NURS 6501 GERD Concept Map
Concept map on GERD pathophysiology: LES dysfunction, impaired esophageal motility, delayed gastric emptying, hiatal hernia, and increased intra-abdominal pressure lead to acid reflux and mucosal damage.
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Concept Map Template
Primary Diagnosis: Gastroesophageal reflux disease (GERD)
1. Describe the pathophysiology of the primary diagnosis in your own words. What are the
patient's risk factors for this diagnosis?
Gastroesophageal reflax disease (GERD) is a chronic condition where stomach acid frequently
leaks into the esophagus, causing symptoms and potential damage (Maret-Ouda et al., 2020).
Understanding the pathophysiology and risk factors for GERD involves examining the
anatomical and physiological components that contribute to the condition.
Pathophysiology of Primary Diagnosis
Lover Esophageal Sphincter (LES) Dysfunction:
’ The LES is a ring of muscle at the lower end of the esophagus where it joins the stomach. It normally
acts as a one-way valve, preventing stomach contents from flowing back intc the esophagus. In GERD,
the LES is weakened or relaxed inappropriately, allowing acid to reflux into the esophagus.
Esophageal Motility Disorders:
* Abnormalities in esophageal motility can impair the ability of the esophagus to clear acid effectively.
For example, decreased peristaltic contractions or a delay in esophageal clearance can exacerbate reflux
symptoms.
Increased Intra- abdominal Pressure:
" Conditions or activities that increase abdominal pressure (e.g., obesity, pregnancy, heavy Lifting) can
push stomach contents against the LES, promoting reflux.
Delayed Gastric Emptying:
* If the stomach takes longer to empty its contents, there is an increased risk of reflux because there is
more stomach acid available to flow back into the esophagus.
Hiatal Hernia:
* A hiatal hernia occurs when part of the stomach bulges through the diaphragm into the chest cavity. This
can compromise the LES s ability' tn prevent reflux and contribute to GERD symptoms.
Esophageal Mucosal Damage:
Chronic exposure to stomach acid can lead to inflammation (esophagitis), ulceration, and Barretf s
esophagus (a precancerous condition) (Maret-Ouda et al., 2020).
Causes Risk Factors (genetic/ethnic'physical)
Gastroesophageal reflux disease (GERD) results from a
combination of factors that impair the normal function
of the lower esophageal sphincter (LES) and other
aspects of esophageal physiology. Here s a detailed
look at the causes of GERD:
Obesity:
• Excess weight increases abdominal pressure,
which can weaken the LES and promote acid
reflux.
Primary Diagnosis: Gastroesophageal reflux disease (GERD)
1. Describe the pathophysiology of the primary diagnosis in your own words. What are the
patient's risk factors for this diagnosis?
Gastroesophageal reflax disease (GERD) is a chronic condition where stomach acid frequently
leaks into the esophagus, causing symptoms and potential damage (Maret-Ouda et al., 2020).
Understanding the pathophysiology and risk factors for GERD involves examining the
anatomical and physiological components that contribute to the condition.
Pathophysiology of Primary Diagnosis
Lover Esophageal Sphincter (LES) Dysfunction:
’ The LES is a ring of muscle at the lower end of the esophagus where it joins the stomach. It normally
acts as a one-way valve, preventing stomach contents from flowing back intc the esophagus. In GERD,
the LES is weakened or relaxed inappropriately, allowing acid to reflux into the esophagus.
Esophageal Motility Disorders:
* Abnormalities in esophageal motility can impair the ability of the esophagus to clear acid effectively.
For example, decreased peristaltic contractions or a delay in esophageal clearance can exacerbate reflux
symptoms.
Increased Intra- abdominal Pressure:
" Conditions or activities that increase abdominal pressure (e.g., obesity, pregnancy, heavy Lifting) can
push stomach contents against the LES, promoting reflux.
Delayed Gastric Emptying:
* If the stomach takes longer to empty its contents, there is an increased risk of reflux because there is
more stomach acid available to flow back into the esophagus.
Hiatal Hernia:
* A hiatal hernia occurs when part of the stomach bulges through the diaphragm into the chest cavity. This
can compromise the LES s ability' tn prevent reflux and contribute to GERD symptoms.
Esophageal Mucosal Damage:
Chronic exposure to stomach acid can lead to inflammation (esophagitis), ulceration, and Barretf s
esophagus (a precancerous condition) (Maret-Ouda et al., 2020).
