Transcript: Gastroesophageal Reflux Disease (GERD) One symptom of GERD is injury of the esophagus. The bottom of the esophagus becomes highly inflamed from the stomach acid. What Cause's "GERD"? •Alcohol (possibly) •Hiatal hernia (a condition in which part of the stomach moves above the diaphragm, which is the muscle that separates the chest and abdominal cavities) •Obesity •Pregnancy •Scleroderma •Smoking What Can I Do To Help My GERD? Remedies: -Apple cider vinegar -Pickle Juice -Dietary changes -Apples -Lemons -Ginger - Water THE END.... or is it..? What is GERD? Gastroesophageal reflux disease is a condition in which the stomach contents, (food or liquid) leak backwards from the stomach into the esophagus. This action can irritate the esophagus, this can cause many symptoms.
Transcript: Pathophysiology 3. Proton Pump Inhibitors – even more powerful than H2 antagonists. PPIs bind directly to the hydrogen-potassium-ATPase pump mechanism itself and irreversibly inhibit the action of this enzyme, which results in a total blockage of hydrogen ion secretion from the parietal cells. Pantoprazole sodium (Pantoloc) Thank You! Gastroesophageal Reflux Disease • Abnormalities Lower esophageal sphincter • Gastric or duodenal ulcer • Gastric or esophageal surgery • Prolonged vomiting • Prolonged gastric intubation GERD is the backward flow of gastric contents from the stomach into the esophagus. Signs & Symptoms • Risk for Aspiration: 1. Foods and fluids should not be taken for 2 to 3 hours before bedtime 2. Should sleep with their heads elevated 6 to 12 inches 1. Antacids – are basic compounds used to neutralize stomach acid. Calcium carbonate (Tums) • Chronic Pain 1. Pain can be reduced by increasing Lower esophageal sphincter pressure, which keeps gastric contents from passing into the esophagus. Factors GERD Treatment 2. H2 Antagonists – reduce but do not eliminate stimulated acid secretion Ranitidine (Zantac) • Painful burning sensation that moves up and down, commonly occurs after meals • If severe, then the pain may radiate to the back, neck, or jaw • Acid regurgitation • Intermittent dysphagia • Belching • Symptoms are likely to occur after activities that increase intra-abdominal pressure such as lifting, straining, and lying supine. • Imbalanced Nutrition 1. Monitor weight changes 2. Advice patient to eat small, frequent meals, because large meals increase pressure in the stomach and delay gastric emptying 3. Avoid fatty foods, coffee, tea, cola, chocolate, alcohol, and acidic and spicy foods Nursing Interventions
Transcript: When does GERD usually appear (at what age)? Different foods, normal aging processes, birth defects and/or injuries can open the lower esophageal (cardiac) sphincter and cause the reflux. Diagram Asthma Some tests that could be administered are an x-ray of the upper digestive system or an esophageal impedance test which measures the movement of substances in the esophagus. Potential Causes Effects Some medications may worsen GERD such as Anticholinergics prescribed for overactive bladder and irritable bowel syndrome. Esophageal Impedance Test Digestive Tract X-Ray Questions People with asthma are at higher risk and their asthma can be confused with a symptom Lifestyle Changes Maintenance GERD often occurs beginning from infancy, usually without long-term health effects. Children and teens simply need to maintain a healthy lifestyle and take medication. Adults, however, with late-onset Acid Reflux may self-medicate incorrectly. Adults need to consult a doctor to receive the correct attention for their GERD. By: Ryan Caynak and Jacquie Marois A lifestyle change may be required to prevent Acid Reflux Disease. Fatty foods, mints, chocolates, alcohol, nicotine, and caffeine need to be avoided. Raising the head at night can also prevent the symptoms. Name one thing you ingest that can enhance the symptoms of GERD An asthma attack could potentially cause an onset of the disease and can cause the cardiac sphincter to relax, allowing stomach acid to go back (reflux) into the esophagus. Medications re-tasting food after swallowing, bad breath, tooth cavities, chest pain, sudden excess of saliva, sore throats, hoarseness and even inflammation of one’s gums. When food, fluids and/or acidic stomach juices back up from the stomach into the esophagus. It irritates the lining of the esophagus Treatment Gastroesophageal Reflux Disease (Acid Reflux Disease) What's Actually Happening Because it irritates the areas around the lungs and airways of the body, it can copy asthma symptoms and increase or affect allergic reactions. How?
