Stomach medicine

PHYSIOLOGY OF CHEMICAL DIGESTION AND ABSORPTION

2012-02-18T16:53:00.000-08:00

VIII. Chemical Digestion

XII. Absorption (pp.898-901)

A. Lipid Absorption

Small Intestine and Associated Structures

2012-02-16T13:38:00.000-08:00

A. Gross Anatomy of Small Intestine

1. It extends from the pyloric sphincter to the ileocecal valve where it joins the large intestine. It has three subdivisions: the duodenum, the jejunum, and the ileum.

B. Microscopic Anatomy of Small Intestine

1. Modifications for absorption

a. It is highly adapted for absorption with three microscopic modifications: plicae

circulares, villi, and microvilli [brush border]

2. Histology of the wall

a. Simple columnar epithelial tissue with tight junctions and goblet cells

b. Theintestinal crypts, or the crypts of Lieberkühn, secrete intestinal juice that

serves as a carrier fluid for absorbing nutrients from chyme.

c. Enteroendocrine cells and the enterogastrones secretin and cholecystokinin

d. Intraepithelial lymphocytes [IELs]

e. Paneth cells: defensins and lysozyme

f. Peyer's patches: part of GALT

C. The liver

1. Functions [more than 200 functions!]

a. Metabolic regulation: regulation of blood composition, removes and stores nutrients, mobilizes stored reserves, performs synthetic activities, plays a role in carbohydrate, lipid & protein metabolism, waste removal, vitamin [A, D, E, K & B₁₂] and mineral [converts iron reserves to ferritin], drug inactivation

b. Hematological regulation: phagocytosis and antigen presentation [Kupffer cells], synthesis of plasma proteins, removal of circulating hormones, removal of antibodies, removal or storage of toxins

c. Synthesis and secretion of bile [mostly water, with minor amounts of ions, bilirubin, cholesterol and an assortment of lipids known as bile salts, that function in the emulsification of lipids

2. Gross Anatomy

a. Hepatic portal vein

3. Microscopic Anatomy

a. Hepatocytes, liver sinusoids, Kupffer cells

D. Gallbladder

1. Stores and concentrates bile

E. Pancreas

1. Functions: secretion of a watery buffer solution of a pH of 7.5-8.8 and a "bucket full

of enzymes" [pancreatic amylase, lipase, nucleases and proteases]

F. Regulation of Bile and Pancreatic Secretion and Entry into the Small Intestine

A. Functions

1.Absorption of water, bile salts, and bacterial-generatedvitamins K, biotin [glucose metabolism] & vitamin B₅ (pantothenic acid) [manufacture of steroids and some neurotransmitters]

B. Gross Anatomy

1. Teniae coli, haustra, &epiploic appendages

2. Subdivisions: cecum, appendix, colon, rectum, anal canal

3. Colon: ascending, transverse, descending, sigmoid

FUNCTIONAL ANATOMY OF THE DIGESTIVE SYSTEM

2012-02-14T13:56:00.000-08:00

A. Functions

1. Storage

2. Mechanical breakdown of food

3. Chemical breakdown of food

4. Production of intrinsic factor [a glycoprotein required for absorption of

vitamin B₁₂ in the small intestine]

5. Protection

B. Gross Anatomy

1. The adult stomach varies from 15–25 cm long; its diameter and volume vary depending on the amount of food it contains.

a. The major regions of the stomach include the cardiac region, fundus, body, and pyloric region.

b. The convex lateral surface of the stomach is its greater curvature, and its convex medial surface is its lesser curvature.

c. Extending from the curvatures are the lesser omentum and the greater omentum, which help to tie the stomach to other digestive organs and the body wall.

C. Microscopic Anatomy

1. The surface epithelium of the stomach mucosa is a simple columnar epithelium composed of goblet cells, which produce a protective two-layer coat of alkaline mucus.

2. The gastric glands of the stomach produce gastric juice, which may be composed of a combination of mucus, hydrochloric acid, intrinsic factor, pepsinogen, and a variety of hormones.

a. Mucous neck cells; mucus

b. Parietal cells: hydrochloric acid and intrinsic factor

c. Chief cells: pepsinogen

d. Enteroendocrine cells: histamine, serotonin, somatostatin, gastrin, etc.

3. H. pylori [You da, man, Barry Marshall!]

D. Digestive Processes Occurring in the Stomach

1. Gastric secretion is controlled by both neural and hormonal mechanisms and acts in three distinct phases: the cephalic phase, the gastric phase, and the intestinal phase.

2. The reflex-mediated relaxation of the stomach muscle and the plasticity of the visceral smooth muscle allow the stomach to accommodate food and maintain internal pressure.

3. The interstitial cells of Cajal establish the stomach’s basic electrical rhythm of peristaltic waves.

4. Regulation of Gastric Secretion

a. Phase 1: Cephalic [Reflex]

b. Phase 2: Gastric

c. Phase 3: Intestinal

5. Regulation of Gastric Emptying

Digestive System Organs: Relationships

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A. Relationship of Digestive Organs to the Peritoneum

1. The visceral peritoneum covers the external surfaces of most of the digestive organs, and the parietal peritoneum lines the body wall of the abdominopelvic cavity.

2. The peritoneal cavity is located between the visceral and parietal peritoneum and is filled with serous fluid.

3. Mesentery is a double layer of peritoneum that extends to the digestive organs from the body wall. It allows blood vessels, lymphatics, and nerves to reach the digestive organs, and holds the organs in place as well as stores fat.

4. Retroperitoneal organs are found posterior to the mesentery, lying against the dorsal abdominal wall [most of pancreas and parts of the large intestine].

B. The splanchnic circulation serves the digestive system and includes those arteries that branch off the abdominal aorta to serve the digestive organs and the hepatic portal circulation [hepatic, splenic, and left gastric arteries of the celiac trunk and the superior &inferior mesenteric arteries]

C. Histology of the Alimentary Canal

1. Mucosa is the innermost, moist, epithelial membrane that lines the entire digestive tract. It secretes mucus, digestive enzymes, and hormones; absorbs digestive end products into the blood; and protects against infectious disease.

2. Submucosa is a moderately dense connective tissue layer containing blood and lymphatic vessels, lymphoid follicles, and nerve fibers.

