How to cure heartburn forever at home - causes of heartburn


Heartburn: causes

1. Heartburn occurs when gastric juice enters the esophagus. It causes ulceration, erosion, or rupture of the lining of the esophagus. This can be fatal. Ulcers narrow the lumen of the stomach, making it difficult to swallow food, which sometimes leads to cancer.

2. Great sensitivity of the digestive membranes.

3. Stomach lesions, nervous stress or sleep after eating.

4. The patient's smoking, consumption of alcoholic and carbonated drinks, coffee and hot spices cause irritation of the mucous membranes of the digestive organs. This increases acid production and relaxes the stomach valve.

5. Heartburn is caused by eating large amounts of tomatoes, citrus fruits, and fried foods. This causes an increase in stomach volume and acid secretion.

6. Taking Aspirin and Ibuprofen promotes the production of acid and its reflux into the esophagus.

7. Tightening belts, lifting a heavy object, obesity, and pregnancy increase intra-abdominal pressure, which provokes heartburn.

8. Hernia, chronic gastritis, removal of the gallbladder, cholecystitis, duodenal disease can also cause heartburn.

Causes of heartburn

Heartburn can occur in healthy people for a variety of reasons, for example, in case of overeating or eating foods that increase the acidity of the stomach.


Main causes of heartburn

If a burning sensation in the epigastric region occurs no more than several times a month and is not accompanied by a pronounced deterioration in well-being, then this condition does not pose a threat. To improve the condition, the patient needs to change his diet and follow a number of recommendations:

  1. Sleep at least 8 hours a day.
  2. Eat often and in small portions.
  3. Reduce the amount of everyday stress and anxiety.
  4. If you overeat, take medications to improve digestion.
  5. Play sports and regularly spend time outdoors.

If heartburn attacks become more frequent, the patient should consult a gastroenterologist.


Instrumental studies of the gastrointestinal tract

Physiological causes of heartburn

In the absence of any pathological processes in the human body, the development of heartburn can be caused by the following factors:

  • eating large amounts of “heavy” food: meat, smoked meats, high-fat foods, sour or spicy foods;
  • doing physical activity immediately after eating;
  • taking certain pharmacological agents, such as antibiotics or non-steroidal anti-inflammatory drugs;
  • consumption of carbonated drinks, especially sweet lemonades;
  • experiencing strong psycho-emotional experiences;
  • long period of hunger;
  • wearing tight clothes, corsets, shapewear, especially after eating;
  • drinking alcoholic beverages, smoking immediately after eating.

In the above cases, an attack of heartburn occurs once and occurs due to the negative impact of any external factors on the functioning of the gastrointestinal tract.


Preventing heartburn

Most often, women during gestation suffer from constant attacks of heartburn. In the early stages of pregnancy, a burning sensation in the stomach and esophagus occurs due to hormonal changes as a result of the release of the hormone progesterone into the blood. In the third trimester, heartburn appears against the background of increased intra-abdominal pressure due to an enlarging uterus. To reduce discomfort, women during gestation should avoid drinking coffee, fatty meats, spicy foods and reduce the amount of citrus fruits in the diet. In addition, after eating, you should rest for 30-40 minutes and not engage in vigorous physical activity.

Heartburn: symptoms

1. With heartburn caused by chronic gastritis, the penetration of gastric juice with acid into the esophagus, an unpleasant sensation appears 2 hours after a meal.

2. With heartburn, the cause of which is poor nutrition, the pain is felt for a long time. After they disappear, heartburn continues.

3. Heartburn from chronic cholecystitis. Pain appears in the right side, in the upper half of the stomach. They are mainly formed after eating fatty foods or shaking while driving a car.

4. Heartburn from hiatal hernia. Then unpleasant sensations torment a person when he lies down or bends over. The pain appears in the stomach, sometimes radiating to the back or heart. The pain goes away if the person gets up.

5. Heartburn from compression of the volume of the gallbladder or intestines, the production of large amounts of acid, is accompanied by belching, rarely nausea.

Heartburn: treatment at home with folk remedies

Pathological causes of heartburn

Frequent attacks of heartburn, epigastric pain and a general deterioration in the patient’s well-being indicate the development of pathological processes in the digestive system. In most cases, a burning sensation in the upper third of the abdominal cavity or in the esophagus occurs when the stomach, gallbladder or pancreas is affected.


