Gastrointestinal tract

The digestive tract is the system of organs within multicellular animals that takes in food, digests it to extract energy and nutrients, and expels the remaining matter. The major function of the gastrointestinal tract are ingestion, digestion, absorption, and defecation. The GI tract differs substantially from animal to animal. Some animals have multi-chambered stomachs, while some animals' stomachs contain a single box. In a human adult male, the GI tract is approximately 6.5 meters (20 feet) long and consists of the upper and lower GI tracts. The tract may also be divided into foregut, midgut, and hindgut, reflecting the embryological origin of each segment of the tract.^[1]

The remainder of this article focuses on human gastrointestinal anatomy; see digestion for the process in other organisms.

Contents 1 Upper gastrointestinal tract 2 Lower gastrointestinal tract 3 Accessory organs 4 Embryology 5 Physiology 5.1 Specialization of organs 5.2 Transit time 6 Pathology 7 Immune function 8 Histology 8.1 Mucosa 8.2 Submucosa 8.3 Muscularis externa 8.4 Adventitia 9 Uses of animal gut by humans 10 See also 11 Notes 12 References 13 External links

Upper gastrointestinal tract

The upper Gastrointestinal tract consists of the mouth, pharynx, esophagus, stomach, and duodenum proximal to the [[ligament o the buccal cavity, which contains the openings of the salivary glands; the tongue; and the teeth.

• Behind the mouth lies the pharynx which prevents food from entering the voice box and leads to a hollow muscular tube, the esophagus.
• Peristalsis takes place, which is the contraction of muscles to propel the food down the esophagus which extends through the chest and pierces the diaphragm to reach the stomach.

Lower gastrointestinal tract

The lower gastrointestinal tract comprises the most of the intestines and anus.

• Bowel or intestine
  • Small intestine, two of the three parts:
    • Duodenum
    • Jejunum
    • Ileum
  • Large intestine, which has three parts:
    • Cecum (the vermiform appendix is attached to the cecum).
    • Colon (ascending colon, transverse colon, descending colon and sigmoid flexure)
    • Rectum
• Anus

Accessory organs

Accessory organs to the alimentary canal include the liver, gallbladder, and pancreas. The liver secretes bile into the small intestine via the bile duct, employing the gallbladder as a reservoir. Apart from storing and concentrating bile, the gallbladder has no other specific function. The pancreas secretes an isosmotic fluid containing bicarbonate, which helps neutralize the acidic chyme, and several enzymes, including trypsin, chymotrypsin, lipase, and pancreatic amylase, as well as nucleolytic enzymes (deoxyribonuclease and ribonuclease), into the small intestine. Both of these secretory organs aid in digestion.

Embryology

The gut is an endoderm-derived structure. At approximately the 16th day of human development, the embryo begins to fold ventrally (with the embryo's ventral surface becoming concave) in two directions: the sides of the embryo fold in on each other and the head and tail fold towards one another. The result is that a piece of the yolk sac, an endoderm-lined structure in contact with the ventral aspect of the embryo, begins to be pinched off to become the primitive gut. The yolk sac remains connected to the gut tube via the vitelline duct. Usually this structure regresses during development; in cases where it does not, it is known as Meckel's diverticulum.

During fetal life, the primitive gut can be divided into three segments: foregut, midgut, and hindgut. Although these terms are often used in reference to segments of the primitive gut, they are nevertheless used regularly to describe components of the definitive gut as well.

Each segment of the primitive gut gives rise to specific gut and gut-related structures in the adult. Components derived from the gut proper, including the stomach and colon, develop as swellings or dilatations of the primitive gut. In contrast, gut-related derivatives—that is, those structures that derive from the primitive gut but are not part of the gut proper—in general develop as outpouchings of the primitive gut. The blood vessels supplying these structures remain constant throughout development.^[2]

part	part in adult	Gives rise to	Arterial supply
foregut	the pharynx, to the upper duodenum	pharynx, esophagus, stomach, upper duodenum, respiratory tract (including the lungs), liver, gallbladder, and pancreas	branches of the celiac artery
midgut	lower duodenum, to the first two-thirds of the transverse colon	lower duodenum, jejunum, ileum, cecum, appendix, ascending colon, and first two-thirds of the transverse colon	branches of the superior mesenteric artery
hindgut	last third of the transverse colon, to the upper part of the anal canal	last third of the transverse colon, descending colon, rectum, and upper part of the anal canal	branches of the inferior mesenteric artery

Physiology

Specialization of organs

Four organs are subject to specialization in the kingdom Animalia.