3. Muscularisexterna typically consists of smooth muscle and is responsible for peristalsis and segmentation.

4. Serosa, the protective outer layer of the intraperitoneal organs, is the visceral peritoneum.

D. The alimentary canal has its own nerve supply made up of enteric neurons that communicate widely with each other to regulate digestive activity.

Help for a Stomach Bloating

2012-02-13T04:07:00.000-08:00

Natural Remedies
Many herbal and homeopathic remedies have been formulated with specific
ingredients to lessen stomach bloating and promote healthy digestion. Herbs such
as Foeniculum Vulgare (Sweet Fennel) and Pulsatilla Vulgaris (Pasque Flower)
The content of this ebook is intended for
informational purposes only.
It is not intended to diagnose or treat any
medical condition. Nothing in this ebook is
intended to be a substitute for
professional medical advice, diagnosis, or
treatment. Always seek the advice of your
physician or other qualified health
provider with any questions you may have

regarding a medical condition.
Never disregard professional medical
advice or delay in seeking it because of
something you have read in this ebook or
on ANY website.
help to alleviate bloating naturally while Arctium lappa (Burdock) is well known as
an herbal systemic cleanser to effectively detoxify the digestive system,
strengthen weak digestion, and relieve wind, as well as distension
(bloating), constipation and indigestion. Natural remedies from a reputable source
can address the underlying causes of bloating without causing further stomach
upsets.
Tips to minimize stomach bloating.
● Control your food habits and eat slowly.
● Limit Buffalo's Milk! 1 OZ (28ml) of undigested milk produces 1 gallon of
gas!
● Lessen wheat products – they contain Gluten that can produce burning
sensations and lead to production of excess gases, resulting in bloating.
● Minimize the use of antibiotics. Antibiotics destroy the harmless bacteria
normally present in the digestive tract that usually help you digest food. So if
you need to take antibiotics at all, be sure to take B-Complex vitamins with
it.
● Limit sugar and salt. Take only what you need. Excessive sugar and salt in
the form of processed foods also causes stomach bloating. Watch out for
fizzy drinks too!
● If you tend to get a bloated stomach during the pre-menstrual phase, try
drinking herbal teas that contain natural diuretics.
The Natural Approach
While Western medicine has become the norm in many cultures, it is not the only
treatment option. Conventional western medicine, often called allopathic
medicine, is the system of medicine taught at most medical schools and most
pharmaceutical and synthetic medicines are manufactured and marketed
according to the principles of allopathic medicine. Allopathic medicine is also
sometimes called orthodox medicine.
Because most of us in the Western world have grown up in a society in which
allopathic medicine is the prevailing norm, we forget that, only a few decades ago,
homeopathic, herbal and other natural medicines were commonly available – and
freely used even by conventional doctors. While there are often heated debates
about which system of medicine is ‘better’ than the other, many responsible
doctors (whether they are allopathic or not) recognize that both have a role to play
in the treatment program.
Natural medicine has often been frowned on by conventional doctors, especially by
those who did not have sufficient knowledge of these medicines. However, it is
encouraging to note that some medical schools are now beginning to re-introduce
it into their course work, thereby providing doctors with a wider range of
treatment options from which to choose. In many countries, especially in Europe,
India and China, natural and homeopathic medicines are commonly prescribed by
conventional doctors and represent a significant part of the total annual drug sales.
Naturopathy is a branch of medicine (just as allopathy is a branch of medicine)
which operates according to the underlying philosophy that the body has an innate
capacity to heal itself. While natural medicines are often called ‘alternative’ or
‘complimentary’ medicines, they are, in fact, a unique and independent form of
Michele Carelse, Clinical
Psychologist
All of our natural remedies are
formulated by our expert team of
herbalists, naturopaths and
homeopaths, and headed by Michele
Carelse.
Michele has had years of experience in
the manufacturing and use of natural
remedies. In addition, she is a trained
Clinical Psychologist and has been
incorporating natural remedies into
her treatment of patients with
depression, anxiety, ADD, ADHD and
stress for many years with spectacular
results.
medicine in their own right, well able to treat a variety of conditions. Perhaps the
term ‘holistic’ medicine is more apt, given the broad range of treatment options
and approaches which are to be found within the practice of natural medicine,
which encompasses many different disciplines, including herbalism, homeopathy,
iridology, osteopathy, chiropractic, therapeutic massage techniques,
aromatherapy, acupuncture and many, many more.
Most naturopaths will use a variety of treatment modalities in order to treat their
patients in a holistic way to support health, relieve symptoms and prevent future
disease. In fact, even the World Health Organization defines health as being "...
more than simply the absence of illness. It is the active state of physical, emotional,
mental and social well-being." This is a wonderfully clear description of holistic or
natural medicine, which strives to support health (thereby relieving or preventing
symptoms), rather than simply eliminating disease.
Although allopathic medicine certainly has a role to play and has made a
tremendous contribution to medical science during the past century, there is a
growing perception that it is not the only answer and that, in many cases, holistic
medicine can accomplish just as much, if not more – without the risk of side
effects, addiction and sacrifice to health so commonly associated with
pharmaceutical drugs. Contrary to common perception, and provided that they are
manufactured in the correct way, natural medicines can work quickly and safely to
promote healing.
In many cases, they can succeed where pharmaceutical drugs have failed. Despite
frequent reports that they are ‘unproven’ and ‘untested’, the opposite is true.
Natural medicines have a long history of usage and there is a wealth of empirical
evidence to support their effectiveness and safety. In addition, active clinical
research is carried out by many academic hospitals and universities to support the
extensive traditional and empirical evidence behind natural medicines.
It is also important to know that, like any medicine, herbal and homeopathic
medicines must be manufactured in the correct way, following acceptable
procedures and manufacturing methods to ensure maximum effectiveness and
safety. Due to the recent rise in popularity of natural remedies, many companies
have sprung up to take advantage of the market. Unfortunately not all of them are
equipped to manufacture to the correct standards, often resulting in a flood of
inferior (and sometimes even unsafe) remedies onto the market – and giving
natural remedies a bad name.
Even some pharmaceutical companies have rushed to claim their market share by
producing so-called ‘standardized’ extracts of herbs and offering these as superior
to the tried and tested methods of naturopathic manufacturing. Nothing could be
further from the truth. While ‘standardized’ extracts may offer benefit of easy
consistency of dosage (and cheaper more efficient production lines), they have
grave disadvantages. These include an increase in side effects as the medicines
produced in this manner lose the natural protective properties of the herbs. In
some cases, these side effects have proved fatal – as was seen in the liver toxicity
associated with standardized extracts of kava kava, a herb previously safely used
for generations without any known side effects.
Most naturopaths recommend what is called the Full Spectrum Method of
extraction – which retains the benefits of ALL the active ingredients within the
herb as opposed to isolating only one – thereby providing a more complete
treatment as well as superior protection against side effects.
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about it HERE! We will do our best to
get you an answer within 24 hours.
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Whatever your choice, always choose wisely. Research what is best for you. If you
have a chronic or life threatening condition, don’t make changes without first
discussing them with your doctor in order that your condition may be monitored.
Well informed and supportive practitioners will support patients who want to take
responsibility for their own health.
Related Natural Remedies:
DigestAssist: Helps maintain digestive comfort and promotes healthy digestion.
Recognizing the need for a healthier and effective approach, Native Remedies has
developed Gastronic Dr. and DigestAssist - both 100% herbal remedies containing
well researched ingredients and manufactured in therapeutic dosage according to
the highest pharmaceutical standards.
Gastronic Dr. is a capsule which is used every day for the continued health of the
digestive tract and to promote ongoing, healthy, trouble-free digestion. Regular
use of Gastronic Dr. safely and effectively acts to promote digestive health.
DigestAssist, the perfect companion to Gastronic Dr., comes in fast-acting and
convenient drop form, and can be taken as needed to promote digestive comfort
after meals, helping you to enjoy your food every day.
These formulas remain true to the whole spectrum method of herbal
extraction, ensuring the bio-availability and balance of all the active ingredients
contained in the remedy. This method of manufacture also significantly reduces
the likelihood of side effects and maintains all active ingredients in perfect balance
– exactly as nature intended!
Learn more about DigestAssist
Gastronic Dr. : Promote healthy digestion and encourage comfort after meals
Recognizing the need for natural support for trouble-free digestion, Native
Remedies has developed Gastronic Dr., a 100% herbal remedy containing natural
ingredients and manufactured in therapeutic dosage according to the highest
pharmaceutical standards.
Gastronic Dr. is a capsule that is used every day for the continued support
of the digestive tract. Regular use of Gastronic Dr. safely supports digestive
health and all organs and structures involved in digestion, as well as the mucus
membranes of the digestive tract. Gastronic Dr. also helps to maintain the
natural balance of essential organisms (such as probiotics) in the digestive
tract, further promoting easy, healthy digestion.
This formula remains true to the whole spectrum method of herbal extraction,
ensuring the bio-availability and balance of all the active ingredients contained in
the remedy. This method of manufacture also significantly reduces the likelihood
of side effects and maintains all active ingredients in perfect balance - exactly as
nature intended!
Learn more about Gastronic Dr.
Gasolve Relief : To support normal levels of gas in the bowels and support
healthy digestion
Gasolve Relief is a 100% herbal natural remedy for supporting the digestive
system and normal levels of gas in the gut.
Just a few drops in a little water or juice will help support digestive calm, soothe
the digestive system and discourage common gas, flatulence and belching.

