Gastrointestinal.ppt
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Transcript of Gastrointestinal.ppt
DIGESTIVE DISORDERSDIGESTIVE DISORDERS
YOGAYOGAFORFOR
ACID PEPTIC DISEASE ACID PEPTIC DISEASE
IRRITABLE BOWEL SYNDROME
IRRITABLE BOWEL SYNDROME
INTRODUCTION
People are probably more aware of their digestive system than an of other system, not lease because of its frequent messages.
Hunger, thirst, appetite, gas and the frequency and nature of bowel movements are all issues affecting daily life.
Eating well, along with regular exercise, is one of the bedrocks of good health.
Plenty of fresh vegetables and fruits, adequate fiber and restricted animal fats and salt are simple dietary guidelines that are essential for maintaining the well-being of all parts of the body, particularly the heart, blood vessels, bones – and the digestive system itself.
The digestive system consists of a long passageway, known as the alimentary canal or digestive tract and associated organs, including the liver, gallbladder, and pancreas.
The digestive tract starts at the mouth and continues through the esophagus and intestines to the anus.
Along its course food is broken down and nutrients extracted, while waste materials are disposed of.
PATH OF FOOD – MOUTH TO ANUSPath of food through the human digestive system includes the following organs and structures:
Mouth – pharynx – esophagus – peristalsis – mucus – sphincter muscles – cardiac sphincter – stomach – pyloric sphincter – small intestine (duodenum, jejunum, ileum) – ileocecal valve – large intestine or colon (cecum, appendix, ascending colon, transverse colon, sigmoid colon) – rectum – anus.
STOMACH The stomach is a J-shaped muscular organ that receives and mixes food with digestive juices, and propels food to the small intestine. Stomach stores 2½ pints (1.5 liters) or more of food from a meal and digests it both physically and chemically.
Small intestine continues the chemical breakdown and is the main site for absorbing the resulting nutrients into the bloodstream.
LIVER, GALLBLADDER & PANCREAS The liver is the body’s largest internal organ and has a
crucial role in the manufacture, processing and storage of may chemicals.
It produces the digestive fluid bile, which is then stored in the gallbladder.
The pancreas secretes vital digestive enzymes.
LIVER The reddish-brown liver, located in the upper right quadrant of the abdominal cavity, is the body’s largest internal organ.
* Each lobe is separated into hepatic lobules consisting of hepatic cells radiating from a central vein.
* Hepatic sinusoids separate groups of hepatic cells.
* Blood from the hepatic portal vein carries blood rich in nutrients to the liver.
* Kupffer cells carry on phagocytosis in the liver.
* Secretions from hepatic cells are collected in bile canals that converge to become hepatic ducts and finally form the common hepatic duct.
LIVER FUNCTIONSMost of the liver’s tasks are concerned with metabolism. They include: breakdown of digestive products; storage of the resulting products; circulation of substances such as vitamins and minerals; construction of complex molecules – enzymes. Bile production - Liver cells secrete bile into small
canals called bile canaliculi, which drain into bile ducts running between the lobules. These bile ducts coverage to form the common hepatic duct, which conveys bile to the gallbladder for storage.
Nutrient processing - Liver removes nutrients from the blood. It converts simple sugars into glycogen – a process called glycogenesis – and synthesizes amino acids.
Glucose regulation - The liver maintains blood glucose levels by converting fat and proteins into glucose – glucogenesis.
Detoxification - Harmful substances in the blood – alcohol and some other poisons, are detoxified. Waste products and unwanted amino acids are converted into urea.
Protein synthesis - Liver synthesizes blood-clotting proteins and proteins for the fluid part of blood (plasma).
Mineral and vitamin storage - Liver is reservoir of minerals such as iron, copper, fat-soluble vitamins including A, B12, D, E and K
Blood waste disposal - Bacteria and general foreign particles are eliminated.
Recycling blood cells - Old red blood cells are broken down and their constituents reused.
GALLBLADDER
Bile salts emulsify fats and aid in the absorption of fatty acids, cholesterol, and certain vitamins.
Bile assists the breakdown of fats (lipids) in the small intestine.
Liver secretes up to 1 liter of bile daily. Bile passes along the left and right hepatic ducts from
the liver’s two lobes, then along the common hepatic and cystic duct to the gallbladder.
This sac holds about 50 mL of bile and concentrates it, ready for release after a meal.
Bile flows along the cystic duct to enter the first part of small intestine, duodenum.
Common bile ducts joins the pancreatic duct at the hepatopancreatic ampulla, which empties into the duodenum.
BILE TRANSPORT
PANCREASThe pancreas has an exocrine function of producing pancreatic juice that aids digestion.
