Delhi Public School,

Ruby Park

Class XII Biology Project

Three digestive disorders common in Kolkata .

Biology(044)

By

Sayak Mandal (Class XII-B)

Board Roll No.

Under the supervision of

Ananya Banerjee
 Certificate

This is to certify that Biology project on the topic “Three digestive disorders in
Kolkata” has been successfully completed by Sayak Mandal of Class XII-B, a
bonafide student of Delhi Public School, Ruby Park, Kolkata, during the session
2023-24 as per the CBSE guidelines for the AISSCE practical examination 2024.

………………………………………………… .…………………………………………………..
Teacher-In-Charge External Advisor
Date: Date:

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 Acknowledgement

This project would not have been possible without the support of many
people. I am immensely grateful to our physics teacher Ms. Ananya
Banerjee for her consistent guidance, support, and encouragement.
Without her mentorship, the project may not have existed at all.
I would also take this opportunity to thank our Principal Mrs. Joyoti
Chaudhuri. I am also thankful to my batchmates for helping me with
resources and information for the project. Lastly, I am forever indebted
to my parents, for always being by my side and striving for me to
achieve a better version of myself.

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Table of Contents
Certificate ....................................................................................................................................................... 1
Acknowledgement ......................................................................................................................................... 2
Project on Hepatitis A .................................................................................................................................... 6
Causes of Hepatitis A ................................................................................................................................. 6
Effects of Hepatitis A .................................................................................................................................. 7
Symptoms of Hepatitis A ........................................................................................................................... 7
Treatment of Hepatitis A............................................................................................................................ 8
Diagnosis of the disease: ........................................................................................................................... 8
Conclusion .................................................................................................................................................. 9
Crohn's Disease: Understanding Its Effects, Symptoms, and Treatment .....................................................11
Effects of Crohn's Disease ........................................................................................................................11
Symptoms of Crohn's Disease ..................................................................................................................11
Diagnosis of Crohn's Disease ...................................................................................................................12
Treatment of Crohn's Disease Crohn's Disease: ......................................................................................12
Medications .........................................................................................................................................12
Surgery .................................................................................................................................................13
Lifestyle Changes..................................................................................................................................13
Case study ................................................................................................................................................14
Conclusion ................................................................................................................................................16
Irritable Bowel Syndrome ............................................................................................................................18
Effects of Irritable Bowel Syndrome ........................................................................................................18
Symptoms of Irritable Bowel Syndrome ..................................................................................................18
Treatment of Irritable Bowel Syndrome ..................................................................................................19
Diet and Lifestyle Changes ...................................................................................................................19
Medications .........................................................................................................................................19
Psychological Therapies .......................................................................................................................19
Diagnosis of Irritable Bowel Syndrome ....................................................................................................20
Causes of Irritable Bowel Syndrome ........................................................................................................20
Living with Irritable Bowel Syndrome ..................................................................................................20
Research on Irritable Bowel Syndrome ...................................................................................................21
Conclusion ................................................................................................................................................23

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 Aim

To investigate three common digestive disorders found in Kolkata.

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Introduction to Digestive System
The digestive system includes the digestive tract and its accessory organs, which
process food into molecules that can be absorbed and utilized by the cells of the
body. Food is broken down, bit by bit, until the molecules are small enough to be
absorbed and the waste products are eliminated. The digestive tract, also called
the alimentary canal or gastrointestinal (GI) tract, consists of a long continuous
tube that extends from the mouth to the anus. It includes the mouth, pharynx,
esophagus, stomach, small intestine, and large intestine. The tongue and teeth are
accessory structures located in the mouth. The salivary glands, liver, gallbladder,
and pancreas are major accessory organs that have a role in digestion. These
organs secrete fluids into the digestive tract.

Digestive disorders are a range of medical conditions that affect the digestive
system, which includes the esophagus, stomach, small intestine, large intestine,
liver, pancreas, and gallbladder. These conditions can cause discomfort, pain, and
other symptoms that can affect a person's quality of life.
There are many different types of digestive disorders, including Irritable Bowel
Syndrome (IBS), Hepatitis A, and Crohn's disease.
IBS is a common condition that affects the large intestine, causing symptoms such
as abdominal pain, bloating, and changes in bowel habits. Hepatitis A is a viral
infection that affects the liver, causing symptoms such as fatigue, nausea, and
abdominal pain. Crohn's disease is a chronic inflammatory bowel disease that can
affect any part of the digestive tract, causing symptoms such as diarrhea,
abdominal pain, and weight loss.
It is important to note that digestive disorders can have a significant impact on
daily life and may require ongoing treatment and management. In addition to the
specific conditions mentioned, there are many other digestive disorders that can
occur, such as acid reflux, ulcers, and celiac disease.If you are experiencing any
digestive symptoms, it is important to talk to your healthcare provider to
determine the underlying cause and develop an appropriate treatment plan.

