responde to topic 1 and topic 2 by separate paragraph: Topic 1: Gastroesophageal

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responde to topic 1 and topic 2 by separate paragraph:
Topic 1:
Gastroesophageal reflux disease (GERD) is characterized by the effects of acid and bile salts to the esophagus when they are refluxed from the stomach. GERD is the result of abnormalities in the esophagus, gastric mobility issues, or increased abdominal pressure. Strictures, pyloric edema, ulcers, or gastroparesis can all be causations of GERD. The severity of symptoms experienced is correlated to the acidity of the contents and the length of exposure.
Peptic ulcer disease (PUD) occurs when there is a breakdown in the lining of the gastrointestinal tract. Genetics, infection with H. pylori, alcohol use, smoking, COPD, pancreatitis, obesity, cirrhosis, age greater than 65 and the regular use of NSAIDS are all risk factors for PUD. Ulcers can vary in severity with some being superficial and others penetrating through to damage blood vessels. Other characteristics of ulcers are single, multiple, acute and chronic.
Our patient has no significant medical history or symptoms that point directly to support the diagnosis of GERD. I believe that our scenario most likely represents PUD and more specifically a duodenal ulcer. Risk factors for duodenal ulcers that are present in our scenario include the use of aspirin and alcohol. Clinical manifestations in our patient that support the diagnosis are epigastric burning and tenderness that occurs at night. Also, the pain is reportedly improved with the ingestion of bland foods or milk.
References
McCance, K. L., & Huether, S. E. (2018). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Mosby.
Topic 2:
Gastrointestinal Case Study
Henry, a 58 y/o male, recently reports waking up in the middle of the night with burning abdominal pain. Symptoms occur several nights a week with occasional discomfort in the middle of the afternoon. A bland diet or drinking milk does seem to help and spicy foods aggregate the symptoms.
PMH: non-contributory
SH: Works in a grocery store, divorced, non-smoker, drink 1-2 beers/day
Allergies: none
Meds: 1 325mg ASA daily for cardiovascular prevention
ROS:
Constitutional: Decrease appetite and 5% weight loss; denies fever
ENT: Denies sore throat or drainage
Lungs: Occasional dry cough at night
Heart: Mid sternum chest burning intermittently
Abdomen: Epigastric burning and tenderness, denies constipation or diarrhea
Ulceration in the mucosal lining of the lower esophagus, stomach, or duodenum is classified as peptic ulcer disease (McCance & Huether, 2019). Acid and pepsin concentrations in the duodenum have been associated with peptic ulcer disease, which weakens the mucosal layer of the stomach and can lead to tissue ulcers (McCance & Huether, 2019).
In contrast, the backflow of acid, pepsin, or bile salts from the stomach to the esophagus is a sign of GERD. Esophagitis (inflamed esophagus) is then caused. The flow of acid, pepsin, and bile salts from the stomach to the esophagus is aided by anomalies in the lower esophageal sphincter’s function (LES). The LES’s weakening or loosening permits stomach contents to reflux into the esophagus (McCance & Huether, 2019).
The patient in the case study has epigastric burning and discomfort that worsens when spicy foods are consumed and is eased by milk or bland diets. The degree of esophagitis caused by GERD is determined by the composition of gastric contents and the length of time the esophageal mucosa has been exposed (McCance & Huether, 2019). The patient habitual use of aspirin can cause (PUD). The patient also describes waking up in the middle of the night with scorching abdominal agony, which is not indicative of GERD but rather of PUD. Heartburn, chronic cough, asthma episodes, laryngitis, sinusitis, and upper abdomen pain are also clinical manifestations of GERD (McCance & Huether, 2019). I think his symptoms most closely represent GERD.
Reference
McCance, K.L., & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in
Adults and children (8th ed.). Elsevier.

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