Gastroesophageal Reflux Disease Essay Example | Topics and Well Written Essays - 4500 words

Gastroesophageal Reflux Disease - Essay Example The superficial layer of the esophagus is known as adventitia. The adventitia attaches the esophagus to surrounding structures. The esophagus secretes mucus and transports food into the stomach but it does not produce digestive enzymes. The stomach contents can reflux (back up) into the inferior portion of the esophagus when the lower esophageal sphincter fails to close adequately after food has entered the stomach; the condition which is known as gastroesophageal reflux disease (GERD). In GERD, the basal layer of of the epithelium is is thickened, and the papillae of the lamina propria are elongated and extend toward the surface. Abnormalities of the lower esophageal sphincter, Hiatus hernia, Delayed esophageal clearance, Gastric contents, Defective gastric emptying, Increased intra-abdominal pressure, and Dietary and environmental factors may be the factors involved in GERD. Clinically, GERD may be diagnosed by radiographic examinations using dyes, endoscopy, and esophageal pH-metr y. PPI trial is also an accepted method of first line diagnostic test. Treatment involves both non-pharmacological treatment measures as well as pharmacotherapy. Non-pharmacological treatment include avoidance of foods and medications that exacerbate GERD, smoking secession, weight reduction, taking a small meal at a time, avoidance of alcohol and elevation of the head of the bed. Drugs for treating GERD include H2 receptor antagonists like cimetidine, ranitidine, famotidine or nizatidine. Proton pump inhibitors such as omeprazole, pantoprazole, lansoprazole and rebeprazole are found to be very effective to reduce acid reflux and hence inflammation. H2 blockers were found to heal ulcers and erosions but the typical reflux changes of the squamous epithelium of the esophageal mucosa are not recovered. Studies confirmed that PPIs not only heal ulcers and erosions but also cures basal cell hyperplasia and elongation of the papillae. The percentage of normal epithelium were also reported to increase significantly after PPI administration in patients with GERD. Two commonly employed treatment alternatives for GERD are antirefluctive surgery and Endoscopic Treatments. Surgery is preferred only when the patient fails to respond to pharmacological treatment, when the patient prefers surgery, in those patients who have complications of GERD like barrett's esophagitis, or if the patient has atypical symptoms and reflux documented on 24-hour ambulatory pH monitoring. Several randomized controlled trials have confirmed that open fundoplication and medical treatment have similar long-term effects for GERD. Laparoscopic antireflux surgery is also reported to have similar outcomes to the open procedures. Endoscopic Treatments for GERD include plicating gastric folds methods (Endoscopic Gastroplication, ELGP method, thermal tissue remodeling /neurolysis method, and bulking injection method. These endoluminal treatments augment the reflux barrier. Section I: Organ system structure and Function. Explain the accepted normal healthy structure of parts and function of organ system; How it works The esophagus is a collapsible muscular tube, about 25 cm (10 in.) long that lies posterior to the trachea. The esophagus begins at the inferior end of the laryngopharynx and passes through the mediastinum anterior to vertebral column. Then it pierces the diaphragm through an opening called the

Strategic Business Management and Its Comparison to the Case of Research Paper - 1

Strategic Business Management and Its Comparison to the Case of iCreative - Research Paper Example The researcher states that for expansion of business through internal venturing and joint ventures, iCreative requires managers and leaders who possess strategic leadership skills along with market intellect and cultural awareness of foreign markets. Being an entrepreneur and introducing a new concept in the market requires a different approach altogether than running family-owned businesses or other established organizations, be it a company or a partnership. Where every organization model requires a different leadership approach, entrepreneurship demands innovation and creativity. Entrepreneurial leaders are required to be dissatisfied with the status quo and should have the ability to question imperfections and present a better alternative. For this purpose, learning ways of existing businesses and modifying them effectively is the gist of entrepreneurial leadership. Entrepreneurial leaders need to have flexibility in their approach and ability to learn continuously. Furthermore, these leaders are expected to have authenticity in their tone when they communicate. Such leaders not only share their insight but also have the humility to encourage their peers and subordinates to share their views. Since an entrepreneurial model is never perfect in the inception, therefore feedbacks and ideas of a team could help this new venture. Entrepreneurial leaders are also expected to have a vision and ability to examine their organizations at different levels of businesses. It not only includes operational and strategic management levels but also involves capability of identifying gaps between existing and desired efficiency and effectiveness. Entrepreneurs are provided with a huge amount of advice and negative feedbacks having the critical effect on business performance.