GI disorders

 Dysphagia Difficulty swallowing

o Causes Nero disease: Parkinson’s, dementias, muscular dystrophy, Huntington’s, ALS, MN,

Guillain Barre Syndrome. Other: Congenital issues/cerebral palsy, Esophageal stenosis,

esophageal diverticula, tumors, stroke, achalasia

 Vomiting – why and consequences Why: protect against substance, reverse peristalsis, increase

intracranial pressure, severe pain. Consequences: lead to fluid, electrolyte, pH imbalance, aspiration

o Emesis types and why the emesis would be a problem Hematemesis: blood in vomit (protein),

Yellow/green: presence of bile. Deep brown: fecal matter. Undigested food

o Treatment of vomiting disorders Antiemetic med., fluid replacement, correct electrolyte

imbalance, restore acid-base

 Esophageal disorders

o Hiatal hernia Stomach section protrudes through diaphragm

 Causes: Weakening of diaphragm muscle, trauma, congenital defects.

 Manifestation: Indigestion; heartburn; frequent belching; nausea; chest pain; strictures;

dysphagia; and soft abdominal mass

 diagnosis: H & P; barium swallow; upper GI Xrays; EGD ,

 treatment: eat small meals, sleep elevated, antacid

o GERD

 Causes: Certain foods: chocolate, caffeine, carbonated beverages, citrus fruit, tomatoes,

spicy or fatty foods, peppermint

 Alcohol consumption; nicotine

 Hiatal hernia

 Obesity; pregnancy

 Certain medications – such as corticosteroids; beta blockers; calcium-channel blockers;

anticholinergics

 NG intubation

 Delayed gastric emptying

 Manifestations: Heartburn, Epigastric pain, Dysphagia, Dry cough, Laryngitis

Pharyngitis, Food regurgitation, Sensation of lump in throat

 Diagnosis: H & P; barium swallow; EGD; esophageal pH monitoring

 Treatments: Avoid triggers; avoid restrictive clothing

 Eat small frequent meals; high Fowler’s positioning, Weight loss; stress reduction;

Antacids; acid reducing agent; mucosal barrier agents, Herbal therapies (licorice,

chamomile), Surgery

 Complications: Esophagitis; strictures; ulcerations; esophageal cancer; chronic

pulmonary disease

o Gastritis/gastroenteritis

 Acute: Can be mild, transient irritation or can be severe ulceration with hemorrhage

 Usually develops suddenly

 Likely to also have nausea & epigastric pain

 Chronic: Develops gradually

 May be asymptomatic but usually accompanied by dull epigastric pain and a sensation of

fullness after minimal intake