Gastroesophageal eflux Disease (GED)
Etiology

Gastroesophageal reflux disease (GED) can be caused by a number of different medical conditions. People suffering from obesity are more likely to develop GED, and given the obesity epidemic in the United States and other western countries this explains why the prevalence of GED approaches 20% in these countries. Pregnant women, smokers, diabetics, asthmatics, and anyone who suffers from slow digesting also have an increased risk of developing this disease.

Some people may suffer from genetic or medical conditions that predispose them to developing GED. A hiatal hernia results when the upper portion of the stomach pushes up into the tube that connects the mouth to the stomach, the esophagus, and if the hernia is severe enough then GED may develop. Schleroderma is a rare, progressive disease that causes the skin and other connective tissues to harden, which may interfere with the proper functioning of the diaphragm that…...

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References

Lacy, Brian E., Weiser, Kirsten, Chertoff, Jocelyn, Fass, Ronnie, Pandolfino, John E., Richter, Joel E. et al. (2010). The diagnosis of gastroesophageal reflux disease. American Journal of Medicine, 123, 583-592.

Mayo Clinic Staff. (2011). GERD. MayoClinic.com. Retrieved 29 Mar. 2011 from  http://www.mayoclinic.com/health/gerd/DS00967 .

GERD

Chronic Health: Comprehensive Case Study Part A
Setting: Skilled nursing facility. The facility largely offers residential care for senior citizens – mostly from the age of 65 and above.
The patient is a 72-year-old Caucasian male who has been undergoing rehabilitation treatment, specifically orthopedic physical therapy, deemed necessary from a medical point of view.
Clinical information:
Chief complaint: Client complains of abdominal pain and “heartburn.”
HPI: Patient points out that he has been experiencing serious pain (described as burning) in his abdomen for the last 2 days. Pain originates from the midepigastric area. At its worst, the patient gives an 8/10 rating to the pain. The patient points out that he has been having similar pain – which comes and goes - over the last 3 weeks. Discomfort mainly experienced in night-time and after ingesting spicy foods. The patient denies vomiting, and also denies having suffered any kind of trauma in the recent past. The patient…...

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References

Chait, M. (2010). Gastroesophageal reflux disease: Important considerations for the older patients. World J Gastrointest Endosc., 2(16), 388-396.

Jeffrey, Q. & Timothy, M. (2018). In adult patients with GERD, do histamine (H2) blockers reduce symptoms and improve quality of life? Evidence-Based Practice, 21(1), 11-18.

Sandhu, D.S. & Fass, R. (2017). Current Trends in the Management of Gastroesophageal Reflux Disease. Gut Liver, 12(1), 7-16.

Wang, Y., Hsu, W., Wang, S.S., Lu, C., Kuo, F., Su, Y., …Kuo, C. (2013). Current Pharmacological Management of Gastroesophageal Reflux Disease. Gastroenterology Research Practice, 4(1), 73-79.

Essay Topic Examples
1. The athophysiology of GERD: Understanding the Mechanisms Behind Acid Reflux
    This essay would delve into the complexities of gastrointestinal physiology, discussing how and why gastroesophageal reflux occurs, including factors like lower esophageal sphincter (LES) dysfunction, hiatal hernia, esophageal motility, and gastric emptying.

2. Lifestyle and Dietary Influences on GERD: An Analysis of revention and Management Strategies
    This topic would explore how lifestyle choices, dietary habits, and obesity impact the incidence and severity of GERD, as well as examining the effectiveness of non-pharmacological interventions such as diet modification, weight management, and the cessation of smoking and alcohol consumption.

3. GERD Medications: A Comparative Review of Treatment Options
    An essay on this topic would involve a detailed comparison of various medications used to treat GERD, such as antacids, H2 blockers, proton pump inhibitors, and prokinetics, including their mechanisms of action, efficacy, side effects, and potential risks.

