WEBVTT

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Welcome

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Today we are going to explore digestive

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conditions . I'm dr Mansfield and I'm

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major spencer . The digestive system

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includes all the organs involved in

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breaking down food into a form the body

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can use for energy to fuel many

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processes including growth and cell

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repair . This process is called

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digestion . Digestive diseases . Also

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known as gastrointestinal diseases can

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be acute , meaning they come on

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suddenly and typically lasts only a

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short time or chronic , meaning they

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are long lasting , sometimes lifelong .

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In this program you can learn about

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each of the organs in the digestive

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system , how they function and how

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acute and chronic diseases or

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conditions affect them . Our

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specialists dr german doctor Malone and

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dr Patel provide their expertise

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throughout the program . In addition ,

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will introduce you to several patients

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who share their personal experiences

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with digestive conditions . Keep in

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mind there maybe terms that you're not

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familiar with . So please visit the

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glossary at any time and be sure to

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check out the other resources included

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in this program . Thank you for joining

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us . Yeah .

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Mhm . The digestive system includes all

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the organs involved in digestion or the

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breaking down of food into nutrients

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that the body uses for energy to fuel

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many processes including growth and

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cell repair . It includes the

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elementary tract , the liver , the

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pancreas and the gallbladder . The

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elementary tracked . Also called the

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digestive tract , is a series of hollow

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organs through which food passes .

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These organs include the mouth , the

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esophagus , the stomach , the small

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intestine , the large intestine and the .

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Mhm . The large intestine is also known

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as the colon and includes the rectum .

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As food moves through the elementary

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track , it mixes with digestive juices

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that break the food down into smaller

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molecules and nutrients . These

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nutrients include carbohydrates ,

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protein fats and vitamins . The body

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absorbs the nutrients through the walls

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of the small intestine into the

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bloodstream , which delivers them to

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the rest of the body . Waste products

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of digestion passed through the large

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intestine and out of the body as solid

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matter called feces or stool . Along

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with digestive juices , bacteria in the

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digestive tract sometimes called gut

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flora or microbiome . Help with

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digestion , nerves , hormones and blood

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also play roles in this digestive

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process .

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Mm mm .

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Yeah . The esophagus is the muscular

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tube that carries food and drink from

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the mouth to the stomach . Dr german .

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Can you tell us more about the

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esophagus ? Sure dr mansfield . When a

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person swallows food from the mouth ,

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pushes into the esophagus through a

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ring like bundle of muscles called the

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upper esophageal sphincter or U . S .

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The U . S . Is under voluntary or

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conscious control and works in

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conjunction with the U . Villa , which

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covers the airway . During the act of

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swallowing layers of muscle in the

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walls of the esophagus . Then contract

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and relax to move the food down toward

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the stomach . This movement which

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resembles an ocean wave traveling

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through the esophagus is called

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peristalsis . As food approaches the

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lower esophageal sphincter or ellis ,

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the muscles relax and allow food to

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pass into the stomach . Unlike the US ,

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the muscles of the L . E . S . Are not

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under voluntary or conscious control .

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The

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stomach is responsible for breaking

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down protein from food and drink dr

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Malone . Can you tell us more about the

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stomach ? Absolutely Major spencer .

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The stomach located in the upper

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abdomen receives food from the

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esophagus through a ring like bundle of

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muscles called the lower esophageal

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sphincter or L . E . S . As the food

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enters the stomach , it mixes with

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digestive juice produced by the stomach

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called stomach acid ridges of muscle

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that line the stomach called rue Guy ,

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contract periodically to churn food and

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drink , helping to mix them with the

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stomach acid . While the stomach is

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capable of accepting large volumes of

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swallowed food from the esophagus , it

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empties its contents called Kym . More

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slowly , time passes through another

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ring like bundle of muscles called the

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pile oryx Sphincter from the stomach

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into the small intestine .

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The

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small intestine , which is about 20 ft

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long , and the average adult breaks

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down starches , protein and

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carbohydrates . Doctor Patel . What

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else can you tell us about the small

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intestine ? Well , dr Mansfield food

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empties out of the stomach through a

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ring like bundle of muscles called the

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pilot sphincter into the small

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intestine . This first part of the

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small intestine where it connects to

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the stomach is called the duodenum .

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The middle part of the small intestine

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is called the june um In the june , um

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a layer of muscle contracts and relaxes

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to move the food through the small

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intestine . This movement which

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resembles an ocean wave moving through

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the small intestine is called

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peristalsis . As the food travels

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through the june , um it mixes with

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digestive juices secreted by the

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pancreas , liver and small intestine .

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The walls of the small intestine

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absorbs the digestive nutrients and

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fluid into the bloodstream , and the

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blood delivers the nutrients to the

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rest of the body . The third and last

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section of the small intestine connects

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to the large intestine or colon . It's

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called the ilium . The ilium mainly

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absorbs vitamin B 12 bile salts and

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other nutrients not absorbed by the

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june , um whatever is not absorbed into

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the bloodstream and the small intestine

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passes through the musical valve as

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waste products into the colon .

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The

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large intestine or colon changes waste

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products of the digestive process into

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stool . Doctor German . Can you tell us

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more about the colon ? Of course ?

