1. Chapter 8
Nasogastric
Aspartate Transaminase
Peptic Ulcer Disease
Gastroesophageal Reflux Disease
Lauran DeCeault

2. Nasogastric


Nasogastric is a general
term that means pertaining
to the nasal cavity and
stomach.
The term is often used to
describe medical
processes:


nasogastric intubation
nasogastric aspiration

3. Nasogastric Intubation

Involves the insertion of a plastic tube
(nasogastric tube) through the nose and into the
stomach, passing through the throat.

4. Nasogastric Intubation


Once the tube is inserted, a healthcare
provider can deliver food or medication
directly to the stomach or retrieve substances.
Most often, nasogastric intubation is used
when an individual person is unable to eat or
swallow on his/her own.

The patient can still digest food on his/her own,
but cannot eat or swallow independently.

5. Nasogastric Aspiration



Refers to the process of removing substances from the stomach
via nasogastric tube.
 Used in patients with gastrointestinal obstructions (gastric
secretions and swallowed air)
The process is also used when an individual may have overdosed on a medication or swallowed a harmful substance.
 Used in patients who have swallowed poisonous substances
NG intubation is a helpful method to determine how the
gastrointestinal tract is functioning as it can be used to remove
contents of the stomach for examination

6. Aspartate transaminase (AST)

An enzyme that is found in red blood cells,
the liver, heart, muscle tissue, pancreas, and
kidneys.

7. AST


Commonly used as a marker for liver health, but also
is found in other organs
The blood usually has low levels of AST, but when a
tissue or organ is damaged, more AST is released in
the bloodstream.

The amount of AST measured in the bloodstream is directly
related to the severity of tissue or organ damage.

Elevated levels of AST may indicate:

Acute pancreatitis

Acute hemolytic anemia

Acute renal disease

Musculoskeletal disease

Mononucleosis

Heart attack/heart failure

Hepatitis or cirrhosis

8. AST: Liver Function Test

Commonly measured (via blood draw) as a
part of a diagnostic liver test:

9. Peptic Ulcer Disease



disease characterized
by sores or ulcers
lining the stomach or
duodenum
no known cause
results when there is
an imbalance
between digestive
fluids in the stomach
and the duodenum

10. Causes of Peptic Ulcer Disease

The lining of the stomach and small intestine stops
protecting the stomach from the irritating acids that
are naturally produced by the stomach.



Stomach lining becomes inflamed, producing an ulcer
Most occur in the first lining of the stomach
Perforation:

Ulcers that protrude the stomach or duodenum


Medical Emergency
Bacteria called Helicobacter pylori (H.pylori) is
known to cause painful ulcers

11. Peptic Ulcer Disease

12. Risk of Peptic Ulcer Disease





Alcoholics
Those who use aspirin, ibuprofen, naproxen
or anti-inflammatory drugs regularly
Smokers and tobacco users
Those undergoing radiation
Possibly stress

13. Symptoms of Peptic Ulcer Disease


Smaller ulcers may be asymptomatic
Symptoms of Peptic Ulcer Disease include:





Abdominal pain
Chest pain
Fatigue
Vomiting
Weight loss

14. Diagnosis & Treatment
of Peptic Ulcer Disease

Tests include:

Esophagogastroduodenoscopy (EGD
or upper endoscopy)



For viewing the stomach and
duodenum
Upper GI X-Rays
Medications to kill the H. pylori
bacteria (if present) and decrease
stomach acid

Misoprostol


For those taking anti-inflammatory
medications on a regular basis
sucralfate

Protects the lining of the stomach

15. Gastroesophageal Reflux Disease
(GERD)


Chronic digestive disease
Occurs when stomach acid or bile flows back into
your esophagus


The acid irritates the lining of esophagus
Caused by permanent or temporary changes to the
barrier that protects the esophagus from the stomach


the lower esophageal sphincter relaxes
Hiatal hernia

16. GERD

17. Symptoms of GERD








Sore throat
Pain in the chest or upper part of the abdomen.
Difficulty swallowing
Wheezing
Dry cough/trouble breathing
Nausea
Vomiting
Burning sensation in chest and throat

18. GERD Risk Factors


Affects 10-20% of those living in the Western world.
Other contributions to GERD:



Obesity
Pregnancy
Certain medications





anti-depressants
Asthma medications
Pain killers
Sedatives
Smoking

19. Treatment of GERD

Lifestyle change

Avoid certain foods and beverages:










Avoid over-eating
Avoid laying down after eating
Lose weight if needed
Quit smoking
Medications






Chocolate
Coffee
Spicy foods
Tomato
Alcohol
Antacids
H2 blockers
PPIs
Prokinetics
Antibiotics
Surgery

20. Bibliography

Fregman, B and Frucht S. “Chapter 8. Digestive System.” Medical Terminology: A Living Language (5th edition). 2005.

Medicine.Net. Gastroesophageal Reflux Disease
(GERD, Acid Reflux, Heartburn). http://www.medicinenet.com/gastroesophageal_reflux_disease_gerd/article.htm#gerd_facts. 15 October
2013.

Medline Plus. Nasogastric feeding tube. http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000182.htm. 14 October 2013.

Medline Plus. Peptic Ulcer. http://www.nlm.nih.gov/medlineplus/ency/article/000206.htm. 15 October 2013.

Paulev-Zubieta. Chapter 22: Gastrointestinal Function and Disorders. New Human Physiology.
http://www.zuniv.net/physiology/book/chapter22.html. 15 October 2013.

Shlamovitz et al. Nasogastric Tube. http://emedicine.medscape.com/article/80925-overview. 14 October 2013.

U.S. Department of health and Human Services. National Digestive Diseases
Information Clearinghouse (NDDIC). http://digestive.niddk.nih.gov/ddiseases/pubs/gerd/#GERD. 14 October 2013.

Wise Geek. The Digestive System. www.wisegeek.com/how-does-the-digestive-system-work.htm. 14 October 2013

Web MD. Digestive Disorders Health Center- Aspartate Aminotransferase (AST). http://www.webmd.com/digestive-disorders/aspartateaminotransferase-ast. 14 October 2013