dr. Mustofa, M.

Sc
LAB. FISIOLOGI FKIK UNSOED
FISIOLOGI SISTEM
PENCERNAAN
Sekresi & Absorpsi
1. Describe the secretion of the oral cavity juice.
2. Describe the secretion of gastric juice and the roles
of stomach in absorption.
3. Explain the functions of the intestinal secretions,
and discuss the regulation of secretory activities.
4. Describe the secretion and regulation of the
accessory digestive organs.
5. Describe the intestinal absorptive processes

Learning Objective

1. AN OVERVIEW OF THE STRUCTURE AND FUNCTION OF
THE DIGESTIVE TRACT
2. ORAL CAVITY AND ASSOCIATED GLANDULAR ORGANS
3. THE STOMACH
4. THE SMALL INTESTINE AND ASSOCIATED GLANDULAR
ORGANS
5. THE LARGE INTESTINE
Outline

Heart
Liver
ABSORPTION
SECRETION
Large intestine
Rectum
Anus
Mouth
Food and
water
Stomach
Hepatic
Portal vein
Small intestine
Salivary glands
MOTILITY
FECES
enzim asam, dll
Vitamin
C, D, B2, B12, dll
Protein
Mineral
Karbonhidrat
Lipid
Adapted by:
Dr. Andreanyta Meliala, PhD.
Vitamin K
Air, Elektrolit
Aktifitas
BAKTERI
Pembentukan
Gas CO2, Metana, dll
FLATUS
Digestion
Movement of Food Through the System

The large, hollow organs of the digestive system contain
muscle that enables their walls to move. The movement of
organ walls can propel food and liquid and also can mix the
contents within each organ. Typical movement of the
esophagus, stomach, and intestine is called peristalsis. The
action of peristalsis looks like an ocean wave moving
through the muscle. The muscle of the organ produces a
narrowing and then propels the narrowed portion slowly
down the length of the organ. These waves of narrowing
push the food and fluid in front of them through each
hollow organ.


Secretion:
Includes both exocrine and endocrine secretions.
Exocrine:
HCl, H
2
0, HC0
3
-
, bile, lipase, pepsin, amylase, trypsin, elastase,
and histamine are secreted into the lumen of the GI tract.
Endocrine:
Stomach and small intestine secrete hormones to help regulate
the GI system.
Gastrin, secretin, CCK, GIP, GLP-1, guanylin, VIP, and somatostatin.
Functions of the GI Tract
(Continued)
Absorption:
Process of the passage of digestion (chemical
subunits) into the blood or lymph.
Functions of the GI Tract
(Continued)
nutrients
The gut wall has a layered organization, with
the absorptive cells lining the lumen and
neural and muscular components below.
Blood and lymph vasculature is abundant to
transport absorbed nutrients.


GIT Regulation

The enteric nervous system coordinates
digestion, secretion, and motility to optimize
nutrient absorption.
Its activity is modified by information from
the CNS
and from local chemical and mechanical
sensors.


GIT Regulation

Johnson Chap. 34-35
Apical Membrane
Johnson Chap. 34-35
(Gut lumen)
(interstitial
space)
P
Outside
Inside
Apical Basolateral
Na
+

K
+

Cl
-
Channels
Na
+

glucose
Na
+
coupled
organic
Cl
-
HCO
3
-
Antiporter
Na
+

K
+

2Cl
-
Symporter
Apical Surface
Johnson Chap. 34-35 Johnson Chap. 34-35
Basolateral Membrane
Johnson Chap. 34-35
Na
+
H
+
Antiporter
Na
+

K
+

2Cl
-
Symporter
K
+

Active
Transporter
Na
+

ATP
(Gut lumen)
Outside
Apical Basolateral
P
(interstitial
space)
Inside
Basolateral Surface
Johnson Chap. 34-35
5 10 15 20
10
20
30
40
Na
+
(mM)
(Intracellular)
T
r
a
n
s
p
o
r
t

R
a
t
e

Na Pump Transport Rate
Johnson Chap. 34-35
Gut lumen Gut lumen
interstitial
space
Cl
-
Na
+

