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active\tform.\tPepsin\tis\tactive\tonly\tin\nthe\tacidic\tenvironment\tof\tthe\tstomach\tand\tacts\tto\tbegin\tthe\tprocess\tof\tprotein\tdigestion.\nAn\tacid-stable\tlipase\tis\tsecreted\tinto\tthe\tstomach\tby\tchief\tcells.\tAlthough\tthis\tlipase\tis\nconsiderably\tless\tactive\tthan\tpancreatic\tlipase,\tit\tcontributes\tto\tthe\toverall\tprocessing\tof\tdietary | [
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pH\tis\tlow,\tranging\tfrom\tabout\t1\tto\t4.\tThe\tcombined\tactions\tof\thydrochloric\tacid\tand\tproteolytic\nenzymes\tresult\tin\ta\tsignificant\treduction\tin\tthe\tconcentration\tof\tviable\tmicroorganisms.\tSome\nmicrobes\tmay\tescape\tand\tenter\tthe\tintestine\tif\tconsumed\tin\tsufficient\tconcentrations\tor\tif\nachlorhydria,\tgastrectomy,\tgastrointestinal | [
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achlorhydria,\tgastrectomy,\tgastrointestinal\n\tdysfunction\tor\tdisease,\tpoor\tnutrition,\tor\tdrugs\tthat\nsuppress\tacid\tsecretions\tare\tpresent.\tThis\tmay\tincrease\tthe\trisk\tof\tpathogenic\tinfection\tin\tthe\nintestine.\nThe\tlower\tesophageal\tsphincter\t(LES),\twhich\tlies\tabove\tthe\tentrance\tto\tthe\tstomach,\tprevents | [
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reflux\tof\tgastric\tcontents\tinto\tthe\tesophagus.\tThe\tpyloric\tsphincter\tin\tthe\tdistal\tportion\tof\tthe\nstomach\thelps\tregulate\tthe\texit\tof\tgastric\n\tcontents,\tpreventing\tbackflow\tof\tchyme\tfrom\tthe\nduodenum\tinto\tthe\tstomach.\tObesity,\tcertain\tfood,\tgastrointestinal\tregulators,\tand\tirritation\tfrom | [
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nearby\tulcers\tmay\talter\tthe\tperformance\tof\tsphincters.\tCertain\tfoods\tand\tbeverages\tmay\talter\tLES\npressure,\tpermitting\treflux\tof\tstomach\tcontents\tback\tinto\tthe\tesophagus\t(see\t\nChapter\t26\n).\nThe\tstomach\tcontinuously\tmixes\tand\tchurns\tfood\tand\tnormally\treleases\n\tthe\tmixture\tin\tsmall | [
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stomach\tdepends\ton\tthe\toverall\tvolume\tand\tcharacteristics\tof\tthe\tfoods.\tLiquids\tempty\tmore\trapidly\nthan\tsolids,\tlarge\tparticles\tempty\tmore\n\tslowly\tthan\tsmall\tparticles,\tand\tenergy-dense\tfoods\tempty\nmore\tslowly\tthan\tthose\tcontaining\tless\tenergy.\tThese\tfactors\tare\timportant\tconsiderations\tfor | [
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] |
practitioners\twho\tcounsel\tpatients\twith\tnausea,\tvomiting,\tdiabetic\tgastroparesis,\tor\tweight\nmanagement\tconcerns\t(see\t\nChapters\t26\n\tand\t\n20\n). | [
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Digestion\tin\tthe\tsmall\tintestine\nThe\tsmall\tintestine\tis\tthe\tprimary\tsite\tfor\tdigestion\tof\tfoods\tand\tnutrients.\n\tThe\tsmall\tintestine\tis\ndivided\tinto\tthe\tduodenum,\tthe\tjejunum,\tand\tthe\tileum\t(see\t\nFig.\t1.2\n).\tThe\tduodenum\tis\napproximately\t0.5\tm\tlong,\tthe\tjejunum\tis\t2\tto\t3\tm,\tand\tthe\tileum\tis\t3\tto\t4\tm.\tMost\tof\tthe\tdigestive | [
