Mr. Jackson comes to the hospital for an esophagogastro duodenoscopy. He is havi

Question

Mr. Jackson comes to the hospital for an esophagogastro duodenoscopy. He is having several symptoms that indicate a potential gastrointestinal condition. As a result, he is admitted in observation. His symptoms include vomiting, weight loss, and dysphagia. The esophagogastroduodenoscopy reveals that the patient has GERD. In addition to GERD, he also has chondromalacia patella, polymyalgia rheumatica, an old bucket handle tear of the medial meniscus, and hypertrophy of the nasal turbinates. The patient takes ibuprofen for periodic pain in the knee, and avoids strenuous exercise. Based on the results of the detailed history, detailed examination, and low complexity medical decision making performed in observation, the remaining conditions were deemed to be well controlled, and it was decided that the patient could be discharged from observation on the same day with instructions to take an over-the-counter antacid and to return to the hospital if his condition doesn’t resolve within one week

Explanation / Answer

Esophagogastro duodenoscopy is a test used to examine the lining of esophagus, mouth and the upper part of the small intestine. This procedure uses endoscope which is a flexible tube and has light and camera at its end. This tube is inserted through the throat of the patient. This test is usually recommended when you have severe chronic heartburn, difficulty in swelling food, tarry stool, unexplained weight loss or anemia, persistent nausea or vomiting, abdominal pain in upper part. As Mr Jackson when tested with Esophagogastro duodenoscopy he is diagnosed with potential gastrointestinal conditions. His symptoms were weight loss, vomiting and dysphagia which means difficulty in swallowing food. Also the test revealed that the patient has GERD ( gastroesophagal reflux disease). This is a digestive disorder in which the acid of stomach flows back into the esophagus. The symptoms of GERD are hurt burn, pain in chest, vomitting, breathing problems, wearing away of teeth.

Besides that the doctor notices that the patient is also suffering from Chondromalacia patella. This is the condition in which the cartilage on the undersurface of kneecap deteriorates and softens. This condition is quite common in young athletes but can be in older people having knee arthritis. Besides that patient has polymyalgia rheumatica a disorder in which there is stiffness and pain muscles of shoulders and is a common symptom in the older people above age 65. Also the patient has symptoms of old bucket handle tear of meniscus, a disorder in which there is complete tear of the support of the meniscus (a cartilage in the knee joint) and the patient is unable to fully straighten the knee. The patient has also symptoms of hypertrophy of the nasal turbinates in which a chronic allergy cause the nasal congestion and blockage of nasal airway passage.

For the treatment of nasal turbinates the treatment of the allergies can minimize the swelling of turbinates( curled bony structures of the nose that leads into the nasal passage. Also nasal steroid sprays can be used which reduces the inflammation of the turbinates and helps in overcome breathing problems. If these are not effective surgical methods to reduce turbinate can be used. For the treatment of old bucket handle tear of meniscus arthroscopic knee surgery can be used so that knee can be bend and straighten properly. For the treatment of chondromalacia patella rest as well as ibuprofen is recommended by the doctors to prevent inflammation around the joints. If inflammation persists then non strenuous exercises like swimming, standing bike riding is recommended. If it does not help then arthroscopic surgery is recommended. For the treatment of polymyalagia rheumatica corticosteroids is recommended. For the treatment of GERD antacids are usually given and also changes in lifestyle like quitting smoking, drinking alcohol or caffeine, losing weight, avoiding spicy or fatty foods can help.

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