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Gastroesophageal Reflux Disease - Case Study Example

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Gastro esophageal reflux disease is a chronic disorder of the digestive system where food, fluids, and stomach juices return back to the esophagus from the stomach. It can occur to people of any age, though it is most common in infants. This can cause irritation to the…
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GERD Patient Education Plan GERD Patient Education Plan Gastro esophageal reflux disease is a chronic disorder of the digestive system where food, fluids, and stomach juices return back to the esophagus from the stomach. It can occur to people of any age, though it is most common in infants. This can cause irritation to the esophagus, causing heartburn. When food is eaten, it passes through the esophagus into the stomach, from the throat. Muscle fibers ring prevents the back movement of swallowed food in the lower esophagus (Gary, 2008). When the muscle ring doesn’t close, the contents can leak into the esophagus.
Heartburn is a common symptom for GERD. Other symptoms may occur less frequently though indicative of GERD including: acid regurgitation, excess saliva, chronic sore throat, chest pain, gum inflammation, chronic sore throat and chest pain. Harsh stomach acids can damage the esophageal lining. Reflux risk factors include alcohol use, pregnancy, obesity and smoking. Reflux and heartburn are worsened by pregnancy. Asthmatic people have higher risks of developing GERD. Flare-ups of asthma cause the lower esophageal sphincter (LES) to relax, therefore allowing the backflow of stomach contents into the esophagus. Asthma medications worsen reflux symptoms (Joel & Ritcher, 2014). Acid reflux may also make the symptoms of asthma worsen through irritating the lungs and the airways, leading to more serious asthma.
However, the following is a patient education plan that focuses on conservation measures in treating GERD. Decreasing the portion size at mealtime may be helpful in controlling symptoms. Taking meals 2-3 hours prior to bedtime may aid in lessening reflux through decreasing stomach acid and emptying it partially. Additionally, being overweight is often associated with worse symptoms of GERD. Overweight patients should find relief in losing some of their weight (Gary, 2008). Moderate exercise is considered to improve GERD symptoms, but vigorous exercises may worsen the symptoms.
Moreover, when sleeping, the patient is advised to elevate the head of the bed at least 6-8 inches, or to sleep on a wedge-shaped bed that is specially designed. This reduces heartburn by allowing gravity minimize stomach contents reflux into the esophagus. It is advisable that the patient does not use a pillow to prop him/her up; this only adds pressure on the stomach, worsening the situation. Cigarette smoking and taking and alcohol usually weakens the LES. Symptoms of GERD may be reduced by halting smoking and stopping alcohol taking behavior. Along with diet and lifestyle changes, over-the counter medicines can be prescribed by the doctor (Gary, 2008). Antacids aid in neutralizing stomach and esophagus acid, and may stop heartburn. Most people find non-prescription antacids providing partial or temporary relief.
For patients with severe and chronic GERD or symptoms that are not relieved by the treatments that are described above need more diagnostic evaluation. Doctors can use a variety of procedures and tests in examining a chronic heart burn patient. The earlier testing phase can encompass an upper Gastrointestinal Series, which is a special X-ray which shows the stomach, duodenum and the esophagus (Joel & Ritcher, 2014). This test may provide limited information on the possibility of reflux but is helpful in ruling out other diagnoses such as peptic ulcers.
Endoscopy is also important for chronic GERD patients. It can show irritation or inflammation of the esophageal tissue lining. If Endoscopy presents questionable or abnormal results, an esophageal lining biopsy may be helpful. Esophageal impedance and manometric studies which involve measurements of esophageal pressure may occasionally aid in identifying low pressure or esophageal muscle contraction abnormalities (Joel & Ritcher, 2014). For those patients where diagnosis proves difficult, doctors can measure acid levels in the esophagus via PH testing, which monitors acid levels of the oesophagus and the symptoms during activity, sleep and meal times.
A few people with GERD may require surgery due to severe reflux as well as a poor response to treatment. Surgery, however, should be the last option, when all the other measures have been considered. Sometimes GERD results in serious complications. Too much esophageal acid may result in esophagitis; consequently causing esophageal ulcers or bleeding (Gary, 2008). Stricture of esophageal lining narrowing can also occur due to chronic scarring. Some individuals may develop Barrett’s esophagus, a condition that may increase esophageal cancer risk.
In conclusion, along with diet and lifestyle changes, over-the counter medicines can be prescribed by the doctor for relieving symptoms of GERD. Antacids aid in neutralizing stomach and esophagus acid, and may stop heartburn. Most people find non-prescription antacids providing partial or temporary relief. However, long-term use of the antacids should be avoided. Drugs, including proton pump inhibitors are most effective in the treatment of GERD disease. However, for severe, chronic cases, further diagnosis, including endoscopy, biopsy and gastrointestinal series may be helpful. Sometimes, GERD may require surgery and this is only recommended when all other options have deemed not helpful.
References
Gary, G. (2008). Gastro esophageal Reflex Disease: A Clinician’s Guide. New York, NY: Professional Communications Inc.
Joel, E & Ritcher M.D. (2014). Gastro esophageal Reflux Disease, An issue of Gastroenterology Clinics of North America. Melbourne: Elsevier. Read More
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