Chapter 2: Physiology of digestion

Digestion is the process by which food consumed by the organism is made available for the body.
In unicellular organisms and in lower non-chordates intra cellular digestion occurs within food
vacuoles, in higher animals digestive system has evolved and the process of digestion is carried
out by the digestive system.

Food is essential for:

1. The digested food is used as source of energy or fuel for the production of energy i. e. ATP.

2. Food is also a source of building blocks for production of essential biomolecules for
development one repair of body tissue.

3. Food provides essential micronutrients such as vitamins and minerals which help and support
various metabolic processes in the body.

4. Water, which is one of the components of food acts ac medium for biochemical reactions of
metabolism. It also actively participates in the reactions like hydrolysis and other.

Diet:

Diet is sum total of food consumed by a person or organism. Based on food consumed by animals
they are of following types:

1. Herbivore: Animals feed on Plants and plant products.

2. Carnivore: Animals feed on other animals.

3. Fungivore: Animals fess on fungus.

4. Bacterivore: Animals feed on bacteria.

5. Saprophyte: Animals feed on decaying material.

6. Omnivores: Animals feed on plant, animals, Fungi, bacteria etc. Human is a n omnivore.

Essential components of diet are carbohydrates, proteins, lipids vitamins minerals and water.

Carbohydrates: They are made up of C, H, O. Diet includes carbohydrates in the form of

polysaccharides like starch and glucogen, cellulose disaccharides like lactose and sucrose and very

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few monosaccharides glucose, fructose and galactose. Sorces; Cereals like wheat, rice, barley,
jawar, corn, oats, Starch vegetables like potato yams, sweet potato. Fruits have glucose fructose;
milk sugar is lactose and cane sugar is sucrose. Daily requirement: 45 to 65 % of total caloric
intake i.e., 225 to 325 gm. Those are energy food serves as preliminary source of energy. They also
serve as dietary fibers.

Protein: Proteins are nitrogen containing compound. They are made up of amino acids. There are
20 different types of amino acid incorporated in proteins. Out of that nine are essential amino acids
for human as they are required to be included in diet. Other 11 are non-essential amino acids as
they can be synthesized in human body. Sources: Pulses, milk, Cheese, yogurt, eggs, meat, sea
food, soy products etc. Daily requirement: 56 gm for average man and 46 gm for average woman.
Proteins are body building food. They help in growth and repair.

Lipids: Lipids are compounds made up of C, H, O. They are in the form of triglycerides,
phospholipids, glycolipids, saturated and unsaturated fatty acids and sterols. Sources: Oil, Ghee,
butter, cheese, milk, meat, other animal food. Daily requirement: 20 to 35 % of total caloric intake
i.e., 44 to 78 gm. Fats are the richest source of energy. They serve as storage food. They are
essential for the absorption of fat-soluble vitamins A, D, E, and K. They also act as insulator.

Vitamins: They are complex organic compounds. They are of two types, Water soluble like Vit B
complex, Vit C and Fat soluble like Vit A, Vir D, Vit E and Vit K. Our body can produce Vit D and
Vit K. Other vitamins should be the part of diet. Vitamins play important role in metabolism. They
may play structural role or they may act as co-enzymes and co-factors for many key enzymes.

Minerals: Many mineral ions are essential for normal metabolism. They play divers role in the
body. Irons, Calcium, iodine, phosphate, sodium, potassium are some of the minerals.

Water: Water is chemically H2O, serves as medium. It is involved in various metabolism

processes like hydrolysis. It plays important role in maintaining fluid content, electrolyte balance
pH of body fluids. It helps in excretion.

Balanced Diet: The diet which contains all essential nutrients in appropriate proportion is called
balanced diet.

Basic Digestive processes:

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Digestive system performs four basic processes which include:

1. Motility: It refers the muscular action. It is of two types, propulsive movement and mixing
movement.

2. Secretion: A number of digestive juices are secreted by various parts of digestive tract and
accessory glands. Secretion is active process. These secretions mainly contain large amount of
water, electrolytes and specific organic constituents like enzymes, mucus, bile salts etc. These
secretions are essential for digestion. Apart from that digestive tract also secretes many hormones
which control various metabolic activities.

3. Digestion: The food we consume has complex polymers. They are large molecules and cannot
cross the plasma membrane, so cannot be absorbed. So, they have to be converted into simple
forms by the process of digestion. Definition: Digestion can be defined as a biochemical
breakdown of the structurally complex food stuff of the diet into smaller absorbable units by the
action of enzymes produced by digestive system.

