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Gastrointestinal system Front and center maggots…my name is GI Joe and it’s time to learn about the GI system. Overview of the GI • The human body, like any other organism requires, vitamins and nutrients to survive. The Gastrointestinal system is responsible for turning the food you eat, into broken down nutrients your body can absorb. Let’s go through the process! •From the time of entrance to the body from the mouth to the exit of waste through the rectum and anus; The food (in its many states) goes through a long process involving several organs and muscle tissues. The Beginning of it All • The digestive process starts with the mouth. • Once the food enters the mouth, it is almost immediately broken down into a smaller, more lubricated mass called a bolus. – The food becomes a bolus when the teeth and saliva work together in “processing” it from its solid state. – The enzyme amylase is present in saliva during this stage to help break down the starch in the food. • When the food is ready to be swallowed, it begins its second stage in the GI process… The Esophagus • The bolus eventually moves through the esophagus which is a long tube that consists of smooth muscle. • Through the action of peristalsis, the bolus is able to reach the stomach. – Peristalsis is the wave-like muscle contractions that mechanically move the bolus. Quiz time! • What enzyme is present in saliva to help break down starch? • What are the wave-like contractions that move the bolus through the esophagus? I wanna see A’s from all you maggots or you can drop and give me 20! The Stomach • Once the bolus finishes its journey through the esophagus, it finds itself in the stomach. • The stomach is the organ in which the food is actually turned into a different state of matter, liquid – This liquid is called chyme. • Upon entering the stomach, gastric glands are triggered to secrete 400 to 800 ml of gastric fluid. This gastric fluid is comprised of four main types of cells… The Gland/Gastric Cells PARIETAL CELLS • Contain hydrochloric acid that enters the stomach to break down the food. CHIEF CELLS • Secrete pepsinogen, which is closely related to the enzyme pepsin. Pepsinogen helps break down the amino acid protein chains for easier digestion. Hormone Secreting Cells • Release the hormone gastrin that also helps break down the food. Mucus Secreting Cells • Prevent damage to the stomach lining by releasing mucus. Mucus serves as a base to neutralize the stomach acid, preventing injuries such as ulcers. Quiz time! • How much gastric fluid is secreted into the stomach for digestion? • What prevents the stomach lining from being damaged by acid? The Small Intestine • After being digested, the chyme passes through the beginning of the small intestine called the duodenum. • During this period of time, nutrients and water are secreted through the linings of the small intestine and into the blood stream. The Gall Bladder and Liver • Both the gall bladder and liver are active while the chyme is in the duodenum. • During this period hormones are secreted that cause the gall bladder to release a substance called bile. – Bile is a substance made in the liver and stored in the gall bladder that helps further break down lipids. • The liver also has the key function of filtering nutrients in the blood stream after they have been secreted through the intestinal walls. The Large Intestine • After all nutrients and water have been absorbed from the chyme, it begins to work its way through the Large Intestine. – Here chyme turns into fecal matter. • Water is reabsorbed into the fecal matter to help the final excretory process. • Finally the fecal matter reaches the rectum (the last 15cm of the large intestine) and with the help of smooth muscles, called sphincter muscles, it is pushed through to the anus. QUIZ TIME! • From where in the small intestine are hormones released? • What two functions does the liver have in this process? • What is the main function of the large intestine? Crohn’s Disease WHAT IS CROHN’S DISEASE? • An inflammatory bowel disease (IBD) • Lifelong • Ulcers in the intestines WHAT CAUSES CROHN’S? • The cause of the disease is still unknown – Possible explanations include the immune system having an abnormal response to normal bacteria in the intestines • Crohn’s can run in the family SYMPTOMS TREATMENT • Some treatments include over the • Stomach pain counter medicines (if mild) or • Diarrhea (possibly 10-20 times prescription medicines to control a day) more severe inflammation • Weight loss • Surgery can remove part of the • Mouth sores intestine, but the disease often comes back • Anal fissures (tears) • People living with Crohn’s disease • Fistulas (openings) between should not smoke, must eat a highorgans calorie, high-protein diet, and should • Excessive vomiting exercise and stay in shape • Chron’s cannot be cured, any HOW IS IT treatment methods are to help coping with the disease only • Diagnosis of Crohn’s disease is DIAGNOSED? done through taking Barium x- • People with Crohn’s often experiment with alternative rays of small intestine/colon, treatment methods including colonscopy, biopsy, or stool massage therapy, and the use of analysis certain herbs and vitamins Acid Reflux (GERD) WHAT IS GERD? • • • Liquid content of stomach regurgitates up into the esophagus Inflames/damages the lining – Liquid contains pepsin and acid, sometimes bile Chronic and usually lifelong WHAT CAUSES ACID REFLUX? • Abnormalities of the lower esophageal sphincter – LES is a muscular ring that is actively contracting and closing off the passage from the esophagus into the stomach – Abnormally weak contraction – Abnormal or transient LES relaxations – Laxity • • Hiatal hernias Esophageal contractions – Defective peristalsis SYMPTOMS • • • • • • • • Heartburn Regurgitation Nausea Ulcers Strictures Barrett’s esophagus Cough and asthma Inflammation of the throat and larynx • Fluid in the sinuses and middle ear HOW IS IT DIAGNOSED? • Heartburn • Endoscopy, biopsies, x-rays • Examination of the throat and larynx • Esophageal acid testing, gastric emptying, acid perfusion tests TREATME NT • Elevate the upper body while sleeping • Elimination of certain foods from the diet – Chocolate, peppermint, alcohol, caffeinated drinks • • • • • Antacids Histamine antagonists (Tagamet) Proton-pump inhibitor (Prilosec) Pro-motility drugs (Reglan) Surgery – Approximately 80% of patients will have goodexcellent relief of symptoms for 5-10 years Quiz time! • How does a colonoscopy to test for Crohn’s disease work? • What can prescription medicines do to treat Crohn’s disease? • Why is the Lower Esophageal Sphincter so important to Acid Reflux? • What is Barrett’s Esophagus? PEPTIC ULCERS WHAT ARE PEPTIC To help the body with digestion, the stomach produces acid. ULCERS? The duodenum, a part of the small intestine, and the lining of the stomach is responsible for regulating the amount of acid. When these two do not function correctly, acid eats into the stomach lining causing peptic ulcers Here is the etiology, symptoms, and treatments of peptic ulcers…pay attention weaklings! ETIOLO GY •Infection of the stomach with a bacteria called H.Plyori. This bacteria causes the stomach to produce too much acid. •Medicines, drinking, and smoking are also causes of peptic ulcers. SYMPTOMS • • • • TREATME NT • Medicine abdominal pain – H-2 Blockers such as bloating or fullness Zantac and Tagamet – Protein Pump Inhibitors nausea and excessive vomiting water brash (a rush of saliva • Self-help – Limiting amounts of spicy after regurgitation to dilute the foods, coffee, or alcohol. acid in the esophagus) – Avoid taking painkillers that commonly lead to • vomiting of blood ulcers – No Smoking! Pay attention ! CIRRHOSIS WHAT IS CIRRHOSIS OF THE •The liver slowly deteriorates and malfunctions due to chronic injury LIVER? •Not trauma related –Caused by long-lasting disease/injuries •Scar tissue replaces healthy tissue, partially blocking blood flow through the liver ETIOLO •Alcohol-related diseases GY •Chronic hepatitis •Drugs •Toxins •infections http://www.youtube.com/watch?v=2 2lZeKoHeeA SYMPTOMS • • • • • • • weakness fatigue Loss of appetite Nausea Vomiting Weight-loss Appearance of spider-like blood vessels on the skin • itching TREATME NT • Eat a nutritional diet – It is a good idea to avoid raw shellfish! – Avoid alcohol and other illicit substances • Mineral and vitamin supplements Make sure your liver looks like the healthy one on the left! QUIZ TIME! •What is the bacteria that is the most common cause for peptic ulcers? •Which one is not a treatment for peptic ulcers? –Limiting amounts of spicy foods –No smoking –Eating foods high in acidity –Avoid taking painkillers QUIZ TIME! • Which of the following is not a common symptom of cirrhosis of the liver? – – – Weight gain Itching Lethargy • What type of tissue replaces the healthy tissue?