Transcript: think of it backwards.... in this case, the food is going down the esophagus to the stomach and during reflux, acid from the stomach goes up the esophagus if the acid reaches high enough, it can go down the trachea to the larnyx/voicebox causing other complications An organ system that breaks down food while absorbing nutrients used by the body for energy. Complications can cause a change in the esophageal lining (Barrett's Esophagus) the esophagus sleeping on your right side causes acid to easily flow down to your esophagus -extra saliva: neutralizes small amounts of gastric acids that back up in esophagus can lead to cancer -saliva neutralizes acid Thank you for viewing this public education piece about GERD by not lying down for at least three hours after eating -causes added pressure on the stomach area, making it harder for the LES to function Nicotine eat dinner earlier Teeth GERD occurs in the Some examples are... gastroparesis -sometimes it feels like a heart attack or angina eating small meals at a time the trachea Proton pump inhibitors (PPI) connected to the mouth branches out into two directions: flat cells called squamous epithelium make up the esophageal lining (squamous mucosa) trouble swallowing makes/secrets bile (bile eliminates waste from blood and digests fat) Pancreas Alcohol mint flavourings spicy food alcohol Some foods... hoarseness, coughing uses contractions (preistalsis) to send food down to stomach the top of the stomach is folded around the base of the esophagus and stitched there this tightens the area around LES which helps to keep it closed H2 blockers blood vessels absorb most of the water + remaining minerals Infants usually grow out of GERD by the time they are 1 year old. Stomach anyone -closes to contain stomach contents (food and acid) By: Neha Patel The Pharynx Produce new cells that form scar tissues... Which thicken the esophageal lining causing esophageal stricture... But, if you have it for more than twice a week, you should get evaluated for GERD. throat and laryngeal inflammation Treatment Carbonated beverages Liver and it makes pushing food down the esophagus to the stomach difficult. sleeping on your stomach causes acid to slide easily up your esophagus. An injured esophageal lining because of the exposure of stomach acids... lined with villi which has blood vessels that absorb nutrients Salivary Glands -when acid stays in stomach for too long, it backs up into esophagus The Mouth nausea they block histamine receptors that signal your stomach to produce acid infection of the lungs frequent heartburn -in a healthy digestive system, if stomach contents slide up the esophagus, muscles would contract and push it back up loosing weight What Is GERD? muscular tube connecting pharynx to stomach -irritates and reddens esophageal lining -relaxes LES muscles Caffeinated drinks obesity by not drinking alcohol The Digestive System -stomach takes to long to empty to GERD elevating upper portion of body while sleeping Some examples are... GERD reduces production of stomach acids appears to repair the damage of the esophageal lining Possible Contributions -digests carbohydrates citrus fruits + juices quitting smoking Heartburn is the burning sensation that occurs in the esophagus once acid enters it. The lining of the esophagus is sensitive causing the pain of heartburn. overweight or pregnant people are more likely (because of the added pressure on their stomachs also known as the colon irritate the esophagus Gastroesophageal Reflux Disease sleeping on your left side prevents acid from flowing into your esophagus Not everyone with heartburn and reflux has GERD Preventing Heartburn and GERD -because of gravity, acid would not slip up the esophagus as easily because of gravity... men, women, infants, children ends at the rectum, which stores food waste Having GERD can lead to other disorders... -causes stomach to create more acid pregnancy chewing gum after meals GERD in Children and Infants -having a full stomach relaxes LES -grinds/mashes food into smaller pieces alcohol use ulcers and bleeding in the esophagus (esophageal erosion) -serious complication has strong muscular walls coffee also uses peristalsis esophageal scarring uses peristalsis to move food around wearing loose clothing -when upper portion of stomach moves upward to chest hiatal hernia The End. Over-the-counter antacids -when acid reflux reaches trachea Gall Bladder tomato based food Large Intestine -digests carbohydrates, fats, proteins etc. -kills harmful bacteria Because of the acid reflux that occurs when you have GERD... With a relaxed LES, it will stop opening and closing when it is supposed to, causing it to be more likely for acid to back up. relax the LES Alka Seltzer secrets enzymes - a muscular valve found between the stomach and esophagus -opens to let food in -activated when a you swallow -the LES of a GERD patient opens/closes frequently increase of saliva The Esophagus acid regurgitation -less
