One of the most common and common diseases of the digestive system

Medical case consultation
#1

Gastroesophageal Reflux Disease (GERD)

One of the most common and common diseases of the digestive system.

The concept of the word GERD

Which is the return of stomach contents to Mary to mouth.

Petophysiology: Two factors are involved in the creation of this disease.

  1. Anti-reflux factors: Three anatomic anti-reflux mechanics are available, which will create GERD if these go away.

A - Diaphragm

: This muscle is like a ring around Mary to maintain pressure in this area and prevent food from returning to Mary. But when this ring grows the stomach out of this

The ring goes up, and the hijab hernia creates a barrier, which is the GERD background maker.

ب - sphincter esophageal lower :

This sponge has very strong loop muscles that are normal and won’t let GERD be created.

  • Positioning Mary in His angle: The existence of this angle prevents GERD.
  1. Reflux risk factors: If these factors exist, GERD may be created.

A - hernia Hiatal (diaphragm hernia)

  • The use of drugs that cause relaxation of spongeter, such as: smoking, tea, coffee, alcohol and… which are in the combination of self-nicotine.

  • Growing the stomach: The bigger the stomach, the more GERD.

Abdominal obesity -

Pregnancy -

Gastric hyper secretory states -

Delayed gastric emptying -

ب - peristalsis esophageal of Disruption :

Pastaltic movements disorder, these movements cause low

Removing acid is rising in GERD and still producing in response to this mucus acid that neutralizes acid.

J - Gluttony (eating)

D - Smoking -

GERD Clinical plates and symptoms: It creates two types of symptoms.

  1. The symptoms of the digestive system:

A thousand Heartburn

ب . Regurgitation

ج .- important but) common Less (Dysphagia

Disfajia creates time for GERD to be chronic and destroyed by the rise of Mary’s acid and created in Mary’s tissue, since this tissue does not have the ability to expand and move, it causes dysfjia.

د . pain chest

Chest pain is very rare, but it is important because it is possible to fall into heartache.

This pain is caused when Mary’s nerve fibers are destroyed by acid.

  1. Syndromes esophageal Extra 🙂

الف . cough Chronic

20 percent of chronic coughs are caused by GERD. These coughs are created because returning materials may enter the trachia.

B - Laryngitis (larynx inflammation)

J - Asthma may be the recurring material of alarjin and cause allergies or stemma.

D - erosions Dental since the recurring material in GERD is acid, it is possible to create dentist.

H - throat of clearing Frequent (repeated throat wiping)

And - pneumonia aspiration Recurrent (repeated sammonia that is a spiriting type)

Because patients with GERD are repeatedly rising, and it’s possible that they’re in the trachia and coughing

Don’t be removed and go to the lower parts (airbags) These drugs in the respiratory system cause inflammation

Sharp airbags or samunia can.

#Recreational Diagnosis:

  • Coronary artery disease (CAD) Is very important -

Displaying GERD from CAD is very important.

  • esophagitis Infections

Marine inflammation: Antibiotics are not used in GERD medicine but it is important in mary inflammation.

  • (allergic. (esophagitis Eosinophilic

Mary’s allergic inflammation: Mary has inflammation in this disease, but it is seen in the blood of Izinophlia, the cause of which is parasite or allergies. In the treatment of this disease, antheistamine and steroids are required.

  • esophagitis induced Pill :

Inflammation that caused the swallowing of the tablet. I diagnose this disease with endoscopy, as a tablet stuck to Mary’s chip will be seen with local inflammation in the endscopy.

  • (PUD (disease ulcer Peptic :

It is diagnosed using endoscopy.

  • colic Biliary

(Bile bag collic): Diagnosis is made by sonography.

  • disorders motility Esophageal muscle

Mary’s motion disorder 🙂 this disease with drugs

Relaxant is treated, but this drug is not used in GERD.

Complications: If GERD is lasting, it may create the following four effects.

  1. Stricture (tightness 🙂 since GERD causes inflammation, destruction, and ferry, it is possible to be tight

It will create a intensity. So the patient who has GERD dysfunctionia has been created with a sticker.

  1. Bleeding: Bleeding also causes destruction.

  2. Esophagus s ’ Barrett: Brett Isophagos is metapalzia, Mary’s room from carpet clay to

It is the stones that are created by GERD. But when this disease is cured this metapalzia

Back to normal again.

  1. Adenocarcinoma: When the acid return continues and is not treated, metapalzia turns into dispensation.

It is possible, but Despalzia is also a return, but if there is no treatment again, Dispalzia will be in Newpalzia.

It changes and cancer creates adinocarcarosinoma, but Nepalzia is not a return.

Diagnosis: The following four methods are available to detect.

(History Patient) Care full history -

  • Finding Clinical (Clinical or Excellent receipts) GERD does not have a great first step.

  • Exam Lab (Albratwari Examination 🙂 One of the exams of Albratwari, measuring the volume of recurrent materials and the amount

Acid is a recurrent material.

40 Imperrazole with trial treatment: Trial therapy (omeprazole 40 mg po bid for one week) -

Meligrams of food is twice a day for a week, which if it causes recovery shows GERD

But if it is not found, it shows GERD is a disorder or it is not GERD.

Treatment: There are three goals in the treatment that need to be done.

  • symptoms the reduce (Reducing patient’s complaint)

gitis of Healing (Healing the destroyed chambers of Mary)

  • Complications the Prevent (Preventing disorder)

There are three steps to achieve those goals that are the following date.

  1. modifications Lifestyle (the original way of life 🙂 not smoking, not drinking tea, coffee, alcohol, decrease

Weight, prevent eating and…

  1. Pharmacological treatment: The drugs that have a role in the treatment of this disease are two types.

A). Inhibitor pump proton (PPI: These drugs will block the hydogen pumps that these pumps are duty

It has HCL building, these drugs will destroy 90 percent of GERD disease in eight weeks but

If the disease is recurring (resistant), the dose of medicine will be doubled. Like the following medicines

Omeprazole 20 mg from after 30 min before meal ✓

Lansoprazole 30 mg from after 30 min before meal ✓

Pantoprazole 40 mg from after 30 min before meal ✓

Esomeprazole 20 mg from after 30 min before meal ✓

Rabeprazole 20 mg from after 30 min before meal ✓

B Blocker Receptors bạlk: These drugs are the second receiver of Hystamine in the digestive system.

It makes, like the following medicines.

Cinnamon 200 mg bid po ✓

Famotidine 40 mg od or bid ✓

Ranitidine 150 mg bid po ✓

Nizatidine 150 mg bid po ✓

  1. Surgical treatment: Surgical process used for GERD treatment called

Fundoplication is learned, which is shown in the following image. In this surgery, the stomach fandus around Mary.

It will be twisted.

Note: Imperrazol and Alnsoprazol are the most effective type of PPI.

Note: GERD is overall esophagitis erosive.