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https://youtu.be/pyDQI0sHgCE

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Pancreatic Exocrine Insufficiency | Gastrointestinal Society

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Maxwell is a 74 year old male who suffers from Gerd and takes antacid medication twice a day. For dinner Maxwell ate steak and baked potato with sour cream. Follow Maxwell's dinner through the digestive system and specify what happens in each digestive organ.
Mouth- When someone eats, the teeth chew food into very small pieces. Glands in the cheeks and under the tongue produce saliva that coats the food, making it easier to be chewed and swallowed. Saliva also contains enzymes that start to digest the carbohydrates in food.
Stomach- The stomach wall produces gastric juice (hydrochloric acid and enzymes) that digests proteins. The stomach acts like a concrete mixer, churning and mixing food with gastric juice to form chyme  a thick, soupy liquid. When you have GERD (chronic acid reflux) your stomach acid persistently flows back up into your mouth through your esophagus. You may experience heartburn, acid indigestion, trouble swallowing, feeling of food caught in your throat and other problems.
Small intestine-  Bile from the gallbladder and enzymes in digestive juices from the pancreas empty into the upper section of the small intestine and help to break down protein and fatty acids. These smaller particles, along with sugars, vitamins, and minerals are absorbed into the bloodstream through the wall of the small intestine.
Large intestine- The lining of the large intestine absorbs water, mineral salts and vitamins. Undigested fibre is mixed with mucus and bacteria — which partly break down the fibre to nourish the cells of the large intestine wall and so help keep the large intestine healthy. Feces are formed and stored in the last part of the large intestine (the rectum) before being passed out of the body through the anus.
Pancreas- The pancreas secretes digestive enzymes into the duodenum that break down protein, fats and carbohydrates. The pancreas also makes insulin, passing it directly into the bloodstream. Insulin is the chief hormone in your body for metabolizing sugar.
Liver- The liver has many functions, but its main job within the digestive system is to process the nutrients absorbed from the small intestine. Bile from the liver secreted into the small intestine also plays an important role in digesting fat and some vitamins.
Gallbladder- The gallbladder stores and concentrates bile from the liver, and then releases it into the duodenum in the small intestine to help absorb and digest fats.
(Digestive system: Function, Organs & Anatomy n.d.)
(Stipanuk & Caudill, 2019)

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How will his medication affect digestion of his dinner?
Antacids are a medicine used to treat heartburn and indigestion. You can get antacids over-the-counter without a prescription. Antacids work quickly to reduce the amount of acid in your stomach to relieve symptoms. Antacids don’t treat the underlying causes of heartburn and indigestion.
Antacids neutralize the acid in your stomach by stopping an enzyme that creates acid to break down food for digestion (pepsin).
(Antacids: Types, uses, Side Effects & Precautions n.d.)

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Kate is a 25 year old female who has Celiac disease but has not done well following a gluten free diet. In addition, she has been taking the medication Orlistat to help with weight loss. For breakfast she ate a bran muffin with butter and a hard-boiled egg. Follow Kate's breakfast through the digestive system and specify what happens in each digestive organ.
Mouth- When someone eats, the teeth chew food into very small pieces. Glands in the cheeks and under the tongue produce saliva that coats the food, making it easier to be chewed and swallowed. Saliva also contains enzymes that start to digest the carbohydrates in food.
Stomach- The stomach wall produces gastric juice (hydrochloric acid and enzymes) that digests proteins. The stomach acts like a concrete mixer, churning and mixing food with gastric juice to form chyme  a thick, soupy liquid.
Small intestine-  Bile from the gallbladder and enzymes in digestive juices from the pancreas empty into the upper section of the small intestine and help to break down protein and fatty acids. These smaller particles, along with sugars, vitamins, and minerals are absorbed into the bloodstream through the wall of the small intestine. The cells on villi break down and absorb nutrients in food. If you have coeliac disease, the mucosa (lining) of your small intestine is damaged. This causes inflammation of the villi, referred to as villous atrophy.
Large intestine- The lining of the large intestine absorbs water, mineral salts and vitamins. Undigested fibre is mixed with mucus and bacteria — which partly break down the fibre to nourish the cells of the large intestine wall and so help keep the large intestine healthy. Feces are formed and stored in the last part of the large intestine (the rectum) before being passed out of the body through the anus.
Pancreas- The pancreas secretes digestive enzymes into the duodenum that break down protein, fats and carbohydrates. The pancreas also makes insulin, passing it directly into the bloodstream. Insulin is the chief hormone in your body for metabolizing sugar.
Liver- The liver has many functions, but its main job within the digestive system is to process the nutrients absorbed from the small intestine. Bile from the liver secreted into the small intestine also plays an important role in digesting fat and some vitamins.
Gallbladder- The gallbladder stores and concentrates bile from the liver, and then releases it into the duodenum in the small intestine to help absorb and digest fats.
(Digestive system: Function, Organs & Anatomy n.d.)
(Stipanuk & Caudill, 2019)

