Outline

Overview of GI Tract
Movement of GI Tract
Nutritional requirements
Exocrine GI secretions
Digestion, absorption, assimilation
Endocrine control

Sekilas
saluran
pencernaan

Menerima
Menyalurkan (Conducting)
dan menyimpan
Digesti, absorpsi
Absorbsi air, defekasi

Proses dasar

1. Sekresi : menghasilkan & menyalurkan enzym, mucus, ions dan

sejenisnya ke lumen saluran pencernaan, and
hormones ke
aliran darah.
2. Absorpsi: Transport air, ion dan nutrient dari lumen melewati
epithel kemudian masuk aliran darah.
3. Motilitas: Kontraksi otot polos dlm dinding saluran pencernaan
untuk memotong, mencampur dan mengaduk isi saluran
pencernaan.

peristaltik

segmentasi

Pengaturan

Ekstrinsik
Sistim Syaraf Pusat
Sistim Endokrin
Intrinsik
Saraf intrinsik
Endokrin intrinsik

DISTRIBUSI SARAF OTONOM KE SALURAN PENCERNAAN

The autonomic nervous system

Sympathetic system:

Parasympathetic system:

Noradrenaline
EFFECTS

(+) secretion of saliva

Acetylcholine (Ach)

ACTION
salivary
glands

Cranial
nerves

Mid
brain

2 (-) vasodilation

(+) contraction

adrenaline
(+) secretion

gut wall,
sphincters

Adrenal
medulla

Spinal cord

1/2 (-) decrease motility

gut blood
vessels

EFFECTS

VII

Pons/
medulla

X
(+) vasoconstriction

ACTION

Salivary glands

(+) secretion of saliva

Gut wall

(+) increased
motility and tone

Gut sphincters

(-) reflex relaxation

Gut secretions

(+) e.g acid, enzymes

& electrolytes

Pancreas

(+) exocrine &

endocrine secretion

Rectum

(+) defaecation

IX

The enteric nervous system

Myenteric plexus

Circular
muscle

Deep
muscular
plexus
Submucosal
plexus

Longitudinal
muscle
Submucosal
artery
MUCOSA

Muscularis mucosa

CNS to gut connections

BRAIN STEM
nodose ganglion

Vagal
efferent
Vagal
afferent
dorsal root
ganglion

Spinal
afferent

SPINAL CORD

The brain-gut axis

Gut- to- brain

Brain- to- gut

(afferent neurons)

(efferent neurons)

autonomic reflexes

Cephalic phase

e.g. vago-vagal reflex

control of gastric tone

thought, smell, taste

stimulate H+

Pain
discomfort, bloating etc.

autonomic reflexes

cyto-protection

reflex control of blood flow

e.g. vago-vagal reflex

control of gastric tone

Receptive relaxation of the body of the

stomach (corpus) in response to a meal

BRAIN STEM

Satiety
effects

nodose g.

Vagal afferent

CCK
receptors

Vagal efferent
fibres

CCK &
DISTENSION

Ach
VIP Ach

Ach

Relaxation of
corpus to
accommodate food

Cholecystokinin (CCK) cell physiology

Fatty acid
Protein
? Other

food intake

Small intestine
lumen

gastric emptying

+
Apical

I-cell

CNS

pancreas

+
basolateral

gallbladder

CCK
circulation
Vagus nerve

CCK: integrator of brain and gut

Cholecystokinin (CCK)
regulates digestion in the small intestine by:
stimulating secretion of pancreatic juice
stimulating gallbladder contraction
inhibiting gastric emptying and food intake
CCK acts directly on pancreas and gallbladder,
and modifies CNS function via the vagus nerve

Kelenjar Ludah

Gas cant escape

(Animal dies from suffocation because
of distended rumen )

 Tongue
Used more by cattle and goats (also use
lips)
Teeth
No upper incisors
Used more by sheep (use lips to sort
feed)
Saliva
Continual production
Cattle: 12 gal/d vs Sheep: 2 gal/d
No enzymes; High pH
Esofagus
No sphincter valve
Opens into reticulum and rumen
Muscle contractions move in both
directions

