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Large Intestine and

Defecation

Bagian Fisiologi
Fakultas Kedokteran Unsoed
Objectives

1. Describe the functions of the colon


2. Describe the feces formation
3. Explain the defecation mechanism
4. Describe secretion in the large intestine
5. Describe absorption in the GI tract
Anatomy of the Large Intestine

 About 1.5 m (5 ft) long


 Extends from the ileum to the anus.
 It is attached to the posterior abdominal
wall by its mesocolon
Histologic :
 4 layer
 absortive cell and goblet cells
 No plicae and villi
 Taenia colitonic contractionhaustra
Functions of the Colon

 Absorptionof water
and electrolytes

 Storage of fecal
matter
Mechanical Digestion in the Large Intestine

 Normally, the valve of ileocecal spincter remains partially closed


 Immediately after a meala gastroileal reflex intensifies
peristalsis in the ileum and forces any chyme into the cecum.
 The hormone gastrin relaxes the sphincter.
 The chyme moves through the small intestine at a fairly constant
rate the time required for a meal to pass into the colon
determined by gastric emptying time
Extrinsic reflex of the GI tract
 Gastrocolic reflex: presence of food and
peristaltic in stomachincreased mass
movementsreach rectumurge to
defecate
 Gastroileal reflex: distention of
stomachintensifies peristalsis in the
ileum and forces any chyme into the
cecum
 Enterogastric reflex: distention of
duodenumdecrease motility and
secretion of the stomach
Secretions of the Large Intestine

 Crypts of Lieberkuhn, but no  Mucus in the large intestines


villi  Protects intestinal wall against
 Mainly mucous cells excoriation
 Mucus  Adherent medium for fecal particles
 Bicarbonate ions  Protects wall from bacterial activity
 Regulated by tactile (within the feces)
stimulation and local  Provides barrier against acidity
reflexes to the mucous cells
Large intestine motility

 Haustral churning (haustration): the haustra remain relaxed and become


distended while they fill up--->when the distension reaches a certain point--
->the walls contract and squeeze the contents into the next haustrum.

 Peristalsis: at a slower rate (3–12 contractions per minute)

 Mass movements
Mass Movements
 a strong peristaltic wave that begins at about the middle of the
transverse colonquickly drives the contents of the colon into the
rectum.
 Mass movements occur 3-4x/day, during or immediately after a meal
 Series of mass movements persists for 10-30 min
 When a mass of feces is forced into the rectum, there is a desire to
defecate
 Mass movements also initiated by irritation in the colon
(e.g. ulcerative colitis)
Movement of the Colon
Chemical Digestion in the Large Intestine

 The final stage of digestion occurs in the colon through the activity of bacteria
 Mucus secreted by the glands, but no enzymes are secreted.
 Chyme is prepared for elimination by the action of bacteria: by fermentation any
remaining carbohydrates and release hydrogen, carbon dioxide, and methane
gases.
 Bacteria also convert any remaining proteins to amino acids and break down the
amino acids into simpler substances---> indole, skatole, hydrogen sulfide, and
fatty acids.

The commensal bacteria in the intestine benefit the host by helping in vitamin
synthesis, digestive absorbance, and by acting as a barrier against pathogenic
bacteria
Chemical Digestion in the Large Intestine

 Indole and skatole


-some is eliminated in the feces and contributes to their odor;
-the rest is absorbed and transported to the liver-->converted to less toxic
compoundsexcreted in the urine.
 Bacteria also decompose bilirubin to simpler pigments, including
stercobilin, which gives feces their brown color.
 Bacterial products that are absorbed in the colon include several
vitamins needed for normal metabolism, among them some B vitamins
and vitamin K
Absorption in the Large Intestine

 Absorption of sodium and chloride


 Most of the water and creates an osmotic gradient for
electrolytes in chyme absorption of water
that enters the colon is
absorbed
 Can absorb 5-8 liters of fluid and
electrolytes daily
 Active absorption of
sodium, creating a  Aldosterone greatly potentiates
gradient for absorption sodium absorption
of chloride
Feces Formation

 By the time chyme has remained in the large intestine 3–10 hours, it
has become solid or semisolid because of water absorption and is now
called feces.
 Feces consist of:
1. Water
2. Inorganic salts
3. Sloughed-off epithelial cells from the mucosa of GI tract
4. Bacteria
5. Products of bacterial decomposition
6. Unabsorbed digested materials
7. Indigestible parts of food.
Defecation

 When mass movement forces feces into the rectum


 Immediate desire to defecate
 Reflex contraction of rectrum
 Relaxation of internal anal sphincter

 Approx. 80 to 200 mL of fecal matter


expelled daily
Defecation

 Internalanal sphincter
(circular smooth
muscle,enteric neurons,
involuntary control)

 External anal sphincter


(striated voluntary muscle)
 Controlled
by pudendal
nerve (somatic NS)
 Voluntary control
Mader, 5th edition
Defecation
 Stretch receptor detect distension of the rectum
 Signals transmitted into sacral spinal cord
 Reflex back to descending colon, sigmoid, rectum and anus (pelvic
nerves)
 Intensify peristalisis
 Relax internal anal sphincter
 Relaxation of the external anal sphincter is voluntary--> defecation
can be postponed.
 If postponed: back to sigmoid
Defecation

 Taking deep breath


 Closure of glottis
 Contraction of abdominal wall muscles
 Relaxation and movement of pelvis floor downward
 Longitudinal muscles contractshorten the rectum
 pushes the walls of the sigmoid colon and rectum inward
Stoolchart
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