GERD

Gastro-Esophageal Reflux

GERD
Etiological Factors/Risk Factors
Smoking
Obesity
Malfunction of Lower esophageal Sphincter or LES
Motility Disorders
Irritation of Esophagus
Hiatal Hernia
Food like( Alcohol.Caffeine.Carbonated beverages.Chocolate.Citrus
fruits and juices.Tomatoes and tomato-based foods.Garlic. Mint.)

Signs and Symptoms

A burning sensation in your chest (heartburn), usually after eating,
which might be worse at night
Chest pain
Difficulty swallowing
Regurgitation of food or sour liquid
Sensation of a lump in your throat
The hallmark symptoms of GERD is: Heartburn –Medstar.Com
Diagnostic Test for GERD
-Diagnostic testing may include an endoscopy or barium swallow
to evaluate damage to the esophageal mucosa.
-Ambulatory 12- to36-hour esophageal pH monitoring is used to
evaluate the degree of acid reflux.
-Bilirubin monitoring (Bilitec) is used to measure bile reflux patterns.
Exposure to bile can cause mucosal damage (Aronson, 2000; Stein et al.,
1999).
Nursing Management
- teaching the patient to avoid situations that decrease lower esophageal
sphincter pressure or cause esophageal irritation.
The patient is instructed to eat a low-fat diet;
to avoid caffeine, tobacco, beer, milk, foods containing peppermint
or spearmint, and carbonated beverages; to avoid eating or drinking 2
hours before bedtime; to maintain normal body weight; to
avoid tight-fitting clothes; to elevate the head of the bed on 6- to
8-inch (15- to 20-cm) blocks; and to elevate the upper body on pillows
MEDICATIONS
If reflux persists, the patient may be given medications such
as antacids or histamine receptor blockers. Proton pump inhibitors
(medications that decrease the release of gastric acid, such as
lansoprazole [Prevacid] or rabeprazole [Aciphex]) may be used.
In addition, the patient may
receive prokinetic agents, which accelerate gastric emptying. These
agents include bethanechol (Urecholine), domperidone (Motilium),
and metoclopramide (Reglan).
SURGICAL TREATMENT
If medical management is unsuccessful, surgical intervention
may be necessary. Surgical management involves a fundoplication
(wrapping of a portion of the gastric fundus around the sphincter
area of the esophagus). Fundoplication may be perormed by
laparoscopy.

Nursing care plans for GERD

Imbalanced Nutrition: Less Than Body Requirements
Acute Pain
Imbalanced Nutrition: More Than Body Requirements
Risk for Aspiration
Deficient Knowledge