Beginning of PP #1

Functions of the Digestive System

• The digestive system have 6 major functions

1. Ingestion- when the food enters the digestive system throught the mouth.

2. Mechanical processing- Physical manipulation of the food, begins with the tongue and continues with the mixing motions of the digestive tract.

3. Digestion- the chemical breakdown of food into smaller particles so that it can be absorved by the lining of the stomach.

4. Secretation- release of water, acids, and enzymes, other sustances by the digestive tract and other accesory organs.

5. Absorption- The movement of the small organic fragments of digestion into interstitial fluid of the digestive tract.

6. Excresion- is the remocal of wante products from the large intestine through the process of defacation.

Components of the Digestive Tract

• There are two major components of the digestive system

1. Grastrointestinal tract

2. Accessory Organs

• The gastrointestinal tract has two additonal sections

1. The upper GI tract- composed of the mouth, pharynx(throat), esophagus, and stomach (This sections transports food through the stomach

2. The lower GI tract- composed of the small and large intestines, and the rectum and anus. Digestion completes in this section, and waste is expelled from the body

• The accesory organs consist of the liver. gallbladder, and pancreas

The Oral Cavity: The Lips and Palate

• The oral cavity is more commonly called the mouth, and it consists of the lips, hard and soft palates, salivary glands, tongue, teeth, and periodontium (gums)

• The lips are scientifically called the labia, surround the oral cavity opening. They not only have important roles in breathing, speaking. and expression, but lips also help to hold the food in the mouth during chewing

• The palate forms the front portion of the palate, and it lined with mucus

1. The hard palate forms the front portion of the palate and is lined with a mucuos membrane. This membrane has rugae, which are irregular ridges into the nasal cavity

2. The soft palate forms the back of the palate. During swalloing, it closes off the nasal passage to prevent food and liquid from migrating into the nasal cavity

3. The uvula is a pieve of tissue that hangs from the free edge of the soft palate, and moves upwards with the soft palate. It has important roles in produsing speech sounds

The Oral Cavity: The Tongue

• The tongue is a large muscular structure that is vital for chewing, speaking and swalloing. The anterior(front) of the tongue moves freely, and the tongue is attached at the posterior(back) portion.

• The dorsum is the upper surface of the tongue characterized by a tough protective covering papillae, which contain taste buds

• The taste buds are the sensory receptors for the sense of taste

• The underside of tbe tongue is known as the sublingual surface, and is covered with numerous vascular structures

• Sub means beneath

• Lingu/o means tongue

• Al means pertaining to

• The sunbligual surface allows for the quick absurption of substances, that is why some medications are given sublingually

• The lingual frenum is a band of tissue that attaches the tongue to the floor of the mouth, limiting the motion of the tongue

The Oral Cavity: Salivation

• Within the oral cavity are salivary glands, which secrete a susbstance called saliva. Saliva is a colorless, liquid substance that lubicates the oral cavity to maintain the health of the teeth, and contains amalyse, which is a digestive enzyme that can begin the digestive process

• There are three salivary glands

1. The submandibular glands are located in the floor of the mouth, near the mandible, or jawbone.

Mandibul/o means mandible

ar means pertaining to

2. The sublingual glands are located beneath the tongue on the floor of the mouth

3. The parotid are located in the face, just in the front of each ear. Ducts carry the saliva from the gland to the inside of the cheek

The Oral Cavity: The Periodontium

• The periodontium are the soft tissue structure that surrond and support the teeth

(Odonti/o) means teeth

(Peri-) means around

(-um) is a noun ending

• The periodontium consists of all the soft tissues that support the teeth, as well as the bony dental arches

• The gingiva (or gums) is a specialized mucous membrane that covers the bone of the dental arches and surrounds the neck of the teeth. The plural of gingiva is gingivae

• The sulcus is the space between the tooth and the gingiva that surrounds it. It is in this space that debris and bacteria can collect, leading to an infection of the gingiva

• The dental arches hold the teeth firmly in place, enabling chewing and speaking. There are three different structures that compose the dental arches.

1. The maxillary arch is the upper jaw and is immovable

2. The mandibular arch is the lower jaw and is a separate bone capable of movement

3. The temporomandibular joint (TMJ) is the point at which the maxillary and the mandibular joints come together

The Oral Cavity: The Teeth

• The medical terms for teeth is dentition, and human dentition consists of four types of teeth.

• (1)Incisors and (2)canine teeth also knows as cuspids are the ones in the front and they are used for biting and tearing. Cuspids generally have a sharp ridgeline and pointed tip

• (3)Premolars and (4)morals, also know as bicuspids are located in the back and they are used for chewing and grinding. They are flattened and have prominent ridges

• Occlusion refers to the contact between the chewing surfaces of the teeth

• The crown of a tooth is the part of the tooth visible in the mouth, and in covered by enamel, which is the hardest substance in the body

• The roots of the tooth hold it securely in the bone of the dental arch, and are protested by a hard subtance called cementum

• The cervix or the neck of the teeth is where the crown and the root meet

• Dentin composed most of the tooth. It is covered with enamel above the gum line, and cementum beneath the gumline

• The pulp cavity is the part of the tooth that is surrounded by the dentin to protect the pulp. In the roots the pulp cavity is called the root canal. The pulp of the tooth consists of blood vessels and nerves for the tooth

The Oral Cavity: Primary and Permanent Teeth (Dentition)

• The set of teeth in the middle are known as deciduous teeth(dentition), or baby teeth, of which there are 20. They erupt from the gums in early childhod , and are replaced.

• The set of teeth at the top and bottom in the image above are known as the permanent teeth (dentition). Permanent dentition cosists of 32 teeth, which are designed to last the remainder of the lifespan. It consists of 8 incisors, 4 canine, 8 premolars, and 12 molars.

