The

Digestive
System
Every cell of the body requires nutrients so the food must be
converted to a usable form and then delivered to the cells.

The digestive system, with the assistance of the circulatory

system, is a complex set of organs, glands, and ducts that work
together to transform food into nutrients for cells. Food is taken
into the digestive system, where it is broken down into smaller
and smaller particles.

Enzymes in the digestive system break the particles down into

very small molecules, which are absorbed into the blood and
transported all over the body. There, those molecules are broken
down by other enzymes to release energy or are assembled into
new molecules to build tissues and organs.
What is the Digestive System?
The digestive system is a
continuous tube that begins at the
mouth and ends at the anus.
Measuring about 30 feet long in
the average adult, it is known as
the alimentary canal or
gastrointestinal tract. It has 3
functions: the digestion of food
into nutrients, the absorption of
nutrients into the bloodstream, and
the elimination of solid wastes.
What is the Digestion and Absorption?

Digestion is the breakdown of food to molecules that are small

enough to be absorbed into the blood.

There are two types of digestion: mechanical digestion and

chemical digestion.
Mechanical digestion breaks large food particles into smaller
ones. Chemical digestion uses enzymes to break covalent
chemical bonds in organic molecules. Large organic molecules
are broken down into smaller molecules. Specifically,
carbohydrates get broken down into monosaccharides, lipids get
broken down into fatty acids and monoglycerides, and proteins
get broken down into amino acids.

Absorption begins in the stomach, where some small,

lipidsoluble molecules, such as alcohol and aspirin, can diffuse
through the stomach epithelium into the blood.
The functions of the digestive system include the
following:
1. Ingestion is the consumption of solid or liquid food,
usually through the mouth.
2. Digestion is the breakdown of large organic molecules
into smaller molecules that can be absorbed. Digestion
occurs through mechanical and chemical means.
3. Absorption is the movement of molecules out of the
digestive tract and into the blood or lymphatic system. The
epithelial cells that line the lumen of the small intestine
absorb the small molecules of nutrients (amino acids,
monosaccharides, fatty acids, vitamins, minerals, and
water) that result from the digestive process.
4. Elimination is the removal of undigested material, such
as fiber from food, plus other waste products from the
body as feces or stool
ANATOMY AND HISTOLOGY OF THE DIGESTIVE SYSTEM

Two main groups

1. Alimentary Canal – continuous coiled
hollow tube; Gastro-Intestinal Tract; Digestive
Tract
2. Accessory Digestive Organs
Organs of the Alimentary Canal

· Mouth
· Pharynx
· Esophagus
· Stomach
· Small intestine
· Large intestine
· Anus
Mouth (Oral Cavity) Anatomy
The buccal cavity or oral cavity, or mouth, is the first part of
the digestive tract.
Mouth (Oral Cavity) Anatomy
· Lips (labia) – protect
the anterior opening
· Cheeks – form the
lateral walls
· Hard palate – forms
the anterior roof
· Soft palate – forms
the posterior roof
· Uvula – fleshy
projection of the
soft palate
Mouth (Oral Cavity) Anatomy
· Vestibule – space
between lips externally
and teeth and gums
internally
 Mouth (Oral Cavity) Anatomy
· Teeth
There are 32 teeth in the normal adult mouth,
located in the mandible and maxillae. The teeth
can be divided into quadrants:
right upper, left upper, right lower, and left lower.
In adults, each quadrant contains one central and
one lateral incisor (to cut); one canine; first and
second premolars; and first, second, and third
molars. The third molars are called wisdom teeth
because they usually appear in the late teens or
early twenties, when the person is old enough to
have acquired some degree of wisdom.
The teeth of adults are called permanent teeth, or
secondary teeth. Most of them are replacements
for the 20 primary teeth, or deciduous teeth,
also called milk or baby teeth, which are lost
during childhood.
 Mouth (Oral Cavity) Anatomy
· Teeth
Each tooth consists of three regions: (1) a crown with
one or more cusps (points), (2) a neck, and (3) a root.
The crown is the visible portion of a tooth. The neck is
the small region between the crown and the root. The
root is the largest region of the tooth and anchors it in
the jawbone. Within the center of the tooth is a pulp
cavity, which is filled with blood vessels, nerves, and
connective tissue, called pulp. The pulp cavity is
surrounded by a living, cellular, calcified tissue called
Dentin. The dentin of the tooth crown is covered by an
extremely hard, acellular substance called enamel,
which protects the tooth against abrasion and acids
produced by bacteria in the mouth. The surface of the
dentin in the root is covered with cementum.
 ORAL CAVITY, PHARYNX, AND ESOPHAGUS
Anatomy of Oral Cavity: Teeth
 ALVEOLI (along the alveolar process of mandible x
maxillae) – where the teeth are rooted
 GINGIVA – dense fibrous CT and most stratified
squamous epithelium that covers the alveolar processes
 Periodontal ligaments – CT fibers that extend from the
alveolar walls that hold the teeth in place
 Dental caries / Tooth decay – result of the
breakdown of enamel by acids produced by bacteria
on tooth surface
 Periodontal disease – inflammation x degeneration
of the periodontal ligaments, gingiva, alveolar bone
 The teeth are used for
chewing the food…
mastication. The food is
broken apart and mixed
with saliva to form a
bolus, ready to be
swallowed.

Muscular constrictions move the bolus through the pharynx

(soft palate at the back of the mouth) and into the esophagus
while blocking the opening to the larynx and preventing the
food from entering the airway.
Mouth (Oral Cavity) Anatomy
· Tongue – attached at hyoid
and styloid processes of the
skull, and by the lingual
frenulum
Mouth (Oral Cavity) Anatomy
Salivary Glands
There are three major pairs of salivary glands:
(1) the parotid glands,
(2) the submandibular glands, and
(3) the sublingual glands
A considerable number of other salivary glands are scattered
throughout the oral cavity, including on the tongue. Salivary
glands produce saliva.
The largest of the salivary glands, the parotid (beside the
ear) glands, are serous glands located just anterior to each
ear. Parotid ducts enter the oral cavity adjacent to the second
upper molars.

