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Dicerticular Disease Education- Brianna Hanzmann

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Dicerticular Disease Education- Brianna Hanzmann

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For a patient with a new diagnosis of Diverticular Disease, they probably came to the hospital due to diverticulitis--an infection of the diverticulum. I would educate them on what diverticulum are--they are essentially small herniations of the bowel that extend through the muscle layer. They can be asymptomatic, but at other points in time, factors related to stress and diet, can cause inflammation and infection in the diverticulum. The patient should be instructed to notify a provider if they are experiencing chronic constipation and/or acute, lower left abdomen pain, because they might be experiencing diverticulitis again and need antibiotics. The patient should know that this is a lifelong disease and should be instructed to avoid seeds and popcorn, as these can get stuck and cause inflammation and infection of the diverticulum. Also, the patient should have a high fiber diet when no symptoms are present, as this prevents infection from occurring by promoting the movement of contents through the bowels. A normal, healthy life is completely manageable with Diverticular Disease.

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Jenny Mallen - IBD disorders and education

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Jenny Mallen - IBD disorders and education

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Ulcerative Colitis and Crohn's disease are chronic disorders and can be successfully managed with nutritional and pharmacologic measures. Patients should be instructed, in simple terms, about various medications that can be used to treat their disorder (e.g. antidiarrheal agents, corticosteroids, and immunomodulators). Patient should also be instructed to take medications as prescribed, have a high fiber diet, take vitamin and iron supplements if necessary. The nurse should also help the patient identify "trigger" foods that may cause exacerbations of the disorder (often milk). If the patient is a smoker, the nurse should encourage smoking cessation because smoking can cause the disease exacerbations to worsen. The patient's educational needs must also be assessed and images may be helpful to help the patient learn about their illness.

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Lactose intolerance is when an individual has a deficiency of lactase. People with a lactase deficiency are unable to fully digest lactose (the sugar in milk. As a result they have diarrhea, gas and bloating when they eat/drink diary products. I would inform these patients in which foods contain lactose such as milk, ice-cream, and cheese I would tell this patient to choose smaller servings of dairy, eating lactose-reduced or lactose-free products, or use lactase enzyme tablets/drops.

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Lactose Intolerance is a huge issue for many people, but why does lactose intolerance exist, and why do we have lactose intolerance? Fixing lactose intolerance is possible, but it's not super easy. Ethnicity does play a role in your lactose intolerance! Animator's Channel: https://www.youtube.com/channel/UCBAGTkIY0NLFic-9xfKOP2g Music: http://www.newgrounds.com/audio/listen/577625 Outtro Music: https://www.youtube.com/watch?v=81ieWke1gVg

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Gastritis is the inflammation of the stomach mucosa. It is a
very common disorder in people. There is two types of gastritis: non-erosive is
usually due to infection with H. Pylori and erosive which is caused by NSAIDs,
alcohol abuse, or radiation therapy. 

Before providing information for this common disorder we
need to make sure that the patient is ready to learn about his conditions by
assessing his/her LOCs, readiness to learn, and make sure there is no barrier
to the learning that will be provided. Once we have assessed the patient we
need to find out what is the best learning method for the patient and get
everything ready before we start education about the condition. 

To a patient with gastritis it is important to teach them
about reducing anxiety caused by pain and all the planned treatments, it is
important to reduce the pain to reduce anxiety and then implement nursing
interventions to further reduce any pain by answering any questions the patient
may have. Optimal nutrition is crucial with gastritis and it is important to
asses their diet and provide information about what foods to avoid and which
ones to consume. Also very important to emphasize the importance of avoiding
alcohol intake or any NSAIDs use. Last but not least we need to teach the
patient about any signs and symptoms of possible complications. 

Finally it is important to make sure that the patient has
undertood all the teaching and by providing all this information in written
format will help the patient remember what needs to be done. Asking a few questions and clarifying any questions is important. Having a family
member when the teaching is done can be helpful in patient’s care.

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Gastritis is the inflammation of the stomach mucosa. It is a
very common disorder in people. There is two types of gastritis: non-erosive is
usually due to infection with H. Pylori and erosive which is caused by NSAIDs,
alcohol abuse, or radiation therapy. 

Before providing information for this common disorder we
need to make sure that the patient is ready to learn about his conditions by
assessing his/her LOCs, readiness to learn, and make sure there is no barrier
to the learning that will be provided. Once we have assessed the patient we
need to find out what is the best learning method for the patient and get
everything ready before we start education about the condition. 

To a patient with gastritis it is important to teach them
about reducing anxiety caused by pain and all the planned treatments, it is
important to reduce the pain to reduce anxiety and then implement nursing
interventions to further reduce any pain by answering any questions the patient
may have. Optimal nutrition is crucial with gastritis and it is important to
asses their diet and provide information about what foods to avoid and which
ones to consume. Also very important to emphasize the importance of avoiding
alcohol intake or any NSAIDs use. Last but not least we need to teach the
patient about any signs and symptoms of possible complications. 

Finally it is important to make sure that the patient has
undertood all the teaching and by providing all this information in written
format will help the patient remember what needs to be done. Asking a few questions and clarifying any questions is important. Having a family
member when the teaching is done can be helpful in patient’s care.

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GASTRITIS

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What is gastritis and What are the causes and treatment

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What Is gastritis ? http://youaskmdanswers.com/autoimmune-gastritis-what-is-gastritis-and-what-are-its-causes-symptoms-and-treatment/ . Gastritis is the inflammation of the inner lining of the stomach.Injury to the lining of the stomach resulting from infections, or from the regular use of drugs such as aspirin, may be the cause of gastritis. Autoimmune gastritis where antibodies attack the stomach lining may also cause this condition.

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Bariatric surgeries are a treatment option for morbid obesity when other non surgical options have failed. I would assess the patient’s readiness to learn, literacy, and learning style. I would show the patient a video of the surgery so they can have a visual of what surgery they are receiving. Before the surgery I would allow the client to express theirs feelings and anxiety related to the surgery. I would teach the patient the changes in their diet an lifestyle that are needed. I would instruct the client about eating small frequent meals that contain protein and fiber, each meal should not exceed one cup.  I would instruct the client to eat foods high in nutrients, consume fat as tolerated, low carbohydrate intake, eat slowly, stay in a low fowlers position during and after meals, do not drink fluids with meals, drink water, walk for at least 30 minutes a day. The patient should know antispasmodic medications, prescribed, dietary supplements and vitamins, and follow up with their health care provider. I would verbally explain this information to the patient and I would present this information in written form in simple languages.

