13. Describe the process of digestion. What are the main functions of the digestive system in general?
The digestive system has two main functions: breaking down large food molecules into
small molecules and absorbing small molecules into the body, which go to the body cells.
The first step of digestion begins in the mouth. The saliva helps moisten food particles and begins the breakdown of carbohydrates. The food is chewed to form a bolus and is forced to the pharynx. The oesophagus is a straight, muscular tube connecting the pharynx to the stomach. The stomach is a c-shaped organ lying in the upper left part of abdomen. The muscle layer churns food and breaks into a chyme. The gastric glands secrete gastric juice, which contains hydrochloric acid, mucus, pepsinogen. The small intestine is divided into three parts: duodenum, jejunum, ileum. Pancreas secretes enzymes, which go to the pancreatic duct, which opens into duodenum. Bile, which breaks down large fat molecules into smaller, enters the duodenum through the bile duct. The surface of intestine contains villi, which can absorbed molecules. The large intestine consists of caecum, ascending colon, transverse colon, descending colon, sigmoid colon and rectum. The function is to reabsorb water, ions and vitamins. It stores the materials not digested by the body and forms the faeces, which consists of water, inorganic salts, bacteria and undigested food.
14. What is gastritis? What are its causes and symptoms? What increases the risk of getting gastritis?
Gastritis is an inflammation of the lining of the stomach. There are two types of gastritis: acute and chronic. Acute gastritis has causes such as excessive alcohol consumption; prolonged use of non-steroidal anti-inflammatory drugs; surgery; traumatic injury; burns and severe infections, non-healthy diet, smoking. Chronic gastritis can be caused by untreated acute, irregular diet, stress, the infection with bacteria primarily H. Pylori; chronic bile reflux; stress; autoimmune disorders. Symptoms may include pain in the stomach; feeling of fullness; heartburn; bloating; belching; vomiting; headache; general malaise; weakness; diarrhea; loss of appetite. The risk of having gastritis increases with preferring hot, spicy, oiled, salty, fast food, using drugs, alcohol, smoking.
15. How to diagnose and treat gastritis? What does the therapy depend on?
To diagnose gastritis doctors may use gastroscopy, blood tests: blood cell count, presence of H. Pylori, urinalysis, stool sample, checking for blood in the stool, X-rays, EGGs, endoscopy, stomach biopsy. Treatment for acute gastritis includes absorbents, light tea without sugar, diet without spicy, hot, cold, salty food. Treatment of chronic gastritis can be divided into two types according to the pathology: hypoacidic and hyperacidic. For treating hyperacidic doctor prescribes antacids and proton pump inhibitors. For treating hypoacidic doctor should prescribe hydrochloric acid, vinegar to decrease the pH in the stomach.
16. What is the stomach cancer? How does it spread in the body?
Stomach or gastric cancer is a malignant tumor arising from the lining of the stomach. Stomach cancers are classified according to the type of tissue: adenocarcinoma, lymphoma, sarcoma. Adenocarcinoma usually begins in cells, the building blocks that make up tissues, which make up organs. Normally cells grow and divide to form new cells. As cells grow old, they die and new cells take their place. Sometimes this process goes wrong. New cells form when body doesn’t need them and old cells don’t die as they should. The build-up of extra cells often forms a mass of tissues called tumor. Stomach cancer can spread by breaking away from the original tumor. Cells enter into blood vessels or lymph vessels which branch all the tissues of the body. Cells may attach to other tissues and form new tumors (metastasis).
17. Speak on the stages of stomach cancer development. What symptoms may develop during cancer progressing? How is the stomach cancer treated? What is the role of nutrition for cancer patients?
There are 5 stages of stomach cancer:
At the 0 stage the tumor is found only in the inner layer of the mucosa of the stomach.
At the 1 stage the tumor has invaded only the submucosa. Cancer cells may be found in up to 6 lymph nodes. Or in another case, the tumor has invaded the muscle layer or subserosa and cancer cells have not spread to lymph nodes.
At the 2 stage the tumor has invaded only the submucosa. Cancer cells have spread to 7-15 lymph nodes. Or in another case, the tumor has invaded the muscle layer or subserosa and cancer cells have spread to 1-6 lymph nodes.Or the tumor has penetrated the outer layer of the stomach and cancer cells have not spread to lymph nodes.
At the 3 stage the tumor has invaded the muscle layer or subserosa. Cancer cells have spread to 7-15 lymph nodes. Or in another case, the tumor has penetrated the outer layer. Cancer cells have spread to 1-15 lymph nodes. Or the tumor has invaded nearby organs such as the liver, colon or spleen. Cancer cells have not spread to lymph nodes.
At the 4 stage cancer cells have spread to more than 15 lymph nodes. Or in another case, the tumor has invaded nearby organs and at least 1 lymph node. Or cancer cells have spread to distant organs.
Early stomach cancer often does not cause symptoms. As the cancer develops, the most common symptoms are: pain in the stomach area; difficulties in swallowing; nausea and vomiting; weight loss; feeling of fullness or bloating after a small meal; vomiting blood or having blood in the stool.
Treatment of the stomach cancer depends on the size, location of tumor, the stage and general health. It is divided on stages:
surgery - removing the whole tumor stomach or the part that has cancer;
chemotherapy - using drugs to kill cancer cells;
radiation therapy - using high energy rays to kill cancer cells;
nutrition - the patient needs the right amount of calories, protein, vitamins, and minerals to maintain his strength to heal. He may need to take daily supplements of vitamin D, B12, calcium and iron
What liver diseases do you know? What symptoms are typical of them?
