Diabetes and Gastro-intestinal diseases

The stomach’s core role is to enable digestion of food and the subsequent absorption of broken down nutrients via the intestines. The production of gastric acids is a key component unique to the stomach’s digestive process. Gastric acids break down food bolus while in the stomach enabling digestion. These acids are potent enough to cause GERD, PUD and a number of other gastric disorders. This paper seeks to describe normal gastric acid stimulation as well as production relative to GERD, PUD and other gastric disorders. By focusing on obesity as a patient factor, this paper will address the pathophysiological issues related to these gastric diseases as and make recommendations on the diagnosis and treatment procedures for a patient suffering from Diabetes.

The stomach’s main purpose is to facilitate digestion and the subsequent absorption into the bloodstream through the intestines. Gastric juices are the most important in the breakdown and food and more so proteins within the stomach. The Oxyntic cells otherwise known as the parietal cells secrete the Hydrochloric acid (HCL) other secretions in the stomach include mucus, lipase and what is referred to as an intrinsic factor. These are secreted through the mucus neck cells, the parietal cells and the chief cells. It is the parietal cells, which produce HCL, the most significant enzyme in protein digestion. The chef cells secrete pepsin, the other significant enzyme in protein digestion. Pepsin works at specific PH conditions which the secretion of HCL serves to attain.. It is however important to accommodate the fact that without the secretion of mucus, HCL and pepsin would take less than three hours to dissolve the stomach lining.

The stomach secretes the intrinsic factor is also secreted by the gastric glands and at a rate of 3 times a minute, peristaltic waves aid in the mixing of food with gastric gland secretions pushing older food to the outer parts of the stomach lining close to the antrum. At the antrum, the secretion of gastric juices increases with peristaltic waves increasing significantly. This significantly increases the rate of digestion.

The stomach’s epithelial walls are intrinsically enabled to resist such damaging effects though the uncontrolled production of gastric juices brings about significant adverse effects in human beings. Related diseases include gastro esophageal reflux disease (GERD), peptic ulcer disease (PUD), and gastritis.

GERD presents classic symptoms, which include regurgitation and heartburn. This is represented through inflammatory senses stemming from the stomach rising up through the chest to the neck area. PUD on the other hand is diagnosed through discomfort and pain localized in the central parts of the stomach. Fatty foods, excessive consumption of alcohol, caffeine, peppermint and garlic are considered as probable causes of GERD. Such foods are known to result in conditions caused by the relaxing of the esophageal sphincter producing heartburn as well as regurgitation. PUD on the other hand is easily relieved through eating as this relieves adverse symptoms associated with PUD.

Gastritis results from the irritations to the stomach lining and this can either be chronic or acute. Gastritis results from excessive alcoholic consumption, stress, chronic vomiting, and the use of anti-inflammatory medicine. The Helicobacter Pylari bacteria, bile reflux, pernicious anemia and other viral or bacterial infections. Lack of early medical intervention sometimes leads to the development of cancer. GERD, PUD and Gastritis associated symptoms are closely related to incidences of adverse gastric conditions relative to diabetes.

Nearly 80% of individuals visiting clinics for diabetic care  report major Gastrointestinal (GI) symptoms. The whole GI tract is easily infected by diabetes. This starts from the mouth’s oral cavity to the esophagus and anorectal region. Symptom experienced are known to vary differ broadly.frequent complaints include dysphagia, early satiety, reflux, constipation, abdominal pain, nausea, vomiting, as well as diarrhoea. Most individuals may remain undiagnosed and poorly treated as the GI tract is not commonly associated diabetes and related problems.

Acute and chronic GI conditions result to specific GI complications. Diabetes is basically a systemic disease affects different organ systems in diverse manners. It is important to point out that the GI is not exception. Diabetes is presented through many complications dependent on the duration of the condition as well as the quality of glycemic control. These appear closely associated with more adverse GI problems. Individuals with a record GERD, PUD and Gastritis are to be considered to possess GI abnormalities unless proven otherwise.

Diabetes complications are mostly related to neuron dysfunction which limit the response  of information to the enteric nervous system. It is advised that individuals with diabetes to consider reasonable physical activity, as this seems beneficial towards the alleviation of adverse effects associated with GERD, PUD and Gastritis. On the other hand, strenuous physical activity is known to present dangerous consequences to people with diabetes.

In conclusion, diabetes and GERD, PUD and Gastritis specific symptoms and endoscopic characteristics are indeed related. Dietary behavior, more so relative to precise dietary components, remain contentious. Soft routine bodily activity with dietary modifications such as fiber rich and low fat foods are known to alleviate the symptoms associated with GERD, PUD and Gastritis.

Diabetes

References

Barazandeh, F., Yazdanbod, A., Pourfarzi, F., Sepanlou, S. G., Derakhshan, M. H., & Malekzadeh, R. (2012). Epidemiology of peptic ulcer disease: endoscopic results of a systematic investigation in Iran. Middle East journal of digestive diseases, 4(2), 90.

Neal R. Chamberlain, N. R. (2013). Infections of the esophagus, stomach, and duodenum. Retrieved from http://www.atsu.edu/faculty/chamberlain/Website/lectures/lecture/GI3.htm

Osefo, N., Ito, T., & Jensen, R. T. (2009). Gastric acid hypersecretory states: recent insights and advances. Current gastroenterology reports, 11(6), 433-441.

Tseng, P. H., Lee, Y. C., Chiu, H. M., Chen, C. C., Liao, W. C., Tu, C. H., … & Wu, M. S. (2012). Association of diabetes and HbA1c levels with gastrointestinal manifestations. Diabetes care, 35(5), 1053-1060.

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