Transcript: It can impact someones life in the following ways: Persistent Typical and Atypical Symptoms: Which causes heartburn, chest pain, sore throat and other symptoms despite medication. Sleeping Positions: Nighttime reflux can make it hard for people who sleep in a typical horizontal positions. Diet: Dietary restrictions including regimented timing of meals and the need to avoid consuming foods and beverages that trigger reflux. Additional Healthcare Costs and Work Productivity: Costs associated with GERD can reach thousands of dollars annually in medications and lost productivity from work. http://www.webmd.com/heartburn-gerd/guide/reflux-disease-gerd-1 GERD 2. Surgery to strengthen the lower esophageal sphincter: The Linx device is a ring of tiny magnetic titanium beads that is wrapped around the junction of the stomach and esophagus. The magnetic attraction between the beads is strong enough to keep the opening between the two closed to refluxing acid, but weak enough so that food can pass through it. It can be implanted using minimally invasive surgery methods. When you have acid relfux your valve relaxes abnormally or weakens, allowing stomach acid to flow back up into your esophagus, causing frequent heartburn. This constant backwash of acid can irritate the lining of your esophagus, causing it to become inflamed. Over time, the inflammation can wear away the esophageal lining, causing complications such as bleeding, or esophageal narrowing How it Affects Your Lifestyle What happens in a normal body A burning sensation in your chest (which is heartburn) that can spread to your throat Sour taste in your mouth Chest pain Difficulty swallowing Dry cough Sore throat Regurgitation of food or sour liquids (acid relfux) Sensation of a lump in your throat No. There is no cure to comepletely stop Gerd, most people take acid stopping prescriptions. These prescriptions don't address the underlying cause of acid reflux but may make it worse, which means that people who start taking antacid prescriptions end up taking them for the rest of their lives. Another really simple way to decrease the feeling of heartburn and GERD is to make a dietary and lifestyle change. http://www.mayoclinic.org/diseases-conditions/gerd/basics/preparing-for-your-appointment/con-20025201 Is there a cure?! What is GERD? Websites Used SYMPTOMS What happens to a body with GERD If your medications don't help your doctor might reccommend a couple different surgery procedures: 1. Surgery to reinforce the lower esophageal sphincter :This surgery involves tightening the lower esophageal sphincter to prevent reflux, surgeons usually perform this surgery laparoscopically. In laparoscopic surgery, the surgeon makes three or four small incisions in the abdomen and inserts instruments, including a flexible tube with a tiny camera, through the incisions. Surgery Surgery cont. When you swallow, the lower esophageal sphincter, which is a circular band of muscle around the bottom part of your esophagus, relaxes to allow food and liquid to flow down into your stomach. Then it closes again. GERD or Gastroesophageal Reflux Disease is when your stomach acid flows back up into your esophagus, and irritates it. Both acid relfex and heartburn are common digestive conditions that many people expierience. http://www.gerdhelp.com/about-gerd/ By: Elisabeth Blocker https://chriskresser.com/get-rid-of-heartburn-and-gerd-forever-in-three-simple-steps/
