The document discusses the structure and functions of the gastrointestinal (GI) tract or digestive system. It describes the main divisions and organs of the GI tract including the mouth, esophagus, stomach, and intestines. It explains the key processes of digestion such as ingestion, mechanical and chemical breakdown of food, absorption of nutrients, and excretion of waste. It provides details on the anatomy and roles of specific organs like the salivary glands, teeth, esophagus, and stomach in the digestion process.

1. Gastrointestinal PhysiologyGastrointestinal Physiology
(Digestive System)(Digestive System)
Dr. G. AHMADDr. G. AHMAD
Assistant Professor PhysiologyAssistant Professor Physiology

2. Functions of the Digestive SystemFunctions of the Digestive System
 Ingest foodIngest food
 Break down food into nutrient moleculesBreak down food into nutrient molecules
 Absorb molecules into the bloodstreamAbsorb molecules into the bloodstream
 Rid the body of indigestible remainsRid the body of indigestible remains

4. Main Divisions of the DigestiveMain Divisions of the Digestive
SystemSystem
 Alimentary CanalAlimentary Canal
 Continuous, muscular digestive tube windingContinuous, muscular digestive tube winding
throughout the bodythroughout the body
 Digests and absorbs food particlesDigests and absorbs food particles
 Contains the following organs:Contains the following organs:
 Mouth, Pharynx, Esophagus, Stomach, Small and LargeMouth, Pharynx, Esophagus, Stomach, Small and Large
IntestinesIntestines
 Accessory Digestive OrgansAccessory Digestive Organs
 Contains the following organs:Contains the following organs:
 Teeth, Tongue, Gallbladder, Salivary Glands, Liver, andTeeth, Tongue, Gallbladder, Salivary Glands, Liver, and
PancreasPancreas

5. Digestive System DivisionsDigestive System Divisions

6. Digestive ProcessesDigestive Processes
 IngestionIngestion
 Mechanical digestionMechanical digestion
 PropulsionPropulsion
 Chemical digestionChemical digestion
 AbsorptionAbsorption
 DefecationDefecation

7. Actions of Digestive (GI) TractActions of Digestive (GI) Tract
 IngestionIngestion
 Occurs when materialOccurs when material
enters via the mouthenters via the mouth
 Mechanical ProcessingMechanical Processing
 Crushing / Shearing –Crushing / Shearing –
makes material easier tomakes material easier to
move through the tractmove through the tract
 DigestionDigestion
 Chemical breakdown ofChemical breakdown of
food into small organicfood into small organic
compounds forcompounds for
absorptionabsorption
 SecretionSecretion
 Release of water acids,Release of water acids,
buffers, enzymes & saltsbuffers, enzymes & salts
by epithelium of GI tractby epithelium of GI tract
and glandular organsand glandular organs
 AbsorptionAbsorption
 Movement of organicMovement of organic
substrates, electrolytes,substrates, electrolytes,
vitamins & water acrossvitamins & water across
digestive epitheliumdigestive epithelium
 ExcretionExcretion
 Removal of wasteRemoval of waste
products from bodyproducts from body
fluidsfluids

8. Features and Functions of theFeatures and Functions of the
MouthMouth
 Buccal/oral cavityBuccal/oral cavity
 Contains stratified squamous epitheliumContains stratified squamous epithelium
 Vestibule:Vestibule: area bounded by lips andarea bounded by lips and
cheeks externally and teeth and gumscheeks externally and teeth and gums
internallyinternally
 Lips:Lips: posses no sweat or oil glandsposses no sweat or oil glands
 Palate:Palate: forms roof of the mouth, soft andforms roof of the mouth, soft and
hard palate, uvulahard palate, uvula

9. Features and Functions of theFeatures and Functions of the
TongueTongue
 Helps grind food into aHelps grind food into a bolusbolus whichwhich
contains partially digested food and salivacontains partially digested food and saliva
 Helps form words and is a sensory organHelps form words and is a sensory organ
for tastefor taste
 Three surface features:Three surface features:
 Filiform papillae (roughness and grip)Filiform papillae (roughness and grip)
 Fungiform papillae (contains taste buds)Fungiform papillae (contains taste buds)
 Foliate papilae (contains taste buds)Foliate papilae (contains taste buds)
 Circumvallate papillae (contains taste buds)Circumvallate papillae (contains taste buds)

