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Introduction\nFood\tprovides\tenergy\tand\tbuilding\tmaterials\tfor\tcountless\tsubstances\tthat\tare\tessential\tfor\tthe\ngrowth\tand\tsurvival\tof\tevery\thuman\tbeing.\tThis\tsection\topens\twith\ta\tbrief\toverview\tof\tthe\tdigestion,\nabsorption,\ttransportation,\tand\texcretion\tof\tnutrients.\tThese\tremarkable\tprocesses\tconvert\tcomplex | [
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model\tof\t“ingestion,\tdigestion,\tand\tutilization.”\tIn\tthis\tmodel,\tconsideration\tis\tgiven\tto\teach\tstep\tto\nidentify\tall\tareas\tof\tinadequacy\tor\texcess.\tIf\tthere\tis\tany\treason\twhy\ta\tstep\tis\taltered\tfrom\tphysical,\nbiochemical,\tor\tbehavioral-environmental\tcauses,\tthe\tnutrition\tprovider\tmust\tselect\tan\tappropriate | [
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structures,\tesophagus,\tstomach,\tliver\tand\tgallbladder,\tpancreas,\tand\tsmall\tand\tlarge\tintestine\t(\nFig.\n1.1\n).\nFIG.\t1.1\nThe\tdigestive\tsystem.\nThe\tGIT\tis\tdesigned\tto\t(1)\tdigest\tthe\tmacronutrients\tprotein,\tcarbohydrates,\tand\tlipids\tfrom\ningested\tfoods\tand\tbeverages;\t(2)\tabsorb\tfluids,\tdigested\tmacronutrients,\tmicronutrients,\tand\ttrace | [
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crypts\nand\tfingerlike\tprojections\tcalled\t\nvilli\n\t(\nFig.\t1.2\n).\tThese\tcrypt-villus\tunits\tare\tlined\twith\ta\tsingle\tlayer\nof\t\nepithelial\tcells\n,\tmany\tof\twhich\tare\t\nenterocytes\n\tthat\tcontain\teven\tsmaller\tcylindrical\textensions\ncalled\t\nmicrovilli\n.\tThe\tepithelial\tcells\tlining\tthe\tintestinal\ttract\thave\ta\tlife\tspan\tof\tapproximately\t3\tto | [
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through\tits\tlumen.\tAfter\tonly\ta\tfew\tdays\tof\tstarvation\tor\tintravenous\tfeeding\t(parenteral\tnutrition),\nthe\tintestinal\tmucosa\n\tatrophies\t(i.e.,\tthe\tsurface\tarea\tdecreases\tand\tsecretions,\tsynthetic\tfunctions,\nblood\tflow,\tand\tabsorptive\tcapacity\tare\tall\treduced).\tResumption\tof\tfood\tintake\tstimulates\tepithelial | [
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cell\tproliferation\tand\treturn\tof\tnormal\tGI\tfunction\tafter\tonly\ta\tfew\tdays.\tThis\tknowledge\tjustifies\tthe\nclinical\tpractice\tof\tfeeding\tan\tindividual\torally\tand/or\tenterally\t(via\ttube),\tas\topposed\tto\nintravenously\t(or\n\tparenterally),\twhen\tadequate\tGIT\tfunction\tis\tpresent\t(see\t\nChapter\t12\n).\nBrief\toverview\tof\tdigestive\tand\tabsorptive\tprocesses | [
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] |
Chapter\t12\n).\nBrief\toverview\tof\tdigestive\tand\tabsorptive\tprocesses\nThe\tsight,\tsmell,\ttaste,\tand\teven\tthought\tof\tfood\tstarts\tthe\tsecretions\tand\tmovements\tof\tthe\tGIT.\tIn\nthe\tmouth,\tchewing\treduces\tthe\tsize\tof\tfood\tparticles,\twhich\tare\tmixed\twith\tsalivary\tsecretions\tthat\nprepare\tthem\tfor\tswallowing.\tA\tsmall\tamount\tof\tstarch\tis\tdegraded\n\tby | [
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digestion\tin\tthe\tmouth\tis\tminimal.\tThe\tesophagus\ttransports\tfood\tand\tliquid\tfrom\tthe\toral\tcavity\tand\npharynx\tto\tthe\tstomach.\tIn\tthe\tstomach,\tfood\tis\tmixed\twith\tacidic\tfluid\tthat\tcontains\t\nproteolytic\n\tand\nlipolytic\tenzymes\n.\tSmall\tamounts\tof\tlipid\tdigestion\ttake\tplace;\tsome\tproteins\tchange\tin\tstructure | [
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] |
due\tto\tdenaturation\tand\tpartial\tdigestion.\tWhen\tfood\treaches\tthe\tappropriate\n\tconsistency\tand\nconcentration,\tit\tis\tnow\tcalled\t\nchyme\n\tand\tpasses\tfrom\tthe\tstomach\tinto\tthe\tsmall\tintestine,\twhere\nmost\tdigestion\ttakes\tplace.\nThe\tfirst\t100\tcm\tof\tthe\tsmall\tintestine\tis\thighly\tactive,\tresulting\tin\tthe\tdigestion\tand\tabsorption\tof\nmost\tingested\tfood\t( | [
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] |
most\tingested\tfood\t(\nFig.\t1.3\n).\tHere\tthe\tpresence\tof\tfood\tstimulates\tthe\trelease\tof\thormones\tthat\nstimulate\tthe\tproduction\tand\trelease\tof\tpowerful\tenzymes\n\tfrom\tthe\tpancreas\tand\tbile\tfrom\tthe\ngallbladder.\tStarches\tand\tproteins\tare\treduced\tto\tsmall-molecular-weight\tcarbohydrates\tand\tsmall\tto | [
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] |
to\tmonosaccharides\tand\nthe\tremaining\tpeptides\tto\tsingle\tamino\tacids,\tdipeptides,\tand\ttripeptides.\nFIG.\t1.3\nSites\tof\tsecretion,\tdigestion,\tand\tabsorption.\nLarge\tvolumes\tof\tfluid\tare\tused\tto\tdigest\tand\tabsorb\tnutrients.\tTogether\twith\tsalivary\tand\tgastric | [
