The document discusses several conditions affecting the mouth and esophagus, including dry mouth, dysphagia, and gastroesophageal reflux disease (GERD). Dry mouth is caused by reduced salivary flow due to medications or diseases and can cause difficulties swallowing and increased infection risk. Dysphagia involves problems swallowing and has oropharyngeal and esophageal forms. GERD involves reflux of stomach acid into the esophagus and can cause damage over time without treatment. Lifestyle changes and medications are used to manage these conditions.
Answer: Table 17-1 describes xerostomia management. Strategies include sipping sugarless beverages or sucking on ice cubes, avoiding dry foods and acidic or spicy or salty foods, trying saliva substitutes, practicing good oral hygiene, and considering medication changes.
Table 17-2 Selected Causes of Dysphagia
Table 17-2 Selected Causes of Dysphagia (cont’d.)
Answer: Malnutrition and weight loss, dehydration, aspiration.
Figure 17-2 The Upper GI Tract, Acid Reflux, and Hiatal Hernia
Normal: The stomach normally lies below the diaphragm, and the esophagus passes through the esophageal hiatus. The lower esophageal sphincter prevents reflux of stomach contents.
Figure 17-2 The Upper GI Tract, Acid Reflux, and Hiatal Hernia (cont’d.)
Acid reflux: Whenever the pressure in the stomach exceeds the pressure in the esophagus, as can occur with overeating and overdrinking, the chance of reflux increases. The resulting “heartburn” is so-named because it is felt in the area of the heart.
Figure 17-2 The Upper GI Tract, Acid Reflux, and Hiatal Hernia (cont’d.)
Hiatal hernia: Risk of acid reflux may increase as a consequence of a hiatal hernia. A “sliding” hiatal hernia occurs when part of the stomach, along with the lower esophageal sphincter, rises into the area above the diaphragm.
Table 17-4 Conditions and Substances Associated with Esophageal Reflux
Answer: Prolonged vomiting can cause esophagitis and fluid and electrolyte imbalances and may require medical care. Chronic vomiting can reduce food intake and lead to malnutrition and nutrient deficiencies.
Answer: Intravenous nutrition support (parenteral nutrition).
Table 17-5 Potential Causes of Gastritis
Table 17-5 Potential Causes of Gastritis (cont’d.)
Answer: Relieve pain, promote healing, and prevent recurrence.
Answer: The goals of nutrition care are to correct nutrient deficiencies, if necessary, and encourage dietary and lifestyle practices that minimize symptoms, as there is no evidence that dietary adjustments alter the rate of healing
or prevent recurrence. Patients should avoid dietary items that increase acid secretion or irritate the GI lining; examples include alcohol, coffee and other caffeine-containing beverages, chocolate, and pepper, although individual tolerances vary. Small meals may be better tolerated than large ones. Patients should avoid food consumption for at least two hours before bedtime.
Figure 17-4 Gastrectomy Procedures
In a gastrectomy, part or all of the stomach is surgically removed. The dashed lines show the removed section.
Answer: The primary goals of nutrition care after a gastrectomy are to meet the nutritional needs of the postsurgical patient and promote the healing of stomach tissue. Another goal is to prevent discomfort or nutrient deficiencies that may arise due to reduced stomach capacity or altered stomach function.
Table 17-7 Symptoms of Dumping Syndrome
Answer: Gastric banding is reversible, whereas the other two are permanent, but it usually results in less weight loss.
Figure 17-5 Surgical Procedures for Severe Obesity