10. Papillae of the TonguePapillae of the Tongue

11. Features and Functions of theFeatures and Functions of the
Salivary GlandsSalivary Glands
 Main functions:Main functions:
 Produces and secretes salivaProduces and secretes saliva
 Cleanses the mouthCleanses the mouth
 Dissolves food chemicals so they can beDissolves food chemicals so they can be
tastedtasted
 Moistens food, compacting it into a bolusMoistens food, compacting it into a bolus
 Begins the chemical breakdown of foodBegins the chemical breakdown of food
 Salivary amylase: starchSalivary amylase: starch

12. Types of Salivary GlandsTypes of Salivary Glands
 Submandibular GlandsSubmandibular Glands
 Found underneath the mandibleFound underneath the mandible
 Sublingual GlandsSublingual Glands
 Found underneath the tongueFound underneath the tongue
 Parotid GlandsParotid Glands
 Found anterior to the ear between masseter and skinFound anterior to the ear between masseter and skin
 Saliva travels to oral orifice via ducts from allSaliva travels to oral orifice via ducts from all
three glandsthree glands

13. Anatomy of the Salivary GlandsAnatomy of the Salivary Glands

14.  Composition of Saliva: 97-99.5% waterComposition of Saliva: 97-99.5% water
 0.5 % electrolytes0.5 % electrolytes
 Sodium, potassium, chloride, phosphate,Sodium, potassium, chloride, phosphate,
and bicarbonateand bicarbonate
 Most important proteins are salivaryMost important proteins are salivary
amylase, mucus and lysozymesamylase, mucus and lysozymes

15. Features and Functions of theFeatures and Functions of the
TeethTeeth
 Break food into smaller parts, increasingBreak food into smaller parts, increasing
surface area for digestionsurface area for digestion
 Types of TeethTypes of Teeth
 Deciduous Teeth (“baby” teeth)Deciduous Teeth (“baby” teeth)
 Permanent TeethPermanent Teeth
 Incisors- cutting and shreddingIncisors- cutting and shredding
 Canines- piercing and tearingCanines- piercing and tearing
 Molars- grindingMolars- grinding
 Premolars- grinding and crushingPremolars- grinding and crushing

17. Tooth StructureTooth Structure
 CrownCrown: exposed: exposed
portion of toothportion of tooth
covered by enamelcovered by enamel
which covers dentinwhich covers dentin
 RootRoot: internal portion: internal portion
that is beneath thethat is beneath the
gums (gingiva) and isgums (gingiva) and is
anchored byanchored by
periodontal ligamentsperiodontal ligaments

18. PharynxPharynx
 Responsible for swallowingResponsible for swallowing
 Swallowing is divided into oropharyngeal stage andSwallowing is divided into oropharyngeal stage and
esophageal stageesophageal stage

19. Features and Functions of theFeatures and Functions of the
EsophagusEsophagus
 Muscular tube that propels food to stomach;Muscular tube that propels food to stomach;
bolus enters stomach throughbolus enters stomach through esophageal hiatusesophageal hiatus
 Esophageal glands – produce mucus to lubricateEsophageal glands – produce mucus to lubricate
bolusbolus
 Esophageal sphincter – prevents backflow intoEsophageal sphincter – prevents backflow into
oral cavityoral cavity
 Cardiac sphincter- prevents backflow intoCardiac sphincter- prevents backflow into
esophagusesophagus

20. Features and Functions of theFeatures and Functions of the
EsophagusEsophagus
 A hollow muscular tubeA hollow muscular tube
 About 25 cm (10 in.) long and 2About 25 cm (10 in.) long and 2
cm (0.80 in.) widecm (0.80 in.) wide
 Conveys solid food and liquidsConveys solid food and liquids
to the stomachto the stomach
 Begins posterior to cricoidBegins posterior to cricoid
cartilagecartilage
 Esophageal glands – produceEsophageal glands – produce
mucus to lubricate bolusmucus to lubricate bolus
 Esophageal sphincter –Esophageal sphincter –
prevents backflow into oralprevents backflow into oral
cavitycavity

21. Anatomy of the EsophagusAnatomy of the Esophagus

22. Digestive Processes in the Mouth,Digestive Processes in the Mouth,
Pharynx, and EsophagusPharynx, and Esophagus
 Mouth processes:Mouth processes:
 IngestionIngestion
 Mechanical digestion (e.g. salivary amylase)Mechanical digestion (e.g. salivary amylase)
 Initiation of PropulsionInitiation of Propulsion
 Mastication: chewingMastication: chewing
 Pharyngeal processes:Pharyngeal processes:
 Deglutition = swallowingDeglutition = swallowing
 Esophageal processes:Esophageal processes:
 Peristalsis (rhythmic contractions, involuntary)Peristalsis (rhythmic contractions, involuntary)