K
+

Cl
-
Na
+

K
+

K
+

Na
+

Salt Secretion
interstitial
space
Salt Absorption
Na
+

K
+

K
+

Cl
-

Na
+
Johnson Chap. 34-35
1 2 3
4 0
20
40
60
80
100
I
o
n

c
o
n
c
e
n
t
r
a
t
i
o
n

(
m
M
)

Flow (ml/min)
Na
HCO
3

Cl
K
20
40
60
80
100
120
140
0
I
o
n

c
o
n
c
e
n
t
r
a
t
i
o
n

(
m
M
)

Na
Cl
HCO
3

K
Saliva Plasma
Salivary Duct Cell
Secretion of Na
+
, K
+
, and Cl
-

Salivary Acinar Cell
Johnson Chap. 34-35
Na
Na
Na
+
K
+
Cl
-
K
+

ATP
Na
+

K
+
Cl
-
K
+

Lumen
Serosal surface
stimuli
Johnson Chap. 34-35 Johnson Chap. 34-35
Na
+

Na
+
K
+
Cl
-

CO
2

K
+

ATP
Na
+

Cl
-
K
+

Lumen
Serosal surface
Na
+
H
+
CO
2

H
2
CO
3

HCO
3
-

Na
+
K
+
Cl
-
HCO
3
-

Salivary Duct Cell
Johnson Chap. 34-35
1 2 3
4 0
20
40
60
80
100
I
o
n

c
o
n
c
e
n
t
r
a
t
i
o
n

(
m
M
)

Flow (ml/min)
Na
HCO
3

Cl
K
20
40
60
80
100
120
140
0
I
o
n

c
o
n
c
e
n
t
r
a
t
i
o
n

(
m
M
)

Na
Cl
HCO
3

K
Saliva Plasma
Salivary Duct Cell
Johnson Chap. 34-35
100 300 500 0
Secretion rate (ml/hr)
0
160
120
80
40
I
o
n

C
o
n
c
e
n
t
r
a
t
i
o
n

(
m
M
)

7.8
7.4
8.2
p
H

300
260
340
O
s
m
o
l
a
l
i
t
y

Osm
pH
Na
+

HCO
3
-

Cl
-

K
+

Pancreatic Secretion
Johnson Chap. 34-35
Intestinal Absorbing Cell
Na
+

K
+
Cl
-
Cl
K
+

ATP
Na
+

Na
+

K
+

Lumen
Serosal surface
glucose
Na
+

Cl
-
HCO
3
-
K
+

A
T
P

Intestinal Secretory Cell
Johnson Chap. 34-35
Na
Na
Na
+
K
+
Cl
-
K
+

ATP
Na
+

Cl
-
Cl
-
K
+

Lumen
Serosal surface
stimuli
A
T
P

Composition and function of saliva
Major salivary components
Mucin 1 (MG1)
sIgA
Mucin 2 (MG2)
Lactoferrin
Peroxidases
Amylases
Carbonic anhydrases
Proline-rich proteins
Lysozyme
Statherins
Histatins
1 10 100 1000 10000
Size (kDa)
Multifunctionality
Salivary
Families
Anti-
Bacterial
Buffering
Digestion
Mineral-
ization
Lubricat-
ion &Visco-
elasticity
Tissue
Coating
Anti-
Fungal
Anti-
Viral
Carbonic anhydrases,
Histatins
Amylases,
Mucins, Lipase
Cystatins,
Histatins, Proline-
rich proteins,
Statherins
Mucins, Statherins
Cystatins, Mucins,
Proline-rich proteins, Statherins
Histatins
Cystatins,
Mucins
Cystatins,
Histatins, Mucins,
Peroxidases
adapted from M.J. Levine, 1993
Mucin Functions
Tissue Coating
Protective coating about hard and soft tissues
Concentrates anti-microbial molecules at mucosal
interface
Lubrication
Mucin Functions (contd)
Aggregation of bacterial cells
Bacterial adhere to mucins may result in surface
attachment, or
Mucin-coated bacteria may be unable to attach to
surface
Bacterial adhesion
Mucin oligosaccharides mimic those on mucosal cell
surface
React with bacterial adhesins, thereby blocking them
Amylases
Hydrolyzes (1-4) bonds of starches
Maltose is the major end-product (20% is
glucose)
Lingual Lipase
Secreted by von Ebners glands of tongue
Involved in first phase of fat digestion
Hydrolyzes medium- to long-chain
triglycerides
Important in digestion of milk fat in new-
born
Unlike other mammalian lipases, it is highly
hydrophobic and readily enters fat globules
Statherins
Calcium phosphate salts of dental enamel are
soluble
Supersaturation of calcium phosphates
maintain enamel integrity
Statherins prevent precipitation or
crystallization of supersaturated calcium
phosphate in ductal saliva and oral fluid