• The first organ is the tongue which is only present in the phylum Chordata.
• The second organ is the esophagus. The crop is an enlargement of the esophagus in birds, insects, and other invertebrates that is used to store food temporarily.
• The third organ is the stomach . In addition to a glandular stomach (proventriculus), birds have a muscular "stomach" called the ventriculus or "gizzard." The gizzard is used to mechanically grind up food.
• The fourth organ is the large intestine. An outpouching of the large intestine called the cecum is present in non-ruminant herbivores such as rabbits. It aids in digestion of plant material such as cellulose

Transit time

The time taken for food or other ingested objects to transit through the gastrointestinal tract varies depending on many factors, but roughly, it takes 2.5 to 3 hours after meal for 50% of stomach contents to empty into the intestines. Total emptying of the stomach takes 4 to 5 hours. Subsequently, 50% emptying of the small intestine takes 2.5 to 3 hours. Finally, transit through the colon takes 30 to 40 hours.^[3]

Pathology

There are a number of diseases and conditions affecting the gastrointestinal system, including:

• Cholera
• Colorectal cancer
• Diverticulitis
• Enteric duplication cyst
• Gastroenteritis, also known as "stomach flu";an inflammation of the stomach and intestines
• Giardiasis
• Inflammatory bowel disease (Crohn's disease and ulcerative colitis)
• Irritable bowel syndrome
• Pancreatitis
• Peptic ulcer disease
• Appendicitis

Immune function

The gastrointestinal tract is also a prominent part of the immune system.^[4] The surface area of the digestive tract is estimated to be the surface area of a football field. As such, the immune system must work hard to prevent pathogens from entering into blood and lymph.^[5] The low pH (ranging from 1 to 4) of the stomach is fatal for many microorganisms that enter it. Similarly, mucus (containing IgA antibodies) neutralizes many of these microorganisms. Other factors in the GI tract help with immune function as well, including enzymes in the saliva and bile. Enzymes such as Cyp3A4, along with the antiporter activities, are also instrumental in the intestine's role of detoxification of antigens and xenobiotics, such as drugs, involved in first pass metabolism. Health-enhancing intestinal bacteria serve to prevent the overgrowth of potentially harmful bacteria in the gut. Microorganisms are also kept at bay by an extensive immune system comprising the gut-associated lymphoid tissue (GALT).

Histology

The gastrointestinal tract has a uniform general histology with some differences which reflect the specialization in functional anatomy.^[6] The GI tract can be divided into 4 concentric layers:

• Mucosa
• Submucosa
• Muscularis externa (the external muscle layer)
• Adventitia or serosa

Mucosa

The mucosa is the innermost layer of the gastrointestinal tract that is surrounding the lumen, or space within the tube. This layer comes in direct contact with the food (or bolus), and is responsible for absorption and secretion, important processes in digestion.

The mucosa can be divided into:

• Epithelium
• Lamina propria
• Muscularis mucosae

The mucosae are highly specialized in each organ of the gastrointestinal tract, facing a low pH in the stomach, absorbing a multitude of different substances in the small intestine, and also absorbing specific quantities of water in the large intestine. Reflecting the varying needs of these organs, the structure of the mucosa can consist of invaginations of secretory glands (e.g., gastric pits), or it can be folded in order to increase surface area (examples include villi and plicae circulares).

Submucosa

The submucosa consists of a dense irregular layer of connective tissue with large blood vessels, lymphatics and nerves branching into the mucosa and muscularis. It contains Meissner's plexus, an enteric nervous plexus, situated on the inner surface of the muscularis externa.

Muscularis externa

The muscularis externa consists of an inner circular layer and a longitudinal outer muscular layer. The circular muscle layer prevents the food from going backwards and the longitudinal layer shortens the tract. The coordinated contractions of these layers is called peristalsis and propels the bolus, or balled-up food, through the GI tract. Between the two muscle layers are the myenteric or Auerbach's plexus.

Adventitia

The adventitia consists of several layers of epithelia. When the adventitia is facing the mesentery or peritoneal fold, the adventitia is covered by a mesothelium supported by a thin connective tissue layer, together forming a serosa, or serous membrane.

Uses of animal gut by humans

• The stomachs of calves have commonly been used as a source of rennet for making cheese.
• The use of animal gut strings by musicians can be traced back to the third dynasty of Egypt. In the recent past, strings were made out of lamb gut. With the advent of the modern era, musicians have tended to use strings made of silk, or synthetic materials such as nylon or steel. Some instrumentalists, however, still use gut strings in order to evoke the older tone quality. Although such strings were commonly referred to as "catgut" strings, cats were never used as a source for gut strings.
• Sheep gut was the original source for natural gut string used in racquets, such as for tennis. Today, synthetic strings are much more common, but the best strings are now made out of cow gut.
• Gut cord has also been used to produce strings for the snares which provide the snare drum's characteristic buzzing timbre. While the snare drum currently almost always uses metal wire rather than gut cord, the North African bendir frame drum still uses gut for this purpose.
• "Natural" sausage hulls (or casings) are made of animal gut, especially hog, beef, and lamb.
• Chitterlings, a kind of food, consist of thoroughly washed pig's gut.
• Animal gut was used to make the cord lines in longcase clocks and for fusee movements in bracket clocks, but may be replaced by metal wire.
• The oldest known condoms, from 1640 AD, were made from animal intestine.^[7]

See also

Wikimedia Commons has media related to: Digestive system

• Dysbiosis
• Gastrointestinal hormone
• Dorland's Illustrated Medical Dictionary
• Major systems of the human body

Notes

References

• National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health.