Sistem pencernaan
ruminansia
Primarily herbivores Cattle,
sheep, goats, deer, elk
Camelidsare pseodu
ruminants
60-75% of ingesta
fermented by microbes

Stomach
Compartment:

Reticulum
Rumen
Omasum
Abomasum

Rumen Characteristics :
Left side of abdomen
Papillae lining
Muscular pillars
Fermentation vat
Primarily anaerobic
Some aerobic microbes
Not functional at birth
Rumen Functions :
Storage
Soaking
Physical mixing and
breakdown
Fermentation
Synthesizes some
vitamins
Synthesizes AA and
protein
Breaks down fibrous
feeds into VFAs

Reticulum characteristics
Located next to heart
Honeycomb appearance
Catches metal and
hardware
Pathways
Esophagus
Rumen
Omasum
No enzymes secreted

Omasum :
Manyplies
No enzymes from walls
Function
Reduce particle size
Absorb some water

Abomasum :

True stomach
that secretes
enzymes from walls
Glandular stomach
like monogastric
fundic region
HCL, Mucin
Pepsinogen,
Rennin and
Lipase

Ruminant Differences:

Esophageal Groove
By passes reticulum and rumen in
young animals
Rumination
Chew their cud (food bolus)
Up to 8 hours/day
Decrease particle size for
microbes
Increases saliva production to
buffer rumen
About 30 times/day
Eructation (belching)
CO2and Methane
Produced by microbial population
in rumen
Rumen contracts and forces gas
out

Rumen Activities
Pembentukan VFA di
Rumen

Volatile Fatty Acids

(VFAs)

Acetic Acid (Acetate)

Propionic Acid (Propionate)

Most comes from cellulose

Important to milk fat in dairy cows
Most comes from starch

Butyric Acid (Butyrate)

Derived from Acetic acid

End Products of Ruminant

Digestion

1.
2.
3.
4.
5.

VFAs (Main energy source for cows)

CO2
CH4(Methane)
NH3(Ammonia)
Microbes

Parietal cells:
HCl and
intrinsic factor
Chief cells:
pepsinogen
(converted to
active enzyme,
pepsin)

Sistim Saraf Intrinsik

Gastrointestinal

Mengandung banyak neuron

Sistim syaraf intrisik mengandung badan sel dan
perlengkapannya
Di dalam dinding usus badan sel tersusun dalam 2
ganglia:
Pleksus Auerbach (mienterik), terletak antara otot
sirkuler dan longitudinal
Pleksus Meissner (submukosal), terletak di lapisan
submukosa

The Pharynx- receiving

Mechanical breakdown of food.

Lubrication of food.
Initial digestion of polysaccharides
(complex sugars).
Salivary glands:

parotid (par= ear, otid=ear)

submandibular
submaxillary

Kelenjar Ludah dan ludah

Saliva disekresikan oleh kelenjar ludah (salivary

gland).
Unit sekretoris kelenjar ludah adalah acini.
Sel ini mensekresikan cairan yang mengandung:
air, electrolytes, lendir (mucus) and enzymes.
Ada tipe sel epitel acinar:
Serous cells, mensekresi a cairan banyak air
sedikit mucus (lendir)
Mucous cells, memproduksi sekreta yg kaya
mucus
Cairan disalurkan ke rongga mulut melalui saluran

lanjutan

Didalam saluran cairan mengalami perubahan komposisi

Natrium secara aktif diabsorbsi kembali,

potassium disekresikan

sejumlah besar bikarbonat disekresikan.

