GERD Brandon Hoff.

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Presentation transcript:

GERD Brandon Hoff

What is GERD? Gastroesophageal Reflux Disease Acid Reflux Disease

What is GERD? Failure of the gastroesophageal sphincter Irritation and inflammation of the esophagus from stomach acid Effects 1/3 of the population at least once a month Effects 10% of the population on a daily basis

Basic Anatomy of the Upper GI Tract Mouth Pharynx Esophagus Stomach

Gastroesophageal Sphincter AKA: Lower Esophageal Sphincter; Cardiac Sphincter Ring of muscle on the inferior portion of the esophagus between the esophagus and stomach Prevents food and stomach content from reentering the esophagus

Gastroesophageal Sphincter Normal Function Relaxes during swallowing to allow food to pass Constricts after ingestion to prevent the back flow of food Function with GERD The sphincter relaxes between swallowing which allows stomach content and corrosive acid to enter the esophagus Causes damage to the lining of the esophagus

Stomach vs. Esophagus Stomach Esophagus pH Goblet Cells 1.5-3.5 Goblet Cells Provides an alkaline layer of mucus to protect the stomach lining. Esophagus Around 7.0 No Goblet Cells

Causes unclear Things that make the sphincter weaker Lifestyle Medications Diet Eating Habits Other Medical Problems

Lifestyle Alcohol Cigarettes Poor posture (slouching)

Medications Calcium Channel Blockers Theophylline

Diet Fatty & Fried Foods Chocolate Onions Garlic Caffeine Acidic Foods Spicy Foods Mint

Eating Habits Large Meals Eating 2-3 Hours Before Bedtime

Other Medical Causes Hiatal Hernia Pregnancy Diabetes with Rapid Weight Gain

Symptoms Heartburn is the most common Starts in the upper abdomen and spreads up the neck Can last up to two hours Worse after eating Not everyone with GERD has Regurgitation of bitter acid while sleeping or bending over Bitter taste Persistent dry cough Hoarseness Tightness in throat Wheezing

Complications of GERD Esophagitis & Ulcers

Complications of GERD (cont) Bleeding

Complications of GERD (cont) Stricture

Complications of GERD (cont) Laryngopharyngeal Reflex

Complications of GERD (cont) Respiratory Problems Asthma 75% have GERD

Complications of GERD (cont) Cancer of the Esophagus

Treatment Relieve Symptoms Prevent Damage to the Esophagus

Medical Treatment Lifestyle changes Medications Antacids PPI’s Block the production of stomach acid Coating agents Protects mucus membranes and sores by providing another layer Promotility Agents Tightens the sphincter and promotes faster emptying of the stomach Surgery Last option Fundoplication Suturing of the fundus around the inferior part of the esophagus Forms a one-way valve Increases the pressure in the lower portion on the esophagus

Emergency Situations in Pt. with GERD Severe chest pain or pressure Especially if it radiates Vomiting blood Vomiting with chest pain Dark tarry stool Difficulty swallowing solids and liquids

Summary What GERD is Causes Complications Treatment Emergency Management

References Donley, Kelli M. "GERD, Asthma Connection Vague: Research Continues." Endonurse.Com. 1 Sept. 2001. 20 May 2008 <http://www.endonurse.com/articles/diseases_disorders/589_191feat4.html>. "Gastroesophageal Reflux Disease (GERD)." Emedicinehealth. 10 Aug. 2005. 27 May 2008 <http://www.emedicinehealth.com/reflux_disease_gerd/article_em.htm>. Gillson, Sharon. "Causes of Gastroesophageal Reflux Disease." About.Com. 2 Jan. 2007. 27 May 2008 <http://heartburn.about.com/od/gerdacidrefluxdisease/a/causes_of_gerd.htm>. "Heartburn/GERD Health Center." Webmd. 18 May 2008 <http://www.webmd.com/heartburn-gerd/>. Lehrer, Jenifer K. "The Heartburn (Acid Reflex) Health Topic." Mdhelp.Com. 3 May 2007. 27 May 2008 <http://www.medhelp.org/HealthTopics/Acid_Reflux.html>. "What Causes GERD?" GERD.Com. Nov. 2007. 25 May 2008 <http://www.gerd.com/consumer/gerd-causes.aspx>.