The Pharynx and Esophagus

• The pharynx is more commonly knows as the throat. It serves as the passageway for both the respiratory and digestive system.

• At the end of the pharynx, there are two tubes

1. The trachea which is the passageway for air into the respiratory system

2. The esophagus is the passageways for food and liquids into the digestive system

• The esophagus is the muscular tube which serves as the passageway for food and liquid from the pharynx to the stomach

• The esophagus has a structure called the lower esophageal sphinter, which is also called the cardiac sphincter.

• A sphincter is a muscular ring. This sphincter is a muscular ring between the esophagus and stomach that serves 2 uses:

1. It relaxes to allow food to enter the stomach

2. It remains closed to prevent the stomach contents from regurgitating(flowing backwards) into the esophagus

The Stomach

• The stomach is the first organ of digestion, composed of 3 main sections: The fundus or the upper rounded part, the main portion, and the antrum or the lower part.

• The stomach contains some features that allow it to begin the process of digestion effectively:

1. The rugae are present in the mucous membrane lining of the smotach. They are folds that allow the stomach to increase and decrease in size, depending on the amount of food or liquid ingensted. The rugae also houses glands that secrete gastric juices

2. Gastric juices are enzymes and hydrocholic acid that begin the process of food digestion. The mucous membrane produces a thick mucus that protects the tissues of the stomach from the acidity of these juices

3. The pyloric sphincter is the circular muscle at the base of the stomach. It controls the flow of food from the stomach to the small intestine.

4. The pylorus is the passage that connects the stomach with the small intestine. The opening to the pylorus is controlled by the pyloric sphincter.

The Small Intestine

• The small intestine is a structure that ranges from the pyloric sphincter to the large intestine. It is roughly 20 feet long when stretched out, but in the body it has a looped structure. About 90% of absorption of nutrients in the body occurs in the small intestine

• It has three different sections

1. The duodenum is the portion of the small intestine from the pyloric sphincter to the jejunum

2. The jejunum is the portion of the small intestine, spanning the area between the duodenum and the ileum

3. The ileum is the longest portion of the small intestine, running from the jejunum to the lage intestine

The terms ileum and ilium are similar but ileum refers to the portion of the smalll intestine and ilium refers to part of the hip bone.

The Large intestine

• The large intestine is the organ that extends from the ileum of the small intestine to the anus. It is shorter than then small intestine, but much wider

• The purpose of the large intestine is to complete the digestion and prepare the solid waste for excresion. It does this by:

1. Reabsorbing water and compacting feces, or the solid waste products of the digestive system

2. Absorbing vitamins that have been released through the activity of bacteria in the intestines

3. Sorting the fecal matter before its excretion

• The large intestine has four major parts: The cecum, colon, rectum, and anus

The Large Intestine: Cecum and Colon

• The cecum is a pouch on the right side of the abdomen, and this is where the compaction of the intestinal contents begin. It goes from the end of the ileum to the beginning og the colon.

• The ileocecal sphincter is a rings like muscle controls the flow of material from the ileum to the cecum

Ile/o means ileum

cec/o means cecum

-al means pertaining to

• The vermiform appendix is more commonly known as simply the appendix, hangs from the end of the cecum. The appendix consists of lymph tissue, but its role in the body is largely unknown.

• The colon is the longest part of the large intestine, and is futher divided into four sections.

1. The ascending colon is the portion that moves upward from the cecum to the underside of the liver

2. The transverse colon is the portion that lays horinzotally across the abdominal cavity from right to left, towards the spleen

3. The decending colon is the portion that travels down the left side of the abdomen to the last part of the colon

4. The sigmoid colon is names after its shape. It is curved like the letter S and it continues from the descending colon to the rectum

The Large Intestine: Rectum and Anus

• The rectum is the last four inches of the large intestine, and the widest part of the large intestine

• The rectum is connected to the anus via the anal canal

• The anus is the opening of the anus canal, and the digestive system overall. The opening of the anus is controlled by the internal and external anal sphicters

• Ofter the term anorectal is used to refer to the anus and the rectum as one structure

An/o means anus

rect/o means rectum

Transverse colon= 5.8cm (5.0-6.5)

Ascending colon= 6.6 cm (6.0-7.0)

Cecum=8.7 cm (8.0-10.5)

Descending and sigmoid colon 6.3cm (6.0-6.8)

Rectum near rectal/sigmoid junction 5.7cm (4.5-7.5)

Accessory Digestive Organs: The Liver and the Biliary Tree

• The accesory organs if the digestive tract (system) consists of the liver, gallbladder, and pancreas. They play a major role in digestion, but do not form part of the digestive tract itself

• The liver is the largest organs in the human body, and has lobes. Its most important functions if the removal of toxins from the blood, and also helps transform food into nutrients and carbohydrates that the body needs

1. The liver converts glucose to glycogen, which is a form of glucose (sugar) that is stored in the cells of the liver as well as in the muscles. When blood sugar levels drop, glycogen stores are released to be used by the body

2. Bilirubin is a yellowish- green pigmented substance that is excreted by the liver, into bile, which is a digestive fluid

3. Bile assits in the digestion of fats. It is produced by the liver, and in concentrated and stored in the gallbladder.

Chol/e means bile

• The billary tree is the collection of channels and ducts through which the bile moves from the liver to the small intestine.

• Small ducts in the liver join like branches, forming the biliary tree. The “trunk” of the tree, and the largest structure, is the common hepatic duct. Bile moves through this duct to the gallbladder, where it enters the cystic duct. Finally, the when the cystic duct leave the gallbladder, it rejoins the common hepatic duct to form the common bile duct. The common bile duct joins to the pancreatic duct, and they enter the duodenum of the small intestine.

