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Gastrointestinal Tract: Disorders of Motility Assignment

Gastrointestinal Tract: Disorders of Motility AssignmentGastrointestinal Tract: Disorders of Motility AssignmentJamie is a 3-month-old female who presents with her mother for evaluation of “throwing up.” Mom reports that Jamie has been throwing up pretty much all the time since she was born. Jamie does not seem to be sick. In fact, she drinks her formula vigorously and often acts hungry. Jamie has normal soft brown bowel movements every day and, overall, seems like a happy and contented baby. She smiles readily and does not cry often. Other than the fact that she often throws up after drinking a bottle, she seems to be a very healthy, happy infant. A more precise history suggests that Jamie does not exactly throw up—she does not heave or act unwell—but rather it just seems that almost every time she drinks a bottle she regurgitates a milky substance. Mom thought that she might be allergic to her formula and switched her to a hypoallergenic formula. It didn’t appear to help at all, and now Mom is very concerned.Gastrointestinal Tract: Disorders of Motility AssignmentORDER A PLAGIARISM-FREE PAPER HERECases like these are not uncommon. The mother was concerned and thinking her daughter may have an allergy; she changed to a different formula. However, sometimes babies have immature GI tracts that can lead to physiology reflux as they adapt to normal life outside the uterus. Parents often do not consider this possibility, prompting them to change formulas rather than seeking medical care. As in the case study above, GI alterations can often be difficult to identify because many cause similar symptoms. This same issue also arises with adults—adults may present with symptoms that have various potential causes. When evaluating patients, it is important for the advanced practice nurse to know the types of questions he or she needs to ask to obtain the appropriate information for diagnosis. For this reason, you must have an understanding of common GI disorders such as gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), and gastritis.Gastrointestinal Tract: Disorders of Motility AssignmentTo PrepareReview this week’s media presentation on the gastrointestinal system.Review Chapter 35 in the Huether and McCance text. Identify the normal pathophysiology of gastric acid stimulation and production.Review Chapter 37 in the Huether and McCance text. Consider the pathophysiology of gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), and gastritis. Think about how these disorders are similar and different.Select a patient factor different from the one you selected in this week’s Discussion: genetics, gender, ethnicity, age, or behavior. Consider how the factor you selected might impact the pathophysiology of GERD, PUD, and gastritis. Reflect on how you would diagnose and prescribe treatment of these disorders for a patient based on this factor.Review the “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in the Week 2 Learning Resources. Use the examples in the media as a guide to construct a mind map for gastritis. Consider the epidemiology and clinical presentation of gastritis.Gastrointestinal Tract: Disorders of Motility AssignmentTo CompleteWrite a 2- to 3-page paper that addresses the following:Describe the normal pathophysiology of gastric acid stimulation and production. Explain the changes that occur to gastric acid stimulation and production with GERD, PUD, and gastritis disorders.Explain how the factor you selected might impact the pathophysiology of GERD, PUD, and gastritis. Describe how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.Construct a mind map for gastritis. Include the epidemiology, pathophysiology, and clinical presentation, as well as the diagnosis and treatment you explained in your paper.References to use in the paper. Gastrointestinal Tract: Disorders of Motility AssignmentHuether, S. E., &McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.Hammer, G. G. ,& McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.Chapter 13, “Gastrointestinal Disease”de Bortoli, N., Martinucci, I., Bellini, M., Savarino, E., Savarino, V., Blandizzi, C., &Marchi, S. (2013). Overlap of functional heartburn and gastroesophageal reflux disease with irritable bowel syndrome. World Journal of Gastroenterology, 19(35), 5787-5797. doi:10.3748/wjg.v19.i35.5787Gastrointestinal Tract: Disorders of Motility AssignmentPathophysiology of Gastric Acid Stimulation and ProductionGastric parietal cells are responsible for the production of gastric acid in the stomach. The gastric acid production is as a result of response hormones, merocrine and paracrine inputs. The gastric acid production is primarily stimulated by the G cells which are located in the pyloric mucosa. For the parietal cells, they are typically stimulated to secrete hydrogen ions into the lumen. Each receptor has a different level of functional importance. Cholecystokinin hormone receptor is bound to the enterochromaffin-like cells (ECL) cells and the parietal cells when gastrin is produced as a response to meals (Hammer, & McPhee, 2014). When the gastrin is bound to parietal cells, it results in activation and translocation of hydrogen and potassium ions and releases if intracellular calcium. Histamine production is promoted by the binding of gastrin to ECL cells. The histamine binds to H2 on parietal cells and increases cyclic AMP production which in turn is followed by the activation and translocation of proton pump at the canalicular membrane.Gastric acid secretion can be inhibited by natural inhibitors such as the release