Small Intestinal Secretions

Dr Sobia Humerah
Associate Professor
ANMC
Brunner’s Glands
• Located in the wall of the first few centimeters of the duodenum.
Secrete large amounts of alkaline mucus to protect the mucosa,
which contains a large amount of bicarbonate ions.
• stimulated by : ● secretin, tactile (chyme contacts brushborder) and
vagal stimulation, irritating stimuli on the duodenal mucosa.
• inhibited by: ● sympathetic stimulation
Crypts of Lieberkühn
• Located in small pits which lie between intestinal villi ★ Secrete
Intestinal juices (Succus Entericus).

• The surfaces crypts and villi are covered by an epithelium composed

of 2 types of cells: ➔ goblet cell secrete mucus. ➔ enterocytes
secrete large quantities of H2O and electrolytes.

• And reabsorb H2O & end-products of digestion over the surfaces of

adjacent villi
• The enterocytes of the mucosa contain the following digestive
enzymes:
• ➔ Aminopeptidases, Oligopeptidases, Intracellular di / tri
peptidases for splitting small peptides into amino acids.
• ➔ sucrase, maltase, isomaltase, lactase ,a-dextrinase for splitting
disaccharides into monosaccharides.
• ➔ Small amounts of intestinal lipase for splitting neutral fats into
glycerol and fatty acids.
• ➔ Nucleotidases for splitting nucleotides into purine and pyrimidine
bases, phosphoric acid and pentose sugar
• Intestinal juice participates in the Neutralization of acid chyme
delivered from stomach.
• At a volume of 1800 ml/day (Composition: 0.6 % organic (enzymes &
mucus), 1 % inorganic (electrolytes) substance and a pH: 7.5-8 .
• ★ Most of the enzymes are found either in the brush border or in the
cytoplasm of the enterocytes.
• ★ Enteropeptidase and amylase secreted into the lumen. stimulated
by : ● Distension, tactile and irritating stimuli. ● Hormones as gastrin,
secretin, CCK & glucagons & enterocrinin(produced by small
intestine). Inhibited by: sympathetic stimulation.
 Absorption of
Carbohydrates, Proteins &
fats
Digestion of Carbohydrate
• In the Mouth and Stomach:
• The ptyalin (an α-amylase) enzyme in saliva hydrolyzes starch into
the disaccharide maltose and other small polymers of glucose.

• The starch digestion sometimes continues in the fundus and body of

the stomach for 1 hour before the food becomes mixed with the
stomach secretions.
In the Small Intestine (by Pancreatic
Amylase):
• Pancreatic secretion has α-amylase (identical in its function with the
α-amylase of saliva but is several times as powerful).
• ★ within 15 to 30 minutes after the chyme empties into the
duodenum and mixes with pancreatic juice, carbohydrates will have
become digested.
• ★ The carbohydrates are almost converted into maltose and/or other
very small glucose polymers before passing beyond the duodenum or
upper jejunum.
• The enterocytes lining the villi contain 4 enzymes (lactase, sucrase,
maltase, and a-dextrinase , isomaltase), which are capable of splitting
the disaccharides lactose, sucrose, and maltose plus other small
glucose polymers, into their constituent monosaccharides.

• These enzymes are located in the enterocytes covering the intestinal

microvilli brush border, so disaccharides are digested as they come in
contact with these enterocytes
Absorption of Carbohydrate
• All the carbohydrates in the food are absorbed in the form of
monosaccharides only a small fraction are absorbed as disaccharides.
• ● Glucose and galactose absorption occurs in a co-transport mode
with active transport of Na+ (2ry active transport) (fastest).

• ● Fructose is independent on Na+ but it transports in luminal

membrane via facilitated diffusion.
• ● Pentose is transported by passive diffusion1 (slowest)
clinical relevance

• Glucose enters the cell with Na+ on the SGLT symporter and exits on
GLUT2.

• ● Fructose enters on GLUT5 and exits on GLUT2. Both of which can be

blocked to produce therapeutic action .
• it is the initial active transport of sodium through the basolateral
membranes of the intestinal epithelial cells

• that provides the eventual force for moving glucose through the
membranes as well.
• The transport of sodium through the intestinal membrane occurs in
two stages.
•

• First is active transport of sodium ions through the basolateral

membranes of the intestinal epithelial cells into the interstitial fluid.
• Sodium absorption is powered by active transport of sodium from
inside the epithelial cells through the basal and lateral walls of these
cells into paracellular spaces.
• This active transport obeys the usual laws of active transport:

• It requires energy, and the energy process is catalyzed by appropriate

adenosine triphosphatase (ATPase) enzymes in the cell membrane
• Part of the sodium is absorbed along with chloride ions;

• in fact, the negatively charged chloride ions are mainly passively

“dragged” by the positive electrical charges of the sodium ions.
• Active transport of sodium through the basolateral membranes of the
cell reduces the sodium concentration inside the cell to a low value
(≈50 mEq/L).
depletion of sodium inside the epithelial
cells