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process\tis\tcompleted\tin\tthe\tduodenum\tand\tupper\tjejunum,\tand\tthe\tabsorption\tof\tmost\tnutrients\tis\nlargely\tcomplete\tby\tthe\ttime\tthe\tmaterial\treaches\tthe\tmiddle\tof\tthe\tjejunum.\tThe\tacidic\tchyme\n\tfrom\nthe\tstomach\tenters\tthe\tduodenum,\twhere\tit\tis\tmixed\twith\tsecretions\tfrom\tthe\tpancreas,\tgallbladder, | [
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and\tduodenal\tepithelium.\tThe\tsodium\tbicarbonate\tcontained\twithin\tthese\tsecretions\tneutralizes\tthe\nacidic\tchyme\tand\tallows\tthe\tdigestive\tenzymes\tto\twork\tmore\teffectively\tat\tthis\tlocation.\nThe\tentry\tof\tpartially\tdigested\tfoods,\tprimarily\tfats\tand\tprotein,\tstimulates\tthe\trelease\tof\tCCK,\nsecretin, | [
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secretin,\n\tand\tGIP,\twhich,\tin\tturn,\tstimulate\tthe\tsecretion\tof\tenzymes\tand\tfluids\tand\taffect\ngastrointestinal\tmotility\tand\tsatiety.\tBile,\twhich\tis\tpredominantly\ta\tmixture\tof\twater,\tbile\tsalts,\tand\nsmall\tamounts\tof\tpigments\tand\tcholesterol,\tis\tsecreted\tfrom\tthe\tliver\tand\tgallbladder.\tThrough\ttheir | [
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the\tregulation\tof\tenergy\tmetabolism\t(\nHylemon\tet\tal,\t2009\n).\tFurthermore,\tbile\tacids\tplay\tan\nimportant\trole\tin\thunger\tand\tsatiety.\nThe\tpancreas\tsecretes\tpotent\tenzymes\tcapable\tof\tdigesting\tall\tof\tthe\tmajor\tnutrients,\n\tand\tenzymes\nfrom\tthe\tsmall\tintestine\thelp\tcomplete\tthe\tprocess.\tThe\tprimary\tlipid-digesting\tenzymes\tsecreted\tby\nthe\tpancreas\tare | [
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Intestinal\tcontents\tmove\talong\tthe\tsmall\tintestine\tat\ta\trate\tof\tapproximately\t1\tcm\tper\tminute,\ntaking\tfrom\t3\tto\t8\thours\tto\ttravel\tthrough\tthe\tentire\tintestine\tto\tthe\tileocecal\tvalve;\talong\tthe\tway,\nremaining\tsubstrates\tcontinue\tto\tbe\n\tdigested\tand\tabsorbed.\tThe\tileocecal\tvalve,\tlike\tthe\tpyloric | [
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absorptive\tarea.\tThe\tsurface\tarea\tis\tattributable\tto\tits\textensive\tlength,\tas\twell\tas\tto\tthe\norganization\tof\tthe\tmucosal\tlining,\twherein\tthere\tare\tcharacteristic\tfolds\tin\tits\tmucosal\tsurface\tthat\nare\tcovered\twith\tfingerlike\n\tprojections\tcalled\tvilli\tand\tinvaginations\tcalled\tcrypts\t(see\t\nFig.\t1.2\n). | [
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Fig.\t1.2\n).\nEnterocytes,\ta\tcell\ttype\tthat\tdoes\tmuch\tof\tthe\tdigestion\tand\tabsorption\tare\tcovered\tby\tmicrovilli,\tor\nthe\t\nbrush\tborder\tmembrane\n,\twhich\tincreases\tthe\tsurface\tarea\teven\tfurther.\tThe\tcombination\tof\nfolds,\tthe\tcrypt-villus\taxis,\tand\tthe\tbrush\tborder\tmembrane\tcreates\tan\tenormous\tabsorptive\tsurface\nof\tapproximately\t200\tto\t300\tm\n2 | [
