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Anatomy and Physiology (Boundless)
22: Digestive System
22.13: Absorption
22.13B: Absorption of Monosaccharides, Amino Acids, Dipeptides, Tripeptides, Lipids, Electrolytes, Vitamins, and Water

22.13B: Absorption of Monosaccharides, Amino Acids, Dipeptides, Tripeptides, Lipids, Electrolytes, Vitamins, and Water

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Glucose, amino acids, fats, and vitamins are absorbed in the small intestine via the action of hormones and electrolytes.

Learning Objectives

Describe the process of absorption of nutrients in the small intestine

Key Points

Proteins are degraded into small peptides and amino acids (di- and tripeptides) before their absorption by proteolytic and digestive enzymes such as trypsin.
Lipids (fats) are degraded into fatty acids and glycerol by pancreatic lipase.
Carbohydrates are degraded into monosaccharide or oligosaccharide sugars by the action of amylase. Carbohydrates, such as cellulose, pass through the human intestinal tract undigested.
Water and some water-soluble vitamins are absorbed by diffusion. Some electrolytes and water non-soluble vitamins require an active uptake mechanism.

Key Terms

trypsin: A digestive enzyme that cleaves peptide bonds (a serine protease).
lipase: Any of a group of enzymes that catalyses the hydrolysis of lipids.
amylase: Any of a class of digestive enzymes that are present in saliva and that break down complex carbohydrates, such as starch, into simpler sugars, such as glucose.

EXAMPLES

During breastfeeding, the lactase enzyme breaks down lactose (milk sugar). However, lactase production ceases after weaning in most populations, so adults in those populations experience gastric discomfort or distress when eating dairy products.

Digestive Enzymes and the Small Intestine

The small intestine is where most chemical digestion occurs. Most of the digestive enzymes that act in the small intestine are secreted by the pancreas and enter the small intestine via the pancreatic duct.

The enzymes enter the small intestine in response to the hormone cholecystokinin, which is produced in the small intestine in response to the presence of nutrients. The hormone secretin also causes bicarbonate to be released into the small intestine from the pancreas in order to neutralize the potentially harmful acid that comes from the stomach.

This image shows the position of the small intestine in the gastrointestinal tract. It is seen between the colon on the right, the stomach above it, the cecum and appendix on its left, and the rectum and anus below it.

Small intestine: This image shows the position of the small intestine in the gastrointestinal tract.

The three major classes of nutrients that undergo digestion are:

Proteins. These are degraded into small peptides and amino acids before absorption. Their chemical breakdown begins in the stomach and continues in the large intestine. Proteolytic enzymes, including trypsin and chymotrypsin, are secreted by the pancreas and cleave proteins into smaller peptides. Carboxypeptidase, which is a pancreatic brush border enzyme, splits one amino acid at a time. Aminopeptidase and dipeptidase free the final amino acid products.
Lipids (fats). These are degraded into fatty acids and glycerol. Pancreatic lipase breaks down the triglycerides into free fatty acids and monoglycerides. Pancreatic lipase works with the help of the salts from the bile secreted by the liver and the gall bladder. Bile salts attach to triglycerides to help emulsify them and aid access by pancreatic lipase. This occurs because the lipase is water soluble, but the fatty triglycerides are hydrophobic and tend to orient towards each other and away from the watery intestinal surroundings. The bile salts are the main thing that holds the triglycerides in their watery surroundings until the lipase can break them into the smaller components that can enter the villi for absorption.
Carbohydrates. Some carbohydrates are degraded into simple sugars, or monosaccharides (e.g., glucose ). Pancreatic amylase breaks down some carbohydrates (notably starch) into oligosaccharides. Other carbohydrates pass undigested into the large intestine for further handling by intestinal bacteria.

Brush Border Enzymes

Brush border enzymes take over from there. The most important brush border enzymes are dextrinase and glucoamylase that further break down oligosaccharides. Other brush border enzymes are maltase, sucrase, and lactase.

Lactase is absent in most adult humans and so lactose, like most polysaccharides, is not digested in their small intestine. Some carbohydrates, such as cellulose, are not digested at all despite being made of multiple glucose units. This is because the cellulose is made out of beta-glucose that makes the inter-monosaccharidal bindings different from the ones present in starch, which consists of alpha-glucose. Humans lack the enzyme for splitting the beta-glucose-bonds, something reserved for herbivores and the bacteria from the large intestine.

The fat-soluble vitamins A, D, and E are absorbed in the upper small intestine. The factors that cause the malabsorption of fat can also affect the absorption of these vitamins. Vitamin B12 is absorbed in the ilium and must be bound to intrinsic factor, a protein secreted in the stomach, in order to be absorbed. If intrinsic factor is missing, then Vitamin B12 is not absorbed and pernicious anemia results.

Of the water-soluble vitamins, the transport of folate and B12 across the apical membrane are independent from sodium (Na+), but the other water-soluble vitamins are absorbed by Na+ co-transporters. In physiology, the primary ions of electrolytes are sodium (Na+), potassium (K+), calcium (Ca2+), magnesium (Mg2+), chloride (Cl−), hydrogen phosphate (HPO42−), and hydrogen carbonate (HCO3−).

Sodium is the main electrolyte found in extracellular fluid and is involved in fluid balance and blood pressure control. Electrolyte balance is regulated by hormones, generally with the kidneys flushing out excess levels. In humans, electrolyte homeostasis is regulated by hormones such as the antidiuretic, aldosterone, and parathyroid hormones.

Serious electrolyte disturbances, such as dehydration and over-hydration, may lead to cardiac and neurological complications that, unless they are rapidly resolved, will result in a medical emergency. Water and minerals are reabsorbed back into the blood in the colon (large intestine) where the pH is slightly acidic—about 5.6 to 6.9.