Mumps is an inflammation of the parotid gland caused by a

viral infection. The inflamed parotid glands become swollen,
often making the cheeks quite large. The virus causing
mumps can also infect other structures. Mumps in an adult
male may involve the testes and can result in sterility.
The submandibular (below the mandible) glands produce
more serous than mucous secretions.
Each gland can be felt as a soft lump along the inferior
border of the mandible.
Mouth (Oral Cavity) Anatomy

· Tonsils
· Palatine tonsils
· Lingual tonsil
 Processes of the Mouth
· Mastication (chewing) of food (esp. the lips and
cheeks). Mastication begins the process of
mechanical digestion, which breaks down large
food particles into smaller ones. The lips and
cheeks move the food around within the oral cavity
and hold the food in place while the teeth crush or
tear it.
· Mixing masticated food with saliva
· Initiation of swallowing by the tongue
· Allowing for the sense of taste
Pharynx Anatomy
· Nasopharynx –
not part of the digestive system
· Oropharynx – posterior to oral
cavity
· Laryngopharynx – below the
oropharynx and connected to
the esophagus
Normally, only the oropharynx and
laryngopharynx carry food
to the esophagus. The posterior walls
of the oropharynx and
laryngopharynx are formed by the
superior, middle, and inferior
pharyngeal constrictor muscles.
 Pharynx Function
· Serves as a passageway for
air and food
· Food is propelled to the
esophagus by two muscle
layers
· Longitudinal inner layer
· Circular outer layer
· Food movement is by
alternating contractions of the
muscle layers (peristalsis)
 Esophagus
· Runs from pharynx to stomach
through the diaphragm
· Conducts food by wavelike
muscular contractions called
peristalsis
(slow rhythmic squeezing)
· Passageway for food only
(respiratory system branches off
after the pharynx)
· At the opening of the stomach is
the lower esophageal sphincter.
This is a muscle valve that
permits the passage of food, but
not the backup of stomach
contents under normal conditions.
Swallowing
Swallowing, or deglutition, can be divided
into
three phases:
(1) the voluntary phase,
(2) the pharyngeal phase, and
(3) the esophageal phase.

During the voluntary phase, a bolus, or mass

of food, is formed in the mouth. The tongue
pushes the bolus against the hard palate. This
forces the bolus toward the posterior part of
the mouth and into the oropharynx.
Swallowing
Swallowing, or deglutition, can be divided into
three phases:
(1) the voluntary phase,
(2) the pharyngeal phase, and
(3) the esophageal phase.

The pharyngeal phase of swallowing is controlled

by a reflex. This phase is initiated when a bolus of
food stimulates receptors in the oropharynx to
elevate the soft palate, closing off the nasopharynx.
The pharynx elevates to receive the bolus of food
from the mouth. The three pharyngeal constrictor
muscles then contract in succession, forcing the
food through the pharynx. At the same time, the
upper esophageal sphincter relaxes, and food is
pushed into the esophagus. As food passes through
the pharynx, the vestibular and vocal folds close,
and the epiglottis is tipped posteriorly, so that the
opening into the larynx is covered. These
movements prevent food from passing into the
larynx.
Swallowing
Swallowing, or deglutition, can be divided into
three phases:
(1) the voluntary phase,
(2) the pharyngeal phase, and
(3) the esophageal phase.

The esophageal phase of swallowing is

responsible for moving food from the pharynx to
the stomach. Muscular contractions of the
esophagus occur in peristaltic waves. A wave of
relaxation of the esophageal muscles precedes the
bolus of food down the esophagus, and a wave of
strong contraction of the circular muscles follows
and propels the bolus through the esophagus.
Gravity assists the movement of material,
especially liquids, through the esophagus.

Peristalsis is a series of wave-like muscle

contractions that move food through the
digestive tract.
Layers of Alimentary Canal Organs
Layers of Alimentary Canal Organs
· Mucosa
· Innermost layer
· Moist membrane
· Surface epithelium
· Small amount of
connective tissue
(lamina propria)
· Small smooth muscle
layer
Layers of Alimentary Canal Organs
· Submucosa
· Just beneath the
mucosa
· Soft connective tissue
with blood vessels,
nerve endings, and
lymphatics
 Layers of Alimentary Canal Organs
· Muscularis externa – smooth
muscle
· Inner circular layer
· Outer longitudinal layer
· Serosa
· Outermost layer – visceral
peritoneum
· Layer of serous fluid-
producing cells
Stomach
The stomach primarily houses food for
mixing with hydrochloric acid and other
secretions. It is an enlarged segment of the
digestive tract in the left superior part of
the abdomen.
Stomach Anatomy

Figure 14.4a
Stomach Anatomy
· Regions of the stomach
· Cardiac region – near
the heart
· Fundus
· Body
· Pylorus – funnel-
shaped terminal end
· Food empties into the
small intestine at the
pyloric sphincter
Stomach Anatomy
· Rugae – internal folds of
the mucosa
· External regions
· Lesser curvature
· Greater curvature
Stomach Functions
· Acts as a storage tank for
food
· Site of food breakdown
· Chemical breakdown of
protein begins
· Delivers chyme (kim)
(processed food) to the
small intestine

Chyme passes through the pyloric sphincter

valve at the bottom of the stomach, into the
small intestine.
 Stomach Anatomy
· Layers of peritoneum
attached to the stomach
· Lesser omentum – attaches
the liver to the lesser
curvature
· Greater omentum –
attaches the greater
curvature to the posterior
body wall
· Contains fat to insulate,
cushion, and protect
abdominal organs
ANATOMY AND HISTOLOGY OF THE DIGESTIVE SYSTEM

Peritoneum
The walls of the abdominal cavity and the abdominal organs are associated with a serous membrane. This
membrane is called the peritoneum.
The serous membrane that covers the organs is the visceral peritoneum, or serosa.
The serous membrane that lines the wall of the abdominal cavity is the parietal peritoneum.
Many of the organs of the abdominal cavity are held in place by connective tissue sheets called
mesenteries.
The mesenteries also provide a route for blood vessels and nerves from the abdominal wall to the organs.
The mesenteries consist of two layers of serous membranes with a thin layer of loose connective tissue
between them. Although “mesentery” is a general term referring to the serous membranes attached to the
abdominal organs, it is also applied specifically to the mesentery associated with the small intestine,
sometimes called the mesentery proper.
The mesentery connecting the lesser curvature of the stomach to the liver and diaphragm is called the
lesser omentum, and the mesentery connecting the greater curvature of the stomach to the transverse
colon and posterior body wall is called the greater omentum. The greater omentum is unusual in that it is
a long, double fold of mesentery that extends inferiorly from the stomach before looping back to the
transverse colon to create a cavity, or pocket, called the omental bursa. Adipose tissue accumulates in the
greater omentum, giving it the appearance of a fat-filled apron that covers the anterior surface of the
abdominal viscera.
ANATOMY AND HISTOLOGY OF THE DIGESTIVE SYSTEM

Peritonitis is a potentially life-threatening

inflammation of the peritoneal membranes. The
inflammation can result from chemical irritation
by substances, such as bile, that
have escaped from the digestive tract. Or it can
result from infection originating in the digestive
tract, as may occur
when an infected appendix ruptures. The main
symptoms of peritonitis are acute abdominal pain
and tenderness that are worsened by movement.
Structure of the Stomach Mucosa

