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Gastrointestinal Diseases

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  • 1. "Each time you are honest and conduct yourself with honesty, a success force will drive you toward greater success. Each time you lie, even with a little white lie, there are strong forces pushing you toward failure." Joseph Sugarman Author and Marketing SpecialistDr.Shashikant.S.K www.yogamaarg.com 1 01/24/13
  • 2. GERDGastroesophageal reflux is a normal physiologic phenomenon in most people, particularly after a meal.Gastroesophageal reflux disease (GERD) occurs when the amount of gastric juice that refluxes into the esophagus exceeds the normal limitDr.Shashikant.S.K2 www.yogamaarg.com 01/24/13
  • 3. Causes of GERDDr.Shashikant.S.K3 www.yogamaarg.com 01/24/13
  • 4. GERD: Symptoms Typical symptoms:  Heartburn (Pyrosis):  Most common  Felt as a retrosternal sensation of burning or discomfort  Occurs usually after eating or when lying down or bending over.  Often relieved with milk or water  Regurgitation:  Effortless return of gastric and/or esophageal contents into the pharynx.  It can induce respiratory complications if gastric contents spill into the tracheobronchial tree. Atypical symptoms  Cough, dyspnea, hoarseness, and chestpainDr.Shashikant.S.K4 www.yogamaarg.com 01/24/13
  • 5. Diagnosis Role out other potential causes for the heartburn:  Cardiac  Peptic ulcer  Esophagitis Esophageal Endoscopy:  The gold standard as a definitive diagnosis Barium swallow  Not as definitive in mild casesDr.Shashikant.S.K5 www.yogamaarg.com 01/24/13
  • 6. Collaborative CareLifestyle modificationsNutritional therapy  Decrease high-fat foods, avoid milk products at night, and avoid late snacking or mealsDrug TherapySurgical therapyEndoscopic therapyDr.Shashikant.S.K6 www.yogamaarg.com 01/24/13
  • 7. Ulcer 7 Ulcers are defined as a breach in the mucosa of the alimentary tract, which extends through the muscularis mucosa into the submucosa or deeper.Dr.Shashikant.S.K www.yogamaarg.com 01/24/13
  • 8. APD (Acid Peptic Diseases) 8 PEPTIC ULCER AN ULCER OF THE ALIMENTARY TRACT MUCOSA, USUALLY IN THE STOMACH OR DUODENUM, & RARELY IN THE LOWER ESOPHAGUS, WHERE THE MUCOSA IS EXPOSED TO THE ACID GASTRIC SECRETIONDr.Shashikant.S.K www.yogamaarg.com 01/24/13
  • 9. CAUSES OF A.P.D 9 1. STRONG FAMILY HISTORY BLOOD GP ‘O’ ARE PRONE TO APD 11. TRIGGERING FACTORS  STRESS - TENSION “NOT ABLE TO LET GO THE STEAM”  ALCOHOL, CHILLI,  STEROIDS, PAIN KILLERSDr.Shashikant.S.K www.yogamaarg.com 01/24/13
  • 10. Pathogenesis of Ulcers Therapy is directed at enhancing host defense or 5eliminating aggressive factors; i.e., H. pylori. Aggressive Factors Defensive Factors  Acid, pepsin  Mucus, bicarbonate layer  Bile salts  Blood flow, cell renewal  Drugs (NSAIDs)  Prostaglandins  H. pylori  Phospholipid  Free radical scavengersDr.Shashikant.S.K www.yogamaarg.com 10 01/24/13
  • 11. 11 Etiology of PUD Normal Increased Attack Hyperacidity Weak defense Helicobacter pylori* Stress, drugs, smokingDr.Shashikant.S.K www.yogamaarg.com 01/24/13
  • 12. 12 The Defensive Forces The Aggressive Forces Bicarbonate Helicobacter pylori When the layer Mucus aggressive factors increase or the HCl acid defensive blood flowdecrease, mucosal damage Mucosal factors Pepsins NSAIDs will result, leading to erosions & ulcerations Prostaglandins Bile acids Growth factors Ischemia and hypoxia. Smoking and alcoholDr.Shashikant.S.K www.yogamaarg.com 01/24/13
  • 13. STRESS EMOTIONAL CORTEX HYPOTHALAMUSPARA SYMPATHETIC SYMPATHETICGASTRIN ACID BL. FLOW POOR MUCUSACID SLOW REPAIR
  • 14. 14Dr.Shashikant.S.K www.yogamaarg.com 01/24/13
  • 15. Gastric Gland 15Dr.Shashikant.S.K www.yogamaarg.com 01/24/13
  • 16. Three types of peptic ulcerGastricDuodenalStress 01/24/13 Dr.Shashikant.S.K www.yogamaarg.com 16
  • 17. Gastric peptic ulcer: 17Dr.Shashikant.S.K www.yogamaarg.com 01/24/13