4. Complications and Extra-esophageal Manifestations of GERD
    This essay would…...

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Primary Sources

Vakil, N., van Zanten, S. V., Kahrilas, P., Dent, J., & Jones, R. \"The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus.\" The American journal of gastroenterology 101.8 (2006): 1900-1920.

Kahrilas, Peter J. \"Gastroesophageal Reflux Disease.\" NEJM, New England Journal of Medicine 359.16 (2008): 1700-1707.

El-Serag, Hashem B., Jennifer R. Sweet, Leila J. Winchester, and Jennifer T. Dent. \"Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review.\" Gut 63.6 (2014): 871-880.

Richter, Joel E., and Donald O. Castell. \"Gastroesophageal Reflux Disease in the Older Patient: Presentation, Treatment, and Complications.\" The American Geriatrics Society 49.2 (2001): 153-162.

Pandolfino, John E., and Peter J. Kahrilas. \"Presentation and Diagnosis of Gastroesophageal Reflux Disease.\" Gastroenterology 149.1 (2015): 6-13.e1.

SOAP NotePatient Initials: S.P. Age: 42 Gender: FemaleSUBJECTIVE DATAChief Complaint (CC): \\\"I\\\'ve been having stomach discomfort and problems for the past few weeks.\\\"History of Present Illness (HPI): 42-year-old Caucasian female presents with complaints of stomach discomfort for the last 3-4 weeks.Location: Upper abdominal regionQuality: Burning sensationQuantity or severity: Moderate to severeTiming: Began gradually about 3-4 weeks ago and has been persistent since thenSetting: Symptoms worsen post mealsFactors: Spicy foods seem to exacerbate discomfort, no relief noted with over-the-counter antacidsAssociated manifestations: eports occasional nausea, bloating, and belchingMedications: OTC antacids as neededAllergies: No known drug allergiesPast Medical History (PMH): Hypertension, Childhood MeaslesPast Surgical History (PSH): Tonsillectomy at age 7Sexual/eproductive History: G2P2, Menarche at age 12, regular menstrual cycles, uses birth control pillsPersonal/Social History: Non-smoker, occasional alcohol use (1-2 glasses of wine/week), no illicit drug use. Works as an accountant, mostly sedentary lifestyle.Immunization History: Flu shot last year, Tdap 10 years agoSignificant Family…...

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ReferencesAlzahrani, M. A., Alfageeh, K., Thabet, T., Ali, N., Alnahdi, N., Mohammed, M., ... & Alsamghan, A. S. (2020) Assessment of Health-Related Knowledge and Practices among Patients with Peptic Ulcer. Middle East Journal of Family Medicine, 7(10), 33.Georgopoulos, S., & Papastergiou, V. (2021). An update on current and advancing pharmacotherapy options for the treatment of H. pylori infection. Expert Opinion on Pharmacotherapy, 22(6), 729-741.Goud, E. S. S., Kannan, R., Rao, U. K., Joshua, E., Tavaraja, R., & Jain, Y. (2019). Identification of Helicobacter pylori in saliva of patients with and without gastritis by polymerase chain reaction. Journal of pharmacy & bioallied sciences, 11(Suppl 3), S523.Hall, S. N., & Appelman, H. D. (2019). Autoimmune gastritis. Archives of pathology & laboratory medicine, 143(11), 1327-1331.Liguori, G., & American College of Sports Medicine. (2020). ACSM\\\\\\\\\\\\\\\'s guidelines for exercise testing and prescription. Lippincott Williams & Wilkins.Shah, S. C., Piazuelo, M. B., Kuipers, E. J., & Li, D. (2021). AGA clinical practice update on the diagnosis and management of atrophic gastritis: expert review. Gastroenterology, 161(4), 1325-1332.Wilkinson, J. M., Cozine, E. W., & Loftus, C. G. (2019). Gas, bloating, and belching: approach to evaluation and management. American family physician, 99(5), 301-309.

