Lusaka Apex Medical University

Faculty of Medicine and Surgery

DEPARTMENT OF PHYSIOLOGICAL SCIENCES

NAME : LAWRENCE MULENGA

COMPUTER No. : 1702001945

COURSE : PGY 110

LECTURER : MR.D.R Siwale

DUE DATE : 08/06/2020

ASSIGNMENT : NO.03

TITLE : PHYSIOLOGY AND DISEASES OF THE GIT

SCENARIO (1)

(1). zollinger-ellison syndrome is a rare condition in which one or more

tumors form in your pancreas or the upper part of your small intestine
( duodenum). these tumors are called gastrinomas, they secrcte large
amount of the hormone gastrin which causes your stomach to produce
too much acid.

(2). g cells

(3). the symptoms of zollinger-ellison syndrome (zes) are secondary to

hypergastrinemia which causes hypertrophy of the gastric mucosa
leading to increased number of parietal cells and increased maximal
acid output .gastrin by itself also stimulates acid secretion resulting in
increased basal acid secretion

(4). first , mucous neck glands secrete mucus which forms a gel-like
protective barrier between the cells and the gastric lumen. second
gastric epithelial cells secrete hco-3 which is trapped in the mucus.
should any h+ penetrate the mucus , it is neutralized by hco-3 before it
reaches the epithelial cells should any pepsin penetrate the mucus it is
inactivated in the relatively alkaline environment.

(5) diarrhea in zollinger–ellison syndrome is caused by steatorrhea as a result of gastric

acid's inactivation of pancreatic digestive enzymes. a secretory diarrhea also results from gastri
acid's inhibition of sodium and water reabsorption in the small intestine.

(6) (1) selectively inhibit the membrane enzyme h+/k+ atpase in gastric parietal cells (e.g
lansoprazole) (2) inhibit the final step in gastrin acid production and basal acid secretion
by covalently binding to the the H+/K+ PUMP (E.g pantoprazole)
SCENARIO (2)

(1) Cholera toxin secreted by V. cholerae binds to epithelial cells in the gut, induces a life

threatening watery diarrhea, and enhances IgA secretion in the gut

(2) a condition in which faeces are discharged from the bowels frequently and in a liquid
form.

(3) In osmotic diarrhea (e.g lactose-deficient persons; sorbitol chewing gum; magnesium
in milk of magnesia), poorly absorbed solutes follow the flow of water into the lumen of
the gastrointestinal tract. In Secretory diarrhea (e.g vibrio cholera, enterotoxigenic
E.coli, VIPoma, stimulant laxatives), volumes of fluid are secreted by the intestine,
overwhelming the absorptive of the gastrointestinal tract. In inflammatory
diarrhea( e.g dysentery, colitis), damage to the intestininal mucosa interferes with
absorption creating osmotic effect from the non-absorbed solutes , also various chemical
released in response to in flammation stimulate intestinal secretion. In rapid (motor)
diarrhea (e.g pathologic hypermotility, intestinal bypass), fluid through the intestine too
quickly for normal absorption to occur.

(4) The mechanisms of toxin-induced diarrhea include: (a) direct effects on ion transport in

intestinal epithelial cells, i.e. direct toxin interaction with intrinsic ion channels
in themembrane and (b) indirect interaction with ion transport in intestinal epithelial
cells mediated by toxin binding to a membrane receptor  

(5) (A) The primary complication of diarrhea is dehydration caused by the loss of large
amounts of water, salt and nutrients., dehydration can lead to other serious conditions
such as low blood pressure, seizures, kidney failure or even death (B)

(6)
 Scenario 3

(1).a sugar present in milk. It is a disaccharide containing glucose and galactose units

structure of lactose

(2). The most common cause of osmotic diarrhea is due to malabsorption of lactose derived
from dairy products, known as lactose intolerance. As described in Carbohydrate Digestion and
Absorption lactose must be cleaved into its component monosaccharides by lactase before their
absorption. You become lactose intolerant  when your small intestine stops making enough of
the enzyme lactase to digest and break down the lactose The bacteria that are normally present
in your large intestine interact with the undigested lactose and cause symptoms such as
bloating , gas, and diarrhea.

(3) . Stomach pain and bloating are common with lactose intolerance. They are caused when
bacteria in the colon ferment lactose that the body has left undigested, resulting in excess gas
and water. Pain is most often situated around the navel and lower tummy
Scenario (4)

(1) Gastrointestinal irritation. A stomach bug or other intestinal infection can make some
nerves more irritated and others less likely to work.

(2) Neurological (brain) disorders. Damage to the nervous system can affect the
transmission of messages from the brain to the muscles of the anal sphincter and vice
versa. Examples include when a person has had a stroke, or has multiple sclerosis or
Parkinson s disease

(3) Pelvic floor disorders. These conditions occur when the pelvic floor muscles that are
responsible for pooping, peeing, and sexual functions don’t work as well as they should.
Some of the conditions include rectal prolapse or rectocele.

(4) Spinal cord injuries. When a person has had a spinal cord injury that causes them to be a
paraplegic or quadriplegic, the nerve signals don’t always transmit normally. As a general
rule, those with quadriplegia tend to have significantly more difficulty with the
defecation reflex

(5) Dyssynergic defecation is a condition that affects the pelvic floor muscles. These are
muscles located in the lower abdomen that allow bowel movements to pass normally.
The pelvic floor muscles do this by supporting organs such as the rectum, uterus and
bladder.
REFERENCES

(1)  Andrei I. Ivanov, editor. Gastrointestinal Physiology and Diseases Methods and

Protocols. 4th Edition 2016. New York, NY; Philadelphia, PA: Springer 

(2)  Norton Greenberger, Richard Blumberg CURRENT Diagnosis & Treatment

Gastroenterology, Hepatology, & Endoscopy,(2009) Third Edition (Lange
Current): 9780071837729: Medicine & Health Science

(3) Gerard E Mullin; Laura E Matarese; Melissa Palmer, Dr. Categoriex:Nutrition.

Gastrointestinal and liver disease nutrition Originally published: September 12,
2011 5th Edition. By Irene Watson, BLOGCRITICS.