Control

Function
Stimulation Inhibition

GIP
↓ Stomach pH
Vagus nerve (ACh) Prostaglandins
Activates pepsinogen to pepsin
HCl Gastrin Secretin
Kills microorganisms
Histamine Somatostatin
(except Helicobacter pylori)
Cholecystokinin

Intrinsic GIP
Vagus nerve (ACh)
factor (IF; vitamin Binds to vitamin B12 and enables its Prostaglandins
Gastrin
B12 binding absorption in the terminal ileum Secretin
protein) Histamine
Somatostatin

Vagus nerve (ACh) High gastric pH

Pepsin Protein digestion
Low gastric pH Somatostatin

Bicarbonate Neutralizes gastric acid Secretin None

Vagus nerve (via gastrin-

releasing

peptide and GRP released

↑ Gastric acid secretion
from presynaptic terminals
↑ Gastric motility Somatostatin
Gastrin of postganglionic fibers)
Proliferation of the Gastric pH < 1.5
Amino acids and peptides
gastric mucosa
Decreased acidity

Distention of the stomach

Chronic PPI administration

 Control
Function
Stimulation Inhibition

↑ Appetite and hunger (lateral

hypothalamus) [5]

↑ Neuropeptide Y release
Fasting
Ghrelin (arcuate nucleus of hypothalamus) Stomach distention (food intake)
Sleep deprivation
↑ Growth hormone release (anterior

pituitary)

↑ Gastric motility [6]

Histamine ↑ Gastric acid secretion Gastrin Somatostatin

↑ Contraction of the gallbladder

Postprandial: fatty
↑ Secretion of pancreatic enzymes by
acids and amino Somatostatin
CCK acting on neural muscarinic pathways
acids entering the small Fasting
↑ Relaxation of the sphincter of Oddi
intestine
↓ Gastric emptying

Inhibits gastrointestinal secretions

↓ Gastric acid

↓ Gastrin

↓ Pepsinogen Postprandial: gastric

↓ Cholecystokinin acid, fatty acids,

Somatostatin Vagus nerve (ACh)
↓ Secretin and amino acids entering

↓ Pancreatic secretions the duodenum

(VIP, glucagon, insulin)

↓ Gastric inhibitory polypeptide

Inhibits gall bladder contraction

 Control
Function
Stimulation Inhibition

Decreases motility of

the stomach and intestine

Causes splanchnic vasoconstriction [7]

Decreases growth

hormone and TSH secretion

↑ Secretion of bile

↑ Pancreatic secretion of bicarbonate,

which neutralizes the Postprandial: ↑ gastric

Secretin acidic chyme arriving from acid and fatty acids in Somatostatin

the stomach (necessary for pancreatic the duodenum

enzyme function)

↓ Secretion of gastric acid

↑ Insulin secretion (more pronounced

Postprandial: fatty acids,
with the administration of oral
Gastric inhibitory glucose, amino
glucose compared to intravenous Fasting
polypeptide (GIP) acids entering small
glucose)
intestine
↓ Secretion of gastric acid

Produces migratory motor

Motilin Fasting Intake of food
complexes (↑ intestinal motility)

Vasoactive ↑ Secretion of water and electrolytes

Distention of the stomach
intestinal ↑ Relaxation of intestinal sphincters Sympathetic activity
Vagal stimulation
peptide (VIP)
and smooth muscle
 Control
Function
Stimulation Inhibition

Relaxation of smooth muscle and

Nitric sphincters (e.g., LES)

- •-
oxide (NO) [8] Improves circulation

(vasodilatory property)

The secretions of the pancreas are also involved in digestion. For a description of these,
see “Exocrine pancreas” and “Endocrine pancreas.”
Autoimmune destruction of parietal cells → ↓ intrinsic factor production → ↓
absorption of B12 in the terminal ileum → pernicious anemia
Elevated serum gastrin levels can be used to support the diagnoses of atrophic
gastritis and Zollinger-Ellison syndrome.
Ghrelin is increased in Prader-Willi syndrome and decreased following gastric bypass
surgery.
Ghrelin causes greed for food.
The antibiotic erythromycin belongs to the class of drugs called motilin agonists, which
can induce peristalsis and increase gastric emptying.
Octreotide, a somatostatin analog, is used to treat bleeding esophageal
varices, gastrinomas, severe noninfectious diarrhea (e.g., chemotherapy-induced
diarrhea, carcinoid syndrome), glucagonoma, and acromegaly.
VIPoma is a VIP-secreting tumor that can manifest
with WDHA syndrome: Watery Diarrhea, Hypokalemia, and Achlorhydria.
In achalasia, degeneration of inhibitory neurons within the myenteric plexuses
(Auerbach plexus) → deficient inhibitory neurotransmitters such as nitric oxide and
vasoactive intestinal peptide → higher resting pressures of the lower esophageal
sphincter.