The digestive fluids that are secreted by the stomach glands aimed at breaking down solid food and to kill bacteria in the stomach are referred to as gastric juices. Gastric acid is produced by the gastric parietal cell located on the walls of the stomach. The region where the gastric juices are secreted into the lumen is the most acidic environment in the human body and is known as the secretory canaliculus (Schubert & Peura, 2008). The secretion of the gastric acid into the lumen occurs in response to a variety of messages from the paracrine, hormonal, and neurocrine inputs. Gastrin, produced by the G cells that are located in the pyloric mucosa of the stomach is the primary hormonal stimulation for gastric acid production. There are various inputs that will stimulate the parietal cells in order for them to secrete hydrogen ions that will flow into the gastric lumen,…...

It is clear that the Roman and Jewish authorities were concerned about the development of the early church. Craig points out that, had the tomb been occupied, it would have been an easy matter for those authorities to indicate Jesus' dead body as a means of disproving the notion that he resurrected. However, there is no evidence to suggest that they did so.
In his second rebuttal, Ludemann reiterates his disbelief that a supernatural resurrection could have occurred. Then, he goes on to say that he will offer an alternative explanation for the events. He believes that Paul's experience with Jesus, which Ludemann has previously explained away as a vision, does capture the nature of all of the disciples' experience with a post-mortem Jesus. He also reiterates the point that the Gospels are not reliable as a historical source given how far removed they were from the events in question.…...

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Works Cited

Copan, Paul and Ronald K. Tacelli (eds). Jesus Resurrection Fact or Figment: A Debate between William Lane Craig and Gerd Ludemann. Downers Grove, IL: Intervarsity Press, 2000.

Jesus
Gerd Theissen and Annette Merz bridge a gap between trade book and scholarly discourse with their 642-page tome The Historical Jesus: A Comprehensive Guide. This joint effort by Theissen and Merz explores the subject matter of the historical Jesus in light of primary sources, especially relying on the Gospels, both canonical and apocryphal. The book is divided into four main sections, in addition to a meaty Introduction, a "Retrospect" called "A Short Life of Jesus," and two helpful indexes, one of Biblical...

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Works Cited

Theissen, Gerd, and Merz, Annette. The Historical Jesus: A Comprehensive Guide. Minneapolis: Fortress, 1998.

Psychology of Multiculturalism: Identity, Gender, And the Recognition of Minority Rights
This paper looks at the issue of multiculturalism, its development, its use by society and the ways in which the field of psychology have reacted towards, and used, multiculturalism. Firstly, a brief history of the meaning of multiculturalism will be entered in to, next a brief discussion of the work of five authors (in particular Kymlicka, Taylor and Gerd) who have been influential in the development of research about multiculturalism will be presented, and then the psychology of multiculturalism will be discussed, from the viewpoint of how multiculturalism has been embraced by psychologists.

What exactly is multiculturalism? Everyone has a different idea of the meaning of this word in their minds, and consequently many different meanings of multiculturalism float around in the literature and in popular speak. Multiculturalism has gained particular significance in the United States, where there have been…...

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Bibliography

Gerd, B. (1999). The Multicultural Riddle: Rethinking National, Ethnic, and Reliogious Identities (Zones of Religion). Routledge.

Gordon, W and Newfield, W. (2000). Mapping Multiculturalism.

Kymlicka, Will. (1995). Multicultural Citizenship: A Liberal Theory of Minority Rights. Oxford University Press.

Kymlicka, W. And Norman, W. (2000). Citizenship in Diverse Societies. Oxford University Press.

For a fifty-seven-year-old man with a fairly unremarkable past medical history, surgery was recommended. Also, performing the surgery could have a positive impact upon his diverticulosis, urinary hesitation, Gerd, BPH (benign prostrate hyperplasia, or enlarged prostate) and mild anemia. A surgery to correct the inguinal hernia had been successfully performed in 1998 without incident, as did the patient's other surgeries, including his varicose vein stripping done in 1987 and eye surgery in 1995.
During an inguinal hernia repair procedure, first, the surgeon makes an incision and separates the muscle and tissues to expose the hernia sac. The sac is cut open and the contents are replaced into the abdomen, the neck of the hernia sac is tied, and the muscles and tissues are sutured. During a laparoscopic procedure the procedure is performed through tiny incisions, using an instrument with a camera attached and a video monitor to guide the repair.…...