Accessory Digestive Organs: The Gallbladder and Pancreas

• The gallbladder is a small, pear-shaped organ about the size of an egg, located under the liver

• It stores and modifies the bile, making it more concentrated

• When bile is needed in the duodenum, the gallbladder contracts, expelling some bile through the biliary tree

• Cholecystic is the medical term for pertaining to the gallbladder

Cholecyst/o means gallbladder

-ic means pertaining to

• The pancreas is an oblong, 15 cm long gland behind the stomach with a bumpy apperance, It has vital roles in both the endocrine and digestive system

• For digestion, the pancreas secretes pancreatic juices. These juices help the process of digestion, and they also contain sodium bicarbonate, which is an alkaline substance that helps counter the acidity of the stomach juices.

• Pancreatic juices leave the pancreas via the pancreatic duct, before joining the common bile duct for emptying into the duodenum.

Beginning of PP #2

Digestion

• Digestion is the process by which foods are broken down into simple components, such as nutrients, for the body to use. There are a few terms to know regarding digestion:

1. Digestive enzymes are substances that facilitate the chemical changes that break down complex foods into simple nutrients for the body.

2. Nutrients are the substances that are necessary for the body to function normally. There are two main classes of nutrients: macronutrients and micronutrients.

3. Macronutrients are the major nutrients needed for the body. They include carbohydrates, proteins, and fats.

4. Micronutrients are the substances that are required for the body to function properly, but they are needed in smaller amounts. They include the vitamins and minerals.

Metabolism and Absorption

• Metabolism ) is the complex process of using the body’s nutrients.

Metabol/o means “change,”

–ism means “condition.”

• There are two parts of metabolism

1. Anabolism is the building up of the body’s cells, structures, and substances from nutrients.

2. Catabolism is the breaking down of the body’s cells and substances to release energy and carbon dioxide.

• These two terms are opposites to one another. Collectively, they are known as metabolism.

• Absorption is the process by which digested nutrients are transported to the cells of the body. There are some specialized structures that facilitate the absorption of nutrients into the body’s cells:

  1. Villi are structures located along the mucous membrane that lines the small intestine. Each of these finger-like structures contains blood vessels, which absorb the nutrients directly into the bloodstream. They also contain lacteals.

  2. Lacteals are specialized structures within the villi that absorb fats and fat-soluble vitamins that the bloodstream cannot transport. The lacteals transport these nutrients to the lymphatic system, through which they are filtered by the lymph nodes and eventually processed until they are in a usable form by the bloodstream.

Digestion: The Oral Cavity

• The oral cavity is the point of entry for food into the digestive system. Digestion begins in the mouth through the process of mastication, or chewing

1. Mastication (chewing) breaks the food down into smaller pieces and mixes it with saliva, both of which allows for the process of swallowing.

2. After chewing, the food mass is known as a bolus, and is ready to be swallowed.

• The swallowed food moves through the pharynx and to the esophagus.

• In the esophagus, two processes help the bolus move down to the stomach. The force of gravity aids in the movement, and the peristalsis of the smooth muscle of the esophagus also help

• Peristalsis is the series of wave-like muscle contractions in a single direction that propels the bolus (food mass) downward.

Digestion: The Stomach and Small Intestine

• In the stomach, the most important mechanism for digestion are the gastric juices. As described in the previous slide, the gastric juices contain hydrochloric acids and enzymes, which break down the food.

  1. Most carbohydrates, lipids, and proteins are only partially broken down in the stomach. Little absorption happens here.

  2. The churning movement of the stomach contents also helps to break down the food, combining it with the gastric juices. Chyme (KYM) is the term for the semifluid mass of partially digested food that passes through the pyloric sphincter and out of the stomach

• The small intestine is where most of the absorption of the nutrients occurs.

  1. In the duodenum, chyme mixes with pancreatic juices and bile to begin the process of emulsification. The bile works on the fatty substances in the chyme, breaking them down to allow them to mix better with the pancreatic juices in that part of the small intestine. This must be completed before nutrient absorption can begin.

  2. The jejunum secretes more digestive enzymes, and the ileum absorbs the nutrients.

Digestion: The Large Intestine

• As stated in an earlier slide, the large intestine mainly receives the waste products and digestion, storing them until they are ready for elimination.

• The large intestine processes the waste matter by reabsorbing excess water into its walls to help maintain fluid homeostasis in the body. What is left of the waste matter is feces.

1. Feces is the solid waste of the body that is expelled through the anus. The process of expelling feces and emptying the large intestine is called defecation

• Importantly, the large intestine contains the gut microflora, which are billions of normal bacteria that aid in digestion by breaking down organic waste material, and help protect against infection and maintain the body’s immune system.

1. As the bacteria break down organic waste material, they produce gas.

2. Borborygmus is the noise caused by the movement of that gas, and flatulence is the passage of that gas out of the body through the rectum and anus.

Beginning of PP #3

General Disorders of the Oral Cavity

• Cheilosis is a disorder of the lips that causes crack-like sores in the corners of the mouth. It is also known as cheilitis.

Cheil/o means lips

-osis means abonormal condition or disease

• Herpes labials are blister-like sores on the lips and/or adjacent facial tissue that are caused by a virus known as oral herpes simplex virus type 1, or HSV-1. This is an extremely common virus, and most adults have been exposed. These sores are also called cold sores or fever blisters.

• Xerostomia is also called dry mouth, and is the lack of enough saliva to hydrate the surfaces of the mouth. This is due to decreased secretions from the salivary glands, as a result of medications or disease. This causes tooth decay, bad breath, difficulty swallowing, and changes in the taste of food.

• Trismus is any restriction to opening the mouth, which is usually caused by trauma, surgery, or radiation. This can cause impaired speech and ability to swallow.