Proline-rich Proteins (PRPs)
Inhibit calcium phosphate crystal growth
Calculus formation
Calculus forms in plaque despite inhibitory
action of statherin and PRPs in saliva
Proteolytic enzymes of oral bacteria or lysed
leukocytes may destroy inhibitory proteins
Plaque bacteria may produce their own
inhibitors
Lactoferrin

Nutritional immunity
Some microorganisms (e.g., E. coli) have adapted
to this mechanism by producing enterochelins.
bind iron more effectively than lactoferrin
iron-rich enterochelins are then reabsorbed by
bacteria
Lactoferrin, with or without iron, can be
degraded by some bacterial proteases.
In unbound state, a direct bactericidal effect
Lysozyme
Present in numerous organs and most body fluids
Sources of oral LZ:
major and minor salivary glands, phagocytic cells
Biological function
Classic concept of anti-microbial activity of LZ is based on its
muramidase activity (hydrolysis of (1-4) bond between N-
acetylmuramic acid and N-acetylglucosamine in the
peptidoglycan layer.
Gram negative bacteria generally more resistant than gram
positive because of outer LPS layer
Other anti-microbial activities of LZ
Muramidase activity (lysis of peptidoglycan
layer)
Cationic-dependent activation of bacterial
autolysins
disrupts membranes
Aggregation of bacteria
Inhibition of glucose uptake and acid production
De-chaining of streptococci
Histatins
A group of small histidine-rich proteins
Potent inhibitors of Candida albicans
growth

Cystatins
Are inhibitors of cysteine-proteases
Are ubiquitous in many body fluids
Considered to be protective against unwanted
proteolysis
bacterial proteases
lysed leukocytes
May play inhibit proteases in periodontal tissues
Also have an effect on calcium phosphate
precipitation
Mekanisme lokal:
Prostaglandin, histamin, dan bahan kimia lain yg
dilepaskan ke cairan interstitial dapat
berpengaruh pada sel sekitar
Mesenger lokal ini penting dalam kordinasi
tanggap terhadap perubahan pH lokal, rangsang
fisik atau kimia lain.
GIT Regulation

Stomach (continued)
Insert fig. 18.5
Stomach

Secrete gastric juice:
Goblet cells: mucus.
Parietal cells: HCl and intrinsic factor.
Chief cells: pepsinogen.
Enterochromaffin-like cells (ECL): histamine
and serotonin.
G cells: gastrin.
D cells: somatostatin.
oxintic: ghrelin.
Gastric Glands

Gastric Secretion
HCl Production
Parietal cells
secrete H
+
into
gastric lumen by
primary active
transport, through
H
+
/ K
+
ATPase
pump.
Parietal cells
basolateral
membrane takes in
Cl
-
against its
electrochemical
gradient, by
coupling its
transport with
HC0
3
-
.
Insert fig. 18.8
HCl production

HCl production is stimulated:
Indirectly by gastrin.
Indirectly by ACh.
ACh and gastrin stimulate release of
histamine.
Histamine:
Stimulates parietal cells to secrete HCl.
HCl production

Makes gastric juice
very acidic.
Denatures ingested
proteins (alter
tertiary structure)
so become more
digestible.
Activates
pepsinogen to
pepsin.
Pepsin is more
active at pH of 2.0.
Insert fig. 18.9
HCl Function

Proteins partially digested by pepsin.
Carbohydrate digestion by salivary amylase
is soon inactivated by acidity.
Alcohol and aspirin are the only commonly
ingested substances absorbed.
Digestion and Absorption in the
Stomach

Parietal and chief cells impermeable to HCl.
Alkaline mucus contains HC0
3
-
.
Tight junctions between adjacent epithelial
cells.
Rapid rate of cell division (entire epithelium
replaced in 3 days).
Prostaglandins inhibit gastric secretions.
Protective Mechanisms of Stomach

