1. Pathophysiology of digestion
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.
education year

2. ● disorders of appetite ● disorders of secretion
Typical forms of disorders of digestion:
● disorders of appetite
● disorders of secretion
● disorders of motility
● disorders of absorption

3. ● hyporexia, anorexia ● hyperrexia, bulimia ● parorexia
DISORDERS OF APPETITE
● hyporexia, anorexia
● hyperrexia, bulimia
● parorexia
● early satiety

4. Disorders of digestion in the oral cavity
Disorders of Disorders of
mastication saliva
secretion

5. DISORDERS OF SALIVA SECRETION
● hyposalivation
● hypersalivation

6. Dysphagia
Mechanical Motor

7. Factors that affect secretion of HCl by parietal cells
Fundus of the stomach
n.vagus
Canaliculus
Acetylcholine
Histamine
Н,К-ATPase
ECL cell
Histamine
PGE2
ECL cell
Somatostatin
Somatostatin
D cell
Gastrin
Antrum
Blood vessel
Gastrin
G cell
D cell
Somatostatin

8. Disorders of gastric secretion Disorders of the rhythm of secretion
Hypersecretion
Hyposecretion
Disorders of the rhythm of secretion

9. Causes of the gastric hypersecretion
● inflammation of the gastric mucosa
- infection (Helicobacter pylori)
- alcohol
- smoking
- spicy food
● excessive secretion of gastrin
- Zollinger-Ellison syndrome
● abnormal parasympathetic control of secretion
● use of aspirin and other NSAID
● hyperthyroidism, hypercortisolism

10. of the stomach and intestine
Humoral factors that control the motility
of the stomach and intestine
Stimulators Inhibitors
Motilin Cholecystokinin
Gastrin Secretin
Substance P Vasoactive
Neurotensin intestinal
Histamine peptide (VIP)
Serotonin
Endorphine
Neuropeptide Y

11. Hypertonia-hyperkinesia
Types of disorders of gastric motility
Hypotonia-hypokinesia
Hypertonia-hyperkinesia

12. Symptoms of the early form (within 30 min after meal):
Dumping-syndrome
Symptoms of the early form (within 30 min after meal):
- tachycardia, palpitations
- dizziness
- profuse sweating
- postural hypotension
- nausea, vomiting
Symptoms of the late form (from 90 min to 3 h after meal):
- dizziness, faint
- palpitations
- confusion

13. Disorders of digestion in the small intestine
Disorders of Disorders of Disorders of
secretion motility absorption

14. The syndrome of intestinal malabsorption – disorder of absorption of all main types of nutrients (proteins, fats, carbohydrates), vitamins, microelements, salts, and water in the small intestine.

15. Etiopathogenetic factors of the intestinal malabsorption syndrome
◙ Defective intraluminal 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

16. DISORDERS OF DIGESTION IN THE LARGE INTESTINE
DIARRHEA
CONSTIPATION

17. Diarrhea – frequent or single bowel emptying with a release of liquid fecal masses

18. Constipation – a syndrome characterized by disorders of bowel emptying (dejection):
- increased intervals between acts of dejection compared with an individual norm;
- regular insufficient bowel
voiding