Syllabus topics (RTMNU)
- Structure and functions of Digestive glands: Salivary, Gastric, Intestinal, Liver and Pancreas
- Digestion and Absorption of Food: Carbohydrates, Proteins and Lipids
- Regulation of Digestion: Neural regulation of digestion
- Hormonal regulation - Gastrointestinal hormones
- Gastrointestinal Disorder: Achalasia, Gastritis, Pancreatitis, Colitis, Irritable Bowel Syndrome (IBS), and peptic ulcers
Structure and Functions of Digestive Glands
Digestive glands are glands that pour digestive juices (enzymes, mucus, bile, HCl) into the alimentary canal to break food into simple absorbable forms.
- Salivary glands: Three pairs in man – parotid (largest, in front of ear; serous), submandibular (mixed) and sublingual (mainly mucous). They are compound tubulo-alveolar glands with serous and mucous acini. They secrete about 1–1.5 litres of saliva daily (pH about 6.8). Saliva has salivary amylase (ptyalin), lingual lipase, mucin, lysozyme and water. Functions: starts starch digestion, moistens and lubricates food, helps speech and taste, kills bacteria.
- Gastric glands: Tubular glands in the stomach mucosa. Cells: chief (peptic) cells secrete pepsinogen and gastric lipase; parietal (oxyntic) cells secrete HCl and intrinsic factor (needed for vitamin B12 absorption); mucous neck cells secrete mucus; G cells secrete gastrin. Gastric juice is strongly acidic (pH 1.5–2).
- Intestinal glands: Crypts of Lieberkühn (all along small intestine) and Brunner's glands (in duodenum submucosa; alkaline mucus to protect against acid). Succus entericus contains maltase, sucrase, lactase, peptidases, nucleotidases and enterokinase.
- Liver: Largest gland of the body. Made of hexagonal hepatic lobules with central vein, hepatic cords and sinusoids; Kupffer cells are phagocytic. It secretes bile (bile salts, bile pigments – bilirubin and biliverdin, cholesterol), stored in the gall bladder. Other functions: glycogen storage, deamination and urea formation, detoxification, synthesis of plasma proteins (albumin, fibrinogen, prothrombin), storage of vitamins A, D, B12 and iron.
- Pancreas: Mixed (heterocrine) gland. Exocrine acini secrete pancreatic juice (trypsinogen, chymotrypsinogen, carboxypeptidase, pancreatic amylase, lipase, nucleases) rich in bicarbonate. Endocrine part – islets of Langerhans (α cells: glucagon, β cells: insulin, δ cells: somatostatin).
Digestion and Absorption of Carbohydrates, Proteins and Lipids
Digestion is the process of converting complex, non-absorbable food into simple, absorbable molecules by enzymes. Absorption is the passage of these products through the intestinal wall into blood or lymph.
| Food | Site and enzyme | End product | Absorption |
|---|---|---|---|
| Carbohydrates | Mouth: salivary amylase; Duodenum: pancreatic amylase; Brush border: maltase, sucrase, lactase | Glucose, fructose, galactose | Glucose and galactose by Na+-glucose co-transport (SGLT-1, active); fructose by facilitated diffusion (GLUT-5); into blood capillaries |
| Proteins | Stomach: pepsin (HCl activates pepsinogen); Duodenum: trypsin, chymotrypsin, carboxypeptidase; Brush border: aminopeptidase, dipeptidase | Amino acids, di- and tripeptides | Na+-linked active transport into blood capillaries |
| Lipids | Duodenum: bile salts emulsify fat; pancreatic lipase | Fatty acids, monoglycerides, glycerol | Form micelles → enter cells → re-form triglycerides → packed as chylomicrons → enter lacteals (lymph) |
Enterokinase activates trypsinogen into trypsin; trypsin then activates chymotrypsinogen and more trypsinogen. Water is absorbed mainly in the small intestine and partly in the colon.
Regulation of Digestion: Neural and Hormonal
Neural regulation: The enteric nervous system (myenteric plexus of Auerbach controls movements; submucosal plexus of Meissner controls secretion) works locally. The parasympathetic system (vagus nerve) increases secretion and motility; the sympathetic system decreases them. Gastric secretion occurs in three phases:
- Cephalic phase: sight, smell, thought of food → vagus → gastric juice.
- Gastric phase: food stretches stomach and peptides stimulate gastrin.
- Intestinal phase: acid chyme in duodenum releases hormones that slow gastric activity.
Hormonal regulation – Gastrointestinal hormones:
| Hormone | Source | Action |
|---|---|---|
| Gastrin | G cells of stomach | Stimulates HCl and pepsinogen secretion, gastric motility |
| Secretin | S cells of duodenum | Bicarbonate-rich pancreatic juice; inhibits gastric secretion |
| Cholecystokinin (CCK) | I cells of duodenum | Contraction of gall bladder, enzyme-rich pancreatic juice |
| GIP (gastric inhibitory peptide) | K cells of duodenum | Inhibits gastric secretion; stimulates insulin release |
| Motilin, Villikinin | Small intestine | Motility; movement of villi |
Gastrointestinal Disorders
- Achalasia: The lower oesophageal sphincter fails to relax due to loss of nerve cells; food is not passed into stomach. Symptoms: difficulty in swallowing (dysphagia), regurgitation, chest pain.
- Gastritis: Inflammation of stomach lining; causes – Helicobacter pylori, alcohol, painkillers (NSAIDs), stress. Symptoms: burning pain, nausea, vomiting.
- Pancreatitis: Inflammation of the pancreas when enzymes become active inside it and digest the gland itself. Causes: gallstones, alcohol. Severe upper abdominal pain; raised serum amylase and lipase.
- Colitis: Inflammation of the colon (infection, ulcerative colitis); diarrhoea with blood or mucus, cramps.
- Irritable Bowel Syndrome (IBS): A functional disorder with abdominal pain, bloating, and alternating diarrhoea and constipation, without visible damage; linked to stress and gut sensitivity.
- Peptic ulcer: An open sore in the stomach (gastric ulcer) or duodenum (duodenal ulcer) caused by acid-pepsin attack when mucus protection fails; main causes H. pylori and NSAIDs.
Likely exam questions
- (Long, 8 marks) Describe the structure and functions of the liver and pancreas as digestive glands.
- (Long, 8 marks) Explain the digestion and absorption of carbohydrates, proteins and lipids in mammals.
- (Short, 4 marks) Write a note on gastrointestinal hormones.
- (Short, 4 marks) What is a peptic ulcer? Give its causes.
- (Short, 4 marks) Explain the neural regulation of gastric secretion.