PHYSIOLOGY OF DIGESTIVE

SYSTEM
FUNCTIONS OF DIGESTIVE SYSTEM
• Ingestion or consumption of food substances.
• Breaking them into small particles.
• Transport of the small particles to different areas of
the digestive tract.
• Secretion of necessary enzymes and other
substances for digestion.
• Digestion of the food particles.
• Absorption of the digestive products(nutrients)
• Removal of unwanted substances from the body.
NERVE SUPPLY TO GI TRACT

• GI tract has 2 types of nerve supply :

– Intrinsic nerve supply
• Auerbach’s plexus
• Meissner’s plexus
– Extrinsic nerve supply
• Sympathetic nerve fibres
• Parasympathetic nerve fibres
1. Intrinsic nerve supply :
• The intrinsic nerve fibres are present within the
wall of GI tract.These fibres are interconnected
and form a network called nerve plexus.
• These nerve plexus contain nerve cell bodies
processes of nerve cell bodies,processes of nerve
cells and the receptors.
• The receptors in the GI tract are stretch receptors
and chemoreceptors.
• The intrinsic nerves are controlled by the extrinsic
nerve fibres.The intrinsic nerve plexus in GI tract is
of 2 types.
i. Auerbach’s plexus :
• It is also known as myenteric nerve plexus.
• It is present in between the inner circular muscle layer and
the outer longitudinal muscle layer.
• The function of auerbach’s plexus is to regulate the
movements of GI tract.
ii. Meissner’s nerve plexus :
• It is otherwise called submucus nerve plexus.
• It is situated in between the muscular layer and
submucosal layers of GI tract.
• The function of Meissner’s plexus is the regulation of
secretory functions of GI tract.
• And these nerve fibres cause constriction of blood vessels
of GI tract.
2. Extrinsic nerve supply :
• The extrinsic nerve supply to GI tract is from ANS.
• Both sympathetic and parasympathetic divisions
of ANS innervate the GI tract.
• Sympathetic nerve fibres : They inhibit the
movements of GI tract and decrease the secretions
of GI tract by secreting the neurotransmitter nor-
adrenaline.
• Parasympathetic nerve fibres : The
parasympathetic nerve fibres accelerate the
secretory activities of the glands in the GI
tract.These also increase the motility of GI tract.
 MOUTH
• Functions of mouth :
i. Ingestion of food materials.
ii. Chewing and mixing the food with saliva.
iii. Appreciation of the taste of food.
iv. Transfer of food(bolus) to the esophagus by
swallowing.
 FUNCTIONS OF SALIVA
1. Preparation of food for swallowing :
• When food enters the mouth,saliva moistens and dissolves it.
• The mucous membrane of mouth is also moistened by saliva.
• It facilitates chewing.
• By the movement of the tongue,the moistened and masticated
food is rolled into a bolus.
• The mucin of saliva lubricates the bolus and facilitates the
swallowing.
2. Appreciation of taste :
• Taste is a chemical sensation.
• Saliva by its solvent action dissolves the solid food substances,so
that the dissolved substances can stimulate the taste buds.
• The stimulated taste buds recognise the taste.
3. Digestive function :
• Saliva has 3 digestive enzymes
namely;salivary,amylase,maltase and lingual lipase.
• Salivary amylase :
– Salivary amylase is a carbohydrate splitting(amylolytic
)enzyme.
– It acts on cooked or boiled starch and converts it into
dextrin and maltose.
– Though starch digestion starts in the mouth,major part
of it occurs in the stomach because,the food stays only
for a short time in the mouth.
– The optimum pH necessary for the activation of salivary
amylase is 6.
– The salivary amylase cannot act on cellulase.
• Maltase :
– The enzyme maltase is present only in
traces in human saliva.
– It converts maltose into glucose.

• Lingual lipase :
- It digests milk fats.
- It hydrolyses triglycerides into fatty acids
and 1,2-diacyl glycerol.
4. Cleansing and protective functions :
• Due to the constant secretion of saliva,the mouth
and teeth are rinsed and kept free from food
debris,shed epithelial cells and foreign particles.
• In this way,saliva prevents bacterial growth by
removing materials,which may serve as culture
media for the bacterial growth.
• The enzyme lysozyme of saliva kills some bacteria
such as staphylococcus,streptococcus and brucella.
• Mucin present in the saliva protects the mouth by
lubricating the mucous membrane of the mouth.
5. Role in speech :
• By moistening and lubricating the soft parts of mouth and lips,saliva
helps in speech.
• If the mouth is dry,articulation and pronounciation become difficult.
6. Excretory function :
• Many substances,both organic and inorganic,are excreted in saliva.
• It excretes substances like mercury,potassium iodide,lead,and
thiocyanate.
• Saliva also excretes some viruses such as those causing rabies and
mumps.
7. Regulation of water balance :
• When the water body content decreases,salivary secretion also
decreases.
• This causes dryness of the mouth and induces thirst.
• When the water is taken,it quenches the thirst and restores the body
water content.
 APPLIED PHYSIOLOGY OF HYPOSALIVATION
• Hyposalivation : The reduction in the secretion of saliva is called
hyposalivation and permanent hyposalivation.
• Xerostomia : It means dry mouth.It is also called pasties or
cottonmouth.It is due to hyposalivation or absence of salivary
secretion(aptyalism).It causes difficulties in
mastication,swallowing and speech.It also causes halitosis(bad
breath-exhalation of unpleasant odours).
• Hypersalivation : The excess secretion of saliva is known as
hypersalivation.
• Drooling : uncontrolled flow of saliva outside the mouth is called
drooling.It is often called ptyalism.It occurs because of excess
production of saliva in association with inability to retain saliva
within the mouth.