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Major spencer . The Sikh um located in

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the lower right abdomen is the first

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part of the colon where it connects to

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the small intestine waste products

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including undigested parts of food and

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older cells from the gastrointestinal

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or gi tract lining enter the C . Come

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from the small intestine muscles , push

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these waste products through the

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different parts of the colon in

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wavelike contractions this movement is

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called peristalsis . After the Sikh um

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waist moves through the ascending colon ,

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which travels up the right side of the

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abdomen . Next the waste goes through

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the transverse colon which runs across

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the abdomen . The descending colon

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which travels down the left side of the

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abdomen is the next part . Finally

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waste passes through a short curving of

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the colon called the sigmoid colon into

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the rectum . As waste products travel

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through these sections , the colon

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absorbs water , salt and some residual

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nutrients . Changing the waste from

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liquid into solid matter . Called stool

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in the rectum . Store stool until it

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passes out of the body through the

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during a bowel movement ,

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The

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liver is a solid organ that filters

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blood and helps break down fats in the

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digestive system . Dr Malone . Can you

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tell us about the liver ? Definitely dr

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mansfield . The liver , which says on

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the upper right side of the abdomen .

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Behind the rib cage , is the largest

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internal organ in the body . It's

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divided into two sections called the

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right and left lobes . The liver

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filters blood coming from the digestive

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track before the blood flows back to

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the heart to be pumped to the rest of

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the body . It also detoxify these

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chemicals and metabolizes drugs . The

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digestive juice secreted by the liver

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and sent to the small intestine is

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called bile . The bile mixes with the

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fat in food and dissolves it . Similar

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to the way detergents dissolve grease

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from a frying pan , enzymes from the

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intestine and pancreas . Can then

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digest the fat molecules bile can be

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temporarily stored in the gallbladder

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if it isn't needed right away . For

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digestion .

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The

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pancreas is a solid organ that sits

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just behind the stomach . It helps

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break down carbohydrates , fats and

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proteins . Doctor Patel . Can you tell

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us more about the pancreas ? Sure thing ?

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Major spencer . The pancreas has two

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kinds of cells execution cells and

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neuro endocrine cells . Execution cells

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produce a digestive juice that contains

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several enzymes to break down

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carbohydrates , fats and protein . This

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digestive juice is delivered to the

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first section of the small intestine

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called the duodenum through small tubes

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called ducks neuroendocrine cells in

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the pancreas produce hormones such as

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insulin and glucose . Gone , insulin

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helps the body cells absorb glucose and

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glucose . Egan stimulates deliver to

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release its stores of extra glucose

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called glycogen glucose molecules ,

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which are the final result of starches

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and carbohydrates broken down by the

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small intestine , are the body's main

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source of energy .

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The gallbladder is a small solid organ

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that sits just under the liver . Doctor

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German , can you tell us more about the

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gallbladder ? Absolutely dr Mansfield .

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The digestive juice produced by the

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liver called bile is stored in the

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gallbladder . When the gallbladder is

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full of bile , it's about the size of a

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small pair . As a person eats the

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gallbladder squeezes bile through the

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bile ducts which connect the

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gallbladder and liver to the small

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intestine . The bile dissolves fat in

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food so that the intestine can digest

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the fat molecules , although bile helps

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digest fats the gallbladder as

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primarily a storage organ is not

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essential . Typically , if a person is

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otherwise healthy , their gallbladder

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can be safely removed without causing

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any observable problems with health or

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digestion . However , some people may

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experience diarrhea after gallbladder

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removal without the gallbladder to

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store bile between meals , bile

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continues to be produced and secreted

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by the liver continuously in small

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amounts , which can irritate the

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intestines and cause diarrhea

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separately . If a person ingests a

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large fatty meal without a gallbladder ,

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there may not be enough bile all at

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once to digest all the fat , which can

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also lead to diarrhea , gallbladder

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removal is common for people who have

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symptoms related to gall stones .

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There are many conditions that can

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affect the esophagus , the stomach or

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both . Some conditions are acute ,

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meaning they come on suddenly and

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typically lasts only a short time .

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Others are chronic or long lasting ,

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sometimes lifelong in this section .

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You can find information about some of

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the more common esophageal and stomach

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conditions including gastroesophageal

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reflux disease , peptic ulcer disease

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and others . We also discuss esophageal

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and stomach cancers including risk

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factors , symptoms and treatment

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options of each .

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Mhm .

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Research suggests that gastroesophageal

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reflux disease or GERD affects around

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one in five adults in United States .

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Dr Malone . Can you tell us about GERD ?

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Sure Dr mansfield you may hear others

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refer to gastroesophageal reflux as

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acid indigestion acid reflux ,

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heartburn or reflux . When

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gastroesophageal reflux happens more

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than twice a week for a few weeks it

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could be good . Gastroesophageal reflux

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happens when the lower esophageal

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sphincter or L . E . S . Becomes weak

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or relaxed . The contents of the

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stomach can then come back up into the

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esophagus which doesn't have the same

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protective lining as stomach stomach

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acid that touches the lining of the

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esophagus can cause a painful burning

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sensation or other symptoms . However

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up to 50% of patients with GERD have no

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symptoms . The L . E . S . Naturally

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relaxes during meals to let food into

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the stomach . It can stay relaxed for

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up to three hours after eating and

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lying down during this time can cause

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acid reflux symptoms . The L . E . S .

