Gastrointestinal Physiology

It is concerned with the provision of nutrients, vitamins,

water and electrolyte for the maintenance of homeostasis.
The processes involved in the coordinated functioning of
the digestive system include ingestion, secretion,
digestion, absorption, fluid and electrolyte balance, and
elimination of waste along with immunologic and non-
immunologic defenses, permit immunologic tolerance
among others.
 Learning Objectives
Describe the functional Anatomy of the GIT

Describe the neural, hormonal and paracrine regulation of GIT

Describe motility in the different segments of the GIT/control

Describe the GIT exocrine secretions

Describe the GIT endocrine glands secretions

Describe the digestion and absorption of the different classes of food

Identify certain diseases of the GIT

Functional Anatomy of the GIT
 Structures of the Digestive System
Organs of Digestion (GI tract or alimentary canal or digestive tract)
• Esophagus
• Stomach
• Small intestine (Duodenum, jejunum, ileum)
• Large intestine (Caecum, AC,TC,DC, sigmoid, rectum)
 Structures of the Digestive System
Accessory Organs of Digestion
• Salivary glands
• Liver
• Gallbladder
• pancreas
Structures of the Digestive System
Structures of the Digestive System

Small Intestine
Structures of the Digestive System
 Histology of the GIT
The layers of the GIT are four
• Mucosa
• Submucosa
• Muscularis Propria
• Serosa
Histology of the GIT
 Epithelium
(endocrine and exocrine secretions, absorption and growth)
• Oesophagus (stratified squamous epithelial cells)
• Stomach (columnar cells, rugae)
• Small intestine (columnar cells, evaginated to form villi, micro-villi
(600X) or invaginated to form glands (or crypts).
• Large intestine (columnar cells, crypts)
• Rectum(stratified squamous epithelial cells)
 Lamina propria
• connective tissue
• blood supply-capillaries,
• enteric neurons, and
• immune cells (e.g., mast cells),
 Muscularis mucosae
• contraction
• expose absorptive cells of GIT to nutrients
• expose nutrients to digestive enzymes
 Submucosa layer
• Blood and lymphatic vessels,
• submucosal plexus
• contain glands that secrete
• gut associated lymphatic tissue (GALT)
 Muscularis propria
• Outer longitudinal muscle
• Inner circular muscle
• Myenteric plexus
• Oblique muscle(stomach)
• Upper part of the oesophagus is striated and lack the layers
 Serosa or Adventitia
It is called serosa if parts of the digestive tract protrude into
the peritoneal cavity. It is made of simple squamous
epithelium.
It is called Adventitia when the outer layer of the digestive
tract is derived from adjacent connective tissue e.g. esophagus
and the retroperitoneal organs
 Regulation of GIT Functions
• Neural
• Hormonal
• Paracrine
Neural Regulation
 Neural Regulation
• Parasympathetic Nervous System
• Cranio-Sacral
• Rest and digest
• Largely excitatory to GIT activities
• Neurotransmitter-- Acetylcholine
• Act on cholinergic (Muscarinic) receptor
Parasympathetic Innervation of the GIT
 Neural Regulation
• Sympathetic Nervous System
• Thoraco-lumbar, T5-L2
• Flight, fight
• Largely inhibitory to GIT activities
• Neurotransmitter– Noradrenaline, Adrenaline
• Act on Adrenergic receptor
Sympathetic Innervation of the GIT
 Enteric Nervous System (Neural)

• The plexuses of the ENS consist of motor neurons, interneurons,

and sensory neurons
 Myenteric (Aueberg) plexus
• supply the longitudinal and
• circular smooth muscle layers of the muscularis
controls GI tract motility frequency and
strength of contraction
 Enteric Nervous System (Neural)

• Meissner's (Submucosal ) Plexus

• supply the secretory cells of the mucosal epithelium,
• control secretions of GI tract
Relationship between ANS and ENS
Endocrine Regulation
Gastrointestinal Hormones
Paracrine Regulation
 GIT Motility
Motility patterns accounts for propulsion, mixing and reservoir

• Phasic • Tonic
Peristaltic(Propulsive/Receiving o Sphincters prevents reflux of luminal
Segments) contents
Segmentation/Mixing, Trituration o Gastroesophageal,Gastroduodenal,
MMC Sphincter of oddi, Ileocolonic
junctions, Internal anal sphincter
 GIT Motility
• General Properties:
• Caveolae: Micro-pits allow for increased surface area on smooth muscle.
• No Striations: Thin and thick filaments run through in a random order. Smooth
muscle has relatively more thin filaments than thick.
• Plasticity: Smooth muscle is able to stretch to a greater length and compress to a
shorter length than skeletal.
• Calcium supply comes more from outside the cell rather than inside (in the SR),
as compared to skeletal.
• Slow, Sustained contraction as compared to skeletal muscle.
 GIT Motility
• SMOOTH MUSCLE CHANNELS:
• Electromechanical Channels: Channels that transduce electrical
activity, in one form or another, to mechanical activity of actin and
• myosin.
• Slow-Leaking Ca+2-Channels
• Ligand-Gated Channels
• Voltage-Gated Na+-Channels
GIT Motility
 GIT Motility
• SMOOTH MUSCLE CONTRACTION:
• Ca+2 enters cell ------> Calmodulin then activates Myosin Light-Chain
Kinase (MLCK) ------> MLCK then phosphorylates myosin,turning it
on and enabling it to interact with actin ------> contraction occurs.
Deglutition(Swallowing)
Deglutition
Vomiting
Gastric Motility
 Gastric Emptying
Volume, composition, physical state, sleep, disease influence GE
Motility in the Small Intestine
Motility in the Large Intestine
Defecation
Defecation Reflex
 GIT Secretion
• Learning Objectives
 Describe the secretions of the digestive tract, their functions and
control
 Source of GIT secretions and volume per
day(9Litres)

