MA. NELIA P.

MAGSINO, MN, RN
NCM 116 Class Instructor
2nd Semester SY. 2022-2023
 (GERD) occurs when stomach
acid repeatedly flows back into
the tube connecting your mouth
and stomach (esophagus).
 This backwash (acid reflux) can
irritate the lining of your
esophagus.
 SIGNS &
SYMPTOMS ☺The most common symptom of GERD is
Your doctor may also frequent heartburn, felt by a painful,
use these names for burning sensation in the middle of your
GERD: chest.
 Acid indigestion ☺ Backwash (regurgitation) of food or
 Acid reflux sour liquid
 Acid regurgitation ☺ Upper abdominal or chest pain
 Heartburn ☺ Trouble swallowing (dysphagia)
 Reflux ☺ Sensation of a lump in your throat
 CAUSES ☺ overweight, obese, or pregnant
☺Belching or eating a (Increased pressure on the
large meal abdomen
☺high in fats, citrus ☺ Smoking or inhaling secondhand
fruits, chocolate, and smoke
peppermint ☺ alcoholic, caffeinated, or
☺Side effects from carbonated beverages
certain medications ☺ Eating soon before going to bed
 DIAGNOSIS
Upper endoscopy

Ambulatory acid (pH) probe test

Upper endoscopy X-Ray

Esophaheal manometry

Transanal Esophagoscopy
 Upper Endoscopy – is a procedure
wherein a thin flexible tube/catheter
equipped with a light and camera is
inserted down to your throat to
visualize the esophagus and stomach.
Ambulatory acid (pH) probe X-ray of the upper
test. A monitor is placed in your digestive system. X-
esophagus to identify when, and rays are taken after
for how long, stomach acid you drink a chalky
regurgitates there. The monitor liquid that coats and
connects to a small computer that fills the inside lining
you wear around your waist or of your digestive
with a strap over your shoulder. tract.

Esophageal manometry. This test
measures the rhythmic muscle
contractions in your esophagus
when you swallow. Esophageal
manometry also measures the
coordination and force exerted by
the muscles of your esophagus.
Transnasal esophagoscopy. This
test is done to look for any damage
in your esophagus. A thin, flexible
tube with a video camera is put
through your nose and moved
down your throat into the
esophagus.
 MANAGEMENT & TREATMENT
I. Lifestyle Changes
 weight loss
 avoidance of carbonated beverages
 abstinence from smoking
 reducing alcohol and caffeine intake
 avoiding “trigger” foods (spicy foods, citrus or acidic foods)
 maintaining a low fat diet
 avoiding eating or drinking several hours before going to bed
 elevating the head of the bed at night.
II. Medications & Surgery
ANTACIDS
 Are medicines that counteract
(neutralise) the acid in your
stomach to relieve indigestion
and heartburn.
PROTON PUMP INHIBITOR
 Are stronger acid blockers
than H-2 blockers and allow
time for damaged esophageal
tissue to heal.
HISTAMINE (H2) BLOCKER
 Medications to reduce acid
production. It may decrease
acid production from the
stomach for up to 12 hours.
SURGERY
 Fundoplication. The goal is to
reinforce the LES to recreate
the barrier that stops reflux
from occurring.
The following are seven (7) nursing care plans and nursing
diagnosis for gastroesophageal reflux disease (GERD):

1. Imbalanced Nutrition: Less Than Body Requirements

2. Acute Pain
3. Imbalanced Nutrition: More Than Body Requirements
4. Risk for Aspiration
5. Deficient Knowledge
6. Anxiety (Pediatric)
7. Risk for Injury (Pediatric)
 Inflammation of the tissue in the esophagus (esophagitis). Stomach
acid can break down tissue in the esophagus, causing inflammation,
bleeding, and sometimes an open sore (ulcer). Esophagitis can cause
pain and make swallowing difficult.
 Narrowing of the esophagus (esophageal stricture). Damage to the
lower esophagus from stomach acid causes scar tissue to form. The
scar tissue narrows the food pathway, leading to problems with
swallowing.
 Precancerous changes to the esophagus (Barrett
esophagus). Damage from acid can cause changes in the tissue lining
the lower esophagus. These changes are associated with an increased
risk of esophageal cancer.