Disorders of the Gastrointestinal System, 2nd Edition
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cause can be corrected (Devuni & Birk, 2020). Treatment includes removing the iden- tified cause, controlling GERD, treating infections, and relieving pain. If noninva- sive approaches are unsuccessful, a fun- doplication surgery can be performed (Devuni & Birk, 2020). | NURSING ALERT Esophagitis can cause patients to have dysphagia, difficulty breathing, and an increased risk of choking and airway blockages due to the forma- tion of strictures (Antunes & Sharma, 2022). Dysphagia can be so severe that some or all of the patient’s regular medications may need to be stopped or administered by routes other than oral. Nurses should be aware that oth- er conditions may temporarily wors- en if this occurs. The patient’s airway should be assessed regularly. Esophageal varices This condition, which leads to dilated veins within the esophagus, is caused by portal hypertension, most often due to liver cirrhosis. About 30% of those diag- nosed with cirrhosis have existing varices already but at ten years postdiagnosis, that climbs to 90% (Meseeha & Attia, 2022). Esophageal varices can be deadly. When one of these dilated veins ruptures, it can cause rapid and heavy bleeding, leading to hypovolemic shock and death. The risk of developing varices and subse- quent rupture increases with the severi- ty of the liver disease (Meseeha & Attia, 2022).
Figure 5. Esophageal Varices
Note . Samir. (2006). Esophageal Varices. https://commons. wikimedia.org/wiki/File:Esophageal_varices_-_wale.jpg#/ media/File:Esophageal_varices_-_wale.jpg. In the public domain. Endoscopy (esophagogastroduode- noscopy or EGD) is used to diagnose the varices. If varices are identified, variceal band ligation is often performed. This procedure involves placing elastic bands at the ends of the identified varices, ef - fectively cutting off the blood flow to the weakened area and preventing bleeding (Meseeha & Attia, 2022). Additional management includes treat- ment of the underlying liver disease or condition, treatment and prevention of secondary infection, hemodynamic resus- citation if bleeding has already occurred, and medications and procedures to low- er portal vein pressure (Meseeha & Attia, 2019).
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