Gastrointestinal Disorders

3. Main Points What are the most common disorders? GERD IBS PUD Crohn�s disease Ulcerative Colitis How is Evolutionary Medicine related to these disorders? Conclusions

4. What are the Most Common GI Disorders? Gastroesophogeal Reflux Disease (GERD) Irritable Bowel Syndrome (IBS) Peptic Ulcer Disease (PUD) Crohn�s disease Ulcerative Colitis

5. Gastroesophageal Reflux Disease (GERD)

6. Causes Gastroesophogeal motility Complex process by which food and liquids are relocated from one anatomic region to another (esophagus to stomach) When the process happens in the reverse order, GERD symptoms can occur

7. Symptoms Heartburn Caused by acid contents of stomach flowing back up into the esophagus as a result of inadequate esophageal sphincter pressure Waterbrash Regurgitation of bitter tasting fluids, experienced daily by about 10% of the general population Chest pain/discomfort Caused by excessive acid flow into the esophagus, which becomes irritated and painful Excessive belching Arises soon after meals, and worsens with eating

9. Irritable Bowel Syndrome (IBS)

10. Causes Realistically, there is no generally accepted cause of IBS Hypotheses Food allergies Stress Amount of fiber in diet Antibiotic use GI infection Chronic alcohol abuse Abnormalities in GI secretions

11. Symptoms Abdominal Pain Dependent upon the strength of bowel contractions Bloating Prolonged contractions prevent a normal passage of air, triggering bloating and belching Constipation/Diarrhea These symptoms may alternate, or one of them may be prevalent in the patient.

13. Peptic Ulcer Disease (PUD)

14. Causes 70% of gastric ulcers and 90% of duodenal ulcers are related to helicobacter pylori These bacterium live underneath the protective mucous lining of the stomach They damage the lining of the stomach and duodenum causing inflammation and the secretion of more stomach acid Ingestion of: Aspirin Ibuprofen Anti-arthritic medications Alcohol

15. Symptoms Pain Often described as burning, gnawing Usually worst when stomach is empty of everything but acid Nausea/Vomiting Occurs most when ulcer is in pylorus, or narrow exit of the stomach, preventing food from leaving the stomach Loss of appetite Feeling bloated

17. Crohn�s Disease

18. Causes The cause of Crohn�s is also unknown Excluded Viral Bacterial Dietary Allergy Possible Emotions Environmental Immunological Genetic

19. Symptoms Diarrhea Improper absorption of food Weight Loss Increased elimination of fat and other food stuffs Abdominal pain Often due to intestinal spasm Fever Battles inflammation Anemia Occurs from blood loss due to ulcerations of the intestine

21. Ulcerative Colitis

22. Causes Also unknown Excluded Pathological Stress Allergies Toxins Possible Auto immune disorder

23. Symptoms Blood in the bowel movement Occurs in over 90% of patients Amount will vary Diarrhea Occurs in 80% of patients Abdominal Pain Result of diarrhea

25. How are these disorders related to Darwinian Medicine?

26. Evolution Diseases of civilization Records exist of symptoms in the Mayan people of the Chiapas region of Mexico No records have been found predating this Stone age body, modern environment Ingestion of medications and toxins Alcohol Medications Aspirin Ibuprofen Antibiotic use Environment Stress Cleanliness Helicobacter pylori Effect of worms on Crohn�s disease

27. Conclusions GI disorders are rather mysterious, and based more on theory, than scientific fact However, these disorders are more and more frequently occuring throughout the general population More research is necessary to remove some of the �fog� about these disorders What causes them? How are they explained from an evolutionary perspective?