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Becomes unnaturally week or relaxed due

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to several things such as increased

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pressure on the abdomen from being

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overweight , obese or pregnant .

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Certain medicines including asthma

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medications and to histamines , calcium

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channel blockers , painkillers ,

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sedatives and antidepressants , smoking

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or inhaling second hand smoke and

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ingestion of caffeine , chocolate or

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mint mm . GERD can cause serious

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complications over time if it's left

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untreated . Some potential

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complications include esophagitis or

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inflammation and ulceration of the

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esophagus . Chronic esophagitis can

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lead to pre cancerous changes in the

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esophagus . Barrett's esophagus , which

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is a condition in which tissue that's

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similar to the lining of the intestine

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replaces the tissue lining of the

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esophagus . In some cases , barrett's

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esophagus can lead to the development

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of a rare but often deadly type of

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esophageal cancer . Asafa gil stricture ,

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meaning the esophagus becomes scarred

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and to narrow this can lead to problems

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with swallowing and respiratory

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problems which can result from stomach

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acid getting into the lungs . Yeah ,

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the most common symptom of

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gastroesophageal reflux disease or GERD

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is regular heartburn ? Doctor Patel .

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Can you tell us more about symptoms of

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GERD ? Of course , Major spencer .

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Heartburn is often described as a

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painful burning sensation in the middle

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of the chest , behind the breastbone

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and in the upper middle abdomen .

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However , not all adults with GERD

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experienced heartburn . Other common

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symptoms of GERD include bad breath ,

14:50.450 --> 14:52.570
taste of food or stomach acid in the

14:52.570 --> 14:55.870
back of the mouth , nausea , pain in

14:55.870 --> 14:58.450
the chest or upper part of the abdomen ,

14:58.940 --> 15:00.740
problems swallowing or painful

15:00.740 --> 15:04.250
swallowing , respiratory problems ,

15:04.640 --> 15:07.760
vomiting and wearing away of the teeth .

15:07.770 --> 15:10.250
It's important to note that some people

15:10.250 --> 15:13.250
with good have no symptoms at all .

15:20.840 --> 15:23.640
The symptoms of gastroesophageal reflux

15:23.640 --> 15:26.240
disease or a GERD can sometimes be

15:26.240 --> 15:28.184
controlled by adopting some simple

15:28.184 --> 15:30.710
habits . Dr german , what can you tell

15:30.710 --> 15:32.870
us about treating symptoms of GERD ?

15:33.020 --> 15:35.187
Well , dr mansfield . Some easy things

15:35.187 --> 15:37.187
you can do if you have GERD include

15:37.460 --> 15:39.690
don't eat or drink items that may cause

15:39.690 --> 15:42.440
gastroesophageal reflux such as greasy

15:42.440 --> 15:45.370
or spicy foods , caffeine , chocolate ,

15:45.670 --> 15:48.840
mint and alcoholic drinks . Don't

15:48.850 --> 15:52.810
overeat , Avoid eating 2-3 hours before

15:52.810 --> 15:55.280
bedtime , quit smoking and avoid

15:55.280 --> 15:57.850
secondhand smoke . Where loose fitting

15:57.850 --> 15:59.850
clothing around the abdomen , tight

15:59.850 --> 16:01.961
clothing can squeeze the stomach area

16:01.961 --> 16:04.150
and push acid up into the esophagus .

16:04.740 --> 16:06.684
Stay upright for three hours after

16:06.684 --> 16:08.960
meals and avoid reclining or slouching

16:09.840 --> 16:12.230
and sleep on a slight angle , raise the

16:12.230 --> 16:14.260
head of your bed 6 to 8 inches by

16:14.260 --> 16:16.371
safely , putting blocks under the bed

16:16.371 --> 16:18.593
posts . Simply using extra pillows will

16:18.593 --> 16:20.940
not help when lifestyle changes , such

16:20.940 --> 16:22.996
as these aren't sufficient to reduce

16:22.996 --> 16:25.107
symptoms , providers may recommend or

16:25.107 --> 16:27.900
prescribe a good medication . Good

16:27.900 --> 16:30.067
medications work in different ways and

16:30.067 --> 16:31.678
it may take trying different

16:31.678 --> 16:33.790
medications or using a combination of

16:33.800 --> 16:36.060
good medications to control symptoms .

16:38.640 --> 16:39.640
Mhm .

16:44.940 --> 16:48.230
A peptic ulcer is an ulcer or sore on

16:48.230 --> 16:50.397
the lining of the stomach or where the

16:50.397 --> 16:52.286
first part of the small intestine

16:52.286 --> 16:54.230
connects to the stomach called the

16:54.230 --> 16:56.286
duodenum . Rarely a peptic ulcer can

16:56.286 --> 16:59.010
develop in the esophagus dr Malone .

16:59.020 --> 17:00.909
Can you tell us more about peptic

17:00.909 --> 17:04.320
ulcers ? Certainly Major spencer , the

17:04.320 --> 17:06.710
most common cause of peptic ulcers is

17:06.710 --> 17:08.543
an infection from the bacteria .

17:08.543 --> 17:12.520
Helicobacter pylori or h . Pylori . H .