23. PeristalsisPeristalsis

24. Features and Functions of theFeatures and Functions of the
StomachStomach
 Temporary storage area for food and allows it toTemporary storage area for food and allows it to
mix with gastric juice to producemix with gastric juice to produce chymechyme
 Regions: cardiac, fundus, body, and pyloricRegions: cardiac, fundus, body, and pyloric

25. Stomach FunctionStomach Function
 Major Functions of the StomachMajor Functions of the Stomach
 Storage of ingested foodStorage of ingested food
 Mechanical breakdown of ingested foodMechanical breakdown of ingested food
 Disruption of chemical bonds in food material by acidDisruption of chemical bonds in food material by acid
and enzymesand enzymes
 Production ofProduction of intrinsic factorintrinsic factor , a glycoprotein, a glycoprotein
required for absorption of vitamin Brequired for absorption of vitamin B1212 in small intestinein small intestine

26. Anatomy of the StomachAnatomy of the Stomach

27. Gastric Juices (hormones)Gastric Juices (hormones)
 Simple columnar epithelium – containsSimple columnar epithelium – contains gastricgastric
pitspits that secretethat secrete gastric juicesgastric juices
 Goblet cellsGoblet cells – secrete mucus that coats– secrete mucus that coats
stomach and prevents it from being digestedstomach and prevents it from being digested
itselfitself
 Parietal cellsParietal cells – secrete– secrete hydrochloric acidhydrochloric acid
(converts pepsinogen into pepsin) and(converts pepsinogen into pepsin) and intrinsicintrinsic
factorfactor (necessary for absorption of vitamin B(necessary for absorption of vitamin B12)12)
 Chief cellsChief cells – secrete pepsinogen which is– secrete pepsinogen which is
converted to pepsin to aid in protein digestionconverted to pepsin to aid in protein digestion
 Enteroendocrine cellsEnteroendocrine cells – release hormones– release hormones
such as:such as:
 Histamine, Serotonin, Gastrin, Endorphins, andHistamine, Serotonin, Gastrin, Endorphins, and
SomatostatinSomatostatin

28.  HistamineHistamine
- activates parietal cells to release HCl- activates parietal cells to release HCl
 SerotoninSerotonin
- contraction of stomach muscle- contraction of stomach muscle
 GastrinGastrin
- gastric glands to increase secretion- gastric glands to increase secretion
 EndorphinsEndorphins
- natural opiates- natural opiates
 SomatostatinSomatostatin
- inhibits gastric secretion- inhibits gastric secretion
- inhibits gastric emptying- inhibits gastric emptying

29. Digestive Processes in theDigestive Processes in the
StomachStomach Three PhasesThree Phases
 Cephalic PhaseCephalic Phase
 Stimulated by the thought, sight, taste, or aroma orStimulated by the thought, sight, taste, or aroma or
foodfood
 Inputs from olfactory receptors and taste budsInputs from olfactory receptors and taste buds
travel to parasympathetic enteric ganglia whichtravel to parasympathetic enteric ganglia which
then stimulate stomach glandsthen stimulate stomach glands
 Gastric PhaseGastric Phase
 Stomach distension activates stretch receptorsStomach distension activates stretch receptors
 Food chemicals (e.g. peptides, rising pH) activateFood chemicals (e.g. peptides, rising pH) activate
chemoreceptors which activate G cells whichchemoreceptors which activate G cells which
secrete gastrinsecrete gastrin
 Intestinal PhaseIntestinal Phase
 Presence of low pH and partially digested foods inPresence of low pH and partially digested foods in
duodenum stimulates intestinal gastrin secretionduodenum stimulates intestinal gastrin secretion

30. Digestive Processes in theDigestive Processes in the
StomachStomach

31. Gastric Motility and EmptyingGastric Motility and Emptying
 Peristaltic waves approach stomach and becomePeristaltic waves approach stomach and become
stronger near pyloric regionstronger near pyloric region
 Pyloric sphincter allows ~ 3 mL of chyme to pass toPyloric sphincter allows ~ 3 mL of chyme to pass to
duodenum and the rest to return to stomach for furtherduodenum and the rest to return to stomach for further
mixingmixing

32. Small IntestineSmall Intestine
 90% of absorption occurs in the small intestine90% of absorption occurs in the small intestine

