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11/18/15

THE GASTROINTESTINAL SYSTEM:


DIGESTION AND ABSORPTION
Irawan Yusuf
Department of Physiology

INTRODUCTION
The gastrointestinal system is the portal

through which nutrition and fluids enter the


body.
Proteins, fats, and complex carbohydrate are
broken own into absorbable units (digested),
principally in the small intestine.
The digested product cross the mucosa and
enter the blood or the lymph (absorption)
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INTRODUCTION
Digestion of major nutrient is an orderly process

involving the action of large number of digestive


enzymes.
Most substances must pass from intestinal lumen
into mucosal cells (enterocytes) and then to
intestinal fluid and then to the blood and lymph.
The transport of all molecules by diffusion,
facilitated diffusion, active transport or others
mechanisms.
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Mucosal of Small Intestine

DIGESTION AND ABSORPTION


OF CARBOHYDRATE
Principal source of calories

in the human diet


Types of carbohydrates
typically ingested
Polysaccharides
(starches, cellulose)
disaccharides (lactose,
sucrose)
Monosaccharides
(fructose, glucose)

Digestion of Carbohydrate
Salivary and pancreatic enzymes
Digestion by -amylase begins in the mouth into a
variety of oligosaccharides such as maltose,
maltotriose, malto-oligosaccharides and -dextrins

Intestinal Brush Border enzymes


isomaltase/-dextrinase debranches -limit dextrin
glucoamylase cleaves malto-oligosaccharides to
glucose
lactase cleaves lactose into glucose and galactose
sucrase cleaves sucrose into fructose and glucose
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Absorption of Carbohydrate
Small intestine brush border
Glucose and galactose are absorbed by Na+glucose transporter (SGLT)
Fructose is absorbed by glucose transporter
5 (GLUT5)

Basolateral membrane
Glucose, galactose and fructose absorbed by
glucose transporter 2 (GLUT2)
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DIGESTION AND ABSORPTION


OF PROTEINS
Proteins digested include:
ingested protein 0.5 - 0.7
gm/day/kg required
proteins in GI secretions
10-30 gm/day
proteins from shed GI
epithelial
cells
10-20
gm/day

Digestion of Proteins
Enzymes Involved in Protein Digestions
Secreted as zymogens
gastric
pancreatic

Activated after secretion


Exhibit pH optimal
acidic for gastric
alkaline for pancreatic
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Digestion of Proteins
PROTEIN DIGESTION ENZYMES
Gastric
Pepsin
secreted as pepsinogen
activated by low gastric pH
cleaves proteins to peptides and amino acids

Pancreatic
Variety of enzymes
cleave proteins to peptides

85% of protein digestion occurs in small intestine


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Digestion of Proteins
PROTEIN DIGESTION ENZYMES
Gastric
Pancreatic

trypsinogen trypsin
chymotrypsinogen chymotrypsin
procarboxypeptidase A carboxypeptidase A
procarboxypeptidase B carboxypeptidase B
proelastase elastase

Brush border peptidases

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Digestion of Proteins
BRUSH BORDER PEPTIDASES
Reduce peptides to oligopeptides and amino
acids
Present at highest levels in jejunum
Three types
Dipeptidases
Aminopeptidases
Dipeptidyl Aminopeptidases

Principal digestion products


Amino acids and di-, tri- and tetra-peptides
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Absorption of Protein
Brush border transport proteins
Amino acid transporters
Na-dependent
Na-independent
Di- and tri-peptide transporters
H+/dipeptide cotransporter
Basolateral transport proteins
Amino acid transporters
Na-dependent
Na-independent

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DIGESTION AND ABSORPTION


OF LIPIDS
Lipids in the diet
triglycerides (greatest
contribution)
sterols
sterol esters
phospholipids
Water insolubility

overcome by

emulsification
formation of micelles

Digestion of Lipids
Gastric lipase
provides small amount of hydrolysis
Pancreatic lipolytic enzymes
glycerol ester hydrolase (pancreatic lipase)
co-lipase
cholesterol ester hydrolase
phospholipase A
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Absorption of Lipids
Most occurs in duodenum and jejunum
Fat digestion products aggregate with bile acids

to form micelles
Micelles greatly increase the lipid/aqueous
interface
Small size of micelle allows diffusion among
brush border microvilli
A halo of lipid digestion products in aqueous
solution surrounds the micelle
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Absorption of Lipids
Most lipid digestion products readily diffuse

across the brush border membrane

Fatty acids
2-monoglycerides
Cholesterol
Lysophoosphatide

Microvillus

protein

membrane

fatty

acid-binding

A Na-dependent cotransporter
Transports long chain fatty acids and cholesterol

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Absorption of Lipids
Cytosolic proteins prevent lipids from

coalescing into droplets

Fatty acid binding proteins


I-FABP
long chain fatty acids

L-FABP
cholesterol, lysophosphatides and monoglycerides

Sterol carrier proteins


SCP-1 and SCP-2
bind cholesterol and other sterols

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Absorption of Lipids
Smooth ER reprocesses lipid digestion products

and reforms:

triglycerides
phospholipids
cholesterol esters

Prechylomicrons
form in SER as resynthesized lipids accumulate
Mature chylomicrons
form in Golgi and are exocytosed basolaterally
taken up by central lacteal
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