Kebanyakan hewan mempunyai 3 pasang kelenjar ludah
utama yg berbeda pada jenis sekreta yg diproduksi:
Kel. Parotid menghasilkan ludah yg serous (banyak
air)
Kel. Submaxillary (mandibular) menghasilkan suatu
campuran serous and mucous
Kel. Sublingual glands menghasilkan air liur yang
berlendir

Fungsi saliva:

Lubrikasi and pengikat: makanan yg dikunyah

menjadi bolus shg mudah ditelan dan tidak merusak
mukosa esofagus. Saliva juga melapisi rongga mulut
dan esofagus shg makanan tdk dapat bersinggungan
langsung dg epitel. Melarutkan makanan kering.
Kesehatan mulut: Rongga mulut selalu dibasuh
dengan air liur sehingga menjaga mulut tetap
bersih. Sekresi saliva menurun bertahap selama
tidur & membiarkan pertumbuhan populasi bakteri
mulut sehingga mulut menjadi bau. Saliva juga
mengandung lysozyme, suatu enzim melisis
bacteria dan mencegah overgrowth populasi
microbial.

lanjutan

Inisiasi pencernaan karbohidrat: pd kebanyakan

species, the sel acinar serous men-sekresi alphaamylase yg dpt memulai pencernaan karbohidrat
menjadi maltosa. Amylase tdk terdapat, atau sangat
sedikit, di saliva carnivora atau sapi.
Menyediakan buffer alkali and cairan: ini sangat
penting bagi ruminansia, memiliki lambung sepan
yang tdk bersifat sekretoris.
Pendinginan secara evaporasi: penting pd anjing, yg
kel. Keringat tdk berkembang dg baik.

Histologi Kel. Ludah

anjing

Acini pada kel. parotid hampir seluruhnya sel epitel serous,

sedang kel. sublingual yang dominan adalah sel epitel mucus.
Pada kel. submaxillary, acini tersusun dari sel epitel serous and
mucus.

Initial carbohydrate
digestion

Parotid gland -large exocrine gland,

releases water, mucous, and amylase.
Esophagus- conducting and storage.
Muscular, skeletal muscle in anterior
part, smooth muscle as near
stomach.
Crop is a pouch off of the esophagus,
acts as a storage organ in birds.

Stomach- protein digestion

Stomach- cardiac region, fundus, pylorus

Big washing machine, mechanically breaks up food
3 exocrine cell types
chief cells- secrete pepsinogen (inactive form pepsin)
parietal cells, secrete HCl, causes very low pH(~2 in
adult)

mucous cells
Very acidic, aids in protein digestion
Therefore both chemical and mechanical digestion

Also produce a protein called intrinsic factor, which helps

vitamin B12 absorption.

Pengaturan Sekresi Asam

ECL cell

+
histamine

H+

+
+

Corpus
acid-secreting

Parietal
cell

Pepsinogen

Chief cell
D-cell

Gland lumen

GASTRIN
Ach

somatostatin

noradrenaline,

CCK, VIP & CGRP

Pengaturan Fungsi sel-G

Protein/peptides/
amino acids

+
Antrum
muscular pump

Gastrin
releasing
peptide
(GRP)

Vagus nerve fibres

Sel G
+

H+
+

Sel D

GASTRIN

H.pylori

somatostatin

Corpus
circulation
ECL cell & parietal cell

Attack and defence in the stomach

Acid & pepsin
Cell surface
phospholipids

pH 2
Mucus-HCO3barrier slows H+
diffusion

MUCUS
pH 7
Tight junctions
between cells
slow H+
diffusion

HCO3Cell migration
and regeneration

Mucosal prostaglandins

H+

Mucosal blood flow

Blood supply
carries H+ away, helps
antioxidant function

Refleks Muntah
Vomit

Vomiting centre
medulla oblongata

Efferent fibres:
LOS, UOS &
pharynx relaxed

phrenic & vagus

nerve

Diaphragm fixed
for inspiration

Afferent fibres:

Contraction of
duodenum,
pylorus and
antrum

pain, bloating,
inflammation,
irritants, toxins....
Intercostal muscles
contracted
High abdominal
muscular pressure

Receptive relaxation of the body of the

stomach (corpus) in response to a meal

BRAIN STEM

Satiety
effects

nodose g.