Stomach Bloating

2012-02-13T04:05:00.000-08:00

What is Stomach Bloating?

Bloating in the stomach can be a common occurrence – most of us will experience

a bloated stomach at some stage of our lives. The feeling of ‘pressure’ and

‘fullness’ in the stomach, that can make it feel as though we are stretched to

capacity or weighted down.

What Causes Stomach Bloating?

Bloating is most often caused by trapped gas in the small intestine. This can cause

flatulence (passing of excessive gas/wind) painful stomach ache and an

uncomfortable feeling when wearing tight clothes. There are a variety of

things that can cause this bloated feeling, including digestion problems such as:

● Indigestion

● Intestinal Gas

● Trapped wind

● Irritable Bowel Syndrome (IBS)

● Dysmotility (a slow digestive system)

Other conditions that may result in a bloated stomach include:

● Candidiasis

● Coeliac Disease

● Premenstrual Syndrome (PMS)

Bloating can also occur as a result of food intolerance, insufficient Hydrochloric

acid in your stomach, insufficient digestive enzymes in your stomach or lack of

good intestinal flora (good bacteria normally present in the gut). Whatever the

cause, the fact remains that for some reason digestion is hampered and

undigested foods are reaching your gut where fermentation takes place causing the

bloating.

As a bloated stomach can indicate more serious conditions, if bloating persists or

worsens, it is advised that you seek medical advice.

The Digestive System ["A man does not live on what he eats, an old proverb says, but on what he digests." Jean Anthelme Brillat-Savarin, The Physiology of Taste: Or Meditations on Transcendental Gastronomy]

2012-02-12T03:20:00.000-08:00

Objectives

1. Describe stimuli and controls of digestive activity.

2. Describe the location and function of the peritoneum.

3. Define retroperitoneal and name the retroperitoneal organs.

4. Define splanchic circulation.

5. Indicate the importance of the hepatic portal system.

6. Describe the tissue composition and the general function of each of the four layers of the

alimentary canal.

7. Identify structural modifications of the wall of the stomach that enhance the digestive process.

8. Name the cell types responsible for secreting the various components of gastric juice and

indicate the importance of each component in stomach activity.

9. Describe stomach structure and indicate changes in the basic alimentary canal structure that

aid its digestive function.

10. Explain how gastric secretion and stomach motility are regulated.

11. Identify and describe structural modifications of the wall of the small intestine that enhance the digestive process.

12. Differentiate between the roles of the various cell types of the intestinal mucosa.

13. Describe the function of local intestinal hormones and paracrines.

14. State the role of bile in digestion and describe how its entry into the small intestine is regulated.

15. Describe the role of the gallbladder.

16. State the role of pancreatic juice in digestion.

17. Describe how entry of pancreatic juice into the small intestine is regulated.

18. List the major functions of the large intestine.

19. List the enzymes involved in chemical digestion; name the foodstuffs on which they act.

20. Describe the process of absorption of breakdown products of foodstuffs that occurs in the small intestine.

21. Describe some of the structural and functional properties of smooth muscle.

Part 1: Overview of the Digestive System (pp. 852–858; Figs. 23.1–23.6)

A. Digestive system organs fall into two main groups: the alimentary canal and the accessory organs.

1. The alimentary canal, or gastrointestinal (GI) tract, is the continuous muscular digestive tube that winds through the body digesting and absorbing foodstuff; its organs include: the mouth, pharynx, esophagus, stomach, small intestine, and large intestine.

