What are the 7 steps of digestive?

Figure 2: The digestive processes are ingestion, propulsion, mechanical digestion, chemical digestion,
absorption, and defecation. What is the digestive system? The digestive system is made up of the
digestive tract and other organs that help the body break down and absorb food. It is a long, twisting
tube that starts at the mouth and goes through the oesophagus, stomach, small intestine, large intestine
and anus

| Overview

The major parts of the digestive system:

Salivary glands

Pharynx

Esophagus

Stomach

Small Intestine

Large Intestine

Rectum

Accessory digestive organs: liver, gallbladder, pancreas

The major layers of the gastrointestinal tract:

Mucosa:

inner layer

lines the gastrointestinal tract

simple columnar epithelilium

Submucosa:

blood vessels

glands

nerve plexuses (Meissner’s plexus)

Muscularis:

peristalsis
nerve plexus (Myenteric plexus)

Serosa:

Outer layer of connective tissue

Functions of the GI system

Motility: movement through the GI tract

Digestion: breakdown of food or chyme

Secretion and absorption: across and epithelial layer either into the GI tract (secretion) or into blood
(absorption)

Storage and elimination:

Esophagus and Stomach

Esophagus

From pharynx to stomach

Salivary glands release mucus for lubrication, antimicrobial agents, and amylase to digest starch.

epiglottis covers respiratory tract during swallowing

At end of esophagus is the lower esophageal sphincter (LES)

Propulsion of food occurs through peristalsis: contraction occurs behind the bolus of food and relaxation
occurs ahead of the bolus of food.

Stomach

Functions:

store food

initiate digestion of proteins

kill bacteria with the strong acidity (low pH of the gastric juice)

make chyme

Parts of the stomach:

Fundus

body
pyloric region (pyloric sphincter)

material passed from the stomach to the small intestine is called the chyme.

The gastric glands of the stomach contain several types of cells:

pH of gastric juice is 2. The low pH of gastric juice:

denatures ingested proteins

optimum pH for pepsin activity is 2.0

at pH 2.0, weak pepsinogen enzymes digest each other to form pepsin

The stomach digests only proteins, but not fats and carbohydrates

There is basically no absoprtion in the stomach

Acid secretion by parietal cell:

H+ transport

H+ is converted to CO2 (blood)

CO2 diffused into parietal cell

CO2 is converted back to H+

H+ is transported into the GI lumen by a H+-K+-ATpase

Cl- transport

Cl- is transported into the parietal by a Cl-/HCO3- transporter

Cl- diffused into the GI lumen via a Cl- channel

are glucose, galactose, and fructose.

Transport across epithelial layer

Lumen side: Na+ cotransporter with monosaccharides

Blood side: passive diffusion via a transporter

Proteins

Stomach: Somewhat digested to short-chain polypeptides by pepsin

Transport across epithelial layer

Lumen side: Na+ cotransporter with amino acids, di-peptides, tri-peptides

Blood side: passive diffusion via a transporter

Fats

Absorption of fats takes place in the duodenum and are transported into the lymphatic system.

Fat droplets, mainly comprised of triglyerides are first emulsified by bile salts (see later section for
discussion of bile salts). Emulsification makes the fat droplets smaller, making them more easily digested
enzymatically.

Pancreatic lipase digests the smaller, emulsified fat droplets into free fatty acids and monoglycerides.

The free fatty acids and monoglycerides form micelles which migrate towards the brush border
membrane. The micelles contain bile salts, lecithin, cholesterol and

The free fatty acids and monglycerides leave the micelle and enter the epithelial cell.

Inside the epithelial cell the free fatty acids and monoglycerides combine with protein to form
chylomicrons (lipid + proteins).

The chylomicrons are secreted into the lymphatic system.

Large Intestine

large intestine is from the ileocecal valve to the anus

parts of the large intestine: ascending colon, transverse colon, descending colon, sigmoid colon, rectum,
anal canal

columnar epithelial cells, goblet cells, scattered lymphocytes, lympathic nodules

contains no villi

involved in absorption of water, electrolytes, vitamins.

