digestive issues: diseases, disorders, and dysfunctions

DIGESTIVE ISSUES:

Diseases, Disorders, and Dysfunctions

5This powerpoint contains images that some students may find disgusting. (www.teclasap.com.br)

Swallowing and NOT Choking

Make note of the steps in swallowing!1. Mastication (chewing)= mechanical digestion2. Addition of salivary amylase= chemical digestion3. Tongue pushes food to back of mouth4. Swallow- read the diagrams!5. Peristalsis is the wave of muscle contraction behind the bolus (ball of food) that moves the food through the entire digestive tract- mouth to anus.

Choking

the mechanical obstruction (food!) of the flow of air from the environment into the lungs

can be partial (allowing inadequate flow of air into the lungs) or complete

prolonged or complete choking results in asphyxia (look it up!) and it is potentially fatal

oxygen stores in the blood and lungs keep the victim alive for several minutes after breathing is stopped completely

Gastroesophageal Reflux Disease

Normal: Closed LES (lower esophageal sphincter) Open LES

LESAcid reflux

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GERD

gastroesophageal reflux disease (GERD) is also called gastric reflux disease or acid reflux disease

chronic symptoms of mucosal damage caused by stomach acid coming up from the stomach into the esophagus

a typical symptom is heartburn

GERD Treatments

1. eating smaller meals earlier in the evening 2. avoiding things that affect the LES (caffeine,

smoking, chocolate, fatty foods, spicy foods, peppermint, alcohol consumption)

3. taking antacids and LOTS water! 4. prescription pharmaceuticals to reduce acid

production or increase motility 5. surgery to rebuild the lower esophageal sphincter6. endoscopic treatments to tighten the LES (by

suturing or applying radio-frequency waves to create scar tissue)

Ulcers

Gastric Ulcer

Esophageal Ulcer

Duodenal Ulcer

An ulcer is a small erosion (hole) in the gastrointestinal tract. The most common type, duodenal, occurs in the first 12 inches of small intestine beyond the stomach.

Ulcers that form in the stomach are called gastric ulcers.

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Gross. Ulcers. (www.teclasap.com.br)

Gastric Ulcer

mainly associated with Helicobacter pylori

also caused by prolonged use of anti-inflammatory drugs, such as Ibuprofen and aspirin, which damage the stomach lining

severe complications include bleeding or perforations = complete hole into abdomen (can cause death due to contamination)!

Ulcer: Treatment

Symptoms: burning pain- feels worse when stomach is empty, but pain returns a couple of hours after eating, black blood in stools

Diagnosis: series of x-rays, endoscopy, tissue sample to identify bacteria

Treatment: antibiotic to kill H. pylori Meds to reduce HCl secretion (rest

stomach)no smoking, no alcohol, decrease NSAID use

e.g. ibubuprofen

Recall the location of the gall bladder?

No? It’s the storage sac tucked under the liver

Purpose? Stores bile until needed for digestion

Gallstones

Small calculi (stones) Big calculi Big calculi withcholecystitis (inflammation)

Gallstones

an accumulation of hardened cholesterol and/or calcium deposits in the gallbladder

can be as small as a grain of sand or as large as a golf ball

can either be “passed” (OUCH!!) or surgically removed

Gallstone Treatment

New treatment: extracorporeal lithotripsy

Shockwave is used to break up gallstones

Used with ERCP- endoscopy with fluoresence to make sure all the big stones are broken up

Pain immediately follows the treatment

Look up the meaning of endoscopy!

Diarrhea

a gastrointestinal disturbance characterized by decreased water absorption and increased peristaltic activity of the large intestine

this results in increased, multiple, watery feces

this condition may result in severe dehydration, especially in infants & elderly

Constipation

a condition in which the large intestine is emptied infrequently and/or with difficulty

too much water is reabsorbed in the colon

the solid waste hardens and is difficult to pass

greater fluid intake, more fibre, and increased exercise are recommended

Hemorrhoids

Internal hemorrhoids

External hemorrhoids

Hemorrhoids are swollen and inflamed veins around the anus or in the lower rectum.