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secretions,\tsecretions\tfrom\tthe\tpancreas,\tsmall\tintestine,\tand\tgallbladder\tsecrete\t7\tL\tof\tfluid\tinto\tthe\nGIT\tlumen\teach\tday—far\tmore\tthan\tthe\t2\tL\tingested\tthrough\tdietary\tintake\teach\tday.\tAll\tbut\t100\tmL\nof\tthe\ttotal\tfluid\tentering\tthe\tlumen\n\tis\treabsorbed:\tabout\t7\tL\tin\tthe\tsmall\tintestine\tand\tabout\t2\tL\tin\nthe\tlarge\tintestine. | [
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may\tbe\tstored,\ttransformed\tinto\tother\tsubstances,\tor\treleased\tinto\tcirculation.\tHowever,\tend\nproducts\tof\tmost\tdietary\tfats\tare\ttransported\tinto\tthe\tbloodstream\n\tvia\tthe\tlymphatic\tcirculation\nbecause\tthey\tare\tnot\twater\tsoluble\tprior\tto\tlipoprotein\tmetabolism\tin\tthe\tliver\t(see\t\nChapter\t28\n). | [
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] |
Chapter\t28\n).\nNutrients\treaching\tthe\tdistal\tsmall\tintestine\tand\tlarge\tintestine,\tmost\tnotably\tfermentable\tdietary\nfiber\tand\tresistant\tstarches,\tare\tfermented\tby\tthe\tmicrobiota\tlocated\twithin\tthe\tlumen\tof\tthese\nintestinal\tsegments.\tFermentation\tproduces\tshort-chain\tfatty\tacids\t(SCFAs)\n\tand\tgas.\tSCFAs\tprovide | [
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] |
and\tgas.\tSCFAs\tprovide\na\tpreferred\tfuel\tsource\tfor\tcells\tof\tthe\tintestine,\tstimulate\tintestinal\tcell\trenewal\tand\tfunction,\nenhance\timmune\tfunction,\tand\tregulate\tgene\texpression.\tIn\taddition,\tsome\tcarbohydrates\thave\n“prebiotic”\tfunctions\tthat\tinduce\tthe\tgrowth\tand\tactivity\tof\tbeneficial\tmicrobes\twithin\tthe\tintestinal | [
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microbiota.\tThe\tlarge\tintestine\talso\tprovides\ttemporary\tstorage\tfor\twaste\tproducts.\n\tThe\tdistal\tcolon,\nrectum,\tand\tanus\tcontrol\tdefecation.\nEnzymes\tin\tdigestion\nHumans\tdigest\tfood\tusing\tthe\tchemical\tprocess\tcalled\t\nenzymatic\thydrolysis\n.\tCofactors\tsuch\tas\nhydrochloric\tacid,\tbile,\tand\tsodium\tbicarbonate\tfacilitate\tthese\tprocesses.\tDigestive\tenzymes | [
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] |
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] |
lumen,\twhereas\tdigestive\tenzymes\tsynthesized\n\tin\tenterocytes\tof\tthe\tsmall\tintestine\tremain\nembedded\twithin\tthe\tbrush\tborder\tmembrane.\tExcept\tfor\tfiber\tand\tresistant\tcarbohydrates,\ndigestion\tand\tabsorption\tof\tfood\tis\tcompleted\tessentially\tin\tthe\tsmall\tintestine.\t\nTable\t1.1\n\tsummarizes\nkey\tenzymes\tinvolved\tin\thuman\tdigestion.\nTABLE\t1.1 | [
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-0.03784744068980217,
-0.019747287034988403,
-0.021615508943796158,
0.04097967594861984,
-0.0017826711991801858,
0.04880213737487793,
-0.03139548748731613,
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0.04721258580684662,
-0.031300924718379974,
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0.03815213963389397,
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-0.13281546533107758,
-0.0373777374625206,
0.03903050348162651,
0.006636748090386391,
0.06646613776683807,
0.002565279370173812,
-0.00945371389389038,
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0.08564219623804092,
0.023964356631040573,
-0.021069826558232307,
0.044583044946193695,
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0.07247863709926605,
0.04960109665989876,
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-0.036917053163051605,
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0.056323640048503876,
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0.09432117640972137,
-0.0063786921091377735,
0.00486459955573082,
-0.0779341533780098,
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-0.03426840528845787,
-0.01889846660196781,
0.013922283425927162,
0.02987523004412651,
-0.03839777410030365,
0.014078899286687374,
-0.03644478693604469,
-0.014345148578286171,
0.02276363968849182,
0.025289665907621384,
0.02688266709446907,
0.01904098503291607,
0.015771066769957542,
-0.007643125019967556,
0.07416998594999313,
0.13456019759178162,
-4.6180563373354744e-8,
0.04467638209462166,
-0.04731522127985954,
-0.005826427135616541,
-0.017006216570734978,
0.015947546809911728,
-0.05977114662528038,
0.11687289923429489,
0.048341210931539536,
0.012230456806719303,
-0.02716543897986412,
-0.009865292347967625,
0.10011139512062073,
-0.044739630073308945,
-0.021002791821956635,
0.06874149292707443,
0.07982370257377625,
-0.04361903667449951,
0.05869622901082039,
-0.010370969772338867,
-0.053266849368810654,
-0.05073098465800285,
0.07490269839763641,
-0.04097318649291992,
-0.015609512105584145,
0.0347525030374527,
-0.03452048450708389,
-0.03940671309828758,
0.011300378479063511,
