Hassan Choudhury 201034 Introduction We, humans, are living creatures, so it comes as no surprise we need to energy(ATP) to carry out basic functions such as movement, rehabilitation and even breathing just to name a few. To acquire energy we need to consume food, but before food is converted to energy(ATP) it passes through the digestive system where it gets digested. Digestion is the breakdown of large insoluble food molecules into smaller soluble ones, this is done so our body can absorb the nutrients from the food we eat. Pharynx Mouth Salivary glands Oesophagus Jujenum Liver Gall bladder Stomach Small intestine Pancreas Duodenum Illeum Appendix Large intestine Rectum Anus Buccal cavity - A whole surrounded by the lips. The soft palate and tounge(taste buds) allow us to taste things. Tonsil filter our mouth from bacteria in food. Jaws(mandible and maxillae), muscles in the face and teeth allow us to masticate(chewing) Mucouse membrane secrete saliva to keep our mouth moist,assist with tasting food and contains hydrolytic enzymes Mouth, larynx , vocal cords, and facial muscles allow speech to happen. Page 1 of 16 Hassan Choudhury 201034 Pharynx - A muscle at the rear of the throat lined with muscles - Tongue moulds chewed food into a bolus(ball) and and presses it against the roof of the mouth to the pharynx, where swallowing occurs as an automatic cranial reflex - The muscles in the pharynx contract, tongue presses against the rood of the mouth, epiglottis covers glottis these prevents food from entering the airway. Oesophagus - 25 cm long, 2.5 cm diameter. Made of 4 layers Mucous membrane secretes mucous to lubricate the passage of food. Submucosa holds mucous membrane in place Stomach - A muscular bag Located in the upper abdomen and below the diaphragm Its walls consist of a thick layer of muscle with longitudinal, circular, smooth and oblique muscle fibres Food enters cardiac end of the stomach from the oesophagus. Epithelial cells secrete gastric juice containing enzymes and hydrochloric acid Peristaltic waves are generated from the muscle walls of the stomach to churn the food in with enzymes and eventually for a chyme. Small intestine - The acidity of the chyme causes the pyloric sphincter muscle to relax In small amounts the chyme can go into the duodenum Duodenum is 25 cm long and has a diameter of 2.5 cm and is attached to the dorsal abdominal wall Made of layers of smooth muscle cells and lined with epithelial cells Receives hydrolytic enzymes and pancreatic juices ,bile from liver these enter at the sphincter of oddi Jejunum is 2.5 m long and has a diameter if 3.8 cm and extends from duodenum to ileum The ileum is 3.6 m long, its walls are thinner than the jujenums and is folded a lot Epithelium contains finger like structure known as villi Villi increase surface area to volume ration thus maximising rate of reaction(absorption in this case) Page 2 of 16 Hassan Choudhury 201034 Pancreas - Located within the pancreas Is a soft pink gland supported by menestery Secretes hydrolytic enzymes to aid with digestion. The ducts are surrounded by bundles of acini Acinar cells contain high amounts of rough endoplasmic recticulum and vesicles Lined with epithelial cells, which secrete ions that increase the ph of the pancreatic juice Helps maintain homeostasis by adjusting blood glucose levels Gall bladder -stores bile and releases it via the bile duct into the duodenum at the sphincter of the oddi in response to food entering the duodenum from the stomach - Thin,green and 10 cm long Liver - - the gall bladder. Bile is released into the small intestine by the gall bladder, when needed. Made up of hexagonal liver lobules, which contain hepocytes Oxygenated blood enters the liver vis the hepatic artery Deoxygenated blood leaves via the hepatic vein Hepatocytes synthesise bile, which enters the canalliculli and then moves into the gall bladder, which is where it is store till its needed Bile contains the following, salts that emulsify the fat to increase surface area to volume ration to maximise rate of reaction, hydrogen-carbonate ions to neutralise acidic chyme ,products(birrublin and biliverdin) of broken red blood cells and cholesterol Stores glycogen, regulates blood glucose levels, makes plasma just to name a few Large intestine - first part of the large intestine is the caecum(sac like) branches from the appendix and contains lots of lymphoid tissue and bacteria which may help it recolonise gut microbiota The colon is comprised of four main parts Ascending, transverse ,descending and sigmoid Colon mucosa contains a high