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Works Cited

Culvert, Lee L. (2004). "Inguinal Hernia Repair." Gale Encyclopedia of Surgery.

General Anesthesia Information." (2007). Surgery. Retrieved 15 Sept 2007 at  http://www.justbreastimplants.com/surgery/general_anesthesia.htm 

Goverman, Jeremy (23 Jan 2006). "Hernia" Medline Encyclopedia Online. Retrieved 15 Sept 2007 at  http://www.nlm.nih.gov/medlineplus/ency/article/000960.htm 

R'os, J. Rodr'guez, P. Munitiz, D. Alcaraz, P. Perez, Flores. (Sept 2001)."Parrilla using a prosthesis." Hernia. 5(3): 1265-4906 (Print) 1248-9204 (Online). http://www.springerlink.com/content/a04wbnfjp82v60t2/

Gastric Acid Stimulation and Production
Pathophysiology of gastric acid stimulation and production

The parietal cells in the stomach are responsible for the production of gastric acid. Parietal cells contain secretory canaliculus, which produce gastric acid and release it into the gastric lumen. Gastric acid is produced as a response to the messages received through hormonal, paracrine, and neurocrine messengers (Schubert & Peura, 2008). The production of gastric acid undergoes three phases namely cephalic phase, gastric phase, and intestinal phase. Gastrin, the major hormonal trigger of gastric acid production is produced by the G cells located in the pyloric mucosa of the stomach. The G cells will release gastrin in response to a meal. However, the Histamine 2 receptors are thought to be the primary stimulus for the secretion of gastric acid.

How GED, PUD, and gastritis affect the stimulation and production of gastric acid

Gastroesophageal reflux disease (GED) is a common digestive disorder caused…...

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References

Boeckxstaens, G. E., & Rohof, W. O. (2014). Pathophysiology of gastroesophageal reflux disease. Gastroenterology Clinics of North America, 43(1), 15-25.

Chait, M. M. (2010). Gastroesophageal reflux disease: Important considerations for the older patients. World journal of gastrointestinal endoscopy, 2(12), 388.

Kahrilas, P. J. (2003). GERD pathogenesis, pathophysiology, and clinical manifestations. Cleveland Clinic journal of medicine, 70(5), S4.

Konturek, P. C., & Konturek, S. J. (2014). Peptic Ulcer Disease Metabolism of Human Diseases (pp. 129-135). New York: Springer.

Nursing 201 Nursing Process PaperClient ProfileThe patient is a white 80year old whose religion is unknown and was admitted on February 2, 2022, for a UTI infection. Care for the patient began on the day of admission. He is a father of three and a grandfather of five, living with his spouse. The social-economic status of the patient is low to middle class had a career as a factory worker. The patient had a full code status of Contrast Dye allergy. The history records reflected an altered mental state, and dementia and frustration were noted, hypertension, Gastroesophageal Reflux Disease (GERD), and Stage 4 chronic kidney disease. Blindness in the left eye was detected, but no challenges were observed with hearing. The patient denies any pain, can move with minimal assistance, has a good appetite, and shows the adjustment to aging since his hobby is spending time with his grandchildren.The patients…...

There is also a specific technique involving this method that is specifically intended to relieve the withdrawal symptoms of addiction (Addicted to caffeine).
In the final analysis, it was a combination of a healthy diet and a planned exercise program, complemented by yoga and a changing mindset that helped Nick to finally overcome his problem. One of the cardinal factors in his rehabilitation process was the understanding of what caffeine was doing to his body and his life. The most important factor in his recovery was the realization that he was in fact addicted and that his problem was not helped by a regular intake of coffee but was in fact worsened by the excessive amount of caffeine that he was ingesting. Once he realized that caffeine was not an aid but rather the central cause of his stress and anxiety he soon began to change his habits. At first…...

