Upper git disorder
- 1. UPPER GASTROINTESTINAL DISORDER Created by : Jessica Faye G. Manansala
- 2. GASTROESOPHAGEAL RELUX DISEASE (GERD) • It is a syndrome resulting from esophageal reflux
- 4. Clinical Manifestation • Heart burn • Odynophagia • Dysphagia • Acid regurgitation • Water brash • Eructation • Pain (back, neck or jaw)
- 5. Risk Factors • Obesity & weight gain • Pregnancy • Chewing tobacco • Smoking • High fats foods • Theophylline • Caffeine • Chocolate
- 6. Diagnosis • Barium swallow • Esophageal manometry • Esophagoscopy • Esophageal biopsy • Cytologic examination • Acid perfusion test
- 10. Treatment • 1. Restrict diet into small frequent feedings. • 2. Drink adequate fluid at meals to assist food passage. • 3. Eat slowly and chew thoroughly to add saliva to the food • 4. Avoid extremely hot or cold food, spices, fats, alcohol, coffee, chocolate & citrus juices.
- 11. Medications • Cytotec- preventing gastric ulcer formation & GERD manifestation • Antacids (30 ml 1hr before and 2 to 3hrs after meal) it helps to neutralize gastric acid secretions. • Histamine receptors antagonist • (zantac, pepcid) – It decreases gastric secretions. • Cholinergic ( bethanechol or urecholine) – for clients with severe manifestation it increase LES pressure and prevent reflux • Metoclopramide (raglan)- increase LES pressure by stimulating the smooth muscle of GIT and increase the rate of gastric emptying. This medication is taken before meal. • Cisapride (propulsid) 15min before meal and at bed time. • Proton pump inhibitor (prevacid) – suppresses secretion of gastric acid,
- 12. Nursing management • Identify specific manifestation • Document when sign and symptoms started ( frequency & severity) • Help client to identify risk factors for GERD • Instruct clients about lifestyle change • Explain the relationship of manifestation to food and various product.
- 13. PEPTIC ULCER DISEASE (PUD) - PUD involves break in continuity of the esophageal, gastric or duodenal mucosa
- 15. DUODENAL ULCER • Duodenal ulcer has an increase incidence than gastric ulcers.
- 16. Stimuli Acid Secretion • Protein rich meals • Alcohol consumption • Calcium • Vagal stimulation
- 17. GASTRIC ULCER • Cause is the break in of the mucosal barrier. • Incompetent pylorus into stomach may break mucosa barrier.
- 18. Risk Factor • smoking (nicotine) • steroids • aspirin • NSAID’s • Caffeine • Alcohol • Stress
- 19. Clinical Manifestation • Pain- aching, burning, cramp, gnawing pain • Gastric ulcer - food may cause pain and vomiting may relieve it. • Duodenal ulcer- empty stomach and ingestion of food or antacid may relieve pain. • Nausea and Vomiting – vomiting is more often in gastric ulcer • Gastric ulcer – anorexia, weight loss and dysphagia • Bleeding
- 20. Diagnosis • X-ray and Endoscopy • CBC • Stool testing • Urea Breath Test
- 21. Treatment • Anatacid • Cimetidine • Rahitidine • Pamotiidne • Clarithromycin • Cytotec
- 22. Nursing Management • Modify diet • Assess bleeding • Prevent shock • Replace fluids • Maintain rest
- 23. GASTRIC CANCER • Gastric cancer refers to the malignant neoplasms found in the stomach, usually adenocarcinoma. Most stomach cancers occur in the pylorus or antrum of the stomach and are adenocarcinomas
- 24. Clinical Manifestation • Early stage – symptoms may be absent • indigestion • anorexia • dyspepsia • weight loss • abdominal pain • constipation • anemia • nausea & vomiting
- 25. Risk Factors • chronic atrophic gastritis • history of exposure to background radiation or trace metal soil • people usually eat pickled food, salted fish & nitrates • metal craft workers, miners, bakers • those working in dusty, smoky & sulfur dioxide containing environment
- 26. Diagnosis • X-ray the upper GIT • Double contrast barium swallow • followed by endoscopy for biopsy • cytologic test • CT scan • Gastroscopy
- 27. Treatment • chemotheraphy • radiation theraphy • surgical resection
- 28. Nursing Management • assess the client history of diet (smoked fish, salty food,smoking) • family history • asked the patient if she/he has a previous gastric surgery • history of risk factors to the development of cancer. • chronic gastritis • pernicious anemia • presence of H.Pylori
- 29. THE END THANKS FOR LISTENING (^.^)!!