IBS and your Digestive System
IBS Foundation
The digestive system is a series of hollow organs joined in a long,
twisting tube from the mouth to the anus. Inside this tube is a lining
called the mucosa. In the mouth, stomach, and small intestine, the
mucosa contains tiny glands that produce juices to help digest food.
There are also two solid digestive organs, the liver and the pancreas,
which produce juices that reach the intestine through small tubes. In
addition, parts of other organ systems (for instance, nerves and blood)
play a major role in the digestive system.
Why Is Digestion Important?
When we eat such things as bread, meat, and vegetables, they are not in
a form that the body can use as nourishment. Our food and drink must be
changed into smaller molecules of nutrients before they can be absorbed
into the blood and carried to cells throughout the body. Digestion is
the process by which food and drink are broken down into their smallest
parts so that the body can use them to build and nourish cells and to
provide energy.
How Is Food Digested?
Digestion involves the mixing of food, its movement through the
digestive tract, and chemical breakdown of the large molecules of food
into smaller molecules. Digestion begins in the mouth, when we chew and
swallow, and is completed in the small intestine. The chemical process
varies somewhat for different kinds of food.
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.
The first major muscle movement occurs when food or liquid is
swallowed. Although we are able to start swallowing by choice, once the
swallow begins, it becomes involuntary and proceeds under the control
of the nerves.
The esophagus is the organ into which the swallowed food is pushed. It
connects the throat above with the stomach below. At the junction of
the esophagus and stomach, there is a ringlike valve closing the
passage between the two organs. However, as the food approaches the
closed ring, the surrounding muscles relax and allow the food to pass.
The food then enters the stomach, which has three mechanical tasks to
do. First, the stomach must store the swallowed food and liquid. This
requires the muscle of the upper part of the stomach to relax and
accept large volumes of swallowed material. The second job is to mix up
the food, liquid, and digestive juice produced by the stomach. The
lower part of the stomach mixes these materials by its muscle action.
The third task of the stomach is to empty its contents slowly into the
small intestine.
Several factors affect emptying of the stomach, including the nature of
the food (mainly its fat and protein content) and the degree of muscle
action of the emptying stomach and the next organ to receive the
stomach contents (the small intestine). As the food is digested in the
small intestine and dissolved into the juices from the pancreas, liver,
and intestine, the contents of the intestine are mixed and pushed
forward to allow further digestion.
Finally, all of the digested nutrients are absorbed through the
intestinal walls. The waste products of this process include undigested
parts of the food, known as fiber, and older cells that have been shed
from the mucosa. These materials are propelled into the colon, where
they remain, usually for a day or two, until the feces are expelled by
a bowel movement.
Production of Digestive Juices
The glands that act first are in the mouth--the salivary glands. Saliva
produced by these glands contains an enzyme that begins to digest the
starch from food into smaller molecules.
The next set of digestive glands is in the stomach lining. They produce
stomach acid and an enzyme that digests protein. One of the unsolved
puzzles of the digestive system is why the acid juice of the stomach
does not dissolve the tissue of the stomach itself. In most people, the
stomach mucosa is able to resist the juice, although food and other
tissues of the body cannot.
After the stomach empties the food and its juice into the small
intestine, the juices of two other digestive organs mix with the food
to continue the process of digestion. One of these organs is the
pancreas. It produces a juice that contains a wide array of enzymes to
break down the carbohydrates, fat, and protein in our food. Other
enzymes that are active in the process come from glands in the wall of
the intestine or even a part of that wall.
The liver produces yet another digestive juice--bile. The bile is
stored between meals in the gallbladder. At mealtime, it is squeezed
out of the gallbladder into the bile ducts to reach the intestine and
mix with the fat in our food. The bile acids dissolve the fat into the
watery contents of the intestine, much like detergents that dissolve
grease from a frying pan. After the fat is dissolved, it is digested by
enzymes from the pancreas and the lining of the intestine.
Absorption and Transport of Nutrients
Digested molecules of food, as well as water and minerals from the
diet, are absorbed from the cavity of the upper small intestine. The
absorbed materials cross the mucosa into the blood, mainly, and are
carried off in the bloodstream to other parts of the body for storage
or further chemical change. As noted above, this part of the process
varies with different types of nutrients.
Carbohydrates: An average American adult eats about half a pound of
carbohydrate each day. Some of our most common foods contain mostly
carbohydrates. Examples are bread, potatoes, pastries, candy, rice,
spaghetti, fruits, and vegetables. Many of these foods contain both
starch, which can be digested, and fiber, which the body cannot digest.