4. Absorption: In small intestine process of digestion is completed. The small absorbable units
resulted from digestion are absorbed by the cells of small intestine along with water vitamins and
electrolytes. After absorption food is transferred to blood.

Stages in digestion

The activities of the digestive system can be grouped under five main headings

➢ Ingestion: this is the taking of food into the alimentary tract, ie eating and drinking
➢ Propulsion: this mixes and moves the content along the alimentary tract
➢ Digestion: this consist of: mechanical digestion (breaking down of food by e.g. mastication
(chewing); chemical digestion (breakdown of food into small molecules by enzymes
produced by digestive glands)
➢ Absorption: this is the process by which digested food substances pass through the walls
of alimentary canal into the blood and lymph capillaries to use by body cells
➢ Elimination: undigested and unabsorbed substances are excreted from the alimentary canal
as faeces by the process of defaecationn.

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Digestion in Mouth:

1. Mechanical Digestion: First step of digestion is mastication. It takes place in mouth with the
help of teeth. Tongue assists in this process. It converts large pieces of food into small particles. It
enhances digestive process. This stage is important to increase the surface area of food so as to
enable to enzymes react on the food well and also helps in easing the way food is emptied into the
stomach.

2. Enzymatic Digestion: salivary glands secrete salivary amylase. It digests polysaccharides to

disaccharides. It acts on the glycoside bond between two successive monosaccharides and
hydrolyze the bond.

3. Proteins and lipids are not digested in mouth.

4. No absorption of food stuff occurs in mouth.

II. Pharynx and Oesophagus

1. Pharynx is a common passage for digestive and respiratory tract. At the base of pharynx there
is an opening of oesophagus called gullet and opening of trachea called glottis. The respiratory
passage remains open continuously except at the time of swallowing. During swallowing the
glottis is closed by a cartilaginous flap called epiglottis.

2. In mouth bolus or ball of food is produced in mouth. It is voluntarily forced by tongue and
pressed against pallet to the back part of mouth into the pharynx. This stimulates swallowing
action.

3. Oesophagus is a tube which carries food from pharynx to stomach. It merely acts as passage for
food. A rapid peristaltic wave sweeps the food in oesophagus within 5 to 9 sec.

4. Secretions of oesophagus mainly include protective mucus to prevent damage to the wall by
sharp edges of food particles.

5. No digestion or absorption takes place in pharynx or oesophagus.

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III. Stomach

Stomach is the most dilated part of alimentary canal. Anatomically it is divided into fundus, body
and pyloric antrum. At its junction with oesophagus, it has a cardiac sphincter and at the junction
with duodenum has a pyloric sphincter. The cardiac sphincter prevents the retrieval of food from
stomach to oesophagus. Pyloric sphincter regulates the flow and rate of emptying of stomach in to
oesophagus.

The wall of stomach is thick muscular. It has an extra muscle layer called oblique muscle layer
inner to the circular muscle layer. Muscularis mucosa is also thicker in stomach. These muscles
help in churning of food. Volume of empty stomach is about 50ml. It can accommodate about 1 lit
meal. It is possible because of deep longitudinal folds of Mucosa. They give extra distensibility to
stomach without rise in intrinsic pressure. At the base of gastric folds there are gastric pits. At these
gastric pits openings of gastric glands are present. Gastric glands secrete gastric juice which helps
indigestion.

Functions of stomach:

Stomach carries three major functions

1. Storage of the food: The ingested food is stored in stomach until it passes to duodenum. It takes
hors to pass the food further sue to very slow peristaltic movement and control by pyloric stomach.

2. Mechanical digestion and mixing of food: food is mixed with gastric juice by the muscle action.
Mixing movement of stomach wall also carry out churning of food. This action converts food in
to smaller particles. During the churning both cardiac and pyloric sphincters remain closed.

3. Enzymatic digestion: This is carried out by the action of gastric juice secreted by gastric gland.

Gastric Glands:

Gastric glands are mucosal glands embedded in mucosa of stomach. These are simple tubular or
branched tubular or coiled tubular glands. The glands of fundas region secrete mainly mucus. The
glands of body region secrete mucus, hydrochloric acid and pepsinogen while pylaral glands
secrete mucus, pepsinogen and gastrin.