· Gastric pits formed by

folded mucosa
· Glands and specialized
cells are in the gastric
gland region
Secretions of the Stomach
As food enters the stomach, the food is mixed with stomach secretions
to become a semifluid mixture called CHYME (juice). Although some
digestion occurs in the stomach, that is not its principal function.
Stomach secretions from the gastric glands include hydrochloric
acid, pepsin, mucus, and intrinsic factor.
1. Hydrochloric acid produces a pH of about 2.0 in the
stomach. The acid kills microorganisms and activates the
enzyme, pepsin.
2. Pepsin is converted from its inactive form, called
pepsinogen. Pepsin breaks covalent bonds of proteins to Intrinsic factor is a glycoprotein
form smaller peptide chains. Pepsin exhibits optimum secreted by parietal cells of the
enzymatic activity at a pH of about 2.0. gastric mucosa. In humans, it
3. Mucus forms a thick layer, which lubricates the epithelial has an important role in the
cells of the stomach wall and protects them from the damaging absorption of vitamin B12
effect of the acidic chyme and pepsin. Irritation of the stomach (cobalamin) in the intestine, and
mucosa stimulates the secretion of a greater volume of mucus. failure to produce or utilize
4. Intrinsic factor binds with vitamin B12 and intrinsic factor results in the
makes it more readily absorbed in the small intestine. condition pernicious anemia
Vitamin B12 is important in deoxyribonucleic acid (DNA)
synthesis and in red blood cell production.

Regulation of Stomach
Secretions
Approximately 2 L of gastric
secretions (gastric juice) are
produced each day. Both
nervous and hormonal
mechanisms regulate
gastric secretions. The neural
mechanisms involve central
nervous system (CNS) reflexes
integrated within the medulla
oblongata.
Higher brain centers can
influence these reflexes. Local
reflexes are integrated within
the enteric plexus in the wall of
the digestive tract and do not
involve the CNS. Hormones
produced by the stomach and
intestine help regulate stomach
secretions.
Heartburn, or gastritis, is a
painful or burning sensation
in the chest usually associated
with an increase in gastric acid
secretion and/or a backflush of
acidic chyme into the
esophagus. Overeating, eating
fatty foods, lying down
immediately
after a meal, consuming too
much alcohol or caffeine,
smoking, and wearing
extremely tight clothing can
all cause heartburn.
Small Intestine
· The body’s major digestive organ
· Site of nutrient absorption into the
blood
· Muscular tube about 21 feet long and
1” diameter extending from the pyloric
sphincter to the ileocecal valve of the
large intestine
· Suspended from the posterior
abdominal wall by the mesentery
 Subdivisions of the Small Intestine
· Duodenum
· Attached to the stomach
· Curves around the head of
the pancreas
· Jejunum
· Attaches anteriorly to the
duodenum
· Ileum
· Extends from jejunum to
large intestine
 Modifications of the Small Intestine
The small intestine is the major site of digestion and
absorption of food, which are accomplished due to the
presence of a large surface area. The small intestine has three
modifications that increase its surface area about 600-fold:
(1) circular folds, (2) villi, and (3) microvilli.

The mucosa and submucosa form a series of circular folds that

run along the digestive tract.
Tiny, fingerlike projections of the mucosa form numerous villi
which are 0.5–1.5 mm long. Most of the
cells composing the surface of the villi have numerous
cytoplasmic extensions, called microvilli. Each villus is
covered by simple columnar epithelium. Within the loose
connective tissue core of each villus are a blood capillary
network and a lymphatic capillary called a lacteal (resembling
milk). The blood capillary network and the lacteal are very
important in transporting absorbed nutrients.
 Mucosa of the Small Intestine
The mucosa of the small intestine is simple columnar
epithelium with four major cell types:
(1) absorptive cells, which have microvilli, produce digestive
enzymes, and absorb digested food;
(2) goblet cells, which produce a protective mucus;
(3) granular cells, which may help protect the intestinal
epithelium from bacteria; and
(4) endocrine cells, which produce regulatory hormones.

The epithelial cells are located within tubular glands of

the mucosa, called intestinal glands or crypts of Lieberkühn,at
the base of the villi. Granular and endocrine cells are located in
the bottom of the glands. The submucosa of the duodenum
contains mucous glands, called duodenal glands, which open
into the base of the intestinal glands.
The duodenum and
the jejunum

The duodenum and the jejunum are lined with

finger-like protrusions calIed villi. They slow
the passage of food, and allow food particles
to be captured in among these finger-like villi
-- so that the blood inside the villi can absorb
the nutrients in the food. Villus capillaries
collect amino acids (proteins) and glucose
(simple sugars). Villus lacteals collect
absorbed fatty acids.
Large Intestine
Anatomy of the Large Intestine
The large intestine consists of
(1) the cecum, (2) the colon,
(3) the rectum, and (4) the anal canal
Vestigial or Evolutionary Remnant
It was found that in herbivorous vertebrates, the appendix is
comparatively larger and it helped in the digestion of tough
herbivorous food such as the bark of a tree. However, as
humans evolved, they started to include more easily digestible
food in their diet and the appendix eventually lost it function.
There are scientists who believe that in time the appendix will
eventually disappear from the human body.
Role in the immune system
Research in recent years has shown that the human appendix
has lymphoid cells, which help the body fight infections. This
strongly suggests that the appendix plays a role in the immune
system.

The appendix has been found to play a role in mammalian

mucosal immune function. It is believed to be involved in
extrathymically derived T-lymphocytes and B-lymphocyte-
mediated immune responses. It is also said to produce early
defences that help prevent serious infections in humans.
Anatomy of the Large Intestine
Attached to the cecum is a tube about
9 cm long called the Appendix.

Appendicitis is an inflammation of the appendix that

usually occurs because of an obstruction. Secretions from
the appendix cannot pass the obstruction; therefore, they
accumulate, causing enlargement and pain. Bacteria
around the appendix can cause infection.

Symptoms include sudden abdominal pain, particularly in

the right lower quadrant at a specific point called the
McBurney point. The McBurney point is midway
between the umbilicus and the right superior iliac spine of
the coxal bone. Appendicitis also can cause a slight fever,
loss of appetite, constipation or diarrhea, nausea, and
vomiting. If the appendix bursts, the infection can spread
throughout the peritoneal cavity, causing peritonitis, with
life-threatening results.
 Function of the Large Intestine
The function of the large intestine, or bowel, is to absorb the remaining
water and nutrients from indigestible food matter, store unusable food
matter (wastes), and then eliminate the wastes from the body. The large
intestine is subdivided into the cecum and the ascending/transverse/
descending/and sigmoid colon sections.
Normally, 18–24 hours are required for material to pass through the
large intestine, in contrast to the 3–5 hours required for chyme o
move through the small intestine. Chyme is converted to feces in
the colon. Feces formation is due to the absorption of water and
salts, the secretion of mucus, and extensive action of
microorganisms. The colon stores the feces until they are
eliminated by the process of defecation.

Numerous microorganisms inhabit the colon. They reproduce

rapidly and ultimately constitute about 30% of the dry weight of
the feces. Some bacteria in the intestine synthesize vitamin K and
other vitamins, which are passively absorbed in the colon. Vitamin
K is essential for blood clotting and bone health
The rectum and anus… The rectum is where feces
are stored until they leave
the digestive system,
through the anus as a
bowel movement.