0.043762024492025375,
0.04362311586737633,
0.10272517055273056,
-0.009633317589759827,
0.028656691312789917,
-0.023449847474694252,
-0.021949402987957,
0.013736176304519176,
-0.04894351214170456,
-0.035479843616485596,
-0.07683706283569336,
0.11622126400470734,
-0.014652262441813946,
-0.038128118962049484,
-0.0254741869866848,
0.03917155787348747,
0.03965070843696594,
-0.0711921751499176,
0.011083681136369705,
0.13919222354888916,
0.012155583128333092,
-0.009770522825419903,
0.003026675432920456,
0.11522257328033447,
0.01600915938615799,
-0.02371829003095627,
-0.06905575841665268,
0.0034529895056039095,
0.06691599637269974,
0.03043276071548462,
0.022239014506340027,
-0.0033867252059280872,
0.0643344447016716,
0.09097742289304733,
0.10877972841262817,
0.01563410274684429
] |
summarizes\nkey\tenzymes\tinvolved\tin\thuman\tdigestion.\nTABLE\t1.1\nSummary\tof\tEnzymatic\tDigestion\tand\tAbsorption\nSecretion\tand\nSource\nEnzymes\nSubstrate\nAction\tand\nResulting\tProducts\nFinal\tProducts\nAbsorbed\nSaliva\tfrom\nsalivary\nglands\tin\nmouth\nα-amylase\nStarch\t(α-linked\npolysaccharides)\nHydrolysis\tto\tform\ndextrins\tand\nmaltose\n—\nLingual\tlipase | [
-0.0014981143176555634,
-0.12650750577449799,
-0.02672400325536728,
0.011569475755095482,
-0.014094267971813679,
0.02829822339117527,
0.04215239733457565,
0.05666140839457512,
-0.03311635181307793,
0.0456993393599987,
0.07635627686977386,
-0.006292286328971386,
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0.03178488835692406,
-0.06404939293861389,
0.0064550056122243404,
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0.00893310084939003,
0.02878311276435852,
0.06983225047588348,
-0.0024418511893600225,
0.012804706580936909,
0.06031087785959244,
-0.024194758385419846,
0.04749300330877304,
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0.008739854209125042,
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0.09498761594295502,
0.007287580985575914,
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0.0017693687696009874,
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0.0013277665711939335,
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0.005439329892396927,
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0.03485656529664993,
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0.07365080714225769,
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0.007873091846704483,
0.0809754803776741,
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0.008046496659517288,
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-0.05530431866645813,
0.08621963858604431,
0.056730836629867554,
0.08182524889707565,
0.01599971391260624,
-0.00812256895005703,
-0.017342258244752884,
0.12031890451908112,
0.013574261218309402,
-0.011132313869893551,
0.053762298077344894,
-0.01307480875402689,
0.015572932548820972,
0.006148516666144133,
-0.0245901457965374,
-0.027418658137321472,
0.002796201268211007,
-0.05775231868028641,
0.02633269876241684,
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0.05618521571159363,
0.0371440164744854,
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0.07385937124490738,
0.023662108927965164,
0.022337282076478004,
0.011632879264652729,
0.06720995157957077,
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0.02461540326476097,
-0.00040866865310817957,
0.08387993276119232,
-0.0012906213523820043,
0.01117277704179287,
-0.04738398641347885,
0.16556203365325928,
0.08133518695831299,
-0.07162513583898544,
0.05218328908085823,
-0.015331788919866085,
2.945048098048642e-33,
0.013060905039310455,
0.0468030646443367,
-0.021125545725226402,
0.03724025562405586,
0.02664221078157425,
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-0.030888838693499565,
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0.029099661856889725,
-0.09209907054901123,
-0.0001929133723024279,
0.002902930835261941,
0.05236116424202919,
-0.028886012732982635,
-0.03925749287009239,
0.0035280755255371332,
0.03841836750507355,
0.02926173061132431,
-0.00425729202106595,
-0.0530022494494915,
0.16666404902935028,
0.024000810459256172,
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0.06815271079540253,
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0.045633330941200256,
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0.014354104176163673,
0.04583938419818878,
0.016856322064995766,
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0.05833955109119415,
0.03520539775490761,
0.026498889550566673,
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0.027490975335240364,
0.04464319348335266,
0.011446226388216019,
0.04515445977449417,
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0.041468486189842224,
0.018174033612012863,
