Digestion Week 2

In the mouth, inadequate chewing means the initial breakdown of food is compromised. Poor ________ breakdown of the food means that acids and enzymes responsible for chemical breakdown later will have a limited surface area to work upon.

Mechanical

Lower levels of ________ _______ and _______ ________ can slow the digestion of carbohydrates and fats.

Salivary amylase, lingual lipase

In the stomach, digestion can go awry when we have insufficient or excessive levels of ______ ______, conditions known as hyper or hypochlorhydria.

Hyaluronic acid

Hypochlorhydria can contribute to many health concerns, including:

-reduced _______

-reduced nutrient absorption

-poor north to South signaling

Immunity

Inflammation from ________ infection can stimulate HCL production in the stomach to fight overgrowth.

Acute

H. pylori produces _______  to protect itself and can damage parietal cells, eventually causing hyperglycemia in the long term.

Bicarbonate

When H pylori penetrates the gastric mucosa, it allows stomach acid and_____ to degrade gastric tissues, leading to _____ _______.

Pepsin, peptic ulcers

The normal pH range of gastric secretions is thought to be _______

1.5-3.5

Hypochlorhydria is usually defined as the stomach contents being less than____

2

Acute stress, _______ histamine, infections, and certain medical conditions can contribute to the development of excessive stomach acid.

Elevated

In the stomach, histamine stimulates________________ of the parietal cells, which secrete acid.

H2 Receptors

______ is the movement of acid into the esophagus

Reflux

______is a symptom of reflux--the pain.

Heartburn

______ is a chronic disease associated with acid reflux.

Gastrointestinal reflux disease (GERD)

 

_______ Is closely related to the function of the LES

Acid reflux

LES function can be affected by factors like muscle/sphincter ________, Excessive intra abdominal pressure, ______hernia, _____ allergy/sensitivities/________, _________ (ex. Alcohol, Peppermint, caffeine), overeating, medications, damage to the_____ ______, stress, hypo/hyper stomach acid production.

 Atrophy, hiatal, food, intolerance, relaxants, vagus nerve

Low stomach acid can impair LES function and delay _________

Gastric emptying

 

The opening and closing of the ________ valve is also regulated, in part, by the pH of the stomach.

Pyloric

 

Reflux from hypochlorhydria may produce more intense symptoms of heartburn. Reflux stemming from lower acidity may produce less heartburn, known as ______ _______.

Silent reflux

Gastroesophageal reflux disease (GERD) may be diagnosed when acid reflux occurs more often than twice a week and damage to the ______ has occurred

Esophagus

GERD can lead to a condition called ______ ______ in which tissue damage leads to an increased risk for esophageal cancer.

Barrett's esophagus

 

Top contributing factors To delayed gastric emptying or gastroparesis include damage to the vagus nerve (common in _______), hypo/hypochlorhydria, duodenum dysfunction.

Diabetes

There is a difference between suboptimal pancreatic exocrine function, where there is generally low output due to other functional issues like inflammation or impaired north to South cascade, and an overt_____ _____ _____ (EPI) Which is an overt, diagnosable disease state.

Exocrine pancreatic insufficiency

 

 

____ is the slowing or stalling of bile through the biliary system, also called biliary stasis.

Cholestasis

In the gallbladder, bile congestion can develop from impaired/delayed contraction and emptying of the bile. This can lead to gallbladder inflammation and ____ ______.

Gallbladder stones

If the gallbladder becomes too inflamed and congested, acute illness may occur, leading to ______ or gallbladder removal.

Cholecystectomy

What is dysbiosis?

A broad umbrella term referring to an imbalance in the intestinal microbiome

 

Dysbiosis varies between individuals, but common patterns include:

-loss of beneficial bacteria/diversity

-overgrowth of harmful or _____ species

-ex. Candida or sibo

-parasitic and viral

-protein putrefaction

Opportunistic

The dybiosis of gram- ______ gut microbiota is a common form.

Negative

When released into the digestive system at high levels, LPS can elicit severe inflammation, degradation of the mucosal membrane, and increase intestinal _________.

 Hyper permeability

The main system of motility in the small intestine is the _______. Chronic interruptions of this mechanism can predispose someone toward _____.

Migrating motor complex, SIBO

MMC only works while _______ and takes 1.5 to 3 hours to complete

Fasting

Ongoing inflammation in the small intestine can lead to an increased production of antibodies, also known as_______, to food particles.

Immunoglobulins

One marker of increased hyper permeability is increased _______. High levels of this induce the disassembly of _________ ______ proteins, lessening the control over what is absorbed into circulation.

Zonulin, tight junctions

There are two main categories of food reactions: _____ and ______.

Immunologic and Non-immunologic

 

Reactions are characterized by the production of various types of antibodies, including ______in classical allergies, and _____in food hypersensitivities.

 IgE, IgG

Non immunologic food reactions are functional ______ related to the ability to digest certain dietary components

Intolerances

What kind of reaction would someone have to casein if they have an IgG-driven hypersensitivity to the milk protein?

Immunologic

What kind of reaction happens to a lactose intolerant individual due to the lack of lactase enzymes needed to digest it?

Non-immunologic

If the ileocecal valve is " stuck open," it can allow microbes and wastes to block flow into the small intestine, potentially contributing to _____.

SIBO

Contributing factors to ileocecal dysfunction include stress, Constipation, poor signaling from the vagus nerve, infections, or alterations to the _______.

Appendix

Lack of fiber in the chyme can result in reduced _____ production, increased risk of diverticula, increased risk of IBS/IBD, and lower intestinal serotonin production

SCFA

What can bristols # 1 & 2 indicate?

Slow transit time

What can bristols # 1&2 cause?

Toxin accumulation, therefore putting a higher burden on the liver

 

What does bristols # 3 & 4 indicate?

Healthy stool

What can bristols # 5, 6 & 7 indicate?

Rapid transit time

What can bristols # 5, 6 & 7 lead to?

Nutrient deficiencies (if transit time is fast enough)