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Digestive Health and Disease in W men. Senior Author Suzanne Rose, MD, MSEd Professor of Medical Education and Medicine Mount Sinai School of Medicine. GASTROSLIDES Project Director Jean-Pierre Raufman Professor of Medicine University of Maryland School of Medicine.

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Digestive Health and Disease in W men

Senior AuthorSuzanne Rose, MD, MSEdProfessor of Medical Education and Medicine Mount Sinai School of Medicine

GASTROSLIDES Project Director

Jean-Pierre Raufman

Professor of Medicine

University of Maryland School of Medicine

GASTROSLIDES Art Director

Jerry Schoendorf, MAMS

Duke University Medical Center

Authors

Ann Ouyang, MBBS

S. Devi Rampertab, MD

Robin Rutherford, MD

Pratima Sharma, MD, MS

Grace L. Su, MD

Trinh Truong, MD

Jacqueline Wolf, MD

Rebecca Van Dyke, MD

Lin Chang, MD

Jennifer Christie, MD

Rosemarie Fisher, MD

Rebekah Gross, MD

Amy Foxx-Orenstein, MD

Asma Khapra, MD

Caroline Loeser, MD

Suwebatu T. Odunsi, MD


GERD / Dyspepsia

Pathophysiology of GERD

Decreased salivation

Impaired esophageal acid clearance

Lower esophageal sphincter (LES)

Impaired tissue resistance

Transient LES relaxation

Decreasing resting tone of LES

Duodenum

Delayed gastric emptying

Castell Do et al. Aliment Pharmacol Ther 2004; 20 (Suppl 9):14

II-4


Constipation

Pelvic Floor Musculature

At rest

Straining to defecate

Symphysis

pubis

Coccyx

Anorectal angle

Anorectal angle

Puborectalis

Rectum

External anal sphincter

Descent of pelvic floor

IV-9


Deeply Infiltrating Endometriosis of the Digestive Tract: Anatomical Distribution

Omentum

1.7%

Small bowel

4.7%

Chapron C et al. Human Reproduction 2006: 21:1839

Cecum and ileocecal junction

4.1%

Sigmoid colon

17.4%

Appendix

6.4%

Rectosigmoid junction and rectum

65.7%

V-54


Pregnancy and Liver Disease Anatomical Distribution

Effects of Estrogens/Pregnancy on Transporters Involved in Cholesterol Excretion

OATPs

NTCP

Sinusoid

Na+

Bile Acids

Bilirubin

ABC B11

ABC C2

Liver

ABC G5/G8

ABC B4

Cholesterol

Phosphatidylcholine (PC)

Gall bladder

Common bile duct

Hepatocyte

to bile duct

Geier A, et al. BBA 2007; 1773:283

VII-79


Mitochondrial b oxidation and oxidative phosphorylation
Mitochondrial Anatomical Distributionb-Oxidation and Oxidative Phosphorylation

Mitochondrial b-Oxidation and Oxidative Phosphorylation

Outer membrane

H+

H+

H+

H+

Inner membrane

H2O

O2

ADP+Pi

ATP

NADH e-

Citric acid cycle

b oxidation

CO2

Acetyl Co-A

Fatty acids

VIII-61


Special Issues - Colon Cancer Anatomical Distribution

Barriers to Successful Colonoscopy in Women

  • Completion Rates

    • Women 88-96%

    • Men 94.3-99.8%

  • Anatomical differences

    • Low BMI

    • Previous pelvic surgery

  • Hysterectomy

  • Diverticulosis in women

Church JM. American Journal of Gastroenterology 1994; 89(4):556

Anderson JC et al. Gastrointestinal Endoscopy2001; 54(5):558

IX-12


Nutrition Anatomical Distribution

Vitamin D Absorption

Diet

vitamin D3 and D2

UVB

Skin

Vitamin D3

7-dehydroxycholesterol

Enterocyte Chylomicron

+

vitamin D

Vitamin D3 + VDBP or albumin

Small intestine

Reabsorption of bile salts and conjugated vitamin D metabolites

Bile salts and conjugated vitamin D

Terminal ileum

25-hydroxylase

25-OHD

1-hydroxylase

1,25-(OH)2 vitamin D

Active form of vitamin D

X-3


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