Gastrointestinal Tract: Disorders of Motility
Jamie is a 3-month-old female who presents with her mother for
evaluation of “throwing up.” Mom reports that Jamie has been throwing up
pretty much all the time since she was born. Jamie does not seem to be
sick. In fact, she drinks her formula vigorously and often acts hungry.
Jamie has normal soft brown bowel movements every day and, overall,
seems like a happy and contented baby. She smiles readily and does not
cry often. Other than the fact that she often throws up after drinking a
bottle, she seems to be a very healthy, happy infant. A more precise
history suggests that Jamie does not exactly throw up—she does not heave
or act unwell—but rather it just seems that almost every time she
drinks a bottle she regurgitates a milky substance. Mom thought that she
might be allergic to her formula and switched her to a hypoallergenic
formula. It didn’t appear to help at all, and now Mom is very concerned.
Cases like these are not uncommon. The mother was concerned and thinking
her daughter may have an allergy; she changed to a different formula.
However, sometimes babies have immature GI tracts that can lead to
physiology reflux as they adapt to normal life outside the uterus.
Parents often do not consider this possibility, prompting them to change
formulas rather than seeking medical care. As in the case study above,
GI alterations can often be difficult to identify because many cause
similar symptoms. This same issue also arises with adults—adults may
present with symptoms that have various potential causes. When
evaluating patients, it is important for the advanced practice nurse to
know the types of questions he or she needs to ask to obtain the
appropriate information for diagnosis. For this reason, you must have an
understanding of common GI disorders such as gastroesophageal reflux
disease (GERD), peptic ulcer disease (PUD), and gastritis.
Review this week’s media presentation on the gastrointestinal system.
Review Chapter 35 in the Huether and McCance text. Identify the normal
pathophysiology of gastric acid stimulation and production.
Review Chapter 37 in the Huether and McCance text. Consider the
pathophysiology of gastroesophageal reflux disease (GERD), peptic ulcer
disease (PUD), and gastritis. Think about how these disorders are
similar and different.
Select a patient factor different from the one you selected in this
week’s Discussion: genetics, gender, ethnicity, age, or behavior.
Consider how the factor you selected might impact the pathophysiology of
GERD, PUD, and gastritis. Reflect on how you would diagnose and
prescribe treatment of these disorders for a patient based on this
Review the “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal
Reflux Disease (GERD)” media in the Week 2 Learning Resources. Use the
examples in the media as a guide to construct a mind map for gastritis.
Consider the epidemiology and clinical presentation of gastritis.
Write a 2 page paper that addresses the following:
Describe the normal pathophysiology of gastric acid stimulation and
production. Explain the changes that occur to gastric acid stimulation
and production with GERD, PUD, and gastritis disorders.
Explain how the factor you selected might impact the pathophysiology of
GERD, PUD, and gastritis. Describe how you would diagnose and prescribe
treatment of these disorders for a patient based on the factor you
Construct a mind map for gastritis. Include the epidemiology,
pathophysiology, and clinical presentation, as well as the diagnosis and
treatment you explained in your paper.