1. Digestive Disorders Stomach Disorders

2. ©http://www.medicinenet.com/stomach_cancer/article.htm

3. Empty Human Stomach ©http://i224.photobucket.com/albums/dd284/SchoolinRhome/HSG/049.jpg

4. Stomach (Dog) ©http://biology.about.com/library/organs/bldigeststomach.htm

5. Stomach Structure  The stomach is made up of 5 layers:  Mucosa: Inner most layer or lining Contains the glands responsible for the digestive enzymes that are secreted Most stomach cancers originate here We will go over the cells found here

6.  Submucosa: support layer for the mucosa  Muscle layer: Muscles in this layer provide a rippling motion that mixes and mashes food  Subserosa: Support system for the outermost layer  Serosa: Outer layer that covers the stomach and holds it in place

7. Layers of the Stomach ©http://www.dkimages.com/discover/previews/854/20117283.JPG

8. Cells of the Stomach  Healthy cells that line the stomach consist of 4 types:  Parietal cells: secrete stomach acid (HCl), aid in B12 absorption  Chief cells: secrete pepsin (enzyme that aids in food digestion)  Mucus cells: secretes mucus which aids in the protection of the stomach lining

9.  G Cells: Secrete the hormone gastrin Gastrin: digestive hormone that regulates the production of stomach acid

10. Histology of the Stomach ©http://media- 2.web.britannica.com/eb-media/15/74315-004-B3A88818.jpg

11. Normal Stomach Cells http://www.technion.ac.il/~mdcourse/274203/slides/Digestive%20tract/4-Stomach%20-%20Fundus.jpg

13. ©http://images.google.com/imgres?imgurl=http://cellbio.utmb.edu/microanatomy/digestive/enteroendocrine2.jpg&imgrefurl =http://cellbio.utmb.edu/microanatomy/digestive/stomach.htm&h=435&w=618&sz=108&hl=en&start=4&um=1&tbnid=BFR dPZu3zRwOwM:&tbnh=96&tbnw=136&prev=/images%3Fq%3Dstomach%2Bcells%26um%3D1%26hl%3Den%26sa%3D N

14. ©http://images.google.com/imgres?imgurl=http://cellbio.utmb.edu/microanatomy/digestive/stomach4.jpg&imgrefurl=http://cellbio.utmb.e du/microanatomy/digestive/stomach.htm&h=435&w=618&sz=131&hl=en&start=11&tbnid=hpDY8dsm1jdScM:&tbnh=96&tbnw=136&pr ev=/images%3Fq%3D%2Bstomach%2Btissue%2Bcells%2Bsamples%26gbv%3D2%26hl%3Den%26sa%3DG

16. Mucus Cells ©http://www.bweems.com/cch7hp.jpg

17. ©http://images.google.com/imgres?imgurl=http://cellbio.utmb.edu/microanatomy/digestive/stomach4.jpg&imgrefurl=http://cellbio.utmb.e du/microanatomy/digestive/stomach.htm&h=435&w=618&sz=131&hl=en&start=11&tbnid=hpDY8dsm1jdScM:&tbnh=96&tbnw=136&pr ev=/images%3Fq%3D%2Bstomach%2Btissue%2Bcells%2Bsamples%26gbv%3D2%26hl%3Den%26sa%3DG

18. Stomach Cancer  May develop in any part of the stomach and spread to other organs  Causes nearly 1 million deaths world-wide  It is associated with diets high in sodium and low in fruits and vegetables  Also associate more often with smokers

19.  Over 80% of gastric cancers are linked to the bacteria Helicobacter pylori  This bacteria is also associated with other digestive disorders

20. H. Pylori ©http://en.wikipedia.org/wiki/H._pylori

21. Symptoms  Discomfort in the stomach area  Feeling full or bloated after a small meal  Nausea and vomiting  Weight loss

