This document discusses several upper gastrointestinal disorders including GERD, peptic ulcer disease, gastric cancer, and their associated risk factors, clinical manifestations, diagnoses, and treatments. GERD is caused by esophageal reflux and common symptoms include heartburn and acid regurgitation. Risk factors include obesity, smoking, and high-fat foods. Diagnoses may involve barium swallow, endoscopy, or acid perfusion tests. Treatment involves dietary changes, medications like antacids or proton pump inhibitors, and lifestyle modifications. Peptic ulcers are breaks in the stomach or duodenal mucosa and are associated with protein meals, alcohol, smoking, NSAIDs, and H. pylori infection. Gastric cancer

1. UPPER GASTROINTESTINAL
DISORDER
Created by :
Jessica Faye G. Manansala

2. GASTROESOPHAGEAL RELUX DISEASE
(GERD)
• It is a syndrome resulting from esophageal reflux

4. Clinical Manifestation
• Heart burn
• Odynophagia
• Dysphagia
• Acid regurgitation
• Water brash
• Eructation
• Pain (back, neck or jaw)

5. Risk Factors
• Obesity & weight gain
• Pregnancy
• Chewing tobacco
• Smoking
• High fats foods
• Theophylline
• Caffeine
• Chocolate

6. Diagnosis
• Barium swallow
• Esophageal manometry
• Esophagoscopy
• Esophageal biopsy
• Cytologic examination
• Acid perfusion test

7. Esophageal Manometry

8. esophagoscopy

9. Acid Perfusion Test

10. Treatment
• 1. Restrict diet into small frequent
feedings.
• 2. Drink adequate fluid at meals to assist
food passage.
• 3. Eat slowly and chew thoroughly to add
saliva to the food
• 4. Avoid extremely hot or cold food,
spices, fats, alcohol, coffee, chocolate &
citrus juices.

11. Medications
• Cytotec- preventing gastric ulcer formation & GERD
manifestation
• Antacids (30 ml 1hr before and 2 to 3hrs after meal) it
helps to neutralize gastric acid secretions.
• Histamine receptors antagonist
• (zantac, pepcid) – It decreases gastric secretions.
• Cholinergic ( bethanechol or urecholine) – for clients
with severe manifestation it increase LES pressure and
prevent reflux
• Metoclopramide (raglan)- increase LES pressure by
stimulating the smooth muscle of GIT and increase the rate
of gastric emptying. This medication is taken before meal.
• Cisapride (propulsid) 15min before meal and at bed time.
• Proton pump inhibitor (prevacid) – suppresses secretion
of gastric acid,

12. Nursing management
• Identify specific manifestation
• Document when sign and symptoms started
( frequency & severity)
• Help client to identify risk factors for GERD
• Instruct clients about lifestyle change
• Explain the relationship of manifestation to
food and various product.

13. PEPTIC ULCER DISEASE
(PUD)
- PUD involves break in continuity of the
esophageal, gastric or duodenal mucosa

15. DUODENAL ULCER
• Duodenal ulcer has an increase
incidence than gastric ulcers.

16. Stimuli Acid Secretion
• Protein rich meals
• Alcohol consumption
• Calcium
• Vagal stimulation

17. GASTRIC ULCER
• Cause is the break in of the mucosal barrier.
• Incompetent pylorus into stomach may break
mucosa barrier.

18. Risk Factor
• smoking (nicotine)
• steroids
• aspirin
• NSAID’s
• Caffeine
• Alcohol
• Stress

19. Clinical Manifestation
• Pain- aching, burning, cramp, gnawing pain
• Gastric ulcer - food may cause pain and
vomiting may relieve it.
• Duodenal ulcer- empty stomach and ingestion
of food or antacid may relieve pain.
• Nausea and Vomiting – vomiting is more often
in gastric ulcer
• Gastric ulcer – anorexia, weight loss and
dysphagia
• Bleeding

20. Diagnosis
• X-ray and Endoscopy
• CBC
• Stool testing
• Urea Breath Test

21. Treatment
• Anatacid
• Cimetidine
• Rahitidine
• Pamotiidne
• Clarithromycin
• Cytotec

22. Nursing Management
• Modify diet
• Assess bleeding
• Prevent shock
• Replace fluids
• Maintain rest

23. GASTRIC CANCER
• Gastric cancer refers to the malignant
neoplasms found in the stomach, usually
adenocarcinoma. Most stomach cancers occur
in the pylorus or antrum of the stomach and are
adenocarcinomas

24. Clinical Manifestation
• Early stage – symptoms may be absent
• indigestion
• anorexia
• dyspepsia
• weight loss
• abdominal pain
• constipation
• anemia
• nausea & vomiting

25. Risk Factors
• chronic atrophic gastritis
• history of exposure to background radiation or
trace metal soil
• people usually eat pickled food, salted fish &
nitrates
• metal craft workers, miners, bakers
• those working in dusty, smoky & sulfur dioxide
containing environment

26. Diagnosis
• X-ray the upper GIT
• Double contrast barium swallow
• followed by endoscopy for biopsy
• cytologic test
• CT scan
• Gastroscopy

27. Treatment
• chemotheraphy
• radiation theraphy
• surgical resection

28. Nursing Management
• assess the client history of diet (smoked fish,
salty food,smoking)
• family history
• asked the patient if she/he has a previous
gastric surgery
• history of risk factors to the development of
cancer.
• chronic gastritis
• pernicious anemia
• presence of H.Pylori

29. THE END
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