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Overview of Gastrointestinal Function

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Overview of Gastrointestinal Function Overview of Gastrointestinal Function George N. DeMartino, Ph.D. Department of Physiology University of Texas Southwestern Medical Center Dallas, TX 75390 The gastrointestinal system Functions of the gastrointestinal system • Digestion • Absorption • Secretion • Motility • Immune surveillance and tolerance GI-OP-13 Histology of the GI tract Blood or Lumenal Serosal Side or Mucosal Side Structure of a villus Villus Lamina propria Movement of substances across the epithelial layer Tight junctions X Lumen Blood Apical membrane Basolateral membrane X X transcellular X X paracellular GI-OP-19 Histology of the GI tract Blood or Lumenal Serosal Side or Mucosal Side Motility in the gastrointestinal system Propulsion net movement by peristalsis Mixing for digestion and absorption Separation sphincters Storage decreased pressure GI-OP-42 Intercellular signaling in the gastrointestinal system • Neural • Hormonal • Paracrine GI-OP-10 Neural control of the GI system • Extrinsic nervous system autonomic central nervous system • Intrinsic (enteric) nervous system entirely with the GI system GI-OP-14 The extrinsic nervous system The intrinsic nervous system forms complete functional circuits Sensory neurons Interneurons Motor neurons (excitatory and inhibitory) Parasympathetic nerves regulate functions of the intrinsic nervous system Y Reflex control of gastrointestinal functions Vago-vagal Afferent reflex Salivary Glands Composition of Saliva O Proteins α−amylase lactoferrin lipase RNase lysozyme et al mucus O Electrolyte solution water Na+ , K + - HCO3 Functions of saliva • Oral protection buffering of hot, cold, acid, base • Oral hygiene bacteriostatic • Lubrication swallowing • Digestion carbohydrates and lipids GI-ME-11 Structure of the esophagus Pharynx Upper Esophageal Sphincter Skeletal (UES) muscle Skeletal and smooth muscle Smooth muscle Diaphragm Lower Esophageal Sphincter Stomach GI-010 (LES) Regulation of the UES during a swallow Reflex Reflex relaxation contraction (neural) (neural) Persistalsis Regulation of the UES during a swallow Reflex Reflex relaxation contraction (neural) (myogenic) VIP (NO ?) Anatomical and functional divisions of the stomach LES Fundus Pyloric Oxyntic gland Orad gland area area Gastric juice Oxyntic gland pylorus G cell Caudad Body Gastrin duodenum (Corpus) Antrum GI-S-15 Mechanism of acid secretion by the parietal cell H O 2 Lumen - Cl- H+ K+ H2O Cl- - + ATP Cl K ADP K+ ATP ADP Na+ H 0 H+ + OH - HCO - Na+ 2 3 Carbonic anhydrase CO2 Blood + GI-S-07 Stimulation of acid secretion in parietal cells Receptors Histamine (H2) Gastrin ACh G G G AC PL-C PL-C H+ H+ Lumen GI-S-13 Stimulation of acid secretion in parietal cells Receptors Histamine (H2) Gastrin ACh G G G AC PL-C PL-C cAMP IP3 + DAG Protein kinase A Ca2+ Protein kinase Substrates C Sequestered H+ / K+ pumps Substrates Sequestered H+ / K+ pumps H+ Membrane-exposed H+ / K+ pumps Lumen GI-S-13 Cephalic phase vagal nucleus of acid secretion vagus nerve thought, sight, smell, taste, or chewing of food H+ ACh Parietal cell GRP ECL cell G cell Histamine Gastrin Efferent pathways circulation GI-S-05 Gastric phase vagal nucleus vagus nerve of acid secretion distension sensed by mechanoreceptors distension in the stomach, presence of amino acids and peptides H+ Amino acids and peptides ACh Parietal cell G cell GRP ECL cell ACh Histamine Gastrin Efferent pathways Afferent pathways circulation GI-S-06 Protection of the epithelial lining of the stomach pH 2 Gastric lumen - - Mucus layer HCO3 HCO3 pH 7 Mucus GI-S-19 Motility in the stomach • Reservoir storage without increased pressure • Grinding and mixing mechanical disruption for digestion and absorption • Regulated pumping optimal delivery to duodenum GI-S-32 The gastrointestinal system Small Intestine Digestion Absorption Secretion Motility Pancreatic Secretion Aqueous Component (ductule cells) water Function: acid neutralization bicarbonate Enzymatic Component (acinar cells) proteases Function: digestion lipases saccharidases Intestinal phase vagal nucleus of pancreatic secretion vagus nerve afferent pathways acid and digestion products for vagal in the duodenum reflex protein amino acids I cells peptides fat H+ efferent S cells pathways for circulation vagal reflex HCO - CCK 3 H O 2 Ach pancreas Secretin Enzymes ductule cells acinar cells GI-SILPGB-02 Secretion from the liver and gallbladder Figure15 NaNa++ ClCl -- KK++ CaCa2+2+ Liver BileBile wwaatteerr acidsacids Figure11 PortalPortal - circulationcirculation HCO3 Gallbladder Secretin Na+ -- HCOHCO3 H20 3 ClCl-- NaNa++ HH2200 Figure14 CCK Ach Sphincter of Oddi BileBile BileBile acidsacids Duodenum Ileum Functions of Bile • Emulsification of dietary lipids required for lipid digestion • Solubilization of lipid digestion products required for lipid absorption • Excretion of waste products bilirubin and cholesterol GI-SILPGB-30 Organic components of bile • Bile acids / bile salts 70% • Phospholipids 20% • Cholesterol 5% • Bilirubin 1% • Everything else 4% GI-SILPGB-40 Components of bile Bile acids package products of lipid digestion into mixed micelles for absorption Products of lipid digestion Mixed micelle + - - + - + - -- Free fatty acid Lysolecithin - + - Cholesterol Monoglyceride GI-SILPGB-36 Digestion and absorption in the small intestine Proteins degradation to amino acids and peptides combined action of lumenal and membrane- bounds proteases absorption by multiple transporters Carbohydrates degradation to monosaccharides combined action of lumenal and membrane- bounds proteases absorption by several transporters Lipids Absorption of monosaccharides in the small intestine Na+/ K+ ATPase SGLT1 K+ ATP¤ADP Na+ Na+ Glucose / Glucose / Glut 2 Galactose Galactose Fructose Fructose Glut 5 Lumen Blood (Apical) (Basolateral) GI-SILPGB-16 Fluid balance in the GI tract 9000 ml 8900 ml VolumeVolume VolumeVolume enterenteriinngg absorbedabsorbed intestinesintestines byby intestinesintestines ~ 20% total 100 ml body water ! Volume excreted Important Principle The absorption of water is dependent on and proportional to the absorption of solutes GI-LI-25 Bad things happen when solutes are not absorbed Colon Jejunum Ileum Na+ Lactose glucose + galactose H2O H2O Normal Diarrhea SCFA CO2 Lactose Lactose H2OLactose H2O Lactase deficiency GI-LI-24 H2O.
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