10 08:29:02
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GI
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GI Disorders
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  1. Gastroesophageal Reflux Disease GERD
    -Backflow of stomach acid into the esophagus.
  2. GERD Signs / Symptoms
    • - Pyrosis
    • - Regurgitation, bitter sour/bitter taste
    • - Tooth erosion
    • - Hoarseness
    • - Eructation
    • - Flatulence
    • - Dysphagia
    • - Odynophagia
    • - Nocturnal cough
    • - Wheezing
  3. Pyrosis
    - Heartburn: burning & pressure sub sternal and retrosternal, radiates up neck, jaw and back. Mimics angina.
  4. Postprandial state
    -Post meal: 20 min � 2 hrs after meals
  5. Eructation
    - Belching
  6. Water brash
    � Reflux salivary hyper-secretion that does not taste bitter.
  7. Dysphagia
    � Difficulty swallowing
  8. Odynophagia
    � Painful swallowing
  9. Dx Tests for GERD
    • -Usually diagnosed by symptoms
    • - Bernstein Test: + if pain if felt when HCL is applied to esophagus
    • - Esophagogastroduodenoscopy (EGD)
    • - Barium swallow (upper GI series) : identifies hiatal hernia
  10. GERD Management
    • - Teach Diet & lifestyle changes
    • - Avoid problem foods / beverages
    • - Stop smoking
    • - Eat 4-6 smaller meals
    • - Lose weight
    • - Eliminate alcohol
    • - Remain upright 1-2 hrs after meals
    • - Avoid tight clothing
    • - Medication therapy
    • Antacids
    • H2 receptor antagonists
    • Proton pump inhibitors
    • -Fundoplication
  11. Antacids
    -aluminum hydroxide, Mylanta
  12. H2 Receptor Antagonists
    • - cimetidine, Tagament
    • - ranitidine, Zantac
    • - famotidine, Pepcid
    • - nizatidine, Axid
  13. Proton Pump Inhibitors
    • - omeprazol, Prilosec
    • - esomeprazole, Nexium
    • - pantoprazol, Protonix
    • - rabeprazol, Aciphex
    • - lansoprazole, Prevacid
  14. Antiulcer
    - secralfate, Carafate
  15. Prokinetics (promotility agents)
    • - metoclopramide, Reglan :
    • - increases peristalsis therefore, promotes gastric emptying & reduces risk of GERD
  16. Fundoplication
    - surgery to strengthen the LES and lessen the possibility of acid reflux also done to correct hiatal hernia.
  17. Complications of GERD
    • - Barrett�s esophagus: Normal squamous epithelium is replaced w/columnar epithelium, increasing risk of esophageal cancer
    • - Can trigger Asthma attacks
    • - Chest pain resulting in bleeding
    • - Narrowing or chronic irritation of esophagus
  18. GERD Prognosis
    • - Can cause esophageal ulcerations and hemorrhage
    • - Risk for aspiration
    • - Increased risk for Adenocarcinoma
    • - Scarring can permanently damage esophagus tissue & produce stricture
  19. Achalasia
    - Cardiospasm: an abnormal condition characterized by the inability of a muscle to relax, particularly the cardiac sphincter of the stomach.
  20. Achalasia Signs & Symptoms
    • - Dysphagia
    • - Regurgitation
  21. Dx tests for Achalasia
    • - Esophagoscopy
    • - Radiologic studies: show esophageal dilation
    • - Manometry: shows absence of primary peristalsis
  22. Achalasia Management
    • - Drug Therapy: to reduce pressure in the LES
    • -Anticholinergics
    • - Nitrates
    • - Calcium channel blockers
    • - Dilation with balloon similar to PCTA
    • - Cardiomyotomy: incision in the muscle layer of the esophagus allowing expansion
    • - High calorie, high protein diets.
  23. Hiatal Hernia
    • - A protrusion of the stomach and other abdominal viscera through an opening, or hiatus in the diaphragm, results of a weakness of the diaphragm.
    • - Anatomical condition not a disease
    • - Treated by fundoplication
  24. Hiatal Hernia Symptoms/ Complication
    • - GERD
    • - Strangulation of the herniated organ
    • - Infarction
    • - Ulceration

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