2. Accessory digestive organs aid digestion physically and produce secretions that break down foodstuff in the GI tract; the organs involved are the teeth, tongue,

gallbladder, salivary glands, liver, and pancreas.

I. Digestive Processes

A. Ingestion is the simple act of putting food into the mouth.

B. Propulsion moves food through the alimentary canal and includes both swallowing andperistalsis.

C. Mechanical digestion is the physical process of preparing the food for chemical digestion and involves chewing, mixing, churning, and segmentation.

D Chemical digestion is a series of catabolic steps in which complex food molecules are broken down to their chemical building blocks by enzymes.

E. Absorption is the passage of digested end products from the lumen of the GI tract through the mucosal cells into the blood or lymph.

F. Defecation eliminates indigestible substances from the body via the anus as feces.

II. Basic Functional Concepts (p. 854; Fig. ]23.4)

A. The digestive system creates an optimal internal environment for it's functioning in the lumen of the GI tract, an area that is technically outside of the body.

1. Digestive activities within the GI tract are triggered by mechanical and chemical stimuli [e.g., stretching of organ by food, osmolarity, pH, etc.]

2. The activities of the digestive system are regulated by

a. Neural mechanisms [Enteric Nervous System (ENS)]: the ENS has roughly as many neurons as the spinal cord, and as many neurotransmitters as the brain, but whose functions remain largely unknown...

Short[myenteric] reflexes control smooth muscle contraction and glandular secretion as relatively localized activities involving small segments of the digestive tract; this mechanism is usually considered parasympathetic, but the plexus also contains sensory neurons, motor neurons and interneurons for local reflexes whose internal workings operate entirely outside the control of the CNS.

Long reflexesinvolve interneurons and motor neurons in the CNS and provide a higher level of control over digestive and glandular activities.

b. Hormonal mechanisms involve as many as 18 hormones, affecting almost every aspect of digestive function...

c. Local mechanisms involve prostaglandins, histamine and other chemicals released into the interstitial fluid and affecting adjacent cells...

Digestive System 1

2012-02-11T14:41:00.000-08:00

Digestive System

The Digestive System ["A man does not live on what he eats, an old proverb says, but on what he digests." Jean Anthelme Brillat-Savarin, The Physiology of Taste: Or Meditations on Transcendental Gastronomy]

Objectives

1. Describe stimuli and controls of digestive activity.

2. Describe the location and function of the peritoneum.

3. Define retroperitoneal and name the retroperitoneal organs.

4. Define splanchic circulation.

5. Indicate the importance of the hepatic portal system.

6. Describe the tissue composition and the general function of each of the four layers of the

alimentary canal.

7. Identify structural modifications of the wall of the stomach that enhance the digestive process.

8. Name the cell types responsible for secreting the various components of gastric juice and

indicate the importance of each component in stomach activity.

9. Describe stomach structure and indicate changes in the basic alimentary canal structure that

aid its digestive function.

10. Explain how gastric secretion and stomach motility are regulated.

11. Identify and describe structural modifications of the wall of the small intestine that enhance the digestive process.

12. Differentiate between the roles of the various cell types of the intestinal mucosa.

13. Describe the function of local intestinal hormones and paracrines.

14. State the role of bile in digestion and describe how its entry into the small intestine is regulated.

15. Describe the role of the gallbladder.

16. State the role of pancreatic juice in digestion.

17. Describe how entry of pancreatic juice into the small intestine is regulated.

18. List the major functions of the large intestine.

19. List the enzymes involved in chemical digestion; name the foodstuffs on which they act.

20. Describe the process of absorption of breakdown products of foodstuffs that occurs in the small intestine.

21. Describe some of the structural and functional properties of smooth muscle.

Part 1: Overview of the Digestive System (pp. 852–858; Figs. 23.1–23.6)

A. Digestive system organs fall into two main groups: the alimentary canal and the accessory organs.

2. Accessory digestive organs aid digestion physically and produce secretions that break down foodstuff in the GI tract; the organs involved are the teeth, tongue,

gallbladder, salivary glands, liver, and pancreas.

Digestive System Questions

2012-02-11T14:35:00.000-08:00

1.	The correct sequence for the layers within the walls of the alimentary canal from inside to outside is the
A)	mucous membrane, muscular layer, serous layer, submucosa.
B)	mucous membrane, submucosa, muscular layer, serous layer.
C)	serous layer, muscular layer, mucous membrane, submucosa.
D)	submucosa, mucous membrane, serous layer, muscular layer.

2.	The teeth that are best adapted for biting off relatively large pieces of food are the
A)	incisors.
B)	cuspids.
C)	bicuspids.
D)	molars.

3.	The salivary enzyme amylase functions to digest
A)	carbohydrates.
B)	proteins.
C)	fats.
D)	all of the above

4.	The main part of the stomach is called the
A)	fundic region.
B)	pyloric region.
C)	cardiac region.
D)	none of the above

5.	A relatively new treatment in the management of gastric ulcers is a drug that inhibits the production of HCl in the stomach. If a person took this medication for a long period, the digestion of which of the following would be affected the most?
A)	carbohydrates
B)	lipids
C)	proteins
D)	none of the above

6.	Gastrin, which is secreted by stomach cells, functions to
A)	inhibit the production of hydrochloric acid.
B)	increase the secretions of the gastric glands.
C)	change pepsin into pepsinogen.
D)	initiate the cephalic phase of digestion.

7.	The hormone called secretin functions to
A)	convert trypsinogen into trypsin.
B)	activate chymotrypsin.
C)	stimulate the release of pancreatic juice.
D)	inhibit the action of pancreatic lipase.

8.	Which of the following is a protein-splitting enzyme found in pancreatic juice?
A)	trypsin
B)	zymogen
C)	amylase
D)	nuclease

9.	What constituent of bile has a digestive function?
A)	bile salts
B)	bile pigments
C)	cholesterol
D)	electrolytes

10.	One of the major functions of the large intestine is to
A)	secrete digestive enzymes.
B)	reabsorb water from chyme.
C)	regulate the release of bile.
D)	break down hemoglobin.