quantity of columnar epithelial cells and has no villi or folds thus leading to a rather flat surface. Also contains very few digestive enzyme secreting cells To protect against the acids and gasses produced by bacteria, goblet cells produce mucus. The passage from the rectum to anal canal is lubricated by mucus Gut bacteria synthesis vitamin B,K and appetite regulating hormones From undigested food, water is collected in the colon Faeces are then into the rectum where even more water is extracted 3 Page 3 of 16 Hassan Choudhury 201034 - Anus When the rectum stretches it activates the defecation reflex When the impulses reach the brain we can make the conscious decision to open the external anal sphincter Peristalsis= wave like motion which pushes contents of the canal along Macro nutrients Macronutrients Positive results Negative results Starch To the solution,add iodine Blue-black Orange Reducing sugar Add benedicts solution to food sample and heat to 80 degrees to catalyse enzamatic processes This test is done to test for more simple sugars than starch so only do this if have gotten negative for reducing sugar.1.break down food and mix with water 2. Filter 3. Add hcl and heat. 4. Add sodium hydrogen carbonate to neutralise acids.5. Add benedicts solution and place in water bath to speed up enzamatic procesess Crimson,yellow,green Blue Non reducing sugar Crimson,yellow,green Blue Page 4 of 16 Hassan Choudhury 201034 Protein Add buiret solution to food samples Lilac Blue Lipids 1. Add ethanol to food sample 2. In a test tube containing water, decant the ethanol. Make 10cm3 of filtered food solution. To 1cm3 of DCPIP, add drops of filtrate,the more drops required to make DCIPIP colourless, the less vitamin c present Cloudy white emulsion formes at surface Stays colourless Dcpip loses colour Blue Vitamin c Results: Yoghurt contains: glucose, monosaccharide, vitamin c and protein Mushroom soup contains: glucose, monosaccharide, starch, lipids Potato contains: glucose, starch, protein, monosaccharides Rice contains: starch Enzymes are biological catalyst, this means they speed up chemical reactions and not actually carry them out.The bonds binding the molecular 'building blocks' inside the food together can be separated by a phenomenon called enzymatic hydrolysis (a form of chemical digestion). Hydrolysis is a phenomenon in which, with the molecule of water, a given molecule is broken into 2 fragments. Hydrolysis of proteins, fats, oils and carbohydrates is enabled and sped up by the catalytic contribution of enzymes.For an example, protein polymers are broken down into the amino acids(monomer). These small molecules will then be ingested through the gut wall and then into the bloodstream until they are secreted. Digestive enzymes and juices Saliva -Amylase(found in the saliva) catalyses the breakdown of starch into maltose Hazards: - DCPIP can stain so cover clothes hands and eyes - Water bath is hot so wear gloves - Enzymes can denature, so to maintain a steady temperature use a water bath - Ethanol can irritate skin and eyes so wear gloves and goggles Page 5 of 16 Hassan Choudhury 201034 - HCL can irritate skin and eyes, so wear gloves and goggles Gastric juices -protease( pepsin and HCL found in gastric juices) catalyse the breakdown of proteins into partly digested protein Pancreatic juices -proteases(trypsin, found in pancreatic juices) the breakdown of protein into peptides -lipases (found in pancreatic juices)catalyse the breakdown of fats into fatty acids and glycerol -amylases(found in pancreatic juices) catalyse the breakdown of starch into maltose Intestinal enzymes -Peptidases catalyse the breakdown of peptides into amino acids -sucrase catalyse the breakdown of sucrose into glucose and fructose -lactase catalyse the breakdown of lactose (milk sugar) into glucose and galactose -maltase catalyse the breakdown of maltose into glucose Bile from the liver -bile salts emulsify fat globules into fat droplets Adaptations of the small intestine -high blood supply, movement of blood will maintain an ideal concentration gradient - Villi and microvilli increase surface are to volume ratio to increase the rate of absorption - Cells have many mitochondria to supply ATP for active transport -membrane is one cell thick reducing the diffusion pathway - carrier proteins for active transport so they can get sufficient amount of nutrients by going against the concentration gradient and co transport so they can manipulate the gradient to get desired nutrients - the small intestine is 23 feet and takes food roughly 8 hours to pass through, this