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The Glands of body regions are made up of three types of cells: Mucous cells secreting mucus,
parietal cells or oxyntic calls secreting HCl and Chief cells or zymogen cells secreting pepsinogen.
Apart from that G cells of gastric gland secrete hormone gastrin, D cells secrete hormone
somatostatin and enterochromaffinlike (ECL) cells secrete histamine.

Functions of mucus:

1. Mucus acts as lubricant and prevents ay mechanical damage to stomach wall by food particles.

2. A layer of thick mucus is secreted by epithelial cells of stomach wall. It does not allow the
digestive enzyme pepsin to come in contact with stomach wall.

3. This mucus is alkaline in nature. It neutralizes HCl and protects stomach wall from its action.

Functions of HCl:

1. Pepsin is protein digesting enzyme. It is secreted in inactive form pepsinogen. HCl

Activates Pepsinogen to pepsin.

2. The optimum PH for the action of pepsin is acidic. HCl creates acidic environment in stomach
which is essential for the action of pepsin.

3. It carries out breakdown of connective tissue and muscles. Thus helps in their digestion.

4. Along with salivary lysozymes it also kills micro-organisms present in egested food.

5. It inhibits the action of salivay amylase. The action of salivary amylase may continue in the core
region of the ingested food in stomach. But as soon as it comes in contact with HCl, it is inhibited.

6. HCl dissolves some of the food contents like bones, cartilage and other hard particles.

Functions of Pepsin:

Pepsin like most of the protein digesting enzymes is secreted in inactive form pepsinogen. It
prevents self-digestion of chief cells and gastric glands. The inactive pepsinogen is synthesized in
chief cells and stored in small membrane bound vesicles. Such vesicles can be observed at luminal

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end of the chief cells. These vesicles are called zymogen granules. So, the cells are also named as
zymogen cells. Pepsinogen is secreted only after receiving the signal.

Pepsin is protein digesting enzyme. It is serine protease. It cleaves peptide bond between
hydrophobic and perfectly aromatic amino acids. It is an endopeptidase as it acts on non-terminal
peptide bonds. Its action is hydrolysis i.e. breaking of a bond by adding a water molecule (H2O
…… H+ + OH-).

Functions of Gastrin:

Gastrin is a proteinous hormone secreted by endocrine cells of gastric glands at antral region. The
hormone is secreted in blood. It acts on the gastric gland and enhances the secretion.

Digestion summary:

1. Mechanical digestion of food takes place in stomach. The thick muscular wall of stomach carries
out churning of food by contraction and relaxation.

2. Digestion of proteins to smaller polypeptides (peptones and proteoses) by the action of pepsin.

3. Digestion of polysaccharides by salivary amylase is continued in stomach before its inhibition

by HCl.

Absorption:

No food stuff is absorbed in stomach. Wall of stomach can absorb alcohol and aspirin.

IV. Small Intestine

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Small intestine is the longest part of alimentary canal. It is long narrow and coiled tube. The wall
of small intestine is made suitable for the digestion and absorption. Special features of small
intestine are

1. Presence of goblet cells. Goblet cells are single celled glands among the surface epithelial cells.
They secrete mucus.

2. Inner surface of intestine is thrown into folds:

a. Presence of pliqua: Pliqua are the large folds of submucosa of intestinal wall. The core of
plique are made up of submucosa covered by mucosa on luminal side.

b. Villi: Villi are the folds of mucosa. The core of folds is of lamina propria covered by
surface epithelium.

c. Microvilli: Plasma membrane of luminal surface of the epithelial cells is thrown into finger
like folds called microvilli.

The structures like Plique, Villi and Microvilli increase the surface area of small intestine by 600
folds, which increase the efficiency of absorption.

3. Perfused blood supply: There is large number of blood vessels supplied to the small intestine as
the absorbed food is transported through the blood.

4. Pears patches: Large patches of lymphoid tissue are present in the submucosa of small intestine
called pears patches.

5. Duodenum the first part of small intestine receives common hepatopancreatic duct. This duct
brings bile from gall bladder and pancreatic juice from pancreas. So digestion in small intestine
includes action of bile, pancreatic juice, intestinal juice and lining epithelial cells.

6. Duodenum has extra protection of higher mucus secretion by submucosal Brunner’s gland
present only in this region.

Digestion in small Intestine:

Digestion in small intestine includes action of bile, pancreatic juice, intestinal juice and lining
epithelial cells.

