Lesson 1

The Site of Foodborne Illness:

The Alimentary Tract

The Alimentary tract is a long hallow tube that begins in the mouth and ends in
the anus. This includes parts of the body where food is swallowed, digested,
absorbed, and excreted. The specific parts comprise of the mouth, pharynx,
esophagus, stomach, small intestine, large intestine, rectum, and anus. It works with
assisting organs such as the salivary glands, liver, gallbladder, and pancreas. The
alimentary tract is part of the digestive system; thus, it is also referred to as digestive
tract and gastrointestinal tract.
It has the following functions:
1. Ingestion – the receipt and softening of food
2. Transport of ingested food
3. Secretion of digestive enzymes, acid, mucus, and bile
4. Absorption of end products of digestion
5. Movement of undigested material
6. Elimination – the excretion of waste products

Regions of the Digestive System

Figure 3.1 Parts of the Digestive System. (credit: Blausen.com staff (2014). "Medical gallery of Blausen Medical
2014". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. Retrieved 12 April 2021.
https://commons.wikimedia.org/wiki/File:Blausen_0316_DigestiveSystem.png. CC-BY-3.0)
I. Alimentary Tract
Mouth – This is the first part of the digestive tract. It is also called oral cavity. It
receives food by ingestion, break it into small particles by mastication, and mix it
with saliva. (See parts in Fig. 3.2)

Figure 3.2 Parts of the oral cavity. (https://commons.wikimedia.org/wiki/File:Illu_mouth.jpg, Retrieved 12 April

2021, illustration is public domain in the United States because it is a work prepared by an officer or employee of
the United States Government as part of that person’s official duties)

Pharynx – The tongue pushes food into the pharynx. When food reaches the opening,
sensory receptors around the fauces respond and initiate an involuntary swallowing
reflex. Peristaltic movements propel the food from the pharynx into the esophagus.
Esophagus – It is a collapsible muscular tube that serves as a passageway between the
pharynx and stomach. The esophageal mucosa has glands that secrete mucus to keep
the lining moist and well lubricated to ease the passage of food.
Stomach – It receives food from the esophagus. It has four different types of cells –
mucous cells, parietal cells, chief cells, and endocrine cells. The first three makes up
the exocrine gastric glands which produces gastric juice. The products of the
endocrine cells are secreted directly into the bloodstream and are not a part of the
gastric juice. The endocrine cells secrete the hormone gastrin, which functions in the
regulation of gastric activity. (See parts of the stomach in Fig. 3.3)
Small intestine – It finishes the process of digestion; it absorbs the nutrients; and
passes the residue on to the large intestine. The accessory organs of the digestive
system are closely associated to the small intestine. The small intestine is divided into
the duodenum, jejunum, and ileum. Exocrine cells in the mucosa of the small
intestine secrete mucus, peptidase, sucrase, maltase, lactase, lipase, and
enterokinase. Endocrine cells secrete cholecystokinin and secretin. (See anatomy of
small intestine Fig. 3.4)
Figure 3.3 Parts of the Stomach (credit: Cancer Research UK - Original email from CRUK, Retrieved 12 April
2021 , https://commons.wikimedia.org/w/index.php?curid=34334205, CC BY-SA 4.0)

Figure 3.4 Anatomy of the Small Intestine (credit: Public Domain, Retrieved 12 April 2021.
https://commons.wikimedia.org/w/index.php?curid=1232514)

Large intestine – It has a larger diameter than the small intestine. It consists of the
colon, rectum, and anal canal. It does not produce digestive enzymes. Chemical
digestion is completed in the small intestine before the chyme (semi-solid mass of
partly digested food) reaches the large intestine. Functions of the large intestine
include the absorption of water and electrolytes and the elimination of feces. (See
anatomy of the large intestine in Figure 3.5)
Rectum and Anus – The rectum continues from the sigmoid colon to the anal canal
and has a thick muscular layer. It is an 8 inches chamber which receives the stool
from the colon and holds it until evacuation. The last 2 to 3 cm of digestive tract is
the anal canal, which continues from the rectum and opens to the outside at the
anus. The anus is surrounded by muscles that controls the evacuation of stool.
Figure 3.5 Anatomy of the large intestine, rectum, and anal canal (credit: By OpenStax College - Anatomy
& Physiology (19 June 2013), Connexions Web site. http://cnx.org/content/col11496/1.6/, Retrieved 12 April
2021, https://commons.wikimedia.org/w/index.php?curid=30148449, CC BY 3.0)