Transcript: CAN I take two main medications daily : - Ran-Pantoprazole 40mg - Buscopan (Hyoscine ButylBromide) 20mg 1. I take one Ran-Pantoprazole 40mg tablet twice daily. This medication is taken 30 minutes or more before a meal is eaten in the morning and in the evening, the reason for this is because the medication can be put into action before the stomach recivces food that could potenially trigger acid backflow. The role of this medication is to bascially "turn down" the acid production in the stomach. 2. I take two Buscopan 20mg tablet twice a day and one Buscopan 20mg tablet once a day, making a total of 5 tablets a day over a span of three times a day. This medication is also taken 30 minutes or more before a meal is eaten, two in the morning, one at lunch time, and two in the evening. Untreated affects I myself suffer from a serious Gastroesophageal Reflux Disease along with a few other disorders/ diseases and this is my story. In June 2014, I was like any other sixteen year old, enjoying the summer months eating ice cream and going to the beach whenever I could. I was a healthy young girl who ate nothing but organic food and ice cream once in a while and who never ate junk food. Little did I know that my whold life would suddenly change permanatley. As the summer months went on I started to experincing serious burning and cramping pains whithin my abdomincal as well as my upper chest area. After eating every meal I was doubled over in pain and felt very neasous along with the burning and cramping. My last thought was that I had something seriously wrong with me, I assumed for three weeks that I had been just fighting off the flu or a gastric/ bacterial infection. Once three weeks had gone by my parents and I started to worry as I was in such extreme pain that I could not move, it was July 22nd when I got rushed to the hospital for the first time. Laying in the ER after getting x-rays and lots of blood taken,the doctor finally came into the room I was in and told my parents and i that my whole digestive tract was so innflamed espically my upper portion, that it would be best for me to stay in there care until they could get specialist to see my within the next day or two. Scared is an understatement for what I had been feeling at that moment, not knowing what was actually wrong with me and why I was in so much pain. Q & A "Heartburn" is the most common symptom of GERD, heartburn is a burning sensation that starts in the chest area and moves upward into the throat. It leaves an acidic taste within your mouth up to 3 hours which is not pleasent. Another common symptom is burning or cramping in the mid abdominal section that can cause sever pain. More serious symptoms may include vomiting, horse voice, and trouble breathing. GastroEsophageal Reflux Disease high acid fruit such as: grapefruit, lemon, orange, ect. tomatoes/ anything tomatoe based coffee any jucies: gatorade, fruit juice chocolate seasoned potatoe chips peppers sugar dairy products seeds salt and much more fish with exceptions meat salad with minimal dressing almond milk green vegtables except peppers pasta and butter muffins/cookies water rice some organic fruits There are two main ways to treat GERD. Medication or surgies is the answer to most cases of GERD. Many medictions can be prescribed to treat the heart- burn and pain but cannot cure the disease completley; how- ever, the disease can go away if the case is mild. Surgey is an opption for peopel who have serious cases, to fix the LES. 1. What does it feel like to have GERD? - It feels like heartburn times 1000 with chest pain, stomach aches, nausea, and no energy. 2. What is most challenging about having the disease? - I take it day by day; however, the most challenging thing would have to be living each day with stomach aches and chosing the corrcet foods. 3. What are your meals like? - 4. Is there anything you used to eat but cannot eat now? - 5. If GERD is not treated correctly or treated at all it can cause more serious affects then just intense heartburn. When the acid enters the esophagus, it starts to burn wholes in then lining and when this happens the tissue has to repair itself. If the tissue rapid starts to repair itself then esophagus cancer can result in the rapid cells repairing the tissue. Can and Cannots of having GERD SYMPTOMS TREATMENTS My testing/ surgeries The main cause of GERD is a weakened or relaxed lower esophageal sphincter(LES). A weakend LES occurs mainly when someone is over weight causing the LES to open as well as eating to much food and the types of food that a person consumes such as high acidic foods, coffee, onions, and chocholate. When the LES relaxes it is allowing food to enter the stomach; however, the LES does not close back properly allowing the acid to flow into the esopahgus. Gastroesophageal Reflux Disease is a chronic conditon within the lower esophageal sphincter caused by stomach acid entering the esophagus. The lower esophageal sphincter opens
