Overview Of The Digestive System

The digestive system is composed of two groups of organs (Figure 7.1):

• the gastrointestinal tract (GI) or • the accessory digestive organs

alimentary canal:
• It includes the • They include
• mouth, length 5–7 meters in a • Teeth: physical breakdown of food
• pharynx, living person. • Tongue: assists in chewing and swallowing
• esophagus, 7–9 meters in a • salivary glands,
• stomach, cadaver because the • liver, never come
• small intestine, muscles along the wall into direct contact
• large intestine, of the GI tract • gallbladder, and with food.
• anus organs are in a state of • pancreas
tonus (sustained
contraction).
Accessory digestive
organs are indicated
with an asterisk (*).
 Functions of the Digestive System
• 1. Ingestion: taking food into the mouth (eating).
• 2. Secretion: Each day, cells within the walls of the GI tract and accessory organs secrete a total of about
7 liters of water, acid, buffers, and enzymes into the lumen of the GI tract.
• 3. Mixing and propulsion: The ability of the GI tract to mix and move material along its length is termed
motility. It is due to alternating contraction and relaxation of smooth muscle in the walls of the GI tract.
• 4. Digestion: mechanical and chemical breakdown of food into small molecules.
• In mechanical digestion the teeth cut and grind food before it is swallowed, and then smooth
muscles of the stomach and small intestine churn the food.
• In chemical digestion the large carbohydrate, lipid, protein, and nucleic acid molecules in food are
broken down into smaller molecules by digestive enzymes.
• 5. Absorption: passage of digested products (small molecules) from the GI tract into the blood and
lymph and circulate to cells throughout the body.
• 6. Defecation: elimination of feces (stools) from the GI tract. The feces include Wastes, indigestible
substances, bacteria, cells shed from the lining of the GI tract, and digested materials that were not
absorbed.
Layers Of The GI Tract
• The wall of the GI tract, from the lower esophagus to the anal canal,
has the same basic, four-layered arrangement of tissues. The four
layers of the tract, from the inside out, are the:
• mucosa,
• submucosa,
• muscularis, and
• serosa (Figure 7.2).
 Layers Of The GI Tract
1- Mucosa. The mucosa, or inner lining of the
tract, is a mucous membrane. It is composed of
Epithelium: a layer that is in direct contact with
the contents of the GI tract,
Lamina propria: a layer of areolar tissue
(connective, separative and protective tissue), it
contains:
• secretary glands and also
• prominent lymphatic nodules that protect
against the entry of pathogens through the
GI tract.
Muscularis mucosae: a thin layer of smooth
muscle. Contractions of the muscularis mucosae
create folds in the mucosa that increase the
surface area for digestion and absorption.
 Layers Of The GI Tract
2. Submucosa. The submucosa consists of
areolar connective tissue that binds the mucosa
to the muscularis.
• It contains:
• many blood vessels and lymphatic vessels
that receive absorbed food molecules.
• Secretary glands and
• networks of neurons that are subject to
regulation by the autonomic nervous
system (ANS) called the enteric nervous
system (ENS), the “brain of the gut.” ENS
neurons within the submucosa control the
secretions of the glands of the GI tract.
 Layers Of The GI Tract
• 3. Muscularis. is a thick layer of muscle.
• In the mouth, pharynx, and upper esophagus,
it consists in part of skeletal muscle that
produces voluntary swallowing. Skeletal
muscle also forms the external anal sphincter,
which permits voluntary control of defecation.
Recall that a sphincter is a thick circle of
muscle around an opening.
• In the rest of the tract, the muscularis consists
of smooth muscle, usually arranged as an inner
sheet of circular fibers and an outer sheet of
longitudinal fibers. Involuntary contractions of
these smooth muscles help break down food
physically, mix it with digestive secretions, and
propel it along the tract. ENS neurons within outer
the muscularis control the frequency and inner
strength of its contractions.
 Layers Of The GI Tract
• 4. Serosa. The serosa, the
outermost layer around organs of
the GI tract below the diaphragm,
is a membrane composed of
simple squamous epithelium and
areolar connective tissue. The
serosa secretes a slippery, watery
fluid that allows the tract to glide
easily against other organs.
 I- Structures of the mouth (oral cavity):
a- The tongue
• The tongue forms the floor of the oral cavity. It is
an accessory digestive organ composed of skeletal
muscle covered with mucous membrane.
• The muscles of the tongue manoeuver food for
chewing, shape the food into a rounded mass,
force the food to the back of the mouth for
swallowing, and alter the shape and size of the Lingual tonsil
tongue for swallowing and speech.
• The lingual frenulum (LING-gwal FREN-u-lum;
lingua tongue; frenum bridle), a fold of mucous
membrane in the midline of the undersurface of
the tongue, limits the movement of the tongue
posteriorly (Figure 7.4a).
• The lingual tonsils lie at the base of the tongue.
• The upper surface and sides of the tongue are
covered with projections called papillae (pa-PIL-e),
some of which contain taste buds.
 I- Structures of the mouth (oral cavity):
b- The Salivary Glands
• The three pairs of salivary glands are
accessory organs of digestion that lie outside
the mouth and release their secretions into
ducts emptying into the oral cavity (see
Figure 7.1).
• The parotid glands are located inferior and
anterior to the ears between the skin and the
masseter muscle.
• The submandibular glands are found in the
floor of the mouth; they are medial and
partly inferior to the mandible.
• The sublingual glands are beneath the
tongue and superior to the submandibular
glands.
 I- Structures of the mouth (oral cavity):
b- The Salivary Glands
• The fluid secreted by the salivary glands, called saliva, is composed of
99.5% water and 0.5% solutes.
• The water in saliva helps dissolve foods so they can be tasted and
digestive reactions can begin.
• The solutes
• One of the solutes, the digestive enzyme salivary amylase, begins
the digestion of starches in the mouth.
• The enzyme lysozyme kills bacteria, thereby protecting the
mouth’s mucous membrane from infection and the teeth from
decay.
• Secretion of saliva, called salivation, is controlled by the autonomic
nervous system.
• parasympathetic stimulation promotes continuous secretion of a
moderate amount of saliva, which keeps the mucous membranes
moist and lubricates the movements of the tongue and lips during
speech.
• Sympathetic stimulation dominates during stress, it inhibits the
salivation process resulting in dryness of the mouth.
c- Digestion in the Mouth
• Mechanical digestion in the mouth results from chewing, or mastication, in which food is
manipulated by the tongue, ground by the teeth, and mixed with saliva. As a result, the food is
reduced to a soft, flexible,easily swallowed mass called a bolus (lump).