0.008822896517813206,
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0.07231181859970093,
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0.029158612713217735,
0.04189804568886757,
0.09946219623088837,
-0.02542719431221485,
0.05883138254284859,
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0.03844866529107094,
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0.016213558614253998,
0.07687468081712723,
0.027916746214032173,
0.10596548020839691,
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-0.005564101040363312,
-0.057007431983947754,
-0.016301944851875305,
-0.022547511383891106,
-0.06890294700860977,
0.024471553042531013,
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0.006953828502446413,
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-0.037506669759750366,
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0.016092495992779732,
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0.03147801011800766,
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0.0040959641337394714,
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-4.043357469415023e-33,
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0.0014117950340732932,
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-0.036734335124492645,
0.05800117924809456,
0.010926143266260624,
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0.065712109208107,
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0.12157611548900604,
0.019676201045513153,
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0.06747593730688095,
0.0024452139623463154,
0.08750677108764648,
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0.0745851993560791,
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0.05996900424361229,
0.06043139845132828,
0.10252641886472702,
0.03998102247714996,
0.017621733248233795,
0.06794192641973495,
0.07714966684579849,
0.032789602875709534,
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0.012047487311065197,
0.028153639286756516,
0.033918485045433044,
0.002247688826173544,
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-0.014142989180982113,
0.03877423703670502,
0.0013844690984115005,
0.0813809409737587,
-0.01914290525019169,
0.058441076427698135,
0.026374375447630882,
-0.059129498898983,
-0.03633861988782883,
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0.045060351490974426,
0.06376989930868149,
-0.04583986476063728,
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0.03131457790732384,
0.02741006389260292,
0.06457077711820602,
0.036224618554115295,
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0.07510887086391449,
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0.019685473293066025,
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0.0598251149058342,
-0.043002497404813766,
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-0.031397562474012375,
-0.04085300490260124,
-0.06022476777434349,
0.06981617957353592,
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0.023602137342095375,
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-0.028908003121614456,
-0.0015928043285384774,
0.018873846158385277,
-0.048114802688360214,
-0.0015971407992765307,
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-0.028444945812225342,
0.02569356933236122,
0.01501192431896925,
0.03575414791703224,
0.011682783253490925,
0.008372289128601551,
-0.056118883192539215,
0.07720523327589035,
0.08382473140954971,
-4.466918213097415e-8,
0.08993060886859894,
-0.08193641155958176,
-0.003494224976748228,
-0.06334920227527618,
-0.0017324642976745963,
-0.04894636571407318,
0.05877530202269554,
0.056592781096696854,
0.026518963277339935,
-0.03682136535644531,
-0.042896293103694916,
0.152261421084404,
-0.04998493194580078,
0.005788127891719341,
-0.00982755422592163,
0.02597743831574917,
-0.07264678925275803,
0.04062938317656517,
-0.0071374825201928616,
-0.06098192185163498,
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0.020682010799646378,
-0.08845771849155426,
0.005251642316579819,
0.032333433628082275,
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0.0010524207027629018,
0.049967676401138306,
0.03908953443169594,
0.025455493479967117,
0.05044880881905556,
-0.03472128510475159,
-0.004103460349142551,
-0.023205716162919998,
0.02355267107486725,
0.02965645119547844,
-0.011695405468344688,
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0.07484114915132523,
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-0.01951953023672104,
0.044414687901735306,
0.03933746740221977,
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-0.028943831101059914,
0.0988084152340889,
0.04565265029668808,
-0.03686170652508736,
0.036285992711782455,
0.043964684009552,