As the rectal walls expand with

waste material, receptors from the
nervous system stimulate the desire
to defecate. For defecation or
egestion, we consciously relax the
external anal sphincter muscle to
expel the waste through the anus.
Anatomy of the Large Intestine
Hemorrhoids are enlarged or inflamed rectal, or
hemorrhoidal, veins that supply the anal canal.
Hemorrhoids may cause pain, itching, and/or bleeding
around the anus. Treatments include increasing bulk
(indigestible fiber) in the diet, taking sitz baths, and using
hydrocortisone suppositories. Surgery may be necessary if
the condition is extreme and does not respond to other
treatments.
•Process of the Alimentary Canal

Ingestion (Mouth) Mastication (Teeth)

Deglutition (Bolus) Peristalsis
(Esophagus) Chyme (Stomach)
Absorption of Nutrients (Small Intestine)
Further Absorption and Waste production (Large
Intestine) Excretion/Defecation (Anus)
Meconium
Meconium is the dark, thick and sticky first poop of a newborn
baby. Meconium can be passed after a baby is born or while still
in the womb. Swallowing some meconium is safe for your baby.
Breathing in meconium can cause serious respiratory problems.

Unlike later feces, meconium is composed of materials ingested

during the time the infant spends in the uterus: intestinal
epithelial cells, lanugo, mucus, amniotic fluid, bile, and water.
Meconium, unlike later feces, is viscous and sticky like tar – its
color usually being a very dark olive green and it is almost
odorless.[1] When diluted in amniotic fluid, it may appear in
various shades of green, brown, or yellow. It should be
completely passed by the end of the first few days after birth,
with the stools progressing toward yellow (digested milk).
Is meconium in amniotic fluid bad?
It's OK if your baby swallows meconium before birth. The concern with meconium is that your baby will
breathe it into their lungs. Aspirating or inhaling meconium can make it hard for your baby to breathe. This
can lead to respiratory distress, infection or other serious conditions.

What is meconium staining?

Meconium staining is when your baby passes meconium before birth. Meconium-stained amniotic fluid is
present in 12% to 20% of all deliveries. It's more common when you are beyond your due date. Stained
amniotic fluid has a green or brown tint. Healthcare providers can recognize meconium-stained amniotic fluid
and check your baby immediately after delivery for signs of respiratory issues.

How long does meconium last?

Your baby should pass their first poop within 24 to 48 hours after birth. Once your baby begins drinking
colostrum (the first form of breastmilk) or formula, their digestive system will push the remaining meconium
out. Most healthcare providers will ensure your baby's poop has begun changing to normal newborn poop.
This means your baby's intestines are working correctly.
What Is Meconium Aspiration Syndrome?
Meconium aspiration syndrome (MAS) happens when a newborn has trouble breathing because meconium got into the lungs.

Meconium can make it harder to breathe because it can:

• clog the airways

• irritate the airways and injure lung tissue
• block surfactant, a fatty substance that helps open the lungs after birth
• With treatment, most babies with meconium aspiration syndrome get better with no problems.

What Causes Meconium Aspiration Syndrome?

Meconium aspiration happens when a baby is stressed and gasps while still in the womb, or soon after delivery when taking those first breaths of
air. When gasping, a baby may inhale amniotic fluid and any meconium in it.

Babies are more likely to pass meconium when:

• They've had a long or hard delivery.

• They are born past their due date.
• The mother has a health problem, like diabetes or high blood pressure.
• The mother smoked or used drugs during the pregnancy.
• They didn't grow well before birth.
Babies who are stressed by low oxygen levels or infections also may pass meconium before birth. When meconium gets in the amniotic fluid,
there's a chance a baby will breathe (aspirate) it into the lungs before, during, or after birth. But most babies with meconium in the amniotic fluid
will not get MAS.
Accessory Organs
the Liver
The liver’s primary contribution to
digestion is the production of bile
or gall which drains into the
duodenum, and some is stored in
the gallbladder. It travels through
the hepatic ducts, which merge
together. Bile helps digest fats. The
liver also stores iron and the fat-
soluble vitamins A, D, E, and K.
the Gallbladder
Bile stored in the gallbladder
becomes more concentrated,
increasing its potency and
intensifying its effect. When
chyme containing fat leaves the
stomach, the gallbladder
contracts and discharges bile
through the cystic duct and
common bile duct and into the
duodenum of the small
intestine.
Gallstones
Gallstones are hardened collections of bile materials that
develop in your gallbladder. They can be as small as a grain of
sand or as big as a ping pong ball. Most don’t cause any
problems, but they can cause problems if they get loose and
travel into your bile ducts. The condition of having gallstones is
called cholelithiasis.
What are gallstones?
Gallstones form in your gallbladder, the small, pear-shaped organ where
your body stores bile. They are pebble-like pieces of concentrated bile
materials. Bile fluid contains cholesterol, bilirubin, bile salts and
lecithin. Gallstones are usually made up of cholesterol or bilirubin that
collect at the bottom of your gallbladder until they harden into “stones.”

Gallstones can be as small as a grain of sand or as big as a golf ball.

They grow gradually, as bile continues to wash over them and they
collect extra materials. Actually, it’s the smaller stones that are more
likely to cause trouble. That’s because smaller stones can travel, while
bigger ones tend to stay put. Gallstones that travel may get stuck
somewhere and create a blockage.

What is cholelithiasis?
Cholelithiasis is the condition of having gallstones. Many people have cholelithiasis and don’t know it.
Gallstones won’t necessarily cause any problems for you. If they don’t, you can leave them alone. But gallstones
can sometimes cause problems by creating a blockage. This will cause pain and inflammation in your organs. If
it goes untreated, it can cause serious complications.
How common are gallstones? The five Fs were a mnemonic device that healthcare
Gallstones are common in providers used in the past to memorize common risk
developed countries, affecting factors for gallbladder disease. The five Fs were: fair,
about 10% of adults and 20% of female, fat, fertile and 40.
those over the age of 65. Only
20% of people diagnosed with
gallstones will need treatment.
Why are women more at risk of developing
gallstones?
Estrogen increases cholesterol, and progesterone
slows down gallbladder contractions. Both hormones
are especially high during certain periods in your
reproductive life, such as menstruation and
pregnancy. When hormone levels begin to drop in
menopause, many people use hormone therapy (HT)
to replace them, which elevates them again.
Women and people assigned female at birth are also
more likely to gain and lose body fat more frequently.
Excessive body fat can translate to extra cholesterol
in your blood. Having obesity increases estrogen. On
the other hand, rapid weight loss has a similar effect
to weight gain. When you lose a lot of body fat at
once, it sends an unusually large load of cholesterol to
your liver for processing, which ends up in your bile.
What is the main cause of gallstones?
As much as 75% of the gallstones healthcare
providers discover are made up of excess cholesterol.
So, we could say that having excess cholesterol in
your blood is the leading cause of gallstones. You
might have extra cholesterol for a variety of reasons.
Some of the most common reasons include metabolic
disorders, such as obesity and diabetes.
High blood cholesterol leads to higher cholesterol
content in your bile. Your liver filters cholesterol from
your blood and deposits it in bile as a waste product
before sending the bile to your gallbladder. Chemicals
in bile (lecithin and bile salts) are supposed to
dissolve cholesterol. But if there’s too much of it,
these chemicals might not be up to the task.
How does having gallstones (cholelithiasis) affect me?
Your gallbladder is part of your biliary system. It belongs to a
network of organs that pass bile between each other. These
organs are connected by a series of pipelines called bile ducts.
Bile travels through the bile ducts from your liver to your
gallbladder, and from your gallbladder to your small intestine.
Your pancreas also uses the bile ducts to deliver its own
digestive juices.

