Gastrointestinal System: Dysphagia, GERD & Hiatal Hernia - Medical-Surgical (GI) | @LevelUpRN

Summary

In this video, Cathy from Level Up RN covers key gastrointestinal disorders, focusing on dysphagia, GERD (gastroesophageal reflux disease), and hiatal hernias. She explains the causes, symptoms, and diagnostic methods for each condition, such as difficulty swallowing, acid reflux, and chest pain. Cathy highlights treatment options, including medications and lifestyle changes, as well as surgical interventions like Nissen fundoplication. The video concludes with a short quiz to reinforce learning, testing viewers' understanding of the material. This informative session offers essential insights for nursing students and healthcare professionals.

Takeaways

• 😀 Dysphagia is difficulty swallowing, which can result from structural issues or neurological disorders like stroke, Parkinson's, or ALS.
• 😀 Symptoms of dysphagia include coughing, throat clearing, difficulty eating or drinking, and aspiration pneumonia (food or liquid entering the lungs).
• 😀 Diagnosis of dysphagia involves referral to a speech-language pathologist and tests such as a barium swallow or EGD.
• 😀 The treatment for dysphagia includes a modified diet (pureed foods, thickened liquids) and specific swallowing techniques like chin tucking.
• 😀 GERD (gastroesophageal reflux disease) occurs when stomach acid backflows into the esophagus, causing inflammation and pain.
• 😀 Common symptoms of GERD include indigestion (dyspepsia), throat irritation, burning chest pain (worse when lying down), and chronic cough.
• 😀 GERD can be diagnosed with procedures like EGD, barium swallow, esophageal pH monitoring, and esophageal manometry.
• 😀 Medications for GERD include antacids, H2 blockers, PPIs, and prokinetic agents, with surgery (Nissen fundoplication) being an option if medications fail.
• 😀 Hiatal hernia occurs when part of the stomach protrudes through the diaphragm, causing symptoms like heartburn, dysphagia, and chest pain after meals.
• 😀 Treatment for hiatal hernia includes GERD medications and surgery (Nissen fundoplication) if necessary, along with lifestyle changes like avoiding spicy foods and smaller meals.
• 😀 Patient education for GERD and hiatal hernia includes advice on diet (avoiding fatty, spicy, or citrus foods), eating smaller meals, and staying upright after meals.

Q & A

What is dysphagia?

Dysphagia is difficulty swallowing, which can be caused by a structural abnormality or disorders affecting the nerves or muscles involved in swallowing, such as a stroke, cerebral palsy, Parkinson's disease, and ALS.

What are the signs and symptoms of dysphagia?

Signs and symptoms of dysphagia include coughing, frequent throat clearing, difficulty eating or drinking, and aspiration pneumonia, where food or liquid enters the airways and causes inflammation and infection in the lungs.

How is dysphagia diagnosed?

Dysphagia is diagnosed through a speech language pathologist evaluation, which assesses the patient's swallowing ability. Other diagnostic tools include a barium swallow test and an EGD (esophagogastroduodenoscopy) to identify structural abnormalities.

What is a Level 1 dysphagia diet?

A Level 1 dysphagia diet involves pureed foods and thickened liquids, which are easier for the patient to swallow. Special thickening powders can be added to liquids, such as coffee, to achieve the necessary consistency.

What is GERD and its pathophysiology?

GERD (gastroesophageal reflux disease) is a condition where gastric contents, including stomach acid and enzymes, backflow into the esophagus. This causes pain, mucosal damage, and conditions like esophagitis and Barrett's esophagus, which can increase the risk of esophageal cancer.

What are the risk factors for GERD?

Risk factors for GERD include obesity, smoking, alcohol use, older age, pregnancy, ascites (fluid accumulation in the abdomen), and hiatal hernia.

What are the common symptoms of GERD?

Common symptoms of GERD include dyspepsia (indigestion), throat irritation, a bitter taste, burning pain in the esophagus (which worsens when lying down), and chronic cough.

How is GERD diagnosed?

GERD is diagnosed through tests such as an EGD (esophagogastroduodenoscopy), an upper GI series (barium swallow), esophageal pH monitoring, and esophageal manometry (which tests the function of the lower esophageal sphincter).

What surgical procedure is used for severe GERD?

For severe GERD that doesn't respond to medications or lifestyle changes, a Nissen fundoplication may be performed. This procedure involves wrapping the top of the stomach (the fundus) around the esophagus to prevent reflux.

What is a hiatal hernia and its symptoms?

A hiatal hernia occurs when a portion of the stomach protrudes through the diaphragm into the thoracic cavity. Symptoms include heartburn, dysphagia, and chest pain after meals. In severe cases, the hernia can become strangulated, blocking blood flow to the stomach and causing necrosis.

How is a hiatal hernia treated?

Treatment for a hiatal hernia includes medications used for GERD, such as antacids, PPIs (proton pump inhibitors), and prokinetic agents. In severe cases, a Nissen fundoplication surgery may be necessary. Patient education for managing a hiatal hernia is similar to GERD, with lifestyle modifications such as avoiding spicy or fatty foods and elevating the head of the bed.