II. Accessory Parts

Salivary Glands – There are three pairs of this (parotid, sublingual, and
submandibular). They are located in or near the mouth and they secrete saliva into
the oral cavity. The purpose of the saliva is to moisten the food, lubricating it for
easy swallowing.

Figure 3.6 The Salivary Glands (credit: Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014".
WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. Retrieved 12 April 2021)

Liver – This organ produces and secretes 600 to 1,000 mL of bile daily. Bile is the
yellow-green, pasty material that contains water, bile salts and acids, pigments,
cholesterol, phospholipids, and electrolytes. The bile acts as emulsifier, allowing
more contact between fat molecules and enzymes in the small intestine.
Gallbladder – Its primary function is to store and concentrate bile from the liver. It is
a small, muscular, pear-shaped sac nestled in a depression on the right underside of
the liver. It holds about a quarter of a cup of bile. It holds and thickens this bile until
such time that cholecystokinin (CCK), a hormone, is released after eating and signals
it to squirt its colorful contents. (See anatomy of the liver and gallbladder in Fig. 3.7)

Figure 3.7 The liver, gallbladder, and stomach (credit: Jiju Kurian Punnoose - Own work, Anatomy of the biliary
tree, liver and gall bladder, Retrieved 12 April 2021, https://commons.wikimedia.org/w/index.php?curid=335263,
CC BY-SA 4.0)

Pancreas – The pancreas contains exocrine glands that produce enzymes important to
digestion. These enzymes include trypsin and chymotrypsin to digest proteins;
amylase for the digestion of carbohydrates; and lipase to break down fats. When food
enters the stomach, these pancreatic juices are released into a system of ducts that
culminate in the main pancreatic duct. The pancreatic juices and bile that are
released into the duodenum, help the body to digest fats, carbohydrates, and
proteins. (See anatomy of the pancreas in Fig 3.8)

Figure 3.8 The Pancreas (credit: Unknown Illustrator - This image was released by the National Cancer Institute,
an agency part of the National Institutes of Health, with the ID 1776 (image) (next)., Retrieved 12 April 2021,
https://commons.wikimedia.org/w/index.php?curid=24055151, Public Domain)
Microbiology of the Alimentary Tract
The gastrointestinal tract of humans contains 10 14 microorganisms, many more
than the total number of our body cells. It is quite likely that they have a great
influence on our well-being, since they are metabolically diverse and active. It is
estimated that the human gastrointestinal tract harbors around 1000 bacterial
species, but only 30-40 species constitute the 95% population. Normally, the microbial
level in the small intestine (particularly in the jejunum and ileum) is about 10 6-7 per
gram; predominantly, Lactobacillus and Enterococcus. The large intestine has about
109-10 per gram of the content. The bacteria in the colon includes Enterobacteriaceae,
Bacteroides, Fusobacterium, Clostridium, Eubacterium, Enterococcus,
Bifidobacterium and Lactobacillus.
In cases of food poisoning, there are bacteria or enterotoxins that can survive
harsh stomach conditions, making their way to the intestines. From here, the trouble
begins or sometimes up to 72 hours after eating a contaminated food. Undetected by
the body’s immune system, the bacteria quietly multiply and produces toxins. They
invade and penetrate the intestinal lining. Discomfort is felt by the time the immune
cells release signaling proteins called pro-inflammatory cytokines, which set in motion
a series of steps causing gut inflammation and swelling. Bacterial toxins cause the
intestinal pores to open, allowing water and other molecules to flood in. Now, the
excess fluid and electrolytes in the gut lead to watery diarrhea which is also
beneficial because it flushes out bacteria and toxins from the intestines; however, it
can lead to dehydration