1. Intervention
1.1. Post-gastric surgery
1.1.1. NG tube placement
1.1.1.1. Secure placement to prevent dislodgment
1.1.1.2. Never irrigate or reposition without orders
1.1.1.3. Oral care Q2 to 4 hours
1.1.1.4. Keep HOB semi Fowler's
1.1.1.5. Prevent aspiration
1.2. Patient education
1.2.1. Risk factors
1.2.1.1. Avoid...
1.2.1.1.1. Tobacco
1.2.1.1.2. Food high in nitrates
1.2.1.2. Treat...
1.2.1.2.1. H. pylori
1.2.2. Dumping syndrome
1.2.2.1. Six small meals
1.2.2.2. High protein and fats
1.2.2.3. Low carbohydrate
1.2.2.3.1. Avoid food high in concentrated sugar
1.2.2.4. Do not mix liquids with meals
1.2.3. Pernicious anemia
1.2.3.1. Monthly vitamin B12 injection for life
2. Assessment
2.1. Risk factors
2.1.1. Smoked and salted food
2.1.1.1. Food high in nitrates
2.1.1.1.1. Cured meat
2.1.2. H. pylori
2.1.3. Pernicious anemia
2.1.3.1. 2 to 3-fold increased in risk
2.1.4. Tobacco
2.1.5. Men 2x > women
2.1.6. Age 50 to 70 years
2.1.7. East Asian, Eastern Europe, South America
2.2. S/S
2.2.1. Usually asymptomatic
2.2.2. Weight loss
2.2.2.1. Most common
2.2.3. Abdominal pain
2.2.4. Dysphagia
2.2.4.1. Proximal or gastroesophageal junction
2.2.5. GI bleeding
2.3. Diagnostics
2.3.1. EGD with biopsy
2.4. Complications
2.4.1. Malnutrition
2.4.2. GI bleeding
2.4.3. GI obstruction
2.4.4. Post-gastric surgery (gastrectomy)
2.4.4.1. Dumping syndrome
2.4.4.1.1. Early
2.4.4.1.2. Late
2.4.4.2. Gastroparesis
2.4.4.2.1. Delayed emptying of solid food by the stomach
2.4.4.3. Anastomotic Leak
2.4.4.4. Malnutrition
2.4.4.5. Wound infection
2.4.4.6. Pernicious anemia
2.4.4.6.1. B12-deficiency anemia