Thursday, October 8, 2015

7 Nursing Diagnosis for GERD


Gastroesophageal Reflux Disease (GERD) is defined as a pathological state as a result of reflux of gastric contents into the esophagus causing a variety of symptoms that interfere in esophageal and extra-esophageal and or complications (Susanto,

The clinical manifestations of GERD may include typical symptoms (esophageal) and atypical symptoms (extra esophagus). GERD symptoms 70% are typical, namely:

  1. Heartburn, that burning sensation in the retrosternal area. Symptoms of heartburn is the most common symptom.
  2. Regurgitation, a condition in which stomach material was in the pharynx. Then sour and bitter taste in the mouth.
  3. Dysphagia. It usually occurs because of complications such as stricture (Joseph, 2009)
Atypical symptoms:
  • Chronic cough, and sometimes wheezing.
  • Hoarseness.
  • Pneumonia.
  • Pulmonary fibrosis.
  • Bronchiectasis.
  • Nonkardiak chest pain (Joseph, 2009).
Other symptoms:
  • Weight loss.
  • Anemia.
  • Haematemesis or melena.
  • Odynophagia (Bestari, 2011).

Complications of GERD include:
  • Barrett's Esophagus, which changes the squamous epithelium, becomes metaplastic columnar.
  • Ulcerative esophagitis.
  • Bleeding.
  • Stricture of the esophagus.
  • Aspirations. (Asroel, 2002).


Nursing Diagnosis for GERD
  1. Risk for aspiration related to barriers to swallow, decreased reflux larynx and glottis to liquid reflux.
  2. Deficient Fluid Volume related to nausea and vomiting / excessive spending.
  3. Imbalanced Nutrition: less than body requirements related to anorexia, nausea, vomiting.
  4. Acute pain related to inflammation of the esophagus lining.
  5. Ineffective airway clearance related to reflux of fluid into the larynx and throat.
  6. Impaired Swallowing related to narrowing / stricture of the esophagus due to gastroesophageal reflux disease.
  7. Anxiety related to the disease process.

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