Digestive system 2

Objectives
1. Discuss the roles of accessory digestive
organs
i. Liver
ii. Gall bladder
iii. Pancreas
2. Discuss the digestive role of small intestine
3. Discuss the digestive roles of large intestine
4. Explain the physiology of defecation
5. Explain digestion and absorption of nutrients
 Starch
 Proteins
 Lipids
 Nucleic acids
 Water, electrolytes and vitamins
Objective 1: Roles of accessory
digestive organs
 i) Liver functions
• Macrophages/kupffer cells remove debris such as
bacteria and worn-out blood cells
• Secrete some 900 ml of bile daily
• Process bloodborne nutrients in various
ways (e.g., they store glucose as glycogen and use amino
acids to make plasma proteins)
• Store fat-soluble vitamins
• Play important roles in detoxification, such as ridding
the blood of ammonia
by converting it to urea
 Bile composition
• yellow-green, alkaline solution
• Contains bile salts, bile pigments, cholesterol,
triglycerides, phospholipids (lecithin and
others), and a variety of electrolytes.
• only bile salts and phospholipids aid the
digestive process.
• Salts are cholesterol derivatives and play a role
in both digestion and absorption
• Bile converts fats into tiny droplets increasing SA
for digestion (emulsification)
• Many substances secreted in bile leave the body
in feces
• 95% of salts are recycled through enterohepatic
circulation(absorbed at terminal ileum)
• Bilirubin is the chief bile pigment
• Bilirubin is a waste product of heme of
hemoglobin
• Globin and iron parts of hemoglobin are recycled
• Bilirubin is absorbed from blood by liver cells and
excreted into bile and metabolized in the intestine
by resident bacteria
• One of its metabolites, stercobilin, gives feces a
brown color
• In absence of bile, feces are gray white with fatty
streaks coz no fats are digested or absorbed
 ii) Gall bladder
• Stores bile that is not immediately needed for
digestion
• Concentrates bile by absorption of water and
ions
 iii) Pancreas
• Produces enzymes that break down all
categories of food stuffs
• About 1200-1500mls of pancreatic juice is
produced daily
• Contains water, enzymes and bicarbonate ions
• Has high ph to neutralize gastric contents
• Enzymes include proteases, amylase, lipases
and nucleases
• Proteases are released in inactive form, and
activated in the duodenum
• This protects the pancreas from autodigestion
• Proteases include: Trypsinogen,
chymotrypsinogen and procarboxypeptidase
• Enteropeptidase/enterokinase in the
duodenum activates trypsinogen to trypsin
• Trypsin activates chymotrypsinogen and
procarboxypeptidase into chymotrypsin and
carboxypeptidase respectively
Regulation of bile and pancreatic secretion

• Hormones and neural stimuli regulate both

the secretion of bile and pancreatic juice and
their release into the small intestine
• Hormones include CCK and secretin
• CCK and secretin are secreted by duodenal
enteroendocrine cells
• Cholecystokinin (CCK) release is stimulated by
proteins and fats in chyme
• Secretin release is stimulated by acidic chyme
• CCK and secretin enter the circulation and
cause the following four events:
 Pancreatic secretion:

• CCK induces secretion by acinar cells of

enzyme rich
pancreatic juice.
• Secretin causes secretion by duct cells of
HC03- rich pancreatic juice.
• Vagus nerve weakly stimulates pancreatic
secretion during cephalic and gastric phase
 Bile secretion by liver
• Bile salts returning from enterohepatic
circulation are the most powerful stimulus for
bile secretion.
• Secretin is a minor stimulus for bile secretion
• After a fatty meal, when enterohepatic
circulation is returning large amounts of salts
to the liver, bile secretion increases
• When no digestion is occuring,
hepatopancreatic sphincter/of Oddi, is closed
and released bile goes back to the gall bladder
 Gall bladder contraction
• CCK causes gallbladder contraction.
• Vagus nerve stimulates weak gallbladder
contraction during cephalic and gastric
phases.
 Hepatopancreatic
sphincter relaxation

