Question

Mrs. G. is a 45-year-old female arrives at the emergency department where you are working with complaints of burning pain in her chest and throat and a sour taste in her mouth. She states this pain has been going on for years after she eats certain foods. She has a large, extended family and does all of the cooking. She is Hispanic and likes to cook her special recipes because she believes that "these foods are good for herself and her family." She is very proud of her cooking and believes that is one of her main contributions to her family. She has never been sick and does not like to take pills.

She is examined by the emergency room doctor and diagnosed with Gastroesophageal Reflux Disease (GERD). The doctor has ordered medication for you to administer. These medications include a proton pump inhibitor (Prilosec), and a Histamine 2 blocker (Pepcid). He also prescribes the proton pump inhibitor to be taken at home for the next two weeks. Mrs. G. starts to feel better and is ready for discharge. You will be providing the client teaching and discharge instructions about GERD.

In your discussion about GERD include:

• Dietary suggestions you would make
• What foods and liquids she should avoid
• What changes she should make
• Barriers she will face in making these changes and how they can be overcome

Answer 1

client teaching and discharge instructions about GERD to Mrs. G are as follows :-

GERD :- Gastro esophageal Reflux Disease (GERD) is a digestive disorder that occurs when an individual swallow food items , food passes down the food pipe to stomach. A ring of muscle tissues also known as esophageal sphincter contracts after food go in to the stomach. If this esophageal sphincter does not work properly the acidic stomach juices or fluids and foods flow Back to esophagus . The leaking back of stomach food contents to food pipe causes GERD disorder. GERD disease can occur at any stage of life from infants to elders.

Dietary suggestions to Mrs. G are as follows:-

GERD in general considered as a chronic disease. Changes to the diet , lifestyle and treatment by doctor with help of drugs can help in treatment of the GERD.

gastro esophageal reflux disease (GERD) Can be prevented by using certain dietary changes.

1. Eating small meals or having frequent meals instead of three large meals. Small meals are easy to digest and they put less pressure on the valve that connects our esophagus and stomach. Slow intake of food also put less pressure on the valve.

2. Foods to eat to reduce the symptoms of GERD are as follows

• fruits Which are high in fiber, magnesium, and potassium, such as berries, apples, pears, avocados, melons, peaches, and bananas.

• eggs, except for there cholesterol contents.

• Intake of green vegetables , green vegetables, such as broccoli, spinach, and Brussels sprouts.

• Intake of certain carbohydrates which is found in potatoes, and some whole grains

• Intake of protein from low cholesterol sources such as almonds, beans etc.

• Eating fermented and pre biotic foods also help patient with digestive issues to restore balance to bacterial Flore in stomach. Natural probiotics foods are yogurt, raw kimchi, raw fermented pickles and vegetables , a fermented tea drink.

• Eating prebiotic rich foods. Prebiotics are foods that are rich in fibers that selectively grow beneficial bacteria. Prebiotic-rich foods are Jerusalem artichokes , onions , garlic , apples , leeks ,greener bananas.

3. Foods to avoid to reduce the symptoms of GERD are as follows:- the foods and drinks which worsen the effect of GERD are :-

• Alcohol

• Citrus fruits, such as oranges and lemons

• Tomatoes and products that contain tomatoes, such as tomato sauce and salsa

• Fatty foods

• Spicy foods

• Onions and garlic.

• Chocolate or chocolate containing items of food.

• Coffee or tea (both regular and decaffeinated)

• caffeine intake.

• Diary products such as products from cow’s milk are to be avoided from diet.

• Individuals who consume more cholesterol and saturated fatty acids are more prone to the symptoms of GERD so intake of cholesterol should be avoided.

4. Life style changes suggestions for Mrs. g are as follows :-

• There should be three to four hours gap between lying to bed or taking dinner.Do not go to bed within two hour after dinner.

• Sleeping in upright position also help in reducing the symptoms of GERD. If individual is wanting to take a nap avoid bed instead use a chair for taking a nap.

• Put pillow under the legs at the head of your bed to raise it at least 6 to 8 inches. This technique helps to keep food down the stomach. Piling up more pillow may put more pressure on belly so it is better to avoid putting on more pillows.

• Stay active or lose fat by exercising. Losing weight help in putting less pressure on stomach.

• Always avoid to wear tight clothes and tight belts. Because this also put pressure on belly.

• Try to stop smoking as soon as possible, avoiding smoking help to reduce the symptoms of GERD,

• Intake of alcohol, tea and coffee should be avoided.

• Take your medicines exactly as directed. Don’t skip doses as directed by the doctor.

The situations when doctors assistance is needed are :-

• Trouble swallowing foods or drinks.

• Pain while swallowing food items.

• Pain in neck chest or throat.

• Vomit because of heart burn

• Feeling of food caught in throat or chest.

• Blood in vomiting.

• Choking , blood coughing or wheezing.

• Soreness of throat is not going away.

• Feeling of weight loss from four to five percent.

• Black or tarry stools.