The liver is the largest gland in the body and one of the most important accessory organs of the digestive system. There are a lot of diseases that can affect on the liver. They include cirrhosis, alcohol abuse; hepatitis A, B, C, D, E; non-alcoholic fatty liver disease; hemochromatosis; biliary diseases. The symptoms may include jaundice, a lack or loss of appetite, weight loss, fatigue, bloating, weakness, itching, yellowing of the whites of the eyes, nausea and vomiting, low-grade fever.
18. What is hepatitis and its types? Compare different types of viral hepatitis (causes, way of transmission, duration incubation period).
Condition defined by the inflammation of the liver parenchyma.
Hepatitis can be infectious and non-infectious.
Non-infectious hepatitis can be caused by toxic drugs, toxins or diseases of immune system (a condition where the immune system attacks and destroys liver cells as foreign bodies).
Infectious hepatitis is caused by viruses A, B, C, D, E (viral) and bacteria (bacterial) and parasites.
Hepatitis A is acquired by consuming materials contaminated with faecal matter of an individual who already has disease. It is usually communicated as a result of poor hygiene or through personal contact. The virus is able to survive at normal room temperature for hours on a hard surface. The incubation period for hepatitis A lasts about 2-6 weeks. Most patients recover within a few months.
Hepatitis B is spread through infected body fluids like blood, semen, saliva, suppurating sores, breast milk. It doesn’t spread by simple physical contact. The incubation period lasts from 1 to 6 months. After recovering the infected person will be immune to any later reinfection with this particular virus. Some individuals may fully recover and have no symptoms and yet remain a capable of infecting others through sexual contact, shared hypodermic needles, food or drinks.
Hepatitis C has no symptoms. Most people become chronically infected. People with strong immune system may recover without treatment. Those with chronic hepatitis C who are not treated or cured may live normal lives but they remain carriers of the disease and can infect other people. Some patients with hepatitis C develop complications like cirrhosis, liver failure or liver cancer. Incubation period lasts 2weeks-six months.
Hepatitis D attacks only individuals with hepatitis B. A person may get 2 forms at the same time. It is transmitted through the same routs as hepatitis B. Hepatitis D can be suspected when the condition of someone with hepatitis B suddenly becomes worse. It can be diagnosed with tests that reveal hepatitis D antibodies in the blood.
Hepatitis E (waterborne disease) is similar to hepatitis A and is transmitted contaminated water supplies. Incubation period lasts about 2 or 6 weeks. Most people with hepatitis E recover from it on their own within a few months. This type of hepatitis is spread in Certain African countries and in Asia.
21. What symptoms are typical of hepatitis? When is it considered chronic? How is it possible to treat cirrhosis?
Hepatitis can be acute or chronic. If an individual with hepatitis remains symptomatic for more than a few months, the condition is considered chronic. All forms have similar symptoms: dark urine, loss of appetite, fatigue, bloating, jaundice, yellowing of whites of the eyes, nausea and vomiting, low-grade fever, weight loss, general malaise.
In patients with acute viral hepatitis, the initial treatment consists of bed rest, abstaining from alcohol, relieving symptoms of nausea, vomiting, and abdominal pain. It is necessary to provide intravenous fluids to prevent dehydration caused by vomiting. Patients with severe nausea and/or vomiting may need to be hospitalized for treatment and intravenous fluids.
• Most patients who have hepatitis A and E get well on their own after a few weeks.
• Hepatitis B and C can be treated with drugs.
It is important to remember that only necessary medications should be administered since the impaired liver is not able to eliminate drugs normally.
Treatment of chronic viral hepatitis include well-balanced diet, avoiding further liver damage from alcohol or NSADs, regular exercises, cessation of smoking, avoiding salty food if there is a tendency to accumulate fluids.
In general, the goals of therapy are to reduce liver inflammation and fibrosis and to prevent progression to cirrhosis and its complications.
Liver transplant may be an option for people whose hepatitis progresses to liver failure and who fail to respond to treatment or cannot tolerate treatment.
Corticosteroids are used to suppress the immune system are the main treatment of autoimmune chronic hepatitis. These drugs usually decrease symptoms, reduce liver inflammation and prolong survival.
22. What is cirrhosis, its types and causes? What are the symptoms and complications cirrhosis?
Cirrhosis is a late stage of fibrosis of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholic abuse. It is a condition in which the liver does not function properly due to long-term damage. The main causes of developing cirrhosis are: alcohol abuse; hepatitis B, C; bacterial infections, gall bladder stones; biliary diseases; drugs and some cases are idiopathic. There are different types of cirrhosis:
alcoholic cirrhosis usually occurs after many years of heavy drinking and may affect up to 15% of all alcoholics.
Cryptogenic cirrhosis is a term used to describe cirrhosis of unknown origin.
Primary biliary cirrhosis occurs due to inflammation of the small bile ducts inside the liver, leading to scarring and obstruction.
haemochromotosis is a disease in which excessive amounts of iron accumulate in the liver.
The symptoms of cirrhosis include: enlarged liver or spleen; the appearance of spider-like blood vessels; jaundice; a lack of appetite; weight loss; weakness; fatigue; easy bruising; itching; esophageal bleeding.
Cirrhosis can develop in different conditions such as:
bruising and bleeding
jaundice
itching because of bile salt products deposited in the skin
hepatic encephalopathy - the liver doesn’t clear nitrogenous substances from the blood, which are carried to the brain
hepatocellular carcinoma
portal hypertension - high blood pressure in the portal vein
ascites - fluid leaks into the abdominal cavity
hepatorenal (hepatopulmonary) syndrome - reduced blood supply to the kidneys (lungs) causing renal failure (cyanosis and dyspnoea)
esophageal varices - the vessels in the stomach and oesophagus may become enlarged.