Gastroesophageal Reflux Disease (GERD): Symptoms, Causes, Treatment

Causes | Clinical features | Complication | Diagnosis of GERD | Management | Nursing Management |

GERD or Acid Reflux- causes, diagnosis, symptoms,management

What is GERD or Acid Reflux?

  • Gastro-Esophageal Reflux Disease (GERD) is reflux (return) of gastric content (mainly acid) towards the mouth resulting in esophageal tissue damage.
  • This is a chronic disease that occurs when stomach acid (HCL) or bile flows into the food pipe and irritates the inner lining.
  • Gastro-Esophageal Reflux Disease (GERD) also known as Acid Reflux.

Causes or Etiology of GERD:-

  • Hiatal Hernia.
  • Obesity.
  • Zollinger Ellison Syndrome:-Hyper-secretion of gastric acid.
  • delayed gastric emptying.
  • delayed esophageal clearance.
  • Increases Intra-abdominal pressure.
  • Inappropriate relaxation of LES (lower esophageal sphincter):- It is the most common cause.
  • Reduce the tone of LES (seen in scleroderma or systemic sclerosis).
  • Food (Alcohol, caffeine, tobacco, spicy food, fried food, etc).

Clinical Feature of GERD:-

most common feature are:-

  • Acidic taste in the mouth.
  • Regurgitation (backflow).
  • Heartburn.

less common feature include:-

  • pain with swallowing.
  • Short throat.
  • Increase salivation (water brash).
  • Chest pain.
  • Coughing.
  • Frequent bleaching.

GERD sometimes causes injury to the esophagus/ Complication:-

  • Reflux esophagitis:- Inflammation of esophageal epithelium which can cause ulcers near the junction of the stomach and esophagus.
  • Esophageal strictures (narrowing):-the persistent narrowing of the esophagus caused by reflux induced inflammation.
  • Barrett’s Esophagus:- Abnormal changes in the cells of the lower esophagus.
  • Esophageal Adenocarcinoma:- A form of cancer.

Diagnosis of GERD:-

  1. EGD:- Esophago Gastro Duodenoscopy:- visualization of the esophagus stomach and first part of the small intestine.
  2. Barium Swallow X-ray:- to assess the presence of an esophageal stricture
  3. Esophageal PH monitoring.

Management of GERD:-

Medical management:-

  • Proton pump inhibitor.
  • H2 receptors antagonist.
  • Antacids.
  • Avoiding drugs like- Aspirin, ibuprofen.
  • Avoiding alcohol, tea, coffee, etc.

Surgical Management:-

  • Nissen Fundoplication:- In this procedure, the upper part of the stomach is wrapped along the lower esophageal sphincter to strengthen the sphincter and prevent acid reflux.

Nursing Management:-

  • Nursing management of Gastro-Esophageal Reflux Disease (GERD) involves teaching the client to avoid situations that decrease lower esophageal sphincter pressure or cause esophageal irritation.

Nursing Intervention:-

  • Monitor the vital signs of the client.
  • Assess the abdomen for distention and intraabdominal pressure.
  • Encourage the client to small frequent meals of high calories and high protein foods.
  • Instruct the client to remain upright position, at least two hours after meals, and avoiding eating three hours before bedtime.
  • Instruct the client to eat slowly and masticate food well.
  • Advice to clients to avoid spicy food and acidic food.
  • Encourage the client to quit smoking and to lose weight if overweight.

See also:- Gastritis or Stomach Inflammation

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