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Each\tday,\ton\taverage,\tthe\tsmall\tintestine\tabsorbs\t150\tto\t300\tg\tof\tmonosaccharides,\t60\tto\t100\tg\tof\nfatty\tacids,\t60\tto\t120\tg\tof\tamino\tacids\n\tand\tpeptides,\tand\t50\tto\t100\tg\tof\tions.\tThe\tcapacity\tfor\nabsorption\tin\tthe\thealthy\tindividual\tfar\texceeds\tthe\tnormal\tmacronutrient\tand\tenergy\trequirements. | [
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Approximately\t95%\tof\tthe\tbile\tsalts\tsecreted\tfrom\tthe\tliver\tand\tgallbladder\tare\treabsorbed\tas\tbile\nacids\tin\tthe\tdistal\tileum.\tWithout\trecycling\tbile\tacids\tfrom\tthe\tGIT\t(enterohepatic\tcirculation),\nsynthesis\tof\tnew\tbile\tacids\tin\tthe\tliver\twould\n\tnot\tkeep\tpace\twith\tneeds\tfor\tadequate\tdigestion.\tBile | [
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not\tkeep\tpace\twith\tneeds\tfor\tadequate\tdigestion.\tBile\nsalt\tinsufficiency\tbecomes\tclinically\timportant\tin\tpatients\twho\thave\tresections\tof\tthe\tdistal\tsmall\nbowel\tand\tdiseases\taffecting\tthe\tsmall\tintestine,\tsuch\tas\tCrohn’s\tdisease,\tradiation\tenteritis,\tand\ncystic\tfibrosis.\tThe\tdistal\tileum\tis\talso\tthe\tsite\tfor\tvitamin\tB\n12 | [
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does\tnot\trequire\tenergy,\tand\tnutrients\tmove\tfrom\ta\tlocation\tof\thigh\nconcentration\tto\tlow\tconcentration.\tWith\tpassive\ttransport\ta\ttransport\tprotein\tmay\tor\tmay\tnot\tbe\ninvolved.\tIf\tthe\tnutrient\tmoves\tthrough\tthe\tbrush\tborder\tmembrane\twithout\ta\ttransport\tprotein,\tthis\nis\ttermed\t\npassive\tdiffusion\n,\tor\tsimple\tpassive\ttransport.\tHowever,\tin\tcases\tin | [
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passive\tdiffusion\n,\tor\tsimple\tpassive\ttransport.\tHowever,\tin\tcases\tin\n\twhich\ta\ttransport\nprotein\tassists\tthe\tpassage\tof\tthe\tnutrient\tacross\tthe\tbrush\tborder\tmembrane,\tthis\tprocess\tis\ttermed\nfacilitated\tdiffusion\n\t(\nFig.\t1.4\n). | [
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FIG.\t1.4\nTransport\tpathways\tthrough\tthe\tcell\tmembrane,\tas\twell\tas\tbasic\ttransport\tmechanisms.\t\nATP,\nAdenosine\ttriphosphate.\nActive\ttransport\n\tis\tthe\tmovement\tof\tmolecules\tacross\tcell\tmembranes\tin\tthe\tdirection\tagainst\ntheir\tconcentration\tgradient\tand\ttherefore\trequires\ta\ttransporter\tprotein\tand\tenergy\tin\tthe\tform\tof | [
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] |
ATP.\tSome\tnutrients\tmay\tshare\tthe\tsame\ttransporter\tand\tthus\tcompete\tfor\tabsorption.\n\tTransport\tor\ncarrier\tsystems\talso\tcan\tbecome\tsaturated,\tslowing\tthe\tabsorption\tof\tthe\tnutrient.\tA\tnotable\nexample\tof\tsuch\ta\tcarrier\tis\tintrinsic\tfactor,\twhich\tis\tresponsible\tfor\tthe\tabsorption\tof\tvitamin\tB\n12\n(see\t\nChapter\t26\n).\nThe\tlarge\tintestine | [
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] |
