D.

2 Digestion
D Human Physiology
Essential Idea
Digestion is controlled by nervous and
hormonal mechanisms
Understandings
■ Nervous and hormonal mechanisms control the secretion of digestive juices
■ Exocrine glands secrete to the surface of the body or the lumen of the gut
■ The volume and content of gastric secretions are controlled by nervous and hormonal
mechanisms
■ Acid conditions in the stomach favour some hydrolysis reactions and help to control pathogens
in ingested food
■ The structure of cells of the epithelium of the villi is adapted to the absorption of food
■ The rate of transit of materials through the large intestine is positively correlated with their
fibre content
■ Materials not absorbed are egested
Applications and skills
Applications:
■ The reduction of stomach acid secretion by proton pump inhibitor drugs
■ Dehydration due to cholera toxin
■ Helicobacter pylori infection as a cause of stomach ulcers

Skills:
■ Identification of exocrine gland cells that secrete digestive juices and villus epithelium cells that
absorb digested foods from electron micrographs
Exocrine glands
Exocrine glands produce and secrete substances via a duct onto an epithelial surface – either:
■ The surface of the body (e.g. sweat glands, sebaceous glands)
■ The lumen of the digestive tract / gut (e.g. digestive glands)

Examples of digestive glands include:

■ Salivary glands – secrete saliva which contains amylase (breaks down starch)
■ Gastric glands – secretes gastric juices which includes hydrochloric acid and proteases (breaks
down protein)
■ Pancreatic glands – secretes pancreatic juices which include lipase, protease and amylase
■ Intestinal glands – secretes intestinal juices via crypts of Lieberkuhn in the intestinal wall
Exocrine glands
Exocrine glands are composed of a cluster of secretory cells which collectively form an acinus
(plural = acini)
■ The acini are surrounded by a basement membrane and are held together by tight junctions
between secretory cells
■ The secretory cells possess a highly developed ER and golgi network for material secretion and
are rich in mitochondria

Exocrine products are released (via secretory vesicles) into a duct, which connects to an epithelial
surface
■ These ducts may arise from a convergence of smaller ductules (each connected to an acinus) in
order to enhance secretion
Exocrine glands
Control of gastric secretions
Control of gastric secretions: nervous mechanism
■ The sight and smell of food triggers an immediate response by which gastric juice is secreted
by the stomach pre-ingestion
■ When food enters the stomach it causes distension, which is detected by stretch receptors in
the stomach lining
■ Signals are sent to the brain, which triggers the release of digestive hormones to achieve
sustained gastric stimulation
Control of gastric secretions: hormonal mechanism
■ Gastrin is secreted into the bloodstream from the gastric pits of the stomach and stimulates
the release of stomach acids
■ If stomach pH drops too low (becomes too acidic), gastrin secretion is inhibited by gut
hormones (secretin and somatostatin)
■ When digested food (chyme) passes into the small intestine, the duodenum also releases
digestive hormones:
■ Secretin and cholecystokinin (CCK) stimulate the pancreas and liver to release digestive
juices
■ Pancreatic juices contain bicarbonate ions which neutralize stomach acids, while the liver
produces bile to emulsify fats
Stomach acid
The gastric glands that line the stomach wall secrete an acidic solution that creates a low pH
environment within the stomach
■ The normal pH of the stomach is roughly 1.5 – 2.0, which is the optimum pH for hydrolysis
reactions by stomach enzymes

The acid conditions in the stomach serve a number of functions:

■ Assists in the digestion of food (by dissolving chemical bonds within food molecules)
■ Activates stomach proteases (e.g. pepsin is activated when pepsinogen is proteolytically
cleaved in acid conditions)
■ Prevents pathogenic infection (stomach acids destroy microorganisms in ingested food)
Stomach acid
The stomach wall is lined by a layer of mucus, which protects the stomach lining from being
damaged by the acid conditions
■ The pancreas releases bicarbonate ions into the duodenum which neutralizes the stomach pH
(intestinal pH ~7.0 – 8.0)
■ Certain foods (e.g. antacids) may also neutralize stomach acids, impairing digestion and
increasing chances of infection
Proton Pumps
The low pH environment of the stomach is maintained by proton pumps in the parietal cells of the
gastric pits
■ These proton pumps secrete H+ ions (via active transport), which combine with Cl– ions to form
hydrochloric acid
■ Certain medications and disease conditions can increase the secretion of H+ ions, lowering the
pH in the stomach