• Dietary carbohydrates are either monosaccharide and disaccharide sugars or complex

polysaccharides such as glycogen and starches. Most of the carbohydrates we eat are starches
from plant sources, but only monosaccharides (glucose, fructose, and galactose) can be absorbed
into the bloodstream. Thus, ingested starches must be broken down into monosaccharides.

• Salivary amylase begins the breakdown of starch by breaking particular chemical bonds between
the glucose subunits. The resulting products include the disaccharide maltose (2 glucose
subunits), the trisaccharid maltotriose (3 glucose subunits), and larger fragments called dextrins
(5 to 10 glucose subunits). Salivary amylase in the swallowed food continues to act for about an
hour until it is inactivated by stomach acids.
 I- Structures of the mouth (oral cavity):
d- The Teeth
• The teeth (dentes) are accessory digestive
organs located in bony sockets of the
mandible and maxillae. The sockets are
covered by the gingivae or gums and are
lined with the periodontal ligament (peri-
around; odont- tooth). This dense fibrous
connective tissue anchors the teeth to
bone (Figure 7.5a).
• Externally, a typical tooth has three major
regions: the crown, root, and neck. = socket

• The crown is the visible portion above the

level of the gums.
• The root consists of one to three
projections embedded in the socket.
• The neck is the junction line of the crown
and root, near the gum line.
 I- Structures of the mouth (oral cavity):
d- The Teeth
• Internally,
• The dentin forms the majority of the tooth. It consists of a calcified = The hardest and the
connective tissue that gives the tooth its basic shape and rigidity. richest in calcium

