Gastroesophageal Reflux Disease (GERD)

Gastroesophageal Reflux Disease (GERD)

- Backflow of the stomach or intestinal contents into the esophagus without vomiting

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- Etiology:

- Incompetent LES

- Fatty meals

- Smoking

- Pyloric stenosis

- Xanthine containing foods - cola, coffee, chocolate

- Clinical manifestations:

- pyrosis (burning sensation in the esophagus)

- regurgitation of sour-tasting gastric secretions

- dysphagia (difficulty in swallowing),

- odynophagia (pain on swallowing)

- symptoms mimicking those of heart attack

- Hpersalivation

- Diagnostics:

- Esoghagoscopy

- Barium swallow

- Esophageal pH every hr for 24 hrs

- Management:

- Antacids

- H2 Blokers

- Bethanochol (Urocholine) – increase LES pressure but increases gastric secretions. should be taken with antacids

- Metochlopramide – increases gastric emptying

- Nursing Intervention

- Eat low fat, high fiber diet

- Avoid foods that increase gastric acid secretions (spicy or acidic foods, tobacco, caffeine and alcohol).

- Avoid food and drinks 3 hours before bedtime or lying down after eating.

- Elevate the head 6-8 inches during sleeping

- Lose weight if necessary

- If symptoms persist, prepare the client for surgical repair (fundoplication)