Disorders of the Gastrointestinal System, 2nd Edition
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Esophageal fistula formation Tissue breakdown from radiation may cause an opening between the esopha- gus and adjacent areas, allowing GI con- tents to leak from the opening and poten- tially leading to infection or serious injury. For example, a fistula to the lung may allow GI contents to move into the lung and may be fatal (Majid & Kheir, 2021). CASE STUDY 2: PART 2 Lee underwent radiation and chemother- apy for his esophageal cancer. Howev- er, he reports that he has been having increasing difficulty swallowing since his treatments began. The nurse suspects he has developed esophageal strictures related to his radiation therapy. This will likely require multiple dilations. After the nurse confirmed this with Lee’s provider, she explained the process and provided emotional support for him. Question Lee was speaking with the nurse about the esophageal dilation after she explained the process to him. What statement about esophageal dilation indicates he needs more education? a. The healthcare provider may perform esophageal dilation with sedation and upper endoscopy. b. During the procedure, he might experience mild pressure in the back of the throat or chest. c. The dilator will cut off his airway during the procedure. d. He might experience a mild sore throat for the remainder of the day after the procedure. Answer/Rationale: The correct answer is c. The endoscope does not interfere with breathing.
| HEALTHCARE CONSIDERATION
Patients undergoing radiation ther- apy should ask their provider about appropriate lotions or salves for radi- ation irritation or burns. These areas are highly susceptible to infection and additional irritation from additives. Numerous salves, lotions, and dress- ings are available; however, there is no superior treatment from these cat- egories (Yang et al., 2020). As postoperative and radiation pa- tients begin to tolerate advances in diet, it is critical to observe for aspira- tion or sudden changes in pain level. Each step in changing the diet should be started with small amounts at inter- vals as tolerated and always with the head of the bed elevated (Raymond, 2021). Patients and families often need sig- nificant emotional support as well as assistance with the patients’ physical needs. The prognosis for esophageal cancers is generally not good, and as the disease progresses, information about home health assistance, pal- liative care, and/or hospice may be needed. Organizations that may help include The American Cancer Society (http://www.cancer.org; 1-800-227- 2345) and the Esophageal Cancer Awareness Association (http://www. ecaware.org; 1-800-601-0613).
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