Gastrointestinal System Disorders Q 73 - Gyan Darpan : Learning Portal
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Friday 15 April 2022

Gastrointestinal System Disorders Q 73

The student nurse is preparing a teaching care plan to help improve nutrition in a patient with achalasia. You include which of the following:
    A. Swallow foods while leaning forward.
    B. Omit fluids at mealtimes.
    C. Eat meals sitting upright.
    D. Avoid soft and semi soft foods.

Correct Answer: C. Eat meals sitting upright.

Eating in the upright position aids in emptying the esophagus. Doing the opposite of the other three also may be helpful. Achalasia is an esophageal smooth muscle motility disorder that occurs due to a failure of relaxation of the lower esophageal sphincter. This condition causes a functional obstruction at the gastroesophageal junction.

Option A: The majority of patients with achalasia typically present with dysphagia, initially with solids than to liquids though 70-97% of patients will have dysphagia to both solids and liquids at presentation. Dysphagia and regurgitation are the most common presenting symptoms in achalasia.
Option B: Instruct patient regarding eating small amounts of bland food followed by a small amount of water. Instruct to remain in an upright position at least 1–2 hours after meals, and to avoid eating within 2–4 hours of bedtime. Gravity helps control reflux and causes less irritation from reflux action into the esophagus.
Option D: Patients need to understand necessary lifestyle changes following myotomy, such as the need to eat small food boluses in an upright position, which allows gravity to assist with food transit and never to lay flat but rather at 30 to 45 degrees due to increased risk for aspiration.

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