It is closely associated with the small intestine.
Cells that produce pancreatic juice, called pancreatic acinar cells, make up the bulk of the pancreas.
Pancreatic and bile ducts join and empty into the small intestine, which is surrounded by the hepatopancreatic sphincter.
PANCREATIC JUICEContains enzymes that digest carbohydrates, fats, proteins, and nucleic acids.
Enzymes include pancreatic amylase, pancreatic lipase, trypsin, chymotrypsin, carboxypeptidase, and two nucleases.
Protein-digesting enzymes are released in an inactive form and are activated upon reaching the small intestine.
SPLEEN
Located in the upper left quadrant.
Consists of white pulp (lymphoid tissue) and red pulp.
Filters and stores blood.
SMALL INTESTINE The lengthy small intestine receives secretions from the pancreas and liver, completes digestion of the nutrients in chyme, absorbs the products of digestion, and transports the remaining residues to the large intestine.
The small intestine consists of the duodenum, jejunum,
and ileum.
LARGE INTESTINES
Large intestine is the final part of the digestive tract and comprises three main regions – Cecum, colon and rectum.
Cecum is a short pouch that links the small intestine to the colon, which is about 5 feet long.
Colon changes liquid digestive waste products from the small intestine into a more solid form that the body excretes as feces via the rectum and anus.
The large intestine absorbs water and electrolytes and forms and stores feces.
The large intestine consists of the cecum (pouch at the beginning of the large intestine), colon (ascending, transverse, descending, and sigmoid regions), the rectum, and the anal canal.
The anal canal opens to the outside as the anus; it is guarded by an involuntary internal anal sphincter and a voluntary external anal sphincter muscle.
The large intestinal wall has the same four layers found in other areas of the alimentary canal, but lacks many of the features of the small intestinal mucosa.
Fibers of longitudinal muscle are arranged in teniae coli that extend the entire length of the colon, creating a series of pouches (haustra).
The large intestine does not digest or absorb nutrients, but it does secrete mucus.
The large intestine absorbs electrolytes and water.
The movements of the large intestine are similar to those of the small intestine.
Peristaltic waves happen only two or three times during the day.
Defecation is stimulated by a defecation reflex that forces feces into the rectum where they can be expelled.
DIGESTION
Digestive process involves a series of physical and chemical actions that break down the components of food into nutrient particles small enough for absorption.
Feces are composed of undigested material, water, electrolytes, mucus, and bacteria.
The color of feces is due to the action of bacteria on bile pigments.
The odor of feces is due to the action of bacteria.
FECES
ACID PEPTIC DISEASEACID PEPTIC DISEASE
ACID PEPTIC DISEASEPROBLEM OF MODERN AGE
AGE 20 - 40yrs DUODENAL.U.INDIA,USA
40 - 50yrs GASTRIC .U.
JAPAN
•HUNGER PAIN CLOCK LIKE 3 AM 3 TO 4 Hrs AFTER MEALS
PAIN ABDOMEN…BURNING, DISCOMFORT, GAS, DISTENSION
PEPTIC ULCEROR
ACID PEPTIC DISEASE
INFLAMMATION OF STOMACH DUE TO ACID PEPTIC DIGESTION
•ELASTIC BAG
•DIGESTION OF PROTEIN BEGINS
•PROTECTION AGAINST GERMS & TOXINS
FUNCTIONS OF STOMACH
DIGESTED BY PEPSIN ENZYME
PROTEIN DIGESTIONPROTEIN IN FOOD
IN CONCENTRATED HYDROCHLORIC ACID MEDIUM
PROTECTORS
•MUCUS COATING
•BICARBONATES
•BLOOD FLOW
•MUCUS CELL TURN OVER
WHAT PROTECTS STOMACH FROM SELF DIGESTION ?
