Mr' G'I

1
Mr. G.I His Pancreas

• Leah, Aaron Julia

2
The Question?

• Mr. G.I. is an alcoholic with a long history of
  chronic pancreatitis, with evidence of
  accumulation of calcified scar tissue.
• What are the consequences of his disease on
  digestive processes and his nutrition status with
  respect to the three energy nutrients?

3
Role of The Pancreas

• Pancreas is a digestive organ that secretes
  enzymes, bicarbonate, and hormones. It is
  located in the upper part of the abdomen behind
  the stomach and it is a heterocrine gland.
• It aids in maintaining homeostasis by endocrine
  and exocrine functions.

4
The Endocrine Function

• The endocrine portion of the pancreas is the
  Islets of Langerhans, containing alpha and beta
  cells which secrete the hormones glucagon and
  insulin.

• When blood glucose is high, such as
• after a meal, insulin is secreted by the
• beta cells of the pancreas. This tells
• the other cells in the body that there is a
  steep enough concentration of glucose for them to
  open up the GLUT transporters to allow diffusion
  down its concentration gradient to be used for
  cellular met.
• When the blood glucose is low, such as in a
  fasted state, glucagon is secreted by the alpha
  cells. This stimulates gluconeogenisis and
  glycogenolysis, which results in increased blood
  sugar.

5
The Exocrine Function

• The exocrine portion of the pancreas secretes
  enzymes and bicarbonate into the duodenum through
  the pancreatic duct and the common bile duct.
• Bicarbonate buffers the acidic chyme that enters
  from the stomach into the small intestine.
• Pancreatic enzymes aid in the breakdown of
  proteins, fats and carbohydrates from foods which
  are then absorbed across the intestinal lining.

6
Pancreatic Enzymes Cont.

• The enzymes released by the pancreas into the
  small intestine are inactive enzymes. Trypsinogen
  is also secreted as an inactive enzyme. Inactive
  trypsinogen is converted to the active trypsin by
  enteropeptidase on the small intestinal lining.
• Trypsin activates other proenzymes secreted by
  the pancreas. The active form of these enzymes
  are involved in digestion of specific nutrients.
  
• Amylase breaks down carbohydrates, mostly
  pancreatic proteases break down proteins, and
  lipases break down fats or triglycerides.

7
Pancreatitis

• This is inflammation of the pancreas.
• There are two types of pancreatitis, the first
  being acute pancreatitis and the other being
  chronic pancreatitis. Mr. GI has chronic
  pancreatitis.
• Chronic pancreatitis occurs when digestive
  enzymes attack and destroy the pancreas and
  nearby tissues, causing pain and calcified
  scarring.
• The usual cause of chronic pancreatitis is many
  years of alcohol abuse.

8
Consequences

• The calcified scarred tissue causes death or
  damage to the enzyme secreting cells and
  sometimes the beta cells.
• When enzyme secreting cells are damaged then
  there is not enough pancreatic enzymes secreted
  into the GI tract to breakdown fats, proteins,
  and carbohydrates so these nutrients cannot be
  absorbed by the body.
• The lack of absorption of valuable nutrients
  results in malnutrition. Weight loss can also
  occur because nutrients are no longer absorbed,
  but excreted in the stool.
• If the insulin producing beta cells are also
  damaged, hyperglycemia may result, possibly
  causing diabetes to develop.

9
Analogy

• Pancreatitis is like Augustus falling into the
  chocolate water and blocking the chocolate from
  getting up the tube.
• Since he is blocking the tube, the chocolate
  cant get out and be made into Wonka bars and the
  Oompa- Loompas dont get the nutrition they need
  from the chocolate bars.