11.	A characteristic shared by all enzymes involved in protein digestion is that all are
A)	secreted by the pancreas.
B)	activated by HCl.
C)	secreted in an inactive form.
D)	stimulated by enterokinase.

12.	Peristalsis occurs in the digestive tract
A)	from the pharynx to the anus.
B)	in the stomach and small intestine only.
C)	in the small and large intestines only.
D)	in the stomach, small intestine, and large intestine.

13.	Digestion of which of the following would be affected the most if the liver were severely damaged?
A)	carbohydrates
B)	lipids
C)	proteins
D)	none of the above

14.	A hiatal hernia is due to a weakness of the
A)	abdominal wall.
B)	pelvic wall.
C)	diaphragm.
D)	stomach wall.

15.	Heartburn is usually caused by the effects of gastric juice on the
A)	heart.
B)	esophagus.
C)	stomach.
D)	small intestine.

16.	Gastric and duodenal ulcers are usually caused by the action of
A)	pepsin.
B)	lipase.
C)	amylase.
D)	none of the above

17.	The greater omentum is composed of the
A)	peritoneal membrane.
B)	pericardial membrane.
C)	pleural membrane.
D)	none of the above

18.	The digestive functions of saliva include
A)	digesting starch into disaccharides.
B)	acting as a lubricant during swallowing.
C)	dissolving food chemicals.
D)	all of the above

19.	When nutrients are digested but are not taken in by the intestinal tissues, the condition is called
A)	malnutrition.
B)	malabsorption.
C)	food intolerance.
D)	food allergy.

20.	If the blood vessels of the anal columns become enlarged, the condition is called
A)	peritonitis.
B)	hemorrhoids.
C)	diarrhea.
D)	none of the above

21.	Which layer of the alimentary canal is responsible for absorption of nutrients?
A)	mucosa
B)	submucosa
C)	muscular layer
D)	serosa

22.	The mechanism of swallowing involves
A)	food being forced into the pharynx.
B)	involuntary reflexes moving food into the esophagus.
C)	peristaltic contractions moving food through the esophagus.
D)	all of the above

23.	Which of the following are major functions of the liver?
A)	storage of certain molecules
B)	blood filtering
C)	secretion of bile
D)	all of the above

24.	Gallstones may form if
A)	bile is concentrated excessively.
B)	hepatic cells secrete too much HCl.
C)	the pH of the gallbladder becomes too alkaline.
D)	all of the above

Answer Key

1.	B
2.	A
3.	A
4.	D
5.	C
6.	B
7.	C
8.	A
9.	A
10.	B
11.	C
12.	A
13.	B
14.	C
15.	B
16.	A
17.	A
18.	D
19.	B
20.	B
21.	A
22.	D
23.	D
24.	A

Cinnamon and Honey

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Cinnamon and Honey ~ Bet the drug companies won't like this one getting around.~

Facts on Honey and Cinnamon : It is found that a mixture of honey and cinnamon cures most diseases. honey is produced in most of the countries of the world. Scientists of today also accept honey as a 'Ram Ban' (very effective) medicine or all kinds of diseases.

Honey can be used without any side effects for any kind of diseases.

Today's science says that even though honey is sweet, if taken in the right dosage as a medicine, it does not harm diabetic patients. Weekly World News, a magazine in Canada, in its issue dated 17 January,1995 has given the following list of diseases that can be cured by honey and cinnamon as researched by western scientists:

HEART DISEASES :
Make a paste of honey and cinnamon powder, apply on bread, instead of jelly and jam, and eat it regularly for breakfast. It reduces the cholesterol in the arteries and saves the patient from heart attack. Also those who have already had an attack, if they do this process daily, they are kept miles away from the next attack. Regular use of the above process relieves loss of breath and strengthens the heart beat.
Arthritis patients :
may take daily, morning, and night, one cup of hot water With two spoons of honey and one small teaspoon of cinnamon powder. If Taken regularly even chronic arthritis can be cured. In a recent research conducted at Copenhagen University, it was found that when the doctors treated their patients with a mixture of one tablespoon of Honey and half teaspoon of Cinnamon powder before breakfast, they found that within a week, out of the 200 people so treated, practically 73 patients were totally Relieved of pain, and within a month, mostly all the patients who could not walk or move around because of arthritis started walking without pain.
BLADDER INFECTIONS:
Take two tablespoons of cinnamon powder and one teaspoon of honey in a Glass of lukewarm water and drink it. It destroys the germs in the bladder.
CHOLESTEROL:
Two tablespoons of honey and three teaspoons of Cinnamon Powder mixed in 16 ounces of tea water, given to a cholesterol patient, was found to reduce The level of cholesterol in the blood by 10 percent within two hours. As Mentioned for arthritic patients, if taken three times a day, any chronic Cholesterol is cured. According to information received in the said Journal, pure honey taken with food daily relieves complaints of cholesterol.
COLDS:
Those suffering from common or severe colds should take one tablespoon Lukewarm honey with 1/4 spoon cinnamon powder daily for three days. This Process will cure most chronic cough, cold, and clear the sinuses.
UPSET STOMACH:
Honey taken with cinnamon powder cures stomach ache and also clears Stomach ulcers from the root.
GAS:
According to the studies done in India and Japan, it is revealed that if Honey is taken with cinnamon powder the stomach is relieved of gas. > IMMUNE SYSTEM:> Daily use of honey and cinnamon powder strengthens the immune system and Protects the body from bacteria and viral attacks. Scientists have found That honey has various vitamins and iron in large amounts. Constant use of Honey strengthens the white blood corpuscles to fight bacteria and viral Diseases.
INDIGESTION:
Cinnamon powder sprinkled on two tablespoons of honey taken before food Relieves acidity and digests the heaviest of meals.
INFLUENZA:
A scientist in Spain has proved that honey contains a natural 'Ingredient' Which kills the influenza germs and saves the patient from flu.
LONGEVITY:
Tea made with honey and cinnamon powder, when taken regularly, arrests the Ravages of old age. Take four spoons of honey, one spoon of cinnamon powder And three cups of water and boil to make like tea. Drink 1/4 cup, three to Four times a day. It keeps the skin fresh and soft and arrests old age. Life spans also increases and even a 100 year old, starts performing the Chores of a 20-year-old.
PIMPLES:
Three tablespoons of honey and one teaspoon of cinnamon powder paste Apply this paste on the pimples before sleeping and wash it next morning with Warm water. If done daily for two weeks, it removes pimples from the root.
SKIN INFECTIONS:
Applying honey and cinnamon powder in equal parts on the affected parts Cures eczema, ringworm and all types of skin infections.
WEIGHT LOSS:
Daily in the morning one half hour before breakfast on an empty stomach And at night before sleeping, drink honey and cinnamon powder boiled in one Cup of water. If taken regularly, it reduces the weight of even the most obese person. Also, drinking this mixture regularly does not allow the fat to accumulate in the body even though the person may eat a high calorie diet.
CANCER:
Recent research in Japan and Australia has revealed that advanced cancer of the stomach and bones have been cured successfully. Patients suffering from these kinds of cancer should daily take one tablespoon of honey with one teaspoon of cinnamon powder for one month three time s a day.
FATIGUE:
Recent studies have shown that the sugar content of honey is more helpful rather than being detrimental to the strength of the body. Senior citizens, who take honey and cinnamon powder in equal parts, are more alert and flexible. Dr. Milton, who has done research, says that a half Tablespoon of honey taken in a glass of water and sprinkled with cinnamon powder, taken daily after brushing and in the afternoon at about 3:00 P.M. When the vitality of the body starts to decrease, increases the vitality of the body within a week.
BAD BREATH:
People of South America, first thing in the morning, gargle with one teaspoon of honey and cinnamon powder mixed in hot water, so their breath stays fresh throughout the day.
HEARING LOSS:
Daily morning and night honey and cinnamon powder, taken in equal parts restore hearing. Remember when we were kids? We had toast with real butter and cinnamon sprinkled on it!
ARTHRITIS:
In America and Canada, various nursing homes have treated patients successfully and have found that as you age, the arteries and veins lose their flexibility and get clogged; honey and cinnamon revitalize the arteries and veins.

