
A.
To describe: The cause and the worsening of heartburn after eating.
Introduction: One frequent cause of acid reflux disease is a stomach irregularity called a hiatal hernia. This happens when the upper part of the stomach and LES move beyond the diaphragm, a muscle that divides the stomach from the chest. Regularly, the diaphragm helps keep acid in our stomach. However, due to the presence of hiatal hernia, acid can move up into the esophagus and induce symptoms of acid reflux disease.
A.

Explanation of Solution
As the diagnosis of gastroesophageal reflux has been made, the heartburn can be explained because of the stomach acid causing contact with the food pipe due to the improper closure of the sphincter. The acid burns the lining of the food pipe, causing the prominent symptom of heartburn. This heartburn often becomes worse after eating, because of two reasons: Firstly, after eating, the stomach cavity is more occupied, which in turn increases the volume of the contents and causes more irritation. Secondly, the secretion of acid in the stomach is aided by the ingested food, therefore, creating more heartburn.
B.
To describe: The reason why the persons with GERD are advised to lose weight, avoid eating fatty foods, remain sitting after eating, and sleep with their head slightly elevated. The possible relationship between these situations and the occurrence of reflux.
Introduction: Gastroesophageal Reflux Disease is a digestive dysfunction that results when acidic stomach juices, or food and fluids back up from the stomach into the esophagus. GERD strikes people of all ages, from infants to older adults. Somebody with asthma is at a greater danger of acquiring GERD.
B.

Explanation of Solution
The reflux occurs due to the lack of closure of the sphincter due to many reasons. One such is an accumulation of fats or the muscle wall. Therefore, the patient is advised to lose weight or lose some fat and manage his/her diet, which in turn will help regulate acid secretion cycles. Also, allowing the sitting posture after ingestion of food will allow the contents to be digested and passed away into the intestine, decreasing the reflux possibilities.
C.
To describe: The possible relationship between GERD and the respiratory symptoms.
Introduction: Gastroesophageal reflux disease (GERD) may trigger or worsen many consumptive diseases. The acid can induce throat irritation, postnasal drip, and hoarseness, as well as chronic cough, chest blockage, and lung inflammation resulting in asthma and bronchitis.
C.

Explanation of Solution
As the acid rises in the food, there is a higher chance of it coming in contact with the respiratory passages such as nasal and pharyngeal cavities. Therefore, the symptoms appear in the respiratory system as well. These symptoms can be caused primarily due to burns or secondarily due to the inflammation of the lining of the related respiratory passages, which in turn will cause difficulty in breathing and sleeping.
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Chapter 29 Solutions
Essentials of Pathophysiology: Concepts of Altered States
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