Causes Risk Factors (genetic/ethnic'physical)
Gastroesophageal reflux disease (GERD) results from a
combination of factors that impair the normal function
of the lower esophageal sphincter (LES) and other
aspects of esophageal physiology. Here s a detailed
look at the causes of GERD:
Obesity:
• Excess weight increases abdominal pressure,
which can weaken the LES and promote acid
reflux.
1. Lower Esophageal Sphincter (LES) Dysfunction:
■ Weakness or Relaxation: The LES may
become weakened or relax inappropriately,
allowing stomach acid and other contents to
flow bark into the esophagus. This can be due
to intrinsic muscle weakness or increased
pressure within the stomach.
2. Hiatal Hernia:
* Sliding Hernia: This occurs when part of the
stomach pushes through the diaphragm into
the chest cavity., disrupting the normal
function of the LES.
* Para oesophageal Hernia: This type is less
common but can also interfere with LES
function and contribute to reflux.
3. Increased Intra-abdominal Pressure:
1 Obesity: Excess abdominal fat increases
pressure on the stomach, pushing acid up into
the esophagus.
* Pregnancy: Hormonal changes and growing
abdominal pressure during pregnancy can lead
to GERD.
* Heavy Lifting or Straining: Activities that
increase abdominal pressure can exacerbate
reflux symptoms.
4. Delayed Gastric Emptying:
* Gastroparesis: A condition where the
stomach empties more slowly than normal can
increase the risk of reflux by keeping acid in
the stomach longer and increasing the
likelihood of it escaping into the esophagus.
5. Esophageal Motility Disorders:
* Disordered Peristalsis: Abnormal
contractions of the esophagus can impair the
clearance of acid from the esophagus ,
contributing to reflux.
6. Lifestyle and Dietary Factors:
* Dietary Triggers: Certain foods and
beverages can relax rhe LES or increase acid
production, including fatty foods, chocolate,
caffeine, alcohol, and spicy foods.
Pregnancy:
* Hormonal changes and increased abdominal
pressure during pregnancv can contribute to
GERD.
Smoking:
* Smoking can weaken the LES and reduce rhe
esophageal mucosal defenses, making reflux
more likely.
Dietary Factors:
* Certain foods and beverages (e.g., fatty foods.,
chocolate, caffeine, alcohol, spicy foods) can
relax the LES or increase stomach acid
production, leading to reflux.
Medications:
■ Some medications, such as antihistamines,
calcium channel blockers, and certain
antidepressants, can relax the LES or
exacerbate reflux.
Hiatal Hernia:
* As mentioned, a hiatal hernia can contribute
to GERD by compromising the LES's
function.
Genetics:
* There may be a genetic predisposition to
GERD, although this is less well-defined.
Age:
* The risk of GERD can increase with age.,
potentially due to changes in esophageal
motility' and LES function over time.
(Sepehr et al.: 2024).
■ Weakness or Relaxation: The LES may
become weakened or relax inappropriately,
allowing stomach acid and other contents to
flow bark into the esophagus. This can be due
to intrinsic muscle weakness or increased
pressure within the stomach.
2. Hiatal Hernia:
* Sliding Hernia: This occurs when part of the
stomach pushes through the diaphragm into
the chest cavity., disrupting the normal
function of the LES.
* Para oesophageal Hernia: This type is less
common but can also interfere with LES
function and contribute to reflux.
3. Increased Intra-abdominal Pressure:
1 Obesity: Excess abdominal fat increases
pressure on the stomach, pushing acid up into
the esophagus.
* Pregnancy: Hormonal changes and growing
abdominal pressure during pregnancy can lead
to GERD.
* Heavy Lifting or Straining: Activities that
increase abdominal pressure can exacerbate
reflux symptoms.
4. Delayed Gastric Emptying:
* Gastroparesis: A condition where the
stomach empties more slowly than normal can
increase the risk of reflux by keeping acid in
the stomach longer and increasing the
likelihood of it escaping into the esophagus.
5. Esophageal Motility Disorders:
* Disordered Peristalsis: Abnormal
contractions of the esophagus can impair the
clearance of acid from the esophagus ,
contributing to reflux.
6. Lifestyle and Dietary Factors:
* Dietary Triggers: Certain foods and
beverages can relax rhe LES or increase acid
production, including fatty foods, chocolate,
caffeine, alcohol, and spicy foods.
Pregnancy:
* Hormonal changes and increased abdominal
pressure during pregnancv can contribute to
GERD.