• CCK causes hepatopancreatic sphincter to

relax.
• Bile and pancreatic juice enter duodenum .
 Objective 2: Digestive roles of small
intestines
• Main sites of digestion and absorption
• Epithelium has the following cell types
– Enterocytes: Absorption of nutrients and
electrolytes & secretion of intestinal juice
– Goblet cells-mucus secretion
– Enteroendocrine cells-CCK & secretin production
– Paneth cells-release antimicrobials (defensins and
lysozyme) they destroy certain bacteria while
preserving others
– Stem cells: Continuously divide to give rise to the
above cells
 Intestinal juice
• 1-2litres daily
• The major stimulus for its production comes
from hypertonic or acidic chyme
• slightly alkaline (7.4-7.8)
• Isotonic with plasma
• Largely water with mucus
 Digestive activities
• Digestive requirements are imported from bile
and pancreatic juice
• Additional substances i.e. brush border enzymes
and bicarbonates for optimal digestion
environment come from the small intestines
• Brush border enzymes do the final breakdown of
food before absorption
• Brush border enzymes are not secreted; they
remain bound on the enterocytes
 Motility of the small intestine
• Segmentation is the principal form of motility
• It ensures that chyme is thoroughly mixed
with bile and pancreatic and intestinal juices
• It also ensures that the absorbable products of
digestion come in contact with the mucosa for
absorption.
• True peristalsis occurs only after most
nutrients have been absorbed
• Segmentation fades and the duodenal mucosa
begins to release the hormone motilin
• As motilin blood levels rise, peristaltic waves
are initiated in the proximal duodenum every
90 to 120 minutes and sweep slowly along the
intestine, moving 50-70 cm (about 2 ft) before
dying out.
• Each successive wave begins a bit more
distally, a pattern of peristaltic activity called
the migrating motor complex(MMC).
• A complete trip to ileum takes 2 hrs
 Ileocecal valve
• It relaxes and allow food residues to enter the
cecum when ileal motility increases
• Its relaxation is stimulated by gastroileal reflex
and hormone gastrin, both of which increase
ileal motility
• Chyme exerts backward pressure and closes
the valve
Objective 3: Digestive role of Large intestine

• Absorbs water and eliminates feces

• The appendix contains masses of lymphoid
tissue, and as part of MALT it plays an
important role in body immunity.
• The large intest ine consists of over a
thousand different types of bacteria and
accounts for a couple of pounds of our body
Weight:
• The bacterial microbiota /bacterial flora
• Their functions include:
– Fermentation. Gut bacteria ferment some
indigestible carbohydrates and the mucin in gut
mucus. The resulting short chain fatty acids can be
absorbed and used for fuel by the body's cells
– Vitamin synthesis. B complex vitamins and some
of the vitamin K the liver needs in order to
produce several clotting proteins are synthesized
by gut bacteria.
• Food remains there for 12-24hours
• The large intestine harvests vitamins made by
the gut bacteria and reclaims most of the
remaining water and some of the electrolytes
(particularly sodium and chloride).
• Mass movements (mass peristalsis) are long,
slow-moving, but powerful contractile waves
that move over large areas of the colon three
or four times daily and force the contents
toward the rectum.
• Typically, they occur during or just after eating.
The presence of food in the stomach activates
the gastroileal reflex in the small intestine and
the propulsive gastrocolic reflex in the colon.
 Objective 4: Physiology of defecation
• Feces move into and distend the rectum,
stimulating stretch receptors there.
• The receptors transmit signals along afferent
fibers to spinal cord neurons.
• A spinal reflex is initiated in which
parasympathetic motor (efferent) fibers
stimulate contraction of the rectum and
sigmoid colon, and relaxation of the internal
anal sphincter .
• If it is convenient to defecate, voluntary motor
neurons are inhibited, allowing the external
anal sphincter to relax so feces may pass.
• Defecation is aided Valsalva maneuver
• And contraction of the levator ani muscle
which lifts the anal canal superiorly. This lifting
action leaves the feces below the anus-and
outside the body
• Defecation
1. Triggered by stretching of wall,
mediated by spinal cord
parasympathetic reflex
2. Stimulates contraction of
smooth muscle in wall and
relaxation of internal anal
sphincter
3. If convenient to defecate
voluntary motor neurons
stimulate relaxation of external
anal sphincter
(aided by diaphragm and
abdominal wall muscles -called
Valsalva maneuver)