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Bile:

Bile is greenish coloured watery alkaline secretion of liver. Liver is the largest gland in vertebrate’s
body. It is central biochemical factory of the body. It influences almost all metabolisms in the body.
One of its functions is secretion of bile. Bile is continuously secreted by hepatocytes and carried
by bile canaliculi to bile ducts which carry it to gall bladder; in gall bladder it is stored until it
receives a signal. Secretion of bile is under the control of two hormones, Secretin and
Cholecystokinin (CCK).

Constituents of Bile:

Bile consist of following components,

1. Bile salts: Bile salts are derivatives of cholesterol. These are taurocholate and glycocholate.
Apart from these organic salts bile also contains NaHCO3. Bile salts are recycled through
enterohepatic circulation.

2. Bile Pigments: These are bilirubin and biliverdin. These are the products of haemoglobin
degradation. Those are excreted through bile to duodenum and then to exterior with feces.

3. Cholesterol: Excess of cholesterol is thrown out through bile.

4. Lecithin

5. Water

Functions of Bile:

a. The bicarbonate ions neutralise the acidic chyme entered in duodenum from stomach.

b. It acts as good buffer.

c. Bile acts as lubricant.

d. Bile salts help in emulsification of lipids.

i. Lipids are hydrophobic in nature. So lipids in the food forms a large aggregate to remain
isolated from the aqueous environment.

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 ii. In this form it is difficult to digest as the lipid digesting enzyme, lipase is hydrophilic in
nature and can act on at the surface of the lipid aggregate.

iii. Bile salts have hydrophobic as well as hydrophilic regions in the same molecule.

iv. They can interact with lipids with the hydrophobic regions and with aqueous surrounding
with hydrophilic region.

v. So they convert large lipid aggregates into small droplets, with surface covered by bile
salts. This makes the droplets stable in aqueous environment.

vi. This enhances the lipid digestion as lipase can act on the surface of each droplet.

e. Bile salts activate pancreatic lipase in some animals.

f. Bile salts help in fat absorption.

Pancreatic Juice:

Pancreatic juice is called as complete digestive juice. It is secreted by exocrine pancreas.

Pancreas is the second largest gland of vertebrate’s body. It is duel in nature. Pancreatic acini with
its duct system comprises exocrine pancreas, while islets of Langerhans form the endocrine
pancreas. Exocrine pancreas secretes pancreatic juice, which is carried through the pancreatic duct
to duodenum. Endocrine pancreas secretes hormones insulin and glucagon which regulate blood
glucose level.

Pancreatic acini are grapes like hollow structures. They are made up of acinar cells. Each
acinar cell is pyramidal in shape and shows the features of typical secretary cell. It has basal
nucleus, abundant RER, Golgi complex and large number of zymogen granules occupying apical
region.

Components of Pancreatic Juice:

Pancreatic juice consisting of two components:

1. Aqueous alkaline secretion: it contains bicarbonates of Na, actively secreted by early

portion of ducts.
2. Enzymatic secretion: it is actively secreted by pancreatic acinar cells Enzymatic secretion
has three types of enzymes.
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 a. Proteolytic enzymes: typsinogen, chymotypsinogen and procarboxypeptidase those
digest proteins.
b. Pancreatic amylase that digests carbohydrates.
c. Pancreatic lipase that digests fat.

Functions of Pancreatic Juice:

Aqueous alkaline solution: Pancreatic juice is alkaline in nature as it content bicarbonate ions
secreted by early ducts. It neutralizes acidic chime and provide alkaline environment for the action
of pancreatic and intestinal enzymes.

Proteolytic enzymes of pancreas are synthesized and secreted in inactive form. They are activated
after reaching to their target site i.e. duodenum. This is for the protection of pancreas and duct
system from self-digestion. In Intestine the wall is lined by a layer of mucus which protects the
intestine from self-digestion. Pancreatic juice contents three proteolytic enzymes.

1. Trypsinogen: it is activated by enterokinase, synthesized by intestinal epithelial calls.

After activation trypsin can act as autocatalyst. Trypsin digests proteins by braking peptide
bonds at carboxyl side of lysine and arginine.

2. Chymotrypsinogen: It is secreted by pancreatic acinar cells. It is inactive form. It is

activated by typsin. It digests proteins by cleaving peptide bond at N-terminal of
tryptophan, tyrosine, Phenylalanine or leucine.

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 3. Procarboxypeptidase: It is activated by trypsin. It acts on the carboxy terminus of the
polypeptide chain. It removes one amino acid at a time.

