Posted: December 3rd, 2022

Diagnosis and Management of Gastrointestinal Disorders

Nursing
Title: Diagnosis and Management of Gastrointestinal Disorders
Number of sources: 4
Paper instructions:
Case Study 2
Victoria is a 15-year-old who complains of chronic sore throat and bad taste in her mouth. Her height and weight are appropriate for age and she remains on the same growth trajectory since infancy. Abdominal examination and chest examination are negative. History reveals frequent burping and occasional feelings of regurgitating food. Diet history reveals she eats a balanced diet, but her primary sources of fluids are coffee, tea, and carbonated drinks.

To Prepare
• Review “Gastrointestinal Disorders” of the Burns et al. text.
• Review and select one of the three provided case studies. Analyze the patient information.
• Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
• Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or non-pharmacologic treatments.
• Consider strategies for educating patients and families on the treatment and management of the gastrointestinal disorder

By Day 3
1. Post an explanation of the differential diagnosis for the patient in the case study you selected.
2. Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis.
3. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments.
4. Finally, explain strategies for educating patients and families on the treatment and management of the gastrointestinal disorder.
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Diagnosis and Management of Gastrointestinal Disorders
Victoria portrays signs of a gastrointestinal disorder. The undesirable taste inside her mouth and a chronic sore throat are signs that the patient could be suffering from hiatal hernia whereby the upper part of the stomach bulges up into the diaphragm (Nabi & Reddy, 2016). It could also mean that the patient has delayed stomach emptying. This leads to frequent acid reflux, which means that the sphincter’s relaxation is weakened or abnormal, hence allowing the backflow of stomach acid into the patient’s esophagus.
The most likely diagnosis for Victoria is Gastroesophageal Reflux Disease (GERD). Such a diagnosis is influenced by the patient’s history of frequent burping. The patient releases air to minimize the stomach distention that causes acid reflux (De Bortoli et al., 2018). Furthermore, the patient has been known to regurgitate frequently, which explains the hiatal hernia. Considering that one of Victoria’s fluids sources is coffee, it explains why she has aggravated acid reflux as a sign of GERD. Finally, the chronic sore throat adds up to the primary symptoms of GERD.
The treatment and management plan for this disease is focused on transforming the patient’s lifestyle. As such, Victoria is obliged to minimize caffeine intake. She could also avoid heavy meals during the evening and exercise regularly. On the other hand, the pharmacological treatment measures could include H2blockers and some over-the-counter antacids that would facilitate stomach acid (Kristo et al., 2019). Besides, acid production could also be blocked using proton pump inhibitors.
Various strategies could be used to educate families and patients on the management and treatment of GERD. One of these is creating awareness on proper dietary measures and foods to avoid such as citrus fruits and tomato products as they can irritate the damaged esophageal lining. The other strategy is creating a schedule for meals whereby they should be taken about 2 to 3 hours before bedtime (Iwakiri et al., 2015). The schedule should also include the recommended amount of food that should be consumed in one sitting.
References
De Bortoli, N., Tolone, S., Frazzoni, M., Martinucci, I., Sgherri, G., Albano, E., … & Savarino, E. V. (2018). Gastroesophageal reflux disease, functional dyspepsia and irritable bowel syndrome: common overlapping gastrointestinal disorders. Annals of gastroenterology, 31(6), 639.
Iwakiri, K., Kinoshita, Y., Habu, Y., Oshima, T., Manabe, N., Fujiwara, Y., … & Ashida, K. (2016). Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2015. Journal of gastroenterology, 51(8), 751-767.
Kristo, I., Paireder, M., Jomrich, G., Felsenreich, D. M., Nikolic, M., Langer, F. B., … & Schoppmann, S. F. (2019). Modern esophageal function testing and gastroesophageal reflux disease in morbidly obese patients. Obesity surgery, 29(11), 3536-3541.
Nabi, Z., & Reddy, D. N. (2016). Endoscopic management of gastroesophageal reflux disease: revisited. Clinical endoscopy, 49(5), 408.

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