General Principles of Digestion and Metabolism
The Process of Digestion
1. Digestion - large food molecules are broken
down to smaller molecules, both mechanically
and chemically
a. Mechanical digestion involves the
physical breakdown of food but does not
alter its chemical makeup.
b. Chemical digestion is a complex process
that reduces food into its chemical
building blocks, which are then
absorbed to nourish the cells of the
body.
2. Absorption - process of transporting these
smaller molecules across the intestinal wall
3. Elimination - undigested portions of food and
waste products are removed from the body
Fi
gure 1. Digestion and Absorption. Digestion
begins in the mouth and continues as food
travels through the small intestine. Most
absorption occurs in the small intestine.
Chemical Digestion
Large food molecules (for example, proteins, lipids,
and starches) must be broken down into subunits
that are small enough to be absorbed by the lining of
the alimentary canal. This is accomplished by
enzymes through hydrolysis. The many enzymes
involved in chemical digestion are summarized
below.
Enzymes from the salivary glands (salivary amylase)
attack carbohydrates (and fats in some species);
enzymes from the stomach (pepsin and gastric
lipase) attack proteins and fats; and enzymes from
the exocrine portion of the pancreas (pancreatic
amylase, protease and pancreatic lipase) attack
carbohydrates, proteins, lipids, DNA, and RNA.
Other enzymes that complete the digestive process
are found in the luminal membranes and the
cytoplasm of the cells that line the small intestine.
The action of the enzymes is aided by the
hydrochloric acid secreted by the stomach and the
bile secreted by the liver.
Carbohydrate Digestion
Three monosaccharides commonly consumed
and readily absorbed: glucose, galactose, and fructose.
Disaccharide sucrose, lactose, and maltose and the
polysaccharides glycogen and starch (chains of
monosaccharides) are also broken down by the body.
Your bodies do not produce enzymes that can break
down most fibrous polysaccharides, such as cellulose.
While indigestible polysaccharides do not provide any
nutritional value, they do provide dietary fiber, which
helps propel food through the alimentary canal.
The chemical digestion of starches begins in the
mouth. In the small intestine, pancreatic amylase does
the ‘heavy lifting’ for starch and carbohydrate digestion.
After amylases break down starch into smaller 2
fragments, the brush border enzyme α-dextrinase starts
working on α-dextrin (breakdown product of starch),
breaking off one glucose unit at a time. Three brush
border enzymes hydrolyze sucrose, lactose, and maltose
into monosaccharides.
Figure 2. Carbohydrate Digestion Flow Chart.
Carbohydrates are broken down into their monomers in a
series of steps
Protein Digestion
Proteins are polymers
composed of amino acids
linked by peptide bonds to
form long chains. Digestion
reduces them to their
constituent amino acids. You
usually consume about 15 to 20
percent of your total calorie
intake as protein.
The digestion of
protein starts in the stomach,
where HCl and pepsin break
proteins into smaller
polypeptides, which then travel
to the small intestine (Figure
3). Chemical digestion in the
small intestine is continued by pancreatic enzymes,
including chymotrypsin and trypsin, each of which act
on specific bonds in amino acid sequences. At the same
time, the cells of the brush border secrete enzymes such
as aminopeptidase and dipeptidase, which further
break down peptide chains. This results in molecules
small enough to enter the bloodstream.
Figure 3. Digestion of Protein. The digestion of protein
begins in the stomach and is completed in the small
intestine.
Lipid Digestion
A healthy diet limits lipid intake to 35 percent of
total calorie intake. The most common dietary lipids are
triglycerides, which are made up of a glycerol molecule
bound to three fatty acid chains. Small amounts of
dietary cholesterol and phospholipids are also consumed.
The three lipases responsible for lipid digestion are
lingual lipase, gastric lipase, and pancreatic lipase.
However, because the pancreas is the only consequential
source of lipase, virtually all lipid digestion occurs in the
small intestine. Pancreatic lipase breaks down each
triglyceride into two free fatty acids and a
monoglyceride. The fatty acids include both short-chain
(less than 10 to 12 carbons) and long-chain fatty acids.
Nucleic Acid Digestion
The nucleic acids DNA and RNA are found in most of
the foods you eat. Two types of pancreatic nuclease are
responsible for their digestion: deoxyribonuclease,
which digests DNA, and ribonuclease, which digests
RNA. The nucleotides produced by this digestion are
further broken down by two intestinal brush border
enzymes (nucleosidase and phosphatase) into pentoses,
phosphates, and nitrogenous bases, which can be
absorbed through the alimentary canal wall. The large
food molecules that must be broken down into subunits
are summarized  - is defined as the process of solute movement
Absorbable Food Substances (Table 9)
Source & Substance
Carbohydrates Monosaccharides: glucose,
galactose, and fructose
Proteins Single amino acids, dipeptides, and
tripeptides
Triglycerides Monoacylglycerides, glycerol, and
free fatty acids
Nucleic acids Pentose sugars, phosphates, and
nitrogenous bases
Absorption
The mechanical and digestive processes have
one goal: to convert food into molecules small enough to
be absorbed by the epithelial cells of the intestinal villi.
Almost all ingested food, 80 percent of
electrolytes, and 90 percent of water are absorbed in the
small intestine. Although the entire small intestine is
involved in the absorption of water and lipids, most
absorption of carbohydrates and proteins occurs in the
jejunum. Notably, bile salts and vitamin B 12 are
absorbed in the terminal ileum. By the time chyme
passes from the ileum into the large intestine, it is
essentially indigestible food residue (mainly plant fibers
like cellulose), some water, and millions of bacteria
Fig 5 .Digestive Secretions and Absorption of Water.
Absorption is a complex process, in which nutrients
from digested food are harvested.
Absorption is achieved by the following mechanisms.
1. Active transport
- may be defined as the process of solute
movement from the lower concentration to the
higher concentration by the expense of energy.
Electrolytes like Na ions are absorbed by active
transport into the blood.
2. Facilitated transport.
- is defined as the process of movement of solutes
across the biological membrane with the help of
specific carrier proteins. Some digested amino
acids and glucose are absorbed into the blood by
this method.
3. Passive transport.
across a cell membrane without a requirement of
energy. After digestion, simpler food substance
is absorbed into the blood by passive transport.
Some digested products from fats cannot be absorbed
into the blood. Example: Fatty acids and glycerol. These
components attach to micelles which are small droplets
and form the micelle-component complex. This micelle
– component complexes are re-formed into
chylomicrons. Chylomicrons are a small protein coated
fat globules. Then, chylomicrons move into the4 lymph
vessels and release the digested products into the blood.
Finally, the digested and absorbed products reach the Mineral Absorption
tissue to be utilized for their activities. This process is
called as assimilation. The electrolytes absorbed by the small intestine
are from both GI secretions and ingested foods. Since
Carbohydrate Absorption