17:12.520 --> 17:15.270
Pylori are spiral shaped bacteria that

17:15.270 --> 17:17.490
likely spread through unclean food ,

17:17.500 --> 17:20.620
water eating utensils and contact with

17:20.620 --> 17:23.200
an infected person's saliva and other

17:23.200 --> 17:26.170
bodily fluids . Another common cause of

17:26.170 --> 17:28.910
peptic ulcers is the long term regular

17:28.910 --> 17:31.900
use of non steroidal anti inflammatory

17:31.900 --> 17:35.310
drugs or Nsaids , such as naproxen or

17:35.310 --> 17:38.330
ibuprofen . Other risk factors of

17:38.330 --> 17:40.930
developing NSAID induced peptic ulcers

17:41.130 --> 17:44.370
include being over 70 years old , being

17:44.370 --> 17:47.100
female , taking more than two types of

17:47.100 --> 17:50.120
N said's having prior peptic ulcers ,

17:50.180 --> 17:52.520
having two or more medical conditions

17:52.520 --> 17:56.380
or diseases taking other medications

17:56.390 --> 17:58.730
such as corticosteroids and medicines

17:58.730 --> 18:01.460
to increase bone mass and drinking

18:01.460 --> 18:05.190
alcohol or smoking . In very rare

18:05.190 --> 18:07.590
cases . Peptic ulcers can be caused by

18:07.590 --> 18:10.230
tumors . Peptic ulcers can lead to a

18:10.230 --> 18:12.610
number of complications including

18:12.620 --> 18:14.830
bleeding from a broken blood vessel in

18:14.830 --> 18:17.560
the ulcer , a perforation or partial

18:17.560 --> 18:19.282
tear in the stomach , or small

18:19.282 --> 18:22.300
intestine at the ulcer , an obstruction

18:22.300 --> 18:24.570
or blockage that can stop food from

18:24.570 --> 18:26.403
moving from the stomach into the

18:26.403 --> 18:29.940
duodenum and peritonitis , which is an

18:29.940 --> 18:31.662
infection of the lining of the

18:31.662 --> 18:33.870
abdominal cavity with or without

18:33.880 --> 18:34.670
preparation .

18:44.640 --> 18:46.650
The most common symptom of a peptic

18:46.650 --> 18:49.070
ulcer is a dull or burning pain in the

18:49.070 --> 18:51.710
stomach . Doctor Patel . What else can

18:51.710 --> 18:53.766
you tell us about symptoms of peptic

18:53.766 --> 18:56.750
ulcers ? Well , dr mansfield stomach

18:56.750 --> 18:58.917
pain from an ulcer maybe felt anywhere

18:58.917 --> 19:01.194
between the bellybutton and breastbone ,

19:01.194 --> 19:03.417
and happens most often when the stomach

19:03.417 --> 19:05.417
is empty , such as between meals or

19:05.417 --> 19:07.590
during the night . It often stops

19:07.590 --> 19:09.910
briefly with eating or taking in acids .

19:10.140 --> 19:12.510
This pain may last for minutes to hours

19:12.520 --> 19:14.670
and comes and goes for several days ,

19:14.680 --> 19:17.330
weeks or months . Other symptoms of a

19:17.330 --> 19:19.720
peptic ulcer may include bleeding with

19:19.720 --> 19:22.460
red or black stools , bloating ,

19:22.940 --> 19:26.850
burping , nausea , poor appetite

19:27.440 --> 19:29.650
vomiting and weight loss

19:29.660 --> 19:32.360
weight .

19:34.540 --> 19:40.720
There

19:40.720 --> 19:42.609
are many prescription medications

19:42.609 --> 19:44.776
available for treating peptic ulcers ,

19:44.776 --> 19:46.942
but treatment typically depends on the

19:46.942 --> 19:49.420
cause of the peptic ulcer dr german ,

19:49.430 --> 19:51.430
can you tell us more about treating

19:51.430 --> 19:53.570
peptic ulcers ? Absolutely . Major

19:53.570 --> 19:55.780
spencer for people whose peptic ulcer

19:55.780 --> 19:57.710
is caused by non steroidal anti

19:57.710 --> 19:59.750
inflammatory drugs . Or Nsaids

19:59.900 --> 20:02.067
providers generally recommend complete

20:02.067 --> 20:04.560
cessation of NSAID use and switching to

20:04.560 --> 20:06.560
another medicine that won't cause a

20:06.560 --> 20:08.616
peptic ulcer such as acetaminophen .

20:08.740 --> 20:10.740
They may also prescribe medications

20:10.740 --> 20:12.851
that reduce stomach acid and coat and

20:12.851 --> 20:14.851
protect the peptic ulcer until it's

20:14.851 --> 20:16.684
able to heal . These medications

20:16.684 --> 20:18.518
include proton pump inhibitors ,

20:18.518 --> 20:21.060
histamine two blockers and protect its

20:21.740 --> 20:23.962
for people whose peptic ulcer is caused

20:23.962 --> 20:26.310
by H . Pylori providers may prescribe a

20:26.310 --> 20:28.300
regiment of multiple medications .

