Gastroesophageal Reflux Disease Essay Example | Topics and Well Written Essays - 4500 words

Gastroesophageal Reflux Disease - Essay ExampleThe superficial layer of the oesophagus is known as adventitia. The adventitia attaches the esophagus to environ structures. The esophagus secretes mucus and transports food into the stomach but it does not produce digestive enzymes. The stomach contents can reflux (back up) into the humble portion of the esophagus when the lower esophageal sphincter fails to close adequately after food has entered the stomach the condition which is known as gastroesophageal reflux disease (GERD). In GERD, the basal layer of of the epithelium is is thickened, and the papillae of the lamina propria are elongated and extend toward the surface. Abnormalities of the lower esophageal sphincter, Hiatus hernia, Delayed esophageal clearance, Gastric contents, Defective gastric emptying, change magnitude intra-abdominal pressure, and Dietary and environmental factors may be the factors involved in GERD. Clinically, GERD may be diagnosed by radiographic examin ations using dyes, endoscopy, and esophageal pH-metry. PPI trial is besides an authoritative method of first line diagnostic test. Treatment involves both non-pharmacological interference measures as well as pharmacotherapy. Non-pharmacological treatment include avoidance of foods and medications that exacerbate GERD, heater secession, weight reduction, taking a small meal at a time, avoidance of alcohol and elevation of the head of the bed. Drugs for treating GERD include H2 receptor antagonists like cimetidine, ranitidine, famotidine or nizatidine. Proton pump inhibitors such as omeprazole, pantoprazole, lansoprazole and rebeprazole are make to be very effective to reduce acid reflux and hence inflammation. H2 blockers were found to heal ulcers and erosions but the typical reflux changes of the squamous epithelium of the esophageal mucosa are not recovered. Studies confirmed that PPIs not only heal ulcers and erosions but also cures basal cell hyperplasia and elongation of t he papillae. The percentage of normal epithelium were also reported to increase significantly after PPI administration in patients with GERD. Two normally employed treatment alternatives for GERD are antirefluctive surgery and Endoscopic Treatments. Surgery is preferred only when the patient fails to respond to pharmacological treatment, when the patient prefers surgery, in those patients who have complications of GERD like barretts esophagitis, or if the patient has atypical symptoms and reflux documented on 24-hour ambulatory pH monitoring. Several randomized controlled trials have confirmed that open fundoplication and medical treatment have similar long-term effects for GERD. Laparoscopic antireflux surgery is also reported to have similar outcomes to the open procedures. Endoscopic Treatments for GERD include plicating gastric folds methods (Endoscopic Gastroplication, ELGP method, thermal create from raw material remodeling /neurolysis method, and bulking injection method. Th ese endoluminal treatments augment the reflux barrier. Section I Organ system structure and Function. Explain the accepted normal healthy structure of parts and run of organ system How it worksThe esophagus is a collapsible muscular tube, about 25 cm (10 in.) long that lies posterior to the trachea. The esophagus begins at the inferior end of the laryngopharynx and passes through the mediastinum anterior to vertebral column. Then it pierces the diaphragm through an opening called the