GASTROINTESTINAL

PHYSIOLOGY

Kazeem O. Ajeigbe Ph.D, FASLN

Associate Professor of Physiology
Federal University, Oye-Ekiti

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OUTLINES
1. INTRODUCTION
o Overview of the alimentary tract
o Functional Anatomy of the tract
o Innervation of the GI tract
o Electrophysiology of GI smooth muscle
o Regulation of GI function

2. GI Motility 3. GI Secretion
-Chewing and Swallowing -Saliva
-Gastric motility -Gastric juice
-Small intestinal motility -Intestinal
juice
-Colonic motility -Pancreatic
juice
-Defeacation -Bile
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4. DIGESTION & ABSORPTION
-Carbohydrate -Water
-Protein -Nutrients and electrolytes
-Fat

5. DISORDERS OF GIT
-Achalasia
-GERD
-Gastritis
-Peptic Ulcer
-Irritable Bowel syndrome
-Inflammatory Bowel Disease

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 From beginning to end:

Mouth

Oesophagus

Stomach

Small intestine
Duodenum (26 cm = 9.8’’)
Jejunum (2.5 m = 8.2 ft)
Ileum (3.5 m = 11.5 ft)

Large intestine (1.5 m = 4.9

ft)
Cecum
Ascending colon
Transverse colon
Descending colon
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The general purpose of the alimentary
tract is to absorb H2O, electrolytes and
nutrients from ingested food and liquid.

This requires:
- Propelling of contents
- Digestion of contents
- Absorption of nutrients
- Large supply of blood flow (~
25% of total)
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 GI Blood Flow

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 As you
would
expect,
there is
extensive
blood flow
for nutrient
absorption

3/3/2023 -Arterial Blood supply

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 Microvasculature of the intestine

Villi greatly increase the surface area of the small

intestine
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 Functional Anatomy of GI

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 Layers of GIT
The GI tract is composed of three basic functional
layers
1. Muscularis externa
-Outer longitudinal layer
-Inner circular layer

2. Submucosa

3. Mucosa
-Muscularis mucosae
-Lamina Propria
-Epithelium

Serosa is the outermost covering.. serves as a

protective layer
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 The morphology of the
epithelium varies
from one part of the GIT
to another

Muscularis mucosae is
thin innermost layer of
GI smooth ms

Nerves and blood vessels

travel in the submucosa

Longitudinal and circular

Ms fibers electrically
connected thru gap jnxs
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 Innervation of the GIT
INTRINSIC NERVES (also known as
enteric nervous system)

-Myenteric plexus
-Submucosa plexus

EXTRINSIC NERVES
-Sympathetic
-Parasympathetic
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 Regulation of GI Function

oNEURAL

oHORMONAL

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 Gastrin….
• Gastrin:
- produced from the stomach (G cells)
- release increased by stomach
distension, peptides, amino acids,
alcohol, caffeine, parasympathetic
innervation
- release inhibited by highly acidic pH
(< 2.0)

- functions: increases gastric (stomach)

secretions (primarily HCl); increases
histamine release; increases gastric
motility; opens pyloric sphincter (between
stomach and small intestine), relaxes
ileocecal sphincter, stimulates growth of
gastric mucosa.
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Histamine..
– Produced by enterochromaffin-like cells
(ECL cells) of the stomach.
– Release is stimulated by gastrin.
– Action: increase HCl secretion from
parietal cells (major factor in HCl
secretion).

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 HOW IT WORKS AT THE RECEPTOR LEVEL

Combined neurocrine, endocrine and paracrine events in

Acetylcholine the activation of gastric HCl secretion
neural input

ACh
receptor
PARIETAL cell
histamine
receptor

H/K
P
ECL cell HCl
histamine- transduction-activation
secreting cell events
secretion
H/K
P

gastrin
receptor

release of
Gastrin histamine
hormonal input ECL cell =
enterochromaffin-like cell

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 HOW IT WORKS AT THE RECEPTOR LEVEL