• Chorda tympani : chorda tympani syndrome in the condition
characterised by sweating while eating.
• Paralytic secretion of saliva : When the parasympathetic nerve to
salivary gland is cut,salivary secretion increases for first 3 weeks
and later diminishes;finally it stops at about sixth week.The
increased secretion of saliva after cutting the parasympathetic
nerve fibres is called paralytic secretion.
• Augmented secretion of saliva : If the nerves supplying salivary
glands are stimulated twice,the amount of saliva secretd by the
second stimulus is more than the amount secreted due to the first
stimulus.
• Mumps : It is an acute viral infection affecting the parotid
glands.The virus causing this disease is paramyxovirus.Symptoms
include puffiness of cheeks(due to swelling of parotid
glands),fever,sore throat and weakness.
• Sjogren’s syndrome : It is an autoimmune disorder in which the
immune cells destroy exocrine glands such as lacrimal glands and
sweat glands.Common symptoms are dryness of the mouth due to
lack of saliva(xerostomia),persistent cough and dryness of eyes.
 STOMACH
• Gastric glands : The gastric glands are fundic glands,pyloric
glands,cardiac glands.
• The function of gastric glands are secretory activities.
• The functions of stomach are as follows :
1. Mechanical function :
i. Storage function – The food is stored in the stomach for a
long period.i.e.for 3-4 hrs and emptied into the intestine
slowly.The maximum capacity of the stomach is upto
1.5L.The slow emptying of stomach provides enough time
for proper digestion and absorption of food substances in
the small intestine.
ii. Formation of chyme – The peristaltic movements of
stomach mix the bolus with gastric juice and convert it into
the semi-solid material known as chyme.
2. Digestive function : Gastric juices carry out
the digestive function.
3. Protective function : Gastric juices carry out
the protective function.
4. Haemopoietic function : Gastric juices carry
out the haemopoietic function.
5. Excretory function : Many substance like
toxins,alkaloids and metals are excreted
through gastric juice.
• Gastric juice :It is the mixture of secretions from different
glands of the stomach.
• The functions of gastric juice are :
1. Digestive function :The gastric juice mainly acts on
proteins.The proteolytic enzymes of the gastric juice are
pepsin and rennin.
i. Pepsin :
i. The major proteolytic enzyme of gastric juice is pepsin.
ii. It is secreted as pepsinogen,which is inactive.
iii. Pepsinogen is converted into pepsin by hydrochloric
acid which is secreted by parietal cells.
iv. The optimim pH for activation of pepsinogen is below 6.
Action of pepsin : The products of protein digestion by
pepsin are proteoses,peptones and polypeptides.Peptin
also causes curdling and digestion of milk(casein).
ii. Gastric lipase :
i. Gastric lipase is a weak lipolytic enzyme.
ii. It is inactive at a pH below 2.5 and it becomes
active only when the pH is between 4 and 5.
iii. This enzyme is a tributyrase(butter fat) and
hydrolyses it into fatty acids and glycerols.
iii. Actions of other enzymes of gastric juice :
i. Gelatinase-degrades type I and type V gelatin
and type IV and V collagen into peptides.
ii. Urase - acts on urea and produces ammonia
iii. Gastric amylase – degrades starch
2. Haemopoietic functions :
i. The intrinsic factor of Castle present in gastric
juice plays an important role in erythropoiesis
ii. It is necessary for absorption of vitamin
B12(which is called extrinsic factor) from GI tract
into the blood.
iii. Vitamin B12 is an important maturation factor
during erythropoiesis.
iv. Absence of intrinsic factor causes deficiency of
vitamin B12.
v. And the deficiency of vitamin B12 leads to
pernicious anaemia.
3. Protective function :
i. The thick mucus present in the gastric juice is
responsible for the protection of gastric wall.
ii. Mucus
• Protects the stomach wall from irritation or
mechanical injury by virtue of its high viscosity.
• Prevents the digestive action of pepsin on the wall
of the stomach particularly gastric mucosa.
• Protects the gastric mucosa from HCl of gastric
juice because of its alkaline nature and its acid
combining power.
4. Function of hydrochloric acids :
i. Activates pepsinogen into pepsin.
ii. Kills some of the bacteria entering the
stomach along with food substances – this
action is called bacteriolytic action.
iii. Provides acid medium which is necessary
for the action of the hormones.
• APPLIED PHYSIOLOGY :
1. Gastritis :
i. Inflammation of gastric mucous membrane is called
gastritis.
ii. It may be acute or chronic.
iii. Acute gastritis is characterized by inflammation of
superficial layers of mucous membrane and infiltration
with leukocytes,mostly neutrophils.
iv. Chronic gastritis involves inflammation of even the deeper
layers and infiltration with more lymphocytes.
v. It results in the atrophy of the gastric mucosa with loss of
chief cells and parietal cells of glands.
vi. Therefore the secretion of gastric juice decreases.
2. Gastric atrophy :
i. It is the condition in which the muscles of the stomach
shrink and become weak.
ii. The gastric glands also shrink resulting in the deficiency of
gastric juice.
3. Peptic ulcer :
i. Ulcer means the erosion of the surface of any organ due to
shedding or sloughing of inflammed necrotic tissue that
lines the organ.
ii. Peptic ulcer means an ulcer in the wall of stomach or
duodenum caused by digestive action of gastric juice.
iii. If peptic ulcer is found in stomach,it is called duodenal
ulcer.
4. Zollinger-Ellison syndrome :
i. Zollinger-Ellison syndrome is characterized
by secretion of excess hydrochloric acid in
stomach.
ii. A tumour of pancreas is the cause of this
disorder.