• HIGH ACID
• PEPSIN
• SMOKING
• CHILLIES
• ALCOHOL
• PAIN KILLER TABS
AGGRESSORS
IMBALANCE
PROTECTORS
AGGRESSORSAPD
•ACUTE GASTRITIS
•CHRONIC GASTRITIS
•EROSION
•PEPTIC ULCER
•COMPLICATIONS
IMBALANCE LEADS TO
CAUSES OF A.P.D1. STRONG FAMILY HISTORY
BLOOD GP ‘O’ ARE PRONE TO APD
11. TRIGGERING FACTORS
• STRESS - TENSION
““NOT ABLE TO LET GO THE STEAM”NOT ABLE TO LET GO THE STEAM”
• H. PYLORI
• ALCOHOL, CHILLI,
• STEROIDS, PAIN KILLERS
STRESS
PARA SYMPATHETIC
ACID
BL. FLOW
POOR MUCUS SLOW REPAIR
EMOTIONAL CORTEX
HYPOTHALAMUS
GASTRIN ACID
SYMPATHETIC
IRRITABLE BOWEL SYNDROME
IRRITABLE BOWEL SYNDROME
COMPLAINTS
MIDDLE AGED -
WOMEN MORE THAN MEN
• ALTERNATE DIARRHOEA
AND CONSTIPATION
• FEELING OF INCOMPLETE
EVACUATION
•- FORMED STOOL
IRRITABLE BOWEL SYNDROME
PERSONALITY:
• HYPER - REACTIVE
• CLEAN
• NERVOUS
• INTROSPECTIVE
• FIXATION ON BOWEL
• CONCENTRATION ON THE BOWEL
IRRITABLE BOWEL SYNDROME OR
FUNCTIONAL BOWEL DISORDER
DEFINITION: -- IRREGULAR BOWEL MOTILITY AND PROPULSION ERROR
CONTROL OF BOWEL MOTILITY
PSYCHE
EMPTYING NERVE
CONTRACTS - COLON
RELAXES - SPHINCTER
SYMPATHETIC
PARA SYMPATHETIC
HOLDING NERVE
CONTRACTS - SPHINCTER
RELAXES - COLON
BOWEL MOTILITY IN IBS
MUSCLE TONE DISORDER - ERRATIC EMPTYING OF BOWELS
HYPER REACTIVITY TO PARA SYMPATHO DRUGS
PARASYMPATHETIC
SYMPATHETIC
INFLAMMATORY BOWEL DISORDER ULCERATIVE
COLITISDEFINITION: EPISODES OF DIARRHOEA
WITH BLOOD & MUCUS
PSYCHO NEURO IMMUNOLOGY
STRESS & AUTO IMMUNITY
THYMUSB
T
CAUSES AUTO IMMUNITY
YOGA MASTERY OVER MIND &
REST TO MIND
DEEP REST TO BRAIN CELLS
REST TO IMMUNE CELLS
HIGHER FACULTY RESTORED
MASTERY OVER KILLER INSTINCT OF IMMUNE CELLS
Ánandamaya KôùaÁnandamaya KôùaVijòanánmaya Vijòanánmaya
KôùaKôùa
PERFECTPERFECTHEALTHHEALTH
Manômaya KôùaManômaya Kôùa
Ann
amay
a Kôù
a
Ann
amay
a Kôù
a
Pránamaya K
ôùa
Pránamaya K
ôùaÁ
DH
IJA
VY
ÁD
HIS
Panchakosa concept
ANANDAMAYA KOSA
• ALL PRACTICES SHOULD TOUCH THIS KOSA
• DIFFUSE FROM NAVAL REGION
• DIFFUSE REGION OF PAIN
• BLISS IS MOKSA
• FREEDOM IS ANANDA
VIGNANAMAYA KOSA
• BASIC CONCEPT OF LIFE
• PURPOSE OF LIFE
• GOALS IN LIFE
• SEARCH FOR TRUTH
• SILENCE IS HAPPINESS
MANOMAYA KOSASTAGE – I OF APD & IBS AS
ADHIJA VYADHI
DHARANA to DHYANA
FOCUS to DEFOCUS
NAVAL to EXPANSION
EMOTIONS - JEALOUSY to
ACCEPTANCE & APPRECIATION
MANOMAYA KOSA cont.
• CM - DEEP CALMNESS
- MEDITATION DIVINE MOOD - CALM - REST
REDUCES STRESS
DEVOTION - BHAKTI - SURRENDER
MANOMAYA KOSA cont.
OF
BEING IN
THE
PRESENCE
OF THE
BELOVED
BEING IN
THE
PRESENCE
OF THE
BELOVED
EMOTIONS
NONCOMPLAINING
TOLERANCE
ACCEPTANCE
SURRENDER
STRESS - ACUTE
CHRONIC
SUPPRESSED
HABITS, CRAVINGS, ALCOHOL, SMOKING
MASTERY OVER MIND TO
STRENGTHEN WILL POWER &
CONFIDENCE
YOGA IS CAPACITY TO DO, NOT TO DO, OR DO IT OTHERWISE
YOGA IS CAPACITY TO DO, NOT TO DO, OR DO IT OTHERWISE
• TO SMOKE, NOT TO SMOKE, REPLACE BY SIMPLER JOY
• SHIFT TO THE INNER COMPARTMENT (ANTHARRANGA) WHEN DISTRESSED.
• REPLACEMENT - SEETALI / SEETKARI, KAPALABHATI
HOW TO STOP SMOKING ?