• Aphthous ulcers are pits in the soft tissues of the mouth that are grayish-white with a red border. Their cause is generally unknown, but they occur often with stress, some foods, or fevers. They are also called canker sores or mouth ulcers.

• Leukoplakia are benign, white lesions that develop on the inside of the cheeks. They are usually caused by chronic irritation in the mouth.

Luek/o means white

–plakia means plaque

• Stomatitis is the inflammation of the mucous membrane lining of the mouth.

Stomat/o means mouth or mouth-like opening

–itis means inflammation

• Stomatomycosis is a fungal infection of the mouth.

myc/o means fungus

–osis means abnormal condition or disease

• Oral thrush is a type of stomatomycosis that is caused by the yeast species Candida albicans, which is the most common pathogen responsible for yeast infections. This causes creamy-looking, white lesions inside the mouth, and can make eating and swallowing painful.

• A cleft lip is a birth defect in which a deep groove runs from the lip to the nose, due to this portion of the mouth failing to close during fetal development.

• A cleft palate is the failure of the palate to close during fetal development. This could be the hard palate, soft palate, or the upper lip. Certain cleft palates can cause a hole between the nose and mouth, making it difficult to eat or speak.

Dental Diseases and Disorders

• Halitosis is more commonly known as bad breath. It can be caused by various disorders, such as dental disease or respiratory or gastric disorders.

Halit/o means breath

• Dental plaque is a substance that consists of bacteria and bacterial byproducts that forms in the sheltered areas near the gums and between teeth. It is a major cause of dental caries and periodontal disease.

• Dental caries is more commonly known as a cavity or tooth decay, and is an infectious process caused by the bacteria that composes plaque. If the decay is not mitigated, the pulp (root canal) of the tooth can become infected and the tooth could die.

• Malocclusion is more commonly known as a cavity or tooth decay, and is an infectious process caused by the bacteria that composes plaque. If the decay is not mitigated, the pulp of the tooth can become infected and the tooth could die.

Mal means bad

• Edentulous means “without teeth.” This term applies to any situation in which the natural permanent (adult) teeth have been lost.

Periodontal Disease

• Periodontal disease is also known as periodontitis, and is the inflammation of the periodontium, or the tissue that surrounds and supports the teeth.

Peri means around or surrounding

odont/o means teeth

• There are three types of periodontitis

• Gingivitis is the inflammation of the gums. It is the earliest stage of periodontitis.

• A dental calculus is dental plaque that has solidified and hardened., irritating the tissues of the periodontium and causing progressively severe inflammation and disease. This is more commonly known as tartar.

• Acute necrotizing ulcerative gingivitis is caused by an abnormally robust growth of bacteria in the oral cavity, causing progressively severe inflammation, bleeding, ulceration, and eventual death of gum tissue. This is also called trench mouth.

• The term necrotizing means “causing tissue death.”

Disorders of the Esophagus

Dysphagia is defined as any difficulty swallowing.

Dys- means difficult

-phagia means swalloing

• Strictures are areas of abnormal narrowing of a bodily structure. In the esophagus, this can lead to dysphagia, and can be due to scar tissue or other abnormalities.

• Eosinophilic esophagitisis an immune system disorder that causes a specific type of white blood cell, known as an eosinophil, to accumulate in the esophagus.

1. This typically happens due to an allergic reaction.

2. Eosinophils contain granules with substances that can cause inflammation, and this inflammation can cause dysphagia.

• Pyrosis is more commonly called heartburn, and is caused by the acidic contents of the stomach migrating into the esophagus.

Pyr/o means fire

• Gastroesophageal reflux disease, abbreviated GERD, is the backward flow of acid from the stomach into the esophagus when the lower esophagus sphinter opens instead of being closed

Reflux means backward or return flow

Gastr/o means stomach

esophag/o means esophagus

–eal means pertaining to

• Barrett’s esophagus is a complication of GERD, and is the damage to the cells of the epithelial tissue of the esophagus due to continued acid exposure. This condition increases the risk of esophageal cancer.

• Esophageal varices are enlarged and swollen veins at the end of the esophagus as it approaches the stomach, which could cause severe bleeding if rupture occurs.

Disorders from the Stomach

• A hiatal hernia is an anatomical abnormality that causes the tissues of the stomach to protrude into the chest through an opening in the diaphragm.

Hiat/o means opening

• A hernia is a protrusion of tissue through the tissues that normally contain it.

• Gastritis is the inflammation of the stomach lining. This is often caused by the bacteria Helicobacter pylori, and generally subsides when the bacteria are destroyed.

• Gastroenteritis is the inflammation of the mucous membrane that lines the stomach, as well as the intestines

enter/o means “intestines

• Gatroparesis is a disorder that causes the muscles in the stomach to slow down to the point that they do not empty the stomach normally.

–paresis means partial paralysis

Gastorrhea is the excessive excretion of mucus or gastric juices in the stomach.

–rrhea means flow

Disorders of the Stomach: Peptic Ulcers

• Peptic ulcers are more commonly just called ulcers, and are painful sores located on the mucous membranes in the digestive system

Pept/o menas digestion

• Peptic ulcers are caused by Helicobacter pylory, or by medications that irritate the mucosa of the digestive system.

• Perforating ulcers are those in which the ulcer is so severe that it erodes the entirety of the wall of the stomach or intestine.

• There are two main types of ulcers

  1. Gastric ulcers are peptic ulcers affecting the stomach.

  2. Duodenal ulcers are peptic ulcers that affect the duodenum of the small intestine.

Intestinal Disorders: Food Sensistivities

• Food allergies are immune system reactions to the proteins in certain foods.

• Lactose intolerance is an inability to digest dairy due to the absence of lactase, which is an enzyme that processes the sugar present in dairy, which is lactose.