Vagal afferent

CCK
receptors

Vagal efferent
fibres

CCK &
DISTENSION

Ach
VIP Ach

Ach

Relaxation of
corpus to
accommodate food

Fisiologi Sel Cholecystokinin (CCK)

Fatty acid
Protein
? Other

Lumen Usus Halus

food intake
gastric emptying

+
Apical

I-cell

CNS

pancreas

+
basolateral

gallbladder

CCK
circulation

n. Vagus

Small intestine- digestion

and absorption

Receives secretory products from

pancreas, liver (via gallbladder)
most absorption of nutrients and water
takes place here
mostly alkaline digestion of proteins,
fats, carbos, because bicarbonate
(HCO-3 from pancreas) neutralizes
stomach acid

Small intestine- digestion

and absorption

duodenum- receives liver and pancreas

secretions, secretes digestive enzymes
jejunum and ileum-digestion and absorption
secretion- transport away from body;
absorption, transport toward bloodstream

Usus Halus

BRUSH BORDER

Glycocalyx

Protein rich coat that covers

microvilli. Contains dipeptidases,
enzymes that breakdown
disaccharides, mucous.

Intestinal surface area

Usus Besar

Most water reabsorbed in small

intestine, butthe principal role of the large
intestine is reabsorption of
remaining water- 8 L of water may
be secreted by GI tract in the
course of a day.
Consolidation of waste.

Gerakan saluran
pencernaan

Three main functions for

movement

translocation of food from point A to B

mechanical breakdown of food
mix food for enzymatic digestion

3 types of movement

Peristalsis- traveling wave of

constriction
segmentation-asynchronous
constriction of gut tube- breaks
down large food particles
regurgitation- reverse peristalsis

Control of motility

PSNS stimulates
SNS inhibits. Exception- irritable
bowel syndrome- SNS stimulates
movement of colon
hormonal control

gastrin(stomach)- stimulates motility

secretin (duodenum) inhibits motility

Cellular basis for motility

Smooth muscle throughout GI tract

GI smooth muscle is myogenic- contracts
12-3 times per minute
GI smooth muscle acts as a functional
syncytium- nexus or gap junctions
connect muscle cells
neuronal and hormonal cues are not
required for contraction, but are
important for changing rate of contraction

Nutritional Requirements

Figure 4.1 The composition of the adult human body

Figure 4.2 Amino acid chemistry

(Part 1)

Figure 4.2 Amino acid chemistry (Part 2)

Figure 4.3 Fatty acids and triacylglycerols (Part 1)

Figure 4.3 Fatty acids and

triacylglycerols (Part 2)

Figure 4.4 Carbohydrate chemistry

Figure 4.5 Vitamin structures

Exocrine Secretions

Salivary glands
Stomach
Pancreas
Liver and gall bladder
Small intestine

Stomach

Chief cells

Parietal cells

Pepsinogen (inactive) converted to pepsin

(active) form of a proteolytic enzyme.
Intrinsic factor- required for vitamin B12
absorption
Hydrochloric acid

Mucous cells

Produksi HCl oleh Sel Parieta

Small intestine

Kel. Brunners glands (duodenal glands)

Ditemukan hanya di duodenum, sekresi
mucous berair

Crypts of Lieberkuhn
Sekresi banyak air dan bikarbonate

Brush border
Mucous and digestive enzymespeptidases, enterokinase, lipases,
disaccharidases

Disaccharide breakdown

Starches broken down into

disaccharides by salivary amylase
(30%) and pancreatic amylase (70%)
Maltase- breaks down maltose to two
glucose molecules.
Lactase- breaks down lactose into
galactose and glucose
Sucrase- breaks down sucrose into
fructose and glucose.

Peptides and carbohydrates are broken down by enzymatic

hydrolysis

PANCREATIC SECRETIONS

Endoproteases
Cleave internal peptide bonds
Trypsin- trypsinogen converted to
trypsin by enterokinase. Attacks on
carboxyl side of arginine or lysine.
Chymotrypsin- chymotrypsinogen
converted to chymotrypsin in small
intestine by trypsin. Attacks on carboxyl
side of tyrosine, phenylalanine,
tryptophan, leucine or methionine.