ensures there is enough time to absorb all the nutrients. Co transport The ingestion of sodium and glucose ions from the small intestines, especially the ileum, is a common example of co-transportation. The transportation of sodium ions must be assisted by a carrier protein from the epithelial cells to the blood through active transport. this decreases the sodium concentration in the epithelial cells In order to generate a favourable concentration gradient between the ileum and the epithelial cell, Therefore, sodium ions diffuse through the epithelial cells down the concentration gradient.This is through a carrier protein for co-transport. If the sodium ions bind and disperse through carrier protein, they can transport either glucose or amino acids with them into the epithelial cells. Active transport Page 6 of 16 Hassan Choudhury 201034 This is the movement of molecules and ions via the use ATP and carrier proteins against the concentatrion gradient(region of lower concentration to an area of higher concentration). In order to transfer substances through the membrane, the carrier proteins serve as pumps. This is rather selective, since only some molecules can attach to the proteins that are pumped from the carrier. On carrier proteins, some molecules may bind to the receptor site. On the inside of the membrane, ATP can bind to the protein and is hydrolysed into ADP and Pi. This allows the proteins to change and open up into the membrane's interior. This allows the molecule, on the other side of the membrane, to be released. Osmosis Osmosis is the net movement of water from high concentration to low concentration through a semi permeable membrane this requires no ATP Diffusion Diffusion is net movement of molecules from high concentration to low concentration. This requires no ATP and is described as passive Absorbtion and Assimilation Absorbtion - Glucose and amino acid are absorbed via active transport with the use of a co transport ion. - Sodium ions are absorbed by the epithelial cells lining the villi this uses atp and further imbalances the concentration gradient. - Fatty acids and glycerol diffuse into the epithelial cell surface membrane via diffusion and are converted back into triglycerides and transported to the Golgi apparatus and a layer of protein is added to form a chylomicron. These out the plasma membrane of epithelial cells of the villi snd enter lymph fluid of the lacteal. Then fat soluble vitamins diffuse across the plasma membrane. Assimalation These nutrients can be used in many ways.For an example, glucose when assimilated it is transported to the liver via the hepatic vein and stored there as glycogen and released according to the body’s needs like respiration , amino acid can be used in protein synthesis as it is a monomer and can make protein polymers like DNA and lipids could be used to make phospholipid bi layers and an excess is stored as adipose tissue. Vitamin E - An antioxidant which reduces the risk of cancer and heart diease Good sources: nuts, prawn, bread and oils A deficiency would lead to poor nerve transmission, muscle weakness and damaged retina Fibre - Lowers blood cholesterol Prevents constipation Page 7 of 16 Hassan Choudhury 201034 - Promotes the frowth of healthy bacteria in gut Good sources: fruit, vegatable, porridge Lack of fibre lead to constipation and not much healthy bacteria in the gut Water - Makes bodily fluids such as gastric juice and helps dispose of urea via urinating Hosts metabolic reactions within cells Regulates body temprature Good source: water and other edible liquids Lack of water leads to: de hydration, disruption of electrolytes, loss of water from blood and enzymatic reactions can take place properly Protein - Growth of body structures such as muscles, organs and antibodies among others. Good source: meat, fish and eggs Deficiency can lead to: kwashiorkor; stunted growth and degradation of muscles. Lipids - Stores energy and can be stored under the skin and insulate heat. Can make membranes, cholesterol and sex hormones Deffiency can lead to: lack of fat solube vitamins(a,d,e) Excess can lead to: obesity, atherosclerosis and increase chance of heart attack Vitamin a Vitamin A is a category of nutrients that are important for male and female eye health and functional and reproductive health. It also plays a role in defence against pathogens in the immune system. According to WHOTrusted Source, the leading cause of preventable blindness in infants is a deficiency of vitamin A. Vitamin A-deficient pregnant women have higher maternal death rates as well. Xerophthalmia