Medical Surgical GERD #1

Question

A client has been diagnosed with gastroesophageal reflux disease (GERD). What are the risk factors for GERD? Select all that apply.

Answers

  1. BMI of 19
    • Rationale:

      This answer is not correct because a BMI of 19 is an ideal BMI for an adult. Obesity (25 or greater) is a risk factor, especially if truncal obesity. The risk factors associated with GERD are smoking, pregnancy, hiatal hernia, and drinking alcohol.

  2. Smoking
    • Rationale:

      This answer is correct because smoking weakens the lower esophageal sphincter. Smoking should be avoided to help minimize GERD symptoms.

  3. Pregnancy
    • Rationale:

      This answer is correct because pregnancy increases intra-abdominal pressure. This pushes on the stomach and causes acid to regurgitate into the esophagus.

  4. Hiatal hernia
    • Rationale:

      This answer is correct because a hiatal hernia is when the top part of the stomach pushes through the diaphragm, which places pressure on the stomach. The pressure pushes on the stomach and allows gastric acid to splash into the esophagus.

  5. Drinking alcohol
    • Rationale:

      This answer is correct because alcohol can relax the lower esophageal sphincter. When the LES relaxes, the acid within the stomach more easily comes up into the esophagus.

Overview

The risk factors associated with GERD are smoking, pregnancy, hiatal hernia, and drinking alcohol. Gastroesophageal reflux disease (GERD) is a condition that occurs when a person has reflux of gastric acid.

Explanation

Learning Outcomes

Gastroesophageal reflux disease (GERD) is a condition that occurs when a person has reflux of gastric acid. The persistent regurgitation of and exposure to stomach acid can damage esophageal tissue to the extent, it causes Barrett’s esophagus. Cellular changes can occur that can lead to esophageal cancer. Various things contribute to GERD symptoms, including physiological, lifestyle, dietary factors, and medications. Physiologic things include a lower esophageal sphincter (LES) is too relaxed allowing acid to regurgitate to the esophagus, causing tissue damage. A hiatal hernia can cause pressure which can push acid from the stomach to the esophagus. Being overweight or pregnant increases intra-abdominal pressure, causing acid to regurgitate into the esophagus from the stomach. Lifestyle factors which relax or irritate the LES includes smoking and alcohol intake. Dietary factors include eating chocolate, spicy or greasy foods, and drinking tea or carbonated beverages.

Test Taking Tip

Know how relaxation of the LES and increased abdominal pressure can contribute to GERD.

Video Rationale