Gastrointestinal system

Overview
Digestion of nutrients
Absorption of
nutrients and water
Principles of GI
regulation
GI secretion and
regulation
GI motility and
regulation
 Gastrointestinal system
Overview
Digestion of nutrients
Absorption of nutrients and water
Fate of nutrients in the liver
Principles of GI regulation
GI secretion and regulation
GI motility and regulation
 Overview
Food for body:

Carbohydrates, proteins and lipids are

absorbed in a form that can not be taken
up by the cells food needs to be broken
a small pieces (mechanical digestion) and
broken down chemically (chemical
digestion)
 Steps in food digestion
Carbohydrates, proteins and lipids are absorbed in a
form that can not be taken up by the cells food needs
to be broken a small pieces (mechanical digestion) and
broken down chemically (chemical digestion)
Chemical digestion refers to the degradation of:
1 2
1- Carbohydrates ---> disaccharides ---> monosaccharides

2- Proteins ---> peptides ---> amino acids

3- Lipids ---> diglycerides ---> monoglycerides and

fatty acids
GI organization

Composed of the GI
tract, a tube running
from the esophagus
to the rectum

Accessory organs are

emptying secretions
into the tract.
Structure of the GI tract

4 layers:
- 1- mucosa: epithelial cells (enterocytes)
role vary with location
- lamina propria = layer of connective
tissue under the epithelial, containing
blood vessels, nerves and lymphatic
vessels (Peyers patches)
- the muscularis mucosae: thin layer of
smooth muscles
- 2- submucosa: layer of connective tissue
rich containing the submucosal plexus
(Meissners plexus)
- 3- muscularis externa radial and
longitudinal smooth muscles + Auerbach
plexus(in contact with Meissners)
- 4- serosa:connective tissue continuying
through the mesenteries (a thin
membranes rich in blood and lymphatic
capillaries) and the peritoneum (a double
layer membrane surrounding the
abdominal organs)
 Gastrointestinal system
Overview
Digestion of nutrients
Absorption of nutrients and water
Fate of nutrients in the liver
Principles of GI regulation
GI secretion and regulation
GI motility and regulation
Functions of the GI system

Digestion:
- Mechanical digestion:
breaking food in small particles
so they are easily broken down
by enzymes mouth and
stomach
- Chemical digestion:
pancreas and duodenum
Nutrient absorption: small
intestine
Water reabsorption: colon
 Functional anatomy of the GI system
Mouth: mostly
mechanical digestion
mastication food is
broken down in small
particles so food particles
can be chemically
digested bolus

Enzymes:
- lingual amylase
carb. (step 1)
- lingual lipase
lipid (step 1)
 Pharynx, esophagus:
passageway for food
(from mouth to
stomach)
Stomach

Stomach: bolus is mixed with

gastric juice (liquid, mucus and
enzymes) chyme

Enzymes:
- pepsin: protein (step 1)
- gastric lipase
lipid (step 1)

Pepsin is first activated by HCl

(pepsinogen pepsin)

Gastric juice pH=2

[chemical digestion is minimal)]

Liver
Roles of the liver:
- Secretes bile
- Processes nutrients
- Remove wastes
from the body
(including old RBCs)
- Detoxify
- Secretes hormones
Liver (bile)

Bile is secreted by the liver

hepatocytes
Bile composition: water, mucus,
bile salts (emulsify lipids), bile
pigments (biliverdin and bilirubin),
cholesterol,
The bile salts are reabsorbed back
to the liver for reuse by the
enterohepatic circulation
Pancreas

- Trypsinogen trypsin
(enterokinase from duodenum).
- Chymotrypsinogen and
carboxypeptidase
chymotrypsin and active
carboxypeptidase).
Step 1 of protein digestion

- Pancreatic amylase Step 1

carbohydrate digestion

- Pancreatic lipase step 1 lipid

digestion

- Bicarbonates ions from the

pancreatic juice help neutralize
the acidity of the chyme.
Figure 20.10
Duodenum
Receive juices from pancreas, liver
and its own wall

* Secretion from the

duodenum: They finish off the
last step of digestion.
- Peptidases (or
dipeptidases) break off the
bond between dipeptides to
free 2 amino acids
- Disaccharidase
(maltase, sucrase, lactase)
break off disaccharides into 2
monosaccharides (mostly
glucose)
- Intestinal lipase breaks
off diglycerides into
monoglycerides and fatty acids.
Nutrients are completely
degraded into forms that can
be absorbed by cell (step 2 of
chemical digestion)

Figure 20.4
Jejunum-Ileum

Nutrients will be reabsorbed

along the jejunum-ileum

Brush border contains villi

which increase the surface of
absorption

The villi are structured for

nutrient absorption
Colon

Reabsorb water from

food and digestive
juices
 Gastrointestinal system
Overview
Digestion of nutrients
Absorption of nutrients and water
Principles of GI regulation
GI secretion and regulation
GI motility and regulation
 Steps in food digestion
1 2
1- Carbohydrates ---> disaccharides ---> monosaccharides

2- Proteins ---> peptides ---> amino acids

3- Lipids ---> diglycerides ---> monoglycerides and

fatty acids
Absorption of carbohydrates

Monosaccharides (mostly
glucose) are absorbed

The monomers are

carried by transporter
molecules across the
epithelial cells and into
the blood capillary
present in the villus
portal vein liver

Figure 20.7
Absorption of proteins

Proteins are
degraded into amino
acids (a.a.)

