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Hepatobiliary system

Digestion and Absorption

of
Alimentary tract

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Organs of GIT with their major functions in digestion and

Digestive System: absorption
Mouth Production of saliva containing α-amylase,
The digestive system is composed of: partial digestion of polysaccharides
a. Long muscular tube – Stomach Elaboration of gastric juice with HCL &
proteases, partial digestion of proteins
the gastrointestinal tract (GI tract) or
Pancreas Release of NaHCO3 & many enzymes required
alimentary canal. for intestinal digestion
b. A set of accessory organs- Liver Synthesis of bile acids
Gall bladder Storage of bile
tongue, teeth, salivary glands, pancreas, liver
Small Final digestion of food staffs, absorption of
and gall bladder. intestine digested products
Large Mostly absorption of electrolytes, bacterial
intestine utilization of certain non-digested and/or
unabsorbed foods

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Gastrointestinal tract
Digestion:
Digestion is a process involving the hydrolysis of
large and complex organic molecules of food
stuffs into smaller and preferably water soluble
molecules which can be easily absorbed by the GI
tract for utilization in the body.
Absorption:
The process by which the digestive end products
pass from the lumen of the GI tract to the
enterocyte and then to the blood is called
absorption.

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Organs involved in secretion of digestive juices Digestive enzymes:

1. Used to digest carbohydrate-
Amylolytic a. Saliva- Salivary α amylase
enzymes b. Pancreatic juice- Pancreatic α amylase
c. Succus entericus- Maltase, sucrase,
lactase, α-limit dextrinase
2. Used to digest protein-
Proteolytic a. Gastric juice- Pepsin
enzymes c. Pancreatic juice-Trypsin, chymotrypsin,
carboxypeptidase, elastase, collagenase
d. Succus entericus- Aminopeptidase,
dipeptidase, tripeptidase

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3. Used to digest fat and lipids-

Purpose of digestion:
Lipolytic a. Saliva- Lingual lipase
Breakdown of large and complex food particles into b. Gastric juice- Gastric lipase
enzymes
smaller one for absorption and subsequent c. Pancreatic juice- Pancreatic lipase,
utilization in the body. cholesterol esterase, phospholipase A2
 Basic process of digestion is hydrolysis catalyzed (lecithinase)
by hydrolases (a group of enzymes found in
digestive juices). 4. Used to digest nucleic acid-
Nucleases Ribonuclease, deoxyribonuclease,
nucleosidase, nucleotidase

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Important digestive juices: Digestive juices and their components:

Digestive juices Important components
Daily
Digestive 1. Saliva 1. Mucus
Source secretion pH
juices 2. Amylolytic enzyme-
(L/day) Salivary α amylase
1. Saliva Salivary glands 1.5 6.7-7.0 3. Lipolytic enzyme-
2. Gastric Gastric glands 2.5 1-3.5 Lingual lipase
juice 2. Gastric 1. Mucus
3. Pancreatic Pancreas 1.5 8.0-8.3 juice 2. HCl
juice 3. Intrinsic factor of Castle (IF)
4. Proteolytic enzyme-
4. Bile Liver 1.0 7.8 Pepsin
5. Intestinal Small intestinal 1.5 7.5 5. Lipolytic enzyme-
juice mucosa Gastric lipase

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Composition of saliva:
Digestive juices Important components
A. Water (99%)
3. Pancreatic 1. Bicarbonate ion (HCO3-)
B. Solid-
juice 2. Colipase
3. Amylolytic enzyme- Pancreatic α i. Organic:
(exocrine
secretion of
amylase a. Mucin
4. Lipolytic enzyme- Pancreatic b. Enzymes: 1. Ptyalin (Salivary α amylase)
pancreas)
lipase, cholesterol esterase,
2. Lingual lipase
phospholipase A2 (lecithinase)
5. Proteolytic enzyme- Trypsin, 3. Lysozymes
chymotrypsin, carboxypeptidase, c. Immunoglobin A (Ig A)
elastase, collagenase d. Lactoferrin
6. Nucleases- Ribonuclease,
ii. Inorganic - Na+, K+, Cl¯, HCO3¯, Ca++, PO4+, Mg++
deoxyribonuclease