 PANCREAS
• Pancreas is a dual organ having two
functions,the endocrine function
and the exocrine function.
• The endocrine function involves the
production of the hormones.
• The exocrine function involves the
secretion of digestive juice-
pancreatic juice.
• Pancreatic juice plays an important
role in the digestion of proteins and
lipids.
• It also digests the carbohydrates.
 DIGESTIVE FUNCTIONS OF PANCREATIC JUICE
• Digestion of proteins :The major proteolytic enzymes of
pancreatic juice are trypsin and chymotrypsin.Other
proteolytic enzymes are carboxypeptidases,nuclease,
elastase and collagenase.
1. Trypsin :
i. It is secreted as inactive trypsinogen which is converted
into active trypsin by enterokinase.
ii. Enterokinase is also called enteropeptidase and is secreted
by the brush bordered cells of duodenal mucus membrane.
iii. Once formed,trypsin itself activates trypsinogen by means
of autocatalytic or autoactive action.
Trypsin inhibitor :
a) Trypsinogen is activated only when it reaches the
small intestine.
b) If trypsin is activated when it is in pancreas,it may
hydrolyze the tissue proteins resulting in
pancreatic damage.
c) But,its activation in the secretory cells,acini and
ducts of pancreas is prevented by an inhibitor
protein called trypsin inhibitor.
d) Any abnormality or deficiency of the trypsin
inhibitor will result in unopposed trypsin activity
which damages the pancreas.
 Actions of trypsin :
i. Digestion of proteins : trypsin is the most powerful protein
digesting enzyme.It is an endopeptidase and breaks the
interior bonds of the protein molecules.By means of
hydrolysis,it converts proteins into proteoses and
polypeptides.
ii. Curdling of milk : it conveys caseinogens in the milk into
casein.
iii. Acceleration of blood clotting.
iv. Activation of other enzymes of pancreatic juice.Trypsin
converts :
chymotrypsinogen into chymotrypsin,procarboxypeptidases
into carboxypeptidases,proelastase into elastase,and
procolipase into colipase.
v. Trypsin also activates collagenase, phospolipase A and
phospholipase B.
vi. Once formed trypsin itself converts trypsinogen into
trypsin(autocatalytic action)
2. Chymotrypsin :
i. It is secreted as inactive chymotrypsinogen which is
activated into chymotrypsin by trypsin.
Action of chymotrypsin :
i. Digestion of proteins : Chymotrypsin is also an
endopeptidase and it hydrolyses the proteins into
polypeptides.
ii. Digestion of milk : Chymotrypsin digests casein faster than
trypsin.The combination of both enzymes causes more
rapid digestion of milk.
3. Carboxypeptidases :
i. The two carboxypeptidases are carboxypeptidase A and
carboxypeptidase B.
ii. Procarboxypeptidase A and B are the precursos for
carboxypeptidases A and B.
iii. The procarboxypeptidases are activated into
carboxypeptidases by trypsin.
Actions of carboxypeptidases :
i. Carboxypeptidases break the terminal bond of protein
molecules.
ii. Therefore,these enzymes are called exopeptidases.
iii. The exopeptidases split the polypeptides and other
proteins into amino acids.
4. Nucleases :
i. The nucleases of pancreatic juice are ribronuclease
and deoxyribonuclease,which are responsible for the
digestion of nucleic acids.
ii. These enzymes convert the ribonucleic acid(RNA) and
deoxyribonucleic acid(DNA) into mononucleotides.
5. Elastase :
i. Proelastase is activated into elastase by trypsin.
ii. Elastase digests the elastic fibres.
6. Collagenase :
i. Procollagenase is activated into collagenase by
trypsin.
ii. It digests collagen.
• Digestion of lipids : The lipolytic enzymes present in
pancreatic juice are pancreatic lipase,cholesterol ester
hydrolase,phospolipase A and phospholipase B.
1. Pancreatic lipase :
i. Pancreatic lipase is a powerful lipolytic enzyme.
ii. It hydrolyses the triglycerides into monoglycerides and
fatty acids.
iii. The activity of pancreatic lipase is accelerated in the
presence of bile.
iv. The optimum pH required for activity of this enzyme is 7 to
9.
v. About 80% of fat is digested by pancreatic lipase.
vi. The deficiency or absence of this hormone leads to
excretion of undigested fat in faeces.
2. Cholesterol ester hydrolase :
i. Cholesterol ester hydrolase or cholesterol esterase
hydrolyses cholesterol ester into free cholesterol and fatty
acid.
3. Phospolipase A :
i. It is activated by trypsin.
ii. Phospolipase A digests phospolipids namely lecithin and
cephalin and converts them into lysophospholipids;lecithin
into lysolecithin and cephalin into lysocephalin.
4. Phospolipase B :
i. Phospolipase B is also activated by trypsin.
ii. This enzyme converts the lysophospholipids(lysolecithin
and lysocephalin) to phosphoryl choline and free fatty
acids.
5. Colipase :
i. Colipase is a small protein coenzyme which facilitates the
efficient hydrolysis of fats by pancreatic lipase.
ii. Colipase binds to the C-terminal,the non-catalytic domain
of lipase so that there is an overall increase in the
hydrophobic binding site of lipase.
6. Bile salt-activated lipase :
i. This enzyme has a weak lipolytic action than pancreatic
lipase.
ii. But it hydrolyses a variety of lipids like
phospholipids,cholesterol esters and triglycerides.
iii. Human milk contains an enzyme similar to bile salt-
activated lipase.
 DIGESTION OF CARBOHYDRATES
• Like salivary amylase,the pancreatic also converts
starch into starch into dextrin and maltose.