• sodium concentration in the chyme is normally about 142 mEq/L (i.e.,

about equal to that in plasma),
• sodium moves down this steep electrochemical gradient from the
chyme through the brush border of the epithelial cell into the
epithelial cell cytoplasm.
• Second

• decrease of sodium inside the cells causes sodium from the intestinal
lumen to move through the brush border of the epithelial cells to the
cell interiors by a process of secondary active transport
• Sodium is also co-transported through the brush border membrane
by specific carrier proteins, including
(1) the sodium-glucose co-transporter
(2) sodium-amino acid co-transporters
(3) the sodium-hydrogen exchanger
Extreme diarrhea

• significant amounts of intestinal secretions are lost to the exterior

the sodium reserves of the body can sometimes be depleted to lethal
levels within hours.
Digestion of Proteins
Digestion of protein in the
stomach
• Pepsin is the important peptic enzyme of the stomach

• (active at a pH:2-3, inactive at a pH above about 5.0).

• pepsin have the ability to digest the protein collagen.

Digestion of protein in the
intestines
• A small percentage of proteins are digested to amino acids(AA) by the
pancreatic juices.

• Proelastase is converted into elastase, which then digests elastin

fibers that partially hold meats together.

• Most protein digestion occurs in the duodenum and jejunum by

aminopeptidases, oligopeptidases and Di/tri peptidases .
Absorption of Proteins
• Proteins are absorbed in the form of dipeptides, tripeptides, and a
few free amino acids.
• AA are transported by 2ry active transport.
• Di and tripeptides cross the brush border by active transport protein
carrier.
• Then they're hydrolyzed by brush border and cytoplasmic
oligopeptidases.
• AA leaves the cell at the basolateral membrane by facilitated
transport.
 Digestion of Fat

• Bile salts and lecithin in the bile help fat digestion by make the fat
globules readily fragmentable with the water in the small intestine
(emulsification of fat)

• Bile salts break the fat globules into very small sizes
• water-soluble digestive enzymes can act on the globule surfaces.
• All fat digestion occurs in the small intestine
 Absorption of Fat
• Bile salts have the ability to form micelles.

• ★ Bile salt & lecithin are amphipathic molecules, each composed of a

sterol nucleus (fat-soluble) and a polar group(water-soluble).

• The polar parts are (-ve) charged-the points where ionization occurs
in water-,
• they allow the entire micelle globule to dissolve in the water of the
digestive fluids.
• Micelles are small spherical, cylindrical globules 3 to 6 nm in diameter
composed of 20 to 40 molecules of bile salts ,

• carry Fatty acids(FA) & monoglycerides(MG) to the luminal borders

of the intestinal epithelial cells.
• Long chain Fatty acids (FA) & monoglycerides (MG),
• cholesterol and fat soluble vitamins
are incorporated into the interior of the micelle.
 Steps of fat absorption
• Fatty acids (FA) & monoglycerides (MG) associated with the micelles in
lumen of intestine.
1.FA & MG leave micelles and enter epithelial cell by diffusion.
2. FA are used to synthesis triglycerides in agranular endoplasmic
reticulum.
3. Fatty globules are combined with proteins to form chylomicrons within
Golgi apparatus.
4. Vesicles containing chylomicrons leave epithelial cells by exocytosis
and enter a lacteal (lymph capillary).
5. Lymph in the lacteal transport chylomicrons away from the intestine
Absorptive surface
• The absorptive surface of the small intestinal mucosa shows many
folds called valvulae conniventes, well developed in the duodenum
and jejunum. They increase the surface area of the absorptive mucosa
X 3-fold .
• The presence of villi on the mucosal surface enhances X 10-fold .
• The epithelial cell on each villus is characterized by a brush border,
(Provides the surface area equivalent to a tennis court) consisting of
as many as 1000 microvilli (X 20- fold).
• All these increase the intestinal surface 600x
Vitamins absorption
• Fat-soluble vitamins (A, D, E, & K) are incorporated into micelles and
absorbed along with other lipids.

• water-soluble vitamins (C, B1, B2, B6, and folic acid) most are
absorbed by Na+-dependent cotransport mechanisms.
Water and electrolyte secretion and
absorption

• Electrolytes and H2O cross intestinal epithelial cells by either

transcellular or paracellular route.
• The permeability of the tight junctions varies with the type of
epithelium.
• Leaky epithelia are in the small intestine and gallbladder.
• A tight epithelium is in the colon.
Hormonal control of absorption
& secretion
• Glucocorticoid = absorption of H2O & ions (small & large intestine).

• Somatostatin = absorption of H2O & ions (ileum & colon).

• Epinephrine = absorption of NaCl (ileum).
• Aldosterone = synthesis of Na+ channels (colon).