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Digestive juices Important components Functions:

4. Bile 1. Bile salt A. Mechanical:
(a digestive juice 2. Bile pigments- bilirubin
without enzyme) 3. Cholesterol ester 1. Lubrication of food
4. Phospholipid- eg.-lecithin 2. Dilute hot & irritant food
5. Succus 1. Enterokinase (enteropeptidase) 3. Bolus formation & swallowing of food
entericus 2. Amylolytic enzymes- Maltase,
sucrase, lactase, α-limit dextrinase 4. Acts as solvent for taste by taste buds
3. Proteolytic enzyme- 5. Keep mouth moist & help speech
Aminopeptidase, dipeptidase, 6. Keep mouth & teeth clean
tripeptidase

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B. Digestive:
Saliva 1. Digestion of Carbohydrate:
α - Amylase
Saliva is the secretion of salivary glands: Starch Maltose, Maltotriose, α - Dextrin
1. Parotid gland
2. Digestion of fat:
2. Submandibular gland
Lingual lipase
3. Sublingual gland Fat Monoglyceride , Fatty acids
4. Lingual gland
C. Maintain oral hygiene by:
Volume: About 1500 ml/day
1. Killing of bacteria by lysozyme, thiocyanate ions,
pH= 6.7 – 7.0 and IgA.
2. Lactoferrin- It binds iron & kills bacteria.
3. Washout of bacteria and food particles by the
flow of saliva.

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Gastric juice
Volume: About 1000-1500 ml/day
pH = 1 – 3.5
Stomach mucosa has 3 types of glands and 4 types of cells:
1. Oxyntic glands (Gastric glands) –
Present in the fundus and body of stomach.
It is composed of 3 types of cells-
a. Mucous neck cells- Mucus
b. Peptic cells (Chief cell) – Pepsinogen, gastric lipase
c. Parietal cells (Oxyntic cells) – HCl, Intrinsic factor
2. Pyloric glands- Present in the antral part of stomach
a. Mucous cells- Mucus
b. G-cells- Gastrin

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Composition of gastric juice: Functions of gastric juice:

A. Water (97-99%)
1. Maintenance of optimum acidic pH for pepsin activity.
B. Solid- (1-3%)
2. Digestive function:
i. Organic:
HCl and pepsin help in protein digestion and
a. Pepsin (inactive zymogen Pepsinogen)
gastric lipase helps in fat digestion.
b. Gastric lipase
3. Protection of gastro-duodenal mucosa from acid-
c. Intrinsic factor of Castle (IF)
peptic digestion by mucus.
d. Mucus
4. Bactericidal action and iron absorption by HCl.
ii. Inorganic - H+, Cl¯, Na+, K+ etc.
HCl is a very important component 5. Helps in the absorption of vitamin B12 by Intrinsic
of gastric juice. Factor of Castle (IF).

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Functions of gastric HCL:

1. Conversion of inactive pepsinogen into active
pepsin and maintenance of optimum pH (1.5-3.5)
for pepsin activity.
2. Denaturation of protein to facilitate protein
digestion by pepsin.
3. Reduces dietary ferric iron (Fe+3) ferrous iron (Fe+2)
to enhance iron absorption.
4. Kills bacteria of foods.

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Functions of Pepsin:
a. Digestion of protein into peptones, proteoses and
polypeptides.
b. Partially digested Protein (by Pepsin) when enter into
the small intestine provoke secretion of further GI
hormones.
Functions of Mucus:
1. Protect gastro-duodenal mucosa from acid-peptic
digestion by forming a protective mucosal barrier
over the mucosal surface of stomach and duodenum.
2. Lubrication & slippage of ingested food along the GIT.