Smoking:
* Smoking can weaken the LES and reduce rhe
esophageal mucosal defenses, making reflux
more likely.
Dietary Factors:
* Certain foods and beverages (e.g., fatty foods.,
chocolate, caffeine, alcohol, spicy foods) can
relax the LES or increase stomach acid
production, leading to reflux.
Medications:
■ Some medications, such as antihistamines,
calcium channel blockers, and certain
antidepressants, can relax the LES or
exacerbate reflux.
Hiatal Hernia:
* As mentioned, a hiatal hernia can contribute
to GERD by compromising the LES's
function.
Genetics:
* There may be a genetic predisposition to
GERD, although this is less well-defined.
Age:
* The risk of GERD can increase with age.,
potentially due to changes in esophageal
motility' and LES function over time.
(Sepehr et al.: 2024).
* Smoking: Tobacco use can weaken ibe LES
and impair esophageal mucosal defenses.
7. Medications:
1 Drug-Induced Relaxation: Some
medications, like antihistamines, calcium
channel blockers., and certain antidepressants,
can relax the LES or slow down gastric
emptying, contributing to reflux.
8. Genetic Predisposition:
1 Family History: There may be a genetic
component to GERD, as individuals with a
family history of the condition are at higher
risk.
9. Increased Stomach Acid Production:
1 Hyperacidity: Conditions that lead to
excessive stomach acid production, such as
Zollinger-Ellison syndrome, can contribute to
GERD.
ID. Anatomical Abnormalities:
1 Esophageal Structure: Structural
abnormalities in the esophagus or stomach can
impact normal functioning and increase reflux
risk.
(Maret-Ouda et al.. 2020)
2. What are the patient's signs and symptoms for this diagnosis? How does the diagnosis impact
other body systems and what are the possible complications'5
Signs and Symptoms - Common presentalon How does the diagnosis impact each body
system? Complications?
Gastroesophageal reflux disease (GERD) presents with
a range of symptoms and can affect various body7
systems over time. Understanding these signs and
symptoms, as well as the potential complications, is
crucial for effective management and treatment.
Signs and Symptoms of GERD:
1. Heartburn:
0 A burning sensation in the chest or
throat, often after eating or when
lying down. This is the most
common symptom of GERD.
1. Respiratory System:
O Asthma: GERD can trigger or
worsen asthma symptoms due to acid
aspiration into the airways.
0 Chronic Cough: Persistent cough
from acid irritation of the respiratory
tract.
2. Dental Health:
0 Dental Erosion: Acid reflux can
erode dental enamel, leading to tooth
sensitivity and decay.
3. ENT (Ear, Nose, and Throat) Symptoms:
and impair esophageal mucosal defenses.
7. Medications:
1 Drug-Induced Relaxation: Some
medications, like antihistamines, calcium
channel blockers., and certain antidepressants,
can relax the LES or slow down gastric
emptying, contributing to reflux.
8. Genetic Predisposition:
1 Family History: There may be a genetic
component to GERD, as individuals with a
family history of the condition are at higher
risk.
9. Increased Stomach Acid Production:
1 Hyperacidity: Conditions that lead to
excessive stomach acid production, such as
Zollinger-Ellison syndrome, can contribute to
GERD.
ID. Anatomical Abnormalities:
1 Esophageal Structure: Structural
abnormalities in the esophagus or stomach can
impact normal functioning and increase reflux
risk.
(Maret-Ouda et al.. 2020)
2. What are the patient's signs and symptoms for this diagnosis? How does the diagnosis impact
other body systems and what are the possible complications'5
Signs and Symptoms - Common presentalon How does the diagnosis impact each body
system? Complications?
Gastroesophageal reflux disease (GERD) presents with
a range of symptoms and can affect various body7
systems over time. Understanding these signs and
symptoms, as well as the potential complications, is
crucial for effective management and treatment.
Signs and Symptoms of GERD:
1. Heartburn:
0 A burning sensation in the chest or
throat, often after eating or when
lying down. This is the most
common symptom of GERD.
1. Respiratory System:
O Asthma: GERD can trigger or
worsen asthma symptoms due to acid
aspiration into the airways.
0 Chronic Cough: Persistent cough
from acid irritation of the respiratory
tract.
2. Dental Health:
0 Dental Erosion: Acid reflux can
erode dental enamel, leading to tooth
sensitivity and decay.
3. ENT (Ear, Nose, and Throat) Symptoms:
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