The most common symptom of internal hemorrhoids is bright red blood on stool, on toilet paper, or in the toilet bowl after a bowel movement.

About 75 percent of people will have hemorrhoids at some point in their lives. Hemorrhoids are most common among adults ages 45 to 65 and in pregnant women.

rectum

anus

Hemorrhoids treatment

Increase dietary fibre Moderate exercise Drink more fluids Cleanliness! May be related to stress = mindfulness,

yoga

Inflammatory Bowel Disease (IBD)

Healthy colon Crohn’s disease

inflammation

Inflammatory Bowel Disease Crohn’s disease is one of a group

of disorders categorized as inflammatory bowel disease (IBD), which also includes ulcerative colitis

intestines become inflamed (red and swollen) and develop sores

causes pain, cramps, intestinal bleeding, weight loss, diarrhea

diagnosed based on symptoms and results of a sigmoidoscopy or a colonoscopy, as well as x-rays

Endoscopy

5This powerpoint contains images that some students may find disgusting. (www.teclasap.com.br)

Crohn’s and IBD

Severity of the disease varies, but occasionally leads to complete obstruction, which sometimes requires surgery

IBD Treatment

goal of treatment is to reduce inflammation and suppress the immune system response

When all medications have been tried and the patient is still suffering, a fecal transplant is

the penultimate option

if ulcerative colitis becomes so severe that all treatment is unsuccessful, it may be necessary to surgically remove part or all of the colon (resulting in a colostomy or ileostomy)

Ostomy

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Gross. Polyps. (www.teclasap.com.br)

Intestinal Polyps

Peduncular polyp

Sessile polyp

Polyps are abnormal growths arising from the inside lining of the colon or rectum. 

They protrude into the intestinal canal. Some are flat (sessile) while others are on a stalk (peduncular).

Diagnosis of polyps?

Sigmoidoscopy or colonoscopy

Tissue samples may be removed using a snare (wire loop) and checked to see if they are benign or malignant

More gross pictures follow.

More pictures of polyps

Intestinal Polyps

Polyps are very common, occurring in 15-20% of the adult population 

Although most polyps are benign (not cancerous) some can change into cancer

Colonoscopy is used to identify and remove polyps

Regular screening begins at age 50

Colon cancer

Colon Cancer

Stage I Stage II Stage III

Appendicitis

an inflammation of the appendix due to infection common treatments involve antibiotics and removal of the

appendix (appendectomy) if untreated, appendix can burst causing infection

(peritonitis) and death

Appendectomy

the surgical (open) or laparoscopic (minimally invasive) removal of the appendix

laparoscopy involves tiny incisions where a camera and surgical instruments are inserted

Clostridium difficile Infection anaerobic, endospore-forming

bacteria found in hospitals and other long-term care facilities (look it up!)

causes severe diarrhea and other intestinal diseases when competing bacteria in the gut flora have been wiped out by antibiotics

can be life-threatening, especially among the elderly

Bleach wipes, hand-washing with soap and water, and gloves are effective and reducing infection

Alcohol-based hand sanitizers are not effective at killing the spores

Polyp Removal Stomach Ulcer Gallbladder stones

THE END!HW: Eat well, exercise, eat more fibre and rest… Unit Test Thursday! Learn the vocab!!!

The second long answer question on your unit test will be to describe the path of a bite of food (containing fat, protein and carbohydrates e.g. steak and potatoes) from mouth to toiletInclude in your answer:1. All the structures the food/bolus/chyme

passes2. Location of mechanical digestion2. Location of chemical digestion3. 4. Any diseases associated with each structure5. All the enzymes- for fat, carbs and proteins- their origin of production, where they are active, what the digestive product is etc.

60 points = 30 marks