is a disease related to vitamin a deficiency and here are the symptoms - Night blindness( cant see in dim light) - Bitots spots(lesions on the cornea) - Corneal ulcers Iron Iron deficiency is the most common dietary deficiency internationally. Deficiency in iron can lead to anaemia. This is a disease of the blood that induces tiredness, fatigue, and a host of other symptoms. Page 8 of 16 Hassan Choudhury 201034 Common Food that contain iron are dark leafy greens, red meat, and egg yolks. It helps to generate red blood cells in the body. Your body produces less red blood cells while you're iron-deficient. The red blood cells it creates are thinner and lighter than blood cells that are stable. They're even less effective at providing the tissues and organs with oxygen. Thiamine Thiamine also known as vitamin b1, is an important part of the nervous system and helps turn carbohydrates into ATP(energy). A lack of of thiamine can lead to fatigue, weight loss, confusion, short term memory loss, nerve and muscle damage and affect the heart. Vitamin b-3 Another mineral that makes the body transform food into atp is niacin. It's known as vitamin B-3. A severe niacin deficiency is also referred to as pellagra.Niacin can be found in peanuts and most animal proteins, as a consequence, in developed countries or in meat-eating societies, this disease is unusual. Diarrhoea, dementia, and skin abnormalities are among the signs of pellagra. With a healthy diet and vitamin B-3 supplements, you can generally prevent it. Calcium Calcium helps grow healthy bones and teeth in your body. It allows your heart, muscle, nerves and muscles function normally. Calcium deficiency sometimes does not immediately display symptoms, but over time, it may lead to severe health concerns. If you do not eat enough calcium, the calcium from your bones will be used instead by your body. Which adds to bone degradation. Good sources of calcium are, dairy products, small fish with bones and calcium set tofu. Vitamin d Around a seventh of people worldwide don't get enough vitamin D, according to Harvard's School of Public Health. There is a greater chance of vitamin D deficiency in individuals with darker skin tones. For healthy bones, vitamin D is important. In order to control the growth of teeth and bones, it lets the body retain the right amount of calcium. A deficiency of this nutrient may contribute to bone growth that is stunted or low.Induced by a lack of calcium and vitamin D, osteoporosis can result in porous and weak bones that crack rather easily. Vitamin c Page 9 of 16 Hassan Choudhury 201034 A essential nutrient that helps the body absorb iron and create collagen is vitamin C. Tissues will begin to decompose if the body does not produce enough collagen. After 8 to 12 weeks, signs of vitamin C deficiency may begin to emerge if they are present. Loss of appetite, loss of weight, exhaustion, irritability, and lethargy are early symptoms. The lack of vitamin c is often referred to as scurvy. Scurvy Scurvy occurs when vitamin C, or ascorbic acid, is deficient. Symptoms of fatigue, anaemia, gum disease, and skin disorders stem from the deficiency. This is due to the fact, to stabilise the structure of collagen, an essential component in connective tissues, vitamin C is needed. Connective tissues, like the formation of blood vessels, are important for body structure and support. The immune system, iron intake, cholesterol metabolism and other functions will also be impaired by the lack of vitamin C. Causes Scurvy is strictly due to a lack of vitamin c, but why does one vitamin have such a great impact? Well vitamin c aka ascorbic acid is responsible for formation of collagen and collagen can be found all over our body and is the most abundant protein in our body as stated by healthline.com. Collagen is responsible for making bones, skin, muscle, tendons, ligaments and blood vessels just to name a few. So if you lack ascorbic acid you you will lack collagen thus leading to scurvy. Symptoms of vitamin c anemia - mood changes, and depression gum disease and loss of teeth due to the destabilised structure of collagen poor wound healing due to the destabilised structure of collagen corkscrew hairs due to destabilised structure of collagen in your scalp. shortness of breath due to damaged collagen in your blood vessels petechiae, or small red spots resulting from bleeding under the skin due to the damged collagen Treatment Scurvy’s symptoms can be hugely attributed to the damaged collagen, to fix this we need to produce healthy and stable collagen, which vitamin c very capable