Transcript Diseases of the Digestive System

Diseases of the
Digestive System
Dr. Jim Whitfield, Ph.D.
Digestive System Overview
 As you have learned the digestive system is the hollow
tube that starts at the mouth and ends at the anus. Its
purpose is to ingest food, digest the food into its
nutrient components, allow for absorption of those
nutrients and the excretion of waste products
Digestive System Overview
 As you have learned the digestive system is the hollow
tube that starts at the mouth and ends at the anus. Its
purpose is to ingest food, digest the food into its
nutrient components, allow for absorption of those
nutrients and the excretion of waste products
 The digestive system is composed of the organs of
digestion and the accessory organs of digestion.
Digestive System Overview
 The organs of digestion include those organs that
come into direct contact with the food (teeth, tongue,
esophagus, stomach, small intestine, large intestine
and rectum)
Digestive System Overview
 The organs of digestion include those organs that
come into direct contact with the food, they include the
teeth, tongue, esophagus, stomach, small intestine,
large intestine and rectum
 The organs of digestion also include the accessory
organs. These are organs that are vital to digestion but
do not actually contact the food, they include the
salivary glands, liver, pancreas, and gall bladder
Digestive System Overview
 Ideally all of these organs function normally and
digestion occurs without issue and the person does not
find themselves in a diseased state
Digestive System Overview
 Ideally all of these organs function normally and
digestion occurs without issue and the person does not
find themselves in a diseased state
 However
Digestive System Overview
 Ideally all of these organs function normally and
digestion occurs without issue and the person does not
find themselves in a diseased state
 However
 As you know many people suffer from a wide variety of
gastrointestinal issues. These diseases can range from
causing mild discomfort through debilitating and
potentially deadly outcomes
Digestive System Overview
 Ideally all of these organs function normally and
digestion occurs without issue and the person does not
find themselves in a diseased state
 However
 As you know many people suffer from a wide variety of
gastrointestinal issues. These diseases can range from
causing mild discomfort through debilitating and
potentially deadly outcomes
 Today we will look at a variety of these conditions
Diseases of the Digestive
System
 Pathology comes from the Greek meaning to
“encounter or experience suffering” in modern terms it
has come to mean the “Study of the disease process”
Diseases of the Digestive
System
 Pathology comes from the Greek meaning to
“encounter or experience suffering” in modern terms it
has come to mean the “Study of the disease process”
 My Ph.D. is in Pathology. I worked for many years
studying illness in people as well as what they died
from. My particular area of study were those diseases
that effected cartilage and bone
Diverticulosis
Diverticulosis happens when pouches (diverticula form in
the wall of the colon. If these pouches get inflamed or
infected, it is called diverticulitis. Diverticulitis can be very
painful.
Diverticulosis
 Doctors aren't sure what causes diverticula in the colon
(diverticulosis). But they think that a low-fiber diet may
play a role. Without fiber to add bulk to the stool, the
colon has to work harder than normal to push the stool
forward. The pressure from this may cause pouches to
form in weak spots along the colon.
Diverticulosis
 Diverticulitis happens when feces get trapped in the
pouches (diverticula). This allows bacteria to grow in
the pouches. This can lead to inflammation or infection.
This inflammation can potentially lead to a rupture of
the colon which can be very serious
Diverticulitis
Diverticulitis is VERY painful it includes terrible
stomach cramps along with a combination of
vomiting and diarrhea. Unless a rupture occurs
it can be treated with antibiotics
Crohn’s Disease
 Crohn’s disease is a type of inflammatory bowel disease (IBD) that
may affect any part of the gastrointestinal tract from mouth to
anus. Signs and symptoms often include abdominal pain, diarrhea
(which may be bloody if inflammation is severe), fever, and weight
loss.
Crohn’s Disease
 Crohn’s disease is a type of inflammatory bowel disease (IBD) that
may affect any part of the gastrointestinal tract from mouth to
anus. Signs and symptoms often include abdominal pain, diarrhea
(which may be bloody if inflammation is severe), fever, and weight
loss.
 Crohn's disease is caused by a combination of environmental,
immune and bacterial factors in genetically susceptible individuals.
It results in a chronic inflammatory disorder, in which the body's
immune system attacks the gastrointestinal tract
Crohn’s Disease
 Crohn’s disease is a type of inflammatory bowel disease (IBD) that
may affect any part of the gastrointestinal tract from mouth to
anus. Signs and symptoms often include abdominal pain, diarrhea
(which may be bloody if inflammation is severe), fever, and weight
loss.
 Crohn's disease is caused by a combination of environmental,
immune and bacterial factors in genetically susceptible individuals.
It results in a chronic inflammatory disorder, in which the body's
immune system attacks the gastrointestinal tract
 There are no medications or surgical procedures that can cure
Crohn's disease.
Crohn’s Disease
 20% of all individuals with Crohns’s disease will need
surgery to remove the abscesses that occur in the
colon
Crohn’s Disease
 20% of all individuals with Crohns’s disease will need
surgery to remove the abscesses that occur in the
colon
 Crohn's has a genetic component. Because of this,
siblings of known people with Crohn's are 30 times
more likely to develop Crohn's than the general
population.
Crohn’s Disease
 80% of all individuals with Crohns’s disease will need
surgery to remove the abscesses that occur in the
colon
 Crohn's has a genetic component. Because of this,
siblings of known people with Crohn's are 30 times
more likely to develop Crohn's than the general
population.
