Biology March 25, 2015 Mr. Robert Lewis Tammy Jeffries People often refer to the entire abdominal region as “the stomach.” In actuality, the stomach is an organ located in the upper left part of your abdomen. It is the first intra-abdominal part of your digestive tract. Your stomach contains several muscles, and can change shape as you eat or change posture. It plays an instrumental role in digestion. When you swallow, food travels down your esophagus, passes the lower esophageal sphincter, and enters the stomach. Your stomach has three jobs: temporary storage of food and liquids, production of digestive juices and emptying the mixture into the small intestine. How long this process takes depends on the foods you eat and how well your stomach muscles function. Certain foods, like carbohydrates, pass through quickly, while proteins remain longer. Fats take the most time to process. Gastroesophageal Reflux Disease Reflux is when stomach contents such as food, acid or bile moves back into your esophagus. When this happens with regular frequency (twice a week or more), it is called gastroesophageal reflux disease (GERD). This chronic condition can cause pain (heartburn) and irritate the esophagus lining. Risk factors include: obesity smoking pregnancy asthma diabetes hiatal hernia delay in stomach emptying scleroderma Zollinger-Ellison syndrome Treatment involves over-the-counter remedies and dietary changes. Severe cases require prescription medication or surgery. Part 4 of 9: Gastritis Gastritis 1 Biology March 25, 2015 Mr. Robert Lewis Tammy Jeffries Gastritis is when your stomach lining becomes inflamed. Acute gastritis may come on suddenly; chronic gastritis happens slowly. According to the Cleveland Clinic, eight in 1,000 people have acute gastritis and two of every 10,000 develop chronic gastritis (Cleveland Clinic, 2013). Symptoms of gastritis include: hiccups nausea, vomiting indigestion bloating appetite loss black stool (due to bleeding in the stomach) Causes include: stress bile reflux from the small intestine access alcohol consumption chronic vomiting use of aspirin or non-steroidal anti-inflammatory medication (NSAIDs) bacteria or viruses pernicious anemia autoimmune diseases Medications can reduce acid and inflammation. You should avoid foods and beverages that cause symptoms. Part 5 of 9: Peptic Ulcer Peptic Ulcer If the lining of your stomach breaks down you may have a peptic ulcer. Most are located in the first layer of the inner lining. An ulcer that goes all the way through the stomach lining is called a perforation and requires immediate medical attention. Symptoms include: 2 abdominal pain nausea, vomiting inability to drink fluids feeling hungry soon after eating fatigue weight loss black colored stool (tarry stools) chest pain Biology March 25, 2015 Mr. Robert Lewis Tammy Jeffries Risk factors include: Helicobacter pylori bacteria excessive alcohol consumption too much aspirin or NSAIDs tobacco radiation treatments using a breathing machine Zollinger-Ellison syndrome Treatment depends on the cause. It may involve medications or surgery to stop the bleeding. Part 6 of 9: Gastroenteritis Viral Gastroenteritis Viral gastroenteritis is when a virus causes your stomach and intestines to become inflamed. The main symptoms are vomiting and diarrhea. You may also have cramping, headache, and fever. Most people recover within a few days. The very young, elderly, and people with other diseases are at increased risk of dehydration. Viral gastroenteritis is spread through close contact or contaminated food or drink. According to the U.S. Centers for Disease Control and Prevention (CDC), outbreaks are more likely to occur in closed environments like schools and nursing homes (CDC, 2011) Part 7 of 9: Hiatal Hernia Hiatal Hernia The hiatus is the gap in the muscle wall that separates your chest from your abdomen. If your stomach slides up into the chest through this gap, you have a hiatal hernia. If part of the stomach pushes through and stays in the chest cavity next to the esophagus, it is called a parasophageal hernia. This less common type of hernia can cut off the stomach's blood supply. Symptoms of hiatal hernia include bloating, belching, pain, or a bitter taste in the throat. The cause is not always known, but can be due to injury or strain. Your risk factor is higher if you are overweight, over age 50, or smoke. Treatment involves medications to treat pain and heartburn. Your doctor may recommend you maintain a healthy weight, limit fatty and acidic foods, and elevate the head of your bed. Severe cases may require surgery. Part 8 of 9: Gastroparesis 3 Biology March 25, 2015 Mr. Robert Lewis Tammy Jeffries Gastroparesis Gastroparesis is a condition in which your stomach takes too long to empty. Symptoms include: nausea, vomiting weight loss bloating heartburn Causes include: diabetes medications that affect the intestines stomach or vagus nerve surgery anorexia nervosa postviral syndromes muscle, nervous system, metabolic disorders Treatment may include medication and dietary changes. In severe cases, surgery may be necessary. Part 9 of 9: Stomach Cancer Stomach Cancer Stomach cancer generally grows slowly over the course of many years. In most cases, it begins in the innermost layer of the stomach lining. Untreated, stomach cancer can spread to other organs or into the lymph nodes or bloodstream. The earlier stomach cancer is diagnosed and treated, the better the outlook. The stomach is located in the upper-left area of the abdomen below the liver and next to the spleen. Its expanded J shape and three layers of muscle help turn liquid and chewed food into material suitable for the intestinal tract. When the stomach is empty, the inside has small folds called rugae. As the stomach expands, these folds disappear to accommodate the new contents. The average stomach can hold about 1.5 gallons of food and liquid at maximum capacity. It only holds food for about four hours before passing it along the digestive tract. The stomach’s main component for digestion is the powerful mix of secretions collectively called gastric juices. To counteract these strong juices, the stomach protects itself with mucus-like 4 Biology March 25, 2015 Mr. Robert Lewis Tammy Jeffries secretions. Without this protection, the stomach would essentially digest itself. Cells in the stomach create the active ingredients in gastric juices: Pepsin: This protein-digesting enzyme activates when food enters the stomach. Hydrochloric acid: This extremely strong acid breaks down food and any other foreign element such as dirt and bacteria. Two muscular rings called sphincters also provide additional defense against the chemicals in the stomach by moving contents along. The esophageal sphincter separates the esophagus and the stomach. When that muscle doesn’t relax properly, it feels like it is difficult to swallow. On the opposite end of the stomach, the pyloric sphincter regulates the speed at which food moves down to the small intestine. After the stomach has done its work, the highly acidic mixture of gastric juices and food (known as chyme) leaves the stomach, moves past the pyloric sphincter, and goes into the duodenum before entering the small intestine. Because the chemicals in the stomach work due to a subtle balance, many problems can arise with the stomach. Some common conditions related to the stomach include: Indigestion, heartburn, Nausea, Vomiting, Diarrhea, Ulcers, and Crohn’s disease. 5