Proton pump inhibitors (PPIs) are drugs which irreversibly bind to the proton pumps and prevent
H+ ion secretion
■ This effectively raises the pH in the stomach to prevent gastric discomfort caused by high
acidity (e.g. acid reflux)
■ Individuals taking PPIs may have increased susceptibility to gastric infections due to the
reduction of acid secretion
PPIs
Digestive infections: Stomach ulcers
Stomach ulcers are inflammed and damaged areas in the stomach wall, typically caused by exposure to
gastric acids

■ There is a strong positive correlation between Helicobacter pylori infection and the development of
stomach ulcers

Helicobacter pylori is a bacterium that can survive the acid conditions of the stomach by penetrating the
mucus lining

■ H. pylori anchors to the epithelial lining of the stomach, underneath the mucus lining
■ An inflammatory immune response damages the epithelial cells of the stomach – including the
mucus-secreting goblet cells
■ This results in the degradation of the protective mucus lining, exposing the stomach wall to gastric
acids and causing ulcers
■ The prolonged presence of stomach ulcers may lead to the development of stomach cancer over many
years (20 – 30 years)
■ H. pylori infections can be treated by antibiotics (previously, stomach ulcers were considered stress
related and not treatable)
Stomach ulcer formation
Intestinal Villi
Once digested food has passed through the stomach, it enters the small intestine for absorption
into the blood
■ The small intestine also releases digestive enzymes to ensure the complete hydrolysis of food
molecules

The inner epithelial lining of the small intestine is highly folded into finger-like projections called
villi (singular: villus)
■ Many villi will protrude into the intestinal lumen, greatly increasing the available surface area
for material absorption
Dietary Fiber
The human intestines function to complete the process of digestion and absorb digested products
into the bloodstream
■ The small intestine absorbs usable food substances (i.e. nutrients – monosaccharides, amino
acids, fatty acids, vitamins, etc.)
■ The large intestine absorbs water and dissolved minerals (i.e. ions) from the indigestible food
residues
Dietary Fiber
Dietary fiber, or roughage, is the indigestible portion of food derived principally from plants and
fungi (cellulose, chitin, etc.)
■ Humans lack the necessary enzymes to break down certain plant matter (e.g. lack cellulase
required to digest cellulose)
■ Certain herbivores (ruminants) possess helpful bacteria in the digestive tract that can break
down indigestible plant matter

The rate of transit of materials through the large intestine is positively correlated with their fiber
content:
■ Roughage provides bulk in the intestines to help keep materials moving through the gut
■ Roughage also absorbs water, which keeps bowel movements soft and easy to pass
Dietary Fiber benefits
There are several health benefits associated with diets rich in dietary fiber:
■ It reduces the frequency of constipation and lowers the risk of colon and rectal cancer
■ It lowers blood cholesterol and regulates blood sugar levels (by slowing the rate of absorption)
■ It aids in weight management (contributes few calories despite consisting of a large volume of
ingested material)
Egestion
Materials that are not absorbed by the small and large intestines are ultimately egested from the
body as faeces
■ A large portion of human feces consists of dietary fiber, such as cellulose and lignin
■ Also present in feces are the remains of intestinal epithelial cells, bile pigments and human
flora (intestinal bacteria)
Egested materials
■ Bile pigments
■ Epithelial cells
■ Lignin
■ Cellulose
■ Human flora (bacteria)

Mnemonic: BELCH
Dehydration due to cholera
Vibrio cholerae is a bacterial pathogen that infects the intestines and causes acute diarrhea and
dehydration
■ The associated disease – cholera – can kill within hours unless treated with oral rehydration
therapies

V. cholerae releases a toxin that binds to receptors on the surface of intestinal epithelium cells
■ This toxin is internalized by endocytosis and triggers the production of cyclic AMP (a second
messenger) within the cell
■ Cyclic AMP (cAMP) activates specific ion channels within the cell membrane, causing an efflux of
ions from the cell
■ The build up of ions in the intestinal lumen draws water from cells and tissues via osmosis –
causing acute diarrhoea
■ As water is being removed from body tissues, dehydration will result if left untreated
Mechanism of action of cholera toxin
The pandemic the world has forgotten