Responses to Gastrointestinal System Discussion
Responses to Gastrointestinal System Discussion
Respond to at least two of your classmates. Participate in the discussion by analyzing each response for completeness and accuracy and by suggesting specific additions or clarifications for improving the discussion question response. Complete your participation for this assignment by the end of the week. Follow APA format
Discussion #1
Ivagba Adeoye
Explain the pathophysiology of Peptic Ulcer Disease as compared to GERD and explain which one his symptoms most closely represent. Support with evidence.
Alterations of the digestive functions is a very common ailment in our society like that which this patient is experiencing. In this case, Henry’s symptoms of pain in the middle of night that goes away in the morning and when he eats bland food with milk, as well as his use of the nonsteroidal anti-inflammatory drug (NSAID) aspirin, leads me to diagnose him with a type of peptic ulcer disease (PUD) called a duodenal ulcer (McCance et al., 2019).
PUD is a rather serious disease that has the potential to cause death and morbidity and typically presents with epigastric pain, internal bleeding, formation of a hole in the gastric mucosa, and gastric outlet obstruction caused by gastric acid secretion or pepsin (Howley et al., 2019). Pelvic ulcers are typically formed due to infection by Helicobacter Pylori (H. pylori), long term use of NSAIDS, chronic alcohol abuse, prolonged smoking, and obesity. Prolonged use of NSAIDS, causes damage to the mucosa by inhibiting mucosal prostaglandin production which in turn decreases bicarbonate secretion and the protective gut barrier mucin, while increasing the secretion of the corrosive hydrochloric acid (McCance et al., 2019). This coupled with an infection by H. Pylori, leads to the gradual breakdown of the mucosa external layer and submucosa by gastric juices and self-digestion.
Gastroesophageal reflux disease (GERD), differs from pelvic ulcer disease in the sense that the issue with GERD is dysfunction of the lower esophageal sphincter which is critical in preventing regurgitation of stomach acids like pepsin into the esophagus causing inflammation and irritation of the esophagus. GERD presents with typical and atypical symptoms. Typical symptoms include, heartburn and regurgitation of acid, whereas atypical symptoms manifests itself as non-cardiac chest pain that can be ruled out with a GI cocktail, chronic cough, sore throat, and hoarseness (Herregods et al., 2015).
Explain the body’s natural protection against peptic ulcers from a pathophysiology standpoint.
As the rest of the body has immune defense system so does the gastrointestinal tract which is a major player in keeping us healthy. H. Pylori is huge contributor to the development of peptic ulcers and h. Pylori can be prevented by good hygiene and keeping your immune system in check. Intestinal mucosa and mucosal secretions, are responsible for the production of the antibody immunoglobulin A as well as protective enzymes that provide defense against pathogens (McCance et al., 2019). The small intestine also has a couple of cells the paneth cells and peyer patches that have a lot to do with the gastrointestinal tract immunity. Paneth cells, secrete antimicrobial peptides and lysozyme to protect the intestines whereas the peyer patches, produce more antimicrobials peptides, immunoglobulin A which are a part of the lymph tissue in the small intestines (McCance et al., 2019).
What diagnostic testing may be used to further evaluate the symptoms and what might this test tell the healthcare provider?
Diagnosis of the right disease is critically important to solving a medical problem by ensuring the right treatment is employed for our patients. In the case of PUD, the gold standard of diagnosis is the utilization of a procedure where a small fiberoptic cable with a camera is introduced in through the mouth to visualize the esophagus, stomach and intestines in real time. This procedure is called an endoscopy. Endoscopy is used to see if there is a lesion, bleeding or a to take a biopsy to rule out malignancy. Further testing utilizing a urea breath test where the patient ingests non-radioactive isotope urea called carbon 13 or 14, which is used to detect H.pylori and the patient is tested again after treatment to ensure eradication of the disease causing bacteria (Fashner & Gitu, 2015).
Reference
Fashner, J., & Gitu, A. C. (2015). Diagnosis and treatment of peptic ulcer disease and h. Pylori infection. American Family Physician, 91(4), 236-242.
Herregods, T. V. K., Bredenoord, A. J., & Smout, A. J. P. M. (2015). Pathophysiology of gastroesophageal reflux disease: New understanding in a new era. Neurogastroenterology & Motility, 27(9), 1202-1213. https:// doi: 10.1111/nmo.12611
Howley, I. W., Bruns, B. R., Tesoriero, R. B., Vesselinov, R., & Kufera, J. A. (2019). Statewide analysis of peptic ulcer disease: As hospitalizations decrease, procedural volume remains steady. The American Surgeon, 85(9), 1028-1032.
McCance, K. L., Huether, S. E., Brashers, V. L., & Rote, N. S. (2019). Pathophysiology: The biologic basis for diseases in adults and children. (8th ed.). St. Louis, MO: Elsevier.
Discussion #2
Sheena John
Gastroesophageal reflux disease (GERD) is a disease that involves the regurgitation of the stomach contents backward into the esophagus (Mayo Clinic, 2020). The backflow is secondary to a malfunction of the lower esophageal sphincter that typically guards the stomach contents from back flowing (Mayo Clinic. These acidic contents from the stomach to the esophagus can erode the lining over time and cause severe burning of the chest and throat or difficulty swallowing (Mayo Clinic, 2020).
Peptic ulcer disease (PUD) is a disease of the digestive tract in which a hole or sore develops in the lining (Harvard Health Publishing, 2018). Ulcers can be painful at times and may or may not be relieved or irritated further with food (Harvard Health Publishing, 2018). The stomach is typically covered with bicarbonate- rich mucus, created by mucus cells. This mucus serves as a barrier to protect the lining from being eroded by gastric acid and other potentially corrosive agents (vivo.colostate.edu, n.d.)
The case study reviews a 58 y.o. male who complained of burning and abdominal pain that awoke him in the middle of the night. It further mentioned that bland diet has aided in providing relief while spicy food exacerbated the symptoms. The individual in the case study is likely suffering from a peptic ulcer. One of the contributory factors of peptic ulcers is the use of non- steroidal anti-inflammatory’s such as aspirin, which inhibit the production of prostaglandins, and allows for erosion of the stomach lining (Harvard Health Publishing, 2018). Common symptoms of PUD include loss of appetite and weight loss which this individual has suffered.
Diagnostic testing for PUD involves visualization with a scope via a procedure called esophagogastroduodenoscopy (EGD) (Caufield & Schafer, 2012). Ulcers identified during an EGD can be “photographed, biopsied, and even treated, if bleeding is present” (Caufield & Schafer, 2012). In addition to an EDG, x-ray’s can be used, in which the client drinks a barium (white chalky substance) prior to the study that allows for the ulcer to be visualized during the x-ray (Caufield & Schafer, 2012). These x-ray’s are known as an “upper GI series” (Caufield & Schafer, 2012).
References
Caufield, S. P. & Schafer, T. W. (2012). Peptic ulcer disease. Retrieved from https://gi.org/topics/peptic-ulcer-disease/
Harvard Health Publishing (2018). Peptic ulcer. Retrieved from https://www.health.harvard.edu/a_to_z/peptic-ulcer-a-to-z
Mayo Clinic (2020). Gastroesophageal reflux disease (GERD). Retrieved from https://www.mayoclinic.org/diseases-conditions/gerd/symptoms-causes/syc-20361940
Vivo.colostate.edu (n.d.). Gastric secretions. Retrieved from http://www.vivo.colostate.edu/hbooks/pathphys/digestion/stomach/secretion.html
Subject: Masters Nursing
Answer preview…………………………..
apa 553 words