33. Small IntestineSmall Intestine
 The DuodenumThe Duodenum
 The segment of small intestine closest to stomachThe segment of small intestine closest to stomach
 25 cm (10 in.) long25 cm (10 in.) long
 ““Mixing bowl” that receivesMixing bowl” that receives chymechyme from stomach andfrom stomach and
digestive secretions from pancreas and liverdigestive secretions from pancreas and liver
 Functions of the duodenumFunctions of the duodenum
 To receive chyme from stomachTo receive chyme from stomach
 To neutralize acids before they can damage the absorptiveTo neutralize acids before they can damage the absorptive
surfaces of the small intestinesurfaces of the small intestine

34. Small IntestineSmall Intestine
 The JejunumThe Jejunum
 Is the middle segment of small intestineIs the middle segment of small intestine
 2.5 meters (8.2 ft) long2.5 meters (8.2 ft) long
 Is the location of mostIs the location of most
 Chemical digestionChemical digestion
 Nutrient absorptionNutrient absorption
 Small villiSmall villi

35. Small IntestineSmall Intestine
 The IleumThe Ileum
 The final segment of small intestineThe final segment of small intestine
 3.5 meters (11.48 ft) long3.5 meters (11.48 ft) long
 Ends at theEnds at the ileocecal valveileocecal valve, a sphincter that, a sphincter that
controls flow of material from the ileum intocontrols flow of material from the ileum into
the large intestinethe large intestine

36. Small IntestineSmall Intestine
 Intestinal SecretionsIntestinal Secretions
 Watery intestinal juiceWatery intestinal juice
 1.8 liters per day enter1.8 liters per day enter
intestinal lumenintestinal lumen
 Moisten chymeMoisten chyme
 Assist in buffering acidsAssist in buffering acids
 Keep digestive enzymesKeep digestive enzymes
and products of digestionand products of digestion
in solutionin solution
 Intestinal MovementsIntestinal Movements
 Chyme arrives inChyme arrives in
duodenumduodenum
 Weak peristalticWeak peristaltic
contractions move it slowlycontractions move it slowly
toward jejunumtoward jejunum

37. Microscopic Anatomy of SmallMicroscopic Anatomy of Small
IntestineIntestine
 VilliVilli: fingerlike projections that increase the: fingerlike projections that increase the
surface area of the SIsurface area of the SI
 MicrovilliMicrovilli: tiny projections on the plasma: tiny projections on the plasma
membranes of columnar cells that appear fuzzymembranes of columnar cells that appear fuzzy
(i.e. brush border cells)(i.e. brush border cells)
 Crypts of LieberkuhnCrypts of Lieberkuhn : secrete intestinal juice: secrete intestinal juice
and special lysozymes that protect againstand special lysozymes that protect against
bacteriabacteria
 Peyer’s PatchesPeyer’s Patches: aggregated lymphoid: aggregated lymphoid
tissues containing lymphocytestissues containing lymphocytes

38. Microscopic Anatomy of the SmallMicroscopic Anatomy of the Small
IntestineIntestine

39. Secretions of the Small IntestineSecretions of the Small Intestine
 SecretinSecretin: released by enteroendocrine cells when: released by enteroendocrine cells when
acidic chyme enters SI; causes release of bicarbonate-acidic chyme enters SI; causes release of bicarbonate-
rich pancreatic juicesrich pancreatic juices
 SomatostatinSomatostatin: slows gastric motility and emptying and: slows gastric motility and emptying and
inhibits production of gastric secretionsinhibits production of gastric secretions
 Cholecystokinin (CCK)Cholecystokinin (CCK) : released when fatty, protein-: released when fatty, protein-
rich chyme enters SI; causes release of enzyme-richrich chyme enters SI; causes release of enzyme-rich
pancreatic juices and bilepancreatic juices and bile
 Brush border enzymesBrush border enzymes: process long peptides,: process long peptides,
nucleic acids, and sugars into smaller onesnucleic acids, and sugars into smaller ones

40. After Digestion: AbsorptionAfter Digestion: Absorption
Protein Fats

41. Functions of the LiverFunctions of the Liver
 Largest internal organLargest internal organ
 Functions:Functions:
 Filters and processes nutrient-rich blood ofFilters and processes nutrient-rich blood of
carbohydrates, proteins, and lipids fromcarbohydrates, proteins, and lipids from
intestineintestine
 Production and regulation of cholesterolProduction and regulation of cholesterol
 Production ofProduction of bilebile which emulsifies fatswhich emulsifies fats
 Removes drugs and hormones fromRemoves drugs and hormones from
circulationcirculation
 Storage of vitamins and mineralsStorage of vitamins and minerals

