NSG 3105 Lecture Notes - Lecture 6: Peptic Ulcer, Upper Gastrointestinal Series, Hiatus Hernia
12 Apr 2020
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Document Summary
Hiatal hernia: herniation of the stomach into the esophagus through an opening in the diaphragm. Multiple factors including weakening of muscles in the diaphragm, increased intra-abdominal pressure (pregnancy), obesity. Complications: gerd, hemorrhage from erosion, stenosis to esophagus, ulcerations of the herniated portion of the stomach, strangulation of the hernia, regurgitation with tracheal aspiration. Collaborative care: lifestyle modifications, elevation of head 30 degrees, use of antacids and antisecretory agents, weight reduction if overweight, surgical therapy. Many asymptomatic until esophageal bleeding secondary to esophagitis or resp complications related to aspiration occur. Gastroesophageal reflux disease: reflux of gastric contents into the esophagus rather than distally into duodenum. Gastric content follows path of least resistance build up in esophagus. 30-60 minutes after eating, lying down, or bending over, with complaints of belching and a bitter unpleasant taste. Increasing hoarseness due to laryngeal inflammation of partially aspirated gastric acid. Regurgitation is common: gerd alarm symptoms: dysphagia, odynophagia, gi bleeding, anemia, unintended weight loss, chest pain.