Usus halus

Getah Pankreas
Getah Empedu
Getah usus halus
Getah pencernaan di Usus
halus

1,8 L /hari
1. Kelenjar Brunner: di mukosa duodenum,
merangsang sekresi:
Mukus: melindungi mukosa duodenum dari iritasi HCl &
pepsin
Buffer :me pH (khime dlm duodenum pH: 1-2 sp 7-8)
2. Kripte Lieberkuhn
Produksi enzim, cairan isotonik dan alkalin
Getah Usus halus

3. Enterosit vili
menghasilkan: amilase, enterokinase, lipase,
peptidase, disakaridase, yang tidak
dikeluarkan ke lumen namun akan memecah
lemak, protein, karbohidrat begitu absorbsi
dimulai
Getah Usus halus

1500 cc / hari
Mengandung: bikarbonat, elektrolit: Na,K,Cl,enzim
Mempunyai 2 fungsi:
1. Endokrin: sel endokrin sekresi insulin & glukagon
2. Eksokrin: berasal dari sel asinus dan epitel: keduanya
menghasilkan cairan disebut cairan pankreas (pancreatic
juice) yg dikeluarkan ke usus halus.
enzim yang dikeluarkan sel asinus berguna untuk memecah khime
menjadi molekul kecil yang mudah diabsorbsi.
Sel epitel mengeluarkan air & ion untuk mengencerkan khime &
sebagai buffer

Getah Pankreas

Pengaturan sekresi melalui pengendalian hormon.
Bila khime masuk duodenum, maka
duodenum mengeluarkan hormon :
1. sekretin: memacu pankreas sekresi buffer air
dengan pH 7,5-8,8 dan buffer bicarbonat
serta fosfat
2. kolesistokinin: rangsang produksi dan sekresi
enzim pankreas
Pengaturan sekresi

Secretin secretion from the duodenum is
triggered by the arrival of acidic chyme from
the stomach.
Secretin is a hormone:
its receptors are found in the pancreas, which
responds with additional bicarbonate
delivery, and its receptors are also associated
with the stomach; this enterogastrone
inhibits gastric motility and secretion.


Pengaturan sekresi

Cholecystokinin secretion from the small
intestine is triggered by the arrival of amino
acids and fatty acids in the chyme.
Cholecystokinin is a hormone: its receptors are
in the pancreas, which responds with additional
enzyme delivery, and
in the gall bladder, which contracts to deliver
more bile, and in the sphincter of Oddi, which
relaxes to facilitate delivery of the enzymes and
bile salts (it is also an enterogastrone).


digestive enzymes secreted as inactive precursors
(zymogens) to prevent autodigestion
important proteolytic enzymes are trypsin, chymotrypsin
and carboxypeptidases
other enzymes are-
pancreatic lipase
pancreatic amylase
trypsinogen is activated by enteropeptidase which is
secreted by intestinal mucosa in response to chyme
trypsin then activates the other proenzymes
trypsin inhibitor secreted to delay activation of
trypsinogen
Enzim pankreatik

F O O D
Aktifasi enzimatik

Were digestive enzymes synthesized in their
active form, they would digest the very cells
that make them. Hence, inactive precursors
(e.g., trypsinogen) become activated (trypsin,
which activates many other
precursors) only after they are transported to
the appropriate place.


cephalic phase ~15% mainly causes secretion of enzymes
into the acini - vagus mediated
gastric phase ~15% gastric distension by means of vago-
vagal reflex evokes enzyme secretion
gastrin release by antral lumen causing more enzyme
release
intestinal phase ~70% -pancreatic HCO3 secretion strongly
stimulated when duodenal pH is acid - S cells secrete
secretin into the blood and this stimluates pancreatic duct
cells
chyme also causes I cells to release CCK which causes
pancreatic enzymes to be secreted (mainly due to
peptones and fatty acids)
Fase sekresi pankreas