• The dentin of the crown is covered by enamel that consists

primarily of calcium phosphate and calcium carbonate. Enamel, the
hardest substance in the body and the richest in calcium salts
(about 95% of its dry weight), protects the tooth from the wear
and tear of chewing. It is also a barrier against acids that easily
dissolve the dentin.
• The dentin of the root is covered by cementum, a bonelike
substance that attaches the root to the periodontal ligament.
• The dentin of a tooth encloses the pulp cavity, a space in the
crown filled with pulp, a connective tissue containing blood
vessels, nerves, and lymphatic vessels. Narrow extensions of the
pulp cavity run through the root of the tooth and are called root
canals. Each root canal has an opening at its base through which
blood vessels bring nourishment, lymphatic vessels offer
protection, and nerves provide sensation.
 I- Structures of the mouth (oral cavity):
d- The Teeth
• Humans have two sets of teeth.
• The 20 deciduous teeth begin
to erupt at about 6 months of
age, and one pair appears about
each month thereafter until all
20 are present (Figure 7.5b).
They are generally lost in the
same sequence between 6 and
12 years of age.
• The 32 permanent teeth appear
between age 6 and adulthood.
There are 32 teeth in a
complete permanent set (Figure
7.5c).
II- Pharynx and Esophagus
• When food is swallowed, it passes from the
mouth into the pharynx (FAIR-inks), a
funnel-shaped tube that is composed of
skeletal muscle and lined by mucous
membrane.
• It extends from the internal nares to the
esophagus posteriorly and the larynx
anteriorly (Figure 7.6a).
• The nasopharynx is involved in respiration
(see Figure 6.2); food that is swallowed
passes from the mouth into the oropharynx
and laryngopharynx before passing into the
esophagus. Muscular contractions of the
oropharynx and laryngopharynx help propel
food into the esophagus.
II- Pharynx and Esophagus
• When food is swallowed, it passes from the
mouth into the pharynx (FAIR-inks), a funnel-
shaped tube that is composed of skeletal
muscle and lined by mucous membrane.
• It extends from the internal nares to the
esophagus posteriorly and the larynx anteriorly
(Figure 7.6a).
• The nasopharynx is involved in respiration (see
Figure 6.2); however, food that is swallowed
passes from the mouth into the oropharynx
and laryngopharynx before passing into the
esophagus. Muscular contractions of the
oropharynx and laryngopharynx help propel
food into the esophagus.
 II- Pharynx and Esophagus
• The esophagus (e-SOF-a-gus eating
gullet) is a muscular tube lined with
stratified squamous epithelium that lies
posterior to the trachea.

• It begins at the end of the

laryngopharynx, passes through the diaphragm
mediastinum and diaphragm, and
connects to the superior aspect of the
stomach. It transports food to the
stomach and secretes mucus.
 III- Stomach
• The stomach is a J-shaped enlargement of the GI tract
directly below the diaphragm. The stomach connects the
esophagus to the duodenum, the first part of the small
intestine (Figure 7.7).
• Because a meal can be eaten much more quickly than the
intestine can digest and absorb, one of the functions of
the stomach is to serve as a mixing chamber and holding
reservoir.
• At appropriate intervals after food is ingested, the
stomach forces a small quantity of material into the
duodenum.
• The position and size of the stomach vary continually; the
diaphragm pushes it inferiorly with each inhalation and
pulls it superiorly with each exhalation. The stomach is the
most elastic part of the GI tract and can accommodate a
large quantity of food, up to about 6.4 liters.
 III-a- Structure of the Stomach
• The stomach has four main regions: cardia,
fundus, body, and pylorus (Figure 7.7).
• The cardia (Lower esophageal Sphincter)
surrounds the superior opening of the
stomach. The stomach then curves upward.
• The fundus is the portion that is superior
and to the left of the cardia .
• The body: is the large central portion of the
stomach located just inferior to the fundus
• The pylorus (pyl- gate; -orus guard); is a
narrow, most inferior region which ends the
stomach. It is divided into two parts , the
pyloric antrum which connects to the body
of the stomach, and the pyloric canal which
connects to the duodenum by the pyloric
orifice. Between the pylorus and
duodenum is the pyloric sphincter.
 III-a- Structure of the Stomach
• The stomach wall is composed of the
same four basic layers as the rest of the
GI tract (mucosa, submucosa,
muscularis, serosa), with certain
differences.
1- the mucosa; When the stomach is
empty, the mucosa lies in large folds,
called rugae (ROO-ge¯ wrinkles). The
surface of the mucosa is a layer of non
ciliated simple columnar epithelial cells
called surface mucous cells (Figure 7.8).
• Epithelial cells also extend downward
and form columns of secretory cells
called gastric glands that line narrow
channels called gastric pits.
• Secretions from the gastric glands flow
into the gastric pits and then into the
lumen of the stomach.
 • Anemia: not enough healthy RBC
• Pernicious anemia: decrease in RBC

