Week_5_Comment 2_Path

GI & Endocrine

Brandy Fields

St. Thomas University

NUR 502

Dr. Morgan

February 12, 2026

GI & Endocrine

Gastroesophageal reflux disease or GERD as it is most referred is the backward flow of gastric contents from the stomach into the esophagus. The gastric contents can go beyond the esophagus extending into the oral cavity, larynx, or lungs causing esophagitis and inflammation of the other affected mucosal surface (Azer & Goosenberg, 2025). Individuals older than fifty years of age, body mass index greater than thirty, alcohol consumption, lack of physical activity, and the consumption of foods high in fat or acidic contribute to the formation of GERD (Azer & Goosenberg, 2025). The underlying pathophysiology to GERD lies in abnormalities in the lower esophageal sphincter. Relaxation of the lower esophageal sphincter, the presence of hiatal hernias, decreased pressure, and obesity contribute to GERD (Dlugasch & Story, 2023).

Acid clearance can be another contributing factor if there is an impairment of peristalsis and lack of bicarbonates in salvia to neutralize acid. Delayed gastric emptying and increased intra-abdominal due to pressure changes further contribute to the development of GERD. Overtime repeated exposure of the esophageal lining to acidic gastric contents or chyme led to inflammation of the esophagus or esophagitis. Patients may report symptoms of heartburn, regurgitation of food, nausea, dry cough, or the sensation of a lump in the throat (Dlugasch & Story, 2023). Barrett esophagus, strictures, ulcerations, chronic laryngitis, asthma exacerbation, and esophageal cancer can potentially arise due to GERD. (Dlugasch & Story, 2023).

Evidence-Based Guidelines

A symptom-based approach is recommended for patients with classic GERD with the absence of major complications. Classic symptoms such as heartburn or regurgitation can be managed with the use of an eight-week trial of a premeal proton-pump inhibitor therapy (Katz et al., 2021). Symptoms such as gastrointestinal bleeding, unexplained weight loss, and persistent vomiting may warrant further diagnostic evaluation. Endoscopy, esophageal pH monitoring, and esophagus manometry are among diagnostic implementations in the treatment and management of GERD. In addition to the pharmacological approach, patients should be educated on lifestyle modifications that can assist in the management of symptoms (Dlugasch & Story, 2023). Maintaining a high fowler position after eating, weight reduction, eating small frequent meals, and the avoidance of late-night meals can assist in the management of GERD (Dlugasch & Story, 2023).

Advance Nurse Practice and Patient Education

Symptoms and other contributing factors are the greatest indicator of complicated or uncomplicated GERD. As mentioned above, patients with uncomplicated GERD will be present with the classic symptoms of heartburn and regurgitation. In those cases, where there are no other symptoms or correlations to disorder progression, the NP can render treatment. Patients presenting with more advanced symptoms such as gastrointestinal bleeding, unexplained weight loss, or anemia warrant referral or endoscopic evaluation. Patients should be provided with clear directions on medication administration to include the importance of timing to meals. Patients should also be encouraged to manage weight and make food choices that decrease the risk of symptom flare ups.

References

Azer, S. A., & Goosenberg, E. (2025, July 6). Gastroesophageal reflux Disease (GERD). StatPearls – NCBI Bookshelf.

Dlugasch, L., & Story, L. (2023). Applied Pathophysiology for the advanced practice nurse. Jones & Bartlett Learning.

Katz, P. O., Dunbar, K. B., Schnoll-Sussman, F. H., Greer, K. B., Yadlapati, R., & Spechler, S. J. (2021). ACG Clinical Guideline for the Diagnosis and Management of Gastroesophageal Reflux Disease. The American Journal of Gastroenterology, 117(1), 2756.

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