APPLIED PHYSIOLOGY
• Pancreatitis : Pancreatitis is the inflammation of
pancreatic acini.There are 2 forms of pancretitis :
1. Acute pancreatitis – Acute pancreatitis is more
severe and it occurs because of heavy alcohol
intake or gallstones.
2. Chronic pancreatitis – Chronic pancreatitis
develops due to episodes of repeated acute
inflammation or as chronic damage to pancreas.
• Steatorrhea :
1. Steatorrhea is the formation of bulky,foul
smelling,frothy and clay coloured stools
with large quantity of undigested fat
because of impaired digestion and
absorption of fat.
2. In steatorrhea the feces is foul
smelling,bulky,pale,loose and greasy.
 LIVER

• Liver is a dual organ having both secretory and

excretory functions.
• Bile
i. Bile is agolden yellow or greenish fluid.It enters
the digestive tract along with pancreatic juice
through the common opening called Ampulla of
Vater.
ii. Bile salts are the sodium and potassium salts of
bile acids.
 FUNCTION OF BILE SALTS
• Emulsification of fats :
i. The lipolytic enzymes cannot digest the fats directly because
the fats are insoluble in water due to the surface tension.
ii. The bile salts reduce the surface tension of the fats by their
detergent action.
iii. Because of this reduction in surface tension,the lipid granules
are broken into minute particles which can be easily digested
by lipolytic enzymes.
• Absorption of fats :
i. Bile salts help in the absorption of digested fats from intestine
into blood.
• Choleteric action :
i. Bile salts stimulate the secretion of bile from liver.This action
is called choleretic action.
• Cholagogue action :
i. Cholagogue is an agent,which increases the release of bile
from gall bladder into the intestine.
ii. This hormone causes contraction of gallbladder and
release of bile.
• Laxative action :
i. Laxative is an agent which induces defecation.
ii. Bile salts act as laxatives by stimulating peristalyic
movements of the intestine.
• Prevention of gallstone formation :
i. Bile salts prevent the formation of gallstone by keeping the
cholesterol and lecithin in solution.
ii. In the absence of bile salts,cholesterol precipitates along
with lecithin and forms gallstone.
 FUNCTIONS OF BILE
• Digestive function
• Absorptive function
• Excretory function : Bile pigments are the major
excretory products of bile.The other substances
excreted in bile are :
i. Heavy metals like copper and iron
ii. Some bacteria like typhoid bacteria
iii. Some toxins
iv. Cholesterol
v. Lecithin
vi. Alkaline phosphatase
• Antiseptic action : Bile inhibits the growth of certain
bacteria in the lumen of intestine by its natural
action.
• Maintenance of pH in GIT : As the bile is highly
alkaline,it neutralizes the acid chyme which enters
the intestine from stomach.Thus,an optimum pH is
maintained for the action of digestive enzymes.
• Prevention of gallstone formation
• Lubrication function : The mucin in bile acts as a
lubricant for the chyme in intestine.
• Cholagogue action : Bile acts as cholagogue.
 FUNCTIONS OF LIVER
• Metabolic function : Liver is the organ where maximum metabolic
reactions are carried out.It plays an important role in energy
metabolism.Metabolism of carbohydrates,proteins,fats,vitamins and
many hormones is carried out in liver.
• Storage function : Many substances like glycogen,amino acids,iron,folic
acid and vitamins A,B12,and D are stored in liver.
• Synthetic function : Liver produces glucose by gluconeogenesis.It
synthesises all the plasma proteins and other proteins(except
immunoglobulins) such as clotting factors,complement factors,and
hormone binding proteins.It also synthesizes steroids,somatomedin and
heparin.
• Secretion of bile : liver secretes bile,which contains bile salts,bile
pigments,cholesterol,fatty acids and lecithin.
• Excretory function : Liver excretes cholesterol,bile pigments,heavy
metals(like lead,arsenic and bismuth),toxins,bacteria like typhoid and
virus(like that of yellow fever)through bile.
• Heat production : Enormous amount of heat is produced in liver
because of the metabolic reactions.Liver is the organ where
maximum heat is produced.
• Haemopoietic function : In fetus,liver produces the blood cells.It
stores vitamin B12 necessary for erythropoiesis and iron necessary
for syntheisi of Hb.Liver produces thrombopoietin that promotes
production of thrombocytes.
• Haemolytic function : The senile RBCs after the lifespan of 120 days
are destroyed by reticuloendothelial cells(Kupffer’s cells)of liver.
• Inactivation of hormones and drugs : Liver catabolizes the
hormones such as growth
hormone,parathormone,cortisol,insulin,glucagon and estrogen.It
also inactivates the drugs particularly the fat soluble drugs.
• Defensive and detoxification functions : The reticuloendothelial
cells of the liver plays an important role in the defense of the
body.Liver is also involved in the detoxification of the foreign
bodies.
 GALL BLADDER
• The major functions of gall bladder are the storage and
concentration of bile.
• Storage of bile : Bile is continuously secreted from liver.But it is
released into intestine only intermittently and most of the bile is
stored in gallbladder till it is required.
• Concentration of bile : Bile is concentrated while it is stored in gall
bladder.
• Alteration of pH of bile : The pH of bile decreases from 8 – 8.6 to 7
– 7.6 and it becomes less alkaline when it is stored in gall bladder.
• Secretion of mucin : Gall bladder secretes mucin,which acts as a
lubricant for movement of chyme in the intestine.
• Maintenance of pressure in biliary system : Due to the
concentrating capacity,gall bladder maintains a pressure of about
7cm H20 in biliary system.This pressure in the biliary system is
essential for the release of bile into the intestine.
