Physiology of Digestive

System

Outline
Introduction
GI motility, vomiting
Secretary function of GIT
Digestive & absorptive function of GIT
Energy and Metabolism
Pathophysiology of GIT

Objective
At the end of this system, students will be
able to:
1. Know general concepts about the
digestive system.

Introduction
The human digestive system is a complex
series

of

organs

and

glands

that

processes food.
In order to use the food we eat, our body
has to break the food down into smaller
molecules that it can process; it also has
to excrete waste.
4

Digestive
Processes
Ingestion
Mechanical digestion
Propulsion
Chemical digestion
Absorption
Defecation
5

Cont`d

Ingestion
Occurs when material enters via the mouth.

Mechanical Processing
Crushing/Shearing makes material easier
to move through the GIT.

Digestion
Chemical breakdown of food into small
organic compounds for absorption.
7

Cont`
d

Secretion
Release of water, acids, buffers, enzymes & salts
by epithelium of GIT and glandular organs.

Absorption
Movement

of

organic

substrates,

electrolytes,

vitamins & water across digestive epithelium.

Excretion
Removal of waste products from body fluids .
8

Main Divisions of Digestive System

Alimentary Canal

Continuous,

muscular

digestive

tube

winding throughout the

body
Digests and absorbs food particles
Contains the following organs:
Mouth, Pharynx, Esophagus, Stomach,
Small and
Large Intestines

Cont`d

Accessory Digestive Organs

Contains the following organs:
Teeth, Tongue, Gallbladder, Salivary
Glands, Liver,
and Pancreas

10

11

Mouth
Mouth ingests food.
Teeth masticates food into small pieces to
increase surface area for digestion.
Saliva (pH=7) moisten and soften food.
Tongue mixes food with saliva and rolls
food into a bolus before swallowing.
Saliva- water, mucus, and salivary amylase.
12

Esophagus
1.Secrete mucus.
2.Moves food from the throat to the stomach
using

muscle

movement

called

peristalsis.
. If acid from the stomach gets in here
thats heartburn.

13

14

Cont`
d

What

happens

during

swallowing

and

breathing?

This

automatically

induces

violent

coughing to force the food particles or H2O

out and to prevent choking.

15

Stomach
J-shaped muscular bag that stores the
food you eat, breaks it down into tiny
pieces.
Mixes food with digestive juices that
contain enzymes to break down proteins
and lipids.
Acid in the stomach kills bacteria.
Food found in the stomach is called
16

Small Intestine
Small intestines are roughly 7m long.
Lining of intestine walls has finger-like
projections called villi, to increase surface
area.
The villi are covered in microvilli which
further

increases

surface

area

for

absorption.
17

Cont`
d

The majority of chemical digestion occurs

in the first of three sections of the small
intestine known as the duodenum.
This section also contains an opening from
the bile duct and pancreatic duct through
which bile and pancreatic enzymes enter
the small intestine.
18

Cont`
d

Food enters the small intestine as a semisolid mixture known as chyme.

The chyme is acidic due to the HCl in the
stomach so it needs to be neutralized.
The presence of chyme in the SI triggers
the

conversion

of

prosecretin

into

secretin.

19

Large Intestine
About 5 feet long.
Accepts

what

small

intestines

dont

absorb.
Rectum (short term storage which holds
feces before it is expelled).

20

Anus
The

human

anus

is

the

external

opening of the rectum.

Its closure is controlled by spincture
muscles.
Feces are expelled from the body through
the anus during the act of defecation, the
primary function of the anus.
21

Accessory Organs

22

Salivary Glands
Parotid glands- produce a serous, watery
secretion.
Submaxillary (mandibular) glands- produce
a mixed serous and mucus secretion.
Sublingual glands- secrete a saliva that is
predominantly mucus in character.

23

24

Liver
1. Regulation of blood glucose concentration
2. Bile secretion
3. Fe storage
4. Protein synthesis
5. Deamination of amino acids

25

Gall Bladder

Stores bile in between meals.

Secretes bile to the duodenum through

the bile duct during mealtime.
Bile

contains

bile

salts,

pigments,

cholesterol and phospholipids.

Bile is an emulsifier not an enzyme.

26

Pancreas
It releases chemicals to aid in digestion.
S-cells located in the walls of the duodenum
sense the acidity of the chyme (pH<3) and
cause Secretin release into the blood.
Secretin reaches and binds to receptors on
pancreatic ductile cells.
27

Cont`d

Duct cells release HCO-3 that causes the

acidity to be neutralized.
The pancreatic digestive enzymes are
optimally active at neutral pH.
This is opposite to Pepsinogen of the
stomach that requires acidic pH.