External links

• Anatomy atlas of the Digestive System
• Overview at Colorado State University
• Your Digestive System and How It Works at [http://digestive.niddk.nih.gov/ National
• [http://www.pediatricfeeding.org/gi_anatomy.htm Normal Anatomy of Digestive Tract and anatomical abnormalities and diseases]

Digestive Diseases Information Clearinghouse (NDDIC)]

v • d • e Anatomy of torso, digestive system: Gastrointestinal tract Upper GI To stomach Mouth • Pharynx (nasopharynx, oropharynx, hypopharynx) • Esophagus (UES, LES)  • Crop Stomach rugae · gastric pits · cardia/gland · fundus/gland · pylorus/gland · pyloric antrum · pyloric canal · greater curvature · lesser curvature · angular incisure Lower GI Intestine: small Duodenum (Suspensory muscle, Major duodenal papilla, Minor duodenal papilla) • Duodenojejunal flexure • Jejunum • Ileum • Ileocecal valve continuous (intestinal villus, crypts of Lieberkühn, circular folds) Intestine: large Vermiform appendix • Cecum • Colon (ascending colon, hepatic flexure, transverse colon, splenic flexure, descending colon, sigmoid colon) continuous (taenia coli, haustra, epiploic appendix) Termination Rectum: Houston valve • rectal ampulla • pectinate line Anal canal: anal valves • anal sinuses • anal columns • Hilton's white line Anus: Sphincter ani internus muscle • Sphincter ani externus muscle Lymph GALT: Peyer's patches (M cells)

v • d • e Anatomy of torso, digestive system: accessory digestive glands Liver by region: Left lobe (Caudate lobe, Quadrate lobe) • Right lobe • Transverse fissure of liver • Bare area of the liver by function: Fibrous capsule of Glisson • Hepatocyte • Space of Disse • Space of Mall • Kupffer cell • Liver sinusoid • Hepatic stellate cell • Hepatic lobule Biliary tract Bile ducts intrahepatic: Bile canaliculus • Canals of Hering • Interlobular bile ducts • Intrahepatic bile ducts • Left and Right hepatic ducts extrahepatic: Common hepatic duct • Cystic duct • Common bile duct Gallbladder by region: Body • Fundus • Neck Pancreas by region: Tail • Body • Neck • Head • Uncinate process by function: Islets of Langerhans • Exocrine pancreas ducts: Pancreatic duct • Accessory pancreatic duct Common Hepatopancreatic ampulla • Sphincter of Oddi

v • d • e Prenatal development/Mammalian development of digestive system Gut Stomodeum Foregut (Buccopharyngeal membrane, Rathke's pouch, Tracheoesophageal septum, Pancreatic bud, Hepatic diverticulum) Midgut Hindgut (Urorectal septum ) Proctodeum Mesentery Dorsal mesentery - Ventral mesentery Other Septum transversum