All carbohydrates are absorbed in the form of

monosaccharides. The small intestine is highly efficient
at this, absorbing at an estimated rate of 120 grams per
hour.

Process: After Carbohydrate digestion, it will be broken

down into its building blocks which is the Glucose
molecules. Within the Lumen of small intestine there are
many Sodium Ions, it plays an important role in
absorption of glucose into the body. In the Enterocyte
(Intestinal cells) there is a Sodium Glucose Linked
Transport (SGLT) which function as co-transport of 2
sodium and 1 glucose. Once they are inside the cell, they
are reabsorb by the bloodstream through Glut 2
transport. It will increase blood glucose levels and
glucose can be use as energy.
Protein Absorption
Almost all (95 to 98 percent) protein is digested
and absorbed in the small intestine.
The small polypeptides (Breakdown product of
protein) will be digested further into small polypeptide,
dipeptides and amino acid. The body can now begin into
Absorption. The Tripeptide (an example of Small
Polypeptide) can be absorb in the enterocyte by Co-
transport with Hydrogen. Once it is inside the cell, it
can be hydrolyze by Cellular peptidases and broken
down into Amino acid. Then the Amino acid can now
diffuse into the bloodstream and will be carried to the
liver.
Lipid Absorption
Absorption of fats occurs only in the small
intestines. Once the triglycerides are broken down into
individual fatty acids and glycerols, along with
cholesterol, they will aggregate into structures called
micelles. Fatty acids and monoglycerides leave the
micelles and diffuse across the membrane to enter the
intestinal epithelial cells. In the cytosol of epithelial
cells, fatty acids and monoglycerides are recombined
back into triglycerides. In the cytosol of epithelial cells,
triglycerides and cholesterol are packaged into bigger
particles called chylomicrons which are amphipathic
structures that transport digested lipids. Chylomicrons
will travel through the bloodstream to enter adipose and
other tissues in the body
Fig 6. Lipid Absorption. Unlike amino acids and simple
sugars, lipids are transformed as they are absorbed
through epithelial cells.
Nucleic Acid Absorption
The products of nucleic acid digestion—pentose
sugars, nitrogenous bases, and phosphate ions—are
transported by carriers across the villus epithelium via
active transport. These products then enter the
bloodstream.
electrolytes dissociate into ions in water, most are
absorbed via active transport throughout the entire small
intestine. During absorption, co-transport mechanisms
result in the accumulation of sodium ions inside the
cells, whereas anti-port mechanisms reduce the
potassium ion concentration inside the cells. To restore
the sodium-potassium gradient across the cell
membrane, a sodium-potassium pump requiring ATP
pumps sodium out and potassium in.
In general, all minerals that enter the intestine
are absorbed, whether you need them or not. Iron and
calcium are exceptions; they are absorbed in the
duodenum in amounts that meet the body’s current
requirements.
Vitamin Absorption
The small intestine absorbs the vitamins that
occur naturally in food and supplements. Fat-soluble
vitamins (A, D, E, and K) are absorbed along with
dietary lipids in micelles via simple diffusion. Most
water-soluble vitamins (including most B vitamins and
vitamin C) also are absorbed by simple diffusion. An
exception is vitamin B12, which is a very large molecule.
Intrinsic factor secreted in the stomach binds to vitamin
B12, preventing its digestion and creating a complex that
binds to mucosal receptors in the terminal ileum, where
it is taken up by endocytosis.
Water Absorption
Each day, about nine liters of fluid enter the
small intestine. About 2.3 liters are ingested in foods and
beverages, and the rest is from GI secretions. About 90
percent of this water is absorbed in the small intestine.
Water absorption is driven by the concentration gradient
of the water: The concentration of water is higher in
chyme than it is in epithelial cells. Thus, water moves
down its concentration gradient from the chyme into
cells. As noted earlier, much of the remaining water is
then absorbed in the colon.
Metabolism
 Once the food has been digested and absorbed, Case Study
the various nutrients are distributed to the tissues via the
blood and, having passed through the cell membranes, Gastroparesis
are exposed to the metabolic machinery of the cell. The
purpose of this machinery is (1) to release some of the Gastroparesis is a condition in which your
energy contained in the nutrients and convert it into a stomach cannot empty itself of food in a normal fashion.
form that can be used for the various functions of the It can be caused by damage to the vagus nerve, which
cell, and (2) to use the rest of the material for the regulates the digestive system. A damaged vagus nerve
synthesis of substances that the body needs for its prevents the muscles in the stomach and intestine from
growth and activities. functioning, preventing food from moving through the
digestive system properly. Often, the cause of
In order to do this the food materials are gastroparesis is unknown.
subjected to a variety of metabolic processes, each of
which involves a well-defined sequence of reactions.
Nearly every step is catalysed by a different enzyme, and
results in a small but specific chemical change. This
field of intermediary metabolism constitutes a major part
of biochemistry. The main metabolic pathways have by
now all been elucidated, and metabolic maps prepared,
which show the possible origins and fates of all the
major cellular constituents.