12\n(see\t\nChapter\t26\n).\nThe\tlarge\tintestine\nThe\tlarge\tintestine\tis\tapproximately\t1.5\tm\tlong\tand\tconsists\tof\tthe\tcecum,\tcolon,\trectum,\tand\tanal\ntract.\tMucus\tsecreted\tby\tthe\tmucosa\tof\tthe\tlarge\n\tintestine\tprotects\tthe\tintestinal\twall\tfrom\nexcoriation\tand\tbacterial\tactivity\tand\tprovides\tthe\tmedium\tfor\tbinding\tthe\tfeces\ttogether. | [
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residues.\tColonic\tcontents\tmove\tforward\tslowly\tat\ta\trate\tof\t5\tcm/h,\tand\tsome\tremaining\tnutrients\nmay\n\tbe\tabsorbed.\nDefecation,\tor\texpulsion\tof\tfeces\tthrough\tthe\trectum\tand\tanus,\toccurs\twith\tvarying\tfrequency,\nranging\tfrom\tthree\ttimes\tdaily\tto\tonce\tevery\t3\tor\tmore\tdays.\tAverage\tstool\tweight\tranges\tfrom\t100 | [
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The\tintestinal\t\nmicrobiota\n,\talso\tcalled\tthe\t\nmicrobiome\n,\tis\ta\tdynamic\tmixture\tof\tessential\tmicrobes\nthat\tdevelops\tunder\tkey\tinfluences\tof\tgenetics,\tenvironment,\tdiet,\tand\tdisease.\tBacterial\tpopulation\nprofiles\tdiffer\talong\tthe\tgastrointestinal\ttract,\tfrom\tthe\tlumen\tto\tthe\tmucosa,\tand\tamong\tindividuals. | [
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control\tof\tepithelial\tcell\tproliferation\tand\tdifferentiation,\t(3)\tproduction\tof\tessential\tmucosal\nnutrients,\tsuch\tas\tshort-chain\tfatty\tacids\tand\tamino\tacids,\t(4)\tprevention\tof\tovergrowth\tof\npathogenic\torganisms,\n\t(5)\tstimulation\tof\tintestinal\timmunity,\tand\t(6)\tdevelopment\tof\tthe\tgut-brain\naxis\t(\nKostic\tet\tal,\t2014\n;\tsee\t\nChapter\t40 | [
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axis\t(\nKostic\tet\tal,\t2014\n;\tsee\t\nChapter\t40\n).\tReduced\tabundance\tor\tchanges\tin\tthe\trelative\tproportions\nof\tthese\tbeneficial\tbacteria,\ta\tstate\tcalled\t\ndysbiosis\n,\tis\tassociated\twith\tvarious\tdiseases\tin\tboth\nchildren\tand\tadults\t(\nBuccigrossi\tet\tal,\t2013\n;\t\nFig.\t1.5\n). | [
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FIG.\t1.5\nFactors\taffecting\tstability\tand\tcomplexity\tof\tintestinal\tmicrobiota\tin\thealth\tand\tdisease.\n\t\nSource:\n(Redrawn\tfrom\tKostic\tAD\tet\tal:\tThe\tmicrobiome\tin\tinflammatory\tbowel\tdisease:\tcurrent\tstatus\tand\tthe\tfuture\tahead,\nGastroenterology\n\t146:1489,\t2014.) | [
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Gastroenterology\n\t146:1489,\t2014.)\nNormally,\trelatively\tfew\tbacteria\tremain\tin\tthe\tstomach\tand\tproximal\tsmall\tintestine\tafter\tmeals\nbecause\tbile,\thydrochloric\tacid,\tand\tpepsin\n\twork\tas\tgermicides.\tHowever,\tdecreased\tgastric\nsecretions\tcan\tincrease\tthe\trisk\tof\tinflammation\tof\tthe\tgastric\tmucosa\t(gastritis),\tincrease\tthe\trisk\tof | [
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] |
bacterial\tovergrowth\tin\tthe\tsmall\tintestine,\tor\tincrease\tthe\tnumbers\tof\tmicrobes\treaching\tthe\tcolon.\nAn\tacid-tolerant\tbacterium\tis\tknown\tto\tinfect\tthe\tstomach\t(Helicobacter\tpylori)\tand\tmay\tcause\ngastritis\tand\tulceration\tin\tthe\thost\t(see\t\nChapter\t26\n). | [
