Mrs T is a 45 yr old female who reports frequent heartburn and regurgitation of acid into her mouth for the past 3 months. There is no change in her usual eating habits, or in her weight. She has no problem with swallowing, food getting stuck, or respiratory issues. There is no abdominal pain. She has tried taking over the counter antacids, such as calcium carbonate (Tums), with only a little relief. Physical:
Body Mass index (BMI) is 28. She is alert and well-nourished. Exam including oropharynx, neck, chest and abdomen are normal.

Answer the following questions based on the scenario and article above.

a. Outline the path that a bolus of food would take from the mouth to the duodenum. This should include any sphincters.
b. Describe the digestive function of each of the areas of the upper GI tract that are mentioned in Q1.
c. Describe the anatomical problem that causes gastroesophageal reflux.
d. Research to find out the names of 2 medications that are used to treat GERD.
e. How do each of these medications work to relieve symptoms?

Solution :

a). The path from mouth to the duodenum is :

Oral cavity  Oropharynx     Laryngopharynx     Esophagus    lower esophageal sphincter  ---   Stomach     Pyloric sphincter      Duodenum.

b). The digestive functions of the organs are :

ORAL CAVITY

The saliva in the oral cavity or the mouth keeps the mouth mist and it helps in food digestion. The salivary amylase converts the stretch into the maltose.

STOMACH

The stomach produces acidic pH and it helps to break the proteins in the food by the enzyme, Pepsinogen.

DUODENUM

In the duodenum, the chyme is mixed with the enzyme, bile and the pancreatic juice which helps in digestion.

c). In the gastroesophageal reflux, the lower sphincter does not function properly and that is why the gastric content that contains the acid and the pepsin regurgitate into the end of lower esophageal. This area is not an acid resistant, so the ulceration takes place.

d). Elevation of a head-end of the patient's bed, so that the gravity stops in  the upward motion of the esophageal contents. The potent acid inhibiting agents like the Omeprazole.

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