Gastrointestinal Tract: Disorders of Motility
Jamie is a 3-month-old female who presents with her mother for
evaluation of “throwing up.” Mom reports that Jamie has been throwing up
pretty much all the time since she was born. Jamie does not seem to be
sick. In fact, she drinks her formula vigorously and often acts hungry.
Jamie has normal soft brown bowel movements every day and, overall,
seems like a happy and contented baby. She smiles readily and does not
cry often. Other than the fact that she often throws up after drinking a
bottle, she seems to be a very healthy, happy infant. A more precise
history suggests that Jamie does not exactly throw up—she does not heave
or act unwell—but rather it just seems that almost every time she
drinks a bottle she regurgitates a milky substance. Mom thought that she
might be allergic to her formula and switched her to a hypoallergenic
formula. It didn’t appear to help at all, and now Mom is very concerned.
Cases like these are not uncommon. The mother was concerned and thinking
her daughter may have an allergy; she changed to a different formula.
However, sometimes babies have immature GI tracts that can lead to
physiology reflux as they adapt to normal life outside the uterus.
Parents often do not consider this possibility, prompting them to change
formulas rather than seeking medical care. As in the case study above,
GI alterations can often be difficult to identify because many cause
similar symptoms. This same issue also arises with adults—adults may
present with symptoms that have various potential causes. When
evaluating patients, it is important for the advanced practice nurse to
know the types of questions he or she needs to ask to obtain the
appropriate information for diagnosis. For this reason, you must have an
understanding of common GI disorders such as gastroesophageal reflux
disease (GERD), peptic ulcer disease (PUD), and gastritis.
To Prepare
Review this week’s media presentation on the gastrointestinal system.
Review Chapter 35 in the Huether and McCance text. Identify the normal
pathophysiology of gastric acid stimulation and production.
Review Chapter 37 in the Huether and McCance text. Consider the
pathophysiology of gastroesophageal reflux disease (GERD), peptic ulcer
disease (PUD), and gastritis. Think about how these disorders are
similar and different.
Select a patient factor different from the one you selected in this
week’s Homework help – Discussion: genetics, gender, ethnicity, age, or behavior.
Consider how the factor you selected might impact the pathophysiology of
GERD, PUD, and gastritis. Reflect on how you would diagnose and
prescribe treatment of these disorders for a patient based on this
factor.
Review the “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal
Reflux Disease (GERD)” media in the Week 2 Learning Resources. Use the
examples in the media as a guide to construct a mind map for gastritis.
Consider the epidemiology and clinical presentation of gastritis.
To Complete
Write a 2 page paper (hire research essay pro writers) that addresses the following:
Describe the normal pathophysiology of gastric acid stimulation and
production. Write my Essay Online Writing Service with Professional Essay Writers – Explain the changes that occur to gastric acid stimulation
and production with GERD, PUD, and gastritis disorders.
Write my Essay Online Writing Service with Professional Essay Writers – Explain how the factor you selected might impact the pathophysiology of
GERD, PUD, and gastritis. Describe how you would diagnose and prescribe
treatment of these disorders for a patient based on the factor you
selected.
Construct a mind map for gastritis. Include the epidemiology,
pathophysiology, and clinical presentation, as well as the diagnosis and
treatment you explained in your paper.
APA
2 pages/600 words
3 sources..not older than 2012
Gastrointestinal
Many factors influence the rate of secretion of gastric acid and is capable of being divided into phases cephalic, intestinal phase, and gastric phase. Gastric acid secretion also known as hydrochloric acid production takes place in the cells and the region of glands found within the mucosa, also found on the apical area of epithelial cells of the GI tract. The stimulation of HCL secretion takes place from three tracks, enterochromaffin-like (ECL) cells, G-cells, and acetylcholine submission from the parasympathetic nerve framework. The G cells tends to secret the hormone peptide gastrin. Gastrin gets attached to the gastrin receptors on ECL cell walls causing stimulation to the release of histamine and gastrin gets attached to the gastrin on the parietal cells causing stimulation of the production of histamine and gastrin gets attached to the surface of the receptors gastrin on the parietal cells leading to secretion of HCL. Final path occurs when the cephalic phase of digestion stimulates the parasympathetic secretion of the acetylcholine coming from vagus nerve.
Gastroesophageal Reflux Disease alludes to a form of digestive disorder resulting from the backing up of stomach juices or fluids into the esophagus from the stomach. With (GERD) the lower esopheal sphincter part is relaxed, there is reduced motility of the esophagus, also regarded as slowed gastric motility or basically the delayed emptying of gastric acid. Esophagitis severity relies on the exposure duration of the mucosal to the refluxate of chyme entailing acids and salts. PUD occurs from an erosion, also known as ulceration occurring in the protective mucosal layers of the duodenum or stomach, it usually occurs in the duodenum. With PUD pepsin and acid concentration tends to penetrate the mucosal barriers and leads to ulceration. With the various protective barrier against HCL hindered, this tends to raise the risk degree of gastric epithelium damage.
Diagnosis of Gastroesophageal reflux disease in the United States is approximately 18% to 27%, and the factors which cause the risk incorporate aging, chemicals, and the availability of the hiatal hernia (Sharma & Policker, 2018). Gastroesophageal reflux disease is normally diagnosed from history, manifestation of clinical equipment, monitoring of the pH and also biopsy tissues. Treating this infection incorporates the utilization of antacids or the pump inhibitors of protons. Consequent behavior factors may also help in the treating of Gastroesophageal reflux disease. Furthermore, impacting knowledge on the patient regarding the disease also assists the patient in reducing smoking too much.
Peptic ulcer disease (PUD) is an infection created by ulceration occurring in thick muscular duodenum layers, stomach or the gut, and it frequently takes place in the duodenum. The lesions of Peptic ulcer disease significantly are from lack of balance in the secretions of protection. Pain felt in the chronic intermittent gastric on a stomach without anything is the most known manifestation of this particular disease and is relieved by rapid food ingestion (Vernon, 2019). The objective in the Peptic ulcer disease management is finding a way to fight complications and reliving the causes.
Gastritis
Behavioral factors involving gastritis incorporate consumption of alcohol or various beverages which are very acidic when ingested, STIs and smoking. Gastritis diagnosis normally needs an assessment of the full medical history, X-rays, testing of the blood and stools for the pH. Treating the gastritis symptoms normally incorporates reducing the concentration of the acid found in the stomach.
References
Bandyopadhyay, N., Fass, R., Yamasaki, T., & Hemond, C. (2019). Gastroesophageal Reflux Disease (GERD). In Pocket Handbook of Esophageal Disorders (pp. 85-121). Springer, Cham.
Sharma, V. K., & Policker, S. (2018). U.S. Patent No. 10,058,703. Washington, DC: U.S. Patent and Trademark Office.
Vernon, A. H. (2019). Medical Management of Peptic Ulcer Disease. In The SAGES Manual of Foregut Surgery (pp. 653-659). Springer, Cham.
Mind Map