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gastritis\tand\tulceration\tin\tthe\thost\t(see\t\nChapter\t26\n).\nBacterial\tabundance\tis\tthe\tgreatest\tand\taction\tis\tmost\tintense\tin\tthe\tdistal\tsmall\tintestine\tand\tthe\nlarge\tintestine.\tAfter\ta\tmeal,\tdietary\tfiber,\tresistant\tstarches,\tremaining\tparts\tof\tamino\tacids,\tand\nmucus\tsloughed\tfrom\tthe\tintestine\tare\tfermented\tby\tthe\tmicrobes\tpresent.\tThis\tprocess\tof | [
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fermentation\tproduces\tgases\t(e.g.,\thydrogen,\tcarbon\tdioxide,\tnitrogen,\tand,\tin\tsome\tindividuals,\nmethane)\n\tand\tSCFAs\t(e.g.,\tacetic,\tpropionic,\tbutyric,\tand\tsome\tlactic\tacids).\tDuring\tthe\tprocess,\nseveral\tnutrients\tare\tformed\tby\tbacterial\tsynthesis,\tsuch\tas\tvitamin\tK,\tvitamin\tB\n12\n,\tthiamin,\tand\nriboflavin. | [
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12\n,\tthiamin,\tand\nriboflavin.\nStrategies\tto\tstabilize\tand\tfortify\tthe\tbeneficial\tmicrobes\twithin\tthe\tmicrobiota\tin\tan\tattempt\tto\nmaintain\tor\timprove\thealth\tinclude\tthe\tconsumption\tof\tprebiotics,\tprobiotics,\tand\tsynbiotics.\nProbiotics\n\tare\tlive\tmicroorganisms,\twhich,\twhen\tadministered\tin\tadequate\tamounts,\tprovide\ta | [
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health\tbenefit\tto\tthe\thost.\tProbiotics\tcan\tbe\tfound\twithin\tfermented\tfood\tproducts\t(such\tas\tyogurt,\nmiso,\tor\tsauerkraut)\tor\tas\ta\tnutritional\tsupplement\t(\nHill\tet\tal,\t2014\n).\tKnowledge\tof\ttheir\trole\tin\npreventing\tand\ttreating\ta\thost\tof\tgastrointestinal\tand\tsystemic\tdisorders\thas\texpanded\ntremendously\tin\trecent\tyears\t(\nFloch,\t2018 | [
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tremendously\tin\trecent\tyears\t(\nFloch,\t2018\n).\tHowever,\twhen\trecommending\ta\tprobiotic,\tpractitioners\nmust\tensure\tthat\tthe\tspecific\tmicrobial\tspecies\thas\tbeen\tshown\tin\tproperly\tcontrolled\tstudies\tto\nprovide\tbenefits\tto\thealth\t(see\t\nChapter\t11\n).\nPrebiotics\n\tare\tnondigestible\tfood\tingredients\tthat\tact\tas\ta\tsubstrate\tthat\tis\tselectively\tutilized\tby | [
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host\tmicroorganisms\tconferring\ta\thealth\tbenefit.\tPrebiotics\ttypically\trequire\tthe\tfollowing\tthree\nattributes\tto\tbenefit\t“beneficial”\tmicrobes,\tsuch\tas\t\nLactobacilli\n\tand\t\nBifidobacteria\n\tspp.:\t(1)\tbe\table\tto\nescape\tdigestion\tin\tthe\tupper\tGIT,\t(2)\tbe\table\tto\tbe\tfermented\tby\tthe\tmicrobiota\tto\tSCFA(s),\tand\t(3) | [
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chicory,\tJerusalem\tartichokes,\tsoybeans,\tand\twheat\tbran.\tStrong\tevidence\texists\tthat\tconsumption\tof\nspecific\tprebiotics\tbenefits\tthe\tGIT\tincluding\tinhibition\tof\tpathogens\tand\timmune\tstimulation,\ncardiometabolic\tsupport\t(e.g.,\treduction\tin\tblood\tlipid\tlevels,\teffects\tupon\tinsulin\tresistance),\n\tmental | [
