Med Equipment & Diagnosis
Page 31
TMS
Medical Diagnostics: Gastroesophageal Reflux
By Chris Correll, MSIMT, CBET, A+
Learning Objective: Gastroesophageal reflux disease (GERD)
Detail basic physics of Acid Reflux (GERD).
Clarify Pathophysiological changes and stomach pressures.
Distinguish between testing and diagnosing using endoscopy.
Review pathology that can be diagnosed with a medical device.
Physics of Acid Reflux: GERD is a chronic condition caused by Dyspepsia, heartburn, indigestion, or acid regurgitation; in that stomach acids
move in a backward flow, rising above the level of the junction of the
esophagus and past the lower esophageal sphincter causing erosion and
stricture within the esophagus. The speculation of cause is unclear but
what we do know is that the natural esophageal mucosa becomes overwhelmed by the exposure to gastric acid, one of the main secretions of
the stomach, together with pancreatic enzymes and pepsin in the reflux
materiel. Chemically it is an acid solution consisting mainly of hydrochloric
acid (HCl), and small quantities of potassium chloride (KCl) and sodium
chloride (NaCl). In fact, the volume of the stomach fluid is 20 to 100 mL
and the pH is acidic (1.5 to 3.5). Therefore, when you swallow, the lower
esophageal sphincter, a circular band of muscle around the bottom part of
your esophagus, relaxes to allow food and liquid to flow down into your
stomach. Then it closes again. However, if this valve weakens, then gastric acid can flow back up into your esophagus, causing frequent heartburn and pain in your daily life. This constant backward flow of acid can
irritate the lining of your esophagus, causing esophagitis, the inflammation, irritation, or swelling of the esophagus. Common triggers over time,
such as consumption of alcohol, coffee, caffeine, cola [very acidic pH 2.5],
Nicotine from smoking tobacco, chocolate, peppermint, butter, sour
cream, fatty/spicy/fried foods, peanuts, almonds, walnuts, wine, vinegar,
hot peppers, tomatoes or red paste color, a highly acidic food can inflame
as well as can erode the esophagus, causing problems such as bleeding ,
breathing problems, ulcers, or esophageal cancer.
Gastro Pathophysiology: Within the region of the lower gastroesophageal sphincter (LES) exist a high-pressure zone (fig. 1). This high pressure
prevents reflux but allows food and liquid particles to pass on through
(Continued)