• Celiac disease is an autoimmune disorder that causes a severe reaction to foods containing gluten, which is a protein found in wheat, barley, and rye. Over time, this hereditary disorder damages the villi of the small intestine, causing malabsorption.

• Gluten intolerance can also be called non-celiac gluten sensitivity, and occurs when the gastrointestinal system responds negatively to the presence of gluten, but does not cause intestinal damage like Celiac disease.

Intestinal Disorders: Inflammation

• Diverticulosis is the presence of an abnormally large amount of diverticula in the colon. The exact cause is unknown, but it is thought to be due to deficient fiber in the diet.

Diverticul/o diverticulum

• Diverticula are small pouches that line the walls of an organ, in this case the intestine. The singular of diverticula is diverticulum

• Diverticulitis ) is the inflammation of the diverticula. This term can also be used to describe an infection of the diverticula.

• Diverticulitis occurs when waste matter gets stuck in the pouch of the diverticula, and can cause cramping, nausea, and abdominal pain.

• Enteritis is any inflammation of the small intestine caused by consuming substances contaminated with bacteria or viruses.

Enter/o means intestine

• Ischemic colitis is tissue damage and inflammation caused by interrupted blood flow to the large intestine.

• Polyps are mushroom-like growths from a mucosal lining. They can be pre-cancerous and malignant, or totally benign.

• Colorectal carcinoma is malignant cancer of the colon, and usually presents itself as colon polyps in the first stage.

Intestinal Disorders: Ileus

• Ileus is defined as the partial or complete stoppage of the movement of the intestines, which causes the buildup and potential blockage of the intestines. This could apply to the small or large intestine.

• Ileus is also known as paralytic ileus, because it is the stoppage of the normal peristalsis (muscle contraction) of the intestines.

• This causes pain, cramping, abdominal distention (swelling), vomiting, and the inability to pass gas or feces.

• A common effect of surgery is postoperative ileus, which is the temporary stoppage of bowel activity after abdominal surgery. This can last up to 72 hours and is considered normal.

Irritable Bowel Syndrome and Inflammatory Bowel Disease

• Irritable bowel syndrome (IBS) is a condition that is generally aggravated by stress or certain foods, and is thought to be caused by bacteria or viruses. It causes intermittent pain and cramping, which is accompanied by constipation or diarrhea

• Inflammatory bowel disease (IBD) is a class of diseases that cause intestinal inflammation and swelling.

  1. These diseases are chronic and incurable. They affect the large and small intestines, and can cause pain, weight loss, fatigue, fever, bleeding, and diarrhea.

  2. These conditions come and go in flare-ups, and then go back to remission. During a flare-up, they are treated with medications and surgery.

  3. The two most common IBDs are ulcerative colitis and Crohn’s disease

Ulcerative Colitis and Crohn’s Disease

• Ulcerative colitis is often abbreviated UC, and is the chronic inflammation of the large intestine and rectum. There is no known cause of ulcerative colitis.

  1. It is characterized by lesions in the mucous membrane of the colon, as well as irritation and pain. It only affects the lining of the colon, however.

  2. UC generally starts in the rectum and progresses upwards through the lower part of the colon, but it can involve the entire large intestine.

• Crohn’s Disease is a chronic autoimmune disorder. It has similar symptoms to UC, but can affect any part of the digestive tract. It is most common in the ileum and colon.

  1. Crohn’s disease affects every layer of the tissue, which can cause scarring and swelling. This can lead to intestinal blockage, which can be a life-threatening condition.

Intestinal Obstruction

• Intestinal obstructions are severe, potentially life-threatening constrictions or blockages of the intestines. It can occur due to a tumor, scar tissue, or ingestion of substances that cannot be digested.

  1. Intestinal adhesions are structures that hold together portions of the intestine that should be separate. This can cause obstruction if severe enough.

  2. Strangulating obstructions are those that block the blood flow to the intestines, leading to tissue death or intestinal perforation. Perforation is a hole through the wall of the intestine.

• Volvulus is the twisting of the intestine, causing obstruction. This causes tissue death of the twisted segment of the intestine.

• Intussusception is the movement of the small intestine into the opening of an adjacent body part.

Intussuscept/o means to take up or receive within

–ion means condition

• An inguinal ) hernia is the protrusion of a small piece of intestine through a weak spot in the abdominal wall or groin. This can be caused by straining due to heavy lifting or passing a stool, or by obesity or pregnancy.

Inguin/o means groin

1. A strangulated hernia occurs when part of the intestine becomes constricted by the hernia, causing the blood supply to the intestine to become cut off.

Infectious Diseases of the Intestines

• Most often, infectious diseases enter the intestines through the ingestion of contaminated food. One exception is Clostridium difficile, which is a severe bacterial infection following the use of antibiotics that wipe out the healthy bacteria of the colon.

• Clostridium difficile causes diarrhea and inflammation of the colon, as well as wasting away due to constant diarrhea.

• Dysestery is an infectious disease of the colon, causing severe diarrhea and abdominal pain. It can be caused by bacteria or viruses, but is often caused by Vibrio cholerae in tropical environments.

• Escherichia coli, which is more commonly known as E. coli, is a bacteria that is the cause of many cases of food poisoning and intestinal distress. There are many strains of E. coli, many of which are not infectious. The infectious strains, however, can cause severe vomiting and bloody diarrhea.

• Salmonellosis is a bacterial infection caused by a bacterium from the Salmonella species. It is spread by consuming undercooked foods, especially poultry and eggs, and unpasteurized milk and dairy products.

Anorectal Disorders

• Diarrhea is the abnormally frequent flow of loose and watery stool, which can lead to dehydration.