Factors that increase the likelihood of gastroesophageal reflux and heartburn

Gastritis

Gastritis is a pathology of the digestive tract, equally common in people of any gender and age group. The disease is an inflammatory and degenerative process in the epithelial lining of the stomach, which can vary etiologically and symptomatically.


Symptoms and causes of gastritis

Patients suffering from gastritis experience the following symptoms:

  1. Heartburn. Depending on the type of disease, pathology can occur both before and after meals. In this case, severe forms of gastritis are often accompanied by a constant burning sensation in the stomach.
  2. Pain in the upper third of the abdominal cavity. During remission, the patient may experience mild spasms or stabbing pain in the epigastrium. During exacerbations, patients complain of intense pain, which can only be relieved by taking medications.
  3. Decreased appetite and impaired absorption of nutrients, leading to weight loss.
  4. Intense thirst, bitter taste in the mouth. A person may develop cracks on the lips and tongue, and with the constant backflow of bile, ulcers form in the patient’s mouth.
  5. Dyspepsia: diarrhea or constipation, which may alternate over a long period. Also, people suffering from gastritis complain of a feeling of heaviness in the stomach, nausea and vomiting.
  6. Due to a disorder in the digestive system, the patient’s general health deteriorates: the skin becomes dry and flabby, acne appears, and hair begins to fall out.


Diagnosis of the stomach using an endoscope

Attention! One of the most difficult to diagnose forms of gastritis is the atrophic type of the disease. In a patient with this pathology, the glands that produce gastric juice are destroyed. A feature of atrophic gastritis is a long asymptomatic course.

Treatment of heartburn with gastritis should be aimed at complex treatment of the disease. An integral part of restoring the digestive system is following a diet. In addition, the gastroenterologist prescribes medications to the patient.


Stomach with heartburn

Pharmacological therapy for gastritis

Group of drugsAction of the medicineProduct nameImage
AnestheticsPain relief for the stomach and esophagusDoverin, Spazmalgon, No-shpa, Almagel A Spasmalgon
AntacidsMeans for neutralizing the action of hydrochloric acidAlmagel, Maalox, Phosphalugel Maalox
Antisecretory drugsMedicines to reduce gastric acid productionOmez, Omeprazole, Kvamatel, Ranisan, Gistak Omeprazole and Omez
Peristalsis stimulantsMeans for normalizing the motor function of the digestive systemDomperidone, Motilium Motilium
AntisepticsAntimicrobial drugs to reduce inflammationDe-Nol, Novobismol, Venter Novobismol

Cholecystitis

Cholecystitis is a disease accompanied by an inflammatory process in the gallbladder. The pathology poses a danger to the patient, since during the disruption of the organ, the formation of stones occurs, which cause obstruction of the biliary tract.

Attention! If left untreated, the patient may develop gangrenous processes in the gallbladder and pancreatitis, which can lead to death.


Cholecystitis

The pathological process develops as a result of disruption of the secretory and motor activity of the gallbladder, which causes inflammation. In most cases, cholecystitis becomes chronic. The disease manifests itself with a number of characteristic symptoms:

  1. Dull, growing pain in the right hypochondrium. Unpleasant sensations increase after eating, especially fatty or spicy foods.
  2. Drinking alcohol, smoking, or eating smoked or fried foods causes severe heartburn, which can lead to nausea and vomiting.
  3. With a chronic inflammatory process, heartburn in many patients persists constantly and is accompanied by pain in the stomach and esophagus.
  4. In the morning, patients experience bitterness in the mouth and belching rotten or sour.

Attention! When chronic cholecystitis recurs, patients experience diffuse or girdling pain in the upper third of the abdomen and subscapular region. In some cases, there is chest tenderness and shortness of breath. Patients also complain of dyspeptic symptoms: diarrhea, nausea and frequent vomiting, excessive gas formation, etc.


Nutrition for cholecystitis

Conservative treatment of pathology includes adherence to diet No. 5.

Drug therapy involves the use of the following means:

  • antimicrobial agents: Azithromycin, Spiramycin, Roxithromycin ;
  • choleretic drugs against hypokinesis: Holagol, Tsikvalon, Cholenzym ;
  • antispasmodic drugs necessary to relieve pain and normalize bile flow: Drotaverine, Atropine, Papaverine ;
  • means to reduce the inflammatory process: Piroxicam, Paracetamol, Ibuprofen ;
  • analgesics: Nise, Analgin, Novigan .