34
Objective 5: Describe the mechanism
of digestion and absorption
 Mechanism of digestion
• Hydrolysis: it involves adding a water molecule
to each molecular bond to be broken
 Mechanism of absorption
• Materials must pass through the enterocytes
• Materials enter an enterocyte through its
apical membrane from the lumen of the gut,
and exit through the basolateral membrane
• The paracellular route is not used because it
has tight junctions
• Once in the interstitial fluid, substances diffuse
into the blood capillaries.
• From the capillary blood in the villus they are
transported in the hepatic portal vein to the
liver.
• Lipid digest ion products enter the lacteal in
the villus to be carried via lymphatic fluid to
the blood.
• Most nutrients are absorbed by active
transport processes driven directly or indirectly
(secondarily) by metabolic energy
• The major absorptive role of the ileum is to
reclaim bile salts to be recycled back to the
liver for resecretion.
Objective 6: Describe the digestion
and absorption of various nutrients
 i) Carbohydrate digestion and absorption

• Salivary amylase breaks down starch into

oligosaccharides-2-8 linked glucose molecules
• Pancreatic amylase breaks down starch and
glycogen into oligosaccharides and disaccharides.
• Brush border enzymes break oligosaccharides and
disaccharides into monosaccharides. Dextrisnase
and glycoamylase act on oligosaccharides with >3
simple sugars while maltase, sucrase and lactase
work on maltose, sucrose and lactose
• Monosaccharides (glucose and galactose) are
cotransported across the apical membrane of
the enterocyte. This active transport uses the
Na+ concentration gradient established by the
Na+-K+ ATPase (pump) in the basolateral
membrane.
• Monosaccharides exit across the basolateral
membrane by facilitated diffusion and enter
the capillary via intercellular clefts.
ii) Protein digestion and absorption
• Pancreatic proteases break down proteins and protein
fragments into smaller pieces and some individual
amino acids.
• Brush border enzymes(dipeptidases, aminopeptidases)
break Protein fragments into amino acids.
• Amino acids are cotransported across the apical
membrane of the enterocyte. This active transport
uses the Na+ concentration gradient established by
the Na+-K+ ATPase (pump) in the basolateral
membrane.
• Amino acids exit across the basolateral
membrane via facilitated diffusion and enter
the capillary via intercellular clefts.
 iii) Lipid digestion and absorption
• Emulsification: Bile salts in the duodenum
break large " fat globules into smaller fat
droplets, increasing the surface area available
to lipase enzymes.
• Digestion: Pancreatic lipases hydrolyze
triglycerides yielding monoglycerides and free
fatty acids.
• Micelle formation. Free fatty acids and
monoglycerides assemble with bile salts and lecithin-
a phospholipid found in bile, forming micelles.
Micelles ferry their contents to enterocytes.
• Diffusion: FA and monoglycerides diffuse from
micelles into enterocytes
• Chylomicron formation: Fatty acids and
monoglycerides
are recombined and packaged with other fatty
substances and proteins to form chylomicrons.
• Chylomicron transport. Chylomicrons are
extruded from enterocytes by exocytosis,
enter lacteals, and are carried away from the
intestine in lymph.
 iv) Nucleic acid digestion and absorption

