American Medical Association Family Medical Guide - American Medical Association [478]
Cognitive-behavioral therapy (see page 710) also has been used with some success to treat pathological gambling by teaching the affected person how to change deeply ingrained patterns of learned behavior and unproductive ways of thinking.
For people who gamble largely to escape their problems—mainly women—the rehabilitation program approach is less successful. Women tend to need more supportive therapy and often require treatment for depression, including antidepressant drugs.
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Disorders of the Digestive System
Your body needs a regular supply of nutrients to grow, make proteins, replace worn-out or damaged tissue, and supply energy for the thousands of chemical reactions that occur constantly in the body. As it passes through the digestive system, the food you eat is broken down so the bloodstream can absorb nutrients from it. The digestive system consists of the digestive tract (the tube that runs from the mouth to the anus and includes the throat, esophagus, stomach, and intestines) and the digestive glands (which include the liver, gallbladder, and pancreas).
Digestion begins in the mouth, where the teeth tear and chew food into small pieces. The salivary glands produce saliva, which lubricates the food and contains an enzyme (a protein that regulates chemical reactions) that aids digestion by breaking down the starch in food. As you chew your food, the tongue moves it around your mouth and forms it into a ball called a bolus. When you swallow, the bolus enters the esophagus, the section of the digestive tract between the throat and the stomach. Rhythmic contractions of the muscles of the esophagus move the food down the esophagus to the stomach.
After the food enters the stomach, muscles in the stomach wall churn it and mix it with digestive juices (produced in the stomach wall), breaking the food down even more. From the stomach, the food passes through another ring of muscles into the short tube called the duodenum, which makes up the first part of the small intestine.
Waves of contractions from muscles in the walls of the small intestine push the food along. Nearly all nutrients are absorbed in the first part of the small intestine except for vitamin B12, which is absorbed at the very end of the small intestine. Inside the small intestine, the food is broken down by a fluid called bile (which helps make fats easier to digest) and by digestive enzymes. The bile flows from the gallbladder into the small intestine through an opening called the bile duct. The gallbladder contracts, and expels the bile into the small intestine when it is needed. Although the gallbladder stores and concentrates the bile, it does not manufacture it. The liver makes bile, trickling it into the gallbladder through a network of tiny tubes. The enzymes that help bile with digestion in the small intestine come from the pancreas and from the lining of the small intestine itself. The bile and the digestive enzymes reduce the food into microscopic pieces that enable nutrients in the food to get through the lining of the wall of the small intestine and be absorbed into the bloodstream.
The Digestive Process
The digestive system is divided into several sections. Each section has a specific role in the breakdown and absorption of food or in the expulsion of stool. Food moves through the esophagus, stomach, small intestine, large intestine, and rectum by waves of muscular contractions called peristalsis. Digestive enzymes (proteins that speed up chemical reactions) help break down food into pieces small enough to pass through the wall of the small intestine and into the bloodstream.
Once in the bloodstream, nutrients travel to the liver, where some are stored, some are assembled into more complex substances, and some are transported to other parts of the body. The nutrients ultimately are stored in the liquid that surrounds each