Broadly speaking, metabolism may be divided into three

areas. (1) Catabolism. This deals with the breakdown of
materials with the release of energy. In the process,
carbon dioxide and water are produced, but these are
essentially by-products since it is the energy liberated Causes of gastroparesis
during their formation that the body requires, and rarely
the carbon dioxide and water themselves. (2) Anabolism  Uncontrolled diabetes
covers the processes by which complex substances are  Gastric surgery with injury to the vagus nerve
built up from simple precursors, and this utilizes much
of the energy released during the course of catabolism. There are many symptoms of gastroparesis, including:
(3) Between the clearly defined anabolic and catabolic
pathways lies a central area of metabolism in which  Heartburn or GERD
various simple compounds are interconverted.  Nausea /Vomiting
 Poor appetite and weight loss
The pathways are said to be amphibolic since  Abdominal bloating
they have a dual function (amphi = both) and provide
material which may be used either for synthesis or for
Gastroparesis is a chronic (long-lasting)
breakdown. Amphibolic pathway, a biochemical
condition. This means that treatment usually doesn't cure
pathway that serves both anabolic and catabolic
the disease. But there are steps you can take to manage
processes. An important example of an amphibolic
and control the condition.
pathway is the Krebs cycle which is also called Citric
acid cycle, which involves both the catabolism of
carbohydrates and fatty acids and the synthesis of Some patients may benefit from medications, including:
anabolic precursors for amino-acid synthesis. All the
metabolic pathways involve the uptake or release of  Reglan (metoclopramide): You take this drug 30
energy.Energy is required for: mins before eating and it causes the stomach
muscles to contract and move food along.
1. Chemical syntheses and the process of growth in  Erythromycin: This is an antibiotic that also
which complex, highly organized molecules are built causes stomach contractions and helps move
and assembled from small molecular precursors. food out.
 Antiemetics: These are drugs that help control
2. The maintenance of the highly ordered structure of the nausea.
cell.
In a severe case of gastroparesis, a feeding tube, or
3. Transport and the movement of materials against a
jejunostomy tube (G-J gastro-jejunal tube), may be used.
concentration gradient, i.e. from a region of lower to one
The tube is inserted through the small intestine during
of higher concentration.
surgery. To feed yourself, put nutrients into the tube,
4. Mechanical work, e.g. the contraction of muscles and which go directly into the small intestine; this way, they
movement of cilia. bypass the stomach and get into the bloodstream more
quickly.
Without the expenditure of energy, membranes and other
cell structures would disintegrate and it is only by the
constant expenditure of energy that living organisms are
able to adapt continually to the prevailing conditions.