  • 18. Medical Management of ulcers Conservative therapy:  Pharmaceutical:  Rest: Both physical and  Antibiotics emotional  To eradicate H. Pylori infections  Recurrence of ulcer is 75-90% as high  Dietary modifications with infection  Elimination of smoking  Antiacids  Long term follow up  Initial drugs of choice care  Histmaine H2 receptor antagonists  Histamine is the final intracellular activator of HCL secretion  Anticholinergic:  Stop the cholinergic stimulation of HCl secretion and slow gastric motility  Not commonly used, if used need to be used with caution in pts with GlaucomaDr.Shashikant.S.K18 www.yogamaarg.com 01/24/13
  • 19. YOGIC MANAGEMENT 19SATVIK FOODMODERATION IN EATINGSPECIAL TECHNIQUE FOR GIDCOME OUT OF STRONG LIKES AND DISLIKESCOME OUT OF EXCESSIVE DESIRESHAPPINESS ANALYSIS EG. GULAB JAMOONDr.Shashikant.S.K www.yogamaarg.com 01/24/13
  • 20. YOGIC MANAGEMENT 20FOOD COOKED AND SERVED IN GOOD ATMOSPHERESUBMISSION OF PRAYERSGOOD POSTURESGOOD YOGIC ACTIVITIESDr.Shashikant.S.K www.yogamaarg.com 01/24/13
  • 21. Irritable bowel syndrome (IBS)Irritable bowel syndrome (IBS) is an intestinal disorder that causes abdominal pain or discomfort, cramping or bloating, and diarrhea or constipation. Irritable bowel syndrome is a long-term but manageable condition.Sometimes called:  “irritable colon”  “spastic colon”
  • 22. IRRITABLE BOWEL SYNDROMEPERSONALITY: • HYPER - REACTIVE • CLEAN • NERVOUS • INTROSPECTIVE • FIXATION ON BOWEL • CONCENTRATION ON THE BOWEL
  • 23. CONTROL OF BOWEL MOTILITY PSYCHE
  • 24. BOWEL MOTILITY IN IBS MUSCLE TONE DISORDER - ERRATIC EMPTYING OF BOWELSHYPER REACTIVITY TO PARA SYMPATHO DRUGS SYMPATHETICPARASYMPATHETIC
  • 25. IBS Characteristics 25There is usually no sign of structural damage to the wall of the intestine (frequently indicated by blood in the stool)Weight loss or nighttime fever are not experiencedA diagnosis of irritable bowel syndrome is made when all organic disease has been ruled out by appropriate medical testsThe Manning Criteria or the Rome II questionnaires are often used for diagnosis
  • 26. Initial Triggers of IBS 26Infection in the digestive tract:  Viruses  Bacteria  Parasites (amoeba; intestinal worms)Pathology in the digestive tract  Inflammatory bowel disease  Coeliac diseaseSurgical procedures in the digestive tract
  • 27. Triggers of IBS (continued) 27Stress:  Stress hormones are released  Neuropeptides may trigger the release of inflammatory chemicalsHormone fluctuations:  Menstrual cycle  Pregnancy  Thyroid
  • 28. Triggers of 28 (continued) IBSChange in types of micro-organisms in the large intestine due to:  Oral antibiotics  Other oral medications  Change in substrate (ie type of food passing into the bowel)Alteration in microbial flora results in:  Different products resulting from the action of micro- organisms on undigested food material:  Gases  Organic acids  Others
  • 29. Mechanisms Responsible for Symptoms 29Key factors in IBS resulting in symptoms include:  Inflammation  Resulting from release of inflammatory mediators  Increased sensitivity to pain  Neuropeptides (tachykinins) generated by the central nervous system interact with neurokinin receptors on the spinal cord  May also result from a response to inflammatory mediators (e.g. histamine)
  • 30. IBS Collaborative CareDiet modificationFiber therapy (20 g/day)AntispasmodicsAntidiarrhealsLaxativesSerotonergic agentsAntidepressants
  • 31. IBS Nonpharmacologic TreatmentsEducation and reassuranceRelaxationStress management techniquesAlternative therapies –Yoga TherapyHypnotherapy
  • 32. IAYT For GID 32 PANCHA PRANA APANA PRANA SAMANA UDANA VYANADr.Shashikant.S.K www.yogamaarg.com 01/24/13
  • 33. Panchakosha viveka 33o Annamaya koshao Pranamaya koshao Manomaya koshao Vijnanamaya koshao Anandmaya KoshaDr.Shashikant.S.K www.yogamaarg.com 01/24/13
  • 34. Thank you Dr.Shashikant.S.K www.yogamaarg.com 34 01/24/13