Pancreatic secretions
(cont)

Carboxy- and aminopeptidases- cleave

outside amino acids.
Lipases- break down triglycerides into
fatty acids and monoglycerides
Trypsin inhibitor- stored in pancreatic
secretory granules. Prevents early
intracellular activation of trypsin.
Also lots of water and bicarbonate ions
to neutralize and dilute acids in S.I.

Liver and bile

Bile is produced in the liver, stored in gall

bladder.
Bile salts- one of the most important
components of bile, required for fat
digestion.
Bile is very alkaline, neutralizes acid in S.I.
Bile transports waste products from liver,
cholesterol, bilirubin, drugs, steroids, and
vitamins.

Bile salts

Bile salts are amphipathic, help

solubilize fatty acids for uptake.
Fatty acids and monoglycerides
have a strong tendency to reassociate after lipolysis- bile salts
prevent fatty acids and
monoglycerides from reassociating.

Digestion, absorption, and

assimilation

Carbohydrate digestion and

absorption.
Fat digestion and absorption.
Protein digestion and absorption.

SGLT- sodium
dependent
glucose
transporter.
Glut- facilitated
diffusion
transporter

FAT DIGESTION

Emulsification- breaking up large lipid

droplets so that enzymes can digest
them.
Enzymatic digestion (hydrolysis) of
triglycerides- pancreatic lipase
Micelle formation-hydrolysis products
form with bile salts to make micelles.
FAs and glycerol and monogycerides
absorbed.

PROTEIN DIGESTION

Pepsin responsible for about 20%

of all protein digestion.
Pancreatic proteases and
peptidases- chymotrypsin, trypsin,
carboxy- and aminopeptidases.

Virtually all of the

water secreted from
exocrine glands is
reabsorbed in the GI
tract.

Hormonal control of digestion

Phases of digestion.
Cephalic phase-sensory input from
food.
Gastric phase-food enters stomach.
Intestinal phase-chyme enters
duodenum.

Cephalic Phase

Increase acid secretion in stomach

Increase enzyme secretion, decrease
volume from pancreas.
Small increase in bile secretion and
contraction of gall bladder.

Hormonal and neuronal control of stomach secretions

+
Sensory stimuli

+
Vagus
nerve

Parietal
cell

ECL
cell

ACh

G cell

D cell

ECL, enterochromaffin-like cell

HCl

Histamine

+
Gastrin

Somatostatin

Gastric hormones

Gastrin-stimulates HCl secretion,

stimulates stomach motility
Somatostatin- inhbits HCl secretion
and inhibits gastrin secretion

Gastric phase

Identical to cephalic phase, but

stimulus is stomach distention

Cerebral
cortex
Cephalic phase
gastric phase
Stomach
distention

Stomach gastrin

Brain stem

Vagus
nerve
Acid
secretion

Intestinal phase

Chyme enters the duodenum-2 subphases

Early intestinal phase

pH > 3.0, gastrin from duodenum stimulates

HCl secretion

Late intestinal phase

pH < 2, acid stimulates secretin release from

the duodenum
Fatty acids, amino acids, stimulate
cholecystokinin secretion from duodenum

Ulcer formation
Acid-rebound theory
Acid and mucous production shuts down during
stress. When recovery occurs, acid starts before
mucous production.

Acid secretion hypothesis

Bacterial hypothesis
Stress decreases immune system function, allows for
an increase in stomach bacteria, specifically
Helicobacter pylori, a bacterium that has been
associated with ulcer formation.

Reflexes pada Kolon dan Rektum

Spinal cord

Distention

Food
in
duodenum

+
Food in
stomach

+
+

+
Colon
VIP
ATP

FAECES

Mass
movements

IAS
EAS

Faeces

rectum

Ach

Pudendal
nerve

anus

Defaecation reflex