A gallstone that travels to the mouth of your gallbladder can

obstruct the flow of bile in or out. A gallstone that makes its
way out of your gallbladder and into the bile ducts could block
the flow of bile through the ducts. This will cause bile to back
up into the nearby organs. When bile backs up, it builds
pressure and pain in your organs and bile ducts and causes
inflammation.

This can lead to a variety of complications, including:

Gallbladder disease. Gallstones are the most common cause of gallbladder diseases. When they get stuck, they
cause bile to back up into your gallbladder, causing inflammation. This can do long-term damage to your
gallbladder over time, scarring the tissues and stopping it from functioning. The stalled flow of bile also makes
infections in your gallbladder more likely.
Liver disease. A blockage anywhere in the biliary system can cause bile to back up into your liver. This will
cause inflammation in your liver, leading to an increased risk of infection and long-term scarring over time
(cirrhosis). If your liver stops functioning well, your whole biliary system breaks down. You can live without a
gallbladder but not without a liver.
Gallstone pancreatitis. A gallstone that blocks the pancreatic duct will cause inflammation in your pancreas. As
with your other organs, temporary inflammation causes pain, and chronic inflammation causes long-term
damage that can stop your organ from functioning.
Cholangitis. Inflammation in your bile ducts can lead to infections in the short term and scarring in the long
term. Scarring in your bile ducts causes them to narrow, which restricts the flow of bile. This can cause long-
term bile-flow problems even after the blockage has been removed.
Jaundice. Backed-up bile will leak into your bloodstream, making you sick. Bile carries toxins that your liver
has filtered from your body. The bilirubin content has a yellow color, which will be visible in the whites of your
eyes.
Malabsorption. If bile can’t travel to your small intestine as intended, you might have difficulty breaking down
and absorbing nutrients from your food. Bile is particularly important for breaking down fats and for absorbing
fat-soluble vitamins in your small intestine.
What are the first signs of having gallstones?
You won’t notice your gallstones unless one gets stuck somewhere and causes a blockage. When that happens, the
most typical symptom is a type of abdominal pain, in the right upper quadrant of your abdomen, called biliary colic.
It occurs in episodes that last for one to several hours, usually after a large or rich meal. That’s when your gallbladder
contracts to send bile to your small intestine for digestion.

If you have occasional episodes of biliary colic, it means that a gallstone is causing a partial blockage, but you can’t
feel it until your gallbladder contracts. The contraction forces pressure through your bile ducts and causes that
pressure to build up inside when it meets resistance. This is a warning sign. When the blockage becomes more
severe, your pain will too.
What is gallstone pain like?
Gallbladder pain most often occurs in the upper right side of your abdomen, under your ribcage, where your
gallbladder is located. But sometimes it feels more vaguely located in your abdomen. The pain can also radiate
somewhere else, most often to your right arm or shoulder blade. It starts as an ache and then steadily increases in
intensity over the first hour before receding again.

Despite the name, biliary colic is not “colicky pain,” which is sharp and comes in waves. It has a slow and steady
arc, and it’s usually dull but severe. It may bring you to the emergency room for relief. You may also notice that your
upper right abdomen is tender to the touch. Biliary colic is often accompanied by nausea and vomiting. It’s also
called a “gallbladder attack.”
What tests are used to diagnose cholelithiasis?
Ultrasound: An abdominal ultrasound is a simple and noninvasive test that requires no preparation or medication. It’s
usually all that’s needed to locate gallstones. However, it doesn’t visualize the common bile duct very well. If your
healthcare provider suspects there’s a gallstone hidden in there, they might need to use another type of imaging test to
find it.

MRCP: Magnetic resonance cholangiopancreatography (MRCP) is a type of MRI that specifically visualizes the bile
ducts. It’s non-invasive and creates very clear images of your biliary system, including the common bile duct. Your
provider might use this test first to find a suspected gallstone there. But if they’re already pretty sure it’s there, they
might skip it and go straight to an ERCP.

ERCP: ERCP stands for endoscopic retrograde cholangiopancreatography. This test is a little more invasive, but it’s a
useful one for finding gallstones because it can also be used to remove them from the ducts if they are stuck there. It
uses a combination of X-rays and endoscopy, which means passing a tiny camera on the end of a long tube down your
throat and into your upper GI tract. (You’ll have medication to make this easier.)

When the camera (endoscope) reaches the top of your small intestine, your healthcare provider will slide another,
smaller tube into the first one to reach farther down into your bile ducts. They will inject a special dye through the tube
and then take video X-rays (fluoroscopy) as the dye travels through the ducts. They can insert tools through the tube to
remove the stones they find.
How are gallstones removed?
There are a few different ways to remove gallstones.

Endoscopy
Gallstones in your bile ducts are removed by endoscopy (ERCP). This doesn’t require any
incisions. The gallstones come out through the long tube that’s been passed down your throat.
Gallstones in your gallbladder are removed by removing the gallbladder (cholecystectomy).
This can usually be done by laparoscopy, a minimally-invasive surgery technique.

Laparoscopy
A laparoscopic cholecystectomy uses small, “keyhole incisions” in your abdomen to operate
with the aid of a small camera called a laparoscope. Your surgeon inserts the laparoscope
through one keyhole and removes your gallbladder through another. Smaller incisions make
for less post-operative pain and a faster recovery time than conventional, “open” surgery.

Open surgery
Some people may have more complicated conditions that require open surgery to manage. If
you have open surgery, you’ll have a longer hospital stay afterward and a longer recovery at
home for your larger incision. Some laparoscopic cholecystectomies may need to convert to
open surgery if your surgeon runs into complications during the procedure.
Can gallstones go away without surgery?
Gallstones in your bile ducts that aren’t stuck can successfully
pass through them and into your intestines. You can pass them
out through your poop. That's a lucky scenario, but in general,
you don’t want to risk having gallstones in your bile ducts in the
first place. If they don’t pass all the way out of you, they will
only grow bigger over time.

