Gastroesophageal Reflux Disease (GERD) Treatment

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Questions and Answers

What is the primary indicator of screening for digestive disorders?

Unintentional weight loss (correct)

Vitamin B12 deficiency

Changes in appetite

Frequent diarrhea

What is the main function of the lower esophageal sphincter (LES)?

To relax and let the food pass into the stomach (correct)

To prevent the backflow of food into the mouth

To allow the passage of food from the mouth to the esophagus

To contract and prevent the passage of food into the stomach

What is the role of dietary habits and nutrition in digestive disorders?

To only treat diseases of the GIT

To diagnose diseases of the GIT

To both prevent and treat diseases of the GIT (correct)

To only prevent diseases of the GIT

What is the primary function of the esophagus?

To transport food from the mouth to the stomach Signup and view all the answers

What is oropharyngeal dysphagia?

A swallowing disorder that affects the transfer of food from the mouth and pharynx to the esophagus Signup and view all the answers

What is the estimated number of outpatient visits per year for digestive disorders?

More than 50 million Signup and view all the answers

What is the main characteristic of esophageal dysphagia?

Difficulty passing a bolus of food through the esophageal lumen and into the stomach Signup and view all the answers

What is a common symptom of dysphagia?

Coughing during or after swallowing Signup and view all the answers

What is the goal of the dysphagia diet?

To return to a regular diet Signup and view all the answers

What type of foods are recommended for patients with dysphagia?

Soft, cohesive foods Signup and view all the answers

What is GERD?

Gastroesophageal reflux disease Signup and view all the answers

What is a common complication of GERD?

Barrett's esophagus Signup and view all the answers

What is the pathophysiology of GERD?

Both b and c Signup and view all the answers

What is a characteristic of oropharyngeal dysphagia?

Muscle failure to push food to the back of the throat Signup and view all the answers

What is a sign of dysphagia?

All of the above Signup and view all the answers

What is the purpose of adding commercial starch thickeners or baby cereals to liquids?

To make liquids thicker Signup and view all the answers

What is the main characteristic of Barrett's esophagus?

A change in the tissue lining of the esophagus Signup and view all the answers

What is recommended to avoid in terms of eating habits to prevent GERD?

Eating bedtime snacks Signup and view all the answers

Which of the following foods is associated with heartburn?

Fat Signup and view all the answers

Why is smoking considered a risk factor for GERD?

It reduces LES pressure Signup and view all the answers

What is the purpose of elevating the head of the bed on 6-inch blocks?

To reduce gastric pressure Signup and view all the answers

Why are non-steroidal anti-inflammatory drugs (NSAIDS) recommended to be avoided in GERD treatment?

They irritate the esophagus Signup and view all the answers

Study Notes

Digestive Disorders

Digestive disorders are common, with over 50 million outpatient visits per year
Dietary habits and nutrition play key roles in prevention and treatment of diseases of the gastrointestinal tract (GIT)
Medical nutrition therapy is necessary to prevent and treat malnutrition associated with diseases of the GIT

Types of Digestive Disorders

Dysphagia
Achalasia
GERD
Dyspepsia
Hiatal hernia
Gastroparesis
Gastric and duodenal ulcer
Dumping syndrome
Cancer

Assessment Parameters

Screening: unintentional weight loss (>2% in a week, >5% in 1 month, and >10% in 6 months)
Diet history: changes in appetite, nausea, vomiting, diarrhea, chewing and swallowing problems, food intolerances, typical intake
Use of supplements, laxatives, medications
Laboratory parameters: vitamin B12, folate, ferritin, 25-hydroxy vitamin D

The Esophagus

A tubular organ, 25 cm in length
Swallowing triggers peristaltic waves
Upper esophageal sphincter relaxes to allow passage of food from the mouth to the esophagus
Lower esophageal sphincter (LES) relaxes to let food pass into the stomach
Esophageal mucus, LES contraction, normal gastric motility, and tight cellular junctions protect tissue damage from acidity

Dysphagia

Two forms: oropharyngeal dysphagia and esophageal dysphagia
Oropharyngeal dysphagia: affects transfer of food from mouth and pharynx to esophagus, neuromuscular condition affecting tongue and pharynx
Esophageal dysphagia: difficulty passing bolus of food through esophageal lumen and into stomach due to obstruction or motility disorder (achalasia)

Causes of Dysphagia

Aging
Neurological disorders (including stroke)
Developmental disabilities
Certain head or neck surgeries

Signs and Symptoms of Dysphagia

Inability to initiate swallowing
Coughing during or after swallowing (due to aspiration of food)
Nasal regurgitation
Bad breath, gurgling noise after swallowing, hoarse or "wet" voice, speech disorder
Sitophobia (food phobia), pain upon swallowing
Food sticking in the throat
Often occurs in elderly

The Dysphagia Diet

No single dysphagia diet, individualized to patient's tolerance
Ultimate goal is to return to regular diet
Pureed diet is the limit for some patients
Foods most easily swallowed must be determined (trial)
Foods to be avoided: peanut butter, bread, cake, tough meat, rice, foods with variable consistence like veg soup
Typical foods: applesauce, pureed and mashed banana, pureed fruits and vegetables, mashed potatoes, puddings, yogurt, ice cream, and custards

GERD and Esophagitis

Regurgitation occurs in >half infants but usually resolves after the 1st year
GERD: repeated episodes of reflux of gastric content into the esophagus → Heartburn and inflammation of the esophagus
GERD can be erosive and non-erosive
Can lead to Barrett's esophagus (serious complication of GERD)

GERD Symptoms

Reflux of gastric secretions
Heartburn
Belching
Pain
Pharyngeal irritation

Treatment of GERD

Avoid eating bedtime snacks or lying down immediately after meals
Remain upright 2 hrs after a meal and consume meals 2-3 hours before bedtime
Avoid large meals that increase gastric pressure and lower LES pressure
Elevate head of bed on 6-inch blocks
Avoid bending over and wearing tight clothing that increases pressure in the stomach
Lose weight if needed
Avoid foods and beverages that irritate the esophagus during periods of esophagitis
Consume small frequent meals
Drink liquids between meals to decrease gastric distension
Limit foods that weaken lower esophageal sphincter pressure or increase gastric acid secretion

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Description

Learn about the treatment options for Gastroesophageal Reflux Disease (GERD) including lifestyle changes and preventive measures.