of. Unlike some animals, we humans can not synthesise vitamin c so we need to get it from the food we eat or oral suppliments. One can increase the amount of vitamin c in their diet with the incorporation of foods such as orange,grapefruit,lime and lemon among many others. Within 24 hours patients may see improvements in their symptoms and start to recover with a week or two and possibly make a full recovery in 3 months. The restored levels of vitamin c has started making healthy and stable collagen once again, this is what cures symptoms such as damaged blood vessels, cork screw hairs, gum disease and poor wound healing among others. Page 10 of 16 Hassan Choudhury 201034 Anaemia Anaemia is when the body is lacking a substantial amount of haemoglobin. Haemoglobin is essential for the transport of oxygen so a lack of haemoglobin leads to a lack of oxygen transport to cells and tissue. Symptoms - - Patients may be lethargic and overexerted easily due to the lack of oxygen caused by the absence of iron Weird food cravings such as clay, ice and dirt due to… White faced(pale) due to the lack of blood flow to the face Inflamed tongue, the tongue will smooth instead of being textured due to the decreased oxygen Increased heart rate, due to the inefficient transport of oxygen the heart pumps faster to compensate Reduced haemoglobin level, as iron is one of three components, which comprise haemoglobin When patients take a blood smear test and the blood cells are inspected under a microscope, the blood cells will be hypo-chromic (they will pale in colour) and microcytic(small) Nails will become koilonychia (spoon shaped) In ability to concentrate Causes - poor intake due to diet or during pregnancy in due to the high demand around the 9 month mark Absorption problems such as intestinal surgery , celiac disease, Crohn’s disease or gastric bypass Blood loss from menstruation, hemroids and wounds etc Treatment - Patients should take Oral Iron supplements, to increase absorption they should take it with something high in vitamin c (orange juice) and on a empty stomach. Patients should also prepare it with a liquid a and drink through a straw as iron may stain teeth. Patients may notice their faeces has darkened, this is normal when taking iron supplements. They may also experience constipation which can be minimised by preparing it with a liquid and if they are really being bothered by it they can get an over the counter stool softener. Patients can expect to recover within a few months. This is possible due to the fact iron is a huge component in haemoglobin, a substance carried by red blood cells to maximise the delivery of oxygen. Restoring the amount iron in out blood restores the amount of haemoglobin in our blood thus the amount if oxygen our cells get. The restored level of oxygen is what get rid of symptoms such as lethargy, increased heart rate, over exertion, low haemoglobin levels and pale face among many others. - Page 11 of 16 Hassan Choudhury 201034 Crohn’s disease Crohn’s disease is a sub category of IBD, which cause inflammation and ulcers at on the GI tract. Crohn’s can be found all along the GI tract but is most commonly found from the terminal of the ileum to the start of the colon. Crohn’s is found in patches, so it’s not found in one continuous strand of infected lining, rather its found in patches of both healthy and inflamed lining. This leads to a cobblestone like appearance when doctors look with a camera what they are seeing is the inflamed and healthy lining contrasting each-other. There are 5 types of Crohn’s disease depending on which part of the GI tract is infected. The first one is illeocolitis, which is the inflammation of the ileum and colon, the second type is gastroduodenum crohns which is found in the stomach and duodenum.The third type is jejunoileitis found in the jejunum and the fourth type is ileitis which can be found at the ileum. The fifth type is granulomateus colitis, which can be found only at the colon.Crohns effects the absorption of digestion as it usually targets the small intestine where a huge amount of absorbtion takes place. Due to the lining of the small intestine being inflamed it can not efficiently absorb nutrients from digestion Causes The cause of this disease is currently unclear, but scientists are certain that it’s a fault within the immune system. This fault may be genetic and effect the gastrointestinal epethilial barrier. This separates the content of the gut and immune system, a “crack” within the barrier causes the immune system to over reacts to non-pathogenic antigens from the