There are some medications that can help to dissolve smaller

gallstones. These take many months to work, so they aren’t the
most practical option for people experiencing symptoms. But
they offer an alternative for people who may not be in a safe
health condition for surgery. They may also be practical for
people who have gallstones but don’t have symptoms yet.
Can diet help to prevent gallstones?
You can reduce your risk of cholesterol gallstones, which are the most common type, by reducing cholesterol in
your diet. Here are some quick tips:

Limit fried and fast foods. These foods are usually fried in saturated fats, which promote LDL cholesterol (the “bad”
type). If you cook with oil, choose plant oils instead of animal fats.
Replace red meat with fish. Red meat is high in saturated fats, while fish is high in omega-3 fatty acids, which
promote HDL cholesterol (the “good” type). The good type helps balance the bad type.
Eat more plants. High-fiber fruits, vegetables and whole grains help to clear out excess cholesterol from your body.
Eating more plants can also help you keep your overall weight down.
Lose weight gradually. Dieting to lose weight can help reduce the cholesterol content in your blood. But it’s better
to lose weight at a slow, steady pace of one to two pounds a week. Rapid weight loss can encourage gallstones.

What is my prognosis if I have gallstones (cholelithiasis)?

If you have gallstones but they haven’t caused you any problems yet, they probably never will. About 2% of
asymptomatic gallstones become symptomatic each year. Once they begin to cause symptoms, they are likely to keep
doing so.
Cholecystectomy is a definitive treatment for most gallstones, and most people recover quickly and completely from
it. Some people may still have gallstones show up in their bile ducts again afterward. These can be treated by an
endoscope. If you use medicine to dissolve your gallstones, this works about 75% of the time, but the gallstones will
often come back again.
the Pancreas
The pancreas secretes pancreatic juice into
the duodenum via the pancreatic duct
which merges with the common bile duct.
This pancreatic juice contains digestive
enzymes and bicarbonate ions.
It’s role is so vital to digestion, that a person
would starve without it, even if they were
consuming an adequate amount of food. It
makes digestive enzymes and hormones, such
as insulin. It delivers digestive enzymes to your
small intestine through the pancreatic duct.
What is pancreatitis?
Pancreatitis is inflammation in your pancreas.
Inflammation causes swelling and pain. If you
have pancreatitis, it might feel like stomach pain
that spreads to your back.
Nutrition
Nutrition is the process by which food is taken into and
used by the body; it includes digestion, absorption, transport,
and metabolism. Nutrition is also the study of food and drink
requirements for normal body function.
Nutrients are the chemicals taken into the body that provide
energy and building blocks for new molecules. Some substances
in food are not nutrients but provide bulk (fiber) in the diet.
Nutrients can be divided into six major classes:
(1) carbohydrates,
(2) lipids,
(3) proteins,
(4) vitamins,
(5) minerals, and
(6) water
 In light of the increasing problem of obesity
in the United States, the DA published
Dietary Guidelines for Americans where the
latest recommendations focus on two
concepts:
(1) balancing calorie intake to obtain and
maintain a healthy weight, and
(2) increasing consumption of healthy,
nutrient-rich foods.
In June 2011, the USDA also introduced
MyPlate, a new food icon to replace the
former food guide icon, called MyPyramid.

Kilocalories
The energy the body uses is stored within the chemical bonds of certain nutrients. A calorie
(cal) is the amount of energy (heat) necessary to raise the temperature of 1 gram (g) of
water 1°C. A kilocalorie (kcal) is 1000 cal and is used to express the larger amounts of
energy supplied by foods and released through metabolism.
Daily Values
Daily Values appear on food labels to help consumers
plan a healthful diet and to minimize confusion.
However, not all possible Daily Values are required to
be listed on food labels.
Daily Values are based on two other sets of reference
values—
Reference Daily Intakes and Daily Reference Values
Reference Daily Intakes (RDIs) are based on the 1968
RDAs
for certain vitamins and minerals. RDIs have been set for
four categories of people: infants, toddlers, people over 4
years of age, and pregnant or lactating women. Generally,
the RDIs are set to the highest 1968 RDA value of an age
category.
For example, the highest RDA for iron in males over 4 years
of age is 10 mg/day and for females over 4 years of age is
18 mg/day. Thus, the RDI for iron is set at 18 mg/day.
∙ Daily Reference Values (DRVs) are set for total fat,
saturated fat, cholesterol, total carbohydrate, dietary fiber,
sodium, potassium, and protein.
 THREE MAJOR FOOD TYPES:
Carbohydrates - Consist primarily of starches, cellulose,
sucrose (table sugar), small amounts of fructose (fruit
sugar), and lactose (milk sugar)
 Polysaccharides – large carbohydrates that consist of many sugars
linked by chemical bonds
 Disaccharides – two sugars; broken down polysaccharide
 Monosaccharides – single sugars; glucose, galactose, and fructose

 Salivary amylase – begins the digestion of carbohydrates in the

mouth
 Pancreatic amylase – continues digestion of carbohydrates
 Disaccharidase – group of enzymes that break the disaccharides to
monosaccharides
 THREE MAJOR FOOD TYPES:
Lipids - Molecules which are insoluble or slightly
soluble in water
• include triglycerides, phospholipids, cholesterol,
steroids, and fat-soluble vitamins.
 Triglycerides – most common type of lipid; 3 fatty
acids bound to glycerol
 Saturated – fatty acids have only single bonds
 Unsaturated – fatty acids have one or more double
bonds
 Emulsification – large lipid droplets are transformed into much smaller
droplets
 Lipase – secreted by pancreas; digests lipid molecules
 Micelles – aggregated bile salts around small droplets of digested lipids
What's the difference between saturated and unsaturated
fat?

Saturated fat. This is solid at room temperature. It's found in

butter, lard, full-fat milk and yogurt, full-fat cheese, and high-
fat meat.
Unsaturated fat. This tends to be liquid at room temperature. It's
found in vegetable oils, fish and nuts.
Saturated fat
The Dietary Guidelines for Americans recommends limiting
saturated fat to less than 10% of calories a day. The
American Heart Association recommends staying under 7%
of daily calories.
Why? Because saturated fat tends to raise low-density
lipoprotein (LDL) cholesterol levels in the blood. High
cholesterol levels can increase your risk of heart disease and
stroke.
Saturated fat occurs naturally in red meat and dairy
products. It's also found in baked goods and fried foods.
Trans fat occurs naturally in small amounts in red meat and
dairy products. Trans fat can also be manufactured by
adding hydrogen to vegetable oil.
This artificial form of trans fat is known as partially
hydrogenated oil. It has unhealthy effects on cholesterol
levels and increases the risk of heart attack and stroke. For
this reason, partially hydrogenated oil can no longer be
added to foods in the U.S.
Unsaturated fat
Studies show that eating foods rich in unsaturated fat
instead of saturated fat improves blood cholesterol levels,
which can decrease your risk of heart attack and stroke.
One type in particular — omega-3 fatty acid — appears
to boost heart health by improving cholesterol levels,
reducing blood clotting, reducing irregular heartbeats and
slightly lowering blood pressure.
There are two main types of unsaturated fat:
Monounsaturated fat. This is found in olive, canola,
peanut, sunflower and safflower oils, and in avocados,
peanut butter and most nuts. It's also are part of most
animal fats such as fats from chicken, pork and beef.
Polyunsaturated fat. This is found in sunflower, corn,
soybean and cottonseed oils. It's also found in walnuts,
pine nuts, flaxseed, and sesame, sunflower and pumpkin
seeds. Omega-3s fall into this category and are found in
fatty fish, such as salmon, herring and sardines.
 THREE MAJOR FOOD TYPES:
LIPOPROTEINS - Lipids combined with proteins
• categorized as high- or low-density
• lipoprotein with a high lipid content has a very low
density (Bad Cholesterol) LDL
• lipoprotein with a high protein content has a
relatively high density. (GOOD Cholesterol) HDL

