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30 Cards in this Set
- Front
- Back
T or F: The entire esophagus functions as one tissue during swallowing?
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True
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Movement of a bolus of food into the stomach.
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Mouth - Pharynx - (upper sphincter relaxes) - esophagus - (peristaltic waves and LES relaxes) - stomach.
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Definition of dysphagia:
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Difficulty in swallowing
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Definition of GastroEsophageal Reflux Disease (GERD):
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The backward flow of the stomach of duodenal contents into the esophagus; may occur normally or as a chronic pathologic condition
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Common symptoms of GERD:
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Reflux of gastric secretions, heartburn with episodes of substernal pain, belching, esophageal spasm. Children's symptoms may also include refusal to eat, vomiting, dysphagia, or c/o abdominal pain.
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Prolong erosive disease (GERD) can result in:
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esophagitis, esophageal erosions, ulceration, scarring, stricture, and even dysphagia.
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What is Barret's esophagus (BE)?
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A condition in which cells lining the distal esophagus become abnormal, even premalignant.
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Acute esophagitis may be caused by:
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ingestion of a corrosive agent, viral inflammation, or intubation.
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Risk of reflux is increased with:
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hiatal hernia, reduced LES pressure, tobacco use, increased abdominal pressure (as in obstructive lung disease), delayed gastric emptying, recurrent vomiting, pregnancy, or other factors.
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GERD can cause esophagitis. The severity of esophagitis is influenced by:
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the composition, frequency, and volume of the gastric reflux; the health of the mucosal barrier; rate of clearance from the esophagus; rate of gastric emptying.
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T or F: Erosive and nighttime GERD are considered to be associated with more severe and prolonged symptoms.
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True. Nighttime GERD is R/t altered phsyiology and anatomy during sleep from decreased salivary secretions and swallowing, decreased GI motility, prolonged exposure to acid, and the supine position.
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Esophagitis, although mainly R/t GERD, can also be R/t:
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Viral/Bacterial infection, reduced LES pressure, Hiatal hernia, intubation, ingestion of corrosive agents, radiation, smoking, large doses/chronic use of asprin or other nonsteroidal antiinflammatory drugs (NSAIDs) or other medications.
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Proton pump inhibitors are considered most effective to treate GERD. How do they work?
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Proton pump inhibitors decrease acid production by the gastric parietal cell.
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Prokinetic agents may be used in person who
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have delyaed gastric emptying.
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Rather than using proton pump inhibitors for all cases of GERD, milder forms of reflux can be managed with what types of medications?
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H2 receptor antagonists
antacids |
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What behavioral modifications are used to manage esophagitis?
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Avoiding lying down after meals and eating within 3 hrs of retiring, wearing loose fitting clothing, avoiding cigarette smoking.
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What is the nutrition management goals for esophagitis and how can they be achieved?
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1 Decrease exposure to gastric contents by: avoiding large meals, dietary fat and alcohol.
2 Decrease acidity of gastric secretions by: avoiding coffee and fermented alcholic beverages. 3 Prevent pain and irritation by: avoiding acid pH foods and spices. |
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Definition of fundoplication:
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A procedure in which the fundus of the stomach is wrapped around the lower esophagus to limit reflux.
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For a person with severe esophagitis, what diet may be best tolerated initially?
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Low-fat, liquid diet because it doesn't increase esophageal distention and it may pass more easily through any strictured areas.
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LES pressure is lowered by:
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carminatives (peppermint and spearmint), coffee, pregnancy, taking pregesterone-based birth control, .
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Risk factors for esophageal cancer includes:
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obesity, alcohol and its degradation into acetaldehyde, nitrities, a diet low in selenium/fruits/vegs/cereal fiber.
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T or F: The presence of hiatal hernia is synonymous with reflux
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False. It does prolong exposure to acid and increase risk of serious esophagitis. It also causes epigastric discomfort after large, energy-dense meals, laying down, or bending over.
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What is the most common type of hiatal hernia?
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The sliding hernia. The less common is the paraesophageal hernia.
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MNT for hiatal hernias include:
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weight reduction, decreasing meal sizes, omitting high-fat, high-kcal meals before reclining, minimizing alcohol consumption.
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Why are tonsils removed?
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To reduce the number and frequency of ear infections, tonsillitis, and sinusitis. Tonsils are considered lymphatic tissue and are therefore part of the immune system.
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The best foods to eat after a tonsilectomy include:
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cold, mild-flavored, soft, moist foods. The first day after surgery, chilled/frozen dairy or fruit slurries and noncitrus juices are tolerated. By day two the diet can be expanded to include warm fluids and soft foods. Within 3-5 days the a normal diet can be consumed.
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MNT for oral cancer:
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Nutrition support by tube feeding or gastrostomy if needed for total or supplemental support. If oral is possible - liquid/soft foods; moist foods for easy mastication and swallowing; small, frequent meals of high caloric density; complex carbs rather than simple carbs.
Use of artificial saliva, frequent consumption of fluids, and normal saline rinses may help the eating process. |
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What is functional dyspepsia (aka nonunlcer dyspepsia)?
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unexpelained persistent or recurrent upper GI discomfort
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What are symptoms of functional dyspepsia?
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vague abdominal discomfort, bloating, early satiety, nausea, belching.
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What is the dietary MNT for dyspepsia?
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Reduce dietary fat intake, smaller meals, diets of low caloric density, and limiting alcohol. Non dietary MNT includes mild exercise and lowering stress levels.
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