Pathophysiology
Meals that are large, high-fat, spicy, or consumed concurrently with alcohol cause relaxation of the
lower esophageal sphincter, allowing hydrochloric acid and pepsin present in gastric contents to
reflux, or pass back, into the esophagus.
The esophagus is easily damaged by acidic gastric contents, resulting in inflammation, edema, and
scarring over time.
Assessment and Diagnostic Findings
Chest pain and burning within an hour of meals.
Endoscopy with biopsy and pH measurement.
Barium swallow.
Complications
Scarring of the esophageal tissue that can cause narrowing of the esophagus and noncompliance
of the lower esophageal sphincter.
Chronic irritation of the esophagus may lead to Barrett’s esophagus (a dysplastic change of normal squamous cells to columnar epithelial cells in areas of irritation), and esophageal CA.
Respiratory difficulties related to aspiration of acidic gastric contents; pain with respiration.
Medical Care and Surgical Treatment
Antacids, H2 blockers, proton pump inhibitors, coating agents, prostaglandins, antiemetics that
increase emptying.
Dilation of the esophagus if narrowing occurs.
Nutritional and lifestyle changes.
Keep in Mind
Avoid large, fatty meals; alcohol use; and tobacco use.
Clothing should be loose around the waist.
Sit upright for 2 hours after eating; don’t eat within 3 hours of retiring; elevate the head of the
bed (HOB) 6–8 inches using shock blocks.
Consume liquids separately from meals to avoidstomach distention.
Meals that are large, high-fat, spicy, or consumed concurrently with alcohol cause relaxation of the
lower esophageal sphincter, allowing hydrochloric acid and pepsin present in gastric contents to
reflux, or pass back, into the esophagus.
The esophagus is easily damaged by acidic gastric contents, resulting in inflammation, edema, and
scarring over time.
Assessment and Diagnostic Findings
Chest pain and burning within an hour of meals.
Endoscopy with biopsy and pH measurement.
Barium swallow.
Complications
Scarring of the esophageal tissue that can cause narrowing of the esophagus and noncompliance
of the lower esophageal sphincter.
Chronic irritation of the esophagus may lead to Barrett’s esophagus (a dysplastic change of normal squamous cells to columnar epithelial cells in areas of irritation), and esophageal CA.
Respiratory difficulties related to aspiration of acidic gastric contents; pain with respiration.
Medical Care and Surgical Treatment
Antacids, H2 blockers, proton pump inhibitors, coating agents, prostaglandins, antiemetics that
increase emptying.
Dilation of the esophagus if narrowing occurs.
Nutritional and lifestyle changes.
Keep in Mind
Avoid large, fatty meals; alcohol use; and tobacco use.
Clothing should be loose around the waist.
Sit upright for 2 hours after eating; don’t eat within 3 hours of retiring; elevate the head of the
bed (HOB) 6–8 inches using shock blocks.
Consume liquids separately from meals to avoidstomach distention.