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Preparing a patient for a colonoscopy requires proper hydration and bowel cleansing prior to the procedure. It is important to instruct the patient that they need to maintain a clear liquid diet beginning at noon the day before the procedure. In order to prepare the bowel, the physician may prescribe laxatives, enemas, sodium phosphate tablets, and/or lavages, depending on the individual needs of the patient. The patient needs to receive clear instructions regarding the timing of bowel prep. For example, laxatives should be taken two nights before the procedure, enemas are to be done until clear return is seen the morning of, lavage solution should be taken orally over 3-4 hours the day before, and 32 sodium phosphate tablets should be taken – 20 the night before (4 tablets every 15 minutes) and the remaining 12 (taken as before) the morning of the colonoscopy. The nurse needs to ensure that the patient is properly hydrated and needs to assess the patient’s ability to swallow. Elderly patients are at risk for dehydration because of difficulty ingesting adequate fluid and diminished ability of their body’s to maintain fluid and electrolyte balance. Due to the diet modification required, care must be taken to prepare diabetic patients so as to avoid hyper- or hypoglycemia. These patients should be instructed to consult with their primary doctor before preparing for the procedure. In order to reduce anxiety, the patient should be told that the colonoscopy will take about 1 hour and during the procedure they may feel discomfort due to the presence of the colonoscope and the instillation of air into the bowel, both of which are normal.

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http://www.nucleushealth.com/ - This 3D medical animation shows the placement of an endoscope in the large colon (bowel) during a colonoscopy procedure. During a colonoscopy a biopsy is sometimes preformed to distinguish between benign and cancerous tissue. If polyps are found during the colonoscopy a polypectomy is generally preformed. ANCE00175

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***Im reposting my post "Gas"***
Gastritis is inflammation of the stomach lining. Possible causes of gastritis include drinking too much alcohol, excessive use of aspirin or ibuprofen or the presence of a bacterium called Helicobacter pylori (H. pylori).

It is always important to assess the patient's needs, concerns, readiness to learn, preferences, support, and possible barriers to learning before educating them. I would then evaluate the patient's diet, becoming familiar with their daily caloric needs, as well as food preferences and patterns of eating. Educating them on foods to avoid like seasoned food, spicy food, acidic foods, caffeine, nicotine, alcohol. It is also important to provide info on the medications they may be taking such as antacids. H2 blockers, proton pump inhibitors.

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In bariatric surgery, there is a criteria for selecting candidates for bariatric surgery which may include months of multidisciplinary counseling, education, and evaluation by a team of dietitians, nurse counselor, psychologist, and surgeon. Though before all of this, the patient’s education level, willingness to learn and adhere, and the best method of teaching them. Once established, the nurse should go over the selection criteria in regards to the patient which include a BMI of 40 or greater than without excessive surgical risk, BMI of 30 or greater with one or more obesity-associated comorbities, failure of nonsurgical attempts of weight loss, and the expectation that the patient will adhere to postoperative care.

Preoperatively, the nurses should assess the patient for any contraindications to major abdominal surgery, questioning the patient if they’ve made attempts to lose weight by nonsurgical means, received counseling regarding risk and benefits of the surgery, possible complications, outcomes, dietary changes, and lifelong needed follow up, screened for mental and behavioral disorders, and that dietary counseling has been initiated for postoperative dietary changes. Before surgery, it is important to tell that patient that they must ingest nothing but clear liquids for about 48 hours prior to surgery and to inform them of guidelines of what they may consume postoperatively which is typically sugar-free drinks, gelatins, pudding, flavored electrolyte drinks, fat-free milk, protein drinks, low-fat soups. Also important is to assess the patient for anxiety in which the nurse may be able to explain what to expect during the surgery and postoperatively and that they may join bariatric surgery support groups that provide them with guidance and tips to reduce their anxiety. Postoperatively, it is important educate the patient on methods of how to relieve pain which may include analgesics or even positioning them in a low Fowler’s position which promotes comfort. It is also important to encourage the patient to slowly sip 30 Postoperatively, it is important educate the patient on methods of how to relieve pain which may include analgesics or even positioning them in a low Fowler’s position which promotes comfort. I is also important to encourage the patient to slowly sip 30 ml of sugar-free oral fluids every 15 minutes and that they should stop ingesting fluids in nauseated or full. Also important is to educate the patient on having six small feedings consisting of a total of 600-800 calories per day with consumption of fluids between meals to prevent dehydration. Diarrhea is a common occurrence in bariatric surgery so the nurse should teach the patient that a diet high in nutrients and fiber should help with that. In regards to the patient’s body image changes, it is important to acknowledge the patient’s feelings as real and to let them know that support groups and counselors are available.

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Gastritis is usually the result of one of inflammation of the stomach lining. Possible causes of gastritis include drinking too much alcohol, excessive use of aspirin or ibuprofen or the presence of a bacterium called Helicobacter pylori (H. pylori)
It is always important to assess the patient's needs, concerns, readiness to learn, preferences, support, and possible barriers to learning before educating them. I would then evaluate the patient's diet, becoming familiar with their daily caloric needs, as well as food preferences and patterns of eating. Educating them on foods to avoid like seasoned food, spicy food, acidic foods, caffeine, nicotine, alcohol. It is also important to provide info on the medications they may be taking such as antacids. H2 blockers, proton pump inhibitors.

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Peptic Ulcer Disease- Christina
Caranica                                        

In providing patient teaching, it
is crucial to have a thorough discussion with the patient about his/her medical
condition from a holistic standpoint. Patient teaching should include the
pathophysiology of the disease, s/s to look out for, preventive measures for
the future/follow-up care, and treatment options (psychological,
pharmacological, nutritional, etc.) 
Depending on the individual, visual aids may be provided in the teaching
process.  This includes the use of
videos, pictures/diagrams, and/or written instructions. As the nurse, it is
important to speak clearly and at a pace in which the patient can easily follow
along with the teaching. As it is a discussion, it is also important to involve
the patient by asking the patient to repeat information back for clarification
and leaving time for questions that he/she may have.

