Questions and Answers
What role do anti-emetic drugs play in the management of vomiting related to gastritis?
Anti-emetic drugs, such as Inj. Perinorm or Tab, Domperidone, are used to effectively reduce vomiting in patients with gastritis.
Describe the clinical manifestation of acute gastritis.
Acute gastritis often presents with symptoms such as abdominal pain, nausea, vomiting, and loss of appetite.
What diagnostic findings may indicate the presence of chronic gastritis?
Diagnostic findings for chronic gastritis may include chronic inflammation observed during endoscopy and histological analysis of gastric tissue.
Explain why Laparoscopic Nissen Fundoplication is considered the gold standard for surgical management of gastroesophageal issues.
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How does the Stretta procedure utilize radiofrequency energy in the treatment of gastroesophageal reflux?
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What are the primary medications used to treat H. pylori infections associated with peptic ulcer disease (PUD)?
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What clinical manifestation is typically indicative of upper gastrointestinal bleeding in patients with PUD?
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Which surgical procedure involves the removal of the distal end of the stomach and anastomosis to the duodenum?
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What is the role of vagotomy in surgical management of PUD?
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What emergency complication may arise from a perforated ulcer, and how is it classified?
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Study Notes
Stretta Procedure and Medical Management
- Stretta procedure utilizes radiofrequency energy near the gastroesophageal junction to inhibit the vagus nerve, reducing discomfort.
- A gastroscopy may be performed alongside the Stretta procedure.
- Anti-emetic drugs like Inj. Perinorm or Tab Domperidone help alleviate vomiting.
- Antacids and H2 blockers (e.g., Cimetidine, Ranitidine, Famotidine) are effective for pain management.
- A prostaglandin E1 analog may be prescribed to protect the gastric mucosa when NSAIDs are problematic.
Gastritis Overview
- Gastritis is the inflammation of the gastric mucosa, classified into acute or chronic types.
- Highest incidence occurs in the fifth and sixth decades of life, with men more frequently affected.
- Heavy alcohol consumption and smoking increase gastritis risk.
Diet Therapy for Gastritis
- Initial treatment involves withholding food and fluids until nausea and vomiting subside.
- Once stabilized, patients can consume decaffeinated tea, gelatin, toast, and bland foods.
Peptic Ulcer Disease (PUD) Management
- Surgical management includes Laparoscopic Nissen Fundoplication, considered the gold standard for treatment.
- In cases resistant to medical therapy, surgical options include:
- Gastroduodenostomy (Billroth I): Resection of the distal stomach, connecting remaining stomach to the duodenum.
- Gastrojejunostomy (Billroth II): Removal of antrum and distal stomach, connecting remaining stomach to jejunum.
- Vagotomy: Transection of the vagus nerve to reduce acid secretion.
- Pyloroplasty: Widening of the pylorus to enhance gastric emptying.
- Subtotal Gastrectomy: Removal of 75%-85% of stomach.
- Antrectomy: Removal of the stomach's antrum.
- Gastroenterostomy: Creates passage from stomach to jejunum to neutralize gastric acid.
- Esophagojejunostomy: Total gastrectomy with jejunum attached to esophagus.
Complications of PUD
- Hemorrhage is a critical complication, with hematemesis indicating upper GI bleeding.
- Perforation is a surgical emergency, where gastric contents leak into the abdomen, leading to peritonitis and potential septicemia.
- Symptoms of perforation include sharp pain, apprehension, and a knee-chest position, with subsequent diminishment in peristalsis.
Nursing Care
- Routine preoperative care includes obtaining informed consent and ensuring patient is NPO.
- Postoperative care involves monitoring the NG tube for function and drainage, ensuring fluid and electrolyte balance.
- Promote pulmonary ventilation by positioning the client in mid to high-Fowler's position for optimal chest expansion.
- Post-removal of NG tube, initiate clear liquids and progressively reintroduce bland foods, while monitoring daily weight.
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Description
This quiz focuses on the medical management aspects of the Stretta procedure, which involves applying radiofrequency energy to the gastroesophageal junction. It discusses the role of gastroscopy and medications like anti-emetics in managing patient discomfort. Test your knowledge on this modern therapeutic technique!
