Patho Patho #19

Question

What is the pathophysiology of gastro-esophageal reflux syndrome (GERD)?

Answers

  1. Decrease in gastric acid secretion within the lower stomach.
    • Rationale:

      This answer choice is not correct because GERD does not result in a decrease of gastric acid secretion. It causes the backflow of acidic contents back up into the esophagus.

  2. Esophageal inflammation caused by spicy foods or carbonated beverages.
    • Rationale:

      This answer choice is not correct because, although the symptoms of GERD may be aggravated by spicy food and carbonated beverages, this is not the underlying pathophysiology of the disease process itself.

  3. Reflux of acidic gastric contents which damage the esophageal lining and initiate an inflammatory response.
    • Rationale:

      This answer is correct because the underlying pathophysiology of GERD is a weak lower esophageal sphincter leading to the backflow of acidic contents up into the esophagus. Classic symptoms include a burning pain in the stomach and esophageal areas following meals.

  4. Reflux of acidic duodenal contents into the lower part of the stomach preventing normal digestion.
    • Rationale:

      This answer choice is not correct because GERD causes the backflow of stomach contents into the esophagus rather than the flow of contents from the duodenum back into the stomach.

Overview

The focus of this question is asking the nurse to determine the underlying pathophysiological of GERD. GERD occurs because of an incompetent lower esophageal sphincter which allows the reflux of contents back up into the esophagus. This reflux of acidic gastric contents into the esophagus can damage the lining of the esophagus.

Explanation

Learning Outcomes

GERD causes a burning pain in the chest and esophagus area. This is because a weak lower esophageal sphincter leads to the backflow of acidic contents back up into the esophagus after eating. It is recommended to teach clients with GERD to sit upright for at least 1-2 hours following eating to prevent the burning pain of GERD.

Test Taking Tip

Make sure you read the stem of each question very carefully. The question is asking about the underlying pathophysiology of GERD rather than specific signs and symptoms.

Video Rationale