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Digestion, Absorption, and Metabolism

Chapter 3

Mosby items and derived items © 2007, 2004, 2002, 2000 by Mosby, Inc., an affiliate of Elsevier Inc.
Role in Wellness

 Physical health dimension


 Maintaining body function depends on digestion and
absorption of nutrients
 Intellectual health dimension
 Deciding and following through with lifestyle behavior
changes to improve health of digestive system is an
aspect of intellectual health
 Emotional health dimension
 Emotional state and ability to handle stress may
increase risk of GI tract disorders such as
constipation, diarrhea, and heartburn

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Role in Wellness, cont’d

 Social health dimension


 Negativity associated with body smells is defined
by society; reducing causes of intestinal gas
guards against socially embarrassing moments
 Spiritual health dimension
 Respecting the sanctity of the human body
includes willingness to follow dietary and lifestyle
changes to enhance functioning of GI tract

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Digestion

 Gastrointestinal (GI) tract consists of the


main organs of the digestive system that form
a tube from mouth to anus; also called
alimentary canal
 Digestive system is series of organs that
prepare ingested nutrients for digestion and
absorption
 Digestion is the process by which foods are
broken down into smaller and smaller units to
prepare nutrients for absorption
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Digestion, cont’d

 Processes of ingestion, digestion, absorption,


and elimination depend on the motility or
movement of GI wall and secretions of
digestive juices and enzymes

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Digestion, cont’d

 The mouth
 Salivary glands secret saliva
 Three salivary glands: parotid glands, submandibular
glands, and sublingual glands
 Exocrine glands secrete chemicals into ducts that
release into a cavity or to surface of body, such as
salivary glands (mouth) and liver (gallbladder)

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Digestion, cont’d

 Food in mouth stimulates chemical and


mechanical digestion
 Chemical digestion is the chemical altering effects of
digestive secretions, gastric juices, and enzymes on food
substance composition
 Mechanical digestion is the crushing and twisting
effects of teeth and peristalsis dividing foods into smaller
pieces
 Functions of teeth and tongue
 Bolus is a masticated lump or ball of food ready to be
swallowed

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Digestion, cont’d

 The esophagus
 A muscular tube through which bolus travels from
mouth to stomach
 Peristalsis is rhythmic contractions of muscles
causing wavelike motions that move food down GI
tract
 Segmentation is forward and backward muscular
action that helps control food mass movement
through GI tract
 Functions of cardiac sphincter

Mosby items and derived items © 2007, 2004, 2002, 2000 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 8
Digestion, cont’d

 The stomach
 Divisions include fundus, upper portion; body,
center portion; and pylorus, lower portion
 Functions of gastric secretions and hormones
 Gastrin is a hormone secreted by stomach mucosa that
increases release of gastric juices
 Gastric motility requires 2 to 6 hours
 Results in chyme, a semiliquid mixture of food mass

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Digestion, cont’d

 Functions of the stomach include:


 Holding food for partial digestion
 Producing gastric juice
 Providing muscular action, which, combined with gastric
juice, mixes and tears food into smaller pieces
 Secreting the intrinsic factor for vitamin B12 absorption
 Releasing gastrin
 Assisting in destroying, through acidity secretions,
pathogenic bacteria that may have inadvertently been
consumed
 Functions of pyloric sphincter

Mosby items and derived items © 2007, 2004, 2002, 2000 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 10
Digestion, cont’d

 The small intestine


 Consists of duodenum, jejunum, and ileum
 Passage through takes about 5 hours
 Major organ of digestion and most absorption
 Intestinal walls
 Villi are fingerlike projections on the walls of the small
intestine that increase the mucosal surface area

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Digestion, cont’d

 Function of hormones, substances that act as


messengers between organs to cause the release
of needed secretions
 Secretions from small intestine, liver, and
pancreas include:
 Enzymes from small intestine such as secretin, a
hormone secreted by small intestine that causes
pancreas to release bicarbonate to small intestine

Mosby items and derived items © 2007, 2004, 2002, 2000 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 12
Digestion, cont’d

 Bile, a substance that emulsifies fats to aid digestion of


lipids; produced by liver and stored in gallbladder
 Cholecystokinin (CCK), a hormone secreted by small
intestine that initiates pancreatic exocrine secretions,
acts against gastrin, and activates gallbladder to release
bile
 Function of ileocecal valve (sphincter)

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Digestion, cont’d

 The large intestine


 Consists of cecum, colon, and rectum
 Passage through takes about 9 to 16 hours
 Site of final absorption of any available nutrients,
usually water and some minerals
 Bacteria in colon produce several vitamins
 Formation of feces and excretion from colon
through anus (sphincter)

Mosby items and derived items © 2007, 2004, 2002, 2000 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 14
Digestion, cont’d

 During passage through GI tract:


 More than 95% of carbohydrates, fats, and
proteins absorbed
 Some minerals, vitamins, and trace elements less
absorbed

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Absorption

 Absorption is the process by which substances


pass through the intestinal mucosa into the
blood or lymph
 Transport processes provide means for
nutrients to actually pass through wall of small
intestine
 Passive digestion and osmosis occur when pressure
is greater on one side of membrane; substance then
moves from area of greater pressure to less
pressure, allowing molecules to travel through
capillaries
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Absorption, cont’d