As a nurse assigned to a patient
with peptic ulcer disease, I would first ask the patient if he/she understands
the disease process and explain it if necessary. This would be something that
should have been addressed when the patient received the diagnosis.  From there, I would talk about medications
and s/s that he/she may be experiencing. Peptic ulcer disease is typically
treated with antibiotics, proton pump inhibitors, and bismuth salts to
eradicate the H.pylori virus.  This also
creates a lower chance of recurrence.  A
patient suffering from ulcers without the presence of H.pylori would require H2
blockers and proton pump inhibitors to reduce acid in the stomach and relieve
symptoms.  I would explain this to the
patient.  I would then advise the patient
to complete the medication regimen for proper healing of the ulcer, as well as
to avoid the use of NSAIDs. I would emphasize this with written
instructions.  Lifestyle changes should
also be included such as the cessation of smoking and diet modifications. Again,
this would be provided in the pamphlet with images and written instructions.
The patient would know to avoid caffeinated beverages, alcohol, and extremes of
temperature in food. In addition, the patient would read the importance of eating
small and frequent meals.  Follow-up care
includes that the patient follows all of these instructions in addition to the
prophylactic use of H2 blockers for one year.

 

Video for patient teaching: 
https://www.youtube.com/watch?v=5mD4cW-71sQ

 

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Peptic Ulcer Disease- Christina
Caranica                                        

In providing patient teaching, it
is crucial to have a thorough discussion with the patient about his/her medical
condition from a holistic standpoint. Patient teaching should include the
pathophysiology of the disease, s/s to look out for, preventive measures for
the future/follow-up care, and treatment options (psychological,
pharmacological, nutritional, etc.) 
Depending on the individual, visual aids may be provided in the teaching
process.  This includes the use of
videos, pictures/diagrams, and/or written instructions. As the nurse, it is
important to speak clearly and at a pace in which the patient can easily follow
along with the teaching. As it is a discussion, it is also important to involve
the patient by asking the patient to repeat information back for clarification
and leaving time for questions that he/she may have.

As a nurse assigned to a patient
with peptic ulcer disease, I would first ask the patient if he/she understands
the disease process and explain it if necessary. This would be something that
should have been addressed when the patient received the diagnosis.  From there, I would talk about medications
and s/s that he/she may be experiencing. Peptic ulcer disease is typically
treated with antibiotics, proton pump inhibitors, and bismuth salts to
eradicate the H.pylori virus.  This also
creates a lower chance of recurrence.  A
patient suffering from ulcers without the presence of H.pylori would require H2
blockers and proton pump inhibitors to reduce acid in the stomach and relieve
symptoms.  I would explain this to the
patient.  I would then advise the patient
to complete the medication regimen for proper healing of the ulcer, as well as
to avoid the use of NSAIDs. I would emphasize this with written
instructions.  Lifestyle changes should
also be included such as the cessation of smoking and diet modifications. Again,
this would be provided in the pamphlet with images and written instructions.
The patient would know to avoid caffeinated beverages, alcohol, and extremes of
temperature in food. In addition, the patient would read the importance of eating
small and frequent meals.  Follow-up care
includes that the patient follows all of these instructions in addition to the
prophylactic use of H2 blockers for one year.

 

Video for patient teaching: 
https://www.youtube.com/watch?v=5mD4cW-71sQ

 

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I would explain to my patient (verbally) that lactose intolerance is common. It is caused by the body not having an enzyme called lactase to break up the sugar found in dairy products (which is called lactose). I would first explain what lactose foods include: milk, ice cream, cheese, yogurt, frozen yogurt, and creamy sauces (such as alfredo sauce). I would then explain the good news: all of these products have alternatives. The patient can substitute milk with almond, coconut, or soy milk. There is also a large number of dairy free ice creams and even vegan (and therefore dairy free) cheese. Patient might also tolerate goat's cheese well because it has a reduced amount of lactose.  I would be sure to send the patient home with a pamphlet that would include foods to avoid and alternative options .

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Lactose intolerance - causes, symptoms, diagnosis, treatment & pathology

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When educating, I would first talk to and assess my patient for general literacy, best learning styles, language, best time to educate, along with any fears or questions they may have. I would choose a time that allows enough time to educate thoroughly while leaving enough time for the patient to express any extra fears or questions about the procedure.

First I will educate that the goal of a gastrostomy, or a percutaneous endoscopic gastrostomy, is to assist in caloric intake to maintain a healthy weight and nutritional status. I will tell the patient that this is an alternative form of feeding in which liquid feedings will be given directly into the stomach. With this, they will not be ingesting food by the way of mouth for however long they have the PEG tube in. I will let the patient know that this is a procedure in which they will be moderately sedated. (At this point I would give the patient an image to show where and how the tube will be inserted)

I will inform the patient that it is normal to see a little bit of drainage on the gauze pad that sits between the insertion site and the tubing and reassure them that this will be assessed and cleaned daily. After the procedure, the skin around the stoma should heal within 3 weeks. During this time of healing, I would encourage the patient and their family to participate in looking for any signs of breakdown, irritation, or bleeding and in keeping good hygiene in that area. After it is healed, I will let them know that if they are going to clean it they must first wash their hands thoroughly, take off the old dressing and throw away, inspect the site, clean the insertion area with soap and water, dry gently and then recover the site with gauze and tape to skin. Soap and water is sufficient and hydrogen peroxide is not to be used. Along with talking about the aftercare, I would provide these hygiene instructions in written form.

I will inform the patient that they can bathe as usual and participate in most activities as long as the tubing is secured. After activity, the patient will need to check around the tubing for any abnormal leakage. If anything abnormal is seen or if the tube comes out, the patient should notify the nurse or call the doctor.

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Every patient is different, therefore, every patient learns differently. There are many teaching and learning methods such as auditory, written, visual, and demonstration. Each patient will have different strengths and weaknesses in their ability to learn and we should always keep this in mind when choosing an education method. In the case of constipation I would educate the importance of prevention and medication that is used to treat it as well as medication that may cause constipation. Education topics include: describe how to establish a bowel routine and the importance of it, the importance of adequate fluid intake, dietary information like suggesting high fiber foods, and how exercise and ambulation help promote regular bowels. The methods I would use would depend upon the patient's preferred learning strategy; but most likely I would use verbal instruction along with pamphlets.

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Upper Gastrointestinal Tract Study- Audrey Guila

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Upper Gastrointestinal Tract Study- Audrey Guila

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-          When educating a patient who is about to get a UGI tract study, it is important to assess their baseline knowledge first and ask if the patient has any questions and concerns. I would make sure that the patient is alert and oriented, with privacy given. I would ask if they were allergic to anything. Based on their knowledge, then I would go ahead and give them information on how this procedure would go without using any jargon. I would educate them on what the study is about, what to expect, and what to do after the procedure.