Dia means through

• Bowel incontinence is defined as the physical inability to control bowel movements. This can happen with age, paralysis, and other conditions.

• Constipation is having less than three bowel movements in a one-week period. This can be caused by disease, medications, pelvic floor dysfunction, or lack of fiber in the diet. Constipation causes hard, dry stools that are often difficult to eliminate.

• Anal fissures are small sores in the skin of the anus that causes severe pain during a bowel movement. Though they can happen any time, they are common with straining due to constipation.

• Hemorrhoids are caused by the slippage of veins, muscles, and/or tissues through the anal opening. This causes pain, itching, bleeding, and fecal leakage.

• A rectocele ) is the bulging of the front wall of the rectum into the vagina as the result of childbirth or pregnancy.

cele means hernia

Abnormal Stools

• Steatorrhea is a fatty stool, which results in foul-smelling, frothy stoold. This can be caused by pancreatic disease, malabsoprtion disorders or removal of the gallbladder

• There are 2 disorders that descrine blood in thr stool

1. Hematochezia is bright red blood in the stool, indicating that the bleeding happened from the lower part of the gastrointestinal tract, or even the rectum or anus.

Hemat/o means blood

chezia means stool

2. Melena is the presence of black, tarry stools, which indicates the presence of digested blood. This means that the bleeding happened further up in the digestive tract.

Liver Disorders

• Hepatitis is the inflammation of the liver. This is usually caused by a viral infection. It is the leading cause of liver cancer and liver transplants.

Hepta means liver

1. Hepatitis A is a virus spread by contaminated food and water, and is the most common form of viral hepatitis. It has a vaccine available.

2. Hepatitis B is a virus transmitted through contaminated blood or body fluids. It also has a vaccine available

3. Hepatitis C is a virus that is also transmitted through contaminated blood or body fluids. It is significant because it can lie undetected for many years, causing liver damage. This form of hepatitis has no vaccine.

• Jaundice is the yellow discoloration of the eyes, skin, and mucous membranes due to liver disease, causing increased amounts of bilirubin in the blood.

• Hepatomegaly is the enlargement of the liver for any reason.

Megaly mans enlargement

• Ascites is the accumulation of fluid in the peritoneal cavity, which causes pressure on the liver’s blood vessels. This is usually due to severe liver disease.

Liver Cirrhosis and Disease

• Cirrhosis is a chronic disease of the liver, causing progressive degeneration and scarring.

Cirrh/o means yellow

1. Cirrhosis is usually caused by excessive alcohol use or hepatitis B or C.

2. The scarred areas of the liver often fill with fat, rendering them physiologically useless.

• Nonalcoholic fatty liver disease is the accumulation of fat in the liver of people without the conditions that cause cirrhosis.

1. People with this condition usually have type 2 Diabetes, who are obese, and who have high cholesterol.

2. Nonalcoholic steatohepatitis is the accumulation of fat in the liver as well as inflammation, and is more serious than nonalcoholic fatty liver disease. It can lead to irreversible cirrhosis and liver cance

Gallbladder Disorders

• Cholecystitis is the inflammation of the gallbladder, which is often associated with gallstones. These stones block the flow of bile, causing inflammation and jaundice.

• A gallstone e is a deposit formed of concentrated bile substances. It is also called a cholelith

Chole/o means bile

-lith means stone

• Cholelithiasis is the presence of gallstones in the gallbladder.

-iasis means abnormal condition

• The pain cased by gallstone is known as biliary colic

• Cholangitis ) is the acute inflammation of a bile duct, which is caused by a bacterial infection. This causes pain in the right upper quadrant of the abdomen, as well as fever and jaundice.

Cholangi/o means bile duct

Disorders of the Pancreas

• Pancreatitis is the inflammation of the pancreas.

Pancreat/o means pancreas

• An insulinoma is a benign tumor of the pancreas. It can cause hypoglycemia (low blood sugar) because it can cause increased insulin secretion, but it can also cause blockage of the pancreatic juices that assist in digestion.

Disorders of the Digestion

• Dyspepsis is discomfort or pain with digestion.

Dys means bad

-pepsia means digestion

• Aerophagia is the excessive swallowing of air during eating or drinking. This can cause painful gas in the stomach and intestines.

• Eructation is the act of orally belching or burping gas from the stomach.

Eruct/o means to belch forth

-tion means action

• Regurgitation is the return of swalloed food into the mouth without necessarily vomiting

• Emesis is the act of vomiting which is the reflex expulsion of the stomach contents through the mouth. This term can also be used as the suffix –emesis.

• Nausea ) is the urge to vomit.

• Hematemesis is the act of vomiting blood, which resembles coffee grounds.

emesis means vomiting

• Hyperemesis is extreme persistent vomiting without relief. This can cause dehydration and other problems. In early pregnancy, it is known as morning sickness, though it can occur at any time of day.

Hyper means excessive

Nutritional Disorders

• Malnutrition is the lack of proper nutrients and minerals in the body due to insufficient ingestion. This could be due to a lack of available food, poor food choices, or the inability of the body to digest and utilize those substances.

Mal- means bad or poor

• Dehydration is th disruption of the body’s electrolyte and fluid balance due to excessive fluid loss and inadequate fluid intake.

De- means removal

hydr/o means water

-tion means the process of

• Malabsorption is the inability of the small intestine to absorb the nutrients that pass through it, which can lead to malnutrition.

• Anorexia is the loss of appetite. This can be caused by disease, medication use, or depression. Anorexia nervosa is a mental disorder that causes anorexia to the point of death, if left untreated.

• Cachexia is the wasting away of an individual due to weight loss and muscle mass loss. This term refers to wasting away even when the patient’s body cannot absorb the nutrients from the food they eat, and is often seen in patients with advanced cancer or AIDS.

