A 40-year-old man reports to his health care provider complaining of heartburn that occurs after eating...

A 40-year-old man reports to his health care provider complaining of heartburn that occurs after eating and also wakes him up at night. He is overweight and admits to enjoying fatty foods and lying down on the sofa and watching TV in the evening. He also complains that lately he has been having a cough and some wheezing. He is negative for peptic ulcerations.

What is causing this man’s heartburn?

Why does it get worse at night or after he eats?

List four lifestyle changes he could implement to limit his symptoms and state how each one will help.

Explain how your diagnosis in answer 1 relates to the respiratory symptoms

Solutions

Expert Solution

What is causing this man’s heartburn?

The symptoms are caused due to Gastroesophageal reflux disease (GERD). GERD is caused by frequent reflux of the acidic gastric contents into the esophagus.

Intermittent relaxation of the lower esophageal sphincter (LES) and and increased intra-abdominal pressure.is the cause for reflux of gastric contents.

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Why does it get worse at night or after he eats?

GERD is worse at night because in the lying position, it is easier for the acid to reflux in to the esophagus. Acid doesnt pass down by gravity. Also, the concentration of acid in the stomach is higher at night.

GERD is worse after a meal because, full stomach causes upward pressure against the lower esophageal sphincter leading to reflux.

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List four lifestyle changes he could implement to limit his symptoms and state how each one will help.

1. Small frequent feeds - avoids gastric distension.

2. Dont lie down soon after a meal - decreases the incidence of reflux

3. Keep head end elevated while sleep - Less pressure on the lower esophageal sphincter (LES)

4. Avoid reflux precipitating drugs - caffeine, chocolates.

5. Reduce over weight - less pressure on the LES.

6. Stop smoking - decreases acid reflux.

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Explain how your diagnosis in answer 1 relates to the respiratory symptoms ?

The gastric contents that entered into the esophagus can reach the pharynx and aspirated, especially during sleep. This can cause irritation of the respiratory mucosa causing throat irritation, postnasal drip and hoarseness, cough or wheezing.

Sydney Mullin answered 11 months ago

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