42. Anatomy of the LiverAnatomy of the Liver
 Right and Left LobesRight and Left Lobes : separated by: separated by falciformfalciform
ligamentligament
 Caudate and Quadrate LobesCaudate and Quadrate Lobes : found on: found on
posterior sideposterior side
 Blood vessels:Blood vessels:
 Hepatic artery/vein and hepatic portal veinHepatic artery/vein and hepatic portal vein
 GallbladderGallbladder: found underneath left lobe, stores: found underneath left lobe, stores
bilebile

43. Gross Anatomy of the LiverGross Anatomy of the Liver

44. Microscopic Anatomy of the LiverMicroscopic Anatomy of the Liver
 Liver LobulesLiver Lobules : structural unit of liver: structural unit of liver
 HepatocytesHepatocytes: liver cells contained within the lobules: liver cells contained within the lobules
 Hepatic portal vein & Hepatic ArteryHepatic portal vein & Hepatic Artery : the: the
circulation of the liver, they bring blood into the livercirculation of the liver, they bring blood into the liver
where it is filtered through thewhere it is filtered through the liver sinusoidalliver sinusoidal
capillariescapillaries
 Kupffer cellsKupffer cells: remove debris: remove debris
 Filtered blood drains into the central vein, then to theFiltered blood drains into the central vein, then to the
hepatic vein, and eventually to the inferior vena cavahepatic vein, and eventually to the inferior vena cava
 BileBile (produced by hepatocytes) drains into the(produced by hepatocytes) drains into the bilebile
ductduct after passing throughafter passing through portal triadportal triad
 Bile then shipped to gallbladder for storageBile then shipped to gallbladder for storage

45. Microscopic Anatomy of the LiverMicroscopic Anatomy of the Liver

46. Function and Regulation of BileFunction and Regulation of Bile
 Bile ducts are present at every portal triadBile ducts are present at every portal triad
 Bile flows downBile flows down bile canaliculibile canaliculi (tiny canals)(tiny canals)
between adjacent hepatocytes towards bile ductbetween adjacent hepatocytes towards bile duct
branches at every portal triadbranches at every portal triad
 Bile enters the bile ducts which drain into theBile enters the bile ducts which drain into the
common hepatic ductcommon hepatic duct
 BileBile emulsifiesemulsifies fats, separating them into smallerfats, separating them into smaller
partsparts
 BilirubinBilirubin: the chief bile pigment, a waste product: the chief bile pigment, a waste product
of the heme of hemoglobin formed during theof the heme of hemoglobin formed during the
breakdown of worn-out erythrocytesbreakdown of worn-out erythrocytes

47. Regulation of Bile ProductionRegulation of Bile Production
 Bile exitsBile exits cystic ductcystic duct uponupon
stimulationstimulation
 CCK released whenCCK released when
acidic, fatty chyme entersacidic, fatty chyme enters
intestinesintestines
 Causes:Causes:
 Gallbladder ContractionGallbladder Contraction
 Pancreatic Juice SecretionPancreatic Juice Secretion
 Relaxation ofRelaxation of
hepatopancreatic sphincterhepatopancreatic sphincter

48. Features and Functions of theFeatures and Functions of the
PancreasPancreas
 Pancreatic Juice secreted byPancreatic Juice secreted by acinaracinar cellscells
 Islets of LangerhansIslets of Langerhans releaserelease insulininsulin andand
glucagonglucagon (important in glucose metabolism)(important in glucose metabolism)
 Pancreatic Juice contains:Pancreatic Juice contains:
 Sodium Bicarbonate (buffers HCl in stomach)Sodium Bicarbonate (buffers HCl in stomach)
 Proteases (break down polypeptides)Proteases (break down polypeptides)
 Pancreatic amylase (digests oligosaccarides andPancreatic amylase (digests oligosaccarides and
disaccharides into monosaccharides)disaccharides into monosaccharides)
 Pancreatic lipases (break down lipids into fatty acidsPancreatic lipases (break down lipids into fatty acids
and glycerol)and glycerol)
 Pancreatic nucleases (break down nucleic acids)Pancreatic nucleases (break down nucleic acids)

