Proton Pump Inhibitors

1 Research Question and Response Student’s Name University Course Professor Date 2 Research Question Research Question : In patients with Gastroesophageal Reflux Symptoms , do lifestyle changes lead to reduced Gastroesophageal Reflux Symptoms compared to medication? Population : Patients with Reflux Symptoms Interventions : Lifestyle Changes Comparison : Medication Outcome : Reduced Gastroesophageal Reflux Symptoms In the United States, about 44% of adults have been affected by gastroesophageal reflux symptoms due to various factors (Ness -Jensen et al., 2016). I usually come across patients suffering from gastroesophageal reflux symptoms, being a GI nurse. People of all ages are prone to be affected by gastroesophageal reflux symptoms . However, in this discussion, my main point of research will be based on adult patients. Currently, gastroesophageal reflux symptoms are treated with proton -pump inhibitors (PPIs). These fall under the first line of treatment of this particular condition. Within the time I have been in service, I have noticed that most people with reflux symptoms do not love proton -pump inhibitors a nd other medications to be administered to them. Recent s tudie s have linked extensive use of proton -pump inhibitors (PPIs) to various diseases lie kidney disease and Alzheimer’s Disease. This is one of the primary reasons I would like to know more if reflux symptom s can be eliminated through lifestyle factors. I will be basing my information through the scope o f reliable clinical research. Gastroesophageal reflux symptoms usually occur in varying severity depending on their causes. For example, while some patients experience unrelenting and persistent reflex es b ecause of a hiatal hernia, others only experience reflux symptoms after eating a meal containing high -fat levels (Patrick, 2011). Esophageal dysplasia (Barrett’s Esophagus) can be caused if gastroesophageal reflux symptom is not treated . Esophageal cancer can then be caused after this (Alsop & Sharma, 2016) . Therefore, esophageal cancer can be avoided by treating the 3 gastroesophageal reflux symptom . Potentially harmful sequelae of reflux like bleeding ulcers that lead to food impactions can be avoided by tr eating the reflex symptoms. As highlighted previously, there has been a mixed reaction within the healthcare sector of whether or not to use the PPIs. This is because they have been identified to pose a risk of developing other diseases. As such, I think it is high time to search for other treatment plans that can be used for reflux. The big question that needs to be addressed now is whether reflux symptoms can be prevented by changing lifestyle factors. By going through various peer -review literature, I can now believe that the gastroesophageal reflux symptom and its related damages can be prevented using lifestyle changes. Nonetheless, the patient is supposed to strictly follow the regiment the same way they would do for medication. This would provide a better platform for both the lifestyle changes and the medication to be compared . In summation, my PICO question is , “In patients with Gastroesophageal Reflux Symptoms, do lifestyle changes lead to reduced Gastroesophageal Reflux Symptoms compared to medication? ” Recent peer -reviewed articles will be used in research this question. T his is a topic I have selected due to its relevance in my area of practice. This concep t can be used by all nurses, regardless of the specialization , since numerous people in the society are suffering from reflux symptoms. 4 References Alsop, B. R ., & Sharma, P. (2016). Esophageal cancer. Gastroenterology Clinics , 45 (3), 399 - 412. Casale, M., Sabatino, L., Moffa, A., Capuano, F., Luccarelli, V., Vitali, M., & ... Salvinelli, F. (2016). Breathing training on lower esophageal sphincter as a complementary treatment of gastroesophageal reflux disease (GERD): a systematic review. European Review For Medical And Pharmacological Sciences , 20 (21), 4547 -4552. Ness -Jensen, E., Hveem, K., El -Serag, H., & Lagergren, J. (2016). Perspectives in clinical gastroenterology and hepatology: Lifestyle intervention in gastroesophageal reflux disease. Clinical Gastroenterology and Hepatology , 14 , 175 -182. http://dx.doi.org/10.1016/j.cgh.2015.04.176 . Patrick, L. (2011). Gastroesophageal Reflux Disease (GERD): A Review of Conventional and Alternative Treatments. Alternative Medicine Review , 16 (2), 116 -133. 5 Response to a Peer Hello peer , I would like to commend you for selecting such a good t opic to research on. Your research question was also well -framed and easy to comprehend. I like your discussion of how type 2 diabetes mellitus is growing to be a significant health concern in Australia and worldwide . For this reason, the healthcare sector should come up with effective measure to help curb the increasing rate of people who are developing diabetes . I like the approach you have taken to show that both diet and physical exercises can prevent type 2 diabetes mellitus. However, you have also not ed an issue about the physical activity being minimally applied in the intervention programs. You have attributed this to the lack of knowledge among the healthcare professionals regarding the existence of the exercise programs. You also highlighted that it is easier for the patient to follow up with the prescribed medication than physical activity. Therefore, more research regarding how physical activity can prove beneficial to diabetic patients must be conducted. I also researched a little bit on your research topic and found some supporting information. For example, some studies have shown that the risk of type 2 diabetes is reduced (Cradock et al., 2017). The magnitude of the risk reduc tion was attenuated for adjustment for differences in body mass index between the active and inactive participants (Hui et al., 2014). However, the diabetes risk was still reduced by 20 -30% with a high level of physical activity even when adjustments were made (Aune et al., 2015). A range of activities of both moderate and vigorous -intensity have proved beneficial in conferring diabetes. Therefore, it is also possible for significant results to be obtained even when patients engage in regular light - intensit y activities (Bao et al., 2014). Some of the major predisposing factor s as far as obesity is involved include a positive family history, obese people, and impaired glucose regulation. Therefore the risk reduction related to higher physical activity tends to be greater among these people. These are the people that are at an increased baseline risk of the disease. The risk of progression to diabetes was found to be reduced when adults with impaired glucose tolerance participated in 150 minutes of moderate p hysical activity. The effect was even higher when weight was also lost in the process. With this said, I believe that healthcare practitioners are better positioned to ensure that type 2 diabetic patients engage in a healthy diet and physical exercise as a proper treatment measure. Therefore , future research studies should focus on information about the physical 6 activities that healthcare professionals can recommend as effective treatment to the patients. I remember you also highlighted that most patients shun away physical activities because of their demanding nature. However, as discussed in the literature above, light -intensity activities a lso reduce the type 2 diabetes risk. Doctors and nurses should therefore recommend these light intensity activities to patients. Overall, I found your post to be quite informative. References Aune, D., Norat, T., Leitzmann, M., Tonstad, S., & Vatten, L. J. (2015). Physical activity and the risk of type 2 diabetes: a systematic review and dose -response meta -analysis. European journal of epidemiology , 30 (7), 529 -542. Bao, W., Tobias, D. K., Bowers, K., Chavarro, J., Vaag, A., Grunnet, L. G., ... & Zhang, C. (2014). Physical activity and sedentary behaviors associated with risk of progression from gestatio nal diabetes mellitus to type 2 diabetes mellitus: a prospective cohort study. JAMA internal medicine , 174 (7), 1047 -1055. Cradock, K. A., ÓLaighin, G., Finucane, F. M., Gainforth, H. L., Quinlan, L. R., & Ginis, K. A. M. (2017). Behavior change techniques targeting diet and physical activity in type 2 diabetes: A systematic review and meta -analysis. International Journal of Behavioral Nutrition and Physical Activity , 14 (1), 1 -17. Hui, S. S. C., Hui, G. P. S., & Xie, Y. J. (2014). Association between physica l activity knowledge and levels of physical activity in Chinese adults with type 2 diabetes. PloS one , 9(12), e115098.