 APPLIED PHYSIOLOGY
• Jaundice/icterus :
i. The yellow pigmentation of the skin ,mucous membrane and deeper tissues
due to increased bilirubin level in blood is called jaundice or icterus.
ii. Jaundice occurs when serum bilirubin level exceeds 2mg%.
iii. The increased blood level of bilirubin is called hyperbilirubinaemia.
iv. The types of jaundice are :
a. Prehepatic/haemolytic jaundice : In this condition,the excretory function of
liver is normal.but,jaundice occurs because of excessive destruction of RBCs
resulting in increased blood level of free bilirubin.The liver cells cannot
excrete that much bilirubin rapidly.So,it accumulates in the blood resulting
in jaundice.
b. Hepatic or hepatocellular or cholestatic jaundice : It is due to the damage of
hepatic cells.Because of the damage,the conjugated bilirubin from liver
cannot be excreted and it returns to blood.
c. Post hepatic or obstructive or extra hepatic jaundice : This type of jaundice
occurs because of the obstruction of bile flow at any level of the biliary
system.
• Hepatitis :
i. Hepatitis is the liver damage caused by many agents.
ii. It is characterised by swelling and inadequate
functioning of liver.Hepatitis may be acute or chronic.
iii. In severe conditions,it may lead to liver failure and
death.
• Cirrhosis of liver : The inflammation and damage of
parenchyma of liver is known as cirrhosis of liver.It
results in degeneration of hepatic cells and dysfunction
of liver.
• Gallstones : Gallstones are formed by precipitation of
cholesterol or calcium ions.
 SMALL INTESTINE
• The functional importance of small intestine is
absorption.
• Maximum absorption of digested food products takes
place in small intestine.
• Secretion from small intestine is called succus
entericus.
 FUNCTIONS OF SUCCUS ENTERICUS
• Digestive function :the enzymes of succus entericus act on the partially
digested food and convert them into final digestive products.
The enzymes are produced and released into succus entericus by
enterocytes of the villi.
i. Proteolytic enzymes : The proteolytic enzymes present in succus
entericus are the peptidases.The peptidases convert peptides into
amino acids.
ii. Amylolytic enzymes :
a. Lactase,sucrase and maltase convert the disaccharides(lactose,sucrose
and maltose)into 2 molecules of monosaccharides.
b. Dextrinase converts dextrin,maltose and maltriose into glucose.
c. Trehalse or trehalose glucohydrolase
hydrolysestrehalose(carbohydrate present in mushrooms and yeast)
and converts it into glucose).
iii. Lipolytic enzyme : Intestinal lipase acts on triglycerides and converts
theminto fatty acids.
• Protective function :
i. The mucus present in succus entericus protects
the intestinal wall from the acid chyme,which
enters the intestine from stomach;thereby it
prevents the intestinal ulcer.
ii. Paneth cells of intestinal glands secrete defensins
which are the anti-microbial peptides.
iii. These peptides are considered as natural peptide
antibiotics because of their role in killing the
phagocytosed bacteria.
• Activator function : The enterokinase present
in intestinal juice activates trypsinogen into
trypsin.Trypsin,in turn activates other
enzymes.
• Haemopoietic function : The intrinsic factor
of Castle,which is present in the
intestine,plays an important role in
erythropoiesis.
• Hydrolytic process : Intestinal juice helps in
all enzymatic reactions of digestion.
 FUNCTIONS OF SMALL INTESTINE
• Mechanical function : The mixing movements of small
intestine help in the thorough mixing of chyme with the
digestive juices like succus entericus,pancreatic juice and
bile.
• Secretory function : Small intestine secretes succus entericus
,enterokinase and GI hormones.
• Hormonal function : Small intestine secretes many GI
hormones such as secretin,cholecystokinin,etc.These
hormones regulate the movement of GI tract and secretory
activities of small intestine and pancreas.
• Digestive function : Succus entericus
• Activator function : Succus entericus
• Haemopoietic function : Succus entericus
• Hydrolytic function : Succus entericus
• Absorptive functions :
i. The presence of villi and microvilli in small intestinal mucosa increases
the surface area of the mucosa.This facilitates the absorptive function
of intestine.
ii. The digested products of foodstuffs,proteins,carbohydrates,fats and
other nutritive substances like vitamins,minerals and water are
absorbed mostly in small intestine.
iii. From the lumen of intestine,these substances pass through lacteal of
villi,cross the mucosa and enter the blood directly or through
lymphatics.
a. Absorption of carbohydrates : The carbohydrates are absorbed from
the small intestine mainly as the monosaccharides viz.
glucose,galactose and fructose.
b. Absorption of proteins : The proteins are absorbed in the form of
amino acids from small intestine.
c. Absorption of fats : Monoglycerides,cholesterol and fatty acids which
are the final products of lipid digestion enter the cells of intestinal
mucosa by simple diffusion.
iv. Absorption of water and minerals :
a. In small intestine,sodium is absorbed actively.It is responsible
for absorption of glucose,amino acids and other substances by
means of sodium co-transport.
b. Water moves in or out of the intestinal lumen until the
osmotic pressure of intestinal contents becomes equal to that
of plasma.
c. In ileum,chloride ion is actively absorbed in exchange for
bicarbonate.The significance of this exchange is not known.
d. Calcium is actively absorbed mostly in upper part of small
intestine.
v. Absorption of vitamins : Most of the vitamins are absorbed in
upper part of small intestine and vitamin B12 is absorbed in
ileum.The absorption of water soluble vitamins is faster than
fat soluble vitamins.