Obesity

• Obesity is the excessive accumulation of fat in the body. To be obese, a person must be 20-30% over the recommended weight standard for their height, age, and gender.

• Body mass index (BMI) is a number that shows body weight adjusted for height. There are four ranges for BMI: Underweight, normal, overweight, and obese. BMI is an extremely useful tool for showing risk factors for disease based on weight, but is not a perfect system. It does not take into account muscle mass or bone mass.

• Morbid obesity occurs when a person weighs more than twice their ideal weight, or has a BMI of over 40.

Beginning of PP#4

Medical Professionals: Oral Cavity

• A dentist is an individual with a doctor of dental surgery (DDS) or doctor of medical dentistry (DMD) degree, who diagnoses and treats disorders of the teeth and tissues in the oral cavity.

• A dental hygienist is a licensed dental professional who performs assessments on a patient’s oral health, provide education, as well as periodontal therapy, including cleaning, radiologic services, and screening for oral cancer.

• A periodontist is a dentist who specializes in preventing and treating disorders of the periodontium, or the tissues of the oral cavity that surround the teeth.

Peri means around

odont/o means teeth

-ist means specialist

• An orthodontist is a dentist who specializes in preventing or correcting malocclusion of the teeth, as well as the jaws.

Orth/o means straight

• An oral/maxillofacial surgeon is a physician who specializes in performing surgery on the face and oral cavity to repair injury or deformities, as well as treating disease.

Medical Professionals: Gastrointestinal

• A gastroenterologists is a physician who specializes in diagnosing and treating digestive system disorders.

Gastr/o means stomach

enter/o means small intestine

-ologists means specialists

• A proctologist is a physician who specializes in diagnosing and treating disorders of the colon, rectum, and anus.

Proct/o means anus and rectum

• Bariatrics is a field of medicine concerned with diagnosing and treating disorders associated with obesity, as well as the prevention and management of obesity and its related diseases.

Bar/o means weight

-iatrics means field of medicine

• A registered dietician is a medical professional who specializes in food and nutrition. This person counsels patients on improving their health through a nutritious diet.

Diagnostic Procedures: Imaging

• There are four major types of imaging used to diagnosed digestive system diseases

1. Abdominal Computed tomography is the use of a CT scan on the abdominal region using radiation to create a detailed cross-section of the tissues of the abdomen. This can illuminate problems with the tissues, including obstructions or tumors.

2. Abdominal ultrasound is a non-invasive procedure that uses high-frequency sound waves instead of radiation to visualize the internal organs.

3. Cholangiography ) is the use of radiation and a contrast medium to visualize the bile ducts and the flow of bile within those ducts. This can identify obstructions in the liver or bile ducts.

-graphy means the process of recording

• A cholangiograms is the record produced from a cholangiography

  4. An upper Gi series s is a radiographic study of the structures of the upper GI system with the use of a barium swallow. Barium is a contrast medium.

  5. A lower GI series is a radiographic study of the structures of the lower GI system with the use of a barium enema, which is the insertion of barium into the rectum.

Diagnostic Procedures: Endoscopy

• There are 5 major methods of endoscopy. Endoscopy is performed with an endoscope, which is an thin, flexible tube with a camera on one end

1. Esophagogastroduodenoscopy is an endoscopy of the esophagus, stomach, and upper duodenum of the small intestine.

2. Anoscopy is the use of an endoscope to examine the anal canal and lower rectum.

An/o means anus

3. Capsule endoscopy is the use of a video camera encapsulated in a pill that a patient can swallow to perform an endoscopy. The capsule records images of the small intestine as it moves through the structures, usually over the span of about 8 hours.

4. Colonoscopy is the examination of the colon with the use of a colonoscope, which is a specialized endoscope

Colon/o means colon

–scopy means “visual examination

• A virtual colonoscopy is performed with the use of MRI or CT. The preparation for this type of colonoscopy is the same as for a traditional colonoscopy.

5. A sigmoidoscopy is the use of an endoscope to examine the rectum, sigmoid colon, and part of the descending colon.

Diagnostic Procedures: Laboratory Testing

• Before any laboratory testing can occur, a stool sample must be acquired. A stool sample is a specimen of feces. There are many tests that can be performed on a stool sample:

1. A visual examination can indicate whether there are issues with the stool consistency, such as fatty stool, diarrhea, etc.

2. Stool cultures can be performed to determine if harmful bacteria are growing in the stool. The stool is placed on bacterial growth plates, and a medical laboratory scientist examines them to determine if the bacterial species growing are normal.

3. Molecular testing can also be performed on the stool to determine if DNA from specific harmful viruses or bacteria are present.

4. A fecal occult blood test, also known as a Hemoccult test, can be done to discover the presence of blood in the stool.

-occult means hidden

• The Cologuard test also looks for occult blood in the stool, which can be an early sign of colon cancer

Treatment Procedures: Medications

• Many medications used to treat disorders of the digestive system are over-the-counter:

1. Antacids are medications that neutralize the acids in the stomach to help relieve discomfort of pyrosis, or to allow peptic ulcers a more alkaline environment in which to heal.

2. Proton pump inhibitors are medications that physically decrease the amount of acid produced in the stomach.

3. Laxatives are medications that stimulate bowel movements through various mechanisms. Bulk-forming laxatives help fecal matter retain water to soften it as it moves through the colon.

4. Antimotility drugs are medications that are used to treat diarrhea.

5. Antiemetic medications are given to help relieve or prevent nausea and vomiting.

Anti- means against

emet/o means vomit

-ic means pertaining to

6. If nausea and diarrhea become severe, a patient may be dehydrated. The following are medications to help combat dehydration:

• Intravenous fluids (IV) are fluids given through a catheter inserted in a vein to treat dehydration.