• Pancreatic nucleases in pancreatic juice

hydrolyze the nucleic acids to their nucleotide
monomers
• Intestinal brush border enzymes
(nucleosidases and phosphatases) then break
the nucleotides apart to release their
nitrogenous bases, pentose sugars, and
phosphate ions
• Special carriers in the epithelium of the villi
actively transport the breakdown products of
nucleic acid digestion across the epithelium.
These then enter the blood.
v) Absorption of vitamins, electrolytes and
water(homework)
 Absorption of vitamins
• The small intestine absorbs dietary vitamins, and the
large intestine absorbs some of the K and B vitamins
made by its enteric bacterial “guests.”
• As already noted, fat-soluble vitamins (A, D, E, and K)
dissolve in dietary fats, become incorporated into the
micelles, and move across the villus epithelium by
passive diffusion.
• It follows that gulping pills containing fat-soluble vitamins
without simultaneously eating some fat-containing food
results in little or no absorption of these vitamins.
• Most water-soluble vitamins (B vitamins and vitamin C)
are absorbed easily by diffusion or via specific active or
passive transporters.
• The exception is vitamin B12, which is a very large,
charged molecule.
• Intrinsic factor, produced by the stomach,
binds to vitamin B12.
• The vitamin B12–intrinsic factor complex then
binds to specific mucosal receptor sites in the
terminal ileum, which trigger its active uptake
by endocytosis.
 Absorption of electrolytes
• Absorbed electrolytes come from both
ingested foods and gastrointestinal secretions.
• Most ions are actively absorbed along the
entire length of the small intestine.
• However, iron and calcium absorption is
largely limited to the duodenum.
• As noted, absorption of sodium ions in the small
intestine is coupled to active absorption of glucose
and amino acids.
• For the most part, anions passively follow the
electrical potential established by sodium transport.
• That is, Na+ is actively pumped out of the epithelial
cells by a Na+-K+ pump after entering those cells.
• Chloride ions are also transported actively, and in the
terminus of the small intestine HCO3– is actively
secreted into the lumen in exchange for Cl–.
• Potassium ions move across the intestinal
mucosa passively by facilitated diffusion (or
via leaky tight functions) in response to
changing osmotic gradients.
• As water is absorbed from the lumen, the
resulting rise in potassium levels in chyme
creates a concentration gradient for its
absorption.
• Thus, anything that interferes with water absorption
(resulting in diarrhea) not only reduces potassium absorption
but also “pulls” K+ from the interstitial space into the
intestinal lumen.

• For most nutrients, the amount reaching the intestine is the

amount absorbed, regardless of the nutritional state of the
body.
• In contrast, absorption of iron and calcium is intimately
related to the body’s need for them at the time.
• Ionic iron, essential for hemoglobin
production, is actively transported into the
mucosal cells, where it binds to the protein
ferritin (fer′ĭ-tin).
• This phenomenon is called the mucosal iron
barrier. The intracellular iron-ferritin
complexes then serve as local storehouses for
iron.
• When body reserves of iron are adequate,
little is allowed to pass into the portal blood,
and most of the stored iron is lost as the
epithelial cells later slough off.
• However, when iron reserves are depleted (as
during acute or chronic hemorrhage), iron
uptake from the intestine and its release to
the blood are accelerated.
• Menstrual bleeding is a major route of iron
loss in females, and the intestinal epithelial
cells of women have about four times as many
iron transport proteins as do those of men.
• In the blood, iron binds to transferrin, a
plasma protein that transports it in the
circulation.
• Calcium absorption is closely related to blood
levels of ionic calcium.
• It is locally regulated by the active form of
vitamin D, which acts as a cofactor to facilitate
active calcium absorption.
• Decreased blood levels of ionic calcium
prompt parathyroid hormone (PTH) release
from the parathyroid glands.
• Besides facilitating the release of calcium ions
from bone matrix and enhancing the
reabsorption of calcium by the kidneys, PTH
stimulates activation of vitamin D by the
kidneys, which in turn accelerates calcium ion
absorption in the small intestine.
 Absorption of water
• Approximately 9 L of water, mostly derived
from GI tract secretions, enter the small
intestine daily.
• Water is the most abundant substance in
chyme, and 95% of it is absorbed in the small
intestine by osmosis.
• The normal rate of water absorption is 300 to
400 ml per hour.
• Water moves freely in both directions across
the intestinal mucosa, but net osmosis occurs
whenever a concentration gradient is
established by the active transport of solutes
(particularly Na+) into the mucosal cells.
• Thus, water uptake is effectively coupled to
solute uptake and, in turn, affects the rate of
absorption of substances that normally pass
by diffusion.
• As water moves into the mucosal cells, these
substances follow along their concentration
gradients.