Contains bacteria which serve a number of functions

absorption of vitamins (B and K)

produce small fatty acids used as energy by GI epithelial cells

help breakdown indigestible molecules

Summary of Water transport in GI tract

Amount of water entering

Amount reasborbed

Small Intestine

Ingestion: 1.5 liters

secretions: 7-9 liters

Total: 8.5-10.5 liters

6.5-9 liters

Large Intestine

1.5-2 liters

1.3-1.7 liters

Rectum

200 ml

Diarrhea is caused by many problems. The end result in a decrease in water absorption, so the stools are
very watery. This can lead to severe dehydration.

Cholera: Na+ secretion into GI lumen

Celiac Sprue: damage to GI wall

Lactose intolerance: osmolarity of the GI lumen

Defecation reflex: opening of the external anal sphincter due to pressure in the rectum.

Liver, Gallbladder and Pancreas

Liver and Gallbladder

Anatomy

Connected to gallbladder via bile duct and then to small intestine

Contains sinusoidal capillaries which are permeable to most substances

Unusual vasculature: G.I. capillaries ® Liver ® vena cava. This allows filtration of ingested substances.
Enterohepatic circulation: from liver via bile duct to small intestine and then from small intestine back
through portal vein to liver

Major functions

production and secretion of bile

detoxication of blood

secretion and storage of glucose

production of albumin

Liver clears substances via the bile duct in a similar manner to the way the kidney clears substances into
the nephron.

Production and secretion of bile

Components of bile:

bile pigment or bilirubin: removes hemoglobin breakdown products

bile salts: adds in fat absorption

phoshpholipids, cholesterol, inorganic ions.

Gallbladder stores bile. Bile entering gallbladder is controlled by the sphincter of Odii.

Pancreas

Endocrine versus exocrine function:

endocrine: involves secretion into blood (inside the body, endo): insulin and glucagons (endocrine
function not discussed in lecture)

exocrine: involves secretion into GI system (outside the body, exo).

Pancreatic juice contains:

water: H2O

bicarbonate: HCO3-

amylase: digests starch

trypsin: digests protein

lipase: digests fatty acids

Control of the Digestive System

automatic activity

autonomic nerves

hormones

Innervation of the gastrointestinal tract

parasympathetic: rest and digest

sympathetic: fight and flight

enteric nervous system: intrinsic nervous system in GI system

Autonomic Branch

Effect on GI system

parasympathetic

motility, open valves

sympathetic

¯ motility, close valves

Three Phases in Control of Gasric Function

Cephalic Phase

Gastric Phase

Intestinal Phase

Cephalic Phase:

Regulation by the vagus nerve: lasts approximately 30 minutes.

The vagus nerve is activated by sight, smell, taste of food.

Activation of the vagus nerve:

indirectly causes the parietal cells to secrete HCl

directly stimulates chief cells to secreate pepsinogen to digest proteins

Gastric Phase
Stimulated by

distension of the stomach (i.e. amount of chyme)

chemical nature of the chyme

The goal of this phase is to release acid and proteolytic enzymes into the stomach.

Feedback loops

A positive feedback loop occurs in which peptides cause acid and pepsinogen to be released and this in
turn causes more peptides in the stomach, which causes acid and pepsinogen to be released, etc..

A negative feedback loop occurs in which the low pH of the stomach inhibits gastrin secretion by the G
cells which results in less acid secretion.

Stimulation of HCl secretion:

Vagus nerve and amino acids in the stomach lumen stimulate gastrin release by G-cells

Gastrin stimulates histamine release by ECL cells

Histamine stimulates HCl secretion by parietal cells.

Stimulus for gastric phase

peptides (particularly phenylalanine and tyrptophan) stimulate pepsinogen and acid secretion

glucose and fats do not stimulate acid secretion.

Intestinal phase

Inhibition of gastric activity due to:

neural reflex: stretch of the duodenum inhibits gastric motility and secretion

hormone: fat in the chyme stimulates an inhibitory hormone. It is not clear what this hormone is.
Potential candidates include gastric inhibitory peptide, somatostatin, cholecystokinin, glucagon-like.

Control of Intestine

Chyme in duodenum stimulates

gastric inhibition

pancreatic secretion

bile secretion

Pancreatic juice secretion is controlled by secretin and cholecystokinin (CCK).

Cholecystokinin: stimulated by fats and proteins in duodenum — results in pancreatic secretion of