GER GER considered as a normal physiologic process that occurs several times a day in healthy infants children and adults Lower esophageal sphincter LES permits gastric contents to enter the esophagus ID: 930772
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Slide1
Gastroesophageal Reflux (GER)
GER considered as a normal physiologic process that occurs several times a day in healthy infants, children and adults.
Lower esophageal sphincter (LES) permits gastric contents to enter the esophagus.
Slide2Gastroesophageal Reflux Disease (GERD)
Serious, chronic or long-lasting form of GER.
Defined as symptoms or complications resulting from the reflux of gastric contents into the esophagus and even into the oral cavity (including larynx) or lung.
Symptoms include heart burn that is painful, burning sensation, regurgitation or both.
Symptoms may be experienced in the evening known as nocturnal GERD, which has a greater impact on quality of life compared to daytime GERD.
Slide3GERDNocturnal GERD is associated with severe
esophagitis
(inflammation of the esophagus).
It can lead to sleep disturbances.
Definite relationship between GERD and obesity (BMI, waist circumference, weight gain).
GERD is frequent during pregnancy in the form of heart burn and may begin in any trimester.
Slide4GERD
Chest pain may be a symptom of GERD.
Presence of GERD indicates an underlying motility disorder such as stricture or malignancy.
Changes in lifestyle, including diet.
Caffeine, alcohol, tobacco and stress.
Recommended small but frequent eating.
Alcoholic and carbonated beverages which enhance gastric distension should be avoided.
Highly acidic foods such as citrus juices and tomatoes should be avoided because they cause pain when the esophagus is already inflamed.
Slide5GERD
Foods seasoned with chili powder and pepper can cause discomfort.
Well balanced healthy diet is preferable.
Use of tobacco products is contraindicated with reflux. Smoking should be stopped.
Slide6Nutrition Management of GERD
Goal: Decrease exposure of esophagus to gastric contents.
Avoid: Large meals, dietary fat and alcohol.
Goal: Decrease acidity of gastric secretions.
Avoid: Coffee and fermented alcoholic beverages.
Goal: Prevent pain and irritation.
Avoid: any food that the patient feels
exacerbartes
his symptoms.
Slide7Gastrectomy
Total
Gastrectomy
means removal
of entire stomach.
It is performed for malignancies that affect the middle or upper stomach.
Colostomy: It is a surgically created opening from the colon to the skin when a portion of the large intestine is removed or bypassed. It can originate from any part of the ascending, transverse, descending, or sigmoid. It typically starts functioning 2-5 days after surgery.
Slide8Ileostomy
An
ileostomy
is a surgically created opening from the distal small bowel (most often the terminal ileum) to the skin when the entire colon, rectum, and anus are removed or bypassed.
Start functioning within 24 hours after surgery.