III-a- Structure of the Stomach number

Not part of the

• The gastric glands contain three types of exocrine gland cells that gastric gland
secrete their products into the stomach lumen: mucous neck cells,
chief cells, and parietal cells and one type of endocrine cells (Figure).
• The mucous neck cells secrete mucus.
• The chief cells secrete an inactive gastric enzyme called pepsinogen
and lipase .
• The Parietal cells produce hydrochloric acid, which
• kills many microbes in food and
• helps convert pepsinogen to the active digestive enzyme pepsin
(for the digestion of proteins).
• also secrete intrinsic factor, that is involved in the absorption of
vitamin B12 after binding it. Inadequate production of intrinsic
factor can result in pernicious anemia* because vitamin B12 is
needed for red blood cell production. The secretions of the
mucous, chief, and parietal cells are collectively called gastric
juice.
• The G cells, a fourth type of cell in the gastric glands, secrete the
hormone gastrin into the bloodstream (endocrine gland cells).
 III-a- Structure of the Stomach
2- The submucosa of the stomach is
composed of areolar connective tissue
that connects the mucosa to the
muscularis.
3- The muscularis has three rather than
two layers of smooth muscle:
• an outer longitudinal layer,
• a middle circular layer, and
• an inner oblique layer (see Figure
8.7).
4- The serosa covering the stomach,
composed of simple squamous epithelium
and areolar connective tissue, is part of
the visceral peritoneum.
III-b- Digestion and Absorption in the Stomach
• Once food reaches the stomach, the stomach wall
is stretched and the pH of the stomach contents
increases because proteins in food have buffered
some of the stomach acid.
• These changes in the stomach trigger nerve
impulses that stimulate the flow of gastric juice
and initiate mixing waves, gentle, rippling
peristaltic movements of the muscularis
(mechanical digestion). These waves macerate
food and mix it with the secretions of the gastric
glands, producing chyme (KI￣M juice), a thick
liquid with the consistency of pea soup.
 III-b- Digestion and Absorption in the Stomach
• Each mixing wave forces a small amount of chyme
through the partially closed pyloric sphincter into the
duodenum, a process called gastric emptying. Most of
the chyme is forced back into the body of the stomach.
The next mixing wave pushes chyme forward again and
forces a little more into the duodenum.
• After the stomach has emptied some of its contents
into the duodenum, reflexes begin to slow the exit of
chyme from the stomach. This prevents overloading of
the duodenum with more chyme than it can handle.
• Foods rich in carbohydrate spend the least time in
the stomach;
• Foods rich in protein remain somewhat longer, and
• Foods rich in fat remain the longest and gastric
emptying is the slowest.
III-b- Digestion and Absorption in the Stomach
• The main event of chemical digestion in the stomach is
the beginning of protein digestion by the enzyme
pepsin, which breaks peptide bonds between the
amino acids of proteins.
• As a result, the proteins become fragmented into
peptides, smaller chains of amino acids.
• Pepsin is most effective in the very acidic environment
of the stomach, which has a pH of 2.

Protein: long chain of amino acids

Pepsin

Peptides = small proteins

Amino acids
III-b- Digestion and Absorption in the Stomach
• The main event of chemical digestion in the stomach is the
beginning of protein digestion by the enzyme pepsin, which breaks
peptide bonds between the amino acids of proteins.
• As a result, the proteins become fragmented into peptides, smaller
chains of amino acids.
• Pepsin is most effective in the very acidic environment of the
stomach, which has a pH of 2.

