Nutritional Sciences case study Courtney H. Oliphont (CHO) is a 38 year-old fema
ID: 51181 • Letter: N
Question
Nutritional Sciences case study
Courtney H. Oliphont (CHO) is a 38 year-old female who works at Stillwater Medical Center as a nurse in the critical care unit during the overnight shift. She is mildly obese with a relatively large abdominal fat pad. Recently, she started to experience dull aching substernal pain. The pain mainly appeared only after eating and was intermittent. CHO explained that there are times where the pain is relatively transient and other times where the pain is intense and lasts for up to an hour or more. When questioned further about her symptoms and her dietary intake, she stated that the pain is often associated with belching and considerably worse when she laid down on the sofa to watch Netflix or after eating meals high in meat protein and fats. Indeed, there are times where the pain is so intense that it radiated to the back, jaws, shoulders, and down the inner aspect of her arms. CHO lost her father to a fatal myocardial infarction when her father was only 48 years old. As a result, she is very concerned that his pain is indicative of cardiovascular disease and an impending cardiac event. Unlike the typical middle-aged male, she decided to schedule an appointment with his family physician. After interviewing this patient, the physician ordered several tests including an electrocardiogram that was completely normal. Radiographic studies of her esophagus and stomach revealed a small portion of the stomach "above the diaphragm". An endoscopic biopsy revealed the presence of mucosal erythema and inflammation. Further esophageal manometric studies indicated that the lower esophageal sphincter pressure was severely reduced. Esophageal pH monitoring showed lowered pH measurements, especially in the distal portion of the esophagus. Based on this case study, your textbooks and other outside sources, answer the following questions.Explanation / Answer
1. From the case study given above, CHO most likely suffers from Gastroesophageal Reflux Disease (GERD). There are a lot of evidences supportig this fact. CHO has pain when she eats food rich in meat proteins and fats. These are rich in proteins and also contain arachidonic acid that are a major cause of inflammation. The endoscopic biopsy revealed inflammation. She has a chest pain which is not associated with any heart disease which might be due to heartburn caused by defective functioning of esophageal spinchter. Esophageal pH showed lower pH measurements which are indicative of the fact that the food comes back into the esophagus as the spinchter is unable to restrict the highly acidic environment to the stomach.
2. CHO experienced pain when lying down because the food mixed with highly acidic digestive juice came back to the esophagus causing substernal pain or heartburn. This happened because the spinchter has become defective and is unable to perform its function properly. Normally the esophagus is separated from the stomach by an esophageal spinchter. Here the spinchter caeses to work properly.
3. First thing would be avoiding consumption of food which are acidic in nature such as citrus fruits. Secondly, such food should be avoied which relax the esophageal spinchter like coffee, peppermint etc. Lastly, drinking alcohol should be avoided as it tends to loosen the esophageal spinchter.
Related Questions
Navigate
Integrity-first tutoring: explanations and feedback only — we do not complete graded work. Learn more.