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Bibliography

Addicted to caffeine. Retrieved September 25, 2009, from  http://www.queendom.com/advices/advice.htm?advice=241 >

Am I Addicted to Caffeine? Retrieved September 25, 2009, from  http://www.wisegeek.com/am-i-addicted-to-caffeine.htm 

Common Sources of Caffeine. Retrieved September 25, 2009, from  http://lds.about.com/library/weekly/aa121202b.htm 

GERD. Retrieved September 25, 2009, from  http://www.nlm.nih.gov/medlineplus/gerd.html

Prescription antifungal or antiyeast medications may also interfere with the action of omeprazole and should not be taken concurrently with it.
Plain Language:

Omeprazole is a drug primarily used to treat the symptoms of heartburn and acid reflux. Acid reflux occurs when stomach acid shoots up into the esophagus, the tube connecting the throat to the stomach.

Although it is a prescription-only medication in many places, it is also sold over-the-counter in some countries. The drug is usually administered in a time-release tablet form, although some patients might prefer the powdered version because the tablets cannot be chewed.

Omeprazole is not an antacid (like olaids or Tums) and works on an entirely different principle. Unlike antacids, omeprazole is not taken to relieve symptoms of heartburn immediately. It is a drug that addresses the root cause of heartburn and acid reflux, and must be taken regularly for it to be effective. The standard course…...

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References

"Omeprazole." (2011). PubMed. Retrieved online:  http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000936/

Jesus soothed away their fear, reassuring them it was him (John 6:20). He then joined them in the boat, and they were moved from that place to the shore where they heading (John 6:20). Here, Jesus takes control over their action, and that place where they disciples are going. He moves them there, and shows that he has the power over nature to walk across the water, and the power over the force of the wind to move the boat back to the shore. He cannot be forced to do that which is not within God's plan for him to do. How can they overcome him and force him to do what they want him to do if he has this strength over nature, which they themselves do not have?
Healing of a Blind Man (Holy Bible, John 9:1-12)

In this passage, where Jesus heals the sight of man who had…...

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Works Cited

Theissen, Gerd and Merz, Annette (1998). The Historical Jesus: A Comprehensive

Guide, Fortress Press, Minneapolis, MN. Book.

Williams, Matt (2007). The Miracles of Jesus: Six in-depth Studies Connecting the Bible

to Life. Zondervan, Grand Rapids, MI. Book.

The Japanese myth partly resembles that of Adam and Eve present in the Bible and in the Quran. However, the first beings in Japan are considered to hold much more power than their equivalents in the west. Another resemblance between the Japanese legends and those in the west is the fact that the kami are considered to live in the high planes of Takamagahara, somewhat resembling mount Olympus, from Greek mythology. Japanese mythology is different from other mythologies through the fact that all of the deities involved in it are good in their character.

In the sixteenth century, when Buddhism entered Japan, the locals had a hard time keeping Shinto as their main religion, since it had not been an organized religion. Even with the fact that Buddhism had been spreading quickly around the country, the presence of Shinto could be felt everywhere, in people's lifestyles and in their culture.

Shintoists consider…...

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Works cited:

1. Amudsen, Christan. (1999). "Insights from the Secret Teachings of Jesus: The Gospel of Thomas." 1st World Publishing.

2. Herman A.L. (1991). "A Brief Introduction to Hinduism: Religion, Philosophy, and Ways of Liberation." Westview Press.

3. Kato, Etsuko. (2004). "The Tea Ceremony and Women's Empowerment in Modern Japan." Routledge.

4. Kumagai Fumie, Keyser Donna J. (1996). "Unmasking Japan Today: The Impact of Traditional Values on Modern Japanese Society." Praeger.