GI part 4 esophagus and GERD.txt

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GI part 4 esophagus and GERD.txt
2012-09-25 18:32:41
GI part

GI part 4 esophagus and reflux/GERD
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  1. Esophageal varices
    • abnormally enlarged veins in the lower part of the espophagus
    • develop when normal blood flow to the liver is slowed
    • blood backs up into neatby smaller blood vessels, such as those in the esophagus, causing the vessles to swell
    • may rupture, causing life-threatening bleeding
  2. Diagnosis for esophageal varices
    • endoscopy
    • imaging
  3. Treatments of esophageal varices
    • to reduce bleeding potential
    • medication (infusion of vasopressin)
    • medical devices (Minnesota or Sengstaken-Blakemore tube; elastic bands to tie off bleeding veins; TIPS - transjugular intrahepatic portosystemic shunt)
    • surgery (liver transplantation)
  4. Esophagitis (reflux) and GERD (gastroesophageal reflux disorder)
    • a general term for any inflammation, irritation or swelling of the esophagus
    • due to backflow of acid-containing fluid from the stomach to the esophagus
    • causes burning chest pain or heartburn that resembles pain of heart disease
  5. Risk factors for reflux and GERD
    • compromised cardiac or lower esophageal sphincter
    • increased acid secretion
  6. Common symptoms of reflux and GERD
    • feeling of food trapped behind the breastbone
    • heartburn or a burning pain in the chest
    • nausea after eating
    • other: coughing or wheezing
    • other: difficulty in swallowing
    • other: hiccups
    • other: hoarseness, change in voice or sore throat
  7. Risk factors for reflux or GERD
    • there are numerous
    • yes, I wasted a flash card on that
  8. Diagnosis for reflux or GERD
    • endoscopy
    • barium fluoroscopy
    • esophageal pH
    • esophageal manometry
  9. Treatments for reflux or GERD
    • avoid certain foods and beverages
    • changes in eating habits and lifestyle
  10. Medications for reflux or GERD
    • OTC antacids
    • anxiolytics
    • pepsin inhibitor
    • prostaglandin E1 (PGE1) analogue
    • gastrointestinal stimulants
    • anticholinergics
    • histamine2 (H2) receptor antagonists
    • proton pump inhibitors
  11. OTC antacids
    neutralize gastric acid secretion and reduces pepsin activity
  12. Anxiolytics
    reduce vagal stimulation and decrease anxiety
  13. Pepsin inhibitor
    binds to surface of proteins of ulcers to coat it, protecting the ulcer from further injury by gastric acid and pepsin
  14. Prostaglandin E1 (PGE1) analogue
    suppresses gastric acid secretion and increases sytoprotective mucus in GI tract
  15. Gastrointestinal stimulants
    increase gastric emptying and motility of upper intestines
  16. Anticholinergics
    decrease GI motility (delaying gastric empyting) and inhibits histamine and gastric acid (HCl) secretion
  17. Histamine2 (H2) receptor antagonists
    reduce histamine-induced gastric acid (HCl) secretion
  18. Proton pump inhibitors
    inhibit gastric acid (HCl) secretion