Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua
Hospital
I'd like to start a series on recognizing the greatness of
the Creator by understanding the little that we do know on
how the body works.
Let's start with the digestive tract which doctors refer to
as the gastrointestinal tract, or GI tract for short. The
processing of food begins with the moment it enters the
mouth. The mouths releases a shower of fluid, called saliva,
which begins the breakdown of starches. This also lubricates
the food for easier passage. At the same time, the teeth
start breaking up the food into smaller pieces which make it
easier for the body to absorb.
The muscles of the jaw propel the food backwards towards the
stronger teeth in the back of the mouth for more intense
breakdown of food, while the epiglottis, a valve at the
beginning of the throat, covers the windpipe so that food
will not enter at the wrong time. In people who are comatose,
elderly, short of breath, demented, or drunk, this may not be
coordinated, and they could choke on their food. It is for
that reason that I am a big advocate of taking a CPR course
which will instruct a person on the Heimlich maneuver, which
can relieve such an obstruction. Even the entrance of liquids
to the windpipe can be dangerous, as it can cause a bad
pneumonia. This is especially important if the liquid is
stomach juices or petroleum.
Once food enters the food pipe, it is propelled downward by
the contractions of the food pipe until it reaches the valve
at the inlet of the stomach. The food pipe is flexible and
can expand, but if a large foreign body is swallowed (even
food), it may need to be taken out by a doctor. This may be a
problem with large pieces of meat in the elderly or with
sharp foreign bodies that kids sometimes swallow. Button
batteries are especially dangerous as are ingestions of
alkali such as drain cleaner. Most coins are not a
problem.
Occasionally there is backup of stomach acids into the food
pipe. This gives a person a feeling of heartburn. This
condition should be treated as it is damaging to the food
pipe. Smokers should know that they have a higher rate of
food pipe cancer, which has a very low survival rate.
The stomach makes very acidic juices to break down most
proteins. We once thought that this organ is so acidic, that
no bacteria could possibly live there. However, we discovered
there a bacteria called heliobacter, which is now known to be
the cause of stomach ulcers. Ulcers are craters in the
stomach that are hard to heal because they are constantly
bathed by the acids of the stomach. They can be complicated,
but proper use of medication can heal this painful
condition.
Stomach cancer occurs more frequently in those from the far
east than in those from the U.S.A. The cause may be related
to diet, as Orientals who immigrate to the U.S.A. then have a
reduced rate of cancer. Smokers need to know that they have
an increased rate of stomach ulcers.
We are out of space, so we will continue our travels down the
GI tract next week. Write me in care of the Yated.
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