 APPLIED PHYSIOLOGY
• Malabsorption : The difficulty in the digestionor absorption of
nutrients from small intestine is called malabsorption.It may be
the failure to absorb either the specific substances like
proteins,carbohydrates,fats and vitamins or some general non-
specific substances of food.Malabsorption affects growth and
development of the body.
• Malabsorption syndrome : The conditions in which the failure of
digestion and absorption occurs in small intestine are called
malabsorption syndrome.Malabsorption syndrome is generally
caused by Crohn’s disease,tropical sprue,steatorrhoea and celiac
disease.
• Crohn’s disease/enteritis : It is an inflammatory bowel
disease(IBD) characterised by inflammation of small
intestine.Usually it affects the lower part of small intestine ,the
ileum.The inflammation causes malabsorption and diarrhoea.
• Tropical sprue : Tropical sprue is a malabsorption
syndrome affecting the residents of or visitors to
tropical areas where the disease is epidemic.
• Steatorrhoea : Malabsorption of fat occurs in
steatorrhoea,the condition caused by deficiency of
pancreatic lipase.
• Celiac disease : Celiac disease is an autoimmune
disorder characterised by the damage of mucosa
and atrophy of villi in small intestine resulting in
impaired digestion and absorption.It is also known
as gluten-sensitive enteropathy,celiac sprue and
non-tropical sprue.
 LARGE INTESTINE
• The large intestine is also known as colon.
• The large intestinal juice contains digestive
enzymes.
 FUNCTIONS OF LARGE INTESTINAL
JUICE
• Neutralisation of acids : Strong acids formed by bacterial
action in large intestine are neutralized by the alkaline
nature of large intestinal juice.The alkalinity of this juice is
mainly due to the presence of large quantity of bicarbonate.
• Lubrication activity :
i. The mucin present in secretion of large intestine lubricates
the mucosa of large intestine and the bowel contents ,so
that,the movement of bowel is facilitated.
ii. The mucin also protects the mucous membrane of large
intestine by preventing the damage caused by mechanical
injury or chemical substances.
 FUNCTIONS OF LARGE INTESTINE
• Absorptive function : Large intestine plays an important
role in the absorption of various substances such as :
i. Water
ii. Electrolytes
iii. Organic substances like glucose
iv. Alcohol
v. Drugs like anaesthetic agents,sedatives and steroids.
• Formation of faeces : After the absorption of
nutrients,water and other substances,the unwanted
substances in the large intestine form faeces.This is
excreted out.
• Excretory function : Large intestine excretes
heavy metals like mercury,lead,bismuth and
arsenic through faeces.
• Seceretory function : Large intestine excretes
mucin and inorganic substances like chlorides
and bicarbonates.
• Synthetic function : The bacterial flora of
large intestine synthesizes folic acid,vitamin
B12 and vitamin K.By this function large
intestine contributes in erythropoietic
activity and blood clotting mechanism.
 APPLIED PHYSIOLOGY
• Diarrhoea : Frequent and profuse discharge of loose or fluid
contents from intestine is called diarrhoea.It occurs due to the
rapid movement of intestine.It may be acute or chronic.
• Constipation : Failure of voiding of faeces,which produces
discomfort ,is known as constipation.It is due to the lack of
movements necessary for defecation.Due to the absence of mass
movement in colon,faeces remain in the large intestine for a long
time resulting in absorption of fluid.So the faeces become hard
and dry.
• Appendicitis : The inflammation of appendix is known as
appendicitis.
• Ulcerative colitis : Ulcerative colitis is an inflammatory bowel
disease(IBD) characterized by the inflammation and ulcerative
abberations in the wall of the large intestine.It is also known as
colitis or proctitis.
 MOVEMENTS OF ALIMENTARY TRACT
• Mastication
• Deglutition
i. Oral stage/first stage
ii. Pharyngeal stage/second stage
iii. Esophageal stage/third stage
iv. Deglutition reflex
• Movements of stomach
• Filling and emptyind of stomach
• Movements of small intestine
• Movements of large intestine
• Defecation
 MASTICATION
• Mastication or chewing is the first mechanical process in the
GI tract by which the food substances are torn or cut into
small particles and crushed or ground into a soft bolus.
• The significances of mastication are :
i. Breakdown of foodstuffs into smaller particles.
ii. Mixing of saliva with food substances thoroughly.
iii. Lubrication and moistening of dry food by saliva so
that,the bolus can be easily swallowed.
iv. Appreciation of taste of the food.
v. Action of mastication is mostly a reflex process.It is carried
out voluntarily also.
vi. The centre for mastication is situated in medulla and
cerebral cortex.
 DEGLUTITION
• Swallowing of food is known as deglutition.
• Oral stage is when the food enters pharynx from
mouth after mastication.It is a voluntary stage.
• Pharyngeal stage is when food enters esophagus
from pharynx.It is an involuntary stage.
• Esophageal stage is when food enters stomach from
esophagus.The function of esophagus is to transport
the bolus from pharynx to stomach.It is an
involunatry stage.
• Deglutition reflex :
i. Though the beginning of swallowing is a voluntary act,later it becomes
involuntary and is carried out by a reflex action called deglutition reflex.
ii. It occurs during pharyngeal and esophageal stages.
iii. Stimulus : When the bolus enters the oropharyngeal region ,the receptors
present in this region are stimulated.
iv. Afferent fibres : afferent impulses from the oropharyngeal receptors pass via
the glossopharyngeal nerve fibres to the deglutition centre.
v. Centre : The deglutition centre is at the floor of the fourth ventricle in
medulla oblongata of brain.
vi. Efferent fibres : The impulses from deglutition centre travel through
glossopharyngeal and vagus nerves (parasympathetis motor fibres) and reach
soft palate,pharynx and esophagus .The glossopharyngeal nerve is concerned
with pharyngeal state of swallowing.The vagus nerve is concerned with
esophageal state.
vii. Response : The reflex causes upward movement of soft palate to close
nasopharynx and upward movement of larynx to close respiratory passage so
that bolus enters the esophagus.Now the peristalsis occurs in esophagus
pushing the bolus into stomach.