4. Pancreatic amylase: It is secreted in pancreatic juice in an active form. It acts on

polysaccharides and hydrolyse it into disaccharides.

Pancreatic Lipase:

Pancreatic lipase is secreted in active or inactive form in different animals. It is very important
enzyme as it is the only lipid digestive enzyme in the digestive system. It acts on triglycerides and
digest it in to monoglycerides and free fatty acids.

Monosaccharides and fatty acids are also hydrophobic. So those are enveloped into 4-7nm
diameter structures called micelles. These are made up of bile salts lecithin and cholesterol present
in bile. These structures are very minute and soluble in water.

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Intestinal Juice:

1. Secretion of small intestine is called succus entericus.

2. It contents water, salts and mucus.

3. No enzymes are secreted directly into intestinal juice.

4. The enzymes synthesized by intestinal epithelial cells remain attached to the plasma membrane
of the cells at microvilli.

5. This facilitates the absorption of digested food after their complete digestion.

6. The intestinal enzymes complete the digestion.

7. Digestion of Proteins:

a. Polypeptides, peptones and proteoses are completely digested to amino acid by various
intestinal enzymes.

b. Small peptides are digested by aminopeptidases. Tripeptides are digested by tripeptidases.

Dipeptides are digested by dipeptidases.

8. Digestion of carbohydrates: Polysaccharides are digested to disaccharides by salivary and

pancreatic amylase. Further digestion is carried out by intestinal enzymes. The product of starch
and glycogen digestion is a disaccharide maltose. Apart from that lactose- the milk sugar and
sucrose-the cane sugar is also the part of our diet. All these disaccharides are digested by their
respective intestinal enzymes.

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9. Digestion of Lipids: Lipids are digested completely by pancreatic lipase to its absorbable form
i.e. to monoglycerides and free fatty acids. No other enzyme is available and required for lipid
digestion.

Thus digestion in small intestine is the combine and coordinated functions bile, pancreatic juice
intestinal enzymes and intestinal juice.

V. Large Intestine:

The large intestine consists of cecum, appendix, colon and rectum. Cecum is a blind ended pouch
below the junction of small intestine and large intestine. Appendix is finger like projection at the
bottom of cecum. It is considered as vestigial structure in human. It houses good bacteria and help
to restore the gut flora. It is also acts as lymphoid organ. In most of the ruminants it houses cellulose
digesting bacteria, which produces an enzyme called cellulase. Cellulase digests cellulose to
shorter polysaccharides, some oligosaccharides and glucose.

Colon is the largest part of large intestine. It has three straight parts viz. ascending colon, transverse
colon and descending colon. The terminal portion of descending colon is S-shaped sigmoid colon.
Next to colon is the straight rectum, which opens exteriorly by anus. Anus is guarded by anal
sphincter. Internal anal sphincter muscles are smooth muscles (involuntary) while external anal
sphincter muscles are voluntary.

Secretion of large intestine:

Large intestine does not secrete any digestive enzyme, as the process of digestion is completed in
small intestine. The secretion of large intestine contents bicarbonate ions and mucus. Bicarbonate
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ions are alkaline in nature. They neutralize the acid produced by fermenting bacteria. Mucus is
protective in nature. It protests large intestinal wall from mechanical injury. It also acts as lubricant.

Absorption in large intestine:

Large intestine receives about 500 ml residue from small intestine. It contents indigestible food,
unabsorbed biliary compounds and remaining fluid. Large intestine absorbs salts and water from
this. At the end of the process feces is formed, which is stored before defecation. Defecation occurs
by defecation reflex, received by internal anal sphincter.

Absorption

I. Absorption of carbohydrates

1. Carbohydrates are absorbed in the form of monosaccharides, like glucose, galactose and
fructose.

2. These are the end products of carbohydrate digestion, which is finalized on digestion of
disaccharides by their respective disaccharidase located in the plasma membrane of microvilli.

3. Absorption of Glucose and Galactose:

a. Glucose and galactose are absorbed by secondary active transport as energy is not directly
used for the transport of these monosaccharides.

b. Glucose and galactose are cotransported along with Na+ from luminal side to the interior
of intestinal cells.

c. Cotransporter operation does not use the energy directly.

d. Absorption of both the monosaccharides depend on Na+ concentration gradient.

e. Na+ concentration is maintained high in the lumen and low in the interior of the cell.

f. This concentration gradient is generated actively (by consuming energy) Na+ - K + pump.

g. Thus glucose and galactose are concentrated in the cell by this cotranspoter activity.

h. Then those are absorbed in the blood vessels in villi by passive transport down the
concentration gradient.

