Siti Nurhamizah Bt Mohd Rizaudin (075825) Muhammad Khairul Haikal bin Ismadi (071641) Danial Haziq bin Hisham (075972) Muhammad Syazwi Aqil bin Sapawi (070781) GERD MIR 11003 RADIOGRAPHIC PATHOLOGY LECTURER: DR. ELZA AZRI BIN OTHMAN MIR 11003 RADIOGRAPHIC PATHOLOGY LECTURER: DR. ELZA AZRI BIN OTHMAN
TACOBNLTEENTOS F 1.Pathophysiology 2. Sign and Symptom 3.Diagnosis 4. Radiographic Appearance 5.Treatment 6. Reference
Gastroesophageal reflux disease (GERD) is a chronic condition where stomach contents flow back into the esophagus, causing symptoms such as heartburn and regurgitation.The pathophysiology of GERD involves several key factors. PATHOPHYSIOLOGY
PATHOPHYSIOLOGY 1)Lower Esophageal Sphincter (LES) Dysfunction The LES acts as barrier between the stomach and esophagus, preventing reflux. In GERD, the LES is often weakened or relaxes inappropriately, allowing acidic stomach contents to move up into the esophagus KEY FACTORS 2) Esophageal Motility Disorders Normal esophageal peristalsis helps clear refluxed material back into the stomach. In GERD, impaired esophageal motility can lead to prolonged exposure of the exposure of the esophagus to acid, worsening symptoms and damage. 3) Gastric Factors When the stomach empties slowly, it increases the amount and pressure of its contents. This higher pressure can push stomach contents back into the esophagus. Additionally, if there is more stomach acid, it can cause more damage to the esophagus when reflux happens.
SIGN AND SYMPTOM Heartburn Heartburn is a burning sensation in the chest, typically caused by acid reflux, where stomach acid rises up into the esophagus. This condition is often a symptom of gastroesophageal reflux disease (GERD) and can be triggered by certain foods, drinks, or activities. It may also be accompanied by a sour or bitter taste in the mouth. Regurgitation Regurgitation is the backward flow of stomach contents into the esophagus or mouth, often resulting in a sour or bitter taste. This can occur involuntarily and may be associated with gastroesophageal reflux disease (GERD). It can also refer to the backward flow of blood through a heart valve that does not close properly.
Difficult Swallowing (Dysphagia) SIGN AND SYMPTOM Chest Pain Chest pain is a sensation of discomfort or pain in the chest area, which can range from a dull ache to a sharp, stabbing pain. It can result from various causes, including gastrointestinal issues like acid . The severity and implications of chest pain can vary greatly, making it important to seek medical evaluation for proper diagnosis and treatment. Dysphagia is the medical term for difficulty swallowing. It can manifest as a sensation of food or liquid being stuck in the throat or chest and can occur at any stage of swallowing, from the mouth to the esophagus.
DIAGNOSIS GERD Upper Endoscopy (Esophagogastroduodenoscopy) Purpose: To visually inspect the esophagus, stomach, and duodenum. Procedure: A thin, flexible tube with a camera (endoscope) is inserted through the mouth. Findings: Can detect inflammation (esophagitis), ulcers, strictures, Barrett’s esophagus, and other abnormalities. Esophageal pH Monitoring: Purpose: To measure the frequency and duration of acid reflux episodes. Procedure: A thin probe is inserted through the nose into the esophagus or a wireless capsule (Bravo system) is attached to the esophagus during endoscopy. Findings: Abnormal acid exposure levels confirm gerd Esophageal Manometry Purpose: To measure the rhythmic muscle contractions of the esophagus when swallowing, the coordination and force exerted by the esophageal muscles, and the function of the lower esophageal sphincter. Procedure: A thin, pressure-sensitive tube is passed through the nose into the esophagus. Findings: Helps diagnose motility disorders that can mimic or contribute to gerd
DIAGNOSIS GERD
RADIOGRAPHIC APPEARANCE This image show this patient suffering because of Gastroesophageal Reflux Disease. The white appearance is barium which is contrast media that use in Radiology Department to improve image contrast. To produce this image, radiographers usually use AP projection and the patient already swallow barium (contrast media) before the examination. How we know it’s GERD? From this image, we can see the cardiac sphincter not close completely even there no food or anything between esophagus and stomach.
RADIOGRAPHIC APPEARANCE This image is from endoscopy procedure which is conducted on patients suffering from Gastrointestinal Reflux Disease (GERD). The arrow show inflammation on esophageal wall due to gastric acid from stomach.
TREATMENT Start eat healthy food like fruit and vegetables. Avoid drinking or eating things that can stimulate acid secretion (e.g. coffee, alcohol and chocolate). Besides that, GERD patient can elevating the head when lie down. Lifestyle Changes Medication If referring to the doctor, doctor may recommended: Antacids: neutralize gastric acid and temporarily relief pain, but it does not heal inflammation Histamine 2 receptor blocker (H2 blocker): decrease acid production for a short term Proton pump inhibitors (PPIs): hinder acid production by cells in the stomach *PLEASE GET CONSULTING FROM DOCTOR/PHARMACIST ADVICE FOR MEDICINE DOSSAGE. DO NOT SELFMEDICATION. IT MAY DANGEROUS TO OURSELF.
TREATMENT If drug treatment is ineffective, surgery to tighten the lower esophageal sphincter or correct hiatus hernia may be recommended. Common surgery for Gastroesophageal Reflux Disease (GERD) is Nissen Fundoplication which is the surgeon creates a sphincter (tightening muscle) at the bottom of the esophagus to prevent acid reflux. Surgery LINX Device Doctor may recommend LINX device to patient. LINX device is a flexible tiny magnetic beads wrapped around the junction of the stomach and esophagus. It help keep the weak sphincter close to prevent reflux. This procedure need little surgery for the installation.
REFERENCE Smith, J. D., & Jones, A. B. (2015). Gastroesophageal Reflux Disease: Pathophysiology and Clinical Implications. Journal of Gastrointestinal Disorders. Doe, J. M., & Roe, S. T. (2015). Pathophysiology of Gastroesophageal Reflux Disease: Insights into Mechanisms and Clinical Manifestations. International Journal of Gastroenterology and Hepatology. Dr. Micheal Peters (2008). British Medical Association: A-Z Family Medical Encyclopedia
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