Gastrointestinal diseases.

Table of Contents
Introduction. ......................................................................................................................................2
Peptic ulcer. ...................................................................................................................................3
Constipatin.........................................................................................................................................3
Celiac diseases....................................................................................................................................4
The physiology of celiac diseases .........................................................................................................4
Inflammatory bowel disease (IBD) .......................................................................................................4
The pathological effect of IBD..............................................................................................................5
DIAGNOSIS OF IBD ..............................................................................................................................5
References: ....................................................................................................................................6

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Introduction.
Gastrointestinal diseases are a common but painful set of disorders that is currently affecting 62 million
Americans annually. There are many factors which predispose a person to GI diseases for example: diet,
exercise and age. In this synopses, we will provide an insight to the main 4 GI diseases: peptic ulcer,
constipation, celiac diseases and IBD.

Common GIT diseases include:

1. Gastroesophageal reflux disease (GERD): This is a condition in which the acid from the stomach
flows back into the esophagus, causing symptoms such as heartburn, regurgitation, and difficulty
swallowing.

2. Irritable bowel syndrome (IBS): This is a chronic condition that causes abdominal pain, bloating,
and changes in bowel habits, such as diarrhea or constipation.

3. Inflammatory bowel disease (IBD): This includes conditions such as Crohn's disease and
ulcerative colitis, which cause inflammation and damage to the digestive tract.

4. Peptic ulcer disease: This is a condition in which sores develop on the lining of the stomach or
the first part of the small intestine that leads from the stomach, causing pain and discomfort.

5. Gastroenteritis: This is an infection of the gut often caused by viruses, bacteria or parasites that
causes symptoms such as diarrhea, vomiting, and abdominal pain.

6. Hemorrhoids: This is a common condition in which the veins in the rectum and anus become
swollen and inflamed, causing pain, itching, and bleeding.

Management of GIT diseases may involve medication, lifestyle changes, and in some cases, surgery.
Early detection and treatment are important in preventing complications and improving quality of life.

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Peptic ulcer.
Peptic ulcer is a distinct breach in the mucosal lining of the stomach (gastric ulcer) or the first part of the
small intestine (duodenal ulcer) as a result of acid and pepsin in the lumen. H pylori is one of the most
common causes of peptic ulcer. Four times as many peptic ulcers arise in the duodenum as in the
stomach itself. Duodenal ulcers are generally benign. Most people with peptic ulcers have these bacteria
living in their digestive tract, but, many people who have these bacteria in their stomach do not develop
an ulcer.

The following factors raise your risk for peptic ulcers:

Drinking too much alcohol

Regular use of aspirin, ibuprofen, naproxen, or other nonsteroidal anti-inflammatory drugs

(NSAIDs) - once in a while is safe for most people

Smoking cigarettes or chewing tobacco

Being very ill, such as being on a breathing machine

Having radiation treatments

Hyperacidity is caused by the diet. Increased consumption of spicy foods and oily foods increases the
extent of acid production. Consuming foods that are very rich in fiber content takes a long time for the
food to pass through the stomach. As a result, the acid production continues until the stomach is
emptied, resulting in increased amount of acid in the stomach. Stomach ulcer or cancers that increase
the production of gastrin automatically increase the acid production.

Fibers are used in peptic ulcer treatment. Soluble fibers, found in apple, oatmeal, and pear are
responsible, for instance, for an increased viscosity in the intestinal content. Insoluble fibers (whole
grains, granola, flaxseed) increase stool bulk, reduce transit time in the large intestine, and make fecal
elimination easier and quicker. Fibers regulate the bowel function, which make them vital for the well-
being of healthy people and in the dietary treatment of many pathologies.

There are many types of nutritional therapy. The objective of peptic ulcer diet therapy is to prevent
hypersecretion of peptic chloride to reduce the sore and pain in the gastric and duodenal mucosa. In

addition, nutritional therapy aims to promote healing, based on a complex sequence of events going
from the initial trauma to the repair of the damaged tissue. Investigation of nutritional deficiencies is
essential in the preparation of an appropriate recovery diet.

Constipatin
Constipation is a digestive disorder that occurs when a person has difficulty passing stool or has
infrequent bowel movements. It is characterized by hard, dry, and small stools that are difficult to pass.
Factors that can contribute to constipation include a low-fiber diet, inadequate fluid intake, lack of
exercise, certain medications, and certain medical conditions. It can occur when the colon absorbs too
much water from the food in the digestive tract, causing the stool to become hard and dry. The muscles
in the colon may also contract weakly, making it difficult for the stool to move through the colon and
rectum.

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Celiac diseases
Celiac disease, also known as gluten-sensitive enteropathy, is an autoimmune disorder of the small
intestine that occurs in genetically predisposed individuals. It is triggered by the ingestion of gluten, a
protein found in wheat, rye, barley, and other grains. When a person with celiac disease consumes
gluten, their immune system responds by damaging the lining of the small intestine, making it difficult
for the body to absorb nutrients from food.

