GASTROESOPHAGEAL

REFLUX DISEASE

SANNY JR. T. NEPOMUCENO

BSN3D
GASTROESOPHAGEAL REFLUX DISEASE
● A digestive disorder that affects the
ring of muscle between your
esophagus and your stomach.

● Occurs when stomach acid

repeatedly flows back into the tube
connecting your mouth and stomach
(esophagus). This backwash (acid
reflux) can irritate the lining of your
esophagus.
CAUSES
● Weakened Lower esophageal
sphincter, valve-like muscle involved
in swallowing

Your LES may not function properly if

you:
 RISK FACTORS
Factors that can increase your likelihood of experiencing GERD are:

● Having obesity or excess weight, which applies excess pressure on abdomen

● Taking certain medications in which acid reflux is a side effect (common ones include
blood pressure medications and antidepressants)
● Smoking (and secondhand smoke), which causes irritation of the digestive tract
 PATHOPHYSIOLOGY
GERD is generally associated with a
weakened esophageal sphincter, the
valve-like muscle involved in
swallowing. It functions by closing
tightly after food passes through. If
weakened, it can no longer close as
tightly and digestive acid from the
stomach starts to backtrack up through
the valve, into the esophagus, and into
the mouth.
 CLINICAL MANIFESTATION
● Heartburn
○ a burning feeling in your stomach that may rise to your chest, neck, and throat
● A sour or bitter taste at the back of your mouth
● Regurgitation of food or liquid from your stomach into your mouth
● A feeling of fullness or of a lump in the back of your throat
● Chronic cough
● A hoarse voice
● Bad breath

Alarming signs and symptoms

● Difficulty swallowing (dysphagia)
● Pain when swallowing (odynophagia)
● Nausea or vomiting
● Weight loss
● Anemia
● Bleeding
 ASSESSMENT AND DIAGNOSTIC

Ambulatory 24-hour
Esophagram Upper endoscopy
pH probe

Esophageal pH
Esophageal manometry
monitoring
 COMPLICATIONS

Esophageal Barrett’s
Esophagitis
Stricture Esophagus
which involves
which is inflammation which happens when
permanent changes to
of your esophagus your esophagus
the lining of your
narrows or tightens
esophagus
 COMPLICATIONS

Esophageal Others
cancer
which affects a small tooth enamel erosion,
portion of people with gum disease, or other
Barrett’s esophagus dental problems
 NURSING MANAGEMNET
✓ Lifestyle Modification:
o Educate the patient on lifestyle changes, including dietary modifications (avoiding trigger foods),
maintaining a healthy weight, and elevating the head of the bed to reduce nocturnal reflux.
✓ Medication Management:
o Administer prescribed medications as directed, such as proton pump inhibitors (PPIs) or H2
blockers, and educate the patient on the proper use, potential side effects, and the importance of
adherence.
✓ Dietary Guidance:
o Provide nutritional counseling to help the patient make informed choices, emphasizing a low-fat
diet, smaller meal portions, and avoiding late-night snacks.
✓ Monitoring and Follow-up:
o Establish a plan for regular follow-up to monitor symptom progression, medication effectiveness,
and the need for adjustments. Encourage open communication about changes in symptoms.
✓ Symptom Management Strategies:
o Teach the patient strategies for managing acute symptoms, such as lifestyle adjustments, the use
of antacids as prescribed, and recognizing when to seek prompt medical attention for severe
symptoms or complications.
 TREATMENT
● Some common medications for GERD include:
✓ Antacids like Tums, Maalox, Rolaids, or Mylanta

✓ Bismuth subsalicylate like Pepto-Bismol

✓ Baclofen prescription

✓ H2-receptor blockers such as Axid AR (nizatidine),

Zantac 360 or Pepcid AC (famotidine), and Tagamet
(cimetidine)

✓ Proton pump inhibitors (PPIs) like Nexium

(esomeprazole), Prevacid (lansoprazole), and Prilosec
(omeprazole)

✓ Prokinetic agents
 REFERENCES
o https://www.verywellhealth.com/gerd-gastrointestinal-reflux-disease-7110515#toc-
treatment-for-gerd
o https://my.clevelandclinic.org/health/diseases/17019-acid-reflux-gerd#management-
and-treatment
o https://www.healthline.com/health/gerd#takeaway
o https://www.webmd.com/heartburn-gerd/reflux-disease-gerd-1
o https://www.mayoclinic.org/diseases-conditions/gerd/symptoms-causes/syc-
20361940
o https://nursing.com/lesson/nursing-care-plan-for-gastroesophageal-reflux-disease-
gerd