 Facilitated diffusion takes place when, despite


positive pressure flow, molecules may be unable
to pass through membrane pores unless aided
 Energy-dependent active transport happens when
fluid pressures work against the passage of
nutrients
 Active process requiring energy supplied by
cell and a “pumping” mechanism, assisted by
special membrane protein carrier

Mosby items and derived items © 2007, 2004, 2002, 2000 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 17
Absorption, cont’d

 Engulfing pinocytosis occurs when a


substance, either fluid or nutrient, contacts
villi membrane
 Villi then surround substance, creating a vacuole
encompassing substance
 Passing through cell cytoplasm, substance then
released into circulatory system

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Absorption, cont’d

 Amounts of vitamins and minerals absorbed


depend on body’s storage levels and
immediate need
 Nutrients such as fats, carbohydrates, and protein
easily absorbed regardless of level of need
 Structure of small intestine, site of almost all
nutrient absorption, allows for efficient
absorption to occur

Mosby items and derived items © 2007, 2004, 2002, 2000 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 19
Absorption, cont’d

 Microvilli sensitive to exact nutrient needs of body


 Their wavelike motions, caused by peristalsis, result in
exposure of nutrient-laden chyme to absorbing cells
 At this point, nutrients are truly “inside” body
 Factors affecting absorption of nutrients
 Combinations of naturally occurring substances
such as fibers or binders

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Absorption, cont’d
 Bioavailability
 Relationship between food and drug absorption
 Once absorbed, nutrients enter circulatory
system of bloodstream or lymphatic system
 General circulatory or blood system receives
absorbed protein, carbohydrates, small parts of
fats, and most vitamins and minerals
 Transports nutrients throughout body

Mosby items and derived items © 2007, 2004, 2002, 2000 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 21
Absorption, cont’d

 Lymphatic system receives large lipids and fat-soluble


vitamins
 Nutrients deposited into bloodstream near heart
 All nutrients circulate through blood, providing for all cells
 Nutrients pass by liver then heart
 Some nutrients end up in storage sites of body
 If not discarded or used by cells, nutrients filtered out of
blood by kidneys

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Absorption, cont’d

 Elimination
 Expulsion of feces of body waste products called
defecation
 Residue may include substances such as
cellulose and other dietary fibers and undigested
tissues
 Undigested fats may combine with dietary minerals such
as calcium and magnesium to form residue
 Additional residue may include water, bacteria, pigments,
and mucus

Mosby items and derived items © 2007, 2004, 2002, 2000 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 23
Absorption, cont’d

 Digestive process across the life span


 Main and accessory organs of digestion develop
and change over life span
 Immature GI tract of young infants
 Age-related lactose intolerance
 Middle years include gallbladder disease and
peptic ulcers
 Older years associated with constipation and
diverticulosis

Mosby items and derived items © 2007, 2004, 2002, 2000 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 24
Metabolism

 Metabolism is set of processes through which


absorbed nutrients are used by body for energy
and to form and maintain body structures and
functions
 Two main processes of metabolism involve
catabolism and anabolism
 Catabolism is breakdown of food components into smaller
molecular particles, causing release of heat and chemical
energy
 Anabolism is process of synthesis from which substances
are formed, such as new bone or muscle tissue

Mosby items and derived items © 2007, 2004, 2002, 2000 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 25
Metabolism, cont’d

 When nutrients reach individual cells:


 Help form new cell structures or create new substances
such as hormones and enzymes
 Assist in use of other nutrients in cell
 Act as catalysts or coenzymes in transforming and using
of carbohydrates, proteins, and lipids

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Metabolism, cont’d

 Provide energy for life-supporting processes or store


energy in ready-to-use state
 Metabolic waste products discarded by cells and
circulate in blood
 Excreted through lungs, kidneys, or large intestine
 Metabolism across the life span
 Later in life amount of food energy decreases in
relation to lowered metabolic rates

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Overcoming Barriers
 Heartburn or gastroesophageal reflux (GER) is
the return of gastric contents into the esophagus
that results in a severe burning sensation under
the sternum
 Symptoms include burning sensation in esophagus,
asthma, chronic cough, and other ear, nose, and throat
ailments
 Preventions and treatment strategies
 Chronic heartburn or GER may result in
gastroesophageal reflux disease/esophagitis or be
caused by hiatal hernia

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Overcoming Barriers, cont’d

 Vomiting is reverse peristalsis


 Causes loss of fluid and electrolytes
 Dehydration a concern, particularly for infants
 Intestinal gas or flatus released from lower
intestinal tract
 Formed by bacteria in large intestine due to
fermentation, lactose intolerance, constipation, and
eating quickly
 Decreasing through changes of food-related behaviors

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Overcoming Barriers, cont’d

 Constipation is straining to pass hard, dry


stools
 Caused by slow movement of feces through colon
 Lifestyle behavior changes to reduce causes

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Overcoming Barriers, cont’d

 Diarrhea is frequent passing of loose, watery


bowel movements
 Occurs when contents of GI tract move through
too quickly to allow water to be absorbed in large
intestine
 May be caused by bacterial or viral infections,
lactose intolerance, spoiled foods, or even stress
 Can lead to dehydration; most at risk are infants
and older adults

Mosby items and derived items © 2007, 2004, 2002, 2000 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 31
Toward a Positive Nutrition Lifestyle:
Contracting
 Contract is a specific agreement with yourself
or between you and a friend, spouse, or other
relative
 Agreement represents willingness to attempt to
change a health-related behavior
 Goal or behavior change is clearly defined and
observable

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