28

Blood Supply to the GIT

GIT blood flow is classified under splanchnic
circulation

which

includes:

Gut,

Spleen,

pancreas etc.
Venous blood collected from these regions
pass through the portal circulation and end in
the liver liver sinusoids hepatic vein
inferior vena cava.
29

Cont`d

Advantage of portal circulation: Potentially

harmful agents that come with the blood
are destroyed by macrophages of the
liver (Reticuloendothelial cells).

30

31

Cont`d

Factors that control blood flow to the GUT

include:
1. Metabolic: Increase in metabolism during or
after a meal increases releases Vasoactive
substances that increases blood flow by 8-fold.
2. Decreased O2-tension: Increases blood flow
(local metabolites like adenosine form).
32

Cont`
d

3. Neural : PNS flow; SNS flow.

4. Counter-current : arterial and venous
blood

vessels

arranged

in

opposite

direction, so shunt may occur that may

cause ischemia of the Villi.

33

Regulation of GIT
Neural innervations

of the GIT that cause

motility include:
a. Afferent sensory fibers: Autonomic (PNS,
SNS)
b. Enteric nervous system

34

A. The sensory afferent nerves

From the GIT-to- the brain.
Carry sensory impulses to the
cord, brain stem (MO

plexus, spinal

and pons), and higher

cerebrum.
More than

80% of the vagus nerves are

sensory afferents rather than motor efferent's.

35

Cont`d

Sensory stimulation occurs by:

a. Stretch or Irritants
b. Excessive distention
c. Chemical stimuli of the food

36

Cont`
d

a.PNS (Cranio-sacral) : is cholinergic Ach.Cranial:

All are in vagus nerve and innervate

esophagus, stomach, SI, and the proximal LI.

.Sacral: Originate in 2,3,4 segments and passes
through the pelvic nerve to the distal LI, sigmoid,
rectum, and anus.
. PNS is excitatory to the GIT & causes increased
motility, however, at the sphincters, PNS
dilatatory action.

has a
37

Cont`
d

b. SNS(Thoraco-lumbar;(T5-L2).

is

adrenergic (NE & E).

. The sympathetics is inhibitory to the
GIT.
. It decreases motility .
. At sphincters, it causes constriction.

38

39

B. ENS : these fibers constitute

a.

The Myenteric plexus (Aurbaches

plexus)
that controls motility.
b. Messiners plexus (Submucosa plexus)
that controls GIT secretions and local
BF.

40

Cont`d

Enteric fibers can act independently and

are therefore, called little brain, they are
numerous (>100 mill) & control local
reflexes.
Produce
inhibitory

several

stimulatory

or

NTs (>13) that enhance or

block GIT- motility.

41

Functional Structures of
Digestive System
GI Motility: two types

1.
Segmentation:
contractions in small segments
increases surface area for enzymatic attack

2. Peristalsis (propulsive):
contraction & relaxation waves
receptive relaxation (relaxation ahead of the ring)
42

43

Cont`d

2-types of Motility:
The law of the gut movement always occurs from
mouth- to- anus unless pathological
a.Mixing movements
b. Propulsive (peristalitic) movement

44

Cont`d

A. Mixing:

occurs due to local contractions taking

place in small segments.

It chops, shakes, and thereby mixes food

with digestive juices.

Provides increase in SA for mixing of

digestive juices with the chyme (stomach,
small and LI).
45

Cont`
d

B. Peristaltic (propulsive) movements:

A peristalitic motion consists of a progressive wave of
strong contraction preceded by relaxation.
This phenomena of relaxation where the muscular walls
ahead of the ring relaxes is called receptive relaxation.
The main stimulus to cause peristalsis is distension
(stretch) of the gut wall.
Peristalsis produces audible sounds (bowel sounds).

46

Vomiting
Forceful expulsion of stomacheal and
upper

intestinal

contents

through

the

esophagus, pharynx, and mouth.

Mechanism of vomition reflex:
Vomition reflex is mainly controlled by
vomition center located in the MO.

47

Cont`
d

Moreover, another center that causes vomition is

the so called

chemoreceptor trigger zone,

CTZ located at the root of the 4th ventricle.

There is a neural connection between the two

centers.

CTZ causes central vomiting and is stimulated

by chemical substances
morphine's

etc),

(e.g., drugs like

pregnancy,

alcohol,

movement etc.
48

49

Cont`
d

Importance of vomition:
Removal

of

toxic

substances

before

absorption.
Consequences of prolonged Vomition:
Excessive Vomition large loses of
fluids and salt severe dehydration
decreased plasma volume circulatory
and metabolic imbalances etc.
50

Defecation reflex
The sacral spinal cord is involved.
Cholinegic PS fibers are important during reflex.
Sympathetic stimulation is not important in this reflex.
Stimulation of receptors in the rectum

Sensory

impulses to the sacral spinal cord impulses through

PSN (pelvic nerves) back to (descending colon, sigmoid,
rectum, and anus) Powerful peristalysis + Relaxation
of internal sphincter expulsion of the bowel.

