BACKWARD FLOW (reflux) of gastrointestinal
contents into the esophagus
GASTROESOPHAGEAL REFLUX DISEASE (GERD)
MOST COMMON upper GI disorder
GASTROESOPHAGEAL REFLUX DISEASE (GERD)
Considered a disease process when acid is excessive and causes undesirable symptoms such as pain and
respiratory distress
GASTROESOPHAGEAL REFLUX DISEASE (GERD)
What is the cause of GERD?
INAPPROPRIATE RELAXATION of lower esophageal
sphincter or inability of the LES to close fully
What is the Subjective Data for GERD if there is Heartburn?
suggest reflux.
What is the Subjective Data for GERD if there is Dysphagia?
suggest narrowing of lumen
What is the most common symptom in objective data for GERD?
Dyspepsia
most accurate method allows for observation of the frequency of reflux episodes and their associated symptoms
24-hour ambulatory esophageal pH monitoring
management of heartburn
Antacids
HISTAMINE RECEPTOR ANTAGONISTS
● famotidine (Pepcid)
● ranitidine (Zantac)
● cimetidine (Tagamet)
● nizatidine (Axid)
PROTON PUMP INHIBITORS
● omeprazole (Priolosec)
● lansoprazole (Prevacid)
● rabeprazole (Aciphex)
● pantoprazole (Protonix)
● esomeprazole (Nexium)
What is the surgical management of GERD that is WRAPPING AND ANCHORING the fundus around the
lower esophageal sphincter?
LAPAROSCOPIC NISSEN FUNDOPLICATION (LNF)
What type of procedure that inhibits the activity of the vagus nerve?
STRETTA PROCEDURE
What type of procedure consists of:
the use of radiofrequency energy through needles to
induce THERMAL BURN in the gastroesophageal
junction tiny lesions occur initially and as it heals, it
tightens the tissues and increase muscle mass at the LES
STRETTA PROCEDURE
What type of procedure consists of:
INJECTION OF SOFT, SPONGY PERMANENT
IMPLANT made of liquid polymeric material into the LES muscle
ENTERYX PROCEDURE
What type of procedure that tightens the lower esophageal sphincter?
ENTERYX PROCEDURE
- opening in the diaphragm through which the esophagus passess becomes enlarged and part of the upper stomach moves up into the lower portion of the thorax
- it also occurs more often in women than in men
HIATAL HERNIA
What are the two types of Hiatal Hernia?
Sliding
Para esophageal
What type of Hiatal Hernia occurs when the upper stomach and the gastroesophageal junction are displaced upward
and slide in and out of the thorax?
Sliding
What type of Hiatal Hernia occurs when all of the part of the stomach pushes through the diaphragm beside the esophagus
Para esophageal