20:28.310 --> 20:30.310
These treatments are referred to as

20:30.310 --> 20:32.950
Triple therapy , Quadruple therapy and

20:32.950 --> 20:35.010
sequential therapy . It's very

20:35.010 --> 20:37.066
important for these patients to also

20:37.066 --> 20:39.230
avoid insides as N sets can worsen

20:39.230 --> 20:42.560
disease and prevent ulcer healing .

20:49.440 --> 20:52.440
I guess I started having gi

20:52.440 --> 20:55.670
problems probably when I was in middle

20:55.670 --> 20:57.559
school , I just kept having these

20:57.559 --> 21:00.720
different uh swallowing symptoms . Um

21:00.730 --> 21:02.730
It was very hard to swallow . I had

21:02.730 --> 21:04.730
trouble with swallowing most of the

21:04.730 --> 21:06.786
time just every now and then I would

21:06.786 --> 21:09.320
choke on food . This onset of this pain

21:09.330 --> 21:12.900
in my chest , a tight aching sometimes

21:12.900 --> 21:15.080
felt like someone was stabbing me . Um

21:15.090 --> 21:17.257
was happening in my chest area , upper

21:17.257 --> 21:19.490
chest . I wasn't certain what was

21:19.490 --> 21:21.712
causing this , why I couldn't swallow ,

21:21.712 --> 21:23.657
why I was getting stuck because it

21:23.657 --> 21:25.601
literally would be anything that I

21:25.601 --> 21:27.768
would eat , it would just get stuck in

21:27.768 --> 21:26.940
my throat and then all of a sudden I

21:26.940 --> 21:29.390
would start having these these painful

21:29.400 --> 21:32.240
uh symptoms and then like gagging

21:32.240 --> 21:35.710
reflexes and such . So um it was very ,

21:35.720 --> 21:37.770
very painful . I did have one time

21:37.770 --> 21:39.881
where I thought it wasn't going to go

21:39.881 --> 21:42.103
down . That was kinda , it was actually

21:42.103 --> 21:44.326
the first day that I started working at

21:44.326 --> 21:47.760
this place . So it was it was pretty

21:47.760 --> 21:49.816
intense , I assumed that it was acid

21:49.816 --> 21:52.500
reflux . Um So I just kinda would take

21:52.500 --> 21:54.722
some over the counter meds and and kind

21:54.722 --> 21:57.050
of that sort of thing . But over time

21:57.050 --> 21:59.850
as I started monitoring what I ate I

21:59.850 --> 22:01.961
kind of realized that it may not have

22:01.961 --> 22:03.961
been there , I was told my problems

22:03.961 --> 22:06.072
could have been me eating too fast or

22:06.072 --> 22:08.239
not chewing my food completely . Um So

22:08.239 --> 22:10.461
I didn't never think about going to the

22:10.461 --> 22:12.461
doctor because it kept happening so

22:12.461 --> 22:14.750
often , I had to really you know seek

22:14.760 --> 22:16.816
medical attention because I was like

22:16.816 --> 22:18.760
this is something , you know and I

22:18.760 --> 22:18.670
don't really come to the hospital

22:18.670 --> 22:20.948
unless there's something wrong with me .

22:20.948 --> 22:23.059
So I was like I really know I need to

22:23.059 --> 22:25.003
go and so the wife being concerned

22:25.003 --> 22:27.114
about it of me complaining about this

22:27.114 --> 22:29.059
pain . She said let's go to the er

22:34.240 --> 22:37.530
e . Eosinophilic

22:37.530 --> 22:40.500
esophagitis or E . O . E . Is a disease

22:40.500 --> 22:42.556
in which a large number of a special

22:42.556 --> 22:44.444
type of white blood cell called a

22:44.444 --> 22:46.790
cinephiles cause inflammation in the

22:46.790 --> 22:49.550
esophagus dr Malone . What can you tell

22:49.550 --> 22:51.950
us about this condition ? Well dr

22:51.950 --> 22:54.670
mansfield inflammation caused by eO

22:54.670 --> 22:56.760
cinephiles can cause many different

22:56.760 --> 22:59.400
types of changes in the esophagus both

22:59.400 --> 23:01.820
on the surface and with the function of

23:01.820 --> 23:04.130
the deeper muscle layers . These

23:04.130 --> 23:06.530
changes can result in stiffening or

23:06.530 --> 23:08.830
narrowing of the esophagus which can

23:08.830 --> 23:11.052
cause difficulty with swallowing called

23:11.052 --> 23:13.580
dysplasia . Or food getting stuck in

23:13.580 --> 23:16.800
the esophagus . In fact dysplasia and

23:16.800 --> 23:19.030
food lodged in the esophagus are the

23:19.030 --> 23:21.940
most common symptoms of E . O . And can

23:21.940 --> 23:24.107
become a medical emergency if the food

23:24.107 --> 23:26.860
does not pass . Other less common

23:26.860 --> 23:29.030
symptoms include heartburn and chest

23:29.030 --> 23:31.930
pain . Currently the only way to

23:31.930 --> 23:34.430
diagnose E . O . Is by performing an

23:34.440 --> 23:38.430
upper gi endoscopy with biopsy . During

23:38.430 --> 23:41.410
endoscopy with biopsy , a thin flexible

23:41.410 --> 23:43.630
tube with a camera is passed through

23:43.630 --> 23:46.190
the esophagus and tiny pieces of tissue

23:46.190 --> 23:48.023
are taken from the lining of the

23:48.023 --> 23:50.450
esophagus , also called the mucosa .