The digestible carbohydrates are broken into simpler molecules by
enzymes in the saliva, in juice produced by the pancreas, and in the
lining of the small intestine. Starch is digested in two steps: First,
an enzyme in the saliva and pancreatic juice breaks the starch into
molecules called maltose; then an enzyme in the lining of the small
intestine (maltase) splits the maltose into glucose molecules that can
be absorbed into the blood. Glucose is carried through the bloodstream
to the liver, where it is stored or used to provide energy for the work
of the body.
Table sugar is another carbohydrate that must be digested to be useful.
An enzyme in the lining of the small intestine digests table sugar into
glucose and fructose, each of which can be absorbed from the intestinal
cavity into the blood. Milk contains yet another type of sugar,
lactose, which is changed into absorbable molecules by an enzyme called
lactase, also found in the intestinal lining.
Protein: Foods such as meat, eggs, and beans consist of giant molecules
of protein that must be digested by enzymes before they can be used to
build and repair body tissues. An enzyme in the juice of the stomach
starts the digestion of swallowed protein. Further digestion of the
protein is completed in the small intestine. Here, several enzymes from
the pancreatic juice and the lining of the intestine carry out the
breakdown of huge protein molecules into small molecules called amino
acids. These small molecules can be absorbed from the hollow of the
small intestine into the blood and then be carried to all parts of the
body to build the walls and other parts of cells.
Fats: Fat molecules are a rich source of energy for the body. The first
step in digestion of a fat such as butter is to dissolve it into the
watery content of the intestinal cavity. The bile acids produced by the
liver act as natural detergents to dissolve fat in water and allow the
enzymes to break the large fat molecules into smaller molecules, some
of which are fatty acids and cholesterol. The bile acids combine with
the fatty acids and cholesterol and help these molecules to move into
the cells of the mucosa. In these cells the small molecules are formed
back into large molecules, most of which pass into vessels (called
lymphatics) near the intestine. These small vessels carry the reformed
fat to the veins of the chest, and the blood carries the fat to storage
depots in different parts of the body.
Vitamins: Another vital part of our food that is absorbed from the
small intestine is the class of chemicals we call vitamins. There are
two different types of vitamins, classified by the fluid in which they
can be dissolved: water-soluble vitamins (all the B vitamins and
vitamin C) and fat-soluble vitamins (vitamins A, D, and K).
Water and Salt: Most of the material absorbed from the cavity of the
small intestine is water in which salt is dissolved. The salt and water
come from the food and liquid we swallow and the juices secreted by the
many digestive glands. In a healthy adult, more than a gallon of water
containing over an ounce of salt is absorbed from the intestine every
24 hours.
How Is the Digestive Process Controlled?
Hormone Regulators
A fascinating feature of the digestive system is that it contains its
own regulators. The major hormones that control the functions of the
digestive system are produced and released by cells in the mucosa of
the stomach and small intestine. These hormones are released into the
blood of the digestive tract, travel back to the heart and through the
arteries, and return to the digestive system, where they stimulate
digestive juices and cause organ movement. The hormones that control
digestion are gastrin, secretin, and cholecystokinin (CCK):
Gastrin causes the stomach to produce an acid for dissolving and
digesting some foods. It is also necessary for the normal growth of the
lining of the stomach, small intestine, and colon.
Secretin causes the pancreas to send out a digestive juice that is rich
in bicarbonate. It stimulates the stomach to produce pepsin, an enzyme
that digests protein, and it also stimulates the liver to produce bile.
CCK causes the pancreas to grow and to produce the enzymes of
pancreatic juice, and it causes the gallbladder to empty.
Nerve Regulators
Two types of nerves help to control the action of the digestive system.
Extrinsic (outside) nerves come to the digestive organs from the
unconscious part of the brain or from the spinal cord. They release a
chemical called acetylcholine and another called adrenaline.
Acetylcholine causes the muscle of the digestive organs to squeeze with
more force and increase the "push" of food and juice through the
digestive tract. Acetylcholine also causes the stomach and pancreas to
produce more digestive juice. Adrenaline relaxes the muscle of the
stomach and intestine and decreases the flow of blood to these organs.
Even more important, though, are the intrinsic (inside) nerves, which
make up a very dense network embedded in the walls of the esophagus,
stomach, small intestine, and colon. The intrinsic nerves are triggered
to act when the walls of the hollow organs are stretched by food. They
release many different substances that speed up or delay the movement
of food and the production of juices by the digestive organs.
For more information visit http://www.ibsfoundation.org