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Gastrointestinal Tract: Disorders of Motility
Assignment 1: 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 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 CompleteWrite a 2- to 3-page paper that addresses the following:
Describe the normal pathophysiology of gastric acid stimulation and production. Explain the changes that occur to gastric acid stimulation and production with GERD, PUD, and gastritis disorders.
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.
| Subject | Nursing | Pages | 6 | Style | APA |
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Answer
Disorders of Motility
Disorder of motility refers to a situation where the muscles and nerves in the gastrointestinal tract are not functioning together in a correct manner; this finally results in difficulties in the processes of digestion (Hall, 2015). The most notable conditions include: chronic intractable constipation, gastroparesis, Hirshsprung’s disease, esophageal achalasia, gastroesophageal reflux disease (GERD), chronic intestinal pseudo-obstruction and many more.
The production and stimulation of gastric acid
Gastric juices in the body are the digestive fluids that are secreted in the stomach and will be used to break down the solid food and kill the bacteria in the stomach. The diet we take or the drug one takes may cause some imbalances in the amount acid produced. The gastric acid will be produced by the parietalcells that are found on the walls of the stomach. The secretory canaliculus is a region in the parietal cell that is the most acidic part of the human body.
During the normal secretion and production, the parietal cells will be stimulated to producethe gastricjuice. The main stimulus for the gastric acid secretion is Histamine 2 receptors (Manna, 2018). Peptic ulcer disease (PUD) will cause the lining of the stomach to break which lead to the gastriculcer. Gastroesophageal reflux disease, on the other hand, is a digestive disorder that will affect the esophagus sphincter. Gastritis disorders on the hand are the inflammation of the lining of the stomach. The above three disorders in individuals will affect the gastric acid secretion and production. Disorders will lead to gastric acid hypersecretion which is an excessive formation of the gastric juice and the acidic component (Rubenstein& Chen, 2014).
Factor that impacts the GERD, PUD, and gastritis pathophysiology
The factor selected is Gender. It is good to understand the gender and sex of individuals before treatment of GERD, PUD, and gastritis disorders. In gastroesophageal reflux disease (GERD), gender –related differences may affect the prevention and treatment of the disorder; this is because of the biological factors that are different between men and women.GERD will affect more women than men. Treatment of gastroesophageal reflux disease (GERD) involves modification of lifestyle mostly among ladies and control of the gastric acid secretion in individuals by use of medical therapy. If the case is serious surgical treatment may be offered (Lee, 2014).
Peptic ulcer disease (PUD) disorder is more common to male as compared to female. The difference is caused by the lifestyle and the prevalence.PUD prevalence in women has got a shorter lifetime as compared to men. Treatment of will vary depending on the clinical presentation .The most common treatment option will be empirical secretory therapy (Rubenstein& Chen, 2014).
Gastritis disorder is more common in male compared to female. Those males with gastritis are also at risk of developing other disorders such as peptic ulcer diseases. Females have a faster ulcer healing capability as compared to males (Wu, et al, 2016). Gender differences will, therefore, play a greater role in the treatment and prevention of gastritis disorder. Use of antacids such as H-2 blockers will mostly be used in females than in males to treat the disorder. Males will mostly be given some medication that is aimed at reducing the acid production.
Mind map for gastritis
Gastritis is a disorder that is an inflammation and erosion of the stomach lining and occurs gradually in individuals. The disorder mostly affects individuals who are 60 years and above mostly males. It is mainly caused by consumption of alcohol, stress, use of certain medication and chronic illnesses. Major symptoms are loss of appetite, nausea, and vomiting, (Feng, et al.2013)
References
Lee, S. W. (2014). The risk factors and quality of life in patients with overlapping functional dyspepsia or peptic ulcer disease with gastroesophageal reflux disease. Gut Liver, 8(2), 160-164.
Hall, J. E. (2015). Guyton and Hall textbook of medical physiology e-Book. Elsevier Health Sciences.
Feng, Z., Huang, J., Xu, Y., Zhang, M., & Hu, S. (2013). Dissociative disorder induced by clarithromycin combined with rabeprazole in a patient with gastritis. Journal of International Medical Research, 41(1), 239-243.
Wu, C. H., Tung, Y. C., Chai, C. Y., Lu, Y. Y., Su, Y. F., Tsai, T. H., ... & Lin, C. L. (2016). Increased risk of osteoporosis in patients with peptic ulcer disease: a nationwide population-based study. Medicine, 95(16).
Rubenstein, J. H., & Chen, J. W. (2014). Epidemiology of gastroesophageal reflux disease. Gastroenterology Clinics of North America, 43(1), 1-14.
Manna, S. (2018). Gastrointestinal physiology. In Review of Physiology (pp. 457-496). jaypee.