Basic Gastro-Enterology. Including Diseases of the Liver by J. M. Naish

By J. M. Naish

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T y p e s of gastric neoplasms. and tumour cells are scanty (Fig. 12). Many of the tumours are highly invasive and spread not only to surrounding organs but commonly to liver, ovaries, peritoneum, lungs, and less commonly to brain and bones. C L I N I C A L PICTURE T h e symptoms are extremely variable and in the early stages there may be none. Later, an insidious loss of weight, strength, and appetite may precede the specifically gastric symptoms of nausea, pain, and vomiting. T h e pain is sometimes worse after food, but may equally well be constant or affected by movement, depending on the invasive stage reached.

A bolus of food then squeezes the posterior wall of the pharynx against the cervical spine and discomfort is felt, but the state of the patient's nervous system probably determines his sensitivity to this type of discomfort. 4. — a. Tonsillitis, pharyngitis, and peri-tonsillar abscess may cause intense dysphagia for a short while. b. Sideropenia may cause atrophic glossitis and oesophagitis which may lead to the formation of mucosal webs (Plummer-Vinson syndrome). 5. —Leiomyoma or carcinoma of the pharynx and upper oesophagus.

The outflow of nervous impulses through the vagus is responsible for the basal or nesting* secretory activity of the parietal cells; sensory stimulation of the olfactory and visual centres or psychic influences will increase the rate of nervous transmission and so cause enhanced parietal cell activity. T h i s leads to the so-called anticipatory flow of acid secretion. 32 BASIC G A S T R O E N T E R O L O G Y 2 . —By using isolated pouches of antral and fundal mucosa it has been shown that the antrum produces a hormone 'gastrin' which travels in the blood-stream and stimulates the parietal cells.

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