STOMACH

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· Functions

o Storage of ingested meal

o Inhibition of bacterial growth

o Mixing contents of stomach

o Physical breakdown of food into small particles, some components solubilized

o Regulates reate of emptying into small intestine

o Provides intrinsic factor for vitamin B12 absorption

· Body of stomach

o Structure of gastric gland

§ Mucus epithelial cells and overlying mucus contribute to gastric mucosal barrier

§ Parietal cells secrete hydrochloric acid and intrinsic fact

· In fundus and body

§ Chief cells produce and secrete pepsinogen

· Fundus, body, and antrum

§ ECL cells synthesis and release histamine

· Do not contact gland lumen

§ Mucus neck cells include stem cells which divide, differentiate and move up and down the gland in normal cellular turnover

§ Endocrine cells

· Somatostatin and ghrelin from fundus

· Gastrin and somatostatin from antrum

· Secretion of HCl by Parietal Cells

o CO2 diffuses into parietal cells from plasma or is produced by cellular metabolism

o Hydrated to H2CO3 via carbonic anhydrase and dissociates to H and HCO3-

o At apical membrane H+ is transported out of the cell in exchange for K+ by H+/K+ ATPase

§ ATPase is a target for proton pump inhibitors

§ Activated in the acid environment of the gastric gland

§ At rest, most are within the cell in inactive form and with stimulation of parietal cells they fuse to luminal membrane

· Activation includes Gastrin, ACh, and histamine

· Activation shows potentiation of response

o Cl- exits passives through a Cl- channel

· Integrated control of Gastric Acid secretion

o Vagus acts directly on parietal cells and indirectly by effects on gastrin and histamine release

o Histamine released from ECL cells reaches parietal cells by local diffusion

o Gastrin released fromantral G cells reaches parietal cells by systemic circulation

o Inhibitory regulators include somatostatin released from D cells in the antrum and body of the stomach, prostagladin from surface cells and intestinal hormones collectively termed “enterogastrone”

· Pepsin

o Proteolytic enzyme secreted by chief cells as an inactive precursor, pepsinogen

o Release stimulated by vagal nerve and by presence of acid in stomach

o Activated by peptide cleavage at acid pH

o Initiates digestion of protein

§ Endopeptidase acting on internal peptide bonds

§ Products are large peptides called peptones (potent stimulators of gastrin and CCK release)

· Intrinsic Factor

o Glycoprotein which binds Vitamin B12

o Produced by Parietal cells

o After binding B12 its binds receptors on ileal absorptive cells and is internalized by endocytosis

o Absent in pernicious anemia

· Gastric Mucosal Barrier

o Protection against acid and pepsin

o Includes:

§ Prominent mucous layer

§ Bicarbonate secreted by surface cells which sets up a pH gradient

§ Tight junctions between epithelial cells

§ Surfactant like molecules secreted by mucosal cells

§ Gastric mucosal blood flow which rapidly removes any penetrating acid

· Gastric Motility

o Proximal: Receptive relaxation as stomach fills (fundus)

o Distal: propulsive mixing and grinding (antrum)

§ Only particles smaller than 1 mm can exit through the pylorus

§ Peristalsis initiated by pacemaker cells

§ Muscular contraction is brought about by action potentials occurring when the smooth muscle cells depolarize below threshold

· Increased by vagal or gastrin stimulation

· Decreased by vagotomy or sympathetic stimulation

o Pylorus regulates outflow

§ Regulated to prevent overload in intestine and allow optimal digestion

§ Increases in fatty acids, acidity, osmolarity, volume, and amino acids in the intestine leads to the release of CCK and secretrin which inhibits stomach emptying

§ Disorders

· Delayed emptying (helped via use of prokinetic agents)

o Outlet obstruction (tumor, scarring)

o Diabetic neuropathy or vagotomy

· Accelerated emptying

o Dumping Syndrome

The Greta Value of Empty Stomach

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“Then Jesus was led by the Spirit into the desert to be tempted by the devil. After fasting for forty days and forty nights, he was hungry” (Matthew 4:1-2).

Keep fasting over this night! Why, for what? Tomorrow you have operation, we cannot operate in full stomach, the doctors said!

Food is important for the body and nutrition is essential for it. Fasting does not mean we do not need to eat. One thing peculiar to this subject is that we cannot find a scripture that gives us a command to fast. It is useless as well if we fast without understanding the spiritual value of this act. Otherwise, we will cling to its mere physical aspect only.