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mental\nhealth\tbenefits\t(e.g.,\tmetabolites\tthat\tinfluence\tbrain\tfunction,\tenergy,\tand\tcognition)\tand\tbone\nhealth\t(e.g.,\tmineral\tbioavailability)\t(\nGibson\tet\tal,\t2017\n).\nSynbiotics\n\tare\ta\tsynergistic\tcombination\tof\tboth\tprobiotics\tand\tprebiotics\tin\tthe\tsame\tfood\tor\nsupplement. | [
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supplement.\nColonic\tsalvage\tof\tmalabsorbed\tenergy\tsources\tand\tshort-chain\tfatty\tacids\nNormally,\tvarying\tamounts\tof\tsome\tsmall-molecular-weight\n\tcarbohydrates\tand\tamino\tacids\tremain\tin\nthe\tchyme\tafter\tleaving\tthe\tsmall\tintestine.\tAccumulation\tof\tthese\tsmall\tmolecules\tcould\tbecome | [
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Digestion\tand\tabsorption\tof\tspecific\ttypes\tof\tnutrients\nCarbohydrates\n\tand\tfiber\nMost\tdietary\tcarbohydrates\tare\tconsumed\tin\tthe\tform\tof\tstarches,\tdisaccharides,\tand\nmonosaccharides.\tStarches,\tor\tpolysaccharides,\tusually\tmake\tup\tthe\tgreatest\tproportion\tof\ncarbohydrates.\tStarches\tare\tlarge\tmolecules\tcomposed\tof\tstraight\tor\tbranched\tchains\tof\tsugar | [
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the\tdigestive\taction\tby\thydrolyzing\ta\tsmall\tamount\tof\tthe\tstarch\tmolecules\tinto\tsmaller\tfragments\n(\nFig.\t1.6\n).\tAmylase\tdeactivates\tafter\tcontact\twith\thydrochloric\tacid.\tIf\tdigestible\tcarbohydrates\nremained\tin\tthe\tstomach\tlong\tenough,\tacid\thydrolysis\tcould\teventually\treduce\tmost\tof\tthem\tinto | [
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] |
monosaccharides.\tHowever,\tthe\tstomach\tusually\tempties\tbefore\tsignificant\tdigestion\tcan\ttake\tplace.\nBy\tfar,\tmost\tcarbohydrate\tdigestion\toccurs\tin\tthe\tproximal\tsmall\tintestine.\nFIG.\t1.6\nThe\tgradual\tbreakdown\tof\tlarge\tstarch\tmolecules\tinto\tglucose\tby\tdigestion\tenzymes. | [
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] |
monosaccharides.\tFor\n\texample,\t\nmaltase\n\tlocated\tat\tthe\tenterocyte\tbrush\tborder\tmembrane\tbreaks\ndown\tthe\tdisaccharide\tmaltose\tinto\ttwo\tmolecules\tof\tglucose.\tThe\tbrush\tborder\tmembrane\talso\ncontains\tthe\tenzymes\t\nsucrase\n,\t\nlactase\n,\tand\t\nisomaltase\n,\twhich\tact\ton\tsucrose,\tlactose,\tand\nisomaltose,\trespectively\t(\nFig.\t1.7\n). | [
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] |
FIG.\t1.7\nStarch,\tsucrose,\tmaltotriose,\tand\tgalactose\tare\tdigested\tto\ttheir\tconstituent\tsugars.\tGlucose\tand\ngalactose\tare\ttransported\tthrough\tthe\tapical\tbrush\tborder\tmembrane\tof\tthe\tenterocyte\tby\ta\tsodium-\ndependent\ttransporter,\tglucose\t(galactose)\tcotransporter;\tfructose\tis\ttransported\tby\tglucose\ttransporter\t5 | [