of somatostatin, CCK, and secretin (Huether, &McCance, 2015).Gastrointestinal Tract: Disorders of Motility AssignmentChanges due to GERD, on gastric acid productionDuring GERD, PUD and gastritis conditions, it is evident that gastric acid stimulation and production undergoes several changes.GERD results from reflux of the gastric materials into the esophagus and in turn causing damages to their walls of the esophagus (Denbow, 2015). The changes in the stimulation and the production of the gastric acid affect the pathophysiology and severity of the conditions (Huether, &McCance, 2015). This rise in gastric acid production during the conditions, makes the balance of the acid towards reflux and in turn affect the standard capacity if the mucosa to withstand the amount of acid. Gastritis causes a bacterial infection known as Helicobacter pylori which damages the stomach walls by wearing it out (De Bortoli et al., 2013). The acid stimulation production elevates the number of H. pylori in the stomach.Gastrointestinal Tract: Disorders of Motility AssignmentHow H. pyloric affects pathophysiology of GERD, PUD, and gastritis.pylori are known for its effects on gastric physiology. The bacteriacan either increase the production or lower the production of gastric acid depending on the kind of gastritis produced (Hammer, & McPhee, 2014). According to studies, it is suggested that decreased production of gastric acid in severe gastritis corpus can sometimes be beneficial in GERD. The low production of the acid is brought about by H. pylori infection which is characterizedby the corpus inflammation.Epidemiological studies have established the negative association between the severity of GERD and H. pylori prevalence (Waldum et al., 2014). Apparently, the results from studies show that H. pylori infection affects the incidence of GERD mostly in Asian countries.Overproduction of gastric acid characterizes the conditions in most cases. It is clear that excessive acid in the stomach causes duodenal walls damages. As aforementioned, H, pylori are known to bring forth production of acid in the stomach. Therefore removal of the bacteria from the stomach can accelerate the healing of the conditions (De Bortoli et al., 2013).Gastrointestinal Tract: Disorders of Motility AssignmentDiagnosis of GERD, PUD, and gastritisPhysical examination is known to be the most ideal in the exploration of peptic acid conditions in the differential diagnosis. In the physical examination method of diagnosis, stool examination can be used for occult bleeding (Hammer, & McPhee, 2014). This is significant in guiding for prognosis and extensive diagnostic investigation.Esophagogastroduodenoscopy can also be employed in the diagnosis of the conditions. In this procedure, a diagnostic endoscopy is used to visualize the upper gastrointestinal tract all the way to the small intestines. The procedure does not require any incision, and thus it is correct to term the method as less invasive. The method is modern, and therefore no injuries are adverse. The only adverse effect of the procedure is a sore throat.Another test that can be used to determine the presence of the conditions is by testing for H, pylori. A serologic test is used for this kind of test to determine whether H, pylori are present.Gastrointestinal Tract: Disorders of Motility AssignmentHistological test- this is regarded to as the most functional diagnostic test. In this diagnosis method, the H. pylori organisms are identified to confirm their presence hence establish whether a patient is suffering from the conditions.Treatment for H. pyloriAntibiotics are administered for 10-14 days in people above 12years in combination with painkillers. Examples include antibiotics such as metronidazole, tetracycline or clarithromycin in combination with analgesics such as bismuth subsalicylate, ranitidine or a proton pump inhibitor. Suppressing acid by the H­­2 blocker or the proton pump inhibitor in combination with antibiotics significantlyhelp to alleviate ulcer-related symptoms like nausea and abdominal pains which in turn enhances the efficacy of antibiotics (Hammer, & McPhee, 2014).Gastrointestinal Tract: Disorders of Motility AssignmentSummaryGastric acid is known to be stimulated by the presence of meals in the stomach and sometimes by psychological effects. Gastric acid is responsible for activating pepsinogen into pepsin, as well as maintaining an optimum environment for digestion. When gastric acid is produced in excess, it leads to conditions such as PUD, GERD, and gastritis. Such conditions can be lethal because of their adverse effect on the duodenal walls. The conditions, however, can be treated by use of antibiotics in conjunction with analgesics.  Gastrointestinal Tract: Disorders of Motility Assignment         ReferencesdeBortoli, N., Martinucci, I., Bellini, M., Savarino, E., Savarino, V., Blandizzi, C., &Marchi, S. (2013). Overlap of functional heartburn and gastroesophageal reflux disease with irritable bowel syndrome. World Journal of Gastroenterology, 19(35), 5787-5797. doi:10.3748/wjg.v19.i35.5787Denbow, D. M. (2015).Gastrointestinal anatomy and physiology. In Sturkie’s Avian Physiology (Sixth Edition) (pp. 337-366).Hammer, G. D., & McPhee, S. J. (2014). Pathophysiology of Disease: An Introduction to Clinical Medicine 7/E.Huether, S. E., &McCance, K. L. (2015).Understanding Pathophysiology-E-Book.Elsevier Health Sciences.Waldum, H. L., Hauso, Ø.,&Fossmark, R. (2014). The regulation of gastric acid secretion–clinical perspectives.Actaphysiologica, 210(2), 239-256. Gastrointestinal Tract: Disorders of Motility Assignment

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