If the patient regularly experiences exacerbations of the pathology, he is prescribed cholecystectomy. This is an operation during which the patient's gallbladder is removed.

Video - Causes of heartburn

Pancreatitis

Persistent heartburn is also caused by pancreatic dysfunction. During this pathology, usually resulting from the formation of stones, cystic or malignant neoplasms, the patient's normal flow of bile is disrupted.


Reasons for the development of pancreatitis

With pancreatitis, the inflammatory process leads to the fact that pancreatic juices and enzymes accumulate in the cavity of the gland and provoke its autodigestion. As a result, patients develop a characteristic clinical picture of the disease:

  1. Aching or cutting pain localized in the epigastric region or just below the costal arch on the right.
  2. Heartburn. Due to disruption of the digestive processes, insufficiently processed chyme enters the small intestine, where it begins to stagnate and ferment. Such food mass, under the influence of the resulting gases, along with juices and enzymes, is thrown back into the stomach and esophagus, causing persistent heartburn.
  3. A bitter taste appears in the mouth. With an exacerbation of pancreatitis, the patient experiences a yellowish coating on the tongue and mucous membranes of the oral cavity.
  4. The sclera of the eyes turn yellow, and the patient's skin acquires a yellowish-gray tint.


Pancreatitis

Treatment for pancreatitis involves the use of the following pharmacological agents:

  • antispasmodics: Trimedat, Meteospasmil, Atropine, etc.;
  • analgesics: Nise, Ketoprofen, Analgin ;

Attention! Acute pancreatitis is often accompanied by severe cramping pain. To stop this attack, you must urgently contact a medical clinic. In this case, the patient is prescribed strong analgesics, for example, Tramadol or Codeine .

  • antacids: Rabeprazole, Famotidine, Pantoprazole ;
  • enzyme preparations: Pancreazim, Mezim, Creon .

Video - Heartburn. What to do with it?

Esophageal hernia

One of the pathologies that causes constant heartburn in a person is a hiatal hernia. This is a pathological process in which the abdominal end of the organ, the cardiac part of the stomach or intestinal loops are displaced into the esophageal opening of the diaphragm.

Attention! In approximately 45% of cases, the disease is asymptomatic. As a result, it is possible to identify this pathology only during preventive diagnostics.


Esophageal hernia

In most cases, patients with a hiatal hernia exhibit the following symptoms:

  1. Persistent heartburn and sour or rotten belching. Heartburn worsens after eating or when bending over, as well as when lying down.
  2. Pain that intensifies immediately after eating. The pain is localized in the sternum or 4-5 cm above the navel, in some cases radiating to the lower back. After a deep breath or belching, the discomfort subsides.
  3. Vomiting and nausea after eating. Patients with a hiatal hernia often vomit poorly digested chyme.
  4. Sensation of a foreign object in the esophagus, difficulty swallowing.
  5. Frequent attacks of hiccups.


Types of hiatal hernia

Treatment of heartburn with a hiatal hernia involves the use of the following remedies:

  • lifestyle correction: giving up bad habits, regular exercise and walks in the fresh air, following a diet;
  • taking H2 blockers to reduce the secretion of hydrochloric acid: Nizatidine, Roxatidine, Famotidine ;
  • prokinetics to normalize the movement of chyme: Domrid, Motilium, Cerucal ;
  • drugs for neutralizing bile acids: Almagel, Rennie, Gastal .

Drug treatment is effective only for patients with non-strangulated hernias. Otherwise, patients need surgery.

Video - Hiatal Hernia

Treatment of heartburn with folk remedies is the most effective

An attack of heartburn can be temporarily relieved with home remedies. However, you will have to go to see a doctor.

1. Chamomile. To prepare the infusion, you will need to pour 2-3 pinches of crushed chamomile into a container and brew with boiling water, in a volume of 1 cup. Leave the broth for 20 minutes, filter and take a teaspoon. You will need to consume about 3 glasses daily.

2. Flax seeds. To prepare the drink, you will need to pour a pinch of seeds into a bowl and add half a glass of boiling water. The infusion should be left until the morning. Before use, add boiled water to the medicine, bringing the amount to 1 glass.

