Re flux Disease (Heartburn) Discussion
Luv Taub, a 32-year-old, married Hmong woman, presents to her primary care Nurse Practitioner
complaining of a persistent burning sensation in her chest and upper abdomen. The symptoms are worse at night while she is lying down and after meals. She enjoys many years of cooking and eating “hot and spicy foods” common in her culture. She has tried drinking hot cocoa to help her sleep. She is a smoker and frequently relies on benzodiazepines for insomnia. She notes a sour taste in her mouth every morning. Physical examination is normal.
In this discussion:
Discuss this patient’s likely diagnosis. Why do you support this “likely” diagnosis?
Describe the pathophysiology of this disorder.
Discuss a plan of care for this patient.
What is the anticipated prognosis for this patient? What lifestyle factors might alter her short- and long-term outcomes?Re flux Disease (Heartburn) Discussion
Include citations from the text or the external literature in your discussions. Remember to respond to at least two of your peers. Please refer to the Course Syllabus for Participation Guidelines & Grading Criteria. Luv Taub, a 32-year-old, married Hmong woman, presents to her primary care Nurse Practitioner complaining of a persistent burning sensation in her chest and upper abdomen. The symptoms are worse at night while she is lying down and after meals. She enjoys many years of cooking and eating “hot and spicy foods” common in her culture. She has tried drinking hot cocoa to help her sleep. She is a smoker and frequently relies on benzodiazepines for insomnia. She notes a sour taste in her mouth every morning. Physical examination is normal.
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In this discussion:
Discuss this patient’s likely diagnosis. Why do you support this “likely” diagnosis?
Describe the pathophysiology of this disorder.
Discuss a plan of care for this patient.
What is the anticipated prognosis for this patient? What lifestyle factors might alter her short- and long-term outcomes?
Include citations from the text or the external literature in your discussions. Remember to respond to at least two of your peers. Please refer to the Course Syllabus for Participation Guidelines & Grading Criteria.
Gastroesophageal reflux disease, or GERD, is the likely diagnosis for this client. Burning pain in the chest and upper belly, worst at night, worst when laying down, worse after taking meals and a bad taste in the mouth after waking up may be the symptoms of GERD (Hammer & McPhee, 2019). Her history of smoking and benzodiazepine use can trigger this disease to progress further.
The pathophysiology of this illness is consists of a few key components. Firstly, gastric emptying is delayed, accompanied by an increased occurrence of transient lower esophageal sphincter relaxation, enhanced acidity development, lack of secondary peristalsis after the relaxation of the short lower esophageal sphincter, and reduced esophageal sphincter tone (Hammer & McPhee, 2019). This may cause the original esophageal lesion. This adds to a cycle involving scarring, inept lower tone of the esophageal sphincter, and repeated damage.
To deter GERD relapse or further symptoms, the patient should live a healthy lifestyle. Consuming a well-balanced diet can limit the production of acids. According to Pointer et al. (2016), consuming high fat and low carbohydrate diet will help all women with respect to decreasing GERD symptoms. Despite common opinion, there is no link between high dietary fat intake and deteriorating GERD symptoms. GERD is added to essential carbohydrates such as sucrose (Pointer et al., 2016). For each teaspoon of sucrose swallowed, the likelihood of getting GERD rises. In the past three decades, the intake of added sugars has risen 20-30 percent (Pointer et al., 2016). Their research showed that after ten weeks, all women who began this diet started taking their GERD drugs.Re flux Disease (Heartburn) Discussion
If possible, she should try to be completely weaned off the benzodiazepines. She should undergo smoking cessation training. She may require a proton pump inhibitor (PPI), histamine 2 receptor antagonist (H2Ra), or an antacid to be added to her drugs. The most commonly used treatment option currently remains acid suppression with PPI therapy as it assists in symptom reduction, recovery, and remission maintenance (Kim et al., 2015). The real outcome of treatment is to alleviate symptoms, cure esophagitis, avoid recurrence of symptoms, and prevent other complications (Kim et al., 2015). The long-term effects may be cancer, Barrett’s esophagus, stricture pressure, congestion, and perforation of stricture if not treated adequately (Hammer & McPhee, 2019).
References:
Hammer, G., & McPhee, S. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th ed.). New York, NY: McGraw-Hill Medical.
Kim, H. J., Kwon, C., Kessler, W. R., Selzer, D. J., McNulty, G., Bapaye, A., Bonavina, L., & Lehman, G. A. (2015). Long term follow up results of endoscopic treatment of gastroesophageal reflux disease with the MUSE endoscopic stapling device. Surgical Endoscopy, 30.
Pointer, S. D., Rickstrew, J., Slaughter, J. C., Vaezi, M. F., & Silver, H. J. (2016). Dietary carbohydrate intake, insulin resistance and gastroesophageal reflux disease: a pilot study in European and African-American obese women. Aliment Pharmacologic Therapy, 44. Re flux Disease (Heartburn) Discussion