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-0.029494138434529305,
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0.026577657088637352,
0.0734167993068695,
-0.026650065556168556,
0.05479557812213898,
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0.055289044976234436,
0.0551508329808712,
0.14629438519477844,
-0.029272057116031647
] |
Hydrolysis\tto\tform\ndextrins\tand\nmaltose\n—\nLingual\tlipase\nTriglyceride\nHydrolysis\tto\tform\ndiglyceride\tand\nfree\tfatty\tacids\n__\nGastric\tsecretion\nfrom\tgastric\nglands\tin\nstomach\nmucosa\nPepsin\t(activated\tfrom\npepsinogen\n\tin\tthe\npresence\tof\nhydrochloric\tacid)\nProtein\nHydrolysis\tof\tpeptide\nbonds\tto\tform\npeptides\tand\namino\tacids\n—\nGastric\tlipase | [
0.000011226810784137342,
-0.12084542959928513,
-0.0005365015240386128,
-0.02691379003226757,
-0.04016389697790146,
0.01324862614274025,
0.02972443960607052,
0.06261953711509705,
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0.061566270887851715,
0.11778988689184189,
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bonds\tto\tform\npeptides\tand\namino\tacids\n—\nGastric\tlipase\nTriglyceride\nHydrolysis\tto\tform\ndiglyceride\tand\nfree\tfatty\tacids\n—\nExocrine\nsecretions\nfrom\npancreatic\nacinar\tcells,\nacting\tin\nduodenum\nLipase\nFat\t(in\tthe\tpresence\nof\tbile\tsalts)\nHydrolysis\tto\tform\nmonoglycerides\nand\tfatty\tacids;\nincorporated\tinto\nmicelles\nFatty\tacids\n\tinto\nmucosal\tcells; | [
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incorporated\tinto\nmicelles\nFatty\tacids\n\tinto\nmucosal\tcells;\nreesterified\tas\ntriglycerides\nCholesterol\testerase\nSterols\t(such\tas\ncholesterol)\nHydrolysis\tto\tform\nesters\tof\ncholesterol\tand\nfatty\tacids;\nincorporated\tinto\nmicelles\nCholesterol\tinto\nmucosal\tcells;\ntransferred\tto\nchylomicrons\nα-Amylase\nStarch\tand\tdextrins\nHydrolysis\tto\tform\ndextrins\tand | [
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α-Amylase\nStarch\tand\tdextrins\nHydrolysis\tto\tform\ndextrins\tand\nmaltose\n—\nTrypsin\t(activated\ntrypsinogen)\nProteins\tand\npolypeptides\nHydrolysis\n\tof\tinterior\npeptide\tbonds\tto\nform\tpolypeptides\n—\nChymotrypsin\t(activated\nchymotrypsinogen)\nProteins\tand\npeptides\nHydrolysis\tof\tinterior\npeptide\tbonds\tto\nform\tpolypeptides\n—\nCarboxypeptidase\n(activated | [
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peptide\tbonds\tto\nform\tpolypeptides\n—\nCarboxypeptidase\n(activated\nprocarboxypeptidase)\nPolypeptides\nHydrolysis\tof\nterminal\tpeptide\nbonds\t(carboxyl\nend)\tto\tform\namino\tacids\nAmino\tacids\nRibonuclease\tand\ndeoxyribonuclease\nRibonucleic\tacids\n(RNA)\tand\ndeoxyribonucleic\nacids\t(DNA)\nHydrolysis\tto\tform\nmononucleotides\nMononucleotides\nElastase | [
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0.10261522978544235,
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0.05385179817676544,
0.05789073184132576,
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0.019961662590503693,
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0.007451342884451151,
0.07859588414430618,
0.1302497684955597,
0.02031996101140976
] |
Hydrolysis\tto\tform\nmononucleotides\nMononucleotides\nElastase\nFibrous\tprotein\n(elastin)\nHydrolysis\tto\tform\npeptides\tand\namino\tacids\n—\nSmall\tintestine\nenzymes\n(embedded\tin\nthe\tbrush\nborder\nmembrane)\nEnterokinase\nTrypsinogen\nActivates\ttrypsin\nDipeptides\tand\ntripeptides\nAminopeptidase\tand\ndipeptidase\t(also\nlocated\twithin\tthe\nenterocyte\tcytosol) | [
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0.032916128635406494,
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0.023586547002196312,
0.009228724054992199,
0.007278173230588436,
0.035820771008729935,
0.038783781230449677,
0.013749861158430576,
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0.12112005054950714,
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0.021770130842924118,
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0.08818324655294418,
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0.08455245196819305,
0.16975125670433044,
0.021309155970811844
] |
dipeptidase\t(also\nlocated\twithin\tthe\nenterocyte\tcytosol)\nPolypeptides\nCleavage\tof\tamino\nacids\n\tfrom\tthe\namino\tterminus\tof\nprotein\t(N-\nterminus)\tor\npeptide\tsubstrates\nAmino\tacids\nSucrase\nSucrose\nHydrolysis\tto\tform\nGlucose\tand | [
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0.010194286704063416,
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0.014902716502547264,
0.054396852850914,
0.061762675642967224,
0.04182308167219162,