Intra- means within

ven/o means venous

–us is a noun ending.

• Oral rehydration therapy is the administration of an electrolyte solution by mouth to fight dehydration caused by diarrhea.

Re- means back

hydr/o means water

–tion means the process of

Treatment Procedures: Pre- and Probiotic and Antioxidants

1. Probiotics are living bacteria that aid in digestion as well as preventing the overgrowth of harmful bacteria. These bacteria are sometimes called “good bacteria,” or normal flora in the medical setting.

Pro- means supporting

bi/o means life

2. Prebiotics are the carbohydrates that are not digestible by the human body, but are consumed by the “good” bacteria in the gut. Without adequate prebiotics, the normal flora may suffer. Some supplements that contain probiotics also contain prebiotics.

3. Antioxidants are chemicals that potentially provide some protection against cellular damage from free radicals, which are substances that may cause harm. These include vitamins and some minerals.

Oral Cavity Treatments

• Dental prophylaxis is the cleaning of teeth by a medical professional, usually a dental hygienist, to remove plaque and calculus to prevent the development of dental caries.

• A root canal is a procedure in which damaged or diseased pulp in the root canal is removed. The aim of a root canal is to save the tooth; once the diseased pulp is removed, the cavity is filled with a protective substance and sealed.

• Dental implants are devices that are anchored to the bone of the jaw to replace or repair a tooth. There are three major types of dental implants:

1. A crown is a metal or porcelain cap that is placed over a damaged tooth to replace the missing or damaged structure.

2. A bridge is a prosthesis that joins artificial teeth to the adjacent natural teeth.

3. A denture is a plate that holds one or more artificial teeth. Most traditional dentures are removable.

Oral Cavity Treatments: Surgery

• Maxillofacial surgery is surgery on the face and jaws to repair injury, correct deformities, or treat disease.

Maxill/o means jaw

faci/o means face

–al means pertaining to

• A gingivectomy is a surgical procedure to remove diseased gingival tissue.

Gingiv/o means gingival tissue

–ectomy means surgical removal

• A palatoplasty is a surgical procedure in which a cleft palate is repaired. This term is also used to describe the surgical procedure performed to repair a cleft lip.

Palat/o means palate

–plasty means surgical repair

Treatment Procedures: Feeding

• If people are unable to feed themselves or otherwise take in food orally, there are some alternatives available for them:

1. A gastrostomy tube is more commonly called a G-tube or a feeding tube, and is a tube that is surgically placed that runs from the exterior of the stomach to the interior. This is done for patients who are unable to swallow or take food by mouth for other reasons.

-ostomy means surgincally creating an opening

2. Nasogastric intubation is the insertion of a feeding tube through the nose, down the esophagus, and into the stomach. Unlike a G-tube, a nasogastric tube is only temporary.

Nas/o means “nose

• Total parenteral nutrition, or TPN, is a specially formulated intravenous solution that is given to patients who cannot or should not get their nutrition through eating and digestion. Total parenteral nutrition provides all of the patient’s nutrition without involving the digestive system.

Parenteral means “not through the digestive system.

Treatment Procedures: Stomach

• A gastrectomy is a surgical procedure to remove all of the stomach, or a portion of the stomach. This is often done when a stomach cancer is present

• Bariatric surgery encompasses three procedures that are performed to treat morbid obesity. They achieve this by restricting the amount of food that the stomach can hold and digest at any given time

1. Lap-band adjustable gastric banding is the placement of an inflatable band around the exterior of the stomach. This restricts the amount of food that can enter the stomach. This procedure is reversible.

2. Gastric bypass surgery is a surgical procedure in which the stomach is made smaller by stapling part of the stomach to create a small pouch. This surgery is not reversible.

3. Endoscopic sleeve gastroplasty involves the suturing of the stomach to make it into a small tube, so that its capacity is reduced.

Treatment Procedures: The Intestines

• An ileectomy is a surgical procedure to remove the ileum of the small intestine.

• A diverticulectomy is the surgical removal of a diverticulum.

• There are a number of colon-specific treatment procedures:

1. A colectomy is the surgical removal of all or part of the colon. This is done in severe cases of ulcerative colitis

2. A colotomy is a surgical incision into the colon.

–otomy means “surgical cutting

3. A gastroduodenostomy is the establishment of a surgical connection (known as an anastomosis) between the upper part of the stomach and the duodenum.

Treatment Porcedures: Ostomies

• Ostomies are surgical procedures performed to create an artificial opening between an organ and the body’s surface.

• A colostomy is the surgical creation of an opening between the outside of the abdomen and the inside of the colon. Fecal matter exits the body through the stoma (hole) created by the ostomy.

• An ileostomy is the surgical creation of an opening between the outside of the abdomen and the inside of the small intestine.

Treatment Procedures: The Rectum and Anus

• A hemorrhoidectomy is a surgical procedure to remove hemorrhoids. Often, rubber band ligation is used to remove the hemorrhoids instead of actual surgery. A rubber band is placed around the base of the hemorrhoid to cut off circulation. Eventually, the hemorrhoid would fall off.

• A proctopexy is a surgical procedure in which a prolapsed rectum is affixed through sutures to any adjacent tissue or organ. This is done to help correct a prolapsed anus

Proct/o means rectum

–pexy means surgical fixation

Treatment Procedures: Accesory Organs

• There are two main treatments used for the gallbladder:

1. A choledocholithotomy is an incision into a bile duct to remove a stone.

2. A cholecystectomy is the removal of the entire gallbladder.

• The liver also has two major surgical treatments available:

1. A hepatectomy is the surgical removal of all or part of the liver

2. A liver transplant can be performed if the liver has failed for any reason other than cancer. Partial liver transplants can be adequate in some cases, since the liver is regenerative.