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Mechanism of secretion of Gastric HCL:

Intrinsic Factor of Castle:
Nature: 1. Within parietal cell, carbon dioxide is hydrated by
carbonic anhydrase (CA) to carbonic acid which is
IF is a glycoprotein secreted by parietal cells of the
dissociated to H and HCO3-.
stomach.
Carbonic Anhydrase
Function: CO2 + H2O H2CO3 HCO3- + H+
Helps absorption of extrinsic factor (vitamin- B12) of
erythropoiesis preventing pernicious anemia. 2. H+ pumped out into gastric lumen actively by H+-K+
ATPase (proton pump).
Significance:
(inhibited by Omeprazole, Pantoprazole etc.)
IF deficiency causes vitamin- B12 deficiency leading to
pernicious anemia (megaloblastic anemia).

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3. HCO3- diffuses back into blood to form NaHCO3 with

Na+ of NaCl and Cl- is released.
4. Cl- then diffuse to gastric lumen and combines with
H+ to form HCl.

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Regulation of gastric juice secretion:

(phases of gastric secretion)
a. Cephalic phase-
 Accounts for 30% of gastric secretion.
 Presence of food in the mouth, thought, sight,
smell and taste of food causes –
stimulation of parasympathetic system in brain
(cerebral cortex and appetite center)

through vagus nerve signal transmitted to stomach

stimulate gastric juice secretion.

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b. Gastric phase -
 Accounts for 60% of gastric secretion.
Post prandial alkali tide (Alkali tide):  Presence of food in the stomach stimulates –
1 molecule of NaHCO3 is formed in blood against i. vagovagal reflexes
1 molecule of HCl produced and this bicarbonate ii. local enteric reflexes
excreted through urine after each meal known as iii. gastrin release
Post prandial alkali tide. iv. histamine release
- all of them increase gastric secretion.

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 Following meal, there is increased secretion of gastric c. Intestinal phase -

juice and HCl. During HCl secretion, parietal cells of  Accounts for 10% of gastric secretion but mostly it
gastric gland secrete H+ into the gastric lumen. For inhibit gastric secretion.
each H+ secreted into the lumen, one HCO3- is  Presence of acid chyme in the duodenum (from
absorbed laterally to the blood that raises the serum stomach)-
HCO3- concentration which is called postprandial
1. stimulates release of small amount of gastrin to
alkalemia.
 Subsequently in post absorptive period serum HCO3- continue gastric juice release
concentration come down to normal by renal HCO3- 2. small intestine also releases
excretion which makes the urine alkaline transiently. i. VIP, GIP
This phenomenon of high serum HCO3- concentration ii. secretin
followed by normal serum HCO3- concentration
iii. CCK (Cholecystokinin)
occurring usually 3 times a day following meal is
known as alkali tide. iv. somatostatin
- all of them inhibit gastric secretion.

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Achlorhydria: Achylia gastrica

- Occurs due to failure of gastric parietal cells to secrete
HCl in gastric juice. It may be associated with failure of
Control of gastric HCL secretion: (chemical regulation IF secretion also by parietal cells.
of parietal cell activity)- - Consequences – iron deficiency anemia, pernicious
 Parietal cell is stimulated by acetylcholine, histamine anemia.
and gastrin. - found in chronic gastritis, gastric atrophy, gastric
carcinoma etc.
 Parietal cell is inhibited by prostaglandin E2,
Hyperchlorhydria:
somatostatin, VIP, GIP, CCK, secretin.
- Occurs due to hyper secretion of HCl in gastric juice.
- found in Zollinger-Ellison syndrome.
Hyperchlorhydria:
- Occurs due to hypo secretion of HCl in gastric juice.
- found in pernicious anemia.

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- Acetylcholine acts by Ach receptor

- Histamine acts by H2 receptor
- Gastrin acts by G receptor.

Drugs causing decrease HCL secretion (used in Peptic

ulcer disease (PUD) Patients:
1. Anticholinergic drugs:
Atropine, Hyoscine N Butyl bromide(Butapan) etc.
2. H2 receptor blocker drugs:
Cimetidine, Ranitidine, Famotidine etc.
3. Proton pump inhibitor drugs:
Omeprazole, Pantoprazole, Lansoprazole etc.

