Upper GI
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Last updated 7:48 PM on 3/22/23
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37 Terms
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Barrett’s Esophagus
intestine like tissue replaces tissue lining esophagus
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manifestations of barrett’s esophagus
\-heartburn
\-symptoms of peptic ulcers or esophageal stricture
\-symptoms of peptic ulcers or esophageal stricture
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sliding hiatal hernia
upper part of stomach moves up into the lower thorax bc the opening in the diaphragm where the esophagus passes through enlarges
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manifestations of sliding hiatal hernia
\-often asymptomatic
\-pyrosis (heartburn)
\-dysphagia and regurgitation
\-pyrosis (heartburn)
\-dysphagia and regurgitation
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manifestations of paraesophageal hiatal hernia
fullness in the chest, stomach slides up next to esophagus
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complications of hiatal hernia
hemorrhage, strangulation, obstruction, paraesophageal hernia
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medical management of hiatal hernia
\-small freq meals
\-sit upright after eating for 1 hr
\-elevated HOB
\-stopping smoking
\-sit upright after eating for 1 hr
\-elevated HOB
\-stopping smoking
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interventions for pts w/ upper GI diorders
\-prevent aspiration and maintain airway
\-manage pain
\-adequate nutrition
\-educate on stopping smoking, alcohol, diet
\-manage pain
\-adequate nutrition
\-educate on stopping smoking, alcohol, diet
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GERD risk factors
asthma, pregnancy, obesity, sedentary lifestyle, smoking
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causes of GERD
incompetent lower esophageal sphincter, increased gastric volume (w/ increased BMI), delayed gastric emptying, hiatal hernia
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manifestations of GERD
\-burning in esophagus
\-indigestion
\-dysphagia, pain w/ swallowing
\-hypersalivation
\-esophagitis
\-indigestion
\-dysphagia, pain w/ swallowing
\-hypersalivation
\-esophagitis
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surgical procedures for GERD
nissan fundoplication
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what to check post endoscopy for GERD?
gag reflex bc of lidocaine used to numb the reflex
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gastritis
\-inflammation of gastric mucosa--swelling of cells w/ fluid and blood
\-mucosa secrete less gastric juice
\-ulceration and hemorrhage
\-mucosa secrete less gastric juice
\-ulceration and hemorrhage
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management of GERD
\-don’t eat 3 hrs before sleeping
\-sit up after eating
\-dietary restrictions
\-sit up after eating
\-dietary restrictions
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causes of gastritis
\-alcohol, NSAIDS (both acute and chronic)
\-Acute: contaminated food, bile reflux, strong acids/alkali
\-chronic: H pylori, smoking
\-Acute: contaminated food, bile reflux, strong acids/alkali
\-chronic: H pylori, smoking
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symptoms of gastritis
\-hiccuping
\-belching
\-anorexia
\-heartburn after eating
\-dyspepsia (indigestion)
\-abdominal pain
\-N/V
\-belching
\-anorexia
\-heartburn after eating
\-dyspepsia (indigestion)
\-abdominal pain
\-N/V
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medical management of acute gastritis
\-avoid food and alc until resolves
\-IV fluids
\-dilution and neutralization of acid/alkalis
\-NG tube
\-antacids
\-IV fluids
\-dilution and neutralization of acid/alkalis
\-NG tube
\-antacids
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management of chronic gastritis
\-diet changes
\-avoid alc, NSAIDS
\-treat h pylori
\-stress reduction
\-avoid alc, NSAIDS
\-treat h pylori
\-stress reduction
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causes of peptic ulcer disease
\-increased secretion of gastric acid damages the mucosa so less mucus secretion
\-disposes ppl to h pylori
\-can be from NSAIDs, alc, smoking, stress
\-disposes ppl to h pylori
\-can be from NSAIDs, alc, smoking, stress
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symptoms of peptic ulcer disease
\-gnawing pain/burning sensation in epigastrium or back
\-pain relieved by eating
\-heartburn
\-vomiting
\-constipation/diarrhea
\-bleeding
\-belching
\-bloating
\-pain relieved by eating
\-heartburn
\-vomiting
\-constipation/diarrhea
\-bleeding
\-belching
\-bloating
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diagnosis for peptic ulcer disease
\-urea breath test
\-endoscopy
\-biopsy
\-endoscopy
\-biopsy
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medical management of PUD
\-2 antibiotics + proton pump inhibitor for h pylori
\-proton pump inhibitors, H2 antagonists
\-diet changes, stoping smoking
\-proton pump inhibitors, H2 antagonists
\-diet changes, stoping smoking
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complications of PUD
hemorrhage, perforation, penetration, pyloric obstruction
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Assessment Post GI Surgery
\-abdominal assessment
\-NPO until flatus and BS return
\-NG tube, assess drainage
\-pain management
\-pulmonary toliet
\-DVT prevention
\-NPO until flatus and BS return
\-NG tube, assess drainage
\-pain management
\-pulmonary toliet
\-DVT prevention
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treatment for GI hemorrhage
\-ABCs, VS, O2
\-treat hypotension w/ rapid bolus of NS or LR
\-if hemoglobin less than 7, give blood products
\-treat hypotension w/ rapid bolus of NS or LR
\-if hemoglobin less than 7, give blood products
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obesity comorbities
\-type II DM
\-dyslipidemia
\-heart disease
\-HTN
\-sleep apnea
\-GERD
\-DVT
\-PE
\-depression
\-dyslipidemia
\-heart disease
\-HTN
\-sleep apnea
\-GERD
\-DVT
\-PE
\-depression
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lifestyle management of obesity
\-1-2 lbs loss/week (10% reduction over 6 months)
\-150 mins exercise/week
\-calorie reduction
\-150 mins exercise/week
\-calorie reduction
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bariatric surgery indications
\-BMI >40
\-BMI> 35 and commorbidity
\-3 failed supervised weight loss programs
\-BMI> 35 and commorbidity
\-3 failed supervised weight loss programs
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roux-en Y gastric bypass
remove part of stomach and bypass duodenum--connect stomach to jejunum
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biggest concern w/ roux en Y gastric bypass & symptoms
dumping syndrome--N/V, diarrhea, cramps
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how to treat dumping syndrome
\-avoid food high in simple sugar
\-eat diet w/ protein, complex carbs, fiber
\-separate solid from liquid in take by 30 mins
\-eat diet w/ protein, complex carbs, fiber
\-separate solid from liquid in take by 30 mins
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laproscopic gastric banding
\-band place ground stomach to create pouch
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restrictive gastric bypass
\-reduce diameter of stomach lumen--capacity adjusted by silicone band
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roux-en Y outcomes
weight loss, no need for antihyperglycemic meds for pts w/ DM
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long term dietary needs after bariatric surgery
\-high protein, complex carbs
\-limit foods w/ sugars
\-supplement: B12, calcium, vitamin D, iron
\-limit foods w/ sugars
\-supplement: B12, calcium, vitamin D, iron
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assessment post bariatric surgery
\-liquids for first week
\-caution w/ alcohol
\-I&Os
\-wound care
\-nutrition counseling
\-caution w/ alcohol
\-I&Os
\-wound care
\-nutrition counseling