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Project on Hepatitis A
Hepatitis A is a viral infection caused by the Hepatitis A virus. It is transmitted
through contaminated food, water, or contact with an infected person. The virus
infects the liver, causing inflammation and damage to the liver cells. In this
project, we will discuss the effects, symptoms, and treatment of Hepatitis A.

Causes of Hepatitis A
Hepatitis A is a viral infection caused by the Hepatitis A virus. This virus is mainly
transmitted through contaminated food, water, or contact with an infected
person. Hepatitis A virus is a highly contagious virus that can spread rapidly in
areas where sanitation and personal hygiene are poor. The virus enters the body
through the mouth and then travels through the bloodstream to the liver, where it
causes inflammation and damage to the liver cells.
Contaminated food and water are the most common sources of Hepatitis A. This
includes food that has been prepared by someone who has the virus and has not
washed their hands properly, or water that
has been contaminated with sewage. In
addition, the virus can also be spread
through close personal contact with
someone who has Hepatitis A, such as
sexual contact or sharing needles.
People who are at a higher risk of
contracting Hepatitis A include those who
travel to areas with poor sanitation, men
who have sex with men, people who use
illegal drugs, and people who work in
healthcare settings. Children who attend daycare centers or schools in areas with
poor sanitation are also at risk.

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Effects of Hepatitis A
Hepatitis A can have both short-term and long-term effects on the body. The
short-term effects include fatigue, nausea, vomiting, abdominal pain, and
jaundice. The severity of the symptoms can vary from person to person, and some
people may not experience any symptoms at all.
In rare cases, Hepatitis A can lead to acute liver failure, which can be life-
threatening. However, most people recover from Hepatitis A within a few weeks
without any long-term effects.

Symptoms of Hepatitis A
The symptoms of Hepatitis A can appear anywhere from 2 to 7 weeks after
exposure to the virus. The most common symptoms include:
• Fatigue
• Nausea and vomiting
• Abdominal pain
• Loss of appetite
• Jaundice (yellowing of the skin and eyes)
• Dark urine
• Pale stools
If you experience any of these symptoms, it is important to see a healthcare
provider for diagnosis and treatment.

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Treatment of Hepatitis A
There is no specific treatment for Hepatitis A. Most people with Hepatitis A will
recover on their own within a few weeks. Treatment is focused on managing the
symptoms and supporting the liver.
Rest is important, as it allows the body to focus its energy on fighting the virus.
Eating a healthy diet and avoiding alcohol and drugs that can damage the liver is
also recommended.
In some cases, hospitalization may be necessary for people with severe symptoms
or complications. However, most people with Hepatitis A can be managed on an
outpatient basis.

Diagnosis of the disease:

Diagnosing Hepatitis A involves several steps, which may include:
1. Physical examination: The doctor will perform a physical examination to
check for signs of jaundice, abdominal pain, and other symptoms.
2. Blood tests: Blood tests can detect the presence of antibodies to the
Hepatitis A virus or the virus itself.
3. Liver function tests: Liver function tests can help determine if the liver is
functioning properly.
4. Imaging tests: Imaging tests, such as ultrasound or CT scan, may be used to
check for liver damage.
5. Medical history: The doctor may ask about the patient's medical history and
recent travel history to determine the likelihood of exposure to the virus.
6. Hepatitis panel: A hepatitis panel may be done to rule out other types of
hepatitis infections.
It is important to see a doctor if you suspect you have been exposed to Hepatitis A
or are experiencing symptoms. Early diagnosis and treatment can help prevent
complications and limit the spread of the virus.

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Doctor's Report
Q. What is the most common route of transmission of hepatitis A?
Ans. Feco oral route
Q. How will you prevent it?
Ans.
Reservoir Control
• Improved sanitation
• Improved disinfected strategy
Transmission Control
• Safe water supply
• Chlorinated water supply > 1ppm in area of increased case of Hepatitis A
• pH < 8.5
Vaccine
Live attenuated vaccine:
• Subcutaneous
• Single dose
• Not very effective, not used commonly
Killed vaccine :
• Formaldehyde inactivated virus vaccine
• Given to child greater than 1years old
• 2 dose taken 6 to 12 months apart
• Life long immunity
Q. What is the most common treatment of Hepatitis A?
Ans. Generally needs no treatment as it’s a self curable disease . 98% of the case
resolute spontaneously.

