Gerd Definition Gastroesophageal reflux disease (GERD) is excessive reflux of hydrochloric acid into the esophagus. II.

. Risk Factors Incompetent lower esophageal sphincter (LES), pyloric stenosis or a motility disorder. III. Pathophysiology A weak or incompetent LES allows backward movement of gastric contents into the esophagus; decreased esophageal peristalsis and salivary function impair clearance of the refluxed acid, resulting in mucosal injury to the esophagus. IV. Assessment/Clinical Manifestations/Signs Aad Symptoms Pyrosis (i.e. burning sensation in the esophagus) Regurgitation of sour-tasting secretions Dysphagia (i.e. difficulty swallowing) and odynophagia ( i.e pain on swallowing) Symptoms mimicking those of a heart attack V. Nursing Management Teach the client to avoid factors that increase lower esophageal irritation. Eat a low-fat, high-fiber diet Avoid irritants, such as spicy or acidic foods, alcohol, caffeine, and tobacco, because they increase gastric acid production. Avoid food or drink 2 hours before bedtime or lying down after eating Elevate the head of the bed on 6 to 8 bocks Lose weight if necessary If symptoms persist, prepare the client for surgical repair, which includes a funduplication (i.e. wrapping a portion of the gastric fundus around the sphincter area of the esophagus) Administer medications, which may include antacids, histamine-receptor antagonists, and proton-pump inhibitors.