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home - Stomach - Miscellaneous - Gastric Physiology VIP 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 VIP

G protein coupled receptors (GPCRs) VIP type 1 and VIP type 2 receptors elevation of cellular cAMP levels. Found in the GI tract and brain. 6 VIP Active VIP Cleaved Gene also produces T-cells Vasoactive Intestinal Polypeptide Produced by Functions of VIP:Stimulates GI epithelial secretion and absorptionPromotes fluid and bicarbonate secretion from bile duct cholangiocytesRelaxes smooth muscle of LES/ sphicnter of Oddi and colon (may have a role in Hirschsprung’s/ achalasia)Increases the growth of certain adenocarcinomasCauses vasodilationExerts anti-inflammatory actions- is produced by Th2 lymphocytes VIP, along with nitric oxide, is a primary component of the non-adrenergic non-cholinergic nerve transmission in the gut Usually VIP serum conc is low and doesnt change with mealIn pancreatic cholera (waterydiarrhea-hypokalemia-achlorhydria,WDHA, or Verner-Morrison syndrome),VIP levels can be very high. VIP receptors on pancreatic acinar and duct cells and enteric mucosal cells mediate fluid secretion in these organs. Receptors are abundant on smooth muscle of sphincters of the lower oesophagus, ampulla of vater, andrectum where VIP regulates sphincter relaxation. Neuronal location:Luminal GI tract.Respiratory airways.Pancreas.Sensory organs.Reproductive system. -PHI (peptide histidineisoleucine)-PHM (peptide histidinemethionine)-PHV (peptidehistidine valine) Receptors Production Written by Dr Sebastian Zeki