23:50.940 --> 23:52.773
These are then inspected under a

23:52.773 --> 23:56.320
microscope . The cause of yo is unknown ,

23:56.330 --> 23:59.210
but some research suggests that this

23:59.210 --> 24:00.988
condition is associated with an

24:00.988 --> 24:03.390
allergic reaction to environmental and

24:03.390 --> 24:06.300
food allergens . A majority of patients

24:06.300 --> 24:08.467
with , you know , we have a history of

24:08.467 --> 24:10.830
allergic conditions such as allergic

24:10.830 --> 24:13.850
rhinitis , asthma , eczema or food

24:13.850 --> 24:16.630
allergy For this reason dietary changes

24:16.630 --> 24:19.300
may be recommended . However , primary

24:19.300 --> 24:21.950
treatment for RIO is a daily proton

24:21.950 --> 24:24.450
pump inhibitor or PPE medication .

24:24.460 --> 24:27.660
Usually continued for life . A topical

24:27.660 --> 24:29.827
allergy medication may be added to the

24:29.827 --> 24:31.500
treatment regimen to be used

24:31.500 --> 24:33.660
intermittently if symptoms remain

24:36.940 --> 24:42.920
many

24:42.920 --> 24:44.476
common over the counter and

24:44.476 --> 24:46.370
prescription medications can have

24:46.370 --> 24:49.020
gastrointestinal side effects . Doctor

24:49.020 --> 24:51.290
Patel . Can you tell us about the gi

24:51.290 --> 24:53.623
side effects of some common medications ?

24:53.623 --> 24:56.720
Sure . Major spencer , gi problems such

24:56.720 --> 25:00.170
as nausea , vomiting , constipation ,

25:00.540 --> 25:03.350
diarrhea , indigestion ,

25:03.940 --> 25:06.930
abdominal pain and bloating are among

25:06.930 --> 25:08.930
the most common side effects of any

25:08.930 --> 25:11.450
medication , including prescription and

25:11.450 --> 25:13.617
over the counter medications , some of

25:13.617 --> 25:15.450
the most common over the counter

25:15.450 --> 25:17.617
medications , including pain relievers

25:17.617 --> 25:19.600
and fever reducers such as non

25:19.600 --> 25:22.250
steroidal anti inflammatory drugs or

25:22.260 --> 25:24.900
Nsaids and acetaminophen can cause

25:24.900 --> 25:27.470
stomach upset and said such as

25:27.470 --> 25:29.850
ibuprofen and naproxen can actually

25:29.850 --> 25:31.628
cause damage to the stomach and

25:31.628 --> 25:34.130
intestinal lining and result in ulcers .

25:34.140 --> 25:36.740
acetaminophen does not cause damage to

25:36.740 --> 25:39.000
the lining of the intestines . Many of

25:39.000 --> 25:40.722
the most frequently prescribed

25:40.722 --> 25:42.850
medications can cause a number of gi

25:42.850 --> 25:45.610
side effects . For instance , diarrhea

25:45.610 --> 25:47.610
and upset stomach are common . Side

25:47.610 --> 25:50.290
effects of many antibiotics leave both

25:50.290 --> 25:52.760
Iraq's in which treats hypothyroidism

25:52.770 --> 25:55.048
is one of the top prescribed medicines .

25:55.180 --> 25:57.150
Some of the gi side effects it can

25:57.150 --> 25:59.890
cause include nausea , stomach cramps ,

25:59.900 --> 26:02.600
diarrhea and difficulty with swallowing .

26:02.610 --> 26:05.030
Another commonly prescribed medication

26:05.030 --> 26:07.180
with gi side effects is metformin ,

26:07.190 --> 26:09.023
which is generally used to treat

26:09.023 --> 26:11.610
diabetes . Diarrhea is a commonly

26:11.610 --> 26:13.610
reported side effect of metformin ,

26:13.610 --> 26:15.610
especially if the medication isn't

26:15.610 --> 26:18.280
started slowly , medications prescribed

26:18.280 --> 26:20.510
to treat heart disease can also cause

26:20.510 --> 26:23.180
gi side effects . For instance , many

26:23.180 --> 26:25.440
people who take statins which are used

26:25.440 --> 26:27.662
to lower bad cholesterol and raise good

26:27.662 --> 26:29.950
cholesterol , report abdominal pain ,

26:29.960 --> 26:32.830
nausea and constipation as side effects .

26:32.880 --> 26:35.430
If narcotics are used for long standing

26:35.430 --> 26:37.400
abdominal pain , they can actually

26:37.410 --> 26:39.480
increase abdominal pain due to its

26:39.480 --> 26:41.536
effects on the nervous system in the

26:41.536 --> 26:42.536
gut .