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 Conclusion
In conclusion, Hepatitis A is a viral infection that can cause inflammation and
damage to the liver. It is transmitted through contaminated food, water, or contact
with an infected person. The symptoms of Hepatitis A can vary from person to
person, but most people recover within a few weeks without any long-term
effects. Treatment is focused on managing the symptoms and supporting the liver.
If you suspect you may have Hepatitis A, it is important to see a healthcare
provider for diagnosis and treatment.

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Crohn's Disease: Understanding Its Effects,
Symptoms, and Treatment
A chronic inflammatory bowel disease that affects the lining of the digestive tract.
Crohn's disease can sometimes cause life-threatening complications. Crohn's
disease can cause abdominal pain, diarrhoea, weight loss, anaemia and fatigue.
Some people may be symptom-free most of their lives, while others can have
severe chronic symptoms that never go away. Crohn's disease cannot be cured.
Medications such as steroids and immunosuppressants are used to slow the
progression of disease. If thesearen't effective, a patient may require surgery.
Additionally, patients with Crohn's disease may need to receive regular screening
for colorectal cancer due to increased risk. In this project, we will discuss the
effects, symptoms, and treatment of Crohn's Disease in detail.

Effects of Crohn's Disease

• Malnutrition and weight loss
• Abscesses and fistulas (abnormal openings)
• Intestinal obstructions
• Anemia
• Joint pain and inflammation
• Eye problems
• Skin disorders
• Colon cancer (in severe cases)

Symptoms of Crohn's Disease

• Abdominal pain and cramping
• Diarrhea
• Fatigue

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 • Loss of appetite
• Weight loss
• Blood in stool
• Nausea and vomiting
• Mouth sores
• Joint pain and swelling

Diagnosis of Crohn's Disease

The diagnosis of Crohn's Disease is based on a combination of factors, including:
• Medical history
• Physical examination
• Laboratory tests
• Imaging studies (e.g., colonoscopy or endoscopy)

Treatment of Crohn's Disease Crohn's Disease:

While there is no known cure for Crohn's Disease, various treatment options can
help manage the symptoms and prevent complications. The treatment plan may
vary depending on the severity of the disease and the individual's overall health.

Medications
There are several types of medications available to treat Crohn's Disease,
including:
• Anti-inflammatory drugs
• Immune system suppressors
• Antibiotics
• Biologic therapies
These medications can help reduce inflammation, relieve symptoms, and prevent
flare-ups.

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Surgery
In some cases, surgery may be necessary to:
• Remove damaged portions of the digestive tract
• Repair fistulas
Surgery may also be recommended if medications and other treatments are not
effective in managing the symptoms of Crohn's Disease.

Lifestyle Changes
Making changes in diet, exercise, and stress management can also help manage
the symptoms of Crohn's Disease. Some lifestyle changes that may be helpful
include:
• Eating a healthy diet that is rich in nutrients and low in fat and processed
foods
• Regular exercise to improve overall health and reduce stress, which can
trigger flare-ups

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 Fig 1. Schematic diagram of Crohn’s disease infected Intestine

Case study
An 18-year-old male presented with a history of abdominal distention for 2 weeks.
It was associated with abdominal pain, dull aching in nature, and non-radiating.
He had a history of vomiting which was non-bilious and non-blood mixed. He also
developed fever for 10 days on and off, which was associated with chills and
headaches.

Test evaluations and reports

Physical examination revealed a well-built man with a blood pressure of 110/70
mmHg, heart rate of 84 bpm, respiratory rate of 21 breaths per minute, and a
temperature of 98.8 °F. The patient appeared appropriate for his stated age, and is
alert and oriented to person, place, and time. The skin was warm and dry; edema
was absent. The head, eyes, ears, nose, and throat reveal no abnormalities.
Pulmonary and cardiovascular systems showed no abnormalities. The abdomen
was observed to be flat and soft with no masses or organomegaly; bowel sounds

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were present. Diffuse tenderness to palpation was present. Murphy’s sign was
negative and hernias were absent. Rectal examination revealed no fistulas or
fissures. There was a good anal sphincter tone and no palpable masses. There
were no abnormalities in the genitourinary system. There were no gross
neurological or musculoskeletal deficits.