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 i. The passive carriers for the monosaccharides are located at basolateral sides of intestinal
cells.

j. In addition to that, significant amount of glucose directly cross the ‘leaky tight junctions’
and absorbed through intercellular region of adjacent epithelial cells.

4. Absorption of Fructose:

a. Fructose is absorbed solely by facilitated diffusion.

b. It is transported passively.

II. Absorption of protein

a. Digested products of proteins are the free amino acids.

b. Small peptides, tripeptides and dispeptides are digested to free fatty acids by their
respective enzymes, which are attached to the microvilli of intestinal epithelium.

c. Amino acids are also cotransported from lumen to intestinal epithelium along with Na+
down the concentration gradient of Na+ like glucose and galactose.

d. Like monosaccharides, amino acids are also transported to capillaries from intestinal cells
of villi by passive transport down the concentration gradient.

III. Absorption of Lipids

a. End products of lipid digestion are monoglycerides and free fatty acids.

b. These end products are hydrophobic, so they are packaged into water soluble micelles.

c. Micelles are formed by bile salts lecithin and cholesterol facilitates lipid absorption.

d. Micelles carry the monoglycerides and fatty acids to the luminal surface of intestinal epithelial
cells.

e. Here monoglycerides and fatty acids passively diffuse to the lipid component of plasma
membrane and enter inside the cell.

f. Micelles are then recycled to carry more monoglycerides and fatty acids.

g. Interior of the epithelial cell triglycerides are resynthesized from monoglycerides and fatty acids.
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h. These triglycerides are also hydrophobic so the form droplets, which are covered by a layer of
lipoprotein.

i. Such water soluble fat droplets are called chylomicrons.

j. Chylomicrons are exocytosed into interstitial fluid of villus. From there they enter the central
lacteal.

k. Thus fats are absorbed into lymphatics and not directly into blood.

l. Fat absorption is appeared to be energy independent but for the secretion of bile salts and for
resynthesis of triglycerides energy is required.

Elimination

The digestive waste, solidified into coherent faeces in the rectum initiate a neural reflex causing
an urge or desire for its removal

The egestion of feaces to the outside through the anal opening (defaecation) is a voluntary process
and is carried out by a mass peristaltic movement

Digestive Problems

1. Choking
food in air passages
usually meats, hot dogs, grapes, carrots, hard candy, popcorn, peanut butter
may not be able to make a sound
DON’T hit on back
2. Vomiting
symptom of many diseases
waves of reverse peristalsis
if severe may empty duodenum as well
rest and drink small amounts of fluids
guard against massive fluid loss
3. Bulemia
self induced vomiting
may cause damage and infection of esophagus, pharynx, or salivary glands

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 erosion of teeth, more dental caries
esophagus may rupture or tear
4. Diarrhea
frequent loose watery stool
intestinal contents moving too fast for fluid absorption to occur
main danger is fluid loss
also upsets acid/base balance
5. Constipation
caused by:
lifestyle …. inadequate water input
lack of physical activity
side effect of medication
increase in fiber, prunes, laxatives … attracts water … softens stool
Colonic Irrigation
alternative medical practice
potentially harmful
unneccessary
can rupture the intestine
frequent use of laxatives and enemas:
can lead to dependency
upset body’s fluid balance
mineral oil
can interfere with absorption of fat soluble vitamins
6. Belching
results from swallowed air
carbonated drinks and chewing gums can contribute
occasionally can be a sign of a more serious disorder:
gall bladder pain, colonic distress

eat slowly, chew thoroughly

relax while eating

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7. Hiccups
repeated spasms of diaphragm
may be triggered by eating or drinking too fast
8. Gas
normally we expell several 100 ml of gas/day
most is odorless 1% are “volatile” gasses
high carb foods known to produce excess gas
9. Heartburn
cardiac sphincter doesn’t close properly
eat or drink too much
clothing too tight
cure: eat small meals
drink liquids 1 hr before or 1 hr after meal
don’t lie down or bend over lose
weight if overweight
don’t smoke
use antacids but sparingly
10. Ulcers
caused by: bacterial infection
use of some antiinflammatory drugs
disorders that cause excessive gastric secretions
diet therapy used to be main cure, now antibiotic

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