Question

Carefully and completely answers each of the six questions that are listed.

Gina Rinaldi is a 66 year- old accountant who is 5 feet 4 inches tall and weighs 170 pounds.  She recently underwent a complete physical examination.  She told her physician that she had been feeling fairly well until she began experiencing heartburn, which has become progressively worse and more painful.  The heartburn often occurs after she eats a large meal and is particularly bad after she goes to bed at night. By directly examining the esophageal lumen using an endoscope the physician found evidence of reflux esophagitis and slight narrowing throughout the esophagus.

Mrs. Rinaldi’s history does not indicate any significant health problems.  During her last physical exam, her physician advised her to stop smoking and lose 20 pounds, but she has not attempted to do either.  The nutrition assessment reveals that Mrs. Rinaldi is feeling stressed because it is the middle of the tax season.  She usually has little time for breakfast, eats a lunch of fast foods at her desk while continuing to work at her desk, and eats a large dinner at around 8.00 P.M.  She generally has wine with dinner and another alcoholic beverage later in the evening.

1.  Explain to Mrs. Rinaldi the meaning of her diagnoses reflux esophagitis and esophageal stricture. Pretend that Mrs. Rinaldi knows very little about her body so your explanation should be very clear.

2.  From the brief history provided, explain the factors that and behaviors that increase her risk of gastroesophageal reflux disease (GERD).

3. What recommendations will you make to help her change these behaviors?  Relate your advice to each of the factors listed in the history.

4. What medications might the physician prescribe, and why?

5. If untreated what are some of the complications of GERD?

6. What would be your advice to Mrs. Rinaldi as an alternative medicine student?

Answer 1

Q1:-Explain to Mrs. Rinaldi the meaning of her diagnoses reflux esophagitis and esophageal stricture. Pretend that Mrs. Rinaldi knows very little about her body so your explanation should be very clear ?

Before knowing what is Reflux esophagitis Mrs.Rinalidi must kbow what is GERD its nothing but gastro esophageal reflux disease .To be clear our food pipe is a long pipe extending from the mouth connecting with stomach and ending at the rectum ,we have an opening that connects  the upper part of the pipe and upper part of the stomach which is known as esophageal sphincter.This sphincter helps preventing the food and acid content in the stomach to regurgitate back to the upper part of food pipe which indeed causes heartburn because of the acidic nature of contents in stomach ;when we have such a regulr regurgitation that acidity will damage the esophagus causing peel off of skin and causing infection known as Reflux Esophagitis and esophageal sticture is the narrowing caused to esophagus (food pipe ) due to infection and healing process and even certain other medical conditions.

Q2:-2.  From the brief history provided, explain the factors that and behaviors that increase her risk of gastroesophageal reflux disease (GERD).

-Alcohol and smoking which induce or triggers the acid reflux

-Her disordered timings of having food like skipping breakfast and having fast food for lunch and having wine at dinner ,these all cause increased acid production in the stomach

-Increased stress which releses the stress hormone and which inturn produces increased gastric secretion and reflux

-she should stop having a large dinner as she sleep and a full filled stomach provides a pressure to sphincter and it opens and the content in the stomach regurgitate

Q3:-What recommendations will you make to help her change these behaviors?  Relate your advice to each of the factors listed in the history.

-Proper timings should be maintained for food she ahould have her breakfast on time by 8am lunch by 1pm and the dinner by 8pm

-she must wait for 1 or 2hours after having food and then she should go to bed

-she should avoid junk foods and carbonated drinks as she is taking it every noon

-she should control and avoid her stress levels

-she should drink lot of water

-she should not starve

-Must avoid spicy foods

-Must quit smoking and alcohol

-she should stop having a large dinner as she sleep and a full filled stomach provides a pressure to sphincter and it opens and the content in the stomach regurgitate

-Should stop taking the wine in the night as she do it

these all the things triggers the regurgitation thus to be avoided

Q4:- What medications might the physician prescribe, and why?

Antibiotics :- for the esophagitis which is the infection

Antacid or a proton pump inhibitors:- To prevent the regurgitation and counteracts to the acid of stomach

Vitamine b complex and anti diarrhoea if needed :- To heal any would or damage to esophagus minorly caused and anti diarrhoeal to reduce frequency and urgency of bowel movements

Q5:-If untreated what are some of the complications of GERD?

• Adult onset asthma
• Esophagitis (Inflammation, irritation, or swelling of the esophagus)
• Stricture (Narrowing of the esophagus)
• Barrett’s Esophagus (Pre-cancerous changes to the esophagus)
• Regurgitation of acid into the lungs(Aspiration)
• Sinusitis
• Ulcerations/bleeding
  
• Esophageal cancer
• Inability to swallow foods
• hoarsness of voice
• Thoat and vocal cord damage

Q6:-What would be your advice to Mrs. Rinaldi as an alternative medicine student?

-lifestyle modifications, such as

*keeping the head of the bed elevated;

*losing weight;

*quitting smoking;

*avoiding caffeine, alcohol, and mints;

*and not eating 2 hours before bedtime.
avoid spicy food

*have food on time

*donot starve

*avoid junk foods

*avoid stress

*drink lots of water