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DigestiveSystem

Disorders of the Liver, Gallbladder and Pancreas


Twoofthemostcommonliverdiseasesarecirrhosisandhepatitis.Cirrhosis,whichoftenresultsfrom
alcoholabuse,iscausedbythedeathofcellsintheliver,whicharethenreplacedbyconnectivetissue.
Liverfunctionisimpairedandtheflowofbloodintothelivermaybehinderedasaresult.Hepatitisis
causedbythreedifferenttypesofvirus.Assuch,itiscommonlyclassifiedashepatitisA,hepatitisB,
andhepatitisC.HepatitisAistransmittedbypoorsanitationpracticesorbyeatingmolluskslivingin
waterscontaminatedwiththevirus.HepatitisBisabloodbornediseasethatisoftenspreadthrough
sexualcontactwithaninfectedpersonorbyusinghypodermicneedlesthathavebeenpreviouslyused
byaninfectedperson.HepatitisCisachronicdiseasethatcanresultincirrhosisorcanceroftheliver.
Itcanalsobetransmittedthroughthebloodandiscommoninpatientswhohavereceivedblood
transfusions.Acommonconditionaffectingthegallbladderisgallstones.Gallstonescanoccurwhenbile
hardensinthegallbladder.Althoughgallstonesareusuallycausedbytoomuchcholesterolinthe
bile,theycanalsobecausedbybilethatcontainstoomuchbilirubinorbilesalts.Twotypesof
gallstonesarecholesterolstonesandpigmentstones.Astheirnamewouldsuggest,cholesterolstones
areprimarilymadeoutofcholesterol.Theyareusuallyyellowishgreen.Pigmentstonesareusually
madeoutofbilirubin.Theytendtobedarkcolored.Sometimesgallstonescanenterthecysticduct,
wheretheycanbecomelodgedandpreventbileorpancreaticjuicefrombeingreleased.Thiscan
preventchymefrombeingdigestedproperly.Threedisordersofthepancreasincludepancreatitis,
pancreaticcancer,andtype1diabetesmellitus.Inpancreatitis,orinflammationofthepancreas,the
enzymesthatthepancreasmakesbecomeactivewhiletheyarestillinsidetheorganandbegintodigest
thetissue.Painisquitecommon,andpeoplewithpancreatitisarelikelytohavenutritionaldeficiencies
becauseoftheroleofthepancreasinsecretingdigestiveenzymes.Acutepancreatitisisaserious
conditionthatcanbecausedbygallstones,overuseofalcohol,infectionssuchasmumps,andsome
drugs.Somecausesofchronicpancreatitisaregenes,cysticfibrosis,highlevelsoffatintheblood,
abuseofalcohol,orincreasedactivityoftheparathyroidgland.Oftentheattackshappenafteraround
ofbingedrinking.Theythenbecomemorefrequent,andthepainassociatedwiththemoftenworsens
andbecomesmorecontinuous.Pancreaticcancercaneitherdevelopintheheadorinthebodyortail,
anditcanoccurineitherendocrineorexocrineglands.Ifthetumorisinthehead,jaundicecanoccur
becausebilesecretionisblocked.However,ifthetumorisinthebodyortail,painismore
common.Menwhosmokearemorelikelytogetpancreaticcancer,andotherriskfactorsincludeeating
foodshighinfat,sugarandredmeat.Theprognosisforthesepatientstendstobepoor,andtreatmentis
usuallyaimedateasingtheirsymptoms.However,somepatientsmayundergoaWhippleprocedure.In
thisprocedure,thedistalpartofthestomach,theduodenum,thepartsofthejejuneum,theheadofthe
pancreas(orpossiblytheentirepancreas),theportionofthecommonbileductthatemptiesintothe
duodenum,andthegallbladderareremoved.Sometimesthespleenisalsoremoved.Thenthestomach,
thecommonbileduct,andthepancreasareattachedtothejejuneum.Type1diabetesistheresultofan
autoimmunedisorderinwhichtheimmunesystemdestroysthecellsthatproduceinsulininthe
pancreas.Thiscanleadtoexcessiveamountsofglucoseintheblood,whichcancauseabuildupof
ketones.Thisbuildupofketonesisquiteseriousandcouldresultinadiabeticcomaanddeath.

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