بسم الله الرحمن الرحيم

GASTROESOPHAGEAL REFLUX DISEASE

( GERD)

PREPARING BY-: ASHRAF IBRAHIM

Difinition

(GERD ) is a common disorder of th gastrointestinal system.When acid from the

stomach leaks up into the oesophagus the condition is known as Gastrooesophageal

reflux. This may cause heartburn and other symptoms.

causes

1 -failure of the lower esophageal sphincter.2 -hiatal hernia.

3 -obesity.4 -high blood calcium.

5 -vomiting.

Pathophysiology

The circular band of muscle (sphincter) at the bottom of the oesophagus normally prevents acid leaking up (reflux). Problems occur if the sphincter does not work very well. This is common but in most cases it is not known why it does not work so well.

Pathophysiology

In some cases the pressure in the stomach rises higher than the sphincter can withstand - for example, during pregnancy, after a large meal, or when bending forward. If have a hiatus hernia (a condition where part of the stomach protrudes into the chest through the diaphragm), have an increased chance of developing reflux. (called Hiatus Hernia.)

Diagnosis

Is usually When Symptom are present- : -esophagogastroduodenoscopy (EGD) .

- Piobsy. - X-ray .

Symptoms

heart burn. chest pain. coughing. pain with Swallowing. increase salivation.

PREVENTION

The following are commonly advised.However there has been little research to prove how well these lifestyle changes help to ease reflux. stop smoking. Foods and drinks. Some medicines. Weight. Bed time.

Treetments

 Antacids

Antacids are alkaline liquids or tablets that reduce the amount of acid .

Acid-suppressing medicinesInclude-:

 omeprazole cimetidine  ,ranitidine

Assessment

Exclude pt with alarm symptoms such as dysphagia gastrointestinal bleeding , pt over 55 years.

-Unintentional weight loss or vomiting.

Nursing management

Interventions-:Explan all tests and procedures to decrease anxietyAllow client to express fears concerns regarding condition

Nursing management

1 -identify to reduce anxiety.2 -express an understanding of the disorder and

treatment.3 -achieve adequate caloric and nutritional intake.

4 -psychological support.5 -In consultation with adietition,develop adiet that

takes the pt food.

Nursing management

6 -if pt is obese, place him on at reduction.7 -head of the bed elevation.

8 -avoid lying down for 3 hours after meals.9 -administer analgesic,oxygen and IV fluids.

10 -check vital signs.11 -avoid caffeine,coffee,chocolate,spicy food and

alcohol.

complications

- Reflex esophagitis. - Esophageal Ulcer.

- Aneamia . - Aspiration.

- barrett’s oesophagus . - Cancer.

References

Medical-surgical nursingSeven edition.

Web Sit : www.medlinplus.com