The stomach and gastric function
Paul Ong, Rachel Skittrall in Gastrointestinal Nursing, 2017
Anatomically, the stomach can be divided into four sections (Figure 4.2): Cardia – The cardia surrounds the superior opening of the stomach and connects to the oesophagus. It contains an abundance of mucus-secreting glands that help protect the stratified squamous epithelial cells of the distal oesophagus.Fundus – The dome-shaped section of the stomach to the left of the abdominal oesophagus is the fundus.Body – Inferior (below) to the fundus is the largest region of the stomach, called the body, and it is here that the bulk of the gastric glands are found that secrete the enzymes and acids.Pylorus – The region that connects the stomach to the duodenum inferiorly at the gastro-duodenal junction is the pylorus. It has two major parts: the pyloric antrum that connects to the body of the stomach and the pyloric canal that joins the duodenum. The pathway of chyme from the pyloric canal to the duodenum is controlled by a thick band of circular muscle called the pyloric sphincter. Glands embedded in the mucosa of the pylorus secrete mucous and digestive hormones that regulate mechanical and chemical digestion.
Basics of Eating Disorders
Wayne A. Bowers in Civil Commitment in the Treatment of Eating Disorders, 2018
Binge eating and chronic vomiting contributes to dental problems such as caries and erosion of tooth enamel. It can also lead to a sensation of fullness, feeling bloated, gastric distress, and damage to the lining of the stomach. Tearing or rupturing of the esophagus and stomach can also occur due to the pressure of binge eating and vomiting, causing serious, life-threatening medical problems (Mehler & Andersen, 2017, Westmoreland et al., 2016). Gastroesophageal reflux disease, a potentially life-threatening condition, occurs when the contents of the stomach, including acid, back up into the esophagus causing inflammation and heartburn symptoms. Untreated, this can lead to Barrett’s esophagus, which leads to precancerous changes in the esophagus (Mehler & Andersen, 2017, Westmoreland et al., 2016). Individuals with bulimia nervosa can experience lung aspiration (inhaling foreign matter, typically vomit, into the lungs), causing damage to lung tissue, pneumonia, shock, and/or respiratory disease. Other common medical complications of a poor diet include constipation, abdominal pain, bladder incontinence, and urinary tract infections. In a starved individual there is growth of long, downy hair on the face, arms, and body (called lanugo)—a sign that the body is attempting to stay warm (Mehler & Andersen, 2017, Westmoreland et al., 2016).
Causes and Assessment of Dysphagia and Aspiration
John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford in Head & Neck Surgery Plastic Surgery, 2018
Achalasia cardia is the classical condition in this group wherein the lower oesophageal sphincter fails to relax and allow food to pass into the stomach. It is caused by degeneration or absence of the ganglion cells (myenteric plexus of Auerbach) in the oesophageal wall. The condition is indistinguishable from Chagas disease, seen in patients from South America and due to infection by Trypanosoma cruzi, which destroys the ganglion cells. Patients present with difficulty in swallowing fluids initially and progressively difficulty with solids. Barium swallow will demonstrate a ‘bird’s beak’ tapering on the oesophagogastric junction and dilatation of the lumen above it. Manometry studies can be used to detect failure of the lower oesophageal sphincter to open even before the features on barium swallow appear.
Current status and advances in esophageal drug delivery technology: influence of physiological, pathophysiological and pharmaceutical factors
Published in Drug Delivery, 2023
Ai Wei Lim, Nicholas J. Talley, Marjorie M. Walker, Gert Storm, Susan Hua
The esophagus is a part of the gastrointestinal tract (GI tract) that connects the pharynx to the stomach. It is a hollow, muscular channel that delivers swallowed food bolus to the stomach. The thickness of the esophageal wall in healthy individuals varies depending on the section of the esophagus, with the largest wall thickness during esophageal contraction of 4.70 mm (95%CI: 4.44-4.95) and during esophageal dilation of 2.11 mm (95%CI: 2.00-2.23) (Xia et al., 2009). The esophagus begins at the upper esophageal sphincter that is formed by the cricopharyngeal muscle and ends with the lower esophageal sphincter, which is surrounded by the crural diaphragm (Standring, 2020). While the average length of the esophagus in an adult is between 23 to 25 cm, the length in children at birth varies between 8 to 10 cm (Standring, 2020; Scott-Brown et al., 2008). The esophagus is lined with non-keratinized squamous epithelium in humans and the muscular elements are smooth muscle (Standring, 2020).
Nivolumab with or without chemotherapy for metastatic gastroesophageal cancers and future perspectives
Published in Expert Review of Anticancer Therapy, 2022
Matheus Sewastjanow-Silva, Kohei Yamashita, Ernesto Rosa Vicentini, Meita Hirschmann, Melissa Pool Pizzi, Allison Michelle Trail, Rebecca E Waters, Jane E. Rogers, Jaffer A Ajani
Esophageal malignancies (ECs) have two known histological subtypes: ESCC and EAC. Their molecular biology, etiology/pathogenesis, and frequent esophageal locations differ. The selection of specific treatment strategies for ECs currently requires understanding of the stage, location of the tumor, the patient’s physiologic health, and the availability of social support. Surgery or endoscopic resection can be used to treat most early-stage ECs. Adjunctive therapies like trimodality (preoperative chemoradiation followed by surgery) or perioperative chemotherapy may be appropriate depending on local practice preferences and the clinical stage of EC. The GEJ is referred to as the junction between the distal esophagus and the cardia, the proximal portion of the stomach. Depending on the location and stage categorization, GECs are treated differently: Siewert Types I and II are treated like ECs, and Siewert Type III is treated like a GAC. More than 95% of GACs are adenocarcinomas, which are categorized by the Lauren classification as diffuse or intestinal type based on the histological characteristics [2]. GACs have been divided into four molecular types: (1) microsatellite instability (MSI), which has hypermethylation and a high mutational burden; (2) chromosomal instability, which has amplification of the genes encoding tyrosine kinase receptors; (3) genomic stability, which has gene variations encoding proteins that are involved in cell adhesion/cell migration pathways (the majority of diffuse type GACs fall into this category); and (4) Epstein–Barr virus (EBV) related, which has DNA hypermethylation.
Efficacy and safety of submucosal tunneling endoscopic resection for upper gastrointestinal submucosal tumors with more than 1-year' follow-up: a systematic review and meta-analysis
Published in Scandinavian Journal of Gastroenterology, 2019
Wei Peng, Shali Tan, Shu Huang, Yutang Ren, Huan Li, Yan Peng, Xiangsheng Fu, Xiaowei Tang
As shown in Table 1, a total of 701 patients and 728 lesions were included in the analysis. All studies were published in China from June 2014 to November 2018. The mean age of these patients was 36.1 years (median age was not included in the calculation), and 262 (37.4%) patients were female. The mean follow-up periods across all studies were 27.0 months (the median follow-up was not included in the calculation). Of the involved 12 studies, 2 were prospective studies and 10 were retrospective studies. Clinical characteristics of the included studies are shown in Table 2. Regarding the lesions, 348 (47.8%) were located in the esophagus, 182 (25.0%) in the esophagogastric junction (EGJ), 124 (17.0%) in the cardia and 74 (10.2%) in the stomach. The mean size of the tumors was 22.0 mm (median tumor size was not included in the calculation). The average procedure time was 51.7 min (the median produce time was not included in the calculation).
Related Knowledge Centers
- Chyme
- Digestive Enzyme
- Gastric Acid
- Gastrointestinal Tract
- Pylorus
- Digestion
- Esophagus
- Small Intestine
- Phases of Digestion
- Chewing