DIGESTIVE SYSTEM

(Pretest 10’ )

I. COMPONENTS AND FUNCTIONS

1. What is the digestive system?
The digestive system is made up of the gastrointestinal tract—also
called the GI tract or digestive tract - and the liver, pancreas, and gallbladder.
The GI tract is a series of hollow organs joined in a long, twisting tube
from the mouth to the anus. The hollow organs that make up the GI tract are
the mouth, esophagus, stomach, small intestine, large intestine, and anus.
The liver, pancreas, and gallbladder are the solid organs of the digestive
system.
The small intestine has three parts.
+ The first part is called the duodenum.
+ The jejunum is in the middle
+ The ileum is at the end.
The large intestine includes the appendix, cecum, colon, and rectum.
+ The appendix is a finger-shaped pouch attached to the cecum.
+ The cecum is the first part of the large intestine.
+ The colon is next.
+ The rectum is the end of the large intestine.
REMEMBER: Bacteria in your GI tract, also called gut flora or
microbiome, help with digestion. Parts of your nervous and circurlatory
systems also help. Working together, nerves, hormones, bacteria, blood, and
the organs of your digestive system digest the foods and liquids you eat or
drink each day.
2. Why is digestion important?
Digestion is important because the body needs nutrients from food and
drink to work properly and stay healthy. Proteins, fats, carbohydrates,
vitamins, minerals , and water are nutrients.
The digestive system breaks nutrients into parts small enough for your
body to absorb and use for energy, growth, and cell repair.
Proteins break into amino acids
 Fats break into fatty acids and glycerol
Carbohydrates break into simple sugars

II. SYMPTOMS
(ACG )
- Diarrheal stools are those that take shape of the container, so they are often
described as loose or watery. Some people consider diarrhea as an increase
in the number of stools, but stool consistency is really the hallmark
- Symptoms of heartburn, also known as acid indigestion, a physical
condition in which acid from the stomach flows backward up into the
esophagus. People will experience heartburn symptoms when excessive
amounts of acid reflux into the esophagus.
- Nausea is the unpleasant urge to vomit.
- Vomiting is the forceful ejection of stomach contents through the mouth.
This is generally a protective mechanism to remove harmful ingested
substances, but can occur from many unrelated infectious and inflammatory
conditions in the body.
- Abdominal pain: Ordinarily, we are unaware of any of the actions of the
organs in the abdomen or any discomfort from activities such as eating,
movement of food through the intestines, or bowel movements. Nerves are
constantly monitoring activities in the body, and when those messages are
transmitted to the brain and come into consciousness as unpleasant
sensations, we may sense pain or discomfort.
- Belching is a normal process and results from swallowed air accumulating
in the stomach. The air can either be belched back or can be passed out of
the stomach into the small intestine and be subsequently passed as rectal gas
(flatus).
- Bloating refers to a sense of fullness in the upper abdomen. This can be
influenced by gas and/or food accumulation in the stomach. Some patients
experience the symptom with normal amounts of gastric gas.
- Flatulence refers to the passage of rectal gas. The gas is generally a
combination of swallowed air and gas produced by the action of colon
bacteria on undigested carbohydrates.
- Constipation is often thought of as a decrease in frequency of stools and
many people believe they are constipated if they do not have a bowel
movement each day. This is not correct, as many persons have as few as
three bowel movements each week and are healthy. For many people,
constipation means too much straining with bowel movements, passage of
small hard stools or a sense that they have not completely emptied their
bowels. ACG defines constipation based upon symptoms including
unsatisfactory defecation with either infrequent stools, difficult stool passage
or both. Any recent change in bowel habits, if persistent, may be cause for
concern.
- Hematemesis - vomiting of blood or coffee-ground-like material.
- Melena - black, tarry stools
- Hematochezia is the passage of fresh blood through the anus, usually in or
with stools (contrast with melena).
III. DIAGNOSTIC TESTS AND PROCEDURES
 1. Blood tests
- Pancreatic function tests
- Liver function tests: aminotransferases, alkaline phosphatase, Gamma-
glutamyl transpeptidase, serum albumin, prothrombin time/international
normalized ratio…
- CBC
- Crp
- Procalcitonin
2. Fecal tests
- Fecal Calprotectin
- Fecal Occult Blood test
- Fecal Immunochemical Test
- Stool culture
3. Breath tests: These can help diagnose a number of digestive disorders.
These include stomach bacteria (H. pylori), poor digestion of sugars (for
example, lactose or milk sugar), bacterial overgrowth, and delayed stomach
emptying (gastroparesis).
4. Imaging tests
- Computed Tomography
- Magnetic Resonance Imaging
- Abdominal ultrasound
- Abdominal X-ray
- Oropharyngeal motility (swallowing) study
- Upper GI (gastrointestinal) series (also called barium swallow).
5. Procedures
- Colonoscopy
- Endoscopic retrograde cholangiopancreatography (ERCP).
- Esophagogastroduodenoscopy (EGD or upper endoscopy).
- Sigmoidoscopy
- Esophageal pH monitoring.
- Capsule endoscopy.
IV. COMMON DISEASES
 V- TREATMENT
1. Medications
- PPI
- Antacids
- Antibiotics
- Probiotics
 2. Surgery
- Partial gastrectomy: This procedure removes part of the stomach. Doctors
typically remove lymph nodes and fatty tissue as well to help ensure all the
cancer is gone.
- Total gastrectomy: Doctors remove the entire stomach, surrounding lymph
nodes and fatty tissue. Next, the surgical team connects the esophagus to the
intestines. A surgeon may create a new “stomach,” or pouch, by folding over
a portion of the intestines, to allow for more effective digestion.
3. Therapeutic endoscopy
Therapeutic endoscopy is the medical term for an endoscopic procedure
during which treatment is carried out via the endoscope.
- Endoscopic injection of bleeding peptic ulcers with adrenaline
- Variceal banding
- Stenting
- Polypectomy