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A change in bowel habits, include, reveals, include, reveals, include,…

- - - - Appendix
  - - - Superior Mesenteric Artery
        
        Ileocolic a
        
        Terminal Ileal a
        
        Anterior Caecal a
        
        Posterior Caecal a
        
        Appendicular a
        
        Middle Colic
        
        Right Colic
      - Parasympathetic
        
        Vagus N
      - Sympathetic
        
        Lesser Thoracic Splanchnic N
    - - Left Colic a
      - Sigmoidal a
      - Superior Rectal
      - Parasympathetic
        
        Pelvic Splanchnic N
      - Sympathetic
        
        Lumber Splanchnic N
- - - - movement of the content
      - happens 3 to 4 times a day
      - gastrocolic reflex and duodenocoliac reflex
    - - mixing
      - Absorption
    - - stretch recetops
        
        sensory pelvic splanchnic nerve
        
        relaxation of the internal anal sphincter
  - - - 1) active absorption of Na
      - 2) Cloride absorption
        
        electrical gradent
      - 3) secretion of HCO3
        
        absorbing equal amount of Cl
      - 4) Absorption of water
        
        osmotic gradent
    - - digesting cellulose
      - forming Vitamins
        
        K
        
        B12
      - gases production
        
        CO2
        
        Hydrogen
- - - - 20-30 , >50
    - - white
  - - - regulation of immune system
      - GI epithelial barrier
- - - - Jewsish descent
    - - northern climates
- - - - Dysplasia
      - Inflammatory infiltrates
      - Crypt abscesses
    - - Erythema
      - Pseudopolyps
      - Toxic megacolon
  - - - Cobblestone
      - Fissures
      - Skip lesions
      - Aphthous ulcers
      - Creeping fat
      - Strictures
    - - Ulceration
      - Paneth cell metaplasia
      - Crypt abscesses
      - Noncaseating granuloma
- - - - increase risk for formation of the polyp
        
        K-ras mutation
        
        polyp formation
        
        P53 mutation
        
        allow progression to carcinoma
  - - - hereditary
        
        lynch syndorme
      - sporadic
        
        hypermethylation of genes
- - - - Fecal calprotectin
      - Suspected pathogens
    - - Ileocolonoscopy
      - Flexible sigmoidoscopy
    - - +pANCA - ASCA
        
        UC
      - +ASCA – pANCA
        
        CD
  - - - Abdominal Pain
      - Rectal Bleeding
      - Chronic Diarrhea
      - Weight loss