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Lecture 2

LECTURE 2.docx

3 Pages
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Department
Nursing
Course Code
NURS 287
Professor
Rick Nilson

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LECTURE 2: GASTROESOPHAGEAL REFLUX DISEASE (GERD)  There is no one single cause of gastroesophageal reflux disease (GERD). It can occur when there is reflux of acidic gastric contents into the esophagus.  Predisposing conditions include hiatal hernia, incompetent lower esophageal sphincter, decreased esophageal clearance (ability to clear liquids or food from the esophagus into the stomach) resulting from impaired esophageal motility, and decreased gastric emptying.  A complication of GERD is Barrett’s esophagus (esophageal metaplasia), which is considered a precancerous lesion that increases the patient’s risk for esophageal cancer.  Most patients with GERD can be successfully managed by lifestyle modifications and drug therapy.  Drug therapy for GERD is focused on improving LES function, increasing esophageal clearance, decreasing volume and acidity of reflux, and protecting the esophageal mucosa.  Because of the link between GERD and Barrett’s esophagus, patients are instructed to see their health care provider if symptoms persist. HIATAL HERNIA  The two most common types of hiatal hernia are sliding and paraesophageal (rolling).  Factors that predispose to hiatal hernia development include increased intraabdominal pressure, including obesity, pregnancy, ascites, tumors, tight girdles, intense physical exertion, and heavy lifting on a continual basis. Other factors are increased age, trauma, poor nutrition, and a forced recumbent position (e.g., prolonged bed rest). Esophageal Cancer  Two important risk factors for esophageal cancer are smoking and excessive alcohol intake. Gastritis  Gastritis occurs as the result of a breakdown in the normal gastric mucosal barrier.  Drugs such as aspirin, nonsteroidal antiinflammatory drugs (NSAIDs), digitalis, and alendronate (Fosamax) have direct irritating effects on the gastric mucosa. Dietary indiscretions can also result in acute gastritis.  The symptoms of acute gastritis include anorexia, nausea and vomiting, epigastric tenderness, and a feeling of fullness. Peptic Ulcer Disease  Gastric and
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