Transcript: Lifestyle Inhibits H+, K+, -ATPase transporter to decrease acid production by parietal cells. Cations and anions of compounds react with HCl in stomach to create products like water. These products then increase gastric pH. Common SEs are GI based: constipation, diarrhea, flatulence Gastroesophageal Reflux Disease GERD Head of bed elevation Food avoidance Posture post meals Salivation Inhibit histamine release in histamine-2 receptors on the parietal cells of the stomach, which, in turn, decreases gastric acid secretion. Epidemiology: 10-12% in Western world and <5% in Asia. Not very many common SEs - primarily GI based Concerning SEs includes rhabdomyolysis and increased risk of bone fracture H2 Antagonists Ranitidine, Famotidine, Cimetidine, Nizatidine Obesity, pregnancy, smoking, asthma, delayed stomach emptying Regurgitation Flow of refluxed materials into pharynx. Materials generally include mostly acid from stomach with some food particles last ingested. Chronic digestive disease that occurs when stomach acid or, occasionally, bile refluxes into the esophagus. Proton Pump Inhibitors Omeprazole, Esomeprazole, Lansoprazole, Pantoprazole Antacids Magnesium, Aluminum, Calcium, or Sodium based Acid from the stomach enters the esophagus due to a malfunctioning LES. Not very many common SEs - primarily GI and CNS (drowsiness, dizziness, headaches) Risk Factors Heartburn Burning sensation in esophagus occurs most commonly postprandial. Due to acid climbing up esophagus and irritating surfaces. Dysphagia Difficulty swallowing most commonly occurs due to strictures.
Transcript: Example of a Jeopardy Template By: Laken Feeser and Rachel Chapman When creating without a template... http://www.edtechnetwork.com/powerpoint.html https://www.thebalance.com/free-family-feud-powerpoint-templates-1358184 Example of a Deal or No Deal Template PowerPoint Game Templates There are free templates for games such as jeopardy, wheel of fortune, and cash cab that can be downloaded online. However, some templates may cost more money depending on the complexity of the game. Classroom Games that Make Test Review and Memorization Fun! (n.d.). Retrieved February 17, 2017, from http://people.uncw.edu/ertzbergerj/msgames.htm Fisher, S. (n.d.). Customize a PowerPoint Game for Your Class with These Free Templates. Retrieved February 17, 2017, from https://www.thebalance.com/free-powerpoint-games-for-teachers-1358169 1. Users will begin with a lot of slides all with the same basic graphic design. 2. The, decide and create a series of questions that are to be asked during the game. 3. By hyper linking certain answers to different slides, the game jumps from slide to slide while playing the game. 4. This kind of setup is normally seen as a simple quiz show game. Example of a Wheel of Fortune Template https://www.teacherspayteachers.com/Product/Wheel-of-Riches-PowerPoint-Template-Plays-Just-Like-Wheel-of-Fortune-383606 Games can be made in order to make a fun and easy way to learn. Popular game templates include: Family Feud Millionaire Jeopardy and other quiz shows. http://www.free-power-point-templates.com/deal-powerpoint-template/ Quick video on template "Millionaire" PowerPoint Games Some games are easier to make compared to others If users are unsure whether or not downloading certain templates is safe, you can actually make your own game by just simply using PowerPoint. add logo here References Example of a Family Feud Template PowerPoint Games are a great way to introduce new concepts and ideas You can create a fun, competitive atmosphere with the use of different templates You can change and rearrange information to correlate with the topic or idea being discussed. Great with students, workers, family, etc. For example: With games like Jeopardy and Family Feud, players can pick practically any answers. The person who is running the game will have to have all of the answers in order to determine if players are correct or not. However, with a game like Who Wants to be a Millionaire, the players only have a choice between answers, A, B, C, or D. Therefore, when the player decides their answer, the person running the game clicks it, and the game will tell them whether they are right or wrong.
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