49. Anatomy of the PancreasAnatomy of the Pancreas

50. Features and Functions of theFeatures and Functions of the
Large IntestineLarge Intestine
 Functions:Functions:
 Reabsorption of remaining water andReabsorption of remaining water and
electrolyteselectrolytes
 Production and absorption of Vitamins B andProduction and absorption of Vitamins B and
KK
 Elimination of fecesElimination of feces
 Diameter is only 7 cm but is larger thanDiameter is only 7 cm but is larger than
that of the small intestinethat of the small intestine

51. Gross Anatomy of the LargeGross Anatomy of the Large
IntestineIntestine
 Teniae ColiTeniae Coli: bands of smooth muscle that create: bands of smooth muscle that create
pocket-like sacs (pocket-like sacs (haustra)haustra)
 CecumCecum: sac-like connection between the small and: sac-like connection between the small and
large intestineslarge intestines
 AppendixAppendix: small structure containing lymphoid tissue;: small structure containing lymphoid tissue;
small immune functionsmall immune function
 Ascending, Descending, Transverse, andAscending, Descending, Transverse, and
Sigmoid ColonSigmoid Colon
 Splenic and hepatic flexureSplenic and hepatic flexure
 RectumRectum: storage area: storage area
 AnusAnus: regulates defecation with two sphincter muscles;: regulates defecation with two sphincter muscles;
internal and externalinternal and external

52. Anatomy of the ColonAnatomy of the Colon

53. Microscopic Anatomy of the LargeMicroscopic Anatomy of the Large
IntestineIntestine
 Simple columnar epithelium for absorptionSimple columnar epithelium for absorption
except in the anal canal where there is stratifiedexcept in the anal canal where there is stratified
squamoussquamous
 No villi, no digestive-secreting cellsNo villi, no digestive-secreting cells
 Goblet cells produce mucus for lubrication ofGoblet cells produce mucus for lubrication of
fecesfeces
 Bacterial flora synthesize vitamin B and most ofBacterial flora synthesize vitamin B and most of
the vitamin K needed for blood clottingthe vitamin K needed for blood clotting

54. The Process of AbsorptionThe Process of Absorption

55. Clinical CornerClinical Corner
 GastritisGastritis- Inflammation of gastric mucosa- Inflammation of gastric mucosa
 Caused by chronic bacterial infectionCaused by chronic bacterial infection
 Ingestion of irritating substances e.g. alcohol/asprineIngestion of irritating substances e.g. alcohol/asprine
 AchlorhydriaAchlorhydria :absence of HCL secretion:absence of HCL secretion
 HypochlorhydriaHypochlorhydria: diminished acid secretions: diminished acid secretions
 Pernicious AnemiaPernicious Anemia : occurs when intrinsic: occurs when intrinsic
factor is not secreted. Absorption of Vit B12 doesfactor is not secreted. Absorption of Vit B12 does
not occur leading to Pernicious anemia (largenot occur leading to Pernicious anemia (large
immature red blood ells)immature red blood ells)

56. Clinical CornerClinical Corner
 Peptic Ulcer:Peptic Ulcer: The damaged are of stomach orThe damaged are of stomach or
upper part of small intestine mucosa caused by theupper part of small intestine mucosa caused by the
digestive action of gastric or small intestinaldigestive action of gastric or small intestinal
secretions.secretions.
 Causes:Causes:
 i) imbalance between gastric and intestinali) imbalance between gastric and intestinal
secretion and the protective coating of mucosasecretion and the protective coating of mucosa
 ii)Helicobacter bacterial infectionii)Helicobacter bacterial infection
 iii) smoking, alcohol and aspirineiii) smoking, alcohol and aspirine

57. Clinical CornerClinical Corner
 SprueSprue: Decreased or malabsorption of nutrients: Decreased or malabsorption of nutrients
 CirrohsisCirrohsis - scarred liver due to chronic- scarred liver due to chronic
inflammationinflammation
 Hepatitis - A,B,C,D, and EHepatitis - A,B,C,D, and E
 Biliary calculiBiliary calculi - gall stones - crystals of- gall stones - crystals of
cholesterol in bilecholesterol in bile
 BorborygmusBorborygmus - rumbling noise caused by gas- rumbling noise caused by gas
through intestinesthrough intestines

58.  Cholecystitis - inflammation of gall bladderCholecystitis - inflammation of gall bladder
 Colitis - inflammation of colonColitis - inflammation of colon
 Dysphagia - difficulty in swallowingDysphagia - difficulty in swallowing
 Enteritis - inflammation of the intestinesEnteritis - inflammation of the intestines
 ConstipationConstipation
 DiarrheaDiarrhea
Clinical corner