Chylomicrons, which are made up of 99% lipid and only 1% protein,

are lipoproteins with an extremely low density.
 THREE MAJOR FOOD TYPES:
Proteins - Chains of amino acids

 Pepsin – enzyme secreted by stomach that breaks

down proteins
 Polypeptides – shorter amino acid chains
 Trypsin, Chymotrypsin, Carboxypeptidase –
enzymes produced by pancreas that continue the
digestive process
 WATER AND MINERALS
WATER
 Approximately 9 L of water enters the digestive tract
 Approximately 2 L from food & drink & remaining 7 liters is from
digestive secretions

Electrolytes (IONS)
1. Na+, K+, Ca2+, Mg2+, PO4 −. are actively transported.
2. Chloride ions (Cl -) move passively through the wall of the duodenum and
jejunum but are actively transported from the ileum.
3. Calcium ions are actively transported, but vitamin D is required for transport,
and the transport is under hormonal control.
 VITAMINS
Vitamins (life-giving chemicals) are organic molecules that exist in minute quantities in food and are essential
to normal metabolism. Essential vitamins cannot be produced by the body and must be obtained through the diet.
Because no single food item or nutrient class provides all the essential vitamins, it is necessary to maintain a
balanced diet by eating a variety of foods. The absence of an essential vitamin in the diet can result in a specific
deficiency disease. A few vitamins, such as vitamin K, are produced by intestinal bacteria, and a few others can be
formed by the body from substances called provitamins. A provitamin is a part of a vitamin that the body
can assemble or modify into a functional vitamin.
EFFECTS OF AGING ON THE
DIGESTIVE SYSTEM
SYSTEMS PATHOLOGY
Diarrhea
Diarrhea is very common, happening in most
people a few times each year. When you have
diarrhea, your stool will be loose and watery. In
most cases, the cause is unknown and it goes
away on its own after a few days. Diarrhea can be
caused by bacteria. Dehydration is a dangerous
side effect of diarrhea.
What is diarrhea?
Going to the bathroom, having a bowel movement, pooping – no matter what you call it, stool is
a regular part of your life. However, sometimes this process of getting waste out of your body
changes. When you have loose or watery stool, it’s called diarrhea. This is a very common
condition and usually resolves without intervention.

Diarrhea can happen for a wide variety of reasons and it usually goes away on its own in one to
three days. When you have diarrhea, you may need to quickly run to the bathroom with urgency
and this may happen more frequently than normal. You may also feel bloated, have lower
abdominal cramping and sometimes experience nausea.

Although most cases of diarrhea are self-limited (happening for a fixed amount of time and
steady level of severity), sometimes diarrhea can lead to serious complications. Diarrhea can
cause dehydration (when your body loses large amounts of water), electrolyte imbalance (loss of
sodium, potassium and magnesium that play a key role in vital bodily functions) and kidney
failure (not enough blood/fluid is supplied to the kidneys). When you have diarrhea, you lose
water and electrolytes along with stool. You need to drink plenty of fluids to replace what’s lost.
Dehydration can become serious if it fails to resolve (get better), worsens and is not addressed
adequately.
What’s the difference between normal diarrhea and severe diarrhea?
There are actually several different ways to classify diarrhea. These types of diarrhea include:

Acute diarrhea: The most common, acute diarrhea is loose watery diarrhea that lasts one to two days. This
type doesn’t need treatment and it usually goes away after a few days.
Persistent diarrhea: This type of diarrhea generally persists for several weeks – two to four weeks
Chronic diarrhea: Diarrhea that lasts for more than four weeks or comes and goes regularly over a long
period of time is called chronic diarrhea.

Who can get diarrhea?

Anyone can get diarrhea. It’s not uncommon for many people to have diarrhea several times a year. It’s very
common and usually not a major concern for most people.

However, diarrhea can be serious in certain groups of people, including:

Young children.
Older adults (the elderly).
Those with medical conditions.
For each of these people, diarrhea can cause other health problems.
Can diarrhea harm your health?
In general, diarrhea is self-limited and goes away (resolves) without intervention. If
your diarrhea fails to improve and resolve completely, you can be at risk of
complications (dehydration, electrolyte imbalance, kidney failure and organ damage).

Call your healthcare provider if you have diarrhea that fails to get better or go away, or
if you experience symptoms of dehydration. These symptoms can include:

• Dark urine and small amounts of urine or loss of urine production.

• Rapid heart rate.
• Headaches.
• Flushed, dry skin.
• Irritability and confusion.
• Light-headedness and dizziness.
• Severe nausea and vomiting, the inability to tolerate or keep anything down by
mouth.
What causes diarrhea?
The cause of most self-limited diarrhea is generally not
identified. The most common cause of diarrhea is a virus that
infects your bowel (“viral gastroenteritis”). The infection
usually lasts a couple of days and is sometimes called
“intestinal flu.”

Other possible causes of diarrhea can include:

Infection by bacteria.
Infections by other organisms and pre-formed toxins
Eating foods that upset the digestive system.
Allergies and intolerances to certain foods (Celiac disease or
lactose intolerance).
Medications.
Radiation therapy.
Malabsorption of food (poor absorption).
Can antibiotics cause diarrhea?
Most antibiotics (clindamycin, erythromycins and broad spectrum antibiotics) can cause diarrhea. Antibiotics
can change the balance of bacteria normally found in the intestines, allowing certain types of bacteria like
C. difficile to thrive. When this happens, your colon can become overrun by bad (pathologic) bacteria that
causes colitis (inflammation of your colon lining).

Antibiotic-associated diarrhea can begin any time while you’re taking the antibiotic or shortly thereafter. If
you experience this side effect, call your healthcare provider to talk about the diarrhea and discuss the best
option to relieve this side effect.

Is there a color of diarrhea that I should be worried about?

