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home - Stomach - Miscellaneous - Gastric Physiology Written by Dr Sebastian Zeki
Nausea and Vomiting:
Understands the pathophysiology of vomiting.
Appreciates the gastrointestinal conditions that cause nausea and
vomiting as well as the range of extra-intestinal causes

Recognises the influence of neurological conditions and metabolic
derangements such as diabetes

Understands the physiology of gastric emptying and how this is
affected by disease, toxins and drugs

Abdominal Pain:
Knows the causes of acute and chronic abdominal pain that arise
from upper gastrointestinal, biliary and pancreatic diseases

Understands the clinical presentations of the various conditions
causing pain and the means by which they can be diagnosed and
treated

Weight Loss:
Knows the significance of weight loss as a consequence of upper
gastrointestinal disease, knows those conditions that present with
loss of weight and how they are managed

Skills
Makes a detailed clinical assessment of patients presenting with
symptoms indicating possible upper gastrointestinal disease,
construct a management plan and be aware of the various avenues
of treatment

Behaviours
Evaluates patients in a structured and timely manner, carries out
appropriate investigations and formulates management plan.

Gastric Physiology

Pancreatic polypeptide, peptide YY, and neuropeptide YReceptors It has 5 receptors- all G-protein linkedPhysiological actionsIt is largely inhibitory L-cells H-cells PYY Neuropeptide Y (NPY)It is secreted from the central and peripheral nervous system.It acts to stimulate food intake.Peripherally, it affects vascular and GI smooth muscle function. Peptide YY (PYY) is secreted by:Enteroendocrine cells of the ileum (L-cells).Enteroendocrine cells of colon (found in H cells).Nerves of the enteric nervous system (in sympathetic neurons). incompletely digested food esp fat + Pancreatic polypeptide (PP)It is secreted from the endocrine cells of the gut and pancreas.It is stimulated by vagal-cholinergic stimulation following a meal.Inhibits pancreatic exocrine secretion/ gallbladder contraction and gut motility, and may influence food intake, energy metabolism, and the expression of gastric ghrelin and hypothalamic peptides. Written by Dr Sebastian Zeki PYY released into the bloodstream can inhibit several GI processes, eg gastric emptying and intestinal motility (called "ileal brake" ).