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The State Education Institution of Higher Professional Training The First Sechenov Moscow State Medical University under Ministry of Health of the Russian Federation. Department of Pathophysiology. Pathophysiology of digestion. Lecture presentation. Professor Pirozhkov S.V.
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The State Education Institution of Higher Professional Training The First Sechenov Moscow State Medical University under Ministry of Health of the Russian Federation Department of Pathophysiology Pathophysiology of digestion Lecture presentation Professor Pirozhkov S.V. 2015-2016education year
Typical forms of disorders of digestion: ● disorders of appetite ● disorders of secretion ● disorders of motility ● disorders of absorption
DISORDERS OF APPETITE ● hyporexia,anorexia ● hyperrexia, bulimia ● parorexia ● early satiety
Disorders of digestion in the oral cavity Disorders ofDisorders of mastication saliva secretion
DISORDERS OF SALIVA SECRETION ● hyposalivation ● hypersalivation
Dysphagia Mechanical Motor
Factors that affect secretion of HClby parietal cells Parietal cell Fundus of the stomach n.vagus Canaliculus Acetylcholine Histamine Н,К-ATPase ECLcell Histamine PGE2 ECL cell Somatostatin Somatostatin D cell Gastrin Antrum Blood vessel Gastrin G cell D cell Somatostatin
Disorders ofgastric secretion Hypersecretion Hyposecretion Disorders of the rhythm of secretion
Causes of the gastric hypersecretion ●inflammation of the gastric mucosa - infection(Helicobacter pylori) - alcohol - smoking - spicy food ● excessive secretion of gastrin - smoking - Zollinger-Ellison syndrome ● abnormal parasympathetic control of secretion ● use of aspirin and other NSAID ● hyperthyroidism, hypercortisolism
Humoral factors that control the motility of the stomach and intestine StimulatorsInhibitors Motilin Cholecystokinin Gastrin Secretin Substance P Vasoactive Neurotensin intestinal Histamine peptide (VIP) Serotonin Endorphine NeuropeptideY
Types of disorders of gastric motility Hypotonia-hypokinesia Hypertonia-hyperkinesia
Dumping-syndrome Symptoms of the early form (within 30 min after meal): - tachycardia, palpitations - dizziness - profuse sweating - postural hypotension - nausea, vomiting Symptomsof the late form (from 90 minto 3 h after meal): - dizziness, faint - palpitations - profuse sweating - confusion
Disorders of digestion in the smallintestine Disorders ofDisorders ofDisorders of secretion motility absorption
The syndrome of intestinal malabsorption – disorder of absorptionof all main types of nutrients (proteins, fats, carbohydrates), vitamins, microelements, salts, and water in the small intestine.
Etiopathogeneticfactors of the intestinal malabsorption syndrome ◙Defectiveintraluminal and terminal digestion ◙Accelerated transit of the intestinal contents ◙Atrophy of the villi of the intestinal mucous membrane ◙Blocking of the intestinal surface by viscous exudate ◙Resection of a large fragment of the small intestine ◙Disturbance of blood and lymph circulation in the intestinal wall
DISORDERS OF DIGESTION IN THELARGE INTESTINE DIARRHEA CONSTIPATION
Diarrhea – frequentor single bowel emptyingwith a release of liquid fecal masses
Constipation – a syndrome characterized by disorders of bowelemptying (dejection): - increased intervals betweenacts of dejection compared with anindividual norm; - regularinsufficient bowel voiding