 APPLIED PHYSIOLOGY
• Dysphagia : Dysphagia means difficulty in
swallowing.
• Esophagial achalasia : It is a neuromuscular disease
characterized by accumulation of food substances in
the esophagus.It is due to failure of lower
esophageal sphincter(cardiac) to relax during
swallowing.The accumulated food substances cause
dilatation of esophagus.
• Gastroesophageal reflux disease(GERD) : It is a
disorder characterized by regurgitation of acidic
gastric content into esophagus.
 MOVEMENTS OF STOMACH
• HUNGER CONTRACTIONS :
i. The movements of empty stomach are related to the sensations of
hunger.So these movements are called the hunger contractions.
ii. Hunger contractions are the peristaltic waves superimposed over the
contractions of gastric smooth muscle as a whole.
iii. The peristaltic contractions of empty stomach involve the entire
stomach.
iv. The type I hunger contractions are the first to appear in the empty
stomach when the tone of the stomach is low.
v. The type II hunger contractions appear when the tonus of the stomach
is stronger.The tonus increases in stomach if the food intake is
postponed even after the appearance of the type I contractions.
vi. The type III hunger contractions or incomplete tetanus appear when
the hunger becomes severe and the tonus increases to a great
extent.Very rare in man as food is usually taken before the appearance
of these contractions.
• RECEPTIVE RELAXATION :
i. Relaxation of the upper portion of the stomach when bolus enters the
stomach from esophagus is called receptive relaxation.
ii. It involves the fundus and upper part of the body of the stomach.
iii. Its significance is to accommodate the food easily without much increase in
pressure inside the stomach.
• PERISTALSIS OF STOMACH :
i. When food enters the stomach,the peristaltic contraction or peristaltic
wave appears with a frequency of 3/min.
ii. It starts from the lower part of the body of stomach,passes through the
pylorus till the pyloric sphincter.
iii. Initially,the contraction appears as a slight indentation on the greater and
lesser curvatures and travels towards pylorus.
iv. The contraction becomes deeper while travelling.
v. Finally,it ends with the constrictionof pyloric sphincter.
vi. This type of peristaltic contraction is called digestive peristalsis because it
is responsible for the grinding of food particles and mixing them with
gastric juice for digestive activities.
 FILLING AND EMPTYING OF STOMACH
• FILLING OF STOMACH :
i. While taking food,the food arranges itself in the stomach in different
layers.
ii. The first eaten food is placed against the greater curvature in the fundus
and body of the stomach.
iii. The successive layers of the food particles lie nearer the lesser curvature
until th elast portion of food eaten lies near the upper end of lesser
curvature adjacent to cardiac sphincter.
iv. The liquid remains near the lesser curvature and flows towards the pyloric
end of the stomach along a V shaped groove.
• EMPTYING OF STOMACH :
i. The food remains in the stomach for about 3 hours.During this
period,digestion takes place.
ii. The digested food in the form of chyme is emptied into the intestine slowly
with the help of peristaltic contractions.
iii. This slow emptying is necessary to facilitate the final digestion and almost
about 80% absorption of the digested food materials.
• REGULATION OF GASTRIC EMPTYING :
i. The emptying of stomach stops mainly due to the inhibition of gastric
motility.The inhibition of motility of stomach is caused by both nervous and
hormonal factors.
ii. Nervous factors : The nervous factor,which regulates the emptying of stomach
is the enterogastric reflex.When the chyme enters the intestine,the gastric
muscle is inhibited and motility stops leading to arrest of gastric
emptying.This is called enterogastric reflex.This reflex involves the vagus
nerves.
iii. Hormonal factors : When an acid chyme enters the duodenum,the duodenal
mucosa releases some hormones which enter the stomach through blood and
inhibit the motility of stomach.
• APPLIED PHYSIOLOGY :
i. Gastric dumping syndrome : Gastric dumping syndrome or rapid gastric
emptying is characterized by series of upper abdominal symptoms.It is due to
the rapid or quick dumping of undigested food from stomach into the
jejunum.
ii. Gastroparesis : It is a symptomatic,chronic disorder characterised by delayed
gastric emptying.
 MOVEMENTS OF SMALL INTESTINE
• The movements of small intestine are essential for mixing the chyme
with digestive juices,propulsion of food and absorption.
• The types of movements that occur in small intestine are :
i. Mixing movements :
a. The mixing movements of small intestine are responsible for proper
mixing of chyme with digestive juices like pancreatic juice,bile and
intestinal juice.
b. Segmentation contractions : These are common types of movements
of small intestine,which occur regularly or irregularly but in a rhythmic
fashion.The contractions occur at regularly spaced intervals along a
section of intestine.Therefore,the segmentation contractions chop the
cgyme many times.This helps in mixing of chyme with digestive juices.
c. Pendular movement : small portions of intestine(loops)sweep forward
nad backward or upward and downward resembling the movements
of pendulum in the clock.This movement also helps in mixing of chyme
with digestive juices.
ii. Propulsive movements :
a. The movements of small intestine which are involved in
pushing the chyme in the aboral direction of intestine are
called propulsive movements.
b. Peristaltic movements : Peristalsis is defined as the wave
of contraction followed by wave of relaxation,which
travels in aboral direction.The stimulation of smooth
muscles of intestine initiates the peristalsis.
c. Peristaltic rush : Sometimes,the small intestine shows a
powerful peristaltic contraction.It is caused by excessive
irritation of intestinal mucosa or extreme distension of the
intestine.The peristaltic rush sweeps the contents of the
intestine into the colon.Thus,it relieves the small intestine
off either irritants or excessive distension.
