Stomach Time to Digest some new information MS
- Slides: 22
Stomach • Time to Digest some new information MS 2 a GI Course
Roadmap • Purpose of the stomach • Anatomy and problem areas • Normal acid secretion • Disruption to acid secretion
Purpose
• Protection • Storage • Trituration • Digestion
Anatomy and Problem areas GOO makes me vomit
Normal Stomach
Pyloric Stenosis X
Gastric Outlet Obstruction X
Boerhaave’s syndrome X
Normal Acid Secretion
It’s complicated…
The Parietal Cell • Makes the acid • Mainly controled by H 2 (histamine) receptor
The ulcer problem • Mucus and Bicarbonate protect the stomach
• The ECL cell uses paracrine histamine to regulate parietal cell
The G cell – Gastrin! • Gastrin production from the G cell
Almost done here – chill out! • The D-cell somatostatin
Disrupted acid secretion
Gastrinoma • What happens if you make lots of gastrin from a tumor? • Hint it usually is in this triangle. • Gastrinoma
Thickened gastric folds • Gastrinoma • Menetrier’s Disease • Infliltrative diseases • Lymphoma • Signet ring adenocarcinoma • Breast cancer
Autoimmune Gastritis • What would happen if we lost our parietal cells • Increased gastrin?
Self Quiz…
What is similar between a patient with Gastrinoma and a patient with atrophic gastritis? A. B. C. D. E. Acid (p. H) in the gastric antrum Gastrin level Size of gastric folds Anti parietal cell antibody titer Likelihood of duodenal ulcer