Gastrointestinal Case Study
Henry, a 58 y/o male, recently reports waking up in the middle of the night with burning abdominal pain. Symptoms occur several nights a week with occasional discomfort in the middle of the afternoon. A bland diet or drinking milk does seem to help and spicy foods aggregate the symptoms.
SH: Works in a grocery store, divorced, non-smoker, drink 1-2 beers/day
Meds: 1 325mg ASA daily for cardiovascular prevention
Constitutional: Decrease appetite and 5% weight loss; denies feverENT: Denies sore throat or drainageLungs: Occasional dry cough at night heart: Mid sternum chest burning intermittentlyAbdomen: Epigastric burning and tenderness, denies constipation or diarrhoea
Summarize the pathophysiology of Peptic Ulcer Disease as compared to GERD and explain which one his symptoms most closely represent. Support with evidence.
A peptic ulcer disease is commonly presented with discomfort in the abdomen. The most common signs and symptoms of peptic ulcer disease is pain or discomfort around the abdominal area. GERT, on the other hand, is commonly presented with signs such as regurgitation and heartburn. In most cases, when a patient presents with complaints of burning feeling originating from the abdomen upwards towards the chest area, GERD is usually the first to be suspected. Ideally, a feeling of heartburn or aspyrosis in GER is usually triggered by excessive alcohol consumption (Atta, et al., 2019). In addition to excessive alcohol consumption, certain foods such as garlic, fatty foods, peppermint and caffeine can also trigger aspyrosis. Consumption of these foods and alcohol affects the gut by causing the lower oesophagal sphincter to expand. The relaxation of the lower oesophagal sphincter allows the refluxate to enter the oesophagus from the stomach. When the refluxate from the stomach enters the oesophagus, regurgitation is triggered. Similarly, when one fails to eat or eats to satisfaction, their peptic ulcers are likely to improve.
Information in the literature shows that majority of patients reporting to the facility and get diagnosed with peptic ulcer disease are also found to be experiencing other co-morbidities such as loss of appetite and they suffer weight loss. Because of the pain in the chest area, the pain likely leads to loss of appetite, hence causes a weight reduction. The most likely suggesting symptoms for this patient is that the pain is high in the middle of the night and in the middle of the afternoon. During these hours, the patient is likely to have not eaten. As suggested in the literature lack of food for long hours is highly associated with peptic ulcer disease (Huether & McCance, 2016).
Atta, M. M., Sayed, M. H., Zayed, M. A., Alsulami, S. A., Al-Maghrabi, A. T., & Kelantan, A. Y. (2019). Gastro-oesophageal reflux disease symptoms and associated risk factors among medical students, Saudi Arabia. International journal of general medicine, 12, 293.
Huether, S. E., & McCance, K. L. (2016). Alterations of digestive function. Pathophysiology. The biologic basis for disease in adults and children. St. Louis, MO: Elsevier Mosby.
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