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Pathophysiology
GERD is the backward flow of gastric contents from the stomach into the esophagus.
GERD
Gastroesophageal Reflux Disease
• Abnormalities Lower esophageal sphincter
• Gastric or duodenal ulcer
• Gastric or esophageal surgery
• Prolonged vomiting
• Prolonged gastric intubation
Factors
• Chronic Pain
1. Pain can be reduced by increasing Lower esophageal sphincter pressure, which keeps gastric contents from passing into the esophagus.
• 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
• 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
Nursing Interventions
Treatment
1. Antacids – are basic compounds used to neutralize stomach acid.
- Calcium carbonate (Tums)
2. H2 Antagonists – reduce but do not eliminate stimulated acid secretion
- Ranitidine (Zantac)
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)
Signs & Symptoms
• 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.