The Food Tube (Esophagus)
- The esophagus is like a long tube, about 25 cm (about 10 inches) long, that carries food from your mouth to your stomach.
- Infections in the tube (Infectious Esophagitis):
- If someone has a weak immune system, they can get white patches in their esophagus from a germ called Candida.
- Other germs like CMV or HSV can also cause problems. Medicines can help, like Ganciclovir for CMV and Acyclovir for HSV.
- Trouble Swallowing (Dysphagia):
- Sometimes, the esophagus can squeeze in a strange way, making it hard to swallow. This is called a “corkscrew esophagus”.
- Another problem, called “Achalasia Cardia,” makes the end of the esophagus look like a “bird beak” on a special test. Doctors can give medicine or do surgery for this.
- Changes in the Tube (Barret Esophagus):
- Sometimes, the lining of the esophagus can change from one type of cell to another. This can lead to a kind of cancer called Adenocarcinoma.
- Plummer-Vinson Syndrome: This is a problem where you have trouble swallowing, low iron, and a web-like growth in your esophagus.
- Medicines that can hurt the tube: Some medicines for bones (Bisphosphonates) can cause problems in the esophagus.
2. The Stomach
- The stomach is a J-shaped bag that holds food.
- Stomach Cells:
- Parietal cells: Make stomach acid and something called “intrinsic factor” which helps your body use vitamin B12.
- Chief cells: Make something called pepsinogen, which helps digest food.
- Sores in the Stomach (Ulcers):
- Gastric Ulcer: A sore in the stomach, usually higher up.
- Duodenal Ulcer: A sore in the first part of the small intestine (duodenum).
- H. Pylori: A common germ that causes ulcers. Doctors treat it with several medicines.
- How to find H. Pylori: Doctors can check your blood, poop, or even your breath.
- Other causes of ulcers: Medicines like NSAIDs (for pain, like in rheumatoid arthritis) can cause stomach ulcers.
- Special Ulcers:
- Curling Ulcer: Happens after severe burns.
- Cushing Ulcer: Happens if there’s high pressure in the brain.
- Stomach Cancer (Gastric Adenocarcinoma):
- This is a type of cancer that can grow in the stomach.
- It can spread to nearby lymph nodes (Virchow nodes), the belly button (Sister Mary Joseph), or even the ovaries (Krukenberg tumor).
- Pernicious Anemia: If someone has low energy, looks pale, and has trouble breathing, it could be this. It’s caused by the body not being able to use vitamin B12 properly because of a problem with parietal cells.
- Zollinger-Ellison Syndrome: This is a problem where a tumor makes too much of a hormone called gastrin, leading to many ulcers, tummy pain, and weight loss.
3. Gut Problems
- IBS (Irritable Bowel Syndrome):
- Common in young women.
- Causes tummy bloating that feels better after going to the bathroom.
- Eating lots of fruits, vegetables, and fluids, and sometimes taking laxatives can help.
- IBD (Inflammatory Bowel Disease): This is a serious problem where the intestines get very inflamed.
- Crohn’s Disease: Can affect any part of the digestive system from mouth to anus, except the rectum. It can have deep sores and look like “cobblestones” inside. It usually doesn’t cause bloody poop.
- Ulcerative Colitis: Only affects the rectum and large intestine. It causes bloody poop and can increase the risk of colon cancer.
- Carcinoid Tumor:
- This is a type of tumor that makes too much of a chemical called serotonin.
- It’s often found in the small intestine (ileum) or appendix.
- Can cause long-lasting diarrhea and weight loss.
- Doctors check for it by looking for a special chemical in the pee.
- Medicines and surgery can help.
- If the tumor is in the heart, it can affect a specific heart valve.
- Too much serotonin can also cause a problem called Pellagra, where you get skin rashes, diarrhea, and confusion because of not enough niacin (a vitamin).
- Lactose Intolerance:
- If you get diarrhea and a bloated tummy after eating dairy, you might have this.
- It means your body doesn’t make enough of an enzyme called lactase to break down lactose (a sugar in milk).
- Eating a diet without lactose helps.
- Celiac Disease:
- This is a problem where eating foods with wheat (like bread) makes you sick.
- It can cause skin rashes and lead to low iron.
- Doctors can do a blood test for it.