The Israelites, the people of God, use to fast in three main occasions: First, when they sin against God they fast as an act of repentance form their wicked ways. (1st Samuel 7:6) By fasting they show humbleness in front of God and forward their petition to gain His reconciliation and forgiveness. Secondly, when they face threats, calamities, plagues or death they fast to draw near to God, to gain His protection and invite Him to fight for them and to deliver them from the hands of the enemy. (2

Chronicles Chapter 20*) Thirdly, when they are about to perform a big task whether physical or spiritual they fast to invite the Spirit of God to go before them to achieve the work. They charge their bodies by the Spirit of God, thus fasting is a privilege equal to power, progress and success. (Nehemiah 1:4*)

As human, two main poles act on us 1st Pole, God, who represents the Holiness. 2nd pole, Satan the tempter, with all his weapons that act on our instincts and desires. To draw toward the 1st pole is to declare or dependence on the Spirit of God who supplies even our physical needs.

Fasting is not meant to be compulsory act. Be aware! Fasting is not a habit. It is not a tradition. It is not mere imitation. Our desire to be near God should be the initiative and the motive for fasting. This is the “fasting led by the Spirit”.

Jesus, before he started His ministry on earth, was led by the Spirit to fast. He withdrew toward the desert where nothing of value can be seen except the holiness and the greatness of the unseen, our God. He withdrew to the desert where he started the battle against Satan, the tempter. There he started His wrestle by fasting against the flesh and against its three main legions which are:

1) The physical needs, instincts and desires: “The tempter came to him and said, ‘If you are the Son of God, tell these stones to become bread. ’Jesus answered’ it is written: Man does not live on bread alone, but on every word that comes from the mouth of God” (Matthew 4:3-4). The suggestion of the devil is that you can satisfy your physical needs by earthly things. Satan tried to pull him away from the spiritual food that gives the satisfaction even to the physical needs. By fasting will not only be released from the bondage of physical food, but will help us to overcome other body instincts and desires like the lust of the flesh. In fact, to teach ourselves this new rule of life is not easy and it needs a lot of Spiritual maturity to say this verse as Paul said ”Everything is permissible but not everything is beneficial. Everything is permissible for me-but I will not be mastered by anything. Food for stomach and stomach for food-But God will destroy them both. The body is not meant for sexual immorality, but for the Lord, and the Lord for the body” (1 Corinthians 6:12-13).

2) The human pride: “Then the devil took him to the Holy City and had him stand on the highest point of the temple. ’If you are the Son of God’ he said,’ throw yourself down’. For it is written:”He will command his angels concerning you, and they will lift you up in their hands, so that you will not strike your foot against a stone’. Jesus answered him, ‘it is also written: Do not put the Lord your God to the test” (Matthew 4:5-7). (The devil used even words from the Holy Scriptures, Psalm

91:11-12). Here, Satan tried to substantiate Jesus claim to be God’s son, (If you are the Son of God).

And, at this point the devil tried to ignite the spirit of pride in Jesus tempting Him to do supernatural things to prove His Identity. The devil does the same with us, pushing us to show our splendour and our pride, which is the mother and the breadwinner of many sins. Fasting is one of the means to control and suppress that pride by depending on God’s Spirit rather than our flesh.

3) Greed for possession: “Again the devil took him to a very high mountain and showed him all the kingdoms of the world and their splendours. ’All this I will give you’, he said, ’If you will bow down and worship me’. Jesus said to him, ‘Away from me, Satan!’ For it is written: Worship the Lord your God, and serve Him only”. (Matthew 4:8-10) The devil here tried to pull Jesus to his side by bribing him with material things. Satan’s option is for Jesus to reign the world by treasures and to deviate God’s plan for Jesus to reign the world by the way of the cross. Fasting helps us refrain from worshipping and serving the idols of money and materialism.

Fasting directs our bodies to serve God by the divine way of living. It can be one of the scales that measure our love toward God. It cleans us from the greed of possessions and the love of position, and draws us toward the Holiness of our God. “Then the devil left him, and angels came and attended him.” (Matthew 4:11) Jesus wrestled with the above three legions and defeated the power of Satan and the flesh through fasting, and replaced them with the power of the Holy Spirit, the cause of later triumphs in His ministry on earth.

My Dear and Beloved: When fasting overcomes all the above flesh components, when fasting is accompanied by humble attitude of renouncing our sins and repentance from our wrong ways, when fasting is accompanied by the act to share our food with the hungry and our clothes with the naked, when fasting is accompanied by the desirable submission to the will of God, this is the healthy and effective fasting. This is “the great value of empty stomach.” The time when we can draw closer to God, and the time that we can surrender our flesh to God, inviting Him to dwell in us, His angels surround us, and the Holy Spirit to work through us. For God is pleased to operate on the empty stomach to heal us, to give us the strength, the courage, the wisdom and the victory over the power of darkness. And “Then your light will break forth like dawn, and you healing will quickly appear; then your righteousness will go before you, and the glory of God will be your rear guard. Then you will call, and the Lord will answer; you will cry for help, and he will say: Here Am I” (Isaiah 58:8-

9a) Therefore commit your life and ways to God as you agree to pray.

My Prayer: Father God I come before you in the name of Jesus who died on the cross for my sins to give me eternal life. Lord help and give me the self-control and the strength to overcome all the flesh desire and gives me the perseverance to fast and to commit my stomach in your hands. Lord help to do that and help me to repent from all my sins and be transform to the likeliness that want to see me. This all I ask and pray in Jesus name Amen.

conti.... Stomach

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The lesser curvature forms the right border of the stomach and extends from the cardiac orifice to the pylorus . It is suspended from the liver by the lesser omentum.

The greater curvature is much longer than the lesser curvature and extends from the left of the cardiac orifice, over the dome of the fundus, and along the left border of the stomach to the pylorus.

The gastrosplenic omentum (ligament) extends from the upper part of the greater

curvature to the spleen,

Relations of the stomach:-

Anteriorly: Posteriorly:

1.The anterior abdominal wall. 1.The lesser sac.

2.The left costal margin. 2.The diaphragm.

3.The left pleura and lung. 3.The spleen.

4.The diaphragm. 4.The left suprarenal gland.

