Diseases of the Digestive System Dr. Jim Whitfield, Ph.D

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


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.


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)


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


Ideally all of these organs function normally and digestion occurs without issue and the person does not find themselves in a diseased state



However



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



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


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”


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

DiverticulosisDiverticulosis 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.

DiverticulosisDoctors 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.

DiverticulosisDiverticulitis 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 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 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 Disease20% 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 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 DiseaseCeliac 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 DiseaseCeliac 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 DiseaseThe 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 DiseaseThe 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 PolypsColon 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 atthe colon from the rectum up to the ileocecal junction and examinethe 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


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.


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 HerniaThe entrance of an organ, typically the stomach,

through the esophageal opening in the diaphragm.

Hiatal Hernia and numerousstomach 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 LangerhansThe 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 LangerhansThe 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 LangerhansThe 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 LangerhansThe 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 secretionof pancreatic lipase

Regulation of blood glucose by Insulin and glucagon

Giant hair ball removed from girls stomach as a result of Trichotillomania!

Thank You!!

Documents

Diseases of the Digestive System Dr. Jim Whitfield, Ph.D