Question

Below are symptoms of a patient related to the Digestive System and Metabolism. Each person needs to answer all of these and then reply substantially to their teammates. As a team you should come to a final conclusion on all 3 questions in regards to the Patient and the symptoms. *Only the people in your group/team can see your discussions. Based on the symptoms answer the following questions:

Identify all anatomical structures related to and/or that are being affected based on the patient case information. (i.e. tissues, organs, vessels, brain components, membranes)

Explain how the anatomical structures and their physiological function/dysfunction are interrelated normally and what is going wrong with the structures in this current patient case information.

Identify and explain possible a diagnosis and what can be done to fix or reverse the current situation described in the patient case information. Please be specific and detailed.

Patient Case (Initial Review):

Noah is a 12 year old boy who lives in a rural town. Noah has been having the following symptoms:

Stomach pain in the form of a burning sensation, it especially hurts when he hasn't eaten in a while

Nausea

Loss of appetite

Frequent burping

Bloating

Unintentional weight loss - Noah has lost 15 lbs.

Noah is taking a trip in to the city to see a doctor to see what he can find out. (That information is below). Please post before I add this additional information.

*Remember to view this situation through the lens of the Digestive Systems and Metabolism, it should drive your inquiry/understanding of what is going on here. More information will be coming from the Doctors below.

Doctors Findings:

The Dr. performed the following diagnostic tests. The findings are below as well.

Blood test - antibodies for a pathogen found

Stool test - pathogen antigens found in the stool

After performing endoscopy of GI, biopsy was taken in the stomach.

Answer 1

Burning pain in the stomach area especially hurts when he hasn't eaten in a while, associated with bloating, nausea and frequent burping, Unintentional weight loss is suggestive of  GERD (Gastro oesophageal reflux disease) or reflux of HCl either due to increased production or breach in the barrier of stomach mucosa.

Stomach is left upper abdomen, hence the pain of mucosal injury of stomach is located at epigastric area.

It is disease in which there is reflux of contents of stomach acidic content into Esophagus responsible for most of symptoms of acid burns ,blaoting etc .

Normal PH of Esophagus is 5-7 .PH less than 4 is pathological

Lower esophageal Sphincter is a physiological Sphincter .

Normal protective mechanism to Prevent reflux of acidic contents into esophagus from stomach are

1) Intraabdominal length of Esophagus should be more than 2cm if it is less than 1 cm leads to Incompetent LES and causing reflux

2) Increased in intragsstric pressure ---> Decrease in LES tone

3) Angle between Esophagus and Stomach ,Right Crura of Diaphragm encircling Esophagus all prevent against Reflux .

Stomach is left upper abdomen, hence the pain of mucosal injury of stomach is located at epigastric area.

Helicobacter pylori is frequently associated with GERD.

The release of host cytokines after direct contact of H pylori with the epithelial cells of the gastric lining results in damage of Gastric mucosa.

Diagnosis --

Blood test will detect antibodies against H. Pylori.

Stool examination will detect H. Pylori antigen in faces.

This novel rapid test is based on monoclonal antibody immunochromatography of stool samples.

Esophagogastroduodenoscopy biopsy usually demonstrate a variable number of H pyloriorganisms adhering to the gastric epithelium, both coating the gastric wall and lining the gastric glands. The mucous film appears to be decreased.

Treatment --

Treatment of acidity with Proton pump inhibitor like Omeprazole or H2 antihistaminics like Ranitidine.

Treatment regimens for H. Pylori are amoxicillin, and clarithromycin for 10-14 days