Concept and Etiology
Gastroesophageal reflux disease or GERD is a condition where chyme periodically backs up from the
stomach into the esophagus. Occasionally, bile can back up into the esophagus. This gastric
backflow occurs because the lower oesophageal sphincter (LES) opens resulting in decreased LES
pressure or increased stomach pressure. (Story, L., 2010, pp273-74). Once this backflow occurs the
patient will feel a burning sensation in their throat or sometimes what feels like a lump in their
throat. “GERD can result in esophagitis, strictures, ulcerations, oesophageal cancer, and chronic
pulmonary disease (e.g., asthma)” (Story, L., 2010).
Classification:
According to NCBI (National Center for Biotechnology Information), based on endoscopic and
histopathologic appearance, GERD is classified into three different phenotypes: non-erosive reflux
disease (NERD), erosive esophagitis (EE) which is characterized by erosions or ulcers of the
oesophageal mucosa, and Barrett esophagus (BE). The complication of BE occurs because of chronic
pathological acid exposure to the distal esophageal mucosa. It leads to a histopathological change
of the distal esophageal mucosa, which is normally lined by stratified squamous epithelium to
metaplastic columnar epithelium. Barrett's esophagus is more commonly seen in Caucasian males
above 50 years, obesity, and history of smoking and predisposes to the development of esophageal
adenocarcinoma.
Clinical Manifestations:
Clinical manifestations include:
• c c c heartburn (early)
• c c c epigastric pain (usually after a meal or when recombinant)
• c c c dysphagia
• c c c nausea (usually after eating)
• c c c dry cough
• c c c laryngitis
• c c c pharyngitis
• c c c regurgitation of food
• c c c sensation of a lump in the throat (Story, L., 2010)
Diagnostic Tests:
Diagnostic procedures for GERD consist of:
• c c c a history
• c c c physical examination
• c c c barium swallow - patient is asked to drink a chalky liquid that coats and fills the inside lining of
your digestive tract. The coating allows your doctor to see a silhouette of your esophagus, stomach
and upper intestine. You may also be asked to swallow a barium pill that can help diagnose a
narrowing of the esophagus that may interfere with swallowing.
• c c c EGD
• c c c esophageal pH monitoring
• c c c esophagus manometry - This test measures the rhythmic muscle contractions in your esophagus
when you swallow. Esophageal c c c c c c c c c c manometry also measures the coordination and force exerted
by the muscles of your esophagus. (Mayo Clinic, 2001)
Concept and Etiology: Gastritis is an inflammation of the stomach lining. It affects the
gastrointestinal system because it affects the entire stomach. It deviates from the definition of
health because the body is not free from illness which is a definition of health.
Classification: Gastritis can be classified as acute and chronic. Acute gastritis is an inflammation or
swelling of the stomach lining that happens suddenly. It can be anywhere from mild to a severe
ulceration with hemorrhage. In most cases it usually resolves itself within 3 days or so. The most
common cause is spicy food, NSAIDS, or other ingesting irritants. With chronic gastritis, the stomach
becomes inflamed as well, but it occurs over a long period of time as it gradually wears away at the
stomach lining. This can be from a time of months to years. H. pylori bacteria is the most common
cause of chronic gastritis.
Signs & Symptoms: c Signs and symptoms of gastritis are indigestion, abdomen cramping (upper),
nausea and vomiting, heartburn, epigastric pain, black stools, and loss of appetite.
Diagnostic Test: Test that can be performed to see if gastritis is a probable diagnosis are performing
a history and physical, GI trach X-ray, stool analysis to check for stomach bleeding, complete blood
count (CBC) to check for anemia and H. pylori antibodies and breath test.
Badii, Chitra. (2020). Chronic Gastritis. Healthline Media.
https://www.healthline.com/health/gastritis-chronic
Kivi, Rose. (2019). Acute Gastritis. Healthline Media. https://www.healthline.com/health/gastritis-
acute
Mayo Clinic. (2021). Gastritis.https://www.mayoclinic.org/diseases-conditions/gastritis/symptoms-
causes/syc-20355807
Story, L. (2017). Pathophysiology: A Practical Approach (3rd Edition). Jones & Bartlett Learning.
https://mbsdirect.vitalsource.com/books/9781284142983
Story, L. (2017). Pathophysiology: A Practical Approach (3rd Edition). Jones & Bartlett Learning.
https://mbsdirect.vitalsource.com/books/9781284142983
Mayo Clinic, Gastroesophageal Reflux Disease, Retrieved on December 6, 2021 from
https://www.mayoclinic.org/diseases-conditions/gerd/symptoms-causes/syc-20361940
Antunes C, Aleem A, Curtis SA. Gastroesophageal Reflux Disease. [Updated 2021 Jul 18]. In: Stat
Pearls [Internet]. Treasure Island (FL): Stat Pearls Publishing; 2021 Jan-. Retrieved on December 6,
2021 from: https://www.ncbi.nlm.nih.gov/books/NBK441938/