Combined neurocrine, endocrine and paracrine events in

Acetylcholine the activation of gastric HCl secretion
neural input

ACh
receptor
PARIETAL cell
histamine
receptor

H/K
P
ECL cell HCl
histamine- transduction-activation
secreting cell events
secretion
H/K
P

gastrin
receptor

release of
Gastrin H-2 receptor blockers
histamine
hormonal input Tagamet
ECL cell =
Zantac
enterochromaffin-like
Pepcid cell
H/K ATPase pump inhibitors
Prilosec
Nexium
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Aciphex
Somatostatin
o Produced by D cells of the stomach

o Secretion is stimulated by activation of

the sympathetic nervous system and by
acidic pH, and is inhibited by activation of
the parasympathetic nervous system,
continuously released, overridden by
gastrin and nerves

o Actions: inhibit gastrin and histamine

secretion (decreased acid release and
3/3/2023gastric motility); also directly
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Secretin…
Produced by duodenum (enteroendocrine cells
of the small intestine); crypts of Lieberkühn

- stimulated by arrival of acidic chyme in

duodenum

- functions: stimulates bicarbonate secretion

from pancreas; inhibits gastric secretion
(decreases HCl production by inhibiting gastrin
release); decreases gastric motility (slowing
rate of gastric digestion and delivery to the
small intestine), increases hepatic bile
production, increases
3/3/2023 CCK,
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Dr Kazeem
Cholecystokinin (CCK)…
produced by enteroendocrine cells of the
duodenum

- release stimulated by fatty acids

in duodenum (also amino acids, acidic
chyme)

- functions: causes gallbladder

contraction (bile to small intestine);
stimulates release of pancreatic
enzymes; decreases gastric motility and
secretion (increases somatostatin
release).
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 Integration of Neural &
Hormonal Function

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 GI
SECRETIONS
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Associated glandular organs of the
alimentary tract produce secretions

Glands subserve two primary functions:

1. Digestive enzymes
2. Mucous glands produce mucus for
lubrication and protection of all parts
of the GIT

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Principles involve
1. Mechanical stimulation:
Direct mechanical stimulation of
glandular cells by food cause the
local gland to secrete via tactile,
chemical irritation and gut wall
distension
2. Parasympathetic and sympathetic
stimulation:
Parasympathetic increases the rate of
secretion while sympathetic can have
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 Typical glandular cell for
formation and secretion of
enzymes

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 SALIVA
• Salivary glands produce about 1000 ml
of saliva per day
• Glands are: Parotid, submandibular
and sublingual
• Secretions could be serous and mucous
• Parotid secretes serous while
submandibular and sublingual produced
mixed secretions

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 Composition of Saliva

• Water
• Electrolytes
• Amylase
• Kallikrein
• Mucus etc

Saliva is hypotonic (Has higher K+ and

HCO3-; and lower Na+ and Cl-)

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 Functions of Saliva
• Carbohydrate digestion
• Provides lubrication and so aids
speech
• Its bactericidal (as it contains
thiocyanate, lysozymes and some
protein antibodies)

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 Regulation of salivary
secretion
• Parasympathetic signals from the
superior and inferior salivatory nuclei
in the medulla. Stimuli are taste,
tactile, and psychic. Salivary blood
vessels also dilates and increase
secretion

• Sympathetic stimulates β-receptors on

the acinar and ductal cell and caused
increased secretion
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 GASTRIC SECRETION

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 Oxyntic Gland Area - proximal 80%
of the stomach (body and fundus) -
secretes HCl and pepsinogen into
stomach lumen.
Pyloric Gland Area - distal 20% of
the stomach (antrum) - secretes
pepsinogen into the lumen, as well as
the hormone gastrin to the
bloodstream.
Gastric Mucosa Surface - secretes
mucus and HCO3- for protection from
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Gastric gland
Mucous cells secrete mucous,
HCO3-, & trefoil peptides.

Chief cells secrete pepsinogen &

gastric lipase.

Parietal cells synthesize and secrete

hydrochloric acid & intrinsic factor.

ECL Cells secrete histamine.

Enteroendocrine cells (specifically G

cells) secrete gastrin

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 Composition of gastric juice

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 Mechanism of HCl
production

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 Regulation of HCl and
Pepsin

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 X X

One inhibitory and

three stimulatory
signals that alter
acid secretion by
parietal cells
in the stomach. X

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Note:
Adverse effects associated with ulcer
treatment may include
1. Decrease absorption of calcium (risk of
osteoporosis)
2. Decrease absorption of B-12 leading to
homocysteine build up (vascular dementia,
anaemia and breast cancer)
3. Risk of ulcerative colitis and antibiotic
resistant infections…

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 Surface epithelium secretes a
mucus layer containing
bicarbonate for protection from
gastric acid.

