Top Banner
Ex Nutr c5-digestion 1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus) Storage, mixing, regulation of emptying Normally ~1.5L, up to 6L
61

Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Dec 31, 2015

Download

Documents

Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Page 1: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 1

Gastrointestinal tract

Mouth Esophagus

Esophagus sphincter Stomach

3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus) Storage, mixing, regulation of emptying Normally ~1.5L, up to 6L

Page 2: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 2

Page 3: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 3

Page 4: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 4

Page 5: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 5

Page 6: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 6

Page 7: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 7

Page 8: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 8

Small intestine Duodenum, jejunum, ileum Intestinal mucosa contains folds of Kerkring

Villi Brush border consisting of ~600 microvilli Increase surface area ~600 folds

Villi consists of a layer of epithelial cells Water, water-soluble particles, electrolytes

diffuse/transport into blood vessels hepatic portal vein liver

Water-insoluble particles lymphatic vessels large veins

Page 9: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 9

Page 10: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 10

Page 11: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 11

Page 12: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 12

Page 13: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 13

Mobility and transit time

Food spend 1-3 days in GI tract: transit time Transit time in small intestine: 3-10 hr

Mobility: movement of food of GI tract Small intestine contains 2 layers of smooth

muscle: longitudinal and circular peristalsis

Page 14: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 14

Page 15: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 15

Gastrointestinal tract

Gall bladder: store, concentrate, release bile Bile: produced by liver, contain electrolytes, bile salts,

cholesterol, lecithin, bilirubin Store 30-60 ml, release up to 1200 ml per day

Pancreas Secrete digestive enzymes, HCO3-

Ileocecal valve Large intestine

Ascending colon, transverse colon, descending colon, rectum, anal canal

Absorption of water and electrolytes, storage of feces

Page 16: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 16

Page 17: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 17

Page 18: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 18

Page 19: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 19

Page 20: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 20

Regulation of GI tract

Sympathetic and parasympathetic nerves Endocrine glands Paracrine glands/cells

Gastrin, secretin, cholecystokinin…

Page 21: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 21

Daily secretion of intestinal juices

Saliva: 1000 ml Gastric secretions: 1500 ml Pancreatic secretion: 1000 ml Bile: 1000 ml Small intestine: 2000 ml Large intestine: 200 ml Total: 6700 ml Mostly reabsorbed

Page 22: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 22

Page 23: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 23

Page 24: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 24

Page 25: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 25

Carbohydrate digestion

Saliva contains -amylase Also contains lysozymes and IgA, protect from invading

bacteria CHO digestion slow down in stomach

Inactivation of amylase by low pH 30-40% CHO digested, predominantly to

oligosaccharides Pancreas secrete -amylase to intestine

Also sucrase, lactase, maltase Bacteria in large intestine ferment cellulose (fiber)

H2, CO2, volatile fatty acids (C2, C4), methane

Page 26: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 26

Page 27: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 27

Digestion of carbohydrate

Page 28: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 28

Lipid digestion

Lingual lipase, slow, 10-30% TG digestion Pancreatic lipase in intestine

Combine with bile 膽鹽 , form micelles (disklike) 乳化 (emulsification)

Absorption through villi Bile salts emulsify lipids into small droplets,

make hydrolysis by pancreatic lipase easier Xenical 羅氏纖

Page 29: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 29

Page 30: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 30

Page 31: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 31

Digestion of fat

Page 32: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 32

Various lipoproteins

Page 33: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 33

Protein digestion

Stomach: pH ~2.0 Activate pepsin (a protease) by HCl Denature food proteins

Intestine Pancreatic proteases secreted as inactive

precursors: trypsinogen, endopeptidases, carboxypeptidases, enteropeptidases

Activated by trypsin 胰蛋白脢 Digest polypeptide into tripeptides, dipeptides,

single amino acids

Page 34: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 34

Digestion of protein

Page 35: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 35

Page 36: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 36

Page 37: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 37

Absorption of carbohydrates

Monosaccharides absorbed by carrier-mediated transport in epithelial cell Sodium cotransporter, combine with Na-K-

ATPase pump Sodium-independent facilitated-diffusion

transporter with specificity for fructose (GLUT 5)

GLUT 2 in contraluminal side

Page 38: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 38Absorption of CHO

Page 39: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 39

Page 40: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 40

Absorption of fatty acids

Monoacylglycerol, FA incorporated into micelles, transported to villi

Diffusion through epithelial membrane In epithelial cell, FA re-esterified into TG,

form chylomicrons 乳糜微粒 , transported through lymphatic system

Short- and medium-chain FA diffuse through contraluminal membrane into portal vein

bile salts reabsorbed

Page 41: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 41

Page 42: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 42

Page 43: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 43

Page 44: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 44

Absorption of amino acids

AA, dipeptides, tripeptides absorbed by sodium-dependent active transport

At least 7 different brush border-specific transport proteins for different AA

Capacity of small intestine to absorb AA is very large, <1% ingested protein in feces

Page 45: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 45

Page 46: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 46

Page 47: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 47

Absorption of water

99% water absorption in small intestine, by simple diffusion Water flow toward compartment with lower

water concentration (higher solute concentration) Osmole: number of solute particles

mOsm/kg (osmolality), mOsm/L (osmolarity) ~290 mOsm/L for most body fluids If ingested high osmolarity, water move into gut

lumen

Page 48: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 48

Page 49: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 49

Page 50: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 50

Absorption of vitamins

Mostly in small intestine via diffusion Digestion free vitamins from coenzymes Fat-soluble vitamins absorbed along with FA

Incorporated into chylomicrons Transported through lymphatic system

Water-soluble vitamins Not retained to any great extent in body

Additional vit K, B12, thiamine, riboflavin can be formed by bacteria in colon

Page 51: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 51

Page 52: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 52

Page 53: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 53

Absorption of minerals

Minerals not very well absorbed in human intestine

Absorption rate, retention rate depend on intake, storage, and requirement

Page 54: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 54

Page 55: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 55

Page 56: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 56

Regulation of gastric emptying

Gastric motility and secretion mostly automatic

Stomach signals: usually positive feedback Nervous signals from stretching and extension of

stomach wall, relax pyloric sphincter Release of gastrin

Intestinal signals: usually negative feedback Duodenum contains receptors for pH, distension

of duodenum, osmolarity

Page 57: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 57

Factors for gastric emptying Fluid volume in stomach, exponential Not affected by exercise up to 80% VO2max

Short- or long-term high intensity exercise reduce gastric emptying

High osmolarity reduce gastric emptying Not important in 200-400 mOsm/L, typical for

most sport drinks High energy density reduce gastric emptying Temperature of food usually no effect Psychological stress reduce gastric emptying

Page 58: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 58

Page 59: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 59

Page 60: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 60

Page 61: Ex Nutr c5-digestion1 Gastrointestinal tract Mouth Esophagus Esophagus sphincter Stomach 3 parts: corpus (body), antrum, fundus Pyloric sphincter (pylorus)

Ex Nutr c5-digestion 61