Small intestine regions

Zollinger-Ellison syndrome (ZES) is characterized by the development of a tumor (gastrinoma) or tumors that secrete excessive levels of gastrin, a hormone that stimulates production of acid by the stomach. In most cases, the tumor or tumors arise within the pancreas and/or the upper region of the small intestine (duodenum). 

The proteases are secreted as inactive zymogens the active site of the enzyme is masked by a small region of its peptide chain, which is removed by hydrolysis of a specific peptide bond. Pepsinogen is activated to pepsin by gastric acid and by activated pepsin (autocatalysis). In the small intestine, trypsinogen, the precursor of trypsin, is activated by enteropeptidase, which is secreted by the duodenal epithelial cells trypsin can then activate chymotrypsinogen to chymotrypsin, proelas-tase to elastase, procarboxypeptidase to carboxypepti-dase, and proaminopeptidase to aminopeptidase. 

Kunkel EJ, Campbell JJ, Haraldsen G, et al. Lymphocyte CC chemokine receptor 9 and epithelial thymus-expressed chemokine (TECK) expression distinguish the small intestinal immune compartment Epithelial expression of tissue-specific chemokines as an organizing principle in regional immunity. J Exp Med... 

Structurally, the large intestine is similar to the small intestine, although the luminal surface epithelium of the former lacks villi. The muscularis mucosa, as in the small intestine, consists of inner circular and outer longitudinal layers. Figure 6 illustrates a photomicrograph and diagrammatic sketches of this region. 

Gastrointestinal sphincters are formed where the circular layer of smooth muscle is thickened. Sphincters occur at several points along the tract. Their function is to limit the movement of food materials from one region to another. For example, the pyloric sphincter found between the stomach and duodenum of the small intestine plays an important role in limiting the rate of gastric emptying. Sphincters undergo tonic contractions that may be sustained for minutes or hours. 

Bile is produced continuously by the liver bile salts are secreted by the hepatocytes and the water, sodium bicarbonate, and other inorganic salts are added by the cells of the bile ducts within the liver. The bile is then transported by way of the common bile duct to the duodenum. Bile facilitates fat digestion and absorption throughout the length of the small intestine. In the terminal region of the ileum, the final segment of the small intestine, the bile salts are actively reabsorbed into the blood, returned to the liver by way of the hepatic portal system, and resecreted into the bile. This recycling of the bile salts from the small intestine back to the liver is referred to as enterohepatic circulation. 

In contrast to segmentation contractions in the small intestine (9 