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Pancreatic Juice Remember,

 Produced by the exocrine part of pancreas. About Proteolytic enzymes:
1. Acinar cells secrete - a. Secreted from pancreatic acinar cells as inactive
- varities of enzymes to digest all types of food.
zymogen form.
2. Centroacinar cells & cells of ducts and ductules
b. Trypsinogen is activated when exposed to acid
secrete -
- Electrolytes (Bicarbonate- HCO3-) chyme in duodenum or by enterokinase.
- Water c. Active trypsin further activates inactive trypsinogen,
- Trypsin Inhibitor procarboxypeptidase, proelastase to their active
 Volume: about 1500 ml / day. forms.
 pH: 8-8.3 (due to presence of HCO3-) d. Trypsin & chymotrypsin are endopeptidase
e. Carboxypeptidase is exopeptidase.

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Composition of pancreatic juice: Functions of Pancreatic Juice:

A. Water - 97-99% 1. HCO3- content of pancreatic juice causes neutralization
of acid chyme of duodenum coming from stomach.
B. Solid - 1-3%
This provide optimum pH in intestine for the activity of
i. Inorganic - mainly HCO3-, Na+, CL- etc. pancreatic enzymes.
ii. Organic: 2. Pancreatic α-amylase acts on starch & produce
a. Protein splitting (proteolytic) enzyme – maltose, isomaltose & oligosaccharides.
1. Trypsin 3. Trypsin & chymotrypsin hydrolyze proteins into small
2. Chymotrypsin polypeptides.
4. Carboxypeptidase acts on polypeptides & splits
3. Elastase
terminal amino acids forming free amino acids.
4. Collagenase 5. Elastase breaks down elastin.
5. Carboxy peptidase A 6. Lipase splits triacylglycerol (TAG) into fatty acids and
- All these are secreted as inactive zymogen form. 2-monoglycerides with the help of bile salts.

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b. Carbohydrate splitting (Amylolytic) enzymes –

Regulation of pancreatic secretion:
Pancreatic α-amylase
c. Fat splitting (Lipolytic) enzymes –
1. Pancreatic lipase 1. Nervous regulation by acetylcholine (Ach):
2. Cholesterol esterase when food is sighted, smelt or present in the stomach
3. Phospholipase A2 (lecithinase)
4. Colipase (+) Parasympathetic system (initiates vagal response)
d. Nucleic acid splitting enzyme –
1. Ribonuclease (+) secretion of Acetylcholine
2. Deoxyribonuclease.
(+) enzyme riched pancreatic secretion

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2. Hormonal regulation by cholecystokinin (CCK) and

secretin: Composition:
A. Water - 98-99%
Partially digested Acid chyme present in
B. Solid - 1-2%
protein/fat and fatty acid duodenum
a. Inorganic: Na+, K+, Cl-, HCO3-, Ca++, Mg++, PO4- -
present in duodenum
b. Organic:
(+) S-cells in duodenum
i. Mucus
(+) I-cells in duodenum & jejunum
ii. Enterokinase (Enteropeptidase)
& jejunum
iii. Enzymes:
(+) secretion of secretin
1. Proteolytic –
(+) secretion of CCK
- Aminopeptidase
HCO3--rich pancreatic
- Dipeptidase
enzyme-rich pancreatic secretion
- Tripeptidase
secretion
(Ecbolic secretion) (Hydrolytic secretion)

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2. Amylolytic –
- Maltase
- Isomaltase (α-limit dextrinase )
- Sucrase
- Lactase
3. Lipolytic – Lipase
4. Nucleic acid splitting enzyme –
- Nucleosidase
- Nucleotidase.

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Intestinal Juice (Succus entericus)

 The small intestinal juice is secreted by the glands of
small intestine-
1. Crypts of Lieberkühn
2. Bruner’s Glands
 Volume: about 1500 ml/day.
 pH: 7.5 (due to presence of HCO3-)
 Function of :
1. Activation of trypsinogen to trypsin by
enterokinase.
2. Helps in carbohydrate and protein digestion.

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