26:51.140 --> 26:53.950
Non steroidal anti inflammatory drugs

26:53.960 --> 26:56.560
or insets are a group of medicines that

26:56.560 --> 26:59.320
reduce inflammation , relieve pain and

26:59.320 --> 27:01.620
lower temperature . They are extremely

27:01.620 --> 27:03.620
common , but they can have unwanted

27:03.620 --> 27:05.930
effects on the digestive system . Dr

27:05.930 --> 27:08.152
german , can you tell us more about the

27:08.152 --> 27:10.370
gi side effects of insects ? Well ,

27:10.370 --> 27:12.850
Major spencer All N said's work by

27:12.850 --> 27:15.560
blocking two types of enzymes . Some of

27:15.560 --> 27:17.782
these enzymes produce a chemical called

27:17.782 --> 27:19.727
prostaglandin , which protects the

27:19.727 --> 27:21.782
stomach lining from stomach acid and

27:21.782 --> 27:23.838
helps control bleeding . When N sets

27:23.838 --> 27:25.893
block these enzymes , the intestinal

27:25.893 --> 27:27.727
lining is no longer protected by

27:27.727 --> 27:29.949
prostaglandins and stomach acid is able

27:29.949 --> 27:32.171
to damage the lining in the stomach and

27:32.171 --> 27:34.282
the first part of the small intestine

27:34.282 --> 27:36.393
called the duodenum . This can result

27:36.393 --> 27:38.504
in ulcers anywhere in the esophagus ,

27:38.504 --> 27:40.560
stomach and intestinal tract . About

27:40.560 --> 27:42.880
50% of people taking in said's have

27:42.880 --> 27:44.860
inflammation or ulcers , which can

27:44.860 --> 27:46.693
occur with even a single dose of

27:46.693 --> 27:48.270
medication

27:55.540 --> 27:58.880
sub mucosal nodule , sometimes called

27:58.880 --> 28:01.360
sub mucosal lesions or sub mucosal

28:01.360 --> 28:03.550
tumors are growths underneath the

28:03.550 --> 28:05.550
mucosa , which is the lining of the

28:05.550 --> 28:08.040
gastrointestinal organs ? Dr Malone .

28:08.050 --> 28:10.030
Can you tell us about some mucosal

28:10.030 --> 28:13.800
modules ? Chorus dr Mansfield Sub

28:13.800 --> 28:15.940
mucosal modules can occur anywhere

28:15.940 --> 28:17.930
throughout the Gi tract , but many

28:17.930 --> 28:20.370
types of sub mucosal modules are most

28:20.370 --> 28:22.780
frequently found in the stomach . Sub

28:22.780 --> 28:24.920
mucosal modules can be benign ,

28:24.930 --> 28:27.860
precancerous or cancerous . They often

28:27.860 --> 28:29.940
have no symptoms and are only found

28:29.940 --> 28:32.050
incidentally during a diagnostic or

28:32.050 --> 28:34.217
screening tests for other conditions ,

28:34.740 --> 28:36.810
symptoms do present in some cases ,

28:36.810 --> 28:38.880
however , and they vary depending on

28:38.880 --> 28:40.991
the type and location of the growth .

28:41.240 --> 28:43.440
The most common type of sub mucosal

28:43.440 --> 28:46.260
modules is a gastrointestinal stromal

28:46.260 --> 28:48.760
tumor or guest , which is most often

28:48.760 --> 28:51.650
found in the stomach . Pancreatic rests

28:51.660 --> 28:53.660
are another type often found in the

28:53.660 --> 28:56.080
stomach . Like pumas are a type of sub

28:56.080 --> 28:57.913
mucosal nodule that can be found

28:57.913 --> 29:00.410
anywhere in the GI tract and Carson

29:00.410 --> 29:02.577
noise are most frequently found in the

29:02.577 --> 29:05.150
rectum and small intestine . Other

29:05.150 --> 29:07.710
types such as lion McComas and granular

29:07.710 --> 29:09.990
cell tumors are most often found in the

29:09.990 --> 29:13.110
esophagus diagnosis of sub mucosal

29:13.110 --> 29:15.060
modules . Usually requires a

29:15.060 --> 29:17.710
specialized upper endoscopy procedure

29:17.750 --> 29:20.550
called endoscopic ultrasonography or

29:20.560 --> 29:23.850
endoscopic ultrasound . Ultrasound uses

29:23.850 --> 29:26.290
high frequency sound waves to create

29:26.300 --> 29:29.480
images of organs inside the body . In

29:29.480 --> 29:32.310
an endoscopic ultrasound or the U . S .

29:32.440 --> 29:34.662
The sound waves are sent through a thin

29:34.662 --> 29:37.450
flexible tube called an endoscope that

29:37.450 --> 29:39.490
is passed into the digestive tract

29:39.500 --> 29:42.420
through the mouth or the . This allows

29:42.420 --> 29:44.700
for ultrasound images to be taken from

29:44.710 --> 29:47.270
inside the body as well as sampling of

29:47.270 --> 29:49.780
the tissue depending on the type of sub

29:49.780 --> 29:52.260
mucosal nodule . Further tests may be

29:52.260 --> 29:54.320
recommended to determine whether the

29:54.320 --> 29:56.650
growth is benign , precancerous or

29:56.650 --> 29:57.550
cancerous

30:07.240 --> 30:09.690
cancer of the esophagus or esophageal

30:09.690 --> 30:11.900
carcinoma is a disease in which

30:11.900 --> 30:14.067
malignant cells form in the tissues of

30:14.067 --> 30:16.860
the esophagus ? Doctor Patel , can you

30:16.860 --> 30:19.220
tell us more about esophageal cancer ?