 Saliva about 1.5 L

Gastric juice about 2.0 L
 Pancreas about 1.5 L
Liver/gallbladder about 0.5 L
 Small intestine  about 1.5 L
• o Protection (esp. antibacterial)
• o Taste (dissolved food chemicals)
• o Lubrication ()
• o Digestion (esp. starch via amylase)
Functions of Saliva
• o Protection (esp. antibacterial)
• o Taste (dissolved food chemicals)
• Thirst
• o Lubrication ()
• Speech
• o Digestion (esp. starch via amylase)
• Diagnosis
Composition and Functions of Saliva
• lysozyme and IgA antibodies,
mucus, water, electrolytes,
Salivary secretion
Salivary Glands
Salivary gland Salivary gland duct Location of Salivary gland duct

Parotid Stensens’ duct  

Submandibular Whartons’ Sublingual papillae

Sublingual Bartholins’ Open with or near Submandibular duct

Duct of Rivinus Opens along sublingual fold

Minor Salivary glands Short ducts Opens into through short ducts
 Paranchymal Elements of Salivary Glands

Glands are made of acini cells that are either serous or mucous.

The serous are like pyramid or triangle and mucous are columnar.

Acini cells are surrounded by myoepithelial cells responsible for its

contraction.
Salivary Secretion
Composition of Saliva at Different
Secretion Rate
Stimulation for Salivary Secretion
 Regulation of Salivary Secretion
• Parasympathetic Innervation of the Salivary Glands
• Pre-ganglionic fibre from inferior salivatory nucleus in cranial
nerve IX synapse in Otic ganglion and send postganglionic fibres
to Parotid glands

• Post-ganglionic fibre from superior salivatory nucleus in cranial

nerve VII synapse in Submandibular ganglion and send
postganglionic fibres to submandibular and sublingual glands.

• Stimulation leads to copious and sustained saliva that is HCO3 and

K+ rich but protein deficient
Parasympathetic Innervation of the Salivary Glands
 Sympathetic Innervation of the Salivary Glands

• Sympathetic fibres emerged from spinal cord to superior cervical

ganglion to innervate, acini, duct and blood vessels.
• Stimulation activate ß adrenergic receptors leading to contraction of
myoepithelial cells to:
 cause scanty and transient saliva rich in protein but deficient in
bicarbonate and K+.
Effect of Mineralocorticoids on Salivary Secretion

• Mineralocorticoids stimulates striated and excretory ducts to

cause decrease Na+ and increase K+

• Arginine Vasopressin AVP increases Na+

• VIP and Substance P stimulate salivary secretion

 Diseases of Salivation
• xerostomia, or “dry mouth.”
• Can be caused by diuretics, antihypertensive, antihistamines. irradiation of
face and neck for cancer treatment, or by chemotherapy agents.
• Sjogren’s disease is an autoimmune disorder wherein the salivary glands
and tear ducts are disabled
 Gastric Secretion
• Sources of Gastric Glandular Secretions
• Cardiac
Sources of Gastric Glandular Secretions

Types of Gastric Gland Types of Gastric Cells

• Cardiac • Mucus producing columnar cells

• Oxyntic • Parietal(Oxyntic cells), Chief

calls ,Mucus neck cells, Endocrine
cells
• Pyloric
• Gastrin secreting cells
Composition and Functions of Gastric Juice

Composition Function
• HCl
• Pepsinogen
• Intrinsic factor
• Electrolytes
• Proteins
Gastric Secretion
 Regulation Gastric Acid Secretion
Neural
 Hormonal
 Phases of Gastric Acid Secretion During Meal

Cephalic Phase-(40%) Thought, taste, smell, chewing, swallowing

Gastric Phase (50%)- Distension/stretch, protein , amino acid,

Intestinal phase(10%)-Distension, product of digestion

Secretion of the Small Intestine
Surface of the Small Intestine- folds, villi, micro-villi (600X)
Secretion of the Large Intestine
Pancreatic Secretion
Liver
Bile
Gall Bladder
Biliary Tree
Jaundice
GIT Peptides
Digestion
 Dietary Carbohydrates
• Monosacharides Hexoses- glucose, fructose ,
galactose

• Disacharides
Maltose(glucose +glucose), Lactose
(glucose +galactose), Sucrose(glucose
+fructose)
Maltriose, α- limit dextrins
• Oligosacharide

Digestible-Starch (Amylose,
Polysacharides Amylopectin), dextrin, glycogen
Dietary fibre- cellulose
Hydrolysis of glycosidic bond
Action of α-Amylase on CHO digestion
Brush border enzymes in the digestion of CHO
Hydrolysis of Fat