5.The left lobe of the liver. 5.The upper part of the left kidney.

6.The splenic artery.

7.The pancreas.

8.The transverse mesocolon

9.The transverse colon.

Blood Supply

Arteries

The arteries are derived from the branches of the celiac artery.

1-The left gastric artery arises from the celiac artery. It passes upward and to the left to reach the esophagus and then descends along the lesser curvature of the stomach.

It supplies the lower third of the esophagus and the upper right part of the stomach.

2-The right gastric artery arises from the hepatic artery at the upper border of the pylorus and runs to the left along the lesser curvature. It supplies the lower right part of the stomach.

3-The short gastric arteries arise from the splenic artery at the hilum of the spleen and pass forward in the gastrosplenic omentum (ligament) to supply the fundus.

4-The left gastroepiploic artery arises from the splenic artery at the hilum of the spleen and passes forward in the gastrosplenic omentum (ligament) to supply the stomach along the upper part of the greater curvature.

5-The right gastroepiploic artery arises from the gastroduodenal branch of the hepatic artery. It passes to the left and supplies the stomach along the lower part of the greater curvature.

Veins

The veins drain into the portal circulation .

1-Left gastric vein

2-Right gastric veins. drain directly into the portal vein.

3-Short gastric veins.

4-Left gastroepiploic veins. join the splenic vein.

5-Right gastroepiploic vein. joins the superior mesenteric vein.

Lymph Drainage

The lymph vessels follow the arteries into the

1-Left and right gastric nodes.

2-The left and right gastroepiploic nodes.

3-And the short gastric nodes.

All lymph from the stomach eventually passes to the celiac nodes,which are located

around the root of the celiac artery on the posterior abdominal wall.

Nerve Supply

The nerve supply includes:

1-Sympathetic fibers derived from the celiac plexus.

2-Parasympathetic fibers from the right and left vagus nerves.

The anterior vagal trunk,which is formed in the thorax from the left vagus nerve, enters the abdomen on the anterior surface of the esophagus.

The trunk, which may be single or multiple, then divides into branches that supply the anterior surface of the stomach.

A large hepatic branch passes up to the liver, and from this a pyloric branch passes down to the pylorus.

The posterior vagal trunk,which is formed in the thorax from the right vagus nerve, enters the abdomen on the posterior surface of the esophagus.

The trunk then divides into branches that supply mainly the posterior surface of the stomach.

A large branch passes to the celiac and superior mesenteric plexuses and is distributed to the intestine as far as the splenic flexure and to the pancreas.

The sympathetic innervation of the stomach carries a proportion of pain-transmitting nerve fibers.

Whereas the parasympathetic vagal fibers are secretomotor to the gastric glands and motor to the muscular wall of the stomach.

The pyloric sphincter receives motor fibers from the sympathetic system and inhibitory fibers from the vagi.

Stomach

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The stomach is the dilated portion of the alimentary & situated in the upper part of the abdomen, extending from beneath the left costal margin into the epigastric and umbilical regions.

Much of the stomach lies under cover of the lower ribs.

It is roughly J-shaped and has :

1-two openings, the cardiac and pyloric orifices.

2-two curvatures, the greater and lesser curvatures.

3-two surfaces, an anterior and a posterior surface.

The stomach is relatively fixed at both ends but is very mobile in between. It tends to be high and transversely arranged

Its shape undergoes considerable variation in the same person and depends on the volume of its contents, the position of the body, and the phase of respiration.

Parts of the stomach:-

1.Fundus: This is dome-shaped and projects upward and to the left of the cardiac orifice. It is usually full of gas.

2.Body: This extends from the level of the cardiac orifice to the level of the incisura angularis, (a constant notch in the lower part of the lesser curvature).

3.Pyloric antrum: This extends from the incisura angularis to the pylorus.

4.Pylorus: This is the most tubular part of the stomach. The thick muscular wall is called the pyloric sphincter, and the cavity of the pylorus is the pyloric canal.

Gastrointestinal Tract

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Esophagus (Abdominal Portion)

The esophagus is a muscular, collapsible tube about 10 in. (25 cm) long that joins the

pharynx to the stomach.

The greater part of the esophagus lies within the thorax.

The esophagus enters the abdomen through an opening in the right crus of th diaphragm.

After a course of about 0.5 in. (1.25 cm), it enters the stomach on its right side.

Relations

The esophagus is related : anteriorly to the posterior surface of the left lobe of the liver.

posteriorly to the left crus of the diaphragm.

The left and right vagi lie on its anterior and posterior surfaces, respectively.

Blood Supply

Arteries

The arteries are branches from the left gastric artery.

Veins

The veins drain into the left gastric vein, a tributary of the portal vein.

Lymph Drainage

The lymph vessels follow the arteries into the left gastric nodes.

Nerve Supply

The nerve supply is the anterior and posterior gastric nerves (vagi) and sympathetic branches of the thoracic part of the sympathetic trunk.

Function

The esophagus conducts food from the pharynx into the stomach.

Wavelike contractions of the muscular coat, called peristalsis, propel the food onward.

Gastro esophageal Sphincter

No anatomic sphincter exists at the lower end of the esophagus. However, the circular layer of smooth muscle in this region serves as a physiologic sphincter.

As the food descends through the esophagus, relaxation of the muscle at the lower end occurs ahead of the peristaltic wave so that the food enters the stomach.

The tonic contraction of this sphincter prevents the stomach contents from regurgitating into the esophagus.

1.	B
2.	A
3.	A
4.	D
5.	C
6.	B
7.	C
8.	A
9.	A
10.	B
11.	C
12.	A
13.	B
14.	C
15.	B
16.	A
17.	A
18.	D
19.	B
20.	B
21.	A
22.	D
23.	D
24.	A

1.	B
2.	A
3.	A
4.	D
5.	C
6.	B
7.	C
8.	A
9.	A
10.	B
11.	C
12.	A
13.	B
14.	C
15.	B
16.	A
17.	A
18.	D
19.	B
20.	B
21.	A
22.	D
23.	D
24.	A

1.	B
2.	A
3.	A
4.	D
5.	C
6.	B
7.	C
8.	A
9.	A
10.	B
11.	C
12.	A
13.	B
14.	C
15.	B
16.	A
17.	A
18.	D
19.	B
20.	B
21.	A
22.	D
23.	D
24.	A