You should drink it on an empty stomach for half a month. Another way will help. An attack of heartburn can be stopped by pouring a pinch of crushed seeds into a glass of warm water and drinking in small sips.

3. Using angelica. The roots, greens and seeds of the plant are ground to a powder. You need to brew 1 pinch of powder with a glass of boiling water. After 20 minutes of infusion, the medicine is ready for use. It should be drunk three times daily.

4. Using anise, dill seed and dry fennel. Take a pinch of everything and stir in a glass of boiling water. Take a sip until the discomfort stops. It is recommended to use no more than half a month.

5. Fresh potato juice will help with heartburn. It eliminates stomach pain, heartburn and belching. The medicine must be prepared from fresh tubers. Tubers that have lain all winter are not suitable. You need to squeeze the juice in the morning before breakfast. It is enough to drink half a glass, lie down for half an hour and start breakfast. Treatment lasts 10 days. If necessary, you can continue drinking juice after 10 days.

6. Oat decoction. First, the whole grain is dried and then ground to a powder. A large pinch of powder is poured into a container and steamed with one and a half glasses of boiling water. The broth is allowed to brew for 5 hours, filtered and drunk 50 ml 20 minutes before dinner.

7. Mix chamomile flowers, celandine herbs, yarrow, St. John's wort and licorice root. A large spoonful of the mixture is brewed with boiling water in the amount of 1 cup. Leave for 3 hours and filter. Take a glass 2 times daily half an hour before meals. Treatment lasts about a month.

8. 10 gr. Licorice root should be mixed with 6 g. orange peel. Steam the mixture with 400 ml of boiling water and bring to a boil. When half the moisture has evaporated, the liquid is cooled and strengthened with 60 g. honey. Consume a quarter of an hour before meals, dividing the decoction into 3 portions. You need to be treated for at least a month.

Features of treatment

To get rid of heartburn, complex treatment is used, which includes medications, adjustments to diet, and lifestyle.

All medications are prescribed by a doctor strictly according to the indications for the diagnosis. Before taking, read the instructions and take into account any contraindications.

For diseases of the gastrointestinal tract, which are accompanied by a burning sensation in the esophagus, the following types of medications are used:

  • Antacids. The active ingredients of the drug are aluminum, magnesium, and calcium hydroxides. They help eliminate burning, relieve cramps and pain in the stomach. The drug neutralizes hydrochloric acid in the stomach.
  • Gastroprotectors. The medicine acts on the cause of heartburn, in functional disorders of the gastrointestinal tract. Gastroprotectors create a protective film on the surface of the gastric mucosa, enveloping the walls of the stomach. The drug also covers the affected areas.
  • Alginates. Prescribed for diseases of the gastrointestinal tract. The active substance alginate enters into a chemical reaction with hydrochloric acid, and a film with a neutral pH is formed on the surface of the stomach contents. The drug has almost no side effects on the body.
  • Antisecretory drugs. A group of medications can reduce the production of hydrochloric acid in the stomach. It is an effective remedy for the treatment of ulcers and gastritis.

If you have frequent heartburn, you should not self-medicate. With the wrong approach to therapy, your health condition can worsen. First, the source is determined, then appropriate treatment is prescribed.

Heartburn in pregnant women: causes

Unpleasant sensations such as heartburn and pain often occur during pregnancy. A pregnant woman's internal organs are being pressed by a growing baby. This happens from the second trimester of pregnancy. Progesterone weakens the esophageal muscles, allowing acid to enter the esophagus.

Increased production of hormones slows down the digestion of food. These two factors are the cause of heartburn. It forms after a meal and lasts several minutes or several hours. However, most women suffer from heartburn constantly and even before meals, especially when they are lying down.

Symptoms

Photo: mojzheludok.com
Depending on the location of heartburn, there are 3 types:

  • pharyngeal heartburn (a burning sensation occurs in the throat);
  • epigastric heartburn (burning sensations and discomfort occur in the epigastric region);
  • retrosternal heartburn (burning sensations are localized behind the sternum; this type of heartburn occurs more often in a horizontal position and with deep bends).