What keeps pepsin from digesting the protein in stomach cells along with the food?
• First, recall that chief cells secrete pepsin in an inactive form (pepsinogen). It is not converted into active
pepsin until it contacts hydrochloric acid in gastric juice.
• Second, mucus secreted by mucous cells coats the mucosa, forming a thick barrier between the cells of the
stomach lining and the gastric juice.
The epithelial cells of the stomach are impermeable to most materials, so little absorption occurs. However,
mucous cells of the stomach absorb some water, ions, and short-chain fatty acids, as well as certain drugs
(especially aspirin) and alcohol.
 Accessory Digestive Organs
• From the stomach, chyme passes
into the small intestine. - Liver
- Gallbladder, and
• Because chemical digestion in the
small intestine depends on
- Pancreas
activities of the pancreas, liver,
and gallbladder, we first consider
duodenum
these accessory digestive organs
and their contributions to They are not part of the path of
digestion in the small intestine. food, but play a critical role.
IV- Pancreas

• The pancreas (pan- all; -creas

flesh) lies behind the stomach
(see Figure).
• Secretions pass from the
pancreas to the duodenum via
the pancreatic duct, which
unites with the common bile
duct from the liver and
gallbladder, forming a common
duct to the duodenum
hepatopancreatic ampula
(Figure 7.9).
 IV- Pancreas
The pancreas is made up of: acini and islets of Langerhans
1. acini are small clusters of glandular epithelial cells, most of which
are arranged in clusters.
• The acini constitute the exocrine portion of the organ (secretion
in the duodenum not in the blood). The cells within acini secrete
a mixture of fluid and digestive enzymes called pancreatic juice.
2. pancreatic islets (islets of Langerhans) The remaining 1% of the
cells are also organized into clusters called (islets of Langerhans) ,
• This is the endocrine portion of the pancreas (secretion in the
blood). These cells secrete
Blood
• the hormones glucagon, vessels
• insulin,
• somatostatin, and
• pancreatic polypeptide.
Pancreatic Juice

• Pancreatic juice is a clear, colorless liquid that consists mostly of water,

some salts, sodium bicarbonate, and enzymes.

• The bicarbonate ions give pancreatic juice a slightly alkaline pH (7.1 to

8.2), which inactivates pepsin from the stomach and creates the optimal
environment for activity of enzymes in the small intestine.

• Pancreatic juice contains emzymes

• Amylase: digest starch into maltose (disaccharides)
• Protease (trypsin): digest proteins into peptides
• Lipase: digest fat into fatty acids and glycerol
 V- Liver and Gallbladder
• The liver
• weighs 1.4 kg in an average adult,
• is the second largest organ of the body after the
skin.
Right and left
• is located below the diaphragm, mostly on the right
side of the body. It has 2 lobs (right and left) Common hepatic duct
separated by the falciform ligament (fig 7.9).
• A connective tissue capsule covers the liver, which in
turn is covered by peritoneum, the serous
=membrane that covers all the viscera.
• It manufactures about 1 liter of bile a day. This bile is
transported via a bile duct to the small intestine to
further break down fats. Any extra bile is stored in
the gallbladder.
 V- Liver and Gallbladder
• The gallbladder (gall- bile)
is a pear-shaped sac that hangs from the lower front
margin of the liver (Figure 7.9).
• It Stores bile from the liver, releases it into the
duodenum.
• Fatty diets can cause gallstones and Removing the
stones typically means removing the gallbladder, but
that the body eventually adjusts to not having the
bile stored.
 Bile
• Bile salts in bile aid in
• emulsification: the breakdown of large lipid globules
into a suspension of small lipid globules that are then
rapidly digested by the lipase of the pancreatic juice,
• absorption of lipids following their digestion.
• The principal bile pigment is bilirubin, which is derived
from heme. When worn-out red blood cells are broken
down in the spleen, iron, globin, and bilirubin are
released.
• The iron and globin are recycled, but some of the
bilirubin is excreted in bile. Bilirubin eventually is broken
down in the intestine, and one of its breakdown products
(stercobilin) gives feces their normal brown color.
• After they have served as emulsifying agents, most bile
salts are reabsorbed by active transport in the final
portion of the small intestine (ileum) and enter portal
blood flowing toward the liver.
VI- Small Intestine
• The major events of digestion and absorption occur in the small
intestine where the stomach empties its contents within 2 to 4 hours
after eating a meal.
• The small intestine averages
• 2.5 cm in diameter;
• its length is about 3 m in a living person and about 6.5 m in a cadaver due to
the loss of smooth muscle tone after death.
Structure of the Small Intestine
• The small intestine has three portions (Figure 7.10a):
• the duodenum,
• the jejunum, and
• the ileum.
• The duodenum, the shortest part (about 25 cm), attaches to the pylorus of the
stomach. Duodenum means “twelve”; the structure is so named because it is
about as long as the width of 12 fingers.
• The jejunum (je-JOO-num empty) is about 1 m long and is so named because it is
empty at death. It is mostly in the left upper quadrant. The final portion of the
small intestine,
• The ileum (IL-e-um twisted), measures about 2 m and joins the large intestine at
the ileocecal sphincter or valve. The ileum is mostly in the right lower quadrant.
 Structure of the Small Intestine
• The wall of the small intestine is composed of the same four layers that make up
most of the GI tract: mucosa, submucosa, muscularis, and serosa (Figure 7.11).
Structure of the Small Intestine
• Special structural features of the small intestine facilitate the process of digestion and absorption: it
contains circular folds, villi, and microvilli.

