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    1. 1. Chapter 8 Nasogastric Aspartate Transaminase Peptic Ulcer Disease Gastroesophageal Reflux Disease Lauran DeCeault
    2. 2. Nasogastric   Nasogastric is a general term that means pertaining to the nasal cavity and stomach. The term is often used to describe medical processes:   nasogastric intubation nasogastric aspiration
    3. 3. Nasogastric Intubation  Involves the insertion of a plastic tube (nasogastric tube) through the nose and into the stomach, passing through the throat.
    4. 4. Nasogastric Intubation   Once the tube is inserted, a healthcare provider can deliver food or medication directly to the stomach or retrieve substances. Most often, nasogastric intubation is used when an individual person is unable to eat or swallow on his/her own.  The patient can still digest food on his/her own, but cannot eat or swallow independently.
    5. 5. Nasogastric Aspiration    Refers to the process of removing substances from the stomach via nasogastric tube.  Used in patients with gastrointestinal obstructions (gastric secretions and swallowed air) The process is also used when an individual may have overdosed on a medication or swallowed a harmful substance.  Used in patients who have swallowed poisonous substances NG intubation is a helpful method to determine how the gastrointestinal tract is functioning as it can be used to remove contents of the stomach for examination
    6. 6. Aspartate transaminase (AST)  An enzyme that is found in red blood cells, the liver, heart, muscle tissue, pancreas, and kidneys.
    7. 7. AST   Commonly used as a marker for liver health, but also is found in other organs The blood usually has low levels of AST, but when a tissue or organ is damaged, more AST is released in the bloodstream.  The amount of AST measured in the bloodstream is directly related to the severity of tissue or organ damage.  Elevated levels of AST may indicate:  Acute pancreatitis  Acute hemolytic anemia  Acute renal disease  Musculoskeletal disease  Mononucleosis  Heart attack/heart failure  Hepatitis or cirrhosis
    8. 8. AST: Liver Function Test  Commonly measured (via blood draw) as a part of a diagnostic liver test:
    9. 9. Peptic Ulcer Disease    disease characterized by sores or ulcers lining the stomach or duodenum no known cause results when there is an imbalance between digestive fluids in the stomach and the duodenum
    10. 10. Causes of Peptic Ulcer Disease  The lining of the stomach and small intestine stops protecting the stomach from the irritating acids that are naturally produced by the stomach.    Stomach lining becomes inflamed, producing an ulcer Most occur in the first lining of the stomach Perforation:  Ulcers that protrude the stomach or duodenum   Medical Emergency Bacteria called Helicobacter pylori (H.pylori) is known to cause painful ulcers
    11. 11. Peptic Ulcer Disease
    12. 12. Risk of Peptic Ulcer Disease      Alcoholics Those who use aspirin, ibuprofen, naproxen or anti-inflammatory drugs regularly Smokers and tobacco users Those undergoing radiation Possibly stress
    13. 13. Symptoms of Peptic Ulcer Disease   Smaller ulcers may be asymptomatic Symptoms of Peptic Ulcer Disease include:      Abdominal pain Chest pain Fatigue Vomiting Weight loss
    14. 14. Diagnosis & Treatment of Peptic Ulcer Disease  Tests include:  Esophagogastroduodenoscopy (EGD or upper endoscopy)    For viewing the stomach and duodenum Upper GI X-Rays Medications to kill the H. pylori bacteria (if present) and decrease stomach acid  Misoprostol   For those taking anti-inflammatory medications on a regular basis sucralfate  Protects the lining of the stomach
    15. 15. Gastroesophageal Reflux Disease (GERD)   Chronic digestive disease Occurs when stomach acid or bile flows back into your esophagus   The acid irritates the lining of esophagus Caused by permanent or temporary changes to the barrier that protects the esophagus from the stomach   the lower esophageal sphincter relaxes Hiatal hernia
    16. 16. GERD
    17. 17. Symptoms of GERD         Sore throat Pain in the chest or upper part of the abdomen. Difficulty swallowing Wheezing Dry cough/trouble breathing Nausea Vomiting Burning sensation in chest and throat
    18. 18. GERD Risk Factors   Affects 10-20% of those living in the Western world. Other contributions to GERD:    Obesity Pregnancy Certain medications      anti-depressants Asthma medications Pain killers Sedatives Smoking
    19. 19. Treatment of GERD  Lifestyle change  Avoid certain foods and beverages:           Avoid over-eating Avoid laying down after eating Lose weight if needed Quit smoking Medications       Chocolate Coffee Spicy foods Tomato Alcohol Antacids H2 blockers PPIs Prokinetics Antibiotics Surgery
    20. 20. Bibliography  Fregman, B and Frucht S. “Chapter 8. Digestive System.” Medical Terminology: A Living Language (5th edition). 2005.  Medicine.Net. Gastroesophageal Reflux Disease (GERD, Acid Reflux, Heartburn). 15 October 2013.  Medline Plus. Nasogastric feeding tube. 14 October 2013.  Medline Plus. Peptic Ulcer. 15 October 2013.  Paulev-Zubieta. Chapter 22: Gastrointestinal Function and Disorders. New Human Physiology. 15 October 2013.  Shlamovitz et al. Nasogastric Tube. 14 October 2013.  U.S. Department of health and Human Services. National Digestive Diseases Information Clearinghouse (NDDIC). 14 October 2013.  Wise Geek. The Digestive System. 14 October 2013  Web MD. Digestive Disorders Health Center- Aspartate Aminotransferase (AST). 14 October 2013