A.a. are carried by

transporter molecules
across the cells and
into the blood
capillaries portal
circulation liver
Lipid absorption
Lipids (triglycerides) are
degraded to monoglycerides
and fatty-acids.
They are absorbed into the cell
by diffusion. The cell
resynthesizes triglycerides.
Because TG are not soluble in
H2O, the TG are surrounded
with proteins and packaged
into chylomicrons
The chylomicrons are emptied
into lymphatic capillaries, the
lacteal lymph circulation
blood cells and liver
Absorption of minerals

Sodium: active absorption in jejunum-
ileum. Chloride follow by
electromagnetic attraction.
Potassium: passive secretion or
absorption, depending on lumenal
concentration if diarrhea,
hypokalemia due to loss of K+
HCO3-: secreted by pancreas,
neutralizes H+ from stomach. Used as
a buffer
Water: Two liters of fluids are taken as
food or drink per day. In addition, 7
liters are used to secrete digestive
jiuces need to reabsorb most of
H2O.
H2O reabsorbed throughout the small
and large intestines. Colon is
especially designed to reabsorb H2O.

Calcium: need an active transport to

cross the intestinal epithelium.
Absorption promoted by a derivative of
Vit D

Iron: actively reabsorbed. Stored as

ferritin
 Gastrointestinal system
Overview
Functional anatomy of the GI system
Digestion and absorption of nutrients and
water
Fate of nutrients in the liver
Principles of GI regulation
GI secretion and regulation
GI motility and regulation
 Fate of nutrients

Glucose:
- used as needed by liver cell
- blood stocked on glucose
- glycogen syntesized
- TG synthesized if needed and
sent to adipose tissue

Amino acids:
- used to restock the blood
- used by the liver to synthesize its
own proteins
- used to synthesize blood
proteins
- if excess: a.a. are deaminated
NH2 used to make urea and the
rest used for energy or stored as
TG

Lipids (next slide)

 Lipids
http://www.lipidlibrary.co.uk/Lipids/lipoprot/in
dex.htm
Absorptive state
Post-absorptive state
 Gastrointestinal system
Overview
Digestion of nutrients
Absorption of nutrients and water
Principles of GI regulation
GI secretion and regulation
GI motility and regulation
GI secretion and regulation

Need to regulate GI function to

changing states (after or
before meals..)
Sensors: 3 different receptors:
- mechanoreceptors: monitor
state of distention
- chemoreceptors monitor
concentrations of substances
in the lumen
- osmoreceptors monitor
osmolarity of lumen contents
Integrating centers: CNS and
enteric NS
Effectors: endocrine, exocrine
cells, smooth muscles
 Control pathways
Both hormonal and neural
Short pathways: involves automatic regulation within the enteric
system itself
Long pathways: involves the CNS (somatic and autonomic)
Three phases: cephalic, gastric and intestinal phases
Cephalic phase: salivary and gastric secretions

Salivary secretion stimulated

by parasympathetic NS by
odors, sight, taste saliva
fluid and rich in enzymes
Stimulated by sympathetic NS
thick secretion, rich in
proteins

Gastric secretion: increase

acid and enzymes secretion in
response to sight, smell and
taste of food
Gastric phase

Stimuli: presence of
food in the stomach
(both distention and
nutrients)
Stimulation of the
parasympathetic NS
and secretion of
gastrin (hormone)
Response: increased
motility and juice
secretion
Intestinal phase

Arrival of nutrients in duodenum decreased gastric

secretion and motility

Promotes secretion of cholecystokinin (CCK) and

secretin
- CCK promotes:
- increased pancreatic enzyme secretion
- gallbladder contraction and sphincter of Oddi
relaxation
- secretin promotes:
- bicarbonate ion secretion (pancreas)
- bile secretion
 Gastrointestinal system
Overview
Digestion of nutrients
Absorption of nutrients and water
Principles of GI regulation
GI secretion and regulation
GI motility and regulation
 Motility and its regulation

The wall has 2 layers

of smooth muscles
with radial and
longitudinal fibers.
The fibers
communicate through
gap junctions
The parasympathetic
NS stimulates smooth
muscle contraction
 Peristalsis: waves of
contraction of longitudinal
muscle fibers moving
down the GI tract
Segmentation: in small
intestine for mixing
chyme

Chewing and swallowing:

Gastric motility

Gastric motility increases with

the presence of gastrin and
decreased under the influence
of CCK, secretin and gastric
inhibitory peptide (GIP)

Vomiting:
- emotional stress, severe
pain, illnesses, toxins
stimulate the vomiting center
in the medulla oblongata
sensation of nausea,
increased HR, skin paleness
is followed by food coming
back up
Motility in the small intestine

Segmentation and peristalsis

increased by distention of the
wall

Intestino-intestinal reflex:
severe distention or injury
inhibits motility in the region.

Ileo-gastric reflex: distension of

ileum inhibits gastric motility

Gastro-ileal reflex: presence of

chyme in stomach increases
motility in ileum
Motility in the colon

Haustration: like segmentation, for

mixing
Colono-colonic reflex: distension in 1
part of the colon induces relaxation in
other parts
Gastro-colic reflex: a meal in the
stomach increases colonic motility

Defecation:
- triggered by distention of the rectal
wall
- signal sent to sacral parasympathetic
and cortex
- smooth muscle anal sphincter open
- if the person decides to go to the
bathroom open voluntary muscle
sphincter

 Clinical applications

Diarrhea: can be due to

bacterial, parasite infections,
toxins, bowel irritation

Laxatives:
- bulk-producing agents
Stool softeners
Hydratants (salines and
osmotic)
Stimulant or irritant

Intestinal obstruction

Hirshprung disease