Villi
Structure of the Small Intestine

• Special structural features of the small intestine facilitate the process of digestion and absorption: it
contains circular folds, villi, and microvilli.
1. Circular folds are permanent ridges of the mucosa and submucosa that enhance absorption by
increasing surface area and causing the chyme to spiral, rather than move in a straight line, as it
passes through the small intestine (see Figure 7.10b).
2. villi (tufts of hair; singular is villus), fingerlike projections of the mucosa that increase the surface area
of the intestinal epithelium. Each villus consists of a layer of simple columnar epithelium sur-rounding
a core of lamina propria. Within the core are an arteriole, a venule, a blood capillary network, and a
lacteal (milky = absorbs fats), which is a lymphatic capillary. Nutrients absorbed by the epithelial cells
covering the villus pass through the wall of a capillary or a lacteal to enter blood or lymph,
respectively.
3. microvilli (micro- = small), tiny projections of the plasma membrane of absorptive cells that increase
the surface area of these cells. Thus, digested nutrients can move rapidly into absorptive cells.
 Structure of the Small Intestine
• The epithelial layer of the small
intestinal mucosa consists of
simple columnar epithelium that
contains many types of cells.
• Absorptive cells of the epithelium
contain microvilli and digest and
absorb nutrients in small intestinal
chyme.
• goblet cells, which secrete mucus.
• intestinal glands, which are deep
crevices lined by epithelial cells
that secrete intestinal juice. intestinal
gland
Intestinal glands also contain three
types of endocrine cells that
secrete hormones into the
bloodstream:
Lacteal : absorbs
fatty acids then
enters the lymph

Capillaries absorbs
glucose , proteins
and amino acids
Then enters the
blood vessels .
VII- Large Intestine
• The large intestine is the last part of the GI tract.
• Its overall functions are
• the contraction of colon muscularis (churning and peristalsis) drive the contents
of colon into rectum
• the completion of absorption, (absorb water, ions and vitamins)
• the production of certain vitamins, (bacteria in large intestine convert proteins to
a.a., break down a.a., and produce some B vitamins and K vitamin.
• the formation of feces, and
• the expulsion of feces from the body (by defecation or emptying the rectum).
 mesentery
a- Structure of the Large Intestine
small Intestine
• The large intestine averages about 6.5 cm in diameter and
about 1.5 m in length.
• It extends from the ileum to the anus and is attached to the
posterior abdominal wall by its mesentery (see Figure 7.3b).
• The large intestine has four principal regions: cecum, colon,
rectum, and anal canal (Figure 7.14).
Large Intestine
• At the opening of the ileum into the large intestine is a valve
called the ileocecal sphincter. It allows materials from the
small intestine to pass into the large intestine. Inferior to the
ileocecal sphincter is the first segment of large intestine,
called the cecum. Attached to the cecum is a twisted coiled
tube called the appendix. This structure has highly
concentrated lymphatic nodules that control the bacteria
entering the large intestine by immune responses.
Anus
 Smooth muscles

Skeletal muscles

Ileum (last section of small intestine)

Cecum (first section of the colon)

The taenia (ribbon) coli contract lengthwise to

produce the haustra, the bulges in the colon.
b- Structure of the Large Intestine