22. Diagnosis  Upper GI: patient drinks a barium solution that appears white on x-rays Allows the stomach to be seen much easier  Endoscopy: a lighted tube is sent down the digestive tract so the physician can see  Biopsy

23. Stomach Cancer ©http://www.brown.edu/Courses/Digital_Path/Lungs/adenocarcinoma_lung.jpg

24. Dyspepsia  Pain in the upper or middle section of the stomach  Approximately 1 in 4 people develop dyspepsia at some point  Usually caused by a stomach ulcer or acid reflux  Usually treated with lifestyle changes and medication

25. Acute Gastritis  A group of conditions characterized by an inflammation of the stomach lining  The stomach usually secretes a protective layer of mucus, however, it may become weakened

26. Acute Gastritis  Usually caused by a bacteria (H. pylori)  Traumatic injury or overuse of certain pain relievers (Advil, Motrin) may also contribute to the condition

27. Chronic Gastritis  Slower, progressive process in which the lining of the stomach is damaged

28. Chronic Gastritis  The stomach epithelium is columnar  When chronic gastritis occurs, the healthy cells are damaged

29.  Parietal cells and chief cells degenerate and are replaced by less specialized mucus cells (goblet cells)  Inflammation occurs and there is a large number of white blood cells that appear

30.  These damaged cells result in deformed cells causing the stomach lining to look like the lining of the intestine  It looks as if someone cut off the tops of the cells  This is called intestinal metaplasia

31. Chronic Gastritis with Intestinal Metaplasia ©http://images.google.com/imgres?imgurl=http://pathology.tmu.edu.tw/microscopy/images/1988- 8.jpg&imgrefurl=http://pathology.tmu.edu.tw/microscopy/showall.asp%3Fno%3D1988&h=480&w=640&sz=64&hl=en&start=2&um=1&t bnid=Gdbf01x7iJAT7M:&tbnh=103&tbnw=137&prev=/images%3Fq%3Dchronic%2Bgastritis%2Bimages%26um%3D1%26hl%3Den

32. Intestinal Metaplasia with Presence of Goblet Cells ©http://esynopsis.uchc.edu/eAtlas/GI/1281.htm

33. For Lab

34. ©http://images.google.com/imgres?imgurl=http://instruction.cvhs.okstate.edu/histology/HistologyReference/hrd1.h16.jpg&imgrefurl=htt p://instruction.cvhs.okstate.edu/histology/HistologyReference/hrd1.htm&usg=__HeLu0xuu1p4S- vFPz0hqSBLZ5Lw=&h=324&w=424&sz=24&hl=en&start=12&um=1&tbnid=BpbJYMaAhOmMnM:&tbnh=96&tbnw=126&prev=/images %3Fq%3Dconnecive%2Btissue%2Bstomach%2Bhistology%26ndsp%3D20%26um%3D1%26hl%3Den%26sa%3DN

35. ©http://images.google.com/imgres?imgurl=http://www.histol.chuvashia.com/images/digestive/stomach-02- l.jpg&imgrefurl=http://www.histol.chuvashia.com/atlas-en/digestive-01- en.htm&usg=__Ae49XMJi0PPZ8Qd8ehCqBB523pk=&h=422&w=450&sz=44&hl=en&start=13&um=1&tbnid=rXMiSzehm5QiDM:&tbnh=119&tbnw=127 &prev=/images%3Fq%3Dstomach%2Bhistology%26um%3D1%26hl%3Den  PYLORIC PART OF THE STOMACH Stained with haematoxylin and eosin 1 - tunica mucosa 2 - tunica submucosa 3 - tunica muscularis propria 5 - lamina propria of the mucosa (contains glands) 7 - gastric pits in the mucosa 8 - muscularis mucosae

38.  The previous image shows the mucosa (epithelium cells) and the submucosa (connective tissue also called lamina propria)  The muscle cells are seen below this is region in the lab

39. Goblet cells and WBC

40. Arrowhead: normal epithilium Arrow: Goblet cell WBCs present

41. Goblet Cells