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glucose\tand\nfructose\nfructose\nα-Dextrinase\n(isomaltase)\nDextrin\n(isomaltose)\nHydrolysis\tto\tform\nglucose\nGlucose\nMaltase\nMaltose\nHydrolysis\tto\tform\nglucose\nGlucose\nLactase\nLactose\nHydrolysis\tto\tform\nglucose\tand\ngalactose\nGlucose\tand\ngalactose\nNucleotidases\nNucleic\tacids\nHydrolysis\tto\tform\nnucleotides\tand\nphosphates\nNucleotides\nNucleosidase\tand | [
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] |
nucleotides\tand\nphosphates\nNucleotides\nNucleosidase\tand\nphosphorylase\nNucleosides\nHydrolysis\tto\tform\npurines,\npyrimidines,\tand\npentose\tphosphate\nPurine\tand\npyrimidine\nbases\nRegulators\tof\tgastrointestinal\tactivity:\tNeural\tand\thormonal\tmechanisms\nMultiple\tlayers\tof\tsmooth\tmuscle\tcontract\tin\tcoordinated\tpatterns\tto\toptimize\tnutrient\tdigestion | [
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along\tthe\n\tGIT.\tThese\tsmooth\tmuscle\tmovements\tare\tregulated\tby\tthe\tenteric\tnervous\tsystem\tand\nenteroendocrine\thormones\tand\tfacilitate\tmixing\tof\tchyme\tand\tdigestive\tsecretions\t(\nsegmentation\n)\nor\tpropulsion\tof\tluminal\tcontents\talong\tthe\tlength\tof\tthe\tGIT\t(\nperistalsis\n).\tTo\tenable\tsuch | [
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peristalsis\n).\tTo\tenable\tsuch\ncoordinated\tactions,\tthe\tenteric\tnervous\tsystem\tis\tintegrated\tthroughout\tthe\tlining\tof\tthe\tGIT\tand\nresponds\tto\tmucosal\treceptors\n\tthat\tsense\tthe\tcomposition\tof\tchyme\tand\tdistention\tof\tthe\tlumen\t(i.e.,\nfullness)\tand\tsend\timpulses\tthat\tcoordinate\tthe\tprocesses\tof\tdigestion,\tsecretion,\tabsorption,\tand\nimmunity. | [
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immunity.\nNeurotransmitters\tfrom\tthe\tcentral\tnervous\tsystem\tinterface\twith\tthe\tenteric\tnervous\tsystem\tto\ncoordinate\tgastrointestinal\tfunctions\tsuch\tas\tmotility,\tsecretion,\tand\tblood\tflow.\tThe\tGIT\tthen\tlargely\nregulates\tits\town\n\tmotility\tand\tsecretory\tactivity.\tHowever,\tsignals\tfrom\tthe\tcentral\tnervous\tsystem | [
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] |
can\toverride\tthe\tenteric\tsystem\tand\taffect\tGIT\tfunction.\tHormones,\tneuropeptides,\tand\nneurotransmitters\tin\tthe\tGIT\tnot\tonly\taffect\tintestinal\tfunction\tbut\talso\thave\tan\teffect\ton\tother\nnerves\tand\ttissues\tin\tmany\tparts\tof\tthe\tbody.\tSome\texamples\tof\tneurotransmitters\treleased\tfrom\nenteric\tnerve\tendings\tare\tlisted\tin\t\nTable\t1.2 | [
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0.06478393822908401,
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] |
enteric\tnerve\tendings\tare\tlisted\tin\t\nTable\t1.2\n.\tIn\tpeople\twith\tgastrointestinal\tdisease\t(e.g.,\tinfections,\ninflammatory\tbowel\tdisease,\tirritable\tbowel\tsyndrome),\tthe\tenteric\tnervous\tsystem\tmay\tbe\noverstimulated,\tresulting\tin\tabnormal\tsecretion,\taltered\tblood\tflow,\tincreased\tpermeability,\tand\naltered\timmune\tfunction.\nTABLE\t1.2 | [
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0.07538149505853653,
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] |
altered\timmune\tfunction.\nTABLE\t1.2\nExamples\tof\tNeurotransmitters\tand\tTheir\tActions\nNeurotransmitter\nSite\tof\tRelease\nPrimary\tAction\nGABA\nCentral\tnervous\tsystem\nRelaxes\tlower\tesophageal\tsphincter\nNorepinephrine\nCentral\tnervous\tsystem,\tspinal\ncord,\tsympathetic\tnerves\nDecreases\tmotility,\tincreases\tcontraction\tof\nsphincters,\tinhibits\tsecretions | [
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GI\ttract,\tspinal\tcord\nFacilitates\tsecretion\tand\tperistalsis\nNitric\toxide\nCentral\tnervous\tsystem,\tGI\ttract\nRegulates\tblood\tflow,\tmaintains\tmuscle\ttone,\nmaintains\tgastric\tmotor\tactivity\nSubstance\tP\nGut,\tcentral\tnervous\tsystem,\tskin\nIncreases\tsensory\tawareness\t(mainly\tpain),\tand\nperistalsis\n5-\nHT\n,\t5-hydroxytryptamine;\t\nGABA\n,\tα-aminobutyric\n\tacid; | [
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are\tactivated\tby\tfear,\tanger,\tand\tstress,\ttend\tto\tslow\ttransit\tof\tintestinal\tcontents\tby\tinhibiting\nneurons\taffecting\tmuscle\tcontraction\tand\tinhibiting\tsecretions.\tThe\tparasympathetic\n\tnerves\ninnervate\tspecific\tareas\tof\tthe\talimentary\ttract\tand\tcontribute\tto\tcertain\tfunctions.\tFor\texample,\tthe | [
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way\tof\tthe\tvagal\nand\tspinal\tnerves.\tInflammation,\tdysmotility,\tand\tvarious\ttypes\tof\tintestinal\tdamage\tmay\tintensify\nthese\tperceptions.\nGastrointestinal\thormones\nRegulation\tof\tthe\tGIT\tinvolves\tnumerous\thormones\tthat\tare\tsecreted\tby\tenteroendocrine\tcells | [
