UPPER GASTROINTESTINAL DISORDER
Created by : Jessica Faye G. Manansala
GASTROESOPHAGEAL RELUX DISEASE (GERD)
• It is a syndrome resulting from esophageal reflux
Clinical Manifestation
• Heart burn• Odynophagia• Dysphagia• Acid regurgitation• Water brash• Eructation• Pain (back, neck or jaw)
Risk Factors
• Obesity & weight gain• Pregnancy• Chewing tobacco• Smoking• High fats foods• Theophylline• Caffeine• Chocolate
Diagnosis
• Barium swallow • Esophageal manometry• Esophagoscopy• Esophageal biopsy• Cytologic examination
• Acid perfusion test
Esophageal Manometry
esophagoscopy
Acid Perfusion Test
Treatment
• 1. Restrict diet into small frequent feedings.
• 2. Drink adequate fluid at meals to assist food passage.
• 3. Eat slowly and chew thoroughly to add saliva to the food
• 4. Avoid extremely hot or cold food, spices, fats, alcohol, coffee, chocolate & citrus juices.
Medications
• Cytotec- preventing gastric ulcer formation & GERD manifestation
• Antacids (30 ml 1hr before and 2 to 3hrs after meal) it helps to neutralize gastric acid secretions.
• Histamine receptors antagonist• (zantac, pepcid) – It decreases gastric secretions.• Cholinergic ( bethanechol or urecholine) – for clients
with severe manifestation it increase LES pressure and prevent reflux
• Metoclopramide (raglan)- increase LES pressure by stimulating the smooth muscle of GIT and increase the rate of gastric emptying. This medication is taken before meal.
• Cisapride (propulsid) 15min before meal and at bed time.• Proton pump inhibitor (prevacid) – suppresses secretion
of gastric acid,
Nursing management
• Identify specific manifestation• Document when sign and symptoms started
( frequency & severity)• Help client to identify risk factors for GERD• Instruct clients about lifestyle change• Explain the relationship of manifestation to
food and various product.
PEPTIC ULCER DISEASE (PUD)
- PUD involves break in continuity of the esophageal, gastric or duodenal mucosa
DUODENAL ULCER
• Duodenal ulcer has an increase incidence than gastric ulcers.
Stimuli Acid Secretion
• Protein rich meals• Alcohol consumption• Calcium• Vagal stimulation
GASTRIC ULCER
• Cause is the break in of the mucosal barrier.• Incompetent pylorus into stomach may break
mucosa barrier.
Risk Factor
• smoking (nicotine)• steroids• aspirin• NSAID’s • Caffeine• Alcohol• Stress
Clinical Manifestation
• Pain- aching, burning, cramp, gnawing pain• Gastric ulcer - food may cause pain and
vomiting may relieve it.• Duodenal ulcer- empty stomach and ingestion
of food or antacid may relieve pain.• Nausea and Vomiting – vomiting is more often
in gastric ulcer• Gastric ulcer – anorexia, weight loss and
dysphagia• Bleeding
Diagnosis
• X-ray and Endoscopy• CBC• Stool testing• Urea Breath Test
Treatment
• Anatacid• Cimetidine• Rahitidine• Pamotiidne• Clarithromycin• Cytotec
Nursing Management
• Modify diet• Assess bleeding• Prevent shock• Replace fluids• Maintain rest
GASTRIC CANCER
• Gastric cancer refers to the malignant neoplasms found in the stomach, usually adenocarcinoma. Most stomach cancers occur in the pylorus or antrum of the stomach and are adenocarcinomas
Clinical Manifestation
• Early stage – symptoms may be absent• indigestion• anorexia• dyspepsia• weight loss• abdominal pain• constipation• anemia• nausea & vomiting
Risk Factors
• chronic atrophic gastritis• history of exposure to background radiation or
trace metal soil• people usually eat pickled food, salted fish &
nitrates• metal craft workers, miners, bakers• those working in dusty, smoky & sulfur dioxide
containing environment
Diagnosis
• X-ray the upper GIT• Double contrast barium swallow• followed by endoscopy for biopsy• cytologic test• CT scan• Gastroscopy
Treatment
• chemotheraphy• radiation theraphy• surgical resection
Nursing Management
• assess the client history of diet (smoked fish, salty food,smoking)
• family history• asked the patient if she/he has a previous
gastric surgery• history of risk factors to the development of
cancer.• chronic gastritis• pernicious anemia• presence of H.Pylori
THE END
THANKS FOR LISTENING (^.^)!!