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(GLUT5).\tGlucose,\tfructose,\tand\tgalactose\tare\ttransported\tacross\tthe\tserosal\tmembrane\n\tby\tthe\tsodium-\nindependent\ttransporter,\tGLUT2.\nThe\tresultant\tmonosaccharides\t(i.e.,\tglucose,\tgalactose,\tand\tfructose)\tpass\tthrough\tthe\nenterocytes\tand\tinto\tthe\tbloodstream\tvia\tthe\tcapillaries\tof\tthe\tvilli,\twhere\tthey\tare\tcarried\tby\tthe | [
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portal\tvein\tto\tthe\tliver.\tAt\tlow\tconcentrations,\tglucose\tand\tgalactose\tare\tabsorbed\tby\tactive\ntransport,\tprimarily\tby\ta\tsodium-dependent\tactive\ttransporter\tcalled\n\tthe\tsodium-glucose\ncotransporter\t(SGLT1).\tAt\thigher\tluminal\tconcentrations\tof\tglucose,\tthe\tfacilitative\ttransporter | [
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GLUT2\tbecomes\ta\tprimary\troute\tfor\ttransport\tof\tglucose\tfrom\tthe\tlumen\tinto\tthe\tenterocyte.\nFructose\tis\tabsorbed\tfrom\tthe\tintestinal\tlumen\tacross\tthe\tbrush\tborder\tmembrane\tusing\tthe\nfacilitative\ttransporter,\tGLUT5.\tAll\tthree\tmonosaccharides—glucose,\tgalactose,\tand\tfructose—exit | [
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the\tbasolateral\tmembrane\tof\tthe\tenterocyte\tinto\tportal\tcirculation\tusing\tthe\tfacilitative\ttransporter,\nGLUT2.\nThe\tactive\ttransporter,\tSGLT1,\tis\tkey\tto\tthe\tability\tof\tthe\tsmall\tintestine\tto\tabsorb\t7\tL\tof\tfluid\teach\nday\tand\tprovides\tthe\tbasis\tfor\twhy\toral\trehydration\tsolutions,\trather\tthan\twater\tor\tsugary\tdrinks, | [
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often\tinclude\tboth\tsugar\tand\tsalt,\tin\taddition\tto\twater.\nSome\tforms\tof\tcarbohydrates\t(i.e.,\tcellulose,\themicellulose,\tpectin,\tgum,\tand\tother\tforms\tof\tfiber)\ncannot\tbe\tdigested\tby\thumans\tbecause\tneither\tsalivary\tnor\tpancreatic\tamylase\thas\tthe\tability\tto | [
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split\tthe\tlinkages\tconnecting\tthe\tconstituent\tsugars.\tThese\tcarbohydrates\tpass\trelatively\tunchanged\ninto\tthe\tcolon,\twhere\tthey\tare\tpartially\tfermented\n\tby\tbacteria\tin\tthe\tcolon.\tHowever,\tunlike\thumans,\ncows\tand\tother\truminants\tcan\tsubsist\ton\thigh-fiber\tfood\tbecause\tof\tthe\tbacterial\tdigestion\tof\tthese | [
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are\tformed.\nProteolytic\tpeptidases\tlocated\ton\tthe\tbrush\tborder\talso\tact\ton\tpolypeptides,\tbreaking\tthem\tdown\ninto\tamino\tacids,\tdipeptides,\tand\ttripeptides.\tThe\tfinal\tphase\tof\tprotein\tdigestion\ttakes\tplace\tin\tthe\nbrush\tborder,\twhere\tsome\tof\tthe\tdipeptides\tand\ttripeptides\tare\thydrolyzed\tinto\ttheir\tconstituent\namino\tacids\tby\n\tpeptide\thydrolases. | [
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transporters\tare\tsodium\tor\tchloride\tdependent,\tand\tsome\tare\tnot.\tConsiderable\tamounts\tof\ndipeptides\n\tand\ttripeptides\talso\tare\tabsorbed\tinto\tintestinal\tcells\tusing\ta\tpeptide\ttransporter,\ta\tform\nof\tactive\ttransport\t(\nWuensch\tet\tal,\t2013\n).\tAbsorbed\tpeptides\tand\tamino\tacids\tare\ttransported\tto\tthe | [