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cholecystokinin\t[CCK]\n\tand\tsomatostatin\tfamily)\talso\tserve\tas\tneurotransmitters\tbetween\tneurons.\nThe\tGIT\tsecretes\tmore\tthan\t30\thormone\tfamilies,\tmaking\tit\tthe\tlargest\thormone-producing\torgan\tin\nthe\tbody\t(\nRehfeld,\t2014\n).\tGastrointestinal\thormones\tare\tinvolved\tin\tinitiating\tand\tterminating | [
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Ghrelin\n,\ta\tneuropeptide\tsecreted\tfrom\tthe\tstomach,\tand\tmotilin,\na\trelated\thormone\tsecreted\tfrom\tthe\tduodenum,\tsend\ta\t“hungry”\tmessage\tto\tthe\tbrain.\tOnce\tfood\nhas\tbeen\tingested,\thormones\tPYY\t3-36,\tCCK,\tglucagon-like\tpeptide-1\t(GLP-1),\toxyntomodulin,\npancreatic\tpolypeptide,\tand\tgastrin-releasing\tpolypeptide\t(bombesin)\tsend\tsignals\tto\tdecrease | [
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hunger\tand\tincrease\tsatiety\t(\nRui,\t2013\n).\tSome\tof\tthe\tGI\thormones,\tincluding\tsome\tof\tthose\tthat\naffect\tsatiety,\talso\ttend\tto\tslow\tgastric\temptying\tand\tdecrease\tsecretions\t(e.g.,\tsomatostatin).\tOther\nGI\thormones\t(e.g.,\tmotilin)\tincrease\tmotility.\nThe\tsignaling\tagents\tof\tthe\tGIT\talso\tare\tinvolved\tin\tseveral\tmetabolic\tfunctions.\tGlucose- | [
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dependent\tinsulinotropic\tpolypeptide\t(GIP)\tand\tGLP-1\tare\tcalled\tincretin\thormones\tbecause\tthey\nhelp\n\tlower\tblood\tsugar\tby\tfacilitating\tinsulin\tsecretion,\tdecreasing\tgastric\temptying,\tand\tincreasing\nsatiety.\tSeveral\tof\tthese\thormones\tand\tanalogs\tare\tused\tin\tmanagement\tof\tobesity,\tinflammatory | [
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bowel\tdisease,\tdiarrhea,\tdiabetes,\tGI\tmalignancies,\tand\tother\tconditions.\tThis\tarea\tof\tresearch\tis\ncritically\timportant.\nSome\tfunctions\tof\tthe\thormones\tthat\taffect\tgastrointestinal\tcell\tgrowth,\tdeoxyribonucleic\n\tacid\n(DNA)\tsynthesis,\tinflammation,\tproliferation,\tsecretion,\tmovement,\tor\tmetabolism\thave\tnot\tbeen | [
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] |
are\tdependent\ton\tparenteral\tnutrition\tto\tmeet\ttheir\tnutrient\tand\tfluid\trequirements\t(\nSeidner\tet\tal,\n2013\n;\tsee\t\nChapter\t27\n).\tThe\tkey\tGIT\n\thormones\tare\tsummarized\tin\t\nTable\t1.3\n. | [
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] |
TABLE\t1.3\nFunctions\tof\tMajor\tGastrointestinal\tHormones\nHormone\nSite\tof\tRelease\nStimulants\tfor\nRelease\nOrgan\nAffected\nEffect\ton\tTarget\tOrgan\nGastrin\nG\tcells\tof\tgastric\nmucosa\tand\nduodenum\nPeptides,\tamino\nacids,\ncaffeine\nStomach,\nesophagus,\nGIT\tin\ngeneral\nStimulates\tsecretion\tof\tHCl\tand\npepsinogen\nDistention\tof\tthe\nantrum | [
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Stimulates\tsecretion\tof\tHCl\tand\npepsinogen\nDistention\tof\tthe\nantrum\nIncreases\tgastric\tantral\tmotility\nSome\talcoholic\nbeverages,\nvagus\tnerve\nIncreases\tlower\tesophageal\nsphincter\ttone\nGallbladder\nWeakly\tstimulates\tcontraction\n\tof\ngallbladder\nPancreas\nWeakly\tstimulates\tpancreatic\nsecretion\tof\tbicarbonate\nSecretin\nS\tcells\tof\tduodenum\nAcid\tin\tsmall | [
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acids,\tfats,\nHCl\nPancreas\nStimulates\tsecretion\n\tof\tpancreatic\nenzymes\nGallbladder\nCauses\tcontraction\tof\tgallbladder\nStomach\nSlows\tgastric\temptying\nColon\nIncreases\tmotility\nMay\tmediate\tfeeding\tbehavior\nGIP\nK\tcells\tof\tduodenum\nand\tjejunum\nGlucose,\tfat\nStomach\nReduced\tintestinal\tmotility\nMotilin\nM\tcells\tof\tduodenum\nand\tjejunum\nInterdigestive\nperiods, | [
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Motilin\nM\tcells\tof\tduodenum\nand\tjejunum\nInterdigestive\nperiods,\nalkaline\tpH\tin\nduodenum\nStomach,\nsmall\nbowel,\ncolon\nPromotes\tgastric\n\temptying\tand\tGI\nmotility\nGLP-1\nL\tcells\tof\tsmall\nintestine\tand\tcolon\n(density\tincreases\tin\ndistal\tGIT)\nGlucose,\tfat,\nshort-chain\nfatty\tacids\nStomach\nProlongs\tgastric\temptying\nPancreas\nInhibits\tglucagon\trelease; | [
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Stomach\nProlongs\tgastric\temptying\nPancreas\nInhibits\tglucagon\trelease;\nStimulates\tinsulin\trelease\nGLP-2\nL\tcells\tof\tsmall\nintestine\tand\tcolon\n(density\tincreases\tin\ndistal\tGIT)\nGlucose,\tfat,\nshort-chain\nfatty\tacids\nSmall\nintestine,\ncolon\nStimulates\tintestinal\n\tgrowth\tand\nnutrient\tdigestion\tand\tabsorption\nCCK\n,\tCholecystokinin;\t\nGI\n, | [
