Question

A 28-year-old graduate student complained of a dull pain (heartburn), burning, and "gnawing" behind the sternum. The pain was postprandial (occurred after meals) and disappeared within a few minutes to an hour after eating a meal. It was often associated with excessive belching and often was worse with lying down or on exertion after heavy meals. Sometimes it radiated to the back, jaws, shoulders, and down the inner aspects of the arms, simulating chest pain and discomfort. X-rays revealed a small portion of the stomach above the diaphragm, and a biopsy revealed mucosal inflammation. Esophageal manometry (determining pressures at the lower esophageal sphincter, LES) revealed decreased LES pressure. Esophageal pH monitoring showed reflux of gastric contents into the esophagus and provided direct evidence of gastroesophageal reflux. Recommended treatment for this individual is avoidance of strong stimulants of gastric acid secretion (e.g, coffee, alcohol) and avoidance of certain drugs (e.g., anticholinergics), and specific foods (fats, chocolates, whole milk, and orange juice), and smoking, all of which reduce LES competence. Elevation of the upper body of about six inches while lying in the bed was also recommended. Suggested treatments were anti-acid medications and anti-nausea medications Bethanechol and Cimetidine Please answer the following questions. 1. What is the disorder of this 26 year old graduate student? Explairn 2. What mechanisms usually prevent the reflux of gastric acid into the esophagus? 3. Which medications are recommended to take and not to take for this condition? 4. Why are Histamine H2 antagonists recommended for this condition? 5. What is the normal pH of the esophagus and the stomach? 6. Why is it recommended to elevate the bed for this condition? 7. What is the graduate student at risk for developing if this condition is untreated?

i need help with questions 5,6, and 7 this is a case study

Answer 1

Q. 5 the normal pH of esophagus is around 7 and normal stomach pH is around 1.5-3.5 because of secreation of HCL by perietal cells of stomach.

Q.6. because it will make a slope towards stomach so if gastric juice comes into esophagus it can go back to stomach due to gravity and elevation also provide some gravity which indeed decrease the filling of esophagus by gastric juice in this Gastroesophageal reflux disease.

Q.7. if the condition is untreated it could produce acute complications like dry cough, difficulty in swallowing, chronic effects could be esophagitis?, bleeding and Barrett's esophagus disease.