In addition to the main burning sensation, there may be complaints of nausea and vomiting, excessive salivation, a feeling of “lump in the throat,” swallowing disorders, and hoarseness of the throat. All these symptoms refer to manifestations of some disease. Often people suffering from heartburn complain of belching. It can be “air”, which is associated with the release of gases from the gastrointestinal tract, mainly from the esophagus and stomach into the oral cavity. There is also sour belching, which is most often associated with stomach diseases, accompanied by an increase in the acidity of gastric juice. With prolonged heartburn, a chronic cough may occur, which few people associate with a problem with the gastrointestinal tract; basically everyone begins to think that the problem has arisen with the respiratory tract. However, after successful treatment of the underlying disease, the symptoms of which were heartburn and cough, both are eliminated.

Heartburn during pregnancy: treatment

Heartburn should be treated with medications that absorb hydrochloric acid. These include: “Almagel”, “Maalox”, “Taltsid”, “Rennie”. You cannot combine these medications with other medications. Doctors do not recommend taking antacids; they can cause stool retention.

Heartburn does not have a harmful effect on the baby's development.

To combat heartburn during pregnancy, a pinch of calamus root powder and 20 grams will help. juniper. The mixture is poured into a container and 500 ml is added. water. The composition is put on fire for 3 minutes of boiling. Leave for 3 hours and filter. Drink a large spoon three times daily half an hour before meals. But, you need to consult your doctor before use.

Consequences

A burning sensation behind the sternum cannot be considered a harmless condition. What are the causes and consequences of heartburn? The esophageal mucosa cannot withstand the aggressive effects of hydrochloric acid due to the peculiarities of its structure . If heartburn exists for a long time, then the inflammatory process in the lower part of the esophagus will steadily progress. This may lead to the following problems:

  • the development of a chronic disease (GERD), which is characterized by erosions, ulcerative defects on the mucous membrane and the threat of bleeding;
  • the addition of a secondary (fungal and other types) infection;
  • formation of scars on the mucous membrane, leading to stenosis and dysphagia (impaired swallowing of food);
  • metaplasia (degeneration) of the epithelium in the esophagus is Barrett's syndrome, which is considered a precancerous condition ;
  • formation of erosions on tooth enamel, caries;
  • inflammation of the ENT organs (sinusitis, laryngitis);
  • obstructive bronchitis and pneumonia - appears due to aspiration of small food particles into the trachea.

After determining the causes and consequences of the disease that caused heartburn, the gastroenterologist decides how to treat the patient, based on the data from the following studies:

  • endoscopy of the esophagus, stomach and duodenum - endoscopy;
  • ultrasonography (ultrasound) of organs located in the abdominal cavity and pelvis;
  • determination of gastric juice acidity ;
  • Helicobacter test;
  • X-ray of the stomach with contrast.

Endoscopic examination

Nutrition for heartburn

1. Food should be steamed. Include carrots, potatoes, bran or corn bread in your diet. There is no need to give up brown rice, lean fish, meat, boiled eggs, semolina, buckwheat and oatmeal, apples and bananas. Drinking alkaline mineral water is beneficial.

2. Fried, spicy, fatty foods should be excluded, these include cottage cheese, fatty sour cream, and kefir.

3. Oranges, limes and lemons increase acid production.

4. Spicy seasonings, fried omelettes, tomato paste, baked goods, strong coffee and tea, carbonated and alcoholic drinks can also trigger heartburn.

5. You should eat fractionally - in small portions, but more often.

6. It is recommended to chew food for a long time.

7. Dinner should be no later than 7 pm.

8. You should drink at least 2 liters of fluid daily.

9. Doctors do not recommend quenching heartburn with soda.

Doctors also recommend that you seek advice from them before using home recipes.

Proper nutrition is the basis for treating heartburn

If heartburn, its causes and treatment at home is a relevant topic for you, then the first and most important thing to do is to normalize your diet.

Treatment for heartburn usually includes antacids and other pharmacological medications that calm the symptoms; However, its excessive use is not recommended as it may cause side effects. For this reason, today we are going to share some good natural remedies to deal with this condition in a healthier way.

This liquid will help dilute the acid and make it easier for it to return to your stomach. This white powder, which can be found in almost any market, is known for having alkaline properties that help neutralize the acidity of the stomach and body in general.

Food should be consumed in small portions, at least three times a day

(ideally, the daily diet is divided into five meals, the last one no later than two hours before bedtime).

Immediately after eating, do not take a horizontal position, do not sit in an uncomfortable position, and avoid active physical activity and heavy lifting.