-          Pt education:

What is this study about? This study enables and aids the examiner to see if there’s something wrong with the patient’s Upper GI (consists of the esophagus, stomach, and the first part of your small intestine). I would show the patient a picture of the GI anatomy if they don’t know where it is. The examiner will observe the stomach’s motility, thickness of gastric wall, the patency of the pyloric valve and the anatomy of the duodenum by using multiple x-rays.

What to expect?

Pre-procedure: Let the patient know that they will be NPO from midnight before the study. I would advise the patient not to smoke, chew gum, or have mints because these things can stimulate gastric motility. Their medications would be held until the study is done or is individualized based on their needs (example would be insulin). I’d let the patient know that jewelry can interfere with the x-ray and that these would need to be removed.

During the procedure: The patient will be given a contrast agent to ingest (a milkshake-like solution that has an unpleasant chalky taste), and will have x-rays taken. The patient might feel some discomfort and pain experienced during the procedure. This procedure usually takes 30-60 mins.

Post-procedure: The patient can resume usual diet per HCP. I would ask the patient to report symptoms such as fast heart rate, difficulty breathing, skin rash, itching, chest pain or abdominal pain. The patient needs to drink plenty of fluids to flush out the contrast and I’d let the patient know that their stool will be white or light colored for 2-3 days. If the stool doesn’t return to normal color, tell the patient to report to the HCP.

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In order for patient's to learn, nurses needs to provide individualized teaching strategies and evaluation methods whether they're visual learners, auditory learners, or kinesthetic learners. Also, knowing the patient's LOC is important because this shows their readiness to learn about their underlying diagnosis, procedures, or treatment plans. Patient's with peptic ulcer is most commonly caused by  a gram negative bacteria (H. Pylori) where patients experience abdominal pain. When patient's experience pain, I wold tell the patient to avoid, aspirin and other NSAIDS, as well as alcohol because it can stimulate acid secretions. In order to diagnose the patient, a endoscopy is done which is a flexible tube that views the patient's digestive tract and can determine H. Pylori infection.

Pharmacologic Treatment involves the use of antibiotics to eradicate H.pylori and avoid NSAIDS.

Dietary modification involves telling the patient to avoid consuming alcohol, coffee, and other caffeinated beverages because it can stimulate acid secretions. Tell the patient to eat at a regular pace in a relaxed setting.

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Before any education, it's important to assess the patient's cognition level and whether or not their LOC is suitable for teaching. After that I would tell them that they have orders form parenteral nutrition. This is basically total nutrition through an IV line. You will be receiving a mixture containing proteins, cars, fats, electrolytes, vitamins, and water. This is done because you cannot orally ingest food. I will continue to assess the nutrition status, hydration status and electrolytes to see if the patient is absorbing all the nutrients. this is especially important if they have any liver or renal impairment. If the patient has further questions about parenteral nutrition, I might bring in the IV bag and show it to them or maybe show them a video that can explain parenteral nutrition further.

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Obesity & Treatment Options- Alyssa Alvarado

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Obesity & Treatment Options- Alyssa Alvarado

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Levels:

overweight: BMI 25-29.9 kg/m2
Obese: BMI exceeds 30 kg/m2
Morbid obesity: BMI exceeds 40 kg/m2
** significant morbidity and mortality with BMI that exceed 30 kg/m2**

Medical Management:
lifestyle modification-  This is the first step in treatment. The patient is placed on a weight loss diet along with behavioral modification and exercise. However, most adults put on these plans do not adhere to the diet plan.
Pharmacologic- medications such as Orlistant and Alli work to reduce caloric intake by binding to gastric and pancreatic lipase to prevent digestions of fats. The negative side to these medications are increased frequency in bowel movements, gas with oily discharge, decreased bile flow.
Others such as Lorcaserin, stimulate serotonin receptors in the satiety and appetite centers of the hypothalamus in the brain curbing hunger. These have only mild side affects such as headache, dry mouth, and nausea.
Surgical management- Bariatric Surgery is performed only if other nonsurgical methods fail. It works by restricting a patient's ability to eat, interfering with ingested nutrient absorption or by doing both. To be considered for this option an individual must have a BMI of 30 kg/m2.

Postop goals: maintain fluid balance and asepsis, as well as pain. Adhere to detailed diet instructions, which means progression of food intake as well as fluid intake as tolerated.

to relieve pain, put the patient in a low Fowlers position. This promotes emptying of stomach.

encouraged intake of sugar-free oral fluids, since they are not implicated to cause dumping syndrome.

Encourage small sips of 30mL of these fluids every 15 minutes. Have patient stop if they start feeling full or nauseous

nutrition- six small feedings consisting of a total of 600-800 calories per day. Consumption of fluids between meals are encouraged to maintain hydration

Bowel habits- constipation and diarrhea may be caused but can be managed with a nutritious diet high in fiber.

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Performed by Alta Bates Summit Medical Center's Bariatric Surgery Program. The Roux en Y gastric bypass surgery is performed either through an abdominal incision or through laparoscopy (6 small incisions). Your surgeon will decide which approach is appropriate for you. Gastric bypass is major surgery and involves stapling of the stomach, turning it into a small pouch.

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IBS can occur in two forms, constipation or diarrhea. This is a chronic syndrome that commonly causes cramping, abdominal pain, bloating, and gas. Patient's Some risk factors include female sex, stress, eating large meals high in fat, drinking caffeine and/or alcohol. Lab findings normally come out normal, and there are no specific diagnostic tests that can confirm a diagnosis of IBS. If I were to educate a patient on IBS I would first use simple terms to explain to them why their bowels aren't functioning properly. I would communicate with them to see what kinds of things exacerbates their IBS and then I would educate them with verbal and written tools on how to modify their lifestyle to decrease IBS triggers. I would tell them to keep a food diary to become more aware of foods that trigger their IBS. I would also educate them on the benefits of yoga for stress relief and gentle exercise. Many people are not willing to give up alcohol or caffeine, so I would try to get them to decrease their intake at first and then eventually ween themselves off.

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It is an excavation that forms in the mucosal wall of the stomach, pylorus, duodenum or esophagus. It occurs in patients who are 65 and older. Incidence is equivalent in men and women. It is most commonly caused by H. Pylori, which can be acquired through ingestion of food and water. Risk factors include the use of NSAIDs such as ibuprofen and aspirin. Familial tendency can also be a significant pre-disposing factor. Symptoms of an ulcer can last for a few days, weeks, or months and many people have no symptoms. Patients usually a dull, gnawing pain or a burning sensation in the epigastrium or the back. Pain commonly occurs after eating (gastric) or 2-3 hours after eating (duodenal). Diagnosis is made through an endoscopy because it allows direct visualization of ulcers, lesions and inflammation. Antibiotics, proton pump inhibitors and bismuth salts are used to treat this disease, and may be taken for 10-14 days. It is important to inform the patient to follow the medications regimen, especially in regards to the antibiotics. The patient is also advised to avoid NSAIDs. The patient is also informed that histamine-2 blockers are usually recommended for a year. It is important to inform the patient to stop smoking and avoid extremes in temperature in foods and beverages and avoid alcohol, coffee, and other caffeinated beverages, as well as eating three regular meals a day.