51

Digestive & absorptive function of GIT

Assignment

52

Absorption
An insignificant absorptive functions takes
place in the stomach, these are:
a. Alcohol
b. Certain drugs (aspirin, morphine etc.)
c. Small quantities of H2O are absorbed
from the stomach.
Organic nutrients (glucose, amino acids
and FFA etc.) are not absorbed from the

53

Energy and
Metabolism
Food

can

affect

our

health

unless

balanced diet is obtained.

Our body
fat

normally burns CHO (~60 %),

(~25%),

and

protein

(~15%)

to

produce energy and perform useful work.

54

Cont`
d

This energy is measured in calories.

On average, the daily caloric needs of food
approximately include:
1600 Cal for children
2000 Cal for adults
2800 Cal for active men

55

Cont`d

So, how do you calculate the % of CHO,

fat and protein in your normal daily diet?
A. Assume how many calories you need
each day,
E.g. 2000 Cal.
B. Determine what % of your calories
come from
CHO, fat and protein.
56

Cont`d

C. Multiply your total calorie by each of the %

and then divide the result by calories per gm
obtained from each food .
1. Each gram of CHO = 4 Cal
2. Each gram of fat

= 9 Cal

3. Each gram of Prot = 4 Cal

57

Cont`d

1.

CHO: [2000 x 0.60]/4 = 300 gm CHO

2.

Fat : [2000 x 0.25]/9 = 56 gm of fat

3.

Prot : [2000 x 0.15]/4 = 75 gm of Prot

So, the caloric requirement = 431 gm/ day.

A little less than a kilo of food/day can sufficient
the needs of your balanced diet.

58

Pathophysiology of
GIT
1. Gastro-esophageal reflux disease
(heart burn)
It occurs when the cardiac sphincter remains
open.
The HCl of gastric refluxes accumulate in the
lower esophagus causing a sensation of heart
burn.
59

Cont`d

2. Achalasia:
The

lower

esophageal

sphincter

remains closed.
This effect results in accumulation of
food in the esophagus causing several
disturbances.

3. Gastritis- Inflammation of gastric

mucosa

Caused

by

chronic

60

bacterial

Cont`d

4. Peptic ulcers :
Excess acid secretion erodes the wall creating
wounds.
If this are deep enough can reach the vascular layer and
cause bleeding.
Increased secretion of Gastrin and excessive activity of
the Vagus nerve as well as psycho-physiological factors
are believed to be involved as causatives.
Bacteria H-pylori is found to be another cause of
ulcer.
61

Cont`d

5. Appendicitis
Appendix has no digestive function and
remains a rudimentary tissue (from cecum).
The special feature is the presence of mass of
lymphoid tissues; therefore sometimes named
as the intestinal tonsil.
Distention, spasm or inflammation caused by
bacteria causes pain (appendicitis).
62

63

6.

Constipation:

is

common

disorder, particularly
of the colon.
Reduced intestinal motility is mainly
responsible for constipation.
Reduced motility increases storage time
that in turn increases the degree of water
absorption from the colon.
64

Cont`d

Dried

feces

therefore,

are

less

less
likely

bulky
to

and,

initiate

movement.
Increased fiber content (cellulose, raw
vegetable) may improved fecal bulk and
thus can stimulate colon motility.

Many

causes

of

constipation

are

clinically known .
65

7. Diarrhea:
excessive and frequent discharge of watery feces
induced by increased intestinal motility.
Some causes:

Toxins acting on intestinal glands (e.g. cholera)

cause
secretion of electrolytes (Na+, Cl-, HCO3) into the
lumen; water follows by osmosis.

66

Cont`d

Nervous (psychogenic) origin: anxiety increases

PS activity to the lower bowls that increasing
motility; absorption time decreases leading to
diarrhea.

8. Lactose intolerance
Enzyme deficiency in the intestine (e.g., some
subjects lack the enzyme lactase (milk sugar) that is
a common cause of diarrhea.
67

 The undigested lactose increase lumen

osmolality (osmotic pressure), thus reducing
H2O absorption in SI, but increased chyme
delivery to the colon.
The undigested lactose will be utilized by the
bacteria in the cecum and colon forming
gas, discomfort and flatulence.

68

List of
Acronyms

GIT- gastrointestinal tract

SI- small intestine
SNS- sympathetic nervous system
PSN- parasympathetic nerves
MO- medulla oblongata
Ach- acetylcholine
LI- large intestine
NE- norepinephrine
E- epinephrine
69

Cont`
d

ENS- enteric nervous system

BF- blood flow
NT- neurotransmitter
SA- surface area
CTZ- chemoreceptor trigger zone
FFA- free fatty acids
H-pylori= helicobacter pylori
PS- parasympathetic
CHO- carbohydrate
Cal- calori
70