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).\tAbsorbed\tpeptides\tand\tamino\tacids\tare\ttransported\tto\tthe\nliver\tvia\tthe\tportal\tvein\tfor\tmetabolism\tby\tthe\tliver\tand\tare\treleased\tinto\tthe\tgeneral\tcirculation.\nThe\tpresence\tof\tantibodies\tto\tmany\tfood\tproteins\tin\tthe\tcirculation\tof\thealthy\tindividuals\tindicates\nthat | [
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that\n\timmunologically\tsignificant\tamounts\tof\tlarge\tintact\tpeptides\tescape\thydrolysis\tand\tcan\tenter\nthe\tportal\tcirculation.\tThe\texact\tmechanisms\tthat\tcause\ta\tfood\tto\tbecome\tan\tallergen\tare\tnot\nentirely\tclear,\tbut\tthese\tfoods\ttend\tto\tbe\thigh\tin\tprotein,\tto\tbe\trelatively\tresistant\tto\tcomplete\ndigestion,\tand\tto\tproduce\tan\timmunoglobulin\tresponse\t(see | [
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digestion,\tand\tto\tproduce\tan\timmunoglobulin\tresponse\t(see\t\nChapter\t25\n).\tWith\tnew\ttechnology,\tit\tis\npossible\tto\tmap\n\tand\tcharacterize\tallergenic\tpeptides;\tthis\teventually\twill\tlead\tto\tbetter\tdiagnosis\tand\ndevelopment\tof\tsafe\timmunotherapy\ttreatments\t(\nMelioli\tet\tal,\t2014\n). | [
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development\tof\tsafe\timmunotherapy\ttreatments\t(\nMelioli\tet\tal,\t2014\n).\nAlmost\tall\tprotein\tis\tabsorbed\tby\tthe\ttime\tit\treaches\tthe\tend\tof\tthe\tjejunum,\tand\tonly\t1%\tof\ningested\tprotein\tis\tfound\tin\tthe\tfeces.\tSmall\tamounts\tof\tamino\tacids\tmay\tremain\tin\tthe\tepithelial\ncells\tand\tare\tused\tfor\tsynthesis\tof\tnew\tproteins, | [
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and\tin\tthe\tstomach\tfrom\tthe\taction\tof\tgastric\tlipase.\t\nGastric\tlipase\n\thydrolyzes\tsome\ttriglycerides,\nespecially\tshort-chain\ttriglycerides\t(such\tas\n\tthose\tfound\tin\tbutter),\tinto\tfatty\tacids\tand\tglycerol.\nHowever,\tmost\tfat\tdigestion\ttakes\tplace\tin\tthe\tsmall\tintestine\tas\ta\tresult\tof\tthe\temulsifying\taction\tof | [
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bile\tsalts\tand\thydrolysis\tby\tpancreatic\tlipase.\tAs\tin\tthe\tcase\tof\tcarbohydrates\tand\tprotein,\tthe\ncapacity\tfor\tdigestion\tand\tabsorption\tof\tdietary\tfat\tis\tin\texcess\tof\tordinary\tneeds.\nEntrance\tof\tfat\tand\tprotein\tinto\tthe\tsmall\tintestine\tstimulates\n\tthe\trelease\tof\tCCK,\tsecretin,\tand | [
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chenodeoxycholic\tacids\twith\tglycine\tor\ttaurine),\tbile\tpigments\t(which\tcolor\tthe\tfeces),\tinorganic\nsalts,\tsome\tprotein,\tcholesterol,\n\tlecithin,\tand\tmany\tcompounds\tsuch\tas\tdetoxified\tdrugs\tthat\tare\nmetabolized\tand\tsecreted\tby\tthe\tliver.\tFrom\tits\tstorage\torgan,\tthe\tgallbladder,\tapproximately\t1\tL\tof | [
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