v • d • e Digestive system · Digestive disease · Gastroenterology (primarily K20-K93, 530-579) Upper GI tract Esophagus Esophagitis (Candidal) · rupture (Boerhaave syndrome, Mallory-Weiss syndrome) · UES (Zenker's diverticulum) · LES (Barrett's esophagus) · Esophageal motility disorder (Nutcracker esophagus, Achalasia, Diffuse esophageal spasm, GERD) · Esophageal stricture · Megaesophagus Stomach Gastritis (Atrophic, Ménétrier's disease, Gastroenteritis) · Peptic (gastric) ulcer (Cushing ulcer, Dieulafoy's lesion) · Dyspepsia · Pyloric stenosis · Achlorhydria · Gastroparesis · Gastroptosis · Portal hypertensive gastropathy · Gastric antral vascular ectasia · Gastric dumping syndrome · Gastric volvulus Intestinal/ enteropathy Small intestine/ (duodenum/jejunum/ileum) Enteritis (Duodenitis, Jejunitis, Ileitis) — Peptic (duodenal) ulcer (Curling's ulcer) — Malabsorption: Coeliac · Tropical sprue · Blind loop syndrome · Whipple's · Short bowel syndrome · Steatorrhea · Milroy disease Large intestine (appendix/colon) Appendicitis · Colitis (Pseudomembranous, Ulcerative, Ischemic, Microscopic, Collagenous, Lymphocytic) · Functional colonic disease (IBS, Intestinal pseudoobstruction/Ogilvie syndrome) — Megacolon/Toxic megacolon · Diverticulitis/Diverticulosis Large and/or small Enterocolitis (Necrotizing) · IBD (Crohn's disease) — vascular: Abdominal angina · Mesenteric ischemia · Angiodysplasia — Bowel obstruction: Ileus · Intussusception · Volvulus · Fecal impaction — Constipation · Diarrhea (Infectious) Rectum Proctitis (Radiation proctitis) · Proctalgia fugax · Rectal prolapse Anus Anal fissure/Anal fistula · Anal abscess  · Anal dysplasia  · Pruritus ani Accessory Liver Hepatitis (Viral hepatitis, Autoimmune hepatitis, Alcoholic hepatitis) · Cirrhosis (PBC) · Fatty liver (NASH) · vascular (Hepatic veno-occlusive disease, Portal hypertension, Nutmeg liver) · Alcoholic liver disease · Liver failure (Hepatic encephalopathy, Acute liver failure) · Liver abscess (Pyogenic, Amoebic) · Hepatorenal syndrome · Peliosis hepatis Gallbladder Cholecystitis · Gallstones/Cholecystolithiasis · Cholesterolosis · Rokitansky-Aschoff sinuses · Postcholecystectomy syndrome Bile duct/ other biliary tree Cholangitis (PSC, Secondary sclerosing cholangitis, Ascending) · Cholestasis/Mirizzi's syndrome · Biliary fistula · Haemobilia · Gallstones/Cholelithiasis common bile duct (Choledocholithiasis, Biliary dyskinesia) Pancreatic Pancreatitis (Acute, Chronic, Hereditary) · Pancreatic pseudocyst · Exocrine pancreatic insufficiency · Pancreatic fistula Hernia Diaphragmatic: Congenital diaphragmatic · Hiatus — Abdominal hernia: Inguinal (Indirect, Direct) · Umbilical · Incisional · Femoral — Obturator hernia · Spigelian hernia · Internal hernia Peritoneal Peritonitis (Spontaneous bacterial peritonitis) · Hemoperitoneum · Pneumoperitoneum GI bleeding/BIS Upper (Hematemesis, Melena) · Lower (Hematochezia) See also: congenital and neoplasia

v • d • e Digestive system, physiology: gastrointestinal physiology Enteric nervous system Meissner's plexus · Auerbach's plexus Exocrine Chief cells (Pepsinogen) · Parietal cells (Gastric acid, Intrinsic factor) · Goblet cells (Mucus) Endocrine/paracrine G cells (gastrin) · D cells (somatostatin) · ECL cells (Histamine) enterogastrone: I cells (CCK) · K cells (GIP) · S cells (secretin) Enteroendocrine cells · Enterochromaffin cell · APUD cell Border Brunner's glands · Paneth cells · Enterocytes Fluids tract: Saliva · Gastric juice · Intestinal juice accessory: Bile · Pancreatic juice Processes upper GI: Swallowing · Vomiting lower GI: Segmentation contractions · Migrating motor complex · Borborygmus · Defecation either/both: Peristalsis (Interstitial cell of Cajal) · Gastrocolic reflex accessory: Enterohepatic circulation

v • d • e Digestive system surgical and other procedures (ICD-9-CM V3 42-54) Digestive tract Esophagus Esophagectomy Stomach Gastrostomy (Percutaneous endoscopic gastrostomy) · Gastrectomy (Billroth I, Billroth II, Roux-en-Y) · Gastric bypass surgery · Gastroenterostomy · Nissen fundoplication · Gastropexy Small bowel Duodenal switch · Jejunoileal bypass · Jejunostomy · Ileostomy · Partial ileal bypass surgery Large bowel Colectomy · Colostomy · Appendicectomy · Hartmann's procedure Rectum Lower anterior resection · Abdominoperineal resection Anus Anal sphincterotomy · Lateral internal sphincterotomy Endoscopy Esophagogastroduodenoscopy · Colonoscopy · Proctoscopy · Sigmoidoscopy · Enteroscopy · Capsule endoscopy Accessory Liver Hepatectomy · Liver transplantation · Artificial extracorporeal liver support (Liver dialysis, Bioartificial liver devices) Gallbladder, bile duct Endoscopic retrograde cholangiopancreatography · Percutaneous transhepatic cholangiography · Cholecystectomy Pancreas Pancreatectomy · Pancreaticoduodenectomy · Pancreas transplantation · Puestow procedure · Frey's procedure Other Herniorrhaphy · Laparotomy · Paracentesis

v • d • e Human organ systems Cardiovascular system · Endocrine system · Gastrointestinal tract (Digestion) · Immune system · Integumentary system · Lymphatic system · Muscular system · Musculoskeletal system · Nervous system · Reproductive system · Respiratory system · Skeletal system · Urinary system