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Summer Latif

Known as hiatus, the opening in the diaphragm through which the esophagus passed becomes enlarged, and part of the upper stomach tends to move up into the lower portion of the thorax. This condition occurs more often in women. There are two types: Sliding or type I is account for 90% of the hiatal hernia. It occurs when the upper stomach and the gastroesophageal junction are displaced upward and slide in and out of the thorax. The second type is the paraesophageal hernia, which occurs when all or part of the stomach pushes through the diaphragm beside the esophagus. The nurse needs to educate the patient about his or her condition, provide pictures or videos.

Clinical manifestation: the patient with a sliding hernia may have heartburn, regurgitation, and dysphagia, reflux may occur, but 50% of the patients are asymptomatic. The patient with the paraesophageal hernia usually feels a sense of fullness or chest pain after eating. Hemorrhage, obstruction, and strangulation can occur in both types. The nurse needs to discuss the patient’s symptoms, and provide written materials about all the signs and symptoms that might be expected with having hiatal hernia.

Assessment and diagnostic findings:  The nurse needs to explain the types of studies used to confirm the diagnosis, such as: X-ray study, barium swallow, and chest CT, which are noninvasive.

Management: Patient need to be educated about feeding, having small feedings that can pass easily through the esophagus will reduce the discomfort. The patient is advised not to recline for 1 hour after eating, to prevent reflux or movement of the hernia, and to elevate the head of the bed on 4-8 inches blocks to prevent the hernia from sliding upward.

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It is important to assess if the patient has any knowledge about the diverticulitis when beginning patient education on the disease. I would then assess the patients level of learning as well as deciding with the patient which tools we may use to help them fully understand the condition they have. Some options available are pamphlets, videos, pictures, as well as a verbal explanation. If the patient spoke a different language, I would make sure to use the translation services provided by the facility. I would first explain the disease process in terms that the patient would understand. Diverticulitis is an infection in your colon, or large intestines, that happens when food and bacteria gets stuck in pouches, diverticula, in the colon and they become inflamed. I would then provide the patient with a picture of a healthy colon and a colon affected by diverticulitis. I would then educate the patient on the treatment of diverticulitis depending on which treatments the doctor orders for them. Some treatment regiments that may be ordered are a analgesic medications, antispasmodic agents, and antibiotics for 7 to 10 days. Also, the patient need to be educated on diet. During the diverticulitis attack, the patient most likely will be placed on a clear liquid diet while inflammation subsides, then a high-fiber, low-fat diet will be recommended for the patient. I would give the patient examples of foods to avoid and foods to eat. Patient should consume prepared cereal or soft-cooked vegetables, foods such as corn and nuts should be avoided. I would also inform the patient to watch for rectal bleeding, continued increased pain in the abdomen, or a hard bloated stomach. If they experience any of these to get go to the nearest emergency room. After the teaching I would ask the patient if they had any questions.

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I would first evaluate the patient's knowledge on gastritis. I would also ask them what their preferred method of learning would be (written-pamphlet, verbal- personal explanation, video, or images). If the patient requested a verbal explanation of his condition, I would explain it to him.

Gastritis is an inflammation of gastric or stomach mucosa and it can be categorized depending on how long you've had it (acute or chronic) and how you developed it (non-erosive- infection with H. Pylori; erosive- from diet, medications or radiation therapy). The symptoms are directly related to your irritated GI tract: abdominal discomfort, fatigue, nausea, anorexia, vomiting and hiccupping. Erosive gastritis can cause bleeding in your GI tract and appear as blood in your vomit or as black tarry stools or bright red bloody stools.  You may have decreased vitamin B12 levels or even pernicious anemia. This is because specific stomach cells (parietal cells secreting intrinsic factor) help us absorb this vitamin but are unable to because of the inflammation.

There are three main components that can help alleviate your condition:
1- Diet. Avoid spicy, irritating, highly seasoned foods; avoid caffeine, nicotine, alcohol. We can consult with a dietian.
2- Medications. The doctor may prescribe meds that basically lower acid levels in the GI tract (antacids, H2 Blockers, PPI's). Antibiotics may be prescribed if H. Pylori is present. It's important that you finish the antibiotics if prescribed. Vitamin B12  may be prescribed.
3- Stress may be a causative agent so stress relief is important. We can consult with a therapist to discuss different stress relieving techniques.

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Laparoscopic Resection Surgery: Patient Education - Annie Alward

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Laparoscopic Resection Surgery: Patient Education - Annie Alward

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I was in the OR this past clinical week and observed a laparoscopic low anterior resection, and I wanted to research more about patient education after the resection. Patient education would include letting the patient know that after the surgery, he will be transported to a recovery room and then will wake up from the general anesthesia. He will be connected to IV fluids to replenish his fluid balance and labs will monitor blood levels and labs associated (for example, my patient was older and had been through many surgeries, and the surgeon said he was bleeding a lot more than expected during surgery due to his surgery, so he may need a transfusion or simply have labs monitored and fluids replaced.) Pain would be a priority, and his post-operative pain would be managed by providing pain medication as prescribed PRN. One important note is that pain medications/narcotics can sometimes slow the recovery of the GI tract, but we don’t want him in pain so it is necessary if he reports pain.

Usually the patient is kept on IV fluids at first, and whenever he starts feeling hungry or thirsty he may start on liquids then up to solids if the doctor, dietician, and nurse deem it appropriate. Since the patient may be nauseous after surgery, it is important to teach the patient to track his intake/output during recovery and to slow or stop eating and take breaks if nauseous.  If the patient is unable to understand or comprehend any instructions, or needs assistance, the nurse should also educate the family members who will be caring for the patient at home after discharge. It is also important to teach the patient that his GI may not immediately go back to how it was functioning before surgery, so it is normal and not something to be alarmed about if digestion habits do not go back to normal right away, but also let patients know to let the nurse know so she can document in case it is abnormal. Some patient teaching to speed up the GI healing process are to stay mobile, ambulate, and reduce usage of pain medications if possible as it delays healing.