Cigarette smoking contributes to a remarkable number of diseases, including coronary heart disease, stroke, chronic
obstructive pulmonary disease, peripheral vascular disease, peptic ulcer disease, and many types of cancer.
General discomfort aches and pains
STAGE - II OF APD / IBS AS ADHIJA VYADHI
PRANA
SAMANA
APANA
PRANIC IMBALANCE
APD - ATIJERNATVAM
TOO MUCH OF PRANA FOCUSSED IN SAMANA
IBS - KUJÈRNATVAM
TOO MUCH OF PRANA FOCUSSED IN APANA
PR
AN
AS
AM
AN
AA
PA
NA
PRANAMAYA KOSA
PRANIC IMBALANCE
PRANAYAMASECTIONAL BREATHING
STABILIZES SAMANA
NS- 12 ROUNDS 4 TIMES A DAY
IAYTANNAMAYA KOSA
DO ANY POSTURES AGGRAVATE PAIN IN APD ?
• FORWARD BEND IN SITTING – BLOCKS PRANA IN STOMACH
EMPHASISE :
STANDING POSTURES BACK BENDING & DRT
VAMANA DHOUTIUDDIYANA BANDHANAULI KRIYA AGNISARA KRIYA
ANNAMAYA KOSA cont.
KRIYAS IN APD
TO BRING HARMONY & BALANCE
•Avoid during episodes of diarrhea
•Dynamic practices in standing position
ASANAS FOR IBS
• EMPHASIZE - INVERTED POSTURES
•VIPARETA KARANI WITH SUPPORT
• - DEEP ABDOMINAL BREATHING
- AAA CHANTING
- ASVINI MUDRA
• PRABHEDAS OF SARVANGASANA
• HALASANA, MATSYASANA
• SIRSASANA
DURING ACUTE ATTACKS
GID & IBS
Cause of concern is a reduction of H.C.L which increases with age, alcohol and smoking
Abundant mucus is produced to protect the stomach lining from being damaged by its own acid
CAUSES
Life style Antibiotics High fat diets High sugar intake High intake of
processed food Anti inflammatory
drugs
Fried foods Alcohol Soda Smoking Anxiety Depression Stress Etc.
CANDIDA
Affects large number of people
Faulty diet and lowered immunity is the cause
Naturally present in GI track
Mutates if immune system is affected or high sugar diets are taken
Belching Excessive gas Abdominal cramps Can cause depression if not
treated Insomnia Itchy ears Muscle pain Sore throat
DIETARY MANAGEMENT
Water from boiled potato peelings Green leafy vegetables Ginger Soft fruits
for GID & IBS
COLITIS
Villi flattened after coming into contact with gluten
Can cause malnutrition Diarrhea Weight loss
DIETARY MANAGEMENT
Avoid gluten containing foods like wheat, barley, oats, rye
Increase fruits and vegetables specially green leafy vegetables well cooked and mashed
Avoid high starchy foods
for COLITIS
DIVERTICULITIS Inflamed diverticula forming small
pouches, which will be filled with waste. Causes pain
SYMPTOMS
Diarrhea – constipation Tenderness Bloating Frequent need to go to toilet
DIETARY MANAGEMENTfor DIVERTICULITIS
Objective – to normalize motility and secretions Include more fluids into the diets High fibers Reduce carbohydrates More proteins (tofu sesame seeds, pumpkin
seeds, chickpea, Soya beans) Include more juices vegetables as well as fruits
DIARRHEA Acute diarrhea is an infection Bloody diarrhea is a serious infection Intermittent bouts of diarrhea may be caused
by food allergies / parasitic infection High intake of caffeine Increased stress
SYMPTOMS Robs body of water and dehydration Excessive fatigue
DIETARY MANAGEMENTfor DIARRHEA
Increased fluids Mineral rich foods Low fiber or no fiber juices and fruits Green leafy vegetables Increased potassium intake After the attack include more green leafy
vegetables Less of insoluble fibers Bland diet is preferable Fish is good it acts as anti inflammatory omega 3
essential fatty acid and vitamin E which has tissue healing properties
DIETARY MANAGEMENTfor ULCERATIVE COLITIS
Dietary management Lowered insoluble fiber (sweet corn, high starchy
vegetables such as carrot, turnip) Avoid wholegrains Eliminate simple carbohydrates and sugars Bread, biscuits, cakes, pies, pasta Small frequent meals Increased fluids Vitamin E rich healthy foods Do not heat the oil Chemically thermally mechanically bland foods
OVERALL YOGIC MANAGEMENT
Satvik food Moderation in eating Special technique for GID Come out of strong likes and dislikes Come out of excessive desires Happiness analysis eg. Gulab jamoon Prayers Good postures Good yogic activities Food cooked and served in good atmosphere
INTEGRATED YOGA MODULE FOR GASTROINTESTINAL DISORDER
Breathing exercises Ankle stretch breathing Tiger breathing Straight leg raise breathing Navasana breathing Instant relaxation technique (IRT)Sithilikarana Vyayama (loosening exercises) Jogging Forward and Backward bending Side bending Twisting Pavanamuktasana kriya Quick relaxation technique (QRT)
Yogasanas Ardhakaticakrasana Padahastasana Parivritta Trikonasana Vakrasana/ Ardha-Matsyendrasana Bhujangasana Salabhasana Uddiyana Bandha / Agnisara Nauli kriya Viparitakarani kriya Deep relaxation technique (DRT)
Pranayama Kapalabhati Vibhaga pranayama (sectional breathing) Nadisuddhi pranayama Sitali/ Sitkari/ Sadanta pranayama Bhramari pranayamaMeditation (Dhyana Dharana) Nadanusandhana OM meditationKriyas Jala Neti Sutra Neti Vamana Dhouti Laghu Sankhapraksalana
SPECIFIC PRACTICE Yoga aims at curing this problem by altering
one's state of mind and helping the person to calm down physically and mentally.