Dilute a teaspoon of baking soda into a glass of water and drink it slowly to eliminate this problem. A teaspoon of baking soda A glass of water. . Active potato compounds also help neutralize stomach acid and regulate the production of gastric juices to combat heartburn and problems such as gastritis.

Pour a spoonful of potato juice, dilute it with water and take very heavy food after eating. It is a spice valued since ancient times for its many digestive properties. In case of heartburn, it is effective due to its mild alkaline effect, which regulates the pH in the stomach to control acidic compounds.

If you have heartburn, exclude from your diet:

  • spicy, fatty and fried foods;
  • marinades and pickles;
  • Rye bread;
  • dairy products with a high percentage of fat;
  • tomato juice and cranberry juice;
  • citrus fruits and juices;
  • chocolate;
  • strong tea and coffee;
  • alcohol;
  • carbonated drinks, including sparkling mineral water.

Speaking about mineral water, it should be noted that if you have heartburn, you should carefully consider its choice

. It comes in several types and can either lower or increase the acidity of the stomach, further aggravating the situation.

Heat the water and when it comes to a boil, add the root teaspoon to the ginger.

  • One teaspoon of ginger root One cup of water.
  • Give the decoction for 10 minutes, strain the contents and consume.

Anise has proven to be a good home remedy for reducing heartburn and all its symptoms;
However, it should be taken with caution as some people are allergic to its active compounds. Heat the water and when it boils, add two teaspoons of anise. Heat for 10 minutes, let sit for another 10 and drink. Although this ingredient contains acids, access to the body has an effect that can reduce acidity. Simply dilute one tablespoon of the product in a glass of water and immediately after eating a large meal.

Be sure to include in your daily diet:

  • bread with bran, as well as whole grain and wheat;
  • vegetable oil;
  • scrambled eggs;
  • lean varieties of meat, poultry and fish (preferably boiled, stewed or baked);
  • well-cooked porridge (especially rice, pearl barley, buckwheat);
  • low-fat dairy products;
  • sweet ripe berries and fruits.

It is advisable to drink clean water, properly selected mineral water without carbon, weak tea

(shouldn't be too hot). Freshly squeezed juices of carrots, cabbage and potatoes (in moderation) are also very useful.

Having an aloe vera plant at home is always considered one of the best natural remedies for treating various diseases. In this case, its gel acts as a stomach tonic, ideal for regulating acidity and improving digestion.

Extract two tablespoons of 100% organic gel and add it to your smoothies or keep it in its natural state. It contains a digestive enzyme known as, which intervenes in various digestive processes and helps reduce burning.

It is recommended to combat common diseases such as constipation, indigestion and gastritis. Eat a piece of papaya in its natural state or take it in juices or smoothies. A cinnamon infusion can do wonders for improving digestion and combating discomforts such as inflammation, heartburn and gas.

Why is heartburn dangerous?

A regular burning sensation in the chest and throat worsens the quality of life. The consequences of constant exposure to aggressive hydrochloric acid of gastric juice, which is thrown into the esophagus, are dangerous. This leads to inflammation, the development of esophagitis, and ulcers.

Other complications of heartburn include:

  • bleeding;
  • the formation of strictures (areas of narrowing) in the esophagus;
  • damage to teeth, the enamel of which is destroyed under the influence of juice from the stomach.

Long-term heartburn increases the likelihood of developing esophageal cancer. It often ends in death due to a special clinical picture - symptoms appear in the final stages, and tumors quickly metastasize, growing into surrounding tissues.

Diseases that may cause heartburn

Heartburn with belching and pain should not be ignored, as its causes can be quite dangerous:

  1. Peptic ulcer disease is a chronic pathology in which ulcers form in the stomach and duodenum.
  2. A hiatal hernia manifests itself as pain after physical activity or heavy lifting.
  3. Chronic gastritis, accompanied by belching, pain, burning as a result of the reflux of gastric juice onto the esophageal mucosa.
  4. Cholecystitis is one of the severe complications of urolithiasis. It develops due to gastric secretions entering the bile ducts.
  5. Reflux disease is a chronic pathology in which the sphincter does not close. Gastric juice is released into the esophagus up to 50 times a day, causing painful shock and a severe attack of heartburn.
  6. Consequences of operations on the gastrointestinal tract.
  7. Tumors of secretory cells.
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