Monday, March 16, 2015

WILTIMS #267-71: GI Mega-Post!

MondayIL: FODMAP is an oft-used acronym for the avoidable dietary causes of GI discomfort.
Fermentable Oligo-, Di- and Monosaccharides And Polyols (in english: carbs, sugars and a special type of alcohol)

TuesdayIL: Severe burns can cause acute gastritis. You might rightly wonder how hurting your skin affects your stomach. The main complication of severe burns is a loss of fluid leading to hypotension. This lack of blood causes hypoxia and ischemia of the mucosal layer of the stomach (among many other effects), leading to decreased mucus production and increased acid damage to the stomach lining.

Phrase of the day: Catastrophic exsanguination - n. the act of bleeding out.

WednesdayIL: Ecstasy, LSD and similar drugs aren't really addictive substances because they don't mess with our reward centers or neurotransmitters that make you happy. They generally just cause hallucinations which, though interesting, just get old and/or too freaky after a while. They're still dangerous and can be abused, they just have limited addiction potential.

Alcohol increases sexual desire (by removing inhibitions) but decreases physiological response to said desires. "It can be less than, you know, a compelling experience that one would hope for, I guess you could say. [chuckles]" ~our pharmacology professor

ThursdayIL: Inflammatory pseudopolyps associated with irritable bowel disease look like the worm-creatures cursed by Ursula in The Little Mermaid. No? Just me?

FridayIL: Yerba mate is an Argentinean tea that's drunk fresh (i.e. still boiling) with a metal straw, causing thermal injury that can result in a higher risk of Barrett's esophagus. Barrett's esophagus is a fairly common condition where the bottom of the esophagus undergoes metaplasia due to chronic irritation, usually from GERD.

Quote of the day: "You can always get a new GI fellow, you can't get a new scope. Don't drop the scope." ~ Director of Liver Transplantation

The pancreas sucks. Besides having the worst cancer, pancreatic inflammation can easily kill you. The best analogy I could come up with to explain why is that the pancreas is like the gas tank in your car. A gas tank holds a relatively dangerous substance that is mixed with fire to create a controlled explosion in the engine. The pancreas holds enzymes that are activated in the gut to digest food. If those enzymes are activated early (throw a match in the gas tank) then they digest the pancreas which, just like the rest of the body, is made of the same building blocks as the food we eat. The pancreas effectively explodes. This releases these enzymes into the retroperitoneal space of the abdomen where the enzymes start digesting anything it comes in contact with: the liver, the kidneys, the intestines, etc. There is nothing we can do for this. The treatment is to give IV fluids and pain meds and hope the patient recovers.

Pancreaticojejunostomy is a crazy procedure used to treat chronic pancreatitis. In order to drain the dangerous secretions from the pancreas, the small intestine is bisected and part of it is used to create a new duct that goes straight from the pancreas to the GI tract.

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