Gastrointestinal Disorders

Gastrointestinal disorders are disorders related with Stomach, Pancreas, Liver, Gallbladder, Small Intestine, and Large Intestine.

GORD (Gastro-oesophageal reflux disease)

GORD is quite common unpleasant disorders such as acid reflux, regurgitation, sometimes vomiting, and/or burning sensation at chest which may be coming from inflammation of lining of oesophagus. Common medication is anti-acid tablets to reduce acid in Stomach.

From Simplified Gastrointestinal Track Diagram

Stomach is temporally storing foods and doing digestion of foods with gastric juice, which is mixing with gastric juice (high acid juice) and churning and breaking down to small pieces of foods to make easy digestion by doing contracting and relaxing by itself, eventually, food is converted to chyme which is thick watery, acidic, soupy mixture.

Gastric juice is highly acidic, with a pH of 0.9–1.5, and contains water (99%), hydrochloric acid (0.4%–0.5%), pepsin, lipase, glycoprotein and mucin, calcium, sodium and potassium salts, etc and it is normally volume 20 to 100 mL and this gastric juice actually is doing melting down foods you are taken from mouth. And this gastric juice can kill and eliminate any kinds of bacteria which is contained in foods and waters. Therefore, even if we are sometimes eating and drinking some dirty foods and waters, we are not sick due to the fact that gastric juice is killing bacteria with hydrochloric acid called as HCL.

From Simplified Stomach Diagram

When chyme is reached to enough acidic level to digest, and then lower gate of stomach called as pylorus opens gate to release the chyme to go duodenum.

Problem is coming from full and/or half indigestion by any reasons. That meaning is foods are not digesting when you have stress and/or thinking too much. Because all bloods are going to your brain due to the need of blood from brain for extra need of nutrients and oxygen for thinking. Your brain is as like central processing unit (CPU) in your personal computer. CPU is a major component in computer. It is consuming lots of power of computer for running many programs and operating system.

Photo of microprocessor with exhausting fan and aluminium heatsink in motherboard of computer for cooling down heat generated from microprocessor.

PPIs (Proton Pump Inhibitors)

PPIs are the most prescribed medications in the world. From the article, PPIs are used over 10 billion dollars a year in Unite States of America (U.S.A.) and 25 billion dollars a year around world (Jaynes M, Kumar AB. The risks of long-term use of proton pump inhibitors: a critical review. Ther Adv Drug Saf. 2018 Nov 19;10:2042098618809927. doi: 10.1177/2042098618809927. PMID: 31019676; PMCID: PMC6463334). The potential side effects of PPIs for long-term usage are as follows. And the research articles are well documented.

  1. PPIs and Clostridium difficile (C. difficile) infection
  2. PPIs and dementia
  3. PPIs and pneumonia
  4. PPIs and antiplatelet agents
  5. PPIs and kidney disease
  6. PPIs and micronutrient deficiency
  7. PPIs and bone mineral density

PPIs are removing gastric acid, so it may help you reducing acid reflux. But you may have another problem. Because gastric juice which is high acid juice with hydrochloride is doing killing bacteria and melting down foods you take. In these functions, the killing micro-organisms are very important function to make a barrier between your inner body and outside environment. Because even if we are cleaning the foods we take properly, there are some micro-organisms in foods and/or drinks we take. So gastric juice which has hydrochloride will kill most of them in foods and/or drinks. There is exempt that Helicobacter pylori (H. pylori) is a type of bacterium that can live in the lining of the stomach even if high acid juice is in stomach wall. They have special mechanism to protect by themselves.

H.pylori may cause stomach inflammation (gastritis) and more serious conditions such as stomach ulcers and stomach cancer ( https://www.healthdirect.gov.au/helicobacter-pylori).

And then mixed with Pancreatic juice from Pancreas and Bile juice from Gallbladder which is produced at Liver.

From P239. 4th Ed. Clinically Oriented Anatomy, Keith L. Moore. Arthur F. Dalley

As you can see above diagram, there are major duodenal papilla which are connecting with Common Bile duct which is connecting to Gallbladder and Liver and Pancreatic duct which is connecting to Pancreas. That meaning is chyme is mixed with Pancreatic juice and Bile juice. Pancreatic juice is high alkaline juice about pH 8. This high pH makes neutralization of chyme which is acidic, entering duodenum. Now chyme is not toxic to intestine and our intestines can absorb nutrients from chyme.

From here, if chyme is not neutralised by any reasons, for example, slightly acidic or slightly alkaline, in that case, chyme is toxic to small intestine and large intestine. Therefore, slightly acidic or slightly alkaline chyme can cause irritation to the membranes of intestines, leading to inflammation of tissues. That irritation can cause rapid evacuation of chyme with tummy pain and then eventually there is no time to absorb any nutrients and waters, leading to urgent diarrhoea.

This diarrhoea and/or any loose bowel motions are not good, because we can’t absorb any nutrients and waters at all. Eventually, we have lack of nutrients and dehydration. Therefore, we can’t maintain our body, eventually, our body is getting weaker.

Usually, after stomach, chyme is mixed with bile juice whose colour is brown colour, so all stools are coloured with brown colour.

Gastritis

Gastritis is meaning “inflammation of Stomach membrane”. It is quite common disorders presented in clinic. Most of people have these disorders with many reasons such as stress, not proper diets, not fresh foods, medications which are anti-inflammatory drugs such as aspirin, ibuprofens, and alcohol etc.

Gastric Ulcer

Gastric Ulcer is an open sore on an internal surface of the Stomach, caused by a break in the mucous membrane which fails to heal (Definitions from Oxford Languages). As you have an experience at the skin ulcer which is not healing, so you will feel painful. If this kind of ulcer is happened in your Stomach membrane, you will feel different feeling. But it is not favourable. Not healing sores may be leading to Stomach Cancer.

Stomach Cancer

Stomach C

Ulcerative Colitis

From Ordás I, Eckmann L, Talamini M, Baumgart DC, Sandborn WJ. Ulcerative colitis. Lancet. 2012 Nov 3;380(9853):1606-19. doi: 10.1016/S0140-6736(12)60150-0. Epub 2012 Aug 20. PMID: 22914296.
Figure 2: Mayo endoscopic score for ulcerative colitis (A) Score 0=normal; endoscopic remission. (B) Score 1=mild; erythema, decreased vascular pattern, mild friability. (C) Score 2=moderate; marked erythema, absent vascular pattern, friability, erosions. (D) Score 3=severe; spontaneous bleeding, ulceration. Images courtesy of Elena Ricart.

As you can see from above picture, picture D is showing bleeding, ulcerations which is whitish image. If the patients are bleeding diarrhea with mucus, it is severe stage of ulcerative colitis.

Recent research article mentions the stress for one of risk factors. (De Sousa JFM, Paghdar S, Khan TM, Patel NP, Chandrasekaran S, Tsouklidis N. Stress and Inflammatory Bowel Disease: Clear Mind, Happy Colon. Cureus. 2022 May 15;14(5):e25006. doi: 10.7759/cureus.25006. PMID: 35582022; PMCID: PMC9107617.)

Tissue Cellular Changing Process for understanding diseases

Typical types of cell changing From P45.3rd Ed Pathophysiology. Kathryn L. McCance