Observations and report analysis

The entire metabolic profile was found to be unremarkable except for
hyponatremia (Na-119 mmol/liter). IV fluid NS was started. Sodium monitoring
was done 6 hourly. Complete Blood Count was normal. A tropical panel for fever
revealed nothing. Monteux test showed no induration after 72 hours of
intradermal injection of tuberculin PPD. The chest radiograph was normal.
Multiple lymph nodes were seen on the USG of the abdomen/pelvis, some of
which were sub-centimetric in the short axis and involved the mesentery and
retroperitoneal area. USG-guided FNAC of inguinal lymph node showed
compatibility with reactive lymphadenitis, negative for malignant cells.

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Doctor’s Report
Q. What is the most common symptoms of CD?
Ans. Recurrent episodes of rt lumbar quadrant pain with diarrhoea , fever and
weight loss.
Q. What investigations do doctor generally prescribe?
Ans. CT abdomen, endoscopy and gut biopsy.
Stages of CD and their management accordingly
1. Mild to moderate CD : Can eat food normally with weight loss 40% of their
body mass without any symptoms. ( like dehydration, fever, obstruction)
2. Moderate to severe CD: They do not respond to treatment or if they have
high fever, significant weight loss, stomach pain and tenderness , occasional
nausea, vomiting or significant anemia.
3. Severe CD: Patient have symptoms despite of taking steroids or have fever
obstruction , fissure , fistula, abscess.
Maintenance therapy of Luminal Crohn’s Disease :
• Azathioprine/6 mercaptopurine (6 mp) + methotrexate
• The following during should not be used in maintenance
1. Oral 5 ASA
2. Corticosteroids
3. Budesonide
• Use anti TNF for maintenance wherever it is used to achieve remission by
induction.

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Conclusion
Crohn's Disease is a chronic condition that can have a significant impact on an
individual's life. However, with the right treatment and lifestyle changes, it is
possible to manage the symptoms and prevent complications. If you or someone
you know is experiencing symptoms of Crohn's Disease, it is essential to consult a
healthcare professional for proper diagnosis and treatment. Crohn's Disease:
Understanding Its Effects, Symptoms, and Treatment 4 It is important to note that
Crohn's Disease affects each individual differently, and what works for one person
may not work for another. Therefore, it is crucial to work closely with a healthcare
professional to develop a personalized treatment plan that addresses individual
needs and goals. Additionally, joining a support group or seeking counseling can
help individuals cope with the emotional impact of living with a chronic illness and
find ways to improve their quality of life.

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Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) is a gastrointestinal disorder that affects the large
intestine. It's a chronic condition that causes a group of symptoms such as
abdominal pain, bloating, cramping, diarrhea, and constipation. IBS is a common
condition that affects millions of people worldwide. In this project, we'll discuss
the effects of IBS, its symptoms, and treatment options.

Effects of Irritable Bowel Syndrome

IBS can affect a person's quality of life in various ways. The symptoms of IBS can
be frustrating and disruptive, leading to anxiety and depression. It can also cause a
person to miss work or social events due to the discomfort and embarrassment
caused by the symptoms. Moreover, IBS can also lead to malnutrition,
dehydration, and weight loss if left untreated.

Symptoms of Irritable Bowel Syndrome

IBS is a complex condition that can present differently from one person to
another. However, some common symptoms of IBS include:
• Abdominal pain and cramping
• Bloating and gas
• Diarrhea or constipation
• Alternating bouts of diarrhea and constipation
• Mucus in the stool
• Feeling of incomplete bowel movement
The symptoms of IBS can be triggered by various factors such as stress, certain
foods, hormonal changes, and medications.

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Treatment of Irritable Bowel Syndrome
There's no cure for IBS, but there are various treatment options available to
manage the symptoms. The treatment of IBS depends on the severity of the
symptoms and the individual's response to different therapies. Some common
treatment options include:

Diet and Lifestyle Changes

Making changes to your diet and lifestyle can help manage the symptoms of IBS.
Some dietary changes that can help include:
• Eating smaller, more frequent meals
• Avoiding trigger foods such as caffeine, alcohol, and spicy foods
• Increasing fiber intake
• Drinking plenty of water
Lifestyle changes such as regular exercise, stress management, and getting enough
sleep can also help manage the symptoms of IBS.