The physiology of celiac diseases

Involves a complex interplay between genetic, immunological, and environmental factors. The
condition is strongly associated with certain genetic variations, particularly those in the human
leukocyte antigen (HLA) genes. These genes help regulate the immune system and are found on
chromosome 6. When a person with celiac disease is exposed to gluten, their immune system produces
antibodies that attack the gluten proteins as well as the lining of the small intestine. This causes
inflammation and damage to the epithelial cells that line the intestine, leading to malabsorption of
nutrients, diarrhea, abdominal pain, and other symptoms.

Celiac disease can affect people of all ages, but it is more commonly diagnosed in children and young
adults. It is estimated to affect around 1% of the world's population, although many cases go
undiagnosed. Individuals with a family history of celiac disease are at increased risk of developing the
condition, as are those with certain autoimmune disorders, such as type 1 diabetes and autoimmune
thyroid disease.

Inflammatory bowel disease (IBD)

Inflammatory bowel disease is a chronic inflammatory disease of the GIT; divided into Chron’s disease
and ulcerative colitis. Although both Chron’s disease and ulcerative colitis are characterized by
inflammation across the intestines, there are some key distinctions between them. In Chron’s disease,
there are some healthy patches between the inflamed areas where as in ulcerative colitis, there is
continuous inflammation throughout the colon. Also, ulcerative colitis only affects the inner most lining
of the colon, on the contrary, Chron’s disease can occur in all the layers of the bowel walls.

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 Chron’s disease Ulcerative colitis

Affected location Can affect any part of the GIT Occurs in the large intestine
and rectum
Most often small intestine
before large intestine

Damaged areas Appear in patches that are Are continuous

next to healthy tissues
Usually starting at the rectum
and spreading further to the
colon

Inflammation Reaches all layers of the GIT Only present in the inner most
lining of the colon

The intestines are lined with epithelium which prevents microorganisms from entering circulation by
sealed intracellular junctions. In IBD however, these junctions are defective as a result of severe
inflammation, which causes excessive deterioration of the epithelium, resulting in additional exposure
of intestinal microbes (which worsen the inflammation). IBD can detrimental impact to people’s health
because inflammation of the lining of the GIT reduces the surface area for absorption of nutrients,
leading to weight loss and malnutrition.

The pathological effect of IBD

varies among the population; for some people, IBD is only a mild illness. For others, it's a debilitating
condition that can lead to life-threatening complications. IBD is characterized by the following
symptoms: diarrhea, rectal bleeding, abdominal pain, fatigue and weight loss.

People at risk of this disease are:

 Age - Most people who develop IBD are diagnosed before they're 30 years old. But some people
don't develop the disease until their 50s or 60s.

 Race or ethnicity - black people are more susceptible

 Family history - increase risk with a positive family history

 Nonsteroidal anti-inflammatory medications.

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Diagnosis of IBD.
IBD is diagnosed using a combination of different imaging studies such as: endoscopy, contrast media
and MRI. We do this in order to visualise the inflammation up close and to differentiate between
Chron’s disease and ulcerative colitis. Blood and stool samples are also taken to determine if the
inflammation is caused by an infection.

In terms of nutrition, the symptoms of IBD can be supressed by focusing on the diet. This means
increasing the intake of: fruits, vegetables, whole grains, lean protein, and low-fat and non-fat dairy
products. Fiber is not broken down by digestive enzymes, therefore will be spending lesser time in the
GIT, hence reducing the strain on the GIT. Having a controlled diet is very important because diet
influences the production of metabolites by normal flora in the intestines which may initiate or
perpetuate IBD. Also, diet can impact the mucus layer which protect the epithelium from contents in the
gut.

References:
CDC: https://www.cdc.gov/ibd/what-is-
IBD.htm#:~:text=What%20Is%20IBD%3F,damage%20to%20the%20GI%20tract

Mayo clinic: https://www.mayoclinic.org/diseases-conditions/inflammatory-bowel-disease/symptoms-

causes/syc-
20353315#:~:text=The%20exact%20cause%20of%20inflammatory,is%20an%20immune%20system%20
malfunction

Ludvigsson JF, Leffler DA, Bai JC, et al. The Oslo definitions for coeliac disease and related terms. Gut.
2013;62(1):43-52

https://pubmed.ncbi.nlm.nih.gov/23609613

National Institute of Diabetes and Digestive and Kidney Diseases. Celiac Disease. Accessed April 20,
2021. https://www.niddk.nih.gov/health-information/digestive-diseases/celiac-d

National Institute of Diabetes and Digestive and Kidney Diseases. (2021). Constipation. Retrieved from
https://www.niddk.nih.gov/health-information/digestive-diseases/constipation

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