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TS is 67 years old with a long history of knee osteoarthritis for which he self-medicates regularly with over-the-counter (OTC) naproxen. He is in the clinic today complaining of a swallowing difficulty that has progressively worsened over the past several months. He has otherwise been healthy and has not seen a doctor in many years.

TS denies significant past medical history. A review of systems is negative except for arthritic symptoms and swallowing difficulty. He denies noticing blood in his stool and vomiting blood. He denies history of gastroesophageal reflux disease (GERD) and ulcer.

He does not drink alcohol, although he drank heavily many years ago. He does not smoke. TS describes the dysphagia this way: “Food gets stuck in my throat, and I can’t get it down.” The feeling occurs only after he has ingested solid food; liquids are not a problem. There is burning chest pain associated with meals.

He is scheduled for an upper gastrointestinal endoscopy.

Questions and topics for discussion:

1. What is the likely cause of his dysphagia?
2. What advice should TS be given regarding his OTC medication at this time?
3. What are the usual signs and symptoms of GERD? How will it be managed?

comment 1

1. what is the likely cause of his dysphagia?

Dysphagia is a swallowing disorder that causes difficulty and pain while swallowing. This condition can make it difficult for people to get the necessary nutrients and can significantly affect the quality of life. TS’s symptoms are under second category of dysphagia. With this type of dysphagia, the person may have sensation that food is stuck behind the sternum according to textbook (Banasik & Copstead,2019). The Authors also confirm the fact that the second type of dysphagia may be the result of any disorder, structural or neuromuscular, in which the peristaltic activity of the body of the esophagus is altered (Banasik & Copstead, 2019). Over the counter medication also can be the cause of his condition and his history of heavily alcohol use also has effects such as causing damage to the esophageal mucosa.

2. What advice should TS be given regarding his OTC medication at this time?

TS should always talk to his doctor before taking any kind of medication to prevent further complications. That way he can receive proper and effective treatment for his medical conditions.

3. What are the usual sign and symptoms of GERD? How will it be managed?

Gastroesophageal reflux disease GERD) is a digestive disorder that occurs when acidic stomach juices, or food back up from the stomach into the esophagus. The most common sign and symptoms of GERD is heartburn, regurgitation, chest pain, and dysphagia. GERD can be managed by changing lifestyle and avoiding food and drinks that trigger the reflux. TS’s physician may also recommend medication to treat reflux. Over-the-counter antacids and H2 blockers may help decrease the effects of stomach acid. Proton pump inhibitors block acid production (Banasik & Copstead, 2019).

References:

Banasik, J. L., & Copestead, L.-E. C. (2019). Pathophysiology (6th ed.) [e-book]. Elsevier.

comment 2

1. What is likely the cause of his dysphagia?

Dyshagia means that you have a hard time swallowing food or liquids or others cant swallow at all. Certain disorders of dysphagia includes multiple scheloris, neuroligcal damage, and muscular dystrophy. T.S possible caused is because of naproxen in which he has been using for a long time. In addition, alcohol is another reason of his dysphagia.

2. What advice should TS be given regarding his OTC medication at this time?

He should stop taking the OTC medication and schedule a doctor’s appointment and the doctor should be able to give him the right prescription,in which the doctor can help him with his osteoarthritis.

3. What are the usual signs and symptoms of GERD? How will it be managed?

GERD is a digestive disorder that the acid from the stomach comes up to the esophagus. The signs and symptoms of GERD includes heartburn, difficulty swallowing, chest pain.There are some lifestyle ways to manage with GERD such as maintianing a healthy weight, dont lie down after a meal, and avoid food and drinks that triggers reflux. And OTC prescription medications such as H-2 receptor blockers, and a presciption of strength proton pump inhibitors for example lansoprazole.

NCH Healthcare System (2014, October 15). Dysphagia. Retrieved from

Mayo Clinic (2020, May 2). Gastroesophageal reflux disease (GERD). Retrieved from https://www.mayoclinic.org/diseases-conditions/gerd/symptoms-causes/syc-20361940

Mayo Clinic (2020, May 22). Gastroesophageal reflux disease (GERD). Retrieved from https://www.mayoclinic.org/diseases-conditions/gerd/diagnosis-treatment/drc-20361959