gut. Enviromental factors may also increase the chance of Crohn’s disease but the only evidence to back this up is higher rates of Crohns in developed countries. Effects and complications Within the walls of the intestine pockets of infections can form due to Crohn’s disease these pockets of infections are referred to as abscess. Abscess can burst and form fistulas. Fistulas are unintended pathways created in the intestinal walls. These pathways can lead to the skin surfaces, organs and different parts of the intestine just to name a few. This can be detrimental, for an example lets say the fistula leads to the bladder. The bladder is a rather sterile organ, which means its very sensitive to bacteria so it can lead to things like sepsis and a renal failiure. Fistures can be categorised based on where they lead to. A fisture going from one part of the intestine to another is known as Enteroenteric. A fisture leading to the anus is know as perianal. A fisture, which connects the intestine to the bladder is referred to as entrovesical. There are more but these were just a few. Patients will experience times when symptoms are present and damage is inflicted, these are referred to as flare ups. Contrary to that patients will experience times when the symptoms are not present snd healing takes place, these are referred to as remissions. Patients will experience a cycle of flare ups and remissions, this continuous cycle of damage and healing creates scarred tissue. Nutritional deficiencies as a result of having Crohns People with Crohns disease may have a protein deficiency due to the damage sustained by the small intestine due to fistulas and inflammation (thus hindering its ability to absorb protein), blood loss via bloody stools, diarrhoea and the use of steroids such as prednisone. Protein deficiency can lead to weak muscles and tiredness as protein(amino acid) is responsible for the structure of DNA and muscle fibres Page 12 of 16 Hassan Choudhury 201034 Calcium deficiency may occur as the medication they take interferes with the absorption of calcium. If parts of the ileum and jejunum have been removed due to surgery patients may be faced with a magnesium deficiency. Symptoms - Pain the lower quadrant of the abdomen, this is due to the fact the illeum is located there which is the most commonly affected part of the gi tract. - Malnourishment, the small intestine is usually the target for Crohn’s and is where a majority of absorption takes place, so the damaged small intestine can not properly absorb nutrients thus leading to malnourishment. - Diarrhoea, this is due to the fact the cells in the large intestine have lost the ability to reabsorb water properly and now the excess eater is being secreted via diarrhoea Treatment One method of reducing the effects of Crohn’s is to avoid eating things which are hard to digest like raw vegetables. This is a very good method as it doesn’t expose you to the risks of surgery, can be cost effective, doesn’t require medical expertise from a doctor. However it is a part of some cultures and religions to eat certain food which may be difficult to digest e.g muslims eat raw dates during the month of Ramadan. Another method is the use of drugs, different drugs are prescribed depending on the severity of Crohn’s. If the case is mild patients are prescribed a 5-aminosalicylates or corticosteroids but if the case is more severe they be prescribed immunosuppressants. 5-aminosalicylates are the first type of drugs that will be prescribed to a patients, a common 5-aminosalicylates is sulfasalazine. Sulfasalizine is an anti- inflammatory, it prevents flare ups and prolongs remissions thus allowing damaged cells and tissue to repair and does not expose you to the risks of surgery(bleeding, infection and surgical errors.) However if the patient is allergic to sulphonamide drugs or the drug does not seem to be working patients may then be prescribed a corticosteroid. A common corticosteroid is prednisone. Prednisone is also an anti-inflammatory drug that prevent flare ups and pro long remission, which allows damaged tissue to heal and also suitable for long term use. However this drug has many side effects such as increased blood sugar levels, risk of infection and thinning of skin. If the case is severe and the patient is not responding to any of the medication above they may need to take immunosuppressant drugs. A common type of immunosuppressant drug is azathioprine. These drugs work by suppressing the immune system, which solves the problem of the immune system overacting to antigens but due to the absence