30:19.230 --> 30:21.380
Of course , Major spencer . There are

30:21.380 --> 30:23.602
two main types of cancer that can occur

30:23.602 --> 30:25.470
in the esophagus . One is called

30:25.470 --> 30:27.820
squamous cell carcinoma , which begins

30:27.820 --> 30:30.098
in the flat cells lining the esophagus .

30:30.140 --> 30:32.780
This type of cancer is most often found

30:32.780 --> 30:34.780
in the upper and middle part of the

30:34.780 --> 30:36.447
esophagus . The other type of

30:36.447 --> 30:39.030
esophageal cancer called adenocarcinoma

30:39.040 --> 30:41.220
begins in the glandular cells which

30:41.220 --> 30:43.442
make and release mucus and other fluids

30:43.640 --> 30:46.170
add no carcinomas usually form in the

30:46.170 --> 30:48.226
lower part of the esophagus near the

30:48.226 --> 30:50.360
stomach because there aren't usually

30:50.360 --> 30:52.471
any early signs or symptoms until the

30:52.471 --> 30:55.050
cancer grows larger . Asafa jal cancer

30:55.050 --> 30:57.640
is often diagnosed at an advanced stage

30:57.640 --> 30:59.862
when the survival rate is significantly

30:59.862 --> 31:00.660
lower .

31:06.040 --> 31:09.980
While the exact cause of

31:09.980 --> 31:12.170
esophageal cancer is unknown , there

31:12.170 --> 31:13.948
are factors that can increase a

31:13.948 --> 31:16.114
person's risk for developing cancer of

31:16.114 --> 31:18.620
the esophagus . Doctor German , can you

31:18.620 --> 31:20.453
tell us about some of these risk

31:20.453 --> 31:23.280
factors ? Sure . Dr Mansfield , risk

31:23.280 --> 31:25.940
factors for esophageal cancer include

31:25.950 --> 31:29.120
age , A soft giggle cancer is more

31:29.120 --> 31:31.320
commonly diagnosed in people over the

31:31.320 --> 31:35.270
age of 55 gender . Men are twice

31:35.270 --> 31:37.437
as likely as women to have a sofa jail

31:37.437 --> 31:41.240
cancer race , squamous cell

31:41.240 --> 31:43.073
cancer is more common in african

31:43.073 --> 31:44.670
americans than caucasians .

31:45.240 --> 31:47.462
Adenocarcinoma , on the other hand , is

31:47.462 --> 31:49.518
more common in middle aged caucasian

31:49.518 --> 31:52.450
men , family history . Mm .

31:52.840 --> 31:54.950
Adenocarcinoma sometimes runs in

31:54.950 --> 31:57.670
families , obesity

31:58.840 --> 32:01.340
being overweight or obese increases the

32:01.340 --> 32:05.190
risk for esophageal cancer , heavy

32:05.190 --> 32:08.530
alcohol use and smoking . These habits

32:08.530 --> 32:10.530
increase the risk for squamous cell

32:10.530 --> 32:13.290
carcinoma , especially together and

32:13.290 --> 32:15.068
irritation of the lining of the

32:15.068 --> 32:17.390
esophagus , gastroesophageal reflux

32:17.390 --> 32:20.500
disease or GERD barrett's esophagus and

32:20.500 --> 32:22.556
other causes of irritation can cause

32:22.556 --> 32:24.611
the cells that line the esophagus to

32:24.611 --> 32:26.740
change , which increases the risk of

32:26.740 --> 32:28.670
developing adenocarcinoma .

32:33.840 --> 32:34.840
Mhm .

32:38.340 --> 32:40.507
There are generally no symptoms in the

32:40.507 --> 32:42.729
early stages of esophageal cancer . But

32:42.729 --> 32:44.910
as the cancer grows , the esophagus

32:44.910 --> 32:47.830
becomes narrowed . DR Malone . Can you

32:47.830 --> 32:49.941
tell us about some of the symptoms of

32:49.941 --> 32:52.530
esophageal cancer , definitely major

32:52.530 --> 32:55.580
spencer . When cancer grows , it takes

32:55.580 --> 32:57.802
up space in the esophagus and makes the

32:57.802 --> 33:00.030
passage through which food pills and

33:00.030 --> 33:02.260
drink travel more narrow . This can

33:02.260 --> 33:04.030
make it difficult to swallow a

33:04.030 --> 33:06.790
condition called dysplasia . At first ,

33:06.800 --> 33:08.890
a person with esophageal cancer may

33:08.890 --> 33:11.110
notice trouble swallowing solid foods

33:11.230 --> 33:13.290
such as meats , breads or raw

33:13.290 --> 33:16.070
vegetables . As the cancer progresses

33:16.070 --> 33:18.126
and the esophagus narrows , they may

33:18.126 --> 33:20.292
have difficulty swallowing medications

33:20.292 --> 33:23.100
and liquids as well . Other symptoms of

33:23.100 --> 33:25.120
a cervical cancer can include

33:25.400 --> 33:28.910
indigestion , heartburn , vomiting ,

33:29.240 --> 33:32.960
choking , coughing , hoarseness of the

33:32.960 --> 33:35.460
voice and involuntary weight loss .

33:36.240 --> 33:36.560
Yeah ,