Chapter 8Nasogastric

Aspartate Transaminase

Peptic Ulcer Disease

Gastroesophageal Reflux Disease

Lauran DeCeault

Nasogastric Nasogastric is a general

term that means pertaining to the nasal cavity and stomach.

The term is often used to describe medical processes: nasogastric intubation nasogastric aspiration

Nasogastric Intubation Involves the insertion of a plastic tube

(nasogastric tube) through the nose and into the stomach, passing through the throat.

Nasogastric Intubation Once the tube is inserted, a healthcare

provider can deliver food or medication directly to the stomach or retrieve substances.

Most often, nasogastric intubation is used when an individual person is unable to eat or swallow on his/her own. The patient can still digest food on his/her own,

but cannot eat or swallow independently.

Nasogastric Aspiration Refers to the process of removing substances from the stomach

via nasogastric tube. Used in patients with gastrointestinal obstructions (gastric

secretions and swallowed air) The process is also used when an individual may have over-

dosed on a medication or swallowed a harmful substance. Used in patients who have swallowed poisonous substances

NG intubation is a helpful method to determine how the gastrointestinal tract is functioning as it can be used to remove contents of the stomach for examination

Aspartate transaminase (AST) An enzyme that is found in red blood cells,

the liver, heart, muscle tissue, pancreas, and kidneys.

AST

Commonly used as a marker for liver health, but also is found in other organs

The blood usually has low levels of AST, but when a tissue or organ is damaged, more AST is released in the bloodstream.

The amount of AST measured in the bloodstream is directly related to the severity of tissue or organ damage. Elevated levels of AST may indicate:

Acute pancreatitis Acute hemolytic anemia Acute renal disease Musculoskeletal disease Mononucleosis Heart attack/heart failure Hepatitis or cirrhosis

AST: Liver Function Test Commonly measured (via blood draw) as a

part of a diagnostic liver test:

Peptic Ulcer Disease disease characterized

by sores or ulcers lining the stomach or duodenum

no known cause results when there is

an imbalance between digestive fluids in the stomach and the duodenum

Causes of Peptic Ulcer Disease The lining of the stomach and small intestine stops

protecting the stomach from the irritating acids that are naturally produced by the stomach. Stomach lining becomes inflamed, producing an ulcer

Most occur in the first lining of the stomach Perforation:

Ulcers that protrude the stomach or duodenum Medical Emergency

Bacteria called Helicobacter pylori (H.pylori) is known to cause painful ulcers

Peptic Ulcer Disease

Risk of Peptic Ulcer Disease Alcoholics Those who use aspirin, ibuprofen, naproxen

or anti-inflammatory drugs regularly Smokers and tobacco users Those undergoing radiation Possibly stress

Symptoms of Peptic Ulcer Disease Smaller ulcers may be asymptomatic Symptoms of Peptic Ulcer Disease include:

Abdominal pain Chest pain Fatigue Vomiting Weight loss

Diagnosis & Treatment of Peptic Ulcer Disease Tests include:

Esophagogastroduodenoscopy (EGD or upper endoscopy) For viewing the stomach and duodenum

Upper GI X-Rays

Medications to kill the H. pylori bacteria (if present) and decrease stomach acid Misoprostol

For those taking anti-inflammatory medications on a regular basis

sucralfate Protects the lining of the stomach

Gastroesophageal Reflux Disease (GERD) Chronic digestive disease Occurs when stomach acid or bile flows back into

your esophagus The acid irritates the lining of esophagus

Caused by permanent or temporary changes to the barrier that protects the esophagus from the stomach the lower esophageal sphincter relaxes Hiatal hernia

GERD

Symptoms of GERD Sore throat Pain in the chest or upper part of the abdomen. Difficulty swallowing Wheezing Dry cough/trouble breathing Nausea Vomiting Burning sensation in chest and throat

GERD Risk Factors Affects 10-20% of those living in the Western world. Other contributions to GERD:

Obesity Pregnancy Certain medications

anti-depressants Asthma medications Pain killers Sedatives

Smoking

Treatment of GERD Lifestyle change

Avoid certain foods and beverages: Chocolate Coffee Spicy foods Tomato Alcohol

Avoid over-eating Avoid laying down after eating Lose weight if needed Quit smoking

Medications Antacids H2 blockers PPIs Prokinetics Antibiotics

Surgery

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