of the immune system you are more prone to infection, cancer and can not take live vaccines. Surgery may be required if there if a frequent intestinal obstruction or there is a tricky fistula or abscess. However unlike other IBS, surgery is not an outright cure Crohn’s disease. This is due to the fact Crohn’s effects the GI tract in patches and you can only selectively remove damaged tissue and reconnect healthy ones. This surgery may improve symptoms but it exposes you to the risks of Page 13 of 16 Hassan Choudhury 201034 surgery ( infection, bleeding and surgical errors) and requires your time, surgical expertise and recovery period. The right treatment for you? (Treatment evaluation) The ideal treatment may vary depending on your circumstance as these treatments vary from another quite drastically. Anyones first resort when treating Crohn’s should be a dietary change as it it requires little resources and commitment. If you are facing complications with food or symptoms have not eased since the dietary change you will be prescribed sulphasalazine this treatment is for those who have been recently diagnosed with Crohn’s disease. If you are still having frequent flare ups or are allergic to sulpha drugs your doctor will give you corticosteroids as a short term fix as these can cause serious side effects.this drug is for those who need a quick fix due to Crohn’s affecting their day to day life and are willing to be affected by the side effects. Your doctor may also prescribe immunosuppressants if the drugs mentioned have not seemed to be effective. Immunosuppressant take weeks maybe months to kick in and when they do they leave you prone to all sorts of pathogens. One should not take immunosuppressants if they work in a environment which heavily expose the to dangerous pathogens(dustbin men, doctors and cleaner etc). This drug is ideal for patients who work from home or spend a majority of their time at home, as they are not exposed to dangerous pathogens. If your prescribed drug does not seem to be working or you have developed a dangerous fistula you may be expected to undergo surgery but even the surgery does not out right cure Crohns and you may have to take days off work to do the surgery and recover. You will be expected to take anaesthetics during this surgery so if you have a history of not responding to anaesthetics or are allergic to them you will not be able to undergo this surgery. This is for those who are willing to expose them selves to the risk of surgery in order to keep their symptoms in check. Bibliography Argosy Publishing, Inc (2019). Mouth. [online] Visiblebody.com. Available at: https://www.visiblebody.com/learn/digestive/digestive-oral-cavity Body, V. (n.d.). Accessory Organs | Digestive Anatomy. [online] www.visiblebody.com. Available at: https://www.visiblebody.com/learn/digestive/digestive-accessory-organs#saliva [Accessed 25 Jan. 2021]. BBC Bitesize. (2019). Digestive system - Revision 7 - GCSE Biology (Single Science) BBC Bitesize. [online] Available at: https://www.bbc.co.uk/bitesize/guides/zwqycdm/revision/7. Page 14 of 16 Hassan Choudhury 201034 the Healthline Editorial Team (2018). Nutritional Deficiencies (Malnutrition). [online] Healthline. Available at: https://www.healthline.com/health/malnutrition#iron www.medicalnewstoday.com. (2017). Scurvy: Symptoms, causes, treatment, and prevention. [online] Available at: https://www.medicalnewstoday.com/articles/155758#_noHeaderPrefixedConten t www.youtube.com. (n.d.). Crohn’s Disease Nursing | Crohns Symptoms, Pathophysiology, Treatment, Diet NCLEX - YouTube. [online] Available at: https://youtu.be/WG8m66Hg5No [Accessed 3 Feb. 2021]. www.youtube.com. (n.d.). Crohn’s Disease: Pathophysiology, Symptoms, Risk factors, Diagnosis and Treatments, Animation. - YouTube. [online] Available at: https://youtu.be/Qm4XjKNVSzc [Accessed 3 Feb. 2021]. https://www.healthline.com/health/crohns-disease/nutritionaldeficiencies#Types-of-Nutritional-Deficiencies Cafasso, J. (2015). Iron Deficiency Anemia. [online] Healthline. Available at: https://www.healthline.com/health/iron-deficiency-anemia#treatment. www.medicalnewstoday.com. (n.d.). Scurvy: Symptoms, causes, treatment, and prevention. [online] Available at: https://www.medicalnewstoday.com/articles/155758#treatment. www.youtube.com. (n.d.). All About “Vitamin C” and “Scurvy” - YouTube. [online] Available at: https://youtu.be/fstgOxlHxN4 [Accessed 5 Feb. 2021]. Annets F. et al. (2016) Pearson BTEC National Applied Science Student Book 1. London: Pearson Education Ltd Page 15 of 16 Hassan Choudhury 201034 Page 16 of 16