 MOVEMENTS OF LARGE INTESTINE
• Usually the large intestine slows sluggish
movemets.Still,these movements are important for
mixing,propulsive and absorptive function.
• Segmentation contraction : Large circular
constrictions,which appear in the colon,are called
mixing segmentation contractions.The contractions
occur at regular distance in colon.
• Mass peristalsis : Mass peristalsis or mass
movement propels the faeces from colon towards
anus.Usually,this movement occurs only a few times
everyday.
 DEFECATION
• Voiding of faeces is known as defecation.
• Faeces are formed in the large intestine and stored in
sigmoid colon.By the influence of an appropriate
stimulus,it is expelled out through the anus.
• This is prevented by tonic constriction of anal
sphincters in the absence of the stimulus.
• Defecation reflex :
i. The mass ovement drives the faeces into sigmoid or
pelvic colon.In the sigmoid colon,the faeces are
stored.
ii. The desire for defecation occurs when some faeces
enter rectum due to the mass movement.
 DIGESTION AND ABSORPTION
• DIGESTION OF CARBOHYDRATES :
i. In the mouth : The enzymes involved in the digestion of
carbohydrates are known as amylolytic enzymes.The only amylolytic
enzyme present in saliva is the salivary amylase or ptyalin.
ii. In the stomach : Gastric juice contains a weak amylase,which plays a
minor role in digestion of carbohydrates.
iii. In the intestine : The carbohydrate splitting enzymes present in the
small intestine are derived from the pancreatic juice and the
intestinal secretion,succus entericus.
a. Amylolytic enzyme in pancreatic juice : Pancreatic juice contains
pancreatic amylase.
b. Amylolytic enzymes in Succus Entericus. : Carbohydrate splitting
enzymes present in succus entericus are
maltase,sucrase,lactase,dextrinase and trehalase.
iv. Final products of carbohydrate digestion : The final products of
carbohydrate digestion are monosaccharides,which are
glucose,fructose and galactose.
• ABSORPTION OF CARBOHYDRATES :
i. Absorption of glucose :
a. Glucose is transported from the lumen of small intestine into
the epithelial cells in the mucus membrane of small intestine
by means of sodium co-transport.
b. From the epithelial cell,glucose is absorbed into the portal
vein by facilitated diffusion.
c. From here,it is transported into blood by active transport
utiilizing the energy liberated by breakdown of ATP.
ii. Absorption of Galactose : Galactose is also absorbed from the
small intestine in the same mechanism as that of glucose.
iii. Absorption of fructose : Fructose is absorbed into the blood by
means of facilitated diffusion.Some molecules of fructose are
converted into glucose.
• DIGESTION OF PROTEINS :
i. In the mouth : Digestion of protein does not occur in mouth,since
saliva does not contain any proteolytic enzymes.So,the digestion of
protein starts only in stomach.
ii. In the stomach:Pepsin is the only proteolytic enzyme in gastric juice.
iii. In the small intestine : Most of the proteins are digested in the
duodenum and jejunum by the proteolytic enzymes of the pancreatic
juice and succus entericus.
a. Proteolytic enzymes in pancretic juice : Pancreatic juice contains
trypsin,chymotrypsin and carboxypeptidases.Trypsin and
chymotrypsin are called endopeptidases as these two enzymes break
the interior bonds of the protein molecules.
b. Proteolytic enzymes in Succus Entericus : The final digestion of the
proteins is by proteolytic enzymes present in the succus entericus.It
contains dipeptidases,tripeptidases and aminopeptidases.
iv. Final products of protein digestion : The final products of protein
digestion are the amino acids which are absorbed into blood from
intestine.
• ABSORPTION OF PROTEINS :
i. The proteins are absorbed in the form of amino
acids from small intestine.
ii. The levo amino acids are actively absorbed by
means of sodium co-transport,whereas,the dextro
amino acids are absorbed by means of facilitated
diffusion.
• DIGESTION OF LIPIDS :
i. In the mouth : Saliva contains lingual lipase.This enzyme is secreted by
lingual glands of mouth and swallowed along with saliva.So,the lipid
digestion does not commence in the mouth.
ii. In the stomach : Gastric lipase or tributyrase is the lipolytic enzyme present
in gastric juice.
iii. In the intestine : almost all the lipids are digested in the small intestine
because of the availibility of bile salts,pancreatic lipolytic enzymes and
intestinal lipase.
a. Role of bile salts : Bile salts play important role in the digestion of lipids.
b. Lipolytic enzymes in pancreatic juice : Pancreatic lipase is the most
important enzyme for the digestion of fats.Other lipolytic enzymes of
pancreatic juice are cholesterol ester hydrolase,phospholipase A and
phospholipase B.
c. Lipolytic enzymes in Succus Entericus : Intestinal lipase is only lipolytic
enzyme present in succus entericus.
iv. Final products of fat digestion : The fatty acids,cholesterol and
monoglycerides are the final products of lipid digestion.
• ABSORPTION OF LIPIDS :
i. Monoglycerides,cholesterol and fatty acids from
the micelles enter the cells of intestinal mucosa by
simple diffusion.
ii. In the mucosal cells,most of the monoglycerides
and some of the fatty acids and cholesterol are
converted into triglycerides.
iii. These lipid particles enter the lymph vessels and
then are transferred into blood from lymph.
iv. Most of the fats are absorbed in upper part of
small intestine .Presence of bile is essential for fat
absorption.