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The very high rate of protein synthesis in acinar cells generates a constant low level of ER stress. The cardiac sphincter between the esophagus and the stomach: If this must be removed then the patient will have reflux from the stomach into the esophagus, especially if lying down too soon after eating a meal. The pyloric sphincter between the stomach and the duodenum: If this must be removed then the stomach will empty quickly after eating, reducing both digestion and absorption of food in the stomach and potentially causing dumping syndrome, also called early gastric emptying.
Pre-surgery anatomy (top panel) and pancreaduodenectomy either sparing the pylorus (second panel) or with resection of the pylorus (third panel). Pancreas resection - A portion of a person's pancreas (or in some cases the entire pancreas) is surgically removed usually because they have a cancerous tumor. The sphincter of Oddi, or otherwise called the sphincter of the hepato-pancreatic ampulla, is located at the second part of the duodenum. The migrating motor complex, or the MMC for short, is smooth muscle contractions that are also termed myoelectrical motor complex.
Another function of the sphincter of Oddi is to prevent entry of contents of the duodenum into the bile duct or pancreatic duct. Although the sphincter of Oddi is just one part of the extra-hepatic biliary tree, its functions are very vital to maintain order inside the human body. During surgical removal of the gallbladder or even in gallstone removal, iatrogenic trauma may be caused to the sphincter of Oddi. Under normal conditions, this ER stress is readily compensated for by the UPR and EOR, which reduce the rate of protein synthesis while increasing production of molecules that facilitate cell recovery and repair. The end of the remaining sigmoid colon is brought out through the surface of the abdomen in a permanent colostomy. After surgery patients may need pancreatic enzyme supplements and insulin depending on how much their body can produce with a reduced pancreas. As the name implies, it houses the ampulla of Vater, which in turn surrounds the bile duct and pancreatic duct.

Its tonic contraction creates a basal pressure higher compared to the pressure in the common bile duct and duodenum.
The substance cholecystokinin relaxes the sphincter of Oddi along with the stimulation of pancreatic enzyme secretion and contraction of the gallbladder. It is always important to go back to the anatomy of the sphincter in order to understand how it is able to perform all these functions at the same time. If the sphincter of Oddi fails to perform even one of its functions, it would have devastating effects to digestion and to the quality of life of the person.
This would cause inflammation to the sphincter which in its process of repair would eventually cause narrowing.
Windham's tutorial Abdominal Anatomy for GIST in our website's Ask the Professional section.
After two hours or more in the stomach, the partly digested food moves into the beginning of the duodenum. The key in order to understand the function of the sphincter of Oddi is to discuss first how it looks like.
It is produced by the mucosal cells that lines the upper small intestine once they detect presence of fats and amino acids. Studies on the physiology of the sphincter of Oddi show that the interplay between the small component sphincters and the longitudinal muscle fibers. Because the sphincter of Oddi relaxes after a meal when it is highly stimulated by cholecystokinin, pain from its dysfunction is mostly felt after eating and is called postprandial pain. Other effects are also paradoxical response of the sphincter of Oddi to cholecystokinin resulting to dyskinesia or non-relaxation. Excessive acinar cell apoptosis can lead to necrosis, a severe systemic inflammatory response, acute respiratory distress, and life-threatening multiorgan failure. When the food reaches the duodenum, the pancreas releases its digestive juices which flow down the pancreatic duct and mix with the food.

This is to ensure that contents of the common bile duct and pancreatic duct do not enter the duodenum. It has three phases, the third phase of which migrates from the antrum of the stomach down to the ileum of the small intestine.
In between contractions, the sphincter of Oddi allows flow of bile and digestive enzymes into the duodenum.
Because of its function as a pump for bile and pancreatic secretions, its failure to do so frequently causes pancreatitis because the digestive enzymes of the pancreas are not secreted and are instead directed on the organ causing inflammation.
Altered Ca2+ release from the ER, and ROS, are thought to activate NF-κB, a key regulator of inflammatory gene expression. Take note that the pancreas secretes digestive enzymes that may be destructive to the mucosa of the gut when uncontrolled by the sphincter of Oddi. The longitudinal fibers of the sphincter of Oddi previously mentioned function as promoters of the flow of bile and digestive enzymes into the duodenum. The sphincter of Oddi also responds to motilin, which controls the motility of the digestive tract.
This mechanism, which is termed as trans-sphincteric flow, shows that the sphincter performs its resistor and pump functions simultaneously. Longitudinal muscle fibers or fasciculi longitudinales are found in between the bile and pancreatic ducts. The sphincter’s contractions increase in frequency and amplitude shortly before and during the intense contractions of the duodenum.
Trans-sphinteric flow is diminished by the action of motilin, with which the sphincter of Oddi also responds.

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