 While the exact cause is unknown, Crohn's disease
seems to be due to a combination of environmental
factors (smoking) and genetic predisposition (at least 4
different DNA mutations)
Crohn’s Disease
Celiac Disease
 Celiac disease is an autoimmune disorder that can
occur in genetically predisposed people where the
ingestion of gluten leads to damage in the small
intestine.
Celiac Disease
 Celiac disease is an autoimmune disorder that can
occur in genetically predisposed people where the
ingestion of gluten leads to damage in the small
intestine.
 Celiac disease is caused by a reaction to gluten protein
found in wheat, rye and barley. An enzyme modifies the
protein causing it to react with the intestinal lining
causing a chronic inflammatory disorder that destroys
the villi of the small intestine
Celiac Disease
 The destruction of the villi of the small intestine
dramatically impacts an individuals ability to absorb
nutrients, particularly carbohydrates and proteins
causing weight loss, fatigue, anemia, abnormal blood
clotting and osteoporosis
Celiac Disease
 The destruction of the villi of the small intestine
dramatically impacts an individuals ability to absorb
nutrients, particularly carbohydrates and proteins
causing weight loss, fatigue, anemia, abnormal blood
clotting and osteoporosis
 There is no cure for celiac disease. The only treatment
is a lifelong avoidance of products that contain gluten
Note the stunting of the
Villi in individuals with
celiac disease
Colon Polyps
 Colon polyps are growths in your large intestine (colon)
. The cause of most colon polyps is not known, but they
are common in adults. Over time, some polyps can turn
into colon cancer. It usually takes many years for that to
happen.
Colonoscopy – Using a flexible camera the doctors is able to look at
the colon from the rectum up to the ileocecal junction and examine
the patient for for precancerous polyps and colon cancer. It is
recommended that you get for first colonoscopy at 50 years of age
Small and large non-cancerous polyps
Cancerous polyp
Gastroesophageal Reflux
Disease (GERD)
 GERD is a chronic symptom of mucosal damage
caused by stomach acid coming up from the stomach
into the esophagus
Gastroesophageal Reflux
Disease (GERD)
 GERD is a chronic symptom of mucosal damage
caused by stomach acid coming up from the stomach
into the esophagus
 GERD is usually caused by changes in the barrier
between the stomach and the esophagus, including
abnormal relaxation of the sphincter between the
esophagus and stomach, which normally holds the top
of the stomach closed, impaired expulsion of gastric
reflux from the esophagus, or a hiatal hernia. These
changes may be permanent or temporary.
Gastroesophageal Reflux
Disease (GERD)
 GERD is often referred to as heartburn. However, the
typical acid reflux we associated as heartburn is usually
much milder than GERD. GERD can cause chronic
damage to the esophagus and increases the patients
chances of developing esophageal cancer
The X-ray show test material that has left the stomach and entered
into the esophagus (arrow) The upper right picture show the normal lower
Portion of the esophagus. The lower right pictures show the entrance
narrowed do to chronic inflammation with exposure to stomach acid
Hiatal Hernia
 The entrance of an organ, typically the stomach,
through the esophageal opening in the diaphragm.
Hiatal Hernia and numerous
stomach ruggae
Diabetes and Insulin &
Glucagon Regulation
 Diabetes is a group of metabolic diseases in which
there are high blood glucose levels over a prolonged
period of time. Symptoms of high blood glucose include
frequent urination, increased thirst, and increased
hunger. If left untreated, diabetes can cause many
complications including kidney failure, cardiovascular
disease, eye damage, ulceration of the feet, stroke and
death
Diabetes and Insulin &
Glucagon Regulation
 Secretion of insulin and glucagon, the hormones that
regulate blood glucose levels, is controlled by the
pancreas. The pancreas serves as part of both the
endocrine system as well as the digestive system.
Insulin and glucagon regulation is an endocrine
function
The Islets of Langerhans
 The islets of Langerhans are clusters of endocrine cells
found within the larger body of the pancreas. They
contain four distinct cell types. However, only two are
important in diabetes
The Islets of Langerhans
 The islets of Langerhans are clusters of endocrine cells
found within the larger body of the pancreas. They
contain four distinct cell types. However, only two are
important in diabetes
 Alpha cells secrete glucagon when blood sugar is low
(before lunch) this causes the liver to break down
stored glycogen and release glucose into the blood
stream
The Islets of Langerhans
 The Beta cells release Insulin when blood glucose is
high (after lunch). Insulin causes liver, muscle and fat
cells to take up excess glucose from the blood
The Islets of Langerhans
 The Beta cells release Insulin when blood glucose is
high (after lunch). Insulin causes liver, muscle and fat
cells to take up excess glucose from the blood
 People with diabetes either do not make insulin (Type I
or Juvenile diabetes) of their tissues do not respond to
the insulin (Type II, Adult Onset) usually caused by
obesity. A third type gestational diabetes affects some
pregnant women who who put on a lot of weight rapidly
Histology of the pancreas showing the endocrine portion (Islets of Langerhans)
as well as the exocrine portions responsible for digestion via the secretion
of pancreatic lipase
Regulation of blood glucose by
Insulin and glucagon
Giant hair ball removed from girls stomach as a result of Trichotillomania!
Thank You!!