• The open end of the cecum merges with the longest portion of the large
intestine, called the colon (food passage).
• The colon is divided into ascending, transverse, descending, and sigmoid
portions.
• The ascending colon ascends on the right side of the abdomen, reaches the
undersurface of the liver, and turns to the left.
• The colon continues across the abdomen to the left side as the transverse colon. It
curves beneath the lower border of the spleen on the left side and passes downward
as the descending colon.
• The S-shaped sigmoid colon begins near the iliac crest of the left hip bone and ends as
the rectum.
b- Structure of the Large Intestine
• The last 2 to 3 cm of the rectum is called the anal
canal. The opening of the anal canal to the exterior
is called the anus. It has an internal sphincter of
smooth (involuntary) muscle and an external
sphincter of skeletal (voluntary) muscle.
• Normally, the anal sphincters are closed except
during the elimination of feces.
• The wall of the large intestine contains the typical
four layers found in the rest of the GI tract: mucosa,
submucosa, muscularis, and serosa. The epithelium
of the mucosa is simple columnar epithelium that
contains mostly absorptive cells and goblet cells
(Figure 7.13). The cells form long tubes called
intestinal glands
c- Digestion and Absorption in the Large Intestine
• The passage of chyme from the ileum into the cecum is regulated by the ileocecal
sphincter.
• The sphincter normally remains slightly contracted so that the passage of chyme
is usually a slow process. Immediately after a meal, a reflex intensifies peristalsis,
forcing any chyme in the ileum into the cecum.
• Peristalsis occurs in the large intestine at a slower rate than in other portions of
the GI tract. Characteristic of the large intestine is mass peristalsis, a strong
peristaltic wave that begins in the middle of the colon and drives the colonic
contents into the rectum. Food in the stomach initiates mass peristalsis, which
usually takes place three or four times a day, during or immediately after a meal.
c- Digestion and Absorption in the Large Intestine
• The final stage of digestion occurs in the colon through the activity of bacteria
that normally inhabit the lumen. The glands of the large intestine secrete mucus
but no enzymes.
• Bacteria ferment any remaining carbohydrates and release hydrogen, carbon
dioxide, and methane gases. These gases contribute to flatus (gas) in the colon,
termed flatulence when it is excessive.
• Bacteria also break down the remaining proteins to amino acids and decompose
bilirubin to simpler pigments, including stercobilin, which give feces their brown
color.
• Several vitamins needed for normal metabolism, including some B vitamins and
vitamin K, are bacterial products that are absorbed in the colon.
c- Digestion and Absorption in the Large Intestine

• Although most water absorption occurs in the small intestine, the large intestine
also absorbs a significant amount.
• The large intestine also absorbs ions, including sodium and chloride, and some
dietary vitamins.
• By the time chyme has remained in the large intestine 3 to 10 hours, it has
become solid or semisolid as a result of water absorption and is now called feces.
• Chemically, feces consist of water, inorganic salts, sloughed-off epithelial cells
from the mucosa of the gastrointestinal tract, bacteria, products of bacterial
decomposition, unabsorbed digested materials, and indigestible parts of food.
d- The Defecation Reflex
• Mass peristaltic movements push fecal material from the sigmoid colon into the rectum. The
resulting distension of the rectal wall stimulates stretch receptors, which initiates a defecation
reflex that empties the rectum.
• Impulses from the spinal cord travel along parasympathetic nerves to the descending colon,
sigmoid colon, rectum, and anus. The resulting contraction of the longitudinal rectal muscles
shortens the rectum, thereby increasing the pressure within it. This pressure plus
parasympathetic stimulation opens the internal sphincter (involuntary).
• The external sphincter is voluntarily controlled. If it is voluntarily relaxed, defecation occurs and
the feces are expelled through the anus; if it is voluntarily constricted, defecation can be
postponed. Voluntary contractions of the diaphragm and abdominal muscles aid defecation by
increasing the pressure within the abdomen, which pushes the walls of the sigmoid colon and
rectum inward. If defecation does not occur, the feces back up into the sigmoid colon until the
next wave of mass peristalsis stimulates the stretch receptors.
• In infants, the defecation reflex causes automatic emptying of the rectum because voluntary
control of the external anal sphincter has not yet developed.