As for diet, patient teaching includes a low fiber diet, which the nurse explained to me is used because it will reduce his needs to go to the bathroom, and his bowel movements will be reduced size and less often. I asked the nurse why that is necessary, and she said it allows the GI tract to heal a little bit and overactive bowels could cause trauma to the fragile GI tract after surgery.  Some low fiber foods to teach the patient about include canned fruits, fresh fruits that have been peeled and cooked such as mangos, pears, apple butter, eggs, and canned vegetables. Foods to teach the patient to avoid include fresh fruit, nuts, fresh vegetables, whole grains, potatoes. Something I could do as a nurse would be to educate the patient, ask him what type of foods he understands he can and cannot eat, and provide him with an example menu he could make at home (breakfast, snack, lunch, snack, and dinner) and provide it to his family as well. That way he has a resource to follow and may have more compliance with the diet. I would also teach him WHY he needs to follow this diet for up to 6 weeks after surgery or until the doctor clears him to go back to a normal fiber diet, and allow him to ask any questions.

I would also teach and explain to the patient that even after part of his colon is removed, as long as he adheres to the diet and instructions, his bowel function will most likely go back to normal activities and the quality of life before surgery, so that any anxiety or fears about his lifestyle and possible changes can be alleviated. Surgery is already scary and invasive enough so letting the patient ask questions and teaching him about what to expect after surgery and long term is extremely important. However, it is important to teach the patient that while he can return to normal exercise, lifting, running, etc., he should not resume those activities for up to 3 weeks after surgery for his normal activities, and he should definitely avoid any heavy lifting for at least 6 weeks. It is important to teach the patient that while these are recommended, his healing process is unique as is all patients, so it is important to have clearance by the doctor before returning to these activities.

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Jessica Dorthalina

Some patients with chronic IBD can eventually have complications or require a permanent fecal diversion to manage symptoms. The idea of an ileostomy, stoma care, body image changes, and dietary modification may seem daunting. Pre-procedure, it is important to educate the patient on their new bowel diversion, and address any concerns and anxiety they may have.

In the weeks leading up to the ostomy surgery, support groups, educational videos, and nutritional meal plans may benefit the patient in preparing for the surgery.

In educating about post-procedure stoma care, I would first address any questions or worries a patient may have, and determine an optimal time for learning and retaining. I would use both verbal and tactile examples of teaching by going through step-by-step interventions on draining or changing an ostomy appliance, and allowing the patient to demonstrate and hold an ostomy bag to become familiar with one. I would also provide the client with an educational video on stoma care, and take home written information they could store, and look back to as a reference when needed on diet, skin care, or potential complications.

The more the patients are prepared and know about what is happening to their body, the more compliant and less anxious they will be about a procedure. Below is an example of a pre-procedure video I would show on ostomy care, and ensuring the patient they are not alone in having an ostomy!

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This is how I change my ostomy bag. I hope you can find it useful to you.If there is anything else that you would like a video about just leave it in the comment bar down below.

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Ulcerative Colitis (Kaitlyn Hitch):

  

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Ulcerative Colitis (Kaitlyn Hitch):

  

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The first step in the process of patient teaching is assessing the patient and their learning needs, their learning style, and their readiness to learn. Assessment includes finding out what patients already know, what they want and need to learn, what they are capable of learning, and what the best way would be to teach them. With patients who are first diagnosed with ulcerative colitis there are many choices they will need to make. The simple act of eating will no longer be able to be taken for granted, due to the diseases impact on the digestive system. This disorder causes chronic inflammation in the gastrointestinal (GI) tract, the area of the body where digestion and absorption of nutrients take place. To help patients understand the disease process and how to recognize symptoms with certain foods, I would show them animated videos to give them a visual. I would make sure they understood everything by asking them questions. I would explain how the ongoing inflammation leads to symptoms such as abdominal pain and cramping, diarrhea, rectal bleeding, weight loss and fatigue. Also could discuss how ulcerative colitis tends to increase the body’s requirements for calories, nutrients and energy. During disease flares, it may be difficult to maintain adequate nutrition. However, maintaining good nutrition helps improve overall wellness, promotes healing and immunity, increases energy levels and may alleviate some gastrointestinal symptoms. I would also review how it is recommended to be on an elimination diet, since there is no specific diet to ulcerative colitis. The elimination diet is just individualized and is avoiding certain foods that worsen symptoms. I would also recommend eating smaller more frequent meals, eating in a relaxed environment, limiting food with insoluble fiber, and avoiding greasy and fried foods. It is extremely important to stay hydrated, especially during the disease flares when there is a lot of diarrhea. To help the patient understand how to find their trigger foods, I would demonstrate how to keep a food dairy to determine them.

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When teaching a patient about Ulcerative Colitis, I would first assess their LOC as well as their openness and readiness to learn. Once the patient is receptive and ready to know more about their diagnosis, I would encourage them to watch an informational video (in addition to my verbal explanation) in order for them to better visualize what is actually going on. I would first go over the common signs and symptoms of the disorder such as bloody diarrhea, rectal bleeding, abdominal cramping, and pain.  We could discuss the symptoms that the patient is currently experiencing and ways to manage those symptoms. I would explain that ulcerative colitis is a IBD that can cause sores or ulcers in the digestive tract. The innermost lining of the large intestine and the rectum are affected by the disease. Even though there is no cure for ulcerative colitis, treatment plans and regimens have shown to greatly reduce symptoms and manage the disease. The doctor may discuss certain drugs to help reduce symptoms such as anti-inflammatory drugs, immunosuppressants, as well as antibiotics and pain relievers. The doctor may also want to discuss the possibility of surgery. I would encourage the patient to watch a video like the one posted below to help give a visual of what is occurring and improve their understanding.

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Crohn 's Disease Patient Education Video Segment

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Ulcerative colitis - short animation from sixpartswater.org

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Jane Han

I think patients learn best when they are ready to learn. For example, they may be concerned about diet restrictions or possible side effects of a colonoscopy procedure. Inherently, I would first want to discuss the process of the procedure and address diet restriction or side effects afterwards. But I think addressing their concerns first before going over the procedure could better serve patient teaching and learning. A patient’s concern can contribute to feeling anxious. I think that once I address the concerns of the patient, they may be more open to learning. For example, in this scenario, I would first let them know that they will be on a clear liquid diet (fat free broth, vegetable juice, pulp free juice) starting the noon 1 day before, then review possible side effects like bloating and cramping, minor bleeding and unlikely, but possible perforation to the colon wall. Once they indicate that they are ready for further learning, I would then teach them what the procedure is and what to expect during the procedure, the reason for the procedure and what would happen if any abnormalities were indicated. I would share with them colon cleansing procedures like bowel preps and also let them know whether any of their current medications may be held or could still be taken. Mostly, I would assess the patient’s readiness to learn and use verbal communication for patient teaching.

