1. Digestion and Absorption of the Food Nutrients Chapter 3 Part 3

2. GI Tract Disorders Factors influencing GI function  Emotional state Intestinal cramping, queasy stomach  Exercise - moderate Reduces liver disease Gallstones Constipation Colon cancer

3. GI Tract Disorders Factors influencing GI function  Exercise – high intensity GERD Hiatal hernia Irritable bowel syndrome Viral gastroenteritis

4. GI Tract Disorders More frequent in women Common in young athletes Infrequent in gliding movement sports  Cycling Serious medical conditions

5. GI Tract Disorders Constipation  Defecation habits are different among people. Difficult or infrequent evacuation  Many causes are possible. Ignoring normal urges Muscle spasms  Slows feces movement Certain medications and supplements  Antacids, calcium, iron

6. GI Tract Disorders Constipation  Colonic irrigation is the internal washing of the large intestine and can be hazardous.  Strategies High-fiber diet Increased fluids Exercise regularly. Respond quickly to the urge to defecate.

7. GI Tract Disorders Laxatives  Can work on the intestinal nerve plexus or mucosal surface  Bulk producing laxatives Bran  Stool softeners Dulcolax  Hydrating agents Milk of magnesia  Hyperosmotic agents Glycerol  Draw water into the large intestine  Regular use can be harmful Decreases muscle action of large intestine

8. GI Tract Disorders Belching and Gas  Strategies Eat slowly. Chew thoroughly. Relax while eating. Watch bothersome foods. Hiccups are triggered by eating or drinking too fast.

9. GI Tract Disorders Hemorrhoids may be a problem.  Swollen veins of the rectum and anus  Intense pressure and straining  Dietary recommendation: Fiber and fluid

10. GI Tract Disorders Diarrhea: 2009-1.5 million deaths worldwide  Frequent, loose, watery stools Irritable bowel syndrome or colitis Infections-bacteria, viruses Cause excess intestinal secretions

11. GI Tract Disorders Types of Diarrhea  Secretory Increased secretion or reduced absorption of fluids Cholera (secretes Cl - into intestinal lumen, Na + follows)  Osmotic Lactose intolerance, high sugar solutions (particularly during ex.)  Exudative Crohn’s disease (blood in bowel)  Motility related Increased motility, diabetic neuropathy  Inflammatory Infections  Dysentery Blood in stool, caused by salmonella poisoning, for ex.

12. GI Tract Disorders Diverticulosis  Intestinal walls weaken and bulge. The bulging pockets are called diverticula Diverticulitis  Worsened condition – inflammation  Requires intervention - surgery Increase fiber intake

14. GI Tract Disorders Heartburn  Lower esophageal sphincter – relaxes Reflux Painful  Acid from stomach reaches esophagus and irritates lining

15. GI Tract Disorders Heartburn and Acid Indigestion  Strategies Small meals Liquids between meals Sit up while eating. Wait 1 hour after eating before lying down. Wait 2 hours after eating before exercising. Refrain from tight-fitting clothing. Avoid bothersome foods. Refrain from tobacco use. Lose weight if overweight.

16. GI Tract Disorders Gastroesophageal Reflux Disease (GERD)  Backward flow of stomach contents into the esophagus.  Exercise exacerbates GERD  > 60% athletes Worst in weightlifters Mild in endurance runners

17. GI Tract Disorders Antacids and acid controllers may help indigestion. 4 hr from evening meal to bed Avoid exercising after eating Avoid foods that relax sphincter  Chocolate, peppermint, coffee, alcohol, tobacco,

18. GI Tract Disorders Irritable Bowel Syndrome  Symptoms Cramps, bloating, increased frequency, diarrhea, constipation  Causes Altered intestinal peristalsis Decrease pain threshold

19. GI Tract Disorders Individualized treatment  Elimination diet-dairy, gas-forming foods (cabbage, beans), some fruit-grapes, cherries  high fiber foods  Moderate caffeine, avoid dairy  Low-fat, small, frequent meals  Stress reduction

20. Choking Food becomes lodged in the trachea. The larynx cannot make sounds. The Heimlich maneuver may need to be used. Strategies  Small bites  Chew thoroughly.  Don’t talk or laugh with food in the mouth.  Don’t eat when breathing hard.

23. Ulcers Peptic ulcer  Area of GI tract eroded by gastric acid, pepsin  Exposes nerves  15% stomach  85% duodenal  Diet Soluble fiber – fruits, vegetables: protective Refined sugar: increases risk

24. Ulcers Treatment  Antibiotics Helicobacter pylori  Cause of most ulcers  Proton pump (H + ) inhibitors Keep HCL from forming  Antacids Neutralize stomach acids

25. Vomiting Body’s adaptive mechanism Dehydration is a concern. May be self-induced as in eating disorders