Upper GI. NFSC 370 - Clinical Nutrition McCafferty. Anatomy: Review. Mouth Salivary glands Food chewed and mixed w/saliva. Bolus is moved toward pharynx and swallowing is stimulated Esophagus: Extends from pharynx to stomach Protected by mucus Empty and collapsed at rest.
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NFSC 370 - Clinical Nutrition
No structural difference (no thickening) but high intraluminal pressure that keeps it closed until food needs to be dumped into the stomach. This prevents gastric reflux.
Conditions that may interfere w/chewing and swallowing:
1. Mouth ulcers (2’ viruses, drugs, radiation therapy)
2. Inadequate Saliva Production
Indigestion and Reflux Esophagitis (GERD)
Protrusion of stomach into the chest cavity through the esophageal hiatus of the diaphragm
Normally, the LES sits right in the hiatus of the diaphragm and is reinforced by it.
Cause: hiatus weakens allowing a portion of the stomach to protrude above the diaphragm.
Most common: “sliding” hiatal hernia.
Pressure generated by the hernia is sufficient to force acidic stomach contents into the esophagus.
Same as for reflux esophagitis.
Inflammation of the stomach mucosa
Erosion of cells of the top layer of mucosa (gastric, duodenal, esophageal).
Mr. C had extensive gastric resection 1 wk ago, and has just begun to eat solids. About 15 minutes after eating he begins to feel weak and dizzy. He looks pale, his heart beats rapidly, and he breaks out into a sweat. Shortly thereafter, he develops diarrhea. What has happened?
The pt. may experience the same symptoms again a few hours later… why?
Nutrition Therapy: The Post-Gastrectomy Diet