Physiology of Upper Gastrointestinal Tract (Gaster, Duodenum)

STOMACH

• 3 main functions:

• Most important to store ingested foods until it can be emptied to small intestine at
rate of appropriate digestion & absorption

• Due to SI as primary site of digestion & absorption, stomach store foods & meter it
into duodenum at a rate that will not exceed SI’s capacity

• Secretes HCl & enzymes for protein digestion initiation

• Mixing movements: foods + gastric secretions  thick liquid mixture (chyme)

Motility

• 4 aspects:

• Filling

• Storage

• Mixing

• Emptying

• Filling

• Empty stomach = 50 mL vol; can expand to ~1L during meal (20x change in vol w/
little Δtension in its wall & little Δintragastric pressure)

• Interior of stomach: deep folds

• During meal, folds get smaller & nearly flat as stomach relaxes slightly w/ each
mouthful (gradual expansion)

• Receptive relaxation:  stomach ability to accommodate extra vol of food w/ less

Δpressure

• >1 L consumed  stomach overdistended   intragastric pressure  discomfort

• Triggered by act of eating via vagus nerve

• Storage

• Cajal interstitial cells (pacemaker cells) in upper fundus generate slow-wave

potentials sweeping down length of stomach towards pyloric sphincter

• Rhythmic pattern of spontaneous depolarization

• BER (Basic Electrical rhythm) of stomach: continuous (w/ or w/out + contraction of

stomach’s circular SM layer)

• Mixing in body/fundus (feeble movement). Fundic area ✗ store foods, contains only
pocket of gas

Body  antrum ✓ mixing

 • Gastric mixing

• The strong antral peristaltic contractions mix the food with gastric secretions to
produce chime

• peristaltic wave propels chyme distally toward the pyloric sphincter

• Tonic contraction of the pyloric sphincter normally keeps it almost, closed.

• The opening is large enough for water and other fluids to pass through with ease
(particles larger than 2 mm in diameter typically do not leave).

• As the peristaltic wave reaches the pyloric sphincter and closes it tightly, the large
particles are forced back upwards toward the body of the stomach

• The bulk of the antral chyme that is forced upward is again propelled forward and
then tumbled back as the next peristaltic wave advances  retropulsion

• Emptying

• Antral peristaltic contraction = driving force for gastric emptuing

• Intensity of antral peristalsis vary markedly under influence of diff signals from
stomach & duodenum

• Gastric emptying is regulated by both factors:

• Influencing stomach’s excitability by slightly depol or hyperpol

gastric smooth muscles

• Excitability: determinant of degree of antral peristaltic activity

•  excitability: more freq BER generating action potentials; 

degree of peristaltic activity in antrum;  rate of gastric emptying

Mechanism of H & Cl ions secretion

• Function of HCl:

– Activate pepsiongen  pepsin

– Aids breakdown of connective tissue & muscle fibers, reducing food into smaller
particles

– Denaturates protein

– Along with lysozyme  kills microorganism

Small Intestine

 The site where most digestion and absorbtion take place.

 Divided into 3 segments: duodenum, jejunum and ileum

 Its motility includes:

 Segmentation

 Migrating motility complex

Secretions

 Exocrine gland cells of small intestine mucosa secrete about 1.5 liters of an aqueous salt and
mucus solution called succus entericus.

 Functions: provides protection and lubrication also provides plenty of H2O to participate in
the digestion of food

 No digestive enzymes are secreted inti the intestinal juice.

Digestion

 Digestion within the small intestine lumen is accomplished by pancreatic enzymes with fat
digestion being enhanced by bile secretion.

 This digestion is completed by special hairlike projections of luminal surface of small instine
epithelial cell, microvilli

Absorption

 All products of carbohydrate, protein and fat digestion, as well as electrolytes, vitamin and
water are absorbed by small intestine indiscriminately. Only absorption calcium and iron is
adjusted by body needs.

 Most absorption occurs in duodenum and jejunum, very little in ileum (normally only B12
and bile salt are absorbed by ileum)