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 Human…

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 Rat…

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 Protective and aggressive
factors in gastric mucosa

Diagrammatic
representation of
peptic ulceration

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 EXOCRINE PANCREAS

The exocrine cells in the pancreas play a central role

in the production of digestive enzymes

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Formation…

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 Secretin stimulates HCO3-
secretion in the pancreatic ducts
when S cells detect that acid is
present in the duodenum

Secretin Receptors are Densely Expressed on Pancreatic

Ductular Cells in Humans

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 BILE
• Bile is produced in the liver
• Bile is stored in the
gallbladder
• Bile is secreted into the small
intestine.
• Bile salts are absorbed in the
small intestine and recycled
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Bile formation by cells in the liver includes 6 components:
bile salts, lecithin, bicarbonate ions, cholesterol, bile pigments, and
trace metals.
The bile is funneled into the gallbladder and then delivered
into the duodenum upon stimulation from CCK

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DIGESTION & ABSORPTION

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Digestion is the breakdown of ingested
food into absorbable form

The ingested food can be broadly

classified as

• Carbohydrate
• Protein
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• Fats
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LUMINAL
• Mixing of chyme with enzymes
BRUSH BORDER
• Specific enzymes present on
the luminal surface of the
enterocytes

CYTOSOLIC/INTRACELLULAR
• Intracellular digestion in the
enterocytes
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Proteins:
• All 3 phases, luminal, brush border and
cytosolic digestion may be involved

Carbohydrates:
• Only luminal and brush border digestion
– no intracellular digestion by the
enterocyte

Lipids:
• All digestion is luminal; triglyceride is re-
formed in the enterocyte!
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 Were digestive enzymes synthesized in their active
form, they would digest the very cells that make
them. Hence, inactive precursors (e.g., trypsinogen)
become activated (trypsin).

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 Digestion of Protein
Proteases stored in inactive form in
pancreas & secreted in response to neuro-
hormonal stimulation.

o Pancreatic trypsinogen converted to

active form by duodenal brush-border
enterokinase

o Trypsin activates all other luminal

peptidases.
o Digestion of oligopeptides in lumen and
small peptides at brush border.
o Uptake of free amino acids, di- and tri-
peptides by active transport mechanisms.
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1. Lumen

2. Brush Border

3. Cytoplasm

Sites of Protein Digestion

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 Carbohydrate Digestion
• Polysaccharides digested in duodenal
lumen by pancreatic amylase to
produce oligosaccharides and
disaccharides.
• Brush border digestion of polymers by
specific amylases and disaccharidases
forms monosaccharides.
• Simple sugars taken up by active
transport processes into enterocytes.
• NO uptake of disaccharides or
oligosaccharides!
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 Fats Digestion
• Lipid digestion in luminal phase only.
• Digestion requires bile salts, pancreatic
lipase, co-lipase and phospholipids.
• Lipids emulsified by bile salts and
phospholipids.
• Triglyceride digested to form free fatty
acids and a monoglyceride.
• Digestion productions taken up by
diffusion

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Bile salts and
phospholipids
convert large
fat globules
into smaller
pieces with
polar surfaces
that inhibit
reaggregation.

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 ABSORPTION

General Features

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By projecting
into the lumen,
the villi increases
the surface area
for absorption of
nutrients.

Microvilli [aka
brush
border] fringe the
villi to further
increase
surface area.
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o Transepithelial transport - nutrients
must pass across the epithelial lining
of the small intestine

o Active transport - most nutrients

must be transported across
membrane using ATP of the cells

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 Carbohydrate Absorption
• Sugars enter blood stream by
facilitated diffusion or active transport
mechanisms.
• Glucose in the intestinal lumen
stimulates the release of GIP
(Gastrointestinal Inhibitory Peptide).
• GIP stimulates the release of insulin
from the pancreas in anticipation of
glucose in the portal blood.
• GIP inhibits gastric motility to facilitate
digestion and absorption from the GI
tract.
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1. Sodium gradient for SGLT1 driven by Na+/K+ ATPase.
2. Basolateral GLUT2 transports monosaccharides to the blood.

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 Protein Absorption

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 Lipid Absorption

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• Free fatty acids and monoglycerides
reformed into triglycerides inside the
enterocytes.
• Triglycerides packaged together with
cholesterol and apo-lipoprotein
molecules to form very large
lipoproteins – CHYLOMICRONS.
• Chylomicrons secreted into lacteals –
terminal of lymphatic system - enters
systemic circulation in neck.
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 TEST

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