When stress does not stimulate excess secretion of gastric juices, the ulcers heal naturally.
One also has to eat correctly so that wrong foods do not upset the digestive system.
It recommends chewing the food slowly and concentrating on eating.
Yoga recommends a high-fiber diet, regular exercise and avoid rushing in the morning.
Ulcers (peptic or duodenal) General considerations: These problems are often
related to stress and life-style. Contraindications: In acute problems we usually
avoid the practices which may increase the pain such as Agnisara Dhauti, Kapalabhati, Mayurasana, Shalabhasana or Bhunjangasana. Dhauti (Kunjal) should be avoided because it removes the protective mucus membrane and may irritate the stomach during vomiting.
Recommendations: General relaxation and relaxation of the abdominal area. Meditation and calming pranayama in Vajrasana.
Pancreas (inflammation) General considerations: Acute inflammation of
the pancreas (pancreatitis) is extremely painful and medical aid should be called immediately.
Contraindications: A careful approach, especially with the practices increasing the pressure in the abdominal cavity, is advisable even in people with chronic pancreatitis.
Recommendations: Relaxation and meditation practices.
Colitis General considerations: It is the inflammation
of the large intestine.
Contraindications: Physically demanding practices strongly pressing or moving the intestines.
Recommendations: Meditation and relaxation.
Kidney and urinary tracts diseases General considerations: Medical advice about the
ability to tolerate any exercise is advisable. Contraindications: People with serious kidney
diseases and dropsy should avoid excessive intake of water (e.g. during Shankha Prakshalana). People with acute inflammatory diseases of the urinary tract should avoid strenuous physical exercises and inverted asanas. To stop the flow of urine repeatedly during urination may strengthen the sphincters, but it may somewhat increase the risk of an inflammation. To insert a catheter (even a sterile one) in the urethra increases the risk of inflammation more.
Recommendations: Relaxation and Ujjayi in Shavasana for acute inflammations. Yoga tradition recommends Uddiyana, Agnisara Dhauti, Garudasana, etc. in non-acute problems.
Gallbladder stones General considerations: Acute problems,
especially if associated with inflammation, require medical aid.
Contraindications: No practices pressing or moving this area (such as Nauli) are advisable.
Recommendations: Proper medical care can be supplemented by relaxation which decreases most types of pain. Laghoo Shankhaprakshalana can be according to Yoga tradition used in non-acute problems.
Recommended Asanas : Rechaka - Puraka Pranayama Uttanapadasan (Raising the legs) - exercises all
abdominal muscles, corrects disorders of pancreas, cures constipation, wind troubles; takes away extra weight of abdominal area.
Pawanmuktasan (Relieving the flatus) - activates pancreas; acts as wind reliever, loosens hip joints, and cures constipation.
Bhujangasan (Cobra pose) - cures indigestion, constipation, stomachache, brings flexibility to spine.
Salabhasan (Locust pose) - activates kidneys, liver, pancreas, helps in diarrhea, acidity and gastro-intestinal disorders.
Paschim Uttaanasan (Head knee forward bend) - relieves stomach troubles, normalizes functioning of the nervous system.
Vajrasan - helps in digestion; relieves pain of calves and knees. Can be done immediately after meals.
Shavasan (Corpse pose) - relaxes all muscles, nerves and organs.
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