Gastrointestinal Disorders
Order Instructions:
To prepare:
• Review “Gastrointestinal Disorders” of the Burns et al. text.
• Review the 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.
Post on or before Day 3 an explanation of the differential diagnosis for the patient in the case study you selected. 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. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients and families on the treatment and management of the gastrointestinal disorder.
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.
SAMPLE ANSWER
GASTROINTESTINAL DISORDERS
GASTROESOPHAGEAL REFLUX DISEASE
A female adolescent reports chronic sore throat accompanied by bad taste in her mouth. Her growth trajectory has been consistent since birth and the body mass index is normal. Both abdominal and chest examinations are normal. History taking reveals frequent burping and regurgitating of food reported to be occasional. On further history taking, she reports that she takes a balanced diet, but her common sources of fluids are coffee, tea and carbonated drinks.
The diagnosis for this patient is gastroesophageal reflux disease (GERD). This is characterized by symptoms such as heartburn, regurgitating of food, sore throat that doesn’t go away for a while and bad taste in the mouth among other signs (TeensHealth, 2015). Although occasional regurgitation of food may be common to everyone, it is a classic sign of GERD especially when it is not associated with nausea. WebMD (2015) defines gastroesophageal reflux as “the return of the stomach’s contents back up into the esophagus”. WebMD further suggests carrying out a special x-ray test known as barium-swallow radiograph that would help rule out other possible problems.
Treatment and management
If GERD is left untreated, serious pathologic changes in the esophageal lining may occur which may develop into more complicated disorders. For this mild case, early treatment would be appropriate which would include Proton pump inhibitor (PPI) such as Omeprazole 20mg once a day before meals for four weeks (PDRHealth, 2015) This would provide a more rapid symptom control and better healing. The chronic sore throat and bad taste in her mouth would be addressed by educating the patient some diet and lifestyle changes such as reducing or avoiding fluids and foods containing caffeine and nicotine and carbonated snacks, taking smaller but frequent meals and eating two to three hours before bedtime.
Differential diagnosis
A patient presenting with the above symptoms would also be suffering from stomach ulcers which would be due to bacteria H.Pylori. The bacteria increase the acid content in the stomach, therefore presenting similar symptoms as GERD.
References.
PDRHealth 2015; Physicians’ Desk Reference from http://www.pdrhealth.com/drugs/prilosec
TeensHealth 2015, Gastroesophageal Reflux Disease. Retrieved from http://kidshealth.org/teen/diseases_conditions/digestive/gerd.html?tracking=T_RelatedArticle#
WebMD 2015, Heartburn/GERD Health Center retrieved from http://www.webmd.com/heartburn-gerd/guide/reflux-disease-gerd-1 last review January 2015
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