The color of your poop (stool) can vary. Stool color can be influenced by the color of the food you eat. Usually,
this isn’t something you need to worry about. But if you ever see red (blood) in your stool or have a bowel
movement that is black, that could be something more serious. Keep a record of any bowel movements that:

Are black and tarry.

Have blood or pus in them.
Are consistently greasy or oily despite non-fatty meals.
Are very foul-smelling.
How do you diagnose diarrhea?
For the majority of mild diarrhea cases, you won’t need medical attention. These cases are self-
limited (only lasts for a fixed amount of time) and get better without medical intervention. The key to
mild diarrhea is supportive therapy – staying hydrated and eating a bland diet.

More serious cases of diarrhea may require medical attention. In these situations, there are a few
diagnostic tests that your provider may order. These tests can include:

Discussing a detailed family history, as well as physical and medical conditions, your travel history,
and any sick contacts you may have.
Doing a stool test on a collected stool sample to check for blood, bacterial infections, parasite and
inflammatory markers.
Doing a breath test to check for lactose or fructose intolerance, and bacterial overgrowth.
Doing blood work to rule out medical causes of diarrhea such as a thyroid disorder, celiac sprue and
pancreatic disorders.
Doing endoscopic evaluations of your upper and lower digestive tract to rule out organic
abnormalities (ulcers, infections, neoplastic process).
How is diarrhea treated?
In most cases, you can treat mild and uncomplicated diarrhea at home. By using an over-the-counter product like bismuth subsalicylate
(Pepto-Bismol® or Kaopectate®) you’ll usually feel better very quickly.

However, over-the-counter medications aren’t always the solution. If your diarrhea is caused by an infection or parasite, you’ll need to
see a healthcare provider for treatment. A general rule is not to use over-the-counter medications for diarrhea if you also have a
fever or blood in your stool. In those cases, call your healthcare provider.

When diarrhea lasts for a long period of time (several weeks), your healthcare provider will base your treatment on the cause. This
could involve a few different treatment options, including:

Antibiotics: Your healthcare provider might prescribe an antibiotic or other medication to treat an infection or parasite that’s causing
the diarrhea.
Medication for a specific condition: Diarrhea can be a sign of several other medical conditions, including irritable bowel syndrome
(IBS), inflammatory bowel disease (IBD) such as Crohn’s disease and ulcerative colitis, microscopic colitis, or bacterial overgrowth.
Once the cause of the diarrhea is identified, diarrhea can usually be controlled.
Probiotics: Groupings of good bacteria, probiotics are sometimes used to re-establish a healthy biome to combat diarrhea. Introducing
probiotics can be helpful in some cases and some healthcare providers feel that it’s worth a try. Always talk to your provider before
starting a probiotic or any kind of supplement. erceflora

It’s important to always follow the instructions on the packaging when you take an over-the-counter medication for diarrhea. The rules
for managing diarrhea in an adult are different than in children. Always call your child’s healthcare provider before giving your child
any type of medication for diarrhea.
Can I manage diarrhea without taking any medication?
When you have an acute case of diarrhea, you can often take care of it without needing any medication. Several
things you can do to care for diarrhea include:

Drinking plenty of water and other electrolyte balanced fluids (like diluted and pulp-free fruit juices, broths,
sports drinks (Gatorade®) and caffeine-free sodas). Make sure to hydrate throughout day. Your body loses water
each time you have diarrhea. By drinking plenty of extra fluids, you are protecting your body from dehydration.
Changing your diet. Instead of picking greasy, fatty or fried foods, go for the BRAT diet:
B: Bananas.
R: Rice (white rice).
A: Applesauce.
T: Toast (white bread).
Cutting back on caffeine. Foods and drinks that have caffeine can have a mild laxative effect, which can make
your diarrhea worse. Foods and drinks with caffeine include coffee, diet sodas, strong tea/green tea, and even
chocolate.
Avoiding foods and drinks that give you gas. If you experience cramping in your stomach with diarrhea, it could
help to cut back on things that cause gas. These can include beans, cabbage, Brussels sprouts, beer and
carbonated beverages.
Sometimes, diarrhea can also make you lactose intolerant. This is usually temporary and it means that you need
to avoid items with lactose (dairy products) until your diarrhea is gone.
What do I do if my baby or young child has diarrhea?
If your child has severe diarrhea, call your healthcare provider. Young children are at a higher risk of
dehydration than adults. You also can’t treat a child’s diarrhea the same way you would an adult case. Over-the-
counter medications can be dangerous in young children and all treatments of diarrhea in children should be
guided by their healthcare provider. It’s important to keep your child hydrated. Your provider will help you
determine the best way to do this, but options often include:

Breast milk.
Formula.
Electrolyte drinks (Pedialyte®) for older children – this is not recommended for babies.
The best option to keep your child hydrated might change as the child ages. Always check with your provider
before giving your child a new liquid or treatment of any kind.
Is diarrhea fatal?
Diarrhea is extremely common, but that doesn’t mean it can’t be dangerous. In extreme cases of diarrhea, you can
become very dehydrated and this can lead to serious complications. Dehydration is one of the most dangerous
side effects of diarrhea. In the very young (infants and small children) and the very old, this can have serious
consequences. It’s important to drink plenty of fluids with electrolytes when you have diarrhea. This allows your
body to replace the fluid and electrolytes that are lost with the diarrhea.

In some parts of the world, diarrhea is a life-threatening condition because of dehydration and electrolyte loss.
Can diarrhea be prevented?
There are a few ways you can decrease your chances of having diarrhea, including:

Avoiding infections with good hygiene habits: Washing your hands with soap and water after using the
bathroom, as well as cooking, handling, and eating, is an important way to prevent diarrhea. Washing your
hands thoroughly can really help keep you and those around you stay healthy.
Getting your vaccinations: Rotavirus, one of the causes of diarrhea, can be prevented with the rotavirus
vaccine. This is given to infants in several stages during the first year of life.
Storing food properly: By keeping your food stored at the right temperatures, not eating things that have gone
bad, cooking food to the recommended temperature and handling all foods safely, you can prevent diarrhea.
Watching what you drink when you travel: Traveler’s diarrhea can happen when you drink water or other
drinks that haven’t been treated correctly. This is most likely to happen in developing countries. To avoid
getting diarrhea there are a few tips to follow. Watch what you drink. Don’t drink tap water, use ice cubes,
brush your teeth with tap water, or consume unpasteurized milk, milk products or unpasteurized juices. You
should also be careful when trying local foods from street vendors, eating raw or undercooked meats (and
shellfish), as well as raw fruits and vegetables. When in doubt, drink bottled water or something that’s been
boiled first (coffee or tea).
 REFERENCES:

VanPutte C. et.al. (2019). Seeley’s

Essentials of Anatomy & Physiology. 10th
edition. New York: McGraw Hill Co. Inc.
 Salamat!
Your body not only can digest food but also
knowledge… feed your brain… - ME