Stimuli of Pancreatic Secretion
ACh - parasympathic vagus nerves as well as
myenteric cholinergics
Gastrin - liberated during gastric phase of stomach
secretion
CCK (cholecystokinin) - secreted by duodenal and
upper jejunal mucosa when food enters small
intestine
these 3 all stimulate production of digestive enzymes
by the acini and act via IP3 to release intracellular Ca
Secretin - same duodenal and upper jejunal mucosa
but secretin acts via cAMP on the ductal cells to
increase HCO3 secretion
Pengiriman nutrient dari saluran cerna ke sirkulasi,
terutama tjd di usus halus permukaan yang
luas.
Absopsi efisien bila:
1. Bentuk hasil pencernaan baik
2. Permukaan absorpsi adekuat
3. Kecepatan/ waktu transit nutrient di usus halus
4. Kofaktor dan atau karier spesifik
Absorbsi usus halus

1. Absorbsi air dan elektrolit
membran intestinal sangat permeabel terhadap
air
Air diserap menggunakan osmotic gradient
Sebagian besar nutrient diserap oleh yeyunum
Absorbsi usus halus

brush border permukaan absorbsi
Na via Na channel dan Na-nutrient cotransporter
Na dipompa ke darah oleh Na-K ATPase
Absorbsi usus halus

2000 g in, 150 g out
Sirkulasi air

Digestive secretions are mostly water, with
the average amounts indicated here. Note
that only 100 ml are excreted in feces, so the
mechanisms for water absorption are
efficient (recall the kidneys primary role in
water and osmotic homeostasis).



2. Pencernaan & absorpsi karbohidrat
300g / hari
Polisakarida kompleks: 64% pati, 0.5%
glikogen
Disakarida: 26% sukrosa, 6.5% laktosa, 3%
MALTOSA
Hidrolisis lengkap 80% glucosa, 14%
fruktosa, 5% galaktosa kapiler


Absorbsi usus halus

Carbohydrate absorption
pancreatic juices cannot further hydrolyse
oligosaccharides
brush border oligosaccharidases
brush border lactase, sucrase-isomaltase and maltase
release monosaccharides (glucose, galactose and
fructose)
glucose and galactose taken up by SGLT1
fructose by GLUT5
all three transported via GLUT2 out into the portal
vein and to the liver

In a normal diet, bulk is Carbs, 250-800 g (ex. Atkins)
+ 125 g protein, +25-160 g fat.
Fat absorption
lipids- mainly triacylglycerols
1 - large oil droplets (shearing forces in gut)
2 - emulsified oil drops with bile salts
pancreatic lipase at oil-water interface
3 - formation of micelles
micelles come to the absorptive surface of gut
monoglycerides and free fatty acids are then
absorbed
4. inside cells resynthesis of triacylglycerols, cholesterol and
phospholipids to chylomicrons
5. secreted into lacteal and to systemic circulation to adipose
tissue where the chylomicron is stripped of its
triacylglycerols and chylomicron remnant goes to liver -
dietary cholesterol to liver. free fatty acids are also
synthesised to prostaglandins (can act as local gut
hormones)


Product Absorption pathway

Carbohydrates Fru Facilitated diffusion
Glu/Gal Active Transport / Sodium

Protein Amino Acids Active transport / Sodium
Proteins (except.) endo-exocytosis
(infants mainly)

Fat Free Fatty Acids Diffusion
Monoglyc. Diffusion

Vitamins (fat) A, D, E, K Diffusion (via micelles)

Vitamins (water) B-12 Binds to Intrin. Factor.
Endocytosis

Iron Active Transport
then into ferritin
kolon
Sekresi:
mukus yang diproduksi oleh sel goblet untuk
pelumas feses dan epitel
HCO
3
-
, untuk menyeimbangkan asam produksi
bakteri
kolon
Absorbsi :
air Osmosis
elektrolit
vitamin yg dihasilkan kerja bakteri:
Vitamin K: larut lemak, untuk pembekuan darah
Biotin: larut air, penting untuk metabolisne glukosa
Vitamin B5: asam pantotenat: larut air, untuk
membuat hormon steroid & beberapa neurotransmiter
Bakteri mengubah bilirubin menjadi urobilinogen (diabsorpsi ke
sirkulasi, dibuang melalui urin) dan sterkobilinIn the large
intestine, active transport of sodium, coupled with osmotic
absorption of water, are the primary activities.
Microbes here are active in the production of vitamin K.


kolon