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How will Kate's Celiac disease affect her digestion and absorption of nutrients? When you have celiac disease and you eat foods with gluten, your body has a reaction that is not normal. The part of your body that fights disease (the immune system) starts to hurt your small intestine. It attacks the tiny bumps (villi) that line your small intestine. The villi help your body take in nutrients from food into your bloodstream. Without the villi, your small intestine can’t get enough nutrients, no matter how much food you eat. You may have celiac disease if you are sensitive to gluten. Gluten is a kind of protein found in wheat, rye, barley, and sometimes in small amounts in mixed oats.
How will the Orlistat impact her digestion and absorption of fats? Orlistat binds to lipases in the gastrointestinal tract and thereby blocks the digestion of dietary triglycerides. This inhibition of fat digestion reduces micelle formation and, consequently, the absorption of long-chain fatty acids, cholesterol, and certain fat-soluble vitamins.
(Coeliac disease and gluten sensitivity n.d.)
(Heck et al., 2000)

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https://youtu.be/mKUV2TBy_EA

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Pancreatic insufficiency - statpearls - NCBI bookshelf. (n.d.). Retrieved September 18, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK555926/
Antacids: Types, uses, Side Effects & Precautions. Cleveland Clinic. (n.d.). Retrieved September 18, 2022, from https://my.clevelandclinic.org/health/drugs/23076-antacid
Heck, A. M., Yanovski, J. A., & Calis, K. A. (2000, March). Orlistat, a new lipase inhibitor for the management of obesity. Pharmacotherapy. Retrieved September 18, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6145169/
Stipanuk, M. H., & Caudill, M. A. (2019). Biochemical, physiological, and molecular aspects of human nutrition. Elsevier Saunders.

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Colton is a 2 year old male who has pancreatic insufficiency due to Cystic Fibrosis. For lunch he ate whole milk cottage cheese and apple slices with peanut butter. Follow Colton's lunch through the digestive system and specify what happens in each digestion organ.
Mouth- When someone eats, the teeth chew food into very small pieces. Glands in the cheeks and under the tongue produce saliva that coats the food, making it easier to be chewed and swallowed. Saliva also contains enzymes that start to digest the carbohydrates in food.
Stomach- The stomach wall produces gastric juice (hydrochloric acid and enzymes) that digests proteins. The stomach acts like a concrete mixer, churning and mixing food with gastric juice to form chyme  a thick, soupy liquid.
Small intestine-  Bile from the gallbladder and enzymes in digestive juices from the pancreas empty into the upper section of the small intestine and help to break down protein and fatty acids. These smaller particles, along with sugars, vitamins, and minerals are absorbed into the bloodstream through the wall of the small intestine.
Large intestine- The lining of the large intestine absorbs water, mineral salts and vitamins. Undigested fibre is mixed with mucus and bacteria — which partly break down the fibre to nourish the cells of the large intestine wall and so help keep the large intestine healthy. Feces are formed and stored in the last part of the large intestine (the rectum) before being passed out of the body through the anus.
Pancreas- The pancreas secretes digestive enzymes into the duodenum that break down protein, fats and carbohydrates. The pancreas also makes insulin, passing it directly into the bloodstream. Insulin is the chief hormone in your body for metabolizing sugar.
Liver- The liver has many functions, but its main job within the digestive system is to process the nutrients absorbed from the small intestine. Bile from the liver secreted into the small intestine also plays an important role in digesting fat and some vitamins.
Gallbladder- The gallbladder stores and concentrates bile from the liver, and then releases it into the duodenum in the small intestine to help absorb and digest fats.
How will Colton's pancreatic insufficiency affect his digestion and absorption of nutrients? Pancreatitis, cystic fibrosis and other conditions that affect the pancreas cause exocrine pancreatic insufficiency (EPI). People with EPI don’t have enough pancreatic (digestive) enzymes to break down foods and absorb nutrients. It can lead to malnutrition. Pancreatic enzyme replacement therapy (PERT) can help. Cystic fibrosis is the top cause of EPI in infants and children. Children inherit cystic fibrosis from a parent. It causes thick mucus to build up in the lungs, making breathing difficult. Mucus also collects in the pancreas, which keeps digestive enzymes from reaching the small intestine.
(Pancreatic insufficiency - statpearls - NCBI bookshelf n.d.)