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after\ta\tmeal;\tand\t(3)\tthe\tpresence\tof\tsecretagogues\tin\tthe\tantrum,\tsuch\tas\tpartially\tdigested\nproteins,\tfermented\talcoholic\tbeverages,\tcaffeine,\tor\tfood\textracts\t(e.g.,\tbouillon).\tWhen\tthe\tlumen\ngets\tmore\tacidic,\n\tfeedback\tinvolving\tother\thormones\tinhibits\tgastrin\trelease\t(\nChu\tand\tSchubert,\n2013 | [
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small\tintestine\tinto\tthe\tbloodstream.\tIt\tis\tsecreted\tin\tresponse\tto\tgastric\tacid\tand\tdigestive\tend\nproducts\tin\tthe\tduodenum,\twherein\tit\tstimulates\tthe\tsecretion\tof\tpancreatic\tjuice\tand\tinhibits\tgastric\nacid\tsecretion\tand\temptying\t(the\topposite\tof\tgastrin).\tNeutralized\tacidity\tprotects\tthe\tduodenal | [
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mucosa\tfrom\tprolonged\texposure\tto\tacid\tand\tprovides\tthe\tappropriate\tenvironment\tfor\tintestinal\nand\n\tpancreatic\tenzyme\tactivity.\tThe\thuman\treceptor\tis\tfound\tin\tthe\tstomach\tand\tductal\tand\tacinar\ncells\tof\tthe\tpancreas.\tIn\tdifferent\tspecies,\tother\torgans\tmay\texpress\tsecretin,\tincluding\tthe\tliver,\ncolon,\theart,\tkidney,\tand\tbrain\t(\nChey\tand\tChang,\t2014 | [
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colon,\theart,\tkidney,\tand\tbrain\t(\nChey\tand\tChang,\t2014\n).\nSmall\tbowel\tmucosal\t“I”\tcells\tsecrete\t\nCCK\n,\tan\timportant\tmultifunctional\thormone\treleased\tin | [
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response\tto\tthe\tpresence\tof\tprotein\tand\tfat.\tReceptors\n\tfor\tCCK\tare\tin\tpancreatic\tacinar\tcells,\npancreatic\tislet\tcells,\tgastric\tsomatostatin-releasing\tD\tcells,\tsmooth\tmuscle\tcells\tof\tthe\tGIT,\tand\tthe\ncentral\tnervous\tsystem.\tMajor\tfunctions\tof\tCCK\tare\tto\t(1)\tstimulate\tthe\tpancreas\tto\tsecrete | [
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enzymes,\tbicarbonate,\tand\twater;\t(2)\tstimulate\tgallbladder\tcontraction;\t(3)\tincrease\tcolonic\tand\nrectal\tmotility;\t(4)\tslow\tgastric\temptying;\tand\t(5)\tincrease\tsatiety.\n\tCCK\tis\talso\twidely\tdistributed\tin\nthe\tbrain\tand\tplays\ta\trole\tin\tneuronal\tfunctioning.\nMotilin | [
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] |
malignant\tdiseases,\tas\twell\tas\tnumerous\ngastrointestinal\tdisorders\tsuch\tas\tdiarrhea,\tshort\tbowel\tsyndrome,\tpancreatitis,\tdumping\tsyndrome,\nand\tgastric\thypersecretion\t(\nVan\tOp\tden\tBosch\tet\tal,\t2009\n;\tsee\t\nChapters\t26\n\tand\t\n27\n).\nDigestion\tin\tthe\tmouth | [
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] |
;\tsee\t\nChapters\t26\n\tand\t\n27\n).\nDigestion\tin\tthe\tmouth\nIn\tthe\tmouth,\tthe\tteeth\tgrind\tand\tcrush\tfood\tinto\tsmall\tparticles.\tThe\tfood\tmass\tis\tsimultaneously\nmoistened\tand\tlubricated\tby\tsaliva.\tThree\tpairs\n\tof\tsalivary\tglands—the\tparotid,\tsubmaxillary,\tand\nsublingual\tglands—produce\tapproximately\t1.5\tL\tof\tsaliva\tdaily.\tEnzymatic\tdigestion\tof\tstarch\tand | [
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mucus,\ta\tprotein\tthat\tcauses\tparticles\tof\tfood\tto\nstick\ttogether\tand\tlubricates\tthe\tmass\tfor\tswallowing.\nThe\tmasticated\tfood\tmass,\tor\tbolus,\tis\tpassed\tback\tto\tthe\tpharynx\tunder\tvoluntary\tcontrol,\tbut\nthroughout\tthe\tesophagus,\tthe\tprocess\tof\tswallowing\t(deglutition)\tis\tinvoluntary.\tPeristalsis\tthen\nmoves\tthe\tfood\trapidly\tinto\tthe\tstomach\t(see | [
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] |
moves\tthe\tfood\trapidly\tinto\tthe\tstomach\t(see\t\nChapter\t39\n\tfor\ta\tdetailed\tdiscussion\tof\tswallowing).\nDigestion\tin\tthe\tstomach\nFood\tparticles\tare\tpropelled\tforward\tand\tmixed\twith\tgastric\tsecretions\tby\twavelike\tcontractions\tthat\nprogress\tforward\tfrom\tthe\tupper\tportion\tof\tthe\tstomach\t(fundus),\tto\tthe\tmidportion\t(corpus),\tand | [
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then\tto\tthe\tantrum\tand\tpylorus.\tIn\tthe\tstomach,\tgastric\tsecretions\tmix\twith\tfood\tand\tbeverages\nproducing\ta\tsemiliquid\tslurry\tcalled\tchyme,\twhich\tis\t50%\twater.\tAn\taverage\n\tof\t2000\tto\t2500\tmL\tof\nfluid\tis\tsecreted\tdaily\tin\tthe\tstomach.\tThese\tgastric\tsecretions\tcontain\thydrochloric\tacid\t(secreted\tby | [
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the\tparietal\tcells),\tpepsinogen,\tgastric\tlipase,\tmucus,\tintrinsic\tfactor\t(a\tglycoprotein\tthat\tfacilitates\nvitamin\tB\n12\n\tabsorption\tin\tthe\tileum),\tand\tgastrin.\tThe\tprotease,\t\npepsin\n,\tis\tsecreted\tin\tan\tinactive\nform,\tpepsinogen,\twhich\tis\tconverted\tby\thydrochloric\tacid\tto\tits\n\tactive\tform.\tPepsin\tis\tactive\tonly\tin | [
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