By Po Sing Leung
Gastrointestinal (GI) body structure is a primary topic that's imperative not just for undergraduate but in addition for graduate classes. The viewers comprise, yet aren't constrained to, scientific, pharmacy, nursing, human biology, chinese language medication, and technological know-how scholars, in addition to different health-related topic scholars. the final targets of this textbook are to provide uncomplicated options and ideas of GI body structure and, extra importantly, to show an knowing of the way to use this data to irregular GI body structure within the medical context. As such, the fundamental wisdom of GI body structure and its software within the type of scientific case reports will be grasped, that are severe for pro examinations and bedside, in addition to for normal perform sooner or later. during this guide, we goal to accomplish those parts via masking the breadth of GI, pancreatic, hepatobiliary, and dietary body structure. in addition, we contain suitable scenario-based medical case in every one bankruptcy so one can overview no matter if the scholars can follow the elemental GI they discover ways to the scientific setting.
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Additional info for The Gastrointestinal System: Gastrointestinal, Nutritional and Hepatobiliary Physiology
B. S. Leung Fig. 16 Some typical examples of neuroregulators of the gut. These regulators are divided into peptides and bioactive non-peptide substances Neurocrine Pathway This pathway is involved in regulatory agents that are made and released from enteric neurons and function as typical neurotransmitters; that is, after release from terminal axons they traverse a narrow “synaptic space” and stimulate specific receptors of the target tissue. This form of regulation is quite specific in that the delivery of the neurotransmitters precisely and rapidly affects a designated target cell.
Because these tumors are generally slow growing, patients can tolerate them for years before they become clinically manifested. 2. What is the pathophysiological basis of the clinical symptoms? Answer: VIP is an important gut peptide typically found in neuroendocrine cells (but also expressed in some enteric neurons) that regulates numerous intestinal functions including motility, intestinal water and electrolyte transport, and blood flow. Because this tumor produces abnormal blood hormone levels, agents like VIP, in particular, can have significant systemic effects.
3. How would you treat this patient’s diarrhea? Answer: Because this tumor has already spread, surgical intervention is not feasible. However, treating the patient with the long-acting somatostatin analog, Octreotide, can inhibit the effects of the tumor. Octreotide has minor direct effects on intestinal mucosa cells that promote net absorption, probably mediated by activation of the inhibitory G-protein, Gi (thereby inhibiting VIP-stimulated adenylate cyclase activity). Octreotide’s major effect appears to be the inhibition of hormone release (and possibly synthesis) by tumor cells.