Medications
There are various medications available to manage the symptoms of IBS. Some
common medications include:
• Antispasmodics to reduce bowel spasms and cramping
• Laxatives for constipation-predominant IBS
• Antidiarrheals for diarrhea-predominant IBS
• Low-dose antidepressants for pain relief and to regulate bowel movement

Psychological Therapies
IBS symptoms can be triggered by stress and anxiety. Therefore, psychological
therapies such as cognitive-behavioral therapy (CBT) and hypnotherapy can be
effective in managing the symptoms of IBS.

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Diagnosis of Irritable Bowel Syndrome
To diagnose IBS, a healthcare provider will typically perform a physical exam and
ask questions about the patient's symptoms, medical history, and family history.
They may also order tests such as blood tests, stool tests, and imaging tests to rule
out other conditions that may have similar symptoms. There are no specific tests
that can diagnose IBS, but the healthcare provider may use specific criteria known
as the Rome criteria to make a diagnosis.

Causes of Irritable Bowel Syndrome

The exact cause of IBS is unknown, but there are several factors that may
contribute to the development of this condition. These factors include:
• Abnormal muscle contractions in the intestine
• Nervous system abnormalities
• Gastrointestinal inflammation
• Changes in gut bacteria
• Food sensitivities
• Mental health conditions such as anxiety and depression

Living with Irritable Bowel Syndrome

Living with IBS can be challenging, but there are several things that people can do
to manage their symptoms and improve their quality of life. These include:
• Keeping a food diary to identify trigger foods
• Practicing stress-management techniques
• Exercising regularly
• Getting enough sleep
• Taking medications as prescribed by a healthcare provider

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 Fig 2. Schematic Diagram of Irritable Bowel Syndrome

Doctor’s Report
Q. Under which criteria will you diagnose that its a case of IBS?
Ans. Rome criteria :
Recurrent abdominal pain (lower GI crampy pain ) occurring once every
week in the last 3 months, associated with two or more of the following
• Related to defection
• Associated with a change in stool frequency
• Associated with the change of appearance of the stool
Criteria should be fulfilled for the last 3 months with symptoms onset over 6
months before prior to diagnosis .
Q. What's is the most common key symptoms of IBS?
Ans. Recurrent abdominal pain and discomfort when he or she is in stress.

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Q. Management of IBS suggested by doctor
Ans. Most importantly advice : low FODMAP diet.

Fig 3 . Systemic flow chart of stages of the process of low FODMAP diet
FODMAPs are Fermented Oligo di- mono polysaccharides. This FODMAPs
produce a lot of gas in large bowels . Hence must be avoided in IBS.
Some food product high in FODMAPs are
• Apple, cherries, mangoes
• Beetroot, garlic, chicory
• Legumes, chickpeas
• Honey etc.
If diet modification fails, management is based as the presentation
1. Diarrhoea predominate IBS
• Alosetron , 5HT3 antagonist. Discontinued as it causes ischemic colitis.
• Loperamide, 2 to 4 mg now used
2. Constipation predominant IBS
• Bulking agent like psyllium husk and lactulose tried first.
• Chloride channel activators , lubiprostone( bicyclic fatty acid)

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Research on Irritable Bowel Syndrome
There is ongoing research on IBS to better understand the causes of this condition
and develop more effective treatments. Some areas of research include:
• Studying the gut microbiome to identify bacteria that may contribute to IBS
• Investigating the role of inflammation in IBS
• Developing new medications to manage IBS symptoms
• Studying the effectiveness of psychological therapies in managing IBS
symptoms

Conclusion
Irritable bowel syndrome is a common condition that affects millions of people
worldwide. While there is no cure for IBS, there are several treatment options
available to manage the symptoms. People with IBS can improve their quality of
life by making diet and lifestyle changes, taking medications as prescribed, and
practicing stress-management techniques. Ongoing research on IBS may lead to
new treatments and a better understanding of this complex condition.

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 Conclusion
In conclusion, digestion disorders can significantly impact one's overall health and quality of life. From
common issues like indigestion to more complex conditions such as inflammatory bowel diseases,
understanding and managing these disorders is crucial. A balanced diet, healthy lifestyle choices, and
prompt medical attention play key roles in mitigating the effects of digestion disorders and promoting
overall well-being. Regular check-ups and collaboration with healthcare professionals are essential for
effective diagnosis, treatment, and long-term management of digestive health.

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Bibliography
• https://www.monashfodmap.com/ibs-central/i-have-ibs/starting-the-low-fodmap-diet/
• K.N.Bhatia, M.P. Tyagi, Elementary Biology Vol.I, Trueman Book Company(2020)

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