A Pain in the Gut: resolving a scenario on gastric physiology issues

Section 1- The Accident 

Question 1 

Before the accident, Frank experienced physical problems such as tiredness, shaky hands, and blurred vision. 

Question 2 

Blurred vision experience by Frank might have been caused by sorbitol, a byproduct of glucose. Frank has been taking a lot of sugars from soda. Upon digestion, sugars are converted into glucose. Excess sugars are converted into sorbitol which accumulates in the lenses of the eye, causing blurred vision. 

Question 3 

Franks’s symptoms could indicate that he was suffering from diabetes mellitus. According to Cleveland Clinic (n.d), symptoms of diabetes are increased thirst, tiredness, blurred vision, numbness or shaking hands, weight loss, and frequent urination. Frank had three of these symptoms. 

Section 2- The Checkup 

Question 1 

Insulin is the hormone responsible for lowering the glucose levels in the blood (Stoppler, 2019). 

Question 2 

The pancreas is the gland that produces insulin (Stoppler, 2019). 

Question 3 

Variable	Insulin Dependent Diabetes Mellitus (IDDM)	Non-Insulin Dependent Diabetes Mellitus (NIDDM)
Blood Insulin Level	Low	Normal
Insulin receptor function	Normal	Low

Question 4 

Frank could have been suffering from type 1, Insulin Dependent Diabetes Mellitus (IDDM) because, according to Table 1, Frank had low levels of insulin in his blood systems. 

Question 5 

The diagnosis presented to Frank could be reasonable because, according to Stoppler (2019), type 1 diabetes mellitus is hereditary. Frank could have inherited diabetes from the family lineage. 

Section 3- Frank Developed Jaundice 

Question 1 

Frank exhibited some new symptoms such as loss of appetite, stomach ache, and exhaustion. 

Question 2 

The doctor observed that Frank’s eyes were abnormally yellow and then realized that Frank had developed Jaundice. 

Question 3 

Bilirubin is the molecule that caused the yellowness of Frank’s eyes, jaundice appearance. 

Question 4 

In the spleen, the hemoglobin from red blood cells is broken down to form unconjugated bilirubin. 

Unconjugated bilirubin is insoluble in blood plasma, so it binds to albumens in the blood and is sent to the liver. 

Bilirubin binds with glucuronic acid to form conjugated bilirubin. It forms part of the bile, which is stored in the gall bladder. 

Food in the gut stimulates gall bladder contraction, and the bile passes down the bile duct to the small intestine , where it aids in the digestion of lipids. 

Question 5 

Red blood cells are broken down in the spleen, and the heme portion of hemoglobin is turned into bilirubin, a molecule that causes yellow coloration of the eyes. Bilirubin being insoluble in water combines with albumens to form unconjugated bilirubin (Doerr, n.d.). In the liver, bilirubin reacts with glucuronic acid to form conjugated bilirubin. Conjugated bilirubin travels to the gall bladder and then to the small intestines to aid digestion. Frank could have been having very high levels of conjugated bilirubin in his blood. The conjugated bilirubin was not moving to the small intestine to aid in digestion, and thud frank had a pale stool. 

Question 6 

The high glucose levels did not cause franks jaundice condition observed earlier. This is because Jaundice is caused by a buildup of bilirubin in the blood and not by high glucose levels. 

Question 7 

Frank’s jaundice condition might be caused by some blockage in the gall bladder preventing the flow of conjugated bilirubin from the liver to the small intestine. 

Question 8 

To confirm my professional opinion about Franks’s condition, I will conduct a CT scan on Frank’s upper abdomen. 

Section 4- Franks Test Results 

Question 1 

Unconjugated bilirubin is formed in the blood after reacting with albumens, a blood protein. 

Question 2 

Franks’s unconjugated bilirubin level was within the normal range, and his results indicated 0.9mg/dl while the normal range was between 0.3mg/dl to 1.6mg/dl. 

Question 3 

Conjugated bilirubin is formed in the liver after unconjugated bilirubin reacts with glucuronic acid. 

Question 4 

The normal range for conjugated bilirubin was between 0mg/dl and 0.3mg/dl, but Frank’s blood had 0.6mg/dl and thus above the normal range. 

Question 5 

Frank blood had high conjugated bilirubin levels because bilirubin was not released to the gall bladder’s small intestine. After conjugated bilirubin has been formed, it is squeezed from the gall bladder into the small intestine via the bile duct to aid in lipids’ digestion. In Frank’s case, the stool was pale in color, and his urine had a low level of bilirubin which indicated that conjugated bilirubin accumulated in the blood system. 

Question 6 

Question 7 

Insulin is secreted by the pancreas. 

Question 8 

Frank’s jaundice condition is caused by three organs, the liver that forms conjugated bilirubin, the gall bladder, which stores the bilirubin, and the pancreas, which blocks the bile duct from transporting bilirubin into the small intestines. 

Question 9 

All the organs and the gland in figure 1 are connected. This is because the bile duct connects the liver and the gall bladder. The bile duct then extends into the pancreas, where it is joined with the pancreatic duct. 

Question 10 

The pancreas’ abnormalities could have caused the high level of conjugated bilirubin and glucose in Frank’s blood. The abnormal pancreas was blocking the normal movement of conjugated bilirubin from the gall bladder into the small intestine. At the same time, it was not producing enough insulin to reduce the levels in the blood. 

Question 11 

Yes, contrary to the previous observation of diabetes mellitus, Frank’s new symptoms and test results indicate that he is suffering from Jaundice. 

Section 5- CT Scans. 

Question 1 

Dark blobs in Frank’s CT scan indicate some form of abnormal growth in the pancreas. 

Question 2 

Dark blobs are located in the pancreas, and thus if cancerous, they could affect the normal functioning of the pancreas. If the normal function of the pancreas is inhibited, insulin secretion will be affected. 

Question 3 

Growth in the head of the pancreas cannot inhibit the liver from producing conjugated bilirubin. The growth, however, can block the bile duct and prevent the passage of bilirubin into the small intestine, causing a buildup of conjugated bilirubin in the blood system. 

Question 4. 

An enlarged pancreas would cause some blocking of the bile duct, which would mean insufficient bile transportation into the small intestine. The bile contains several important enzymes that aids in the digestion of fats, lipids, carbohydrates, and proteins in the small intestine. Consequently, Frank will suffer from indigestion and malnutrition if necessary; action is not taken. 

Question 5 

Frank has an enlarged pancreas due to some growth. His enlarged pancreas is blocking the bile duct and interfering with bilirubin’s movement from the gall bladder to the small intestine; this leads to the build-up of bilirubin in the blood. 

Question 6 

Yes, I would like to modify Frank’s diagnosis by suggesting that he has pancreatic cancer. 

References 

Cleveland Clinic. (n.d.).  Diabetes mellitus: Types, risk factors, symptoms, treatments .  https://my.clevelandclinic.org/health/diseases/7104-diabetes-mellitus-an-overview 

Doerr, S. (n.d.).  18 jaundice symptoms, causes, treatments & prognosis . eMedicineHealth.  https://www.emedicinehealth.com/jaundice/article_em.htm 

Ripple, J. T., Marcaccio, S. E., Sherman, D. R., & Stephens, P. J. A pain in the gut: A case study in gastric physiology.  Blood ,  5 (10), 1. 

Stöppler, M. C. (n.d.).  9 symptoms of type 1 & type 2 diabetes: Complications, causes & diet . MedicineNet.  https://www.medicinenet.com/diabetes_mellitus/article.htm