Part 10

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The food passes from the stomach, through the pylorus into the small intestine. The first twelve inches of the small intestine is known as the duodenum. In the duodenum it is acted upon by the pancreatic juice from the pancreas, the bile from the liver, and the intestinal juices. These juices act upon proteins, fats, and carbohydrates. The bile acts upon the fats, while the pancreatic and intestinal juices act chiefly upon the carbohydrates.

As the food enters the intestine, it is changed, by the sodium carbonate, from the acid condition produced in the stomach, to alkaline reaction.

The bile exercises an important influence upon digestion, any disturbance in the flow of this greenish-brown secretion being very quickly shown both in stomach and intestinal digestion. It emulsonizes and saponifies the fats, it aids in their absorption, and it lubricates the intestinal mass, facilitating its passage through the entire length of the intestines. Thus, it is a very potent agent in regulating the bowel movements. A diminution in the flow of bile quickly expresses itself in constipation.

Fats are almost entirely digested in the small intestine. The presence of fat stimulates the flow of pancreatic juice, which, in turn, stimulates the flow of bile from the liver. For this reason, if the liver is sluggish, fatty foods are desirable. Olive oil is prescribed for gall stones to stimulate the action of the bile ducts.

Before the fat molecules can be absorbed, they must first be broken up into glycerin and fatty acids and further changed to a fine emulsion, which gives the contents of the small intestine a milky appearance. After they are broken up into these fatty acids and thus brought to the finest state of emulsion, they are readily saponified, being then soluble in water and in a state to be absorbed by the walls of the intestines. The fats are absorbed almost entirely in the small intestine,—mostly in the duodenum.

As a rule, the starches, or dextrin, will not be fully digested by the saliva and those which have failed of salivary digestion are acted upon by amylase (one of the solids of the intestinal juice) and changed to maltose, while the trypsin from the pancreas, together with the intestinal juice, acts upon any protein which has failed to be fully digested in the stomach, changing it into peptone. In the form or peptone it is absorbed through the “sucking” villi of the intestinal walls.

The food is forced along the intestinal tract by peristaltic or muscular relaxation and contraction waves, as in the stomach. As it is so forced, the nutrient elements, after being put into condition for absorption, are taken up through the villi of the intestinal walls by the portal veins and the lacteals of the sub-mucous lining. (See page 78).

It is now believed that a larger proportion of food is digested and absorbed than was heretofore realized, and that the excretions from the intestines are, in many cases, made up almost entirely of refuse, and of the catabolic waste of the system. In an ordinary, mixed diet, it is stated that about ninety-two per cent of the proteins, ninety-five per cent of the fats, and ninety-seven per cent of the carbohydrates are retained by the body.

In digestion, it is of the utmost importance that the muscular, mucous, and the sub-mucous coats, and the secreting glands of the stomach and intestines be kept thoroughly strong and active, that the digestive juices may be freely poured out, the nutriment be freely absorbed, and the food be moved along the digestive tract. The strength of any organ is gained through the nutriment in the blood; therefore, daily exercise, which calls the blood freely to these organs, is imperative.

The greater part of the food is absorbed through the intestines, yet some proteins, which have been fully digested by the gastric juice, and certain fats, particularly the fats in milk, which are in a natural state of emulsion, may be absorbed through the walls of the stomach. However, the absorption through the stomach is small compared to that through the intestines.

The small intestine is particularly fitted for absorption. Every inch or so along its course the mucous lining is thrown up into folds, as if to catch the food as it passes toward the large intestine, and to hold it there until the villi have the opportunity to absorb it. These transverse folds of the intestinal walls are called valvulæ conniventes. The villi are fingerlike projections of the mucous lining of the intestines, which stand out upon the lining somewhat as the nap on plush. They have been called “sucking” villi, because during the movements of the intestines they seem to suck in the liquid food. As soon as the foodstuffs,—proteins, carbohydrates, and fats, are put in a dissoluble state ready for absorption, they are very promptly absorbed by the villi. If, for any reason, they remain unabsorbed, they are liable to ferment by the action of the trypsin, or to be attacked by the bacteria always present in the intestines.

The peptones, sugars, and saponified fats are rapidly absorbed, while the undigested portion, together with the unabsorbed water, the bile, mucus and bacterial products, are passed through the ileo-cecal valve into the large intestine.

That the large intestine is also adapted to the absorption of fats is shown by clinical experiments with patients who cannot retain food in the stomach, the food in such cases being given through rectal injections.

In the large intestine, the mass passes up the ascending colon, across the transverse colon, and down the descending colon, losing, by absorption, foodstuffs not absorbed in the stomach and small intestine.

While water and salt are absorbed both in the stomach and in the small intestine, the evident purpose in leaving the larger part of the water to be absorbed in the large intestine is that it may assist the intestinal contents in passing along. The water also stimulates the peristaltic movement.

As the food is absorbed through the walls of the alimentary canal, it is picked up by the rootlets of the mesenteric veins and by the lymph channels,—the latter, through the abdominal cavity, are called lacteals. Nearly all of the fats are absorbed through the lacteals. The whitish color given to the contents of the lacteals, by the saponified fats, gives rise to the term lacteal, meaning “whitish.”

Nearly all of the proteins and sugars pass through the mesenteric veins and the portal veins into the liver. Here the sugars are at once attacked by the liver cells and built up into glycogen as described on page 81 and the proteins are passed through the liver into the arterial blood stream. A small portion of the proteins, however, do not go to the liver, but are passed directly into the lymphatics and thus into the blood stream, where they are again carried to the liver.

To sum up,—the larger part of the absorption of sugars, starches, proteins, and fats is through the small intestine, though some are absorbed in the stomach and a very little through the large intestine; while some water and salts are absorbed in the stomach and small intestine, these are largely absorbed in the large intestine.

FOOTNOTES:

A knowledge of the mucous lining of the stomach and intestines, and of the tributary glands, such as the liver and pancreas, is important to a thorough understanding of digestion, and the reader is referred to “The Vital Organs: Their Use and Abuse” of this series. This takes up the study of the secretion of digestive juices, the conditions favoring normal secretions, etc.

See “The Vital Organs; Their Use and Abuse” by Susanna Cocroft.

For illustration see the frontispiece of “The Circulation, Lungs, Heart,” of this series.

The Work of Various Organs Affecting Digestion

The purpose of this chapter is to show the work of other organs than the digestive organs in converting the digested food to use in the body, in tearing down waste, and in eliminating waste and an excess of material above the body needs.

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The liver is commonly called the chemical work-shop of the body. The proteins and sugars are carried through the blood (portal veins) to the liver directly they are absorbed from the alimentary canal. As the food materials filter through the blood capillaries, between the liver cells, several substances are absorbed, particularly sugar, which is here changed into animal starch called glycogen. It is held in the liver for a few hours in the form of glycogen and then redigested by the action of an amylolitic ferment and again gradually given out into the blood in the form of sugar; hence sugar is subject first to the anabolic change of being built up into glycogen, and then to the catabolic change of oxidation and breaking down.

While the conversion of the sugar is one chief office of the liver, it also acts upon the proteins,—not as they are first passed through the liver in the blood, but as they are returned to the liver from the muscle tissue, partly oxidized and broken up into simpler products. The liver cells absorb and further oxidize and combine them into nitrogenous waste, which the kidneys throw off in urea.