Upper GI System

Anorexia

  • Lack of appetite; common symptom of many diseases.

  • Nursing care includes daily weight monitoring.

Nausea and Vomiting

  • Protect airway; may require IV fluids, electrolyte replacement, NG tube if persistent.

Gastroesophageal Reflux Disease (GERD)

Pathophysiology

  • Lower esophageal sphincter dysfunction leads to reflux.

Symptoms

  • Epigastric pain, heartburn, regurgitation, dysphagia.

Diagnosis

  • Barium swallow, esophagoscopy, pH monitoring.

Complications

  • Respiratory issues, Barrett's esophagus (precancerous change).

Medical Management

  • Lifestyle changes, antacids, H2 receptor antagonists (e.g., Zantac), Proton pump inhibitors (PPIs).

Surgical Interventions

  • Nissen Fundoplication, Transoral Incisionless Fundoplication (TIF).

Nursing Management

  • Promote weight loss, smaller meals, and avoid triggers (e.g., coffee, chocolate).

Hiatal Hernia

Types

  • Sliding Hiatal Hernia: esophagus/stomach slides through diaphragm.

  • Paraesophageal Hernia: serious, risk for strangulation.

Symptoms

  • Epigastric pain, heartburn, reflux, dysphagia.

Diagnosis

  • Barium swallow, esophagoscopy.

Management

  • Lifestyle changes, medications, surgical options (e.g., Fundoplication).

Peptic Ulcer Disease

Characteristics

  • Erosion of GI lining, often due to H. pylori.

Symptoms

  • Anorexia, pain (relieved by food), nausea, vomiting, bleeding.

Diagnostic tests

  • Upper GI series, endoscopy, lab tests for anemia and H. pylori.

Medical Management

  • Combination antibiotics, acid-reduction therapies, sucralfate.

Surgical Management

  • Total gastrectomy, gastrojejunostomy.

Obesity

Definition

  • Weight >20% over ideal body weight; BMI >30 signifies obesity.

Medical Complications

  • Pulmonary and metabolic issues, GI disorders, cancer risk.

Management

  • Weight loss strategies, medications (e.g., Orlistat), bariatric surgery options.

Postoperative Care

  • Monitor for complications such as infection, bowel obstruction, and nutritional deficiencies.

Client Education

  • Progress diet from clear liquids to regular foods; manage post-surgical symptoms.