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The first step in patient education is assessing their readiness to learn. As the nurse, I would explain the purpose and procedure to the patient prior to insertion of the tube, in a language the patient can understand. I would verbally inform the patient of activities of the procedure, such as gagging, and promote cooperation during the procedure. Showing the patient the tube and how the insertion will take place by using images may alleviate some anxiety.
Education of post procedure also takes place prior to inserstion, including expected changes in body image and potential complications. Education on self-care management takes place prior to discharge. Education is very important for patients who require long-term tube feedings at home. This education begins while the patient is still in the hospital and it is important to education both the patient and the family. I would provide education while administering tube feedings so they can observe, participate and ask questions. I would provide verbal and written information on equipment needed, how to buy and store formula, and directions for administration including water flushes.
Proving written information to use at home will be very beneficial. It is important as a nurse to make sure the patient and caregiver understand the written information before discharge.

Explaining the procedure using an image like this so the patient can visualize:

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Food is such a huge part of our culture. Thus, when a patient suffering from a disease like IBS or colorectal cancer  must undergo a colectomy (resection of their colon) a question that may come to their mind is “how will this surgery affect my diet and what can I eat after?” In nursing education and nutrition are key. When approaching life after colon resection surgery, it is important to educate patients based off of the stages of their healing colon. Therefore, I would find it important and better understood if the patient received a timeline of their healing process (gauged by days, weeks, or months postop) in correlation with what foods they can expect to eat or avoid. It would be important to verbally explain the information on the timeline, but after the timeline could serve as a little calendar a patient can put on their fridge with for example 1 day postop, their diet, and foods to avoid, then 1 week postop, their diet and foods to avoid, etc.

A possible food timeline post-colectomy (of course it would be displayed in a colorful, easy to understand, fridge-worthy way):

Postop DAY 1-2 - bowels are beginning to heal - NPO until bowel sounds and passing gas

Postop by DAY 3- - bowels can process some liquids - clear liquid diet like juice, clear broth, etc.

Postop DAY 4- advance to full liquids like pudding, smooth soup, etc.

Postop Week 4 or 5  - soft foods are tolerable like mashed potatoes, oatmeal, etc

Postop Week 1 - back to your normal diet, but some foods to avoid that can cause diarrhea and stomach pain include: raw vegetables, dairy, and high-fiber.

Although these food can be gradually brought back into diet if symptoms are not too severe. Small frequent meals decrease symptoms.

Here’s an example of how it could look, mind you this is not for a colectomy..

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The most important aspect when doing patient teaching is checking the level of understanding and education they have. At what level can they read? What was their highest education level? You have to assess if they have prior knowledge of the disease process? The other important thing is to assess what type of learner they are: are they a visual, auditory, or mixed learner? This way you could know what supplemental material you may need. Once this is established it's still important to use relatable terms with your patient and also with educating their family.
Peptic ulcer disease is when the mucous in the wall of the stomach, pylorus, or duodenum causes the wall to break down. This forms a hollow portion in the wall. Ulcers are generally caused by a bacterial infection caused by the bacteria H.pylori, another reason is the use of NSAIDs such as ibuprofen and aspirin. The mucous does this because it either increases its acid production or the mucosa is diminished. The signs and symptoms include: a dull or burning sensation in the area or in the back, especially after eating; heartburn; vomiting; constipation; bleeding; and diarrhea. The best way to diagnose this disease is through an upper endoscopy, which allows the physician to see the area where the ulcer is at. The treatment is by antibiotics.

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The nurse must assess the patient and decide when the patient is ready to be educated about the condition. Whether your patient has Crohn's Disease or Ulcerative Colitis, both conditions are relatively the same when it comes to Nursing Interventions. The nurse assists the patient in determining what correlation their symptoms have with certain foods, activities, or emotional stress and how those correlations may be managed. Fluid intake and nutrition are also very important in patients with IBD. Patients with IBD tend to have fluid volume deficit due to diarrhea, so it is the nurses responsibility to measures I&O, daily weight, skin turgor, oliguria, fatigue, decreased temperature, increased hematocrit, and hypotension. In this situation, the nurse encourages oral intake and monitors IV flow rate to make sure the patient is receiving enough fluids. For those patients with severe malnutrition, parenteral nutrition or enteral nutrition may be necessary at first. The patient should gain 0.5 kg during parenteral nutrition. Once food is tolerable to the patient, small, frequent meals high in protein and low residue should be consumed to prevent overdistention of the stomach.

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Patients learn in a variety of ways. There are visual learners, auditory learners, and kinesthetic learners. It's really important for nurse to assess how their patients will best learn information and to individualize their education. Before patient teaching, a nurse should assess if the patient is ready to learn new information. Are they in pain? What is their level of consciousness? Are they nauseous?  Are they anxious? Do they want other members of their family present for education?  Any of these factors  can make it overwhelming for a patient to absorb new information. Many materials can be provided during the teaching session, whether they be handouts, videos, diagrams, or verbal. Offering more than one of these during patient teaching will probably be very beneficial for the patient.

Inflammatory bowel disease (IBD) includes Crohn's disease and ulcerative colitis, and it's incidence has been rising over the past years. When nonsurgical methods fail to treat this condition, surgery may  be the answer. Often patients end up with an ileostomy, which is when an opening is made surgically in the small intestine and it is attached to the abdominal wall creating a stoma. Fecal matter from the small intestine drains through the stoma to the outside of the body, usually collecting in a pouch. Ileostomies can be permanent or temporary. Preoperative education to patients in the hospital is really important for this procedure. Some patients will have little knowledge about this procedure and may be very anxious about how they will live life with this change. Education can be really helpful in calming their anxiety and even helping them accept this body change. It's especially important to provide education beforehand on how to care for their ileostomy and how to change the pouches. This teaching must also be reinforced before they go home. I think with this education, the involvement of a WOC nurse and videos can be very helpful. I have attached a video from a series of videos about ileostomies for patients and their families.

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Stomawise Basic & Quick Bag Change for Ileostomy and Colostomy

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Welcome to the American College of Surgeons (ACS) Ostomy Home Skills Program. You and your family are important members of the surgical team. Watching these video chapters should help you understand how to care for yourself or family member after your operation.

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There are variations of teaching methods that are appropriate per patient's level of understanding. Whether it be paperwork with concise information of the disease process (where the patient can look back at) or a video that visually shows what happens to the specific organ involved. Asking the patient what works best for them in understanding the material better is an approach I would take. Assessing the patient's baseline knowledge of their disease is important. Diet modification can be a significant preventive measure or treatment for acute gastritis. Initially, I'd ask the patient what type of foods they eat on a daily basis. Then I'd educate the patient on what foods that irritate the stomach and can lead to gastritis such as, spicy, irritating, seasoned foods, juices that contain citric acid; caffeine, nicotine, and alcohol (Hinkle and Cheever, 2014, p. 1265). For example, daily consumption of hot cheetos, strawberry lemonade, and intake of excedrin can result in irritation of the stomach lining and inflammation. Inflammation of the lining results in abdominal discomfort, indigestion, nausea, vomiting, hiccuping, anorexia, and headache (Hinkle and Cheever, 2014, p. 1262).  I'd also account for any cultural aspects of food preferences for the patient to assure that total elimination of certain foods doesn't affect their cultural background. Not only do foods cause gastritis, but long-term use of NSAIDS is also a significant cause of gastritis. Introducing alternative methods to treat pain can help in preventing further incidences or exacerbation of gastritis. I'd ask the patient to record a daily diary of their food intake to keep track of possible foods that are contributing to their diagnosis of gastritis. Depending on how they learn best, I'd also provide them a list of what to avoid and show them the video below to help them better absorb their condition.
If the patient needs further information, I'd gather different resources on the disease to assure they have a clear understanding.

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Alimentos Prohibidos Para La Gastritis | Alimentos Malos Para La Gastritis

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La Sabila Es Buena Para La Gastritis | Como Preparar La Sabila Para La Gastritis

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Treat Gatritis | Foods & Healthy Recipes

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Gastritis is an inflammation of the lining of the stomach. It can have a number of causes, but most are lifestyle excesses-smoking, too much alcohol, too much caffeine, and overeating. This video explores the many causes of gastritis, recommended treatments, and preventive steps. One Of Patient, Doctor and Society (PDS) videos..!

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Timing is key to patient education. Choosing a time that is best for the patient involves a few assessments. If the patient is experiencing pain, this is most likely not a good time to provide education. Starting the education in the preoperative phase may also help the patient have a clear understanding why a procedure may be needed and the importance of postoperative care. The nurse needs to know how the patient learns best. Do they like pictures, videos, written instructions? Would they like multiple sessions of teaching? What's they're literacy like? Will they need a translator? Would including the family help adherence? These are questions we need to ask ourselves and the patient before giving education.
Many diagnosis are life changing. Life modifications may need to be made and can be difficult for some to adjust to. Irritable Bowel Syndrome is a chronic functional bowel disorder that affects frequency and consistency of defecation (Hinkle and Cheever, 2014, p. 1292). There are various factors can be associated with the syndrome such as heredity, stress, diet, alcohol, and smoking. I want to educate my patient on the diet modifications they would need to implement as well as how to identify which foods are irritating. Restricting possible irritants and then gradual reintroduction may help decipher which foods are irritating. Keeping a food- symptom diary may help identify triggers. Some diet modifications include a high-fiber diet, increased fluid intake but not with meals, and discouraging alcohol and smoking.

If my patient liked the use of videos in the learning, attached is a video discussing the pathophysiology, symptoms, and management of the disease the extends beyond diet modifications including medications and stress reduction techniques.

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A patients ability to learn varies with each person. I would assess their literacy, LOC, pain, and any caregivers or family that would need to be included in the conversation. I would also determine which language they best understand, in situations if the patient were bi-lingual. I would like to discuss how i would educate a patient with a new diagnosis of GERD. I would first question my patient about what they already know about GERD. And explain further about what they didnt or did already know. GERD stands for gastroesophageal reflux disorder. It is a common reflux disorder that could be caused by many factors that cause stomach acids to reflux back up into your esophagus (throat). Symptoms of GERD are pyrosis (burning in the esophagus), dypepsia (indigestion), regurgitation, painful swallowing, and esophagitis (inflammation in the throat). We will need to do an endoscopy or barium swallow to see if there is any abnormalities or damage to the esophagus. To manage symptoms of your GERD, you will need to avoid caffeine, tobacco, beer, milk, and carbonated beverages. Also, not to eat or drink 2 hours before bedtime, and to elevate the upper body with pillows while you sleep. Some medications that will help the symptoms of GERD include pepcid, proton pump inhibitors, and any over-the-counter antacids (Hinkle & Cheever, 2014, P. 1253). It is very important to control symptoms and reflux of GERD because it could manifest into disorders called Barretts Esophagus or even cancer of the esophagus.

Here is a one minute video describing GERD. You will also be given written information about GERD and which foods to avoid and what mediations that may help relieve symptoms of GERD.

I would answer any questions/concerns if they had any.

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Video Journal and Encyclopedia of GI Endoscopy

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Los Angeles Classification of Gastroesophageal Reflux Disease

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Gastrointestinal Reflux Disease - What Is GERD - Treating GERD

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Gastrointestinal Reflux Disease - What Is GERD - Treating GERD Visit http://www.gastrolondon.co.uk/ for more information

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Every patient learns differently and there are many factors that affect this. Depending on the patient's condition some may be more alert than others so it is important to assess not only their LOC but also their preferred way of learning. I want to discuss how I would educate a patient with a new Dx of Achalasia. Achalasia is a rare disorder of the esophagus (ch. 46 p. 1250) where there is ineffective peristalsis along with the inability of the lower esophageal sphincter to relax when swallowing. This causes a backup of food that does not pass into the stomach. Since most patients seek treatment on their own, it is usually not an emergent procedure. This being said they are alert and ready to learn about their disease. I would first use a video or a picture and explain to them how the normal swallowing process works. This is very important for them to understand so that they can see how their condition differs from normal. Next I would explain exactly how their disease differs and show them an educational video so that they can get a better grasp of the disorder. Lastly I would answer any questions/concerns they have and prepare them for surgery.

This video discusses the normal swallowing process, how it differs in patients with achalasia and also discusses the different diagnostic procedures that are performed.

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In this episode, Dr. Adriana Lazarescu discusses swallowing mechanisms and esophageal motility disorders with an emphasis on the diagnosis of achalasia.