Disorders of the oesophagus (Oesophangitis (Nursing management (Promote…
Disorders of the oesophagus
Is an acute or chronic inflammation of the mucosa and sub mucosal lining of the oesophagus.
Consumption of caffeinated drinks
Incompetent lower oesophageal sphincter is associated with gastroesophageal reflux.
The backward flow of acidic gastric content occurs through the weak cardiac sphincter into the oesophagus.
Contributory factors include: impaired gastric emptying from gastro paresis, inflammation, ulceration and mucosal damage of the oesophagus.
Assessment findings and symptoms
Heartburn- Occurs 30 to 60 minutes.
Spontaneous regurgitation of sour and bitter gastric contents and sometimes accompanied by vomiting
Regurgitation of food when lying down in bed at night
A burning sensation in lower chest after swallowing hot fluids and hot fatty foods.
Intolerance of spices alcohol and caffein
Difficult in swallowing but a less common symptom
Atypical chest pain which result in difficult swallowing.
-First line drug therapy - Antacids is administered to neutralise gastric acidity.
Histamine receptor blockers can be given to reduce stomach acidity.
Second line drug therapy- High dose of H2 blockers are administered to promote gastric emptying.
-A vagotomy is performed to reduce the acidity of the stomach contents. It is also done to tighten the sphincter muscles to decrease reflux.
-Gastrostomy can be performed to enhance nutrition if swallowing is impossible.
Instruct the patient to eat high protein food ,low fat diet and avoid spicy foods
Patient's head must be elevated from 15-20 centimetres blocks to empty oesophagus
Promote adequate nutritional intake
Assess any content in the vomitus to the patient
The integrity of oral mucosa must be maintain.
Refer the patient to the dietician if weight is reduced
Discuss the condition of the patient with the family including the patient.
Is a chronic progressive condition in which the tone in the lower two thirds of the oesophageal musculature is increased.
Alcohol and tobacco
Degenerative changes in the ganglion cells.
Cancer of oesophagal
There is an increase in tine of lower oesophageal sphincter .
Defective innervation by the Auerbach's plexus is the result of increased of the tone of the oesophageal sphincter
The results is poor tone and peristalsis distention of the lower part of the oesophagus
There is delayed emptying of the oesophagus into the stomach
Assessment findings and symptoms
Progressively increasing difficulty in swallowing both solids and liquids
Feelinng of something stuck in the throat
Earlier the patient complain of heartburn in the substernal region
Patient must be given frequent doses of antacids to neutralise gastric contents
Patient should be encouraged to chew food properly
Patient must adopt an upright position at night to prevent the reflux of food.
Dilation of the oesophageal sphincter (oesophago-myotomy)
Opening of the sphincter mechanically by inflating a balloon in it.
Administering of drugs (nitrites) and calcium channel blockers
chew food thoroughly
need to eat slow
drink plenty of water with meals
avoid eating near bed time
regular check ups for the oesophagus even after treatment once a year
Definition-is the protrusion of the upper part of the stomach into the thorax through a tear or weakness in the diaphragm.
people over 50 years
drug use such as cocaine
sitting position for defecation
congenital muscle weakness
factors which increase intra-abdominal pressure
increase in age
part of the stomach protrude upward into the mediastinal cavity due to weakness of the diaphragm
clinical features of hiatus hernia a the regurgitation of gastric contents
These cause ulceration and oesophagitis with resultant bleeding
Assessment and common findings
heart burn due to acid fluid regurgitation
flatulence and belching
A feeling of fullness and dypnoea
severe burning pain
reducing reflux by enhancing the repair of the hernia below the diaphragm
and narrow the oesophageal opening
protecting the oesophagus from ulceration by acid reflux
prevent and manage complications
antacids should be taken after meal land at bed time
patient should be advice wear loose underwear
eat small, frequent, bland meals which a high in fibre and drink lot of water
eat the evening meal three hours before going to bed
avoid smoking, drinking alcohol and citrus juice
assume an upright position or fowlers position after eating and at night to keep the stomach In the abdominal cavity
avoid bending, heavy lifting, coughing and vomiting
Are sacs or pouches formed at the weak point of the gastrointestinal tract.
Age common in ages of 70 to80
Gender especially males
Gastroesophageal reflux disease
People with dysphagia
Tobacco and alcohol use
Inflammation from outside the oesophagus
Improper functioning of the lower oesophageal sphincter
Motor disorders of the oesophagus
Strictures of the oesophagus
Improper movement of food through the oesophagus
malfunctioning of the swallowing mechanism
Large pouch fills with regurgitated food
Regurgitation occurs when the person bends over or lie down
Food is inhaled into the lungs when sleeping leading to pneumonia
Pouch enlarges and causes dysphagia
Complains of an odour due to stagnant food
Sour taste in the mouth
Regurgitation of stagnant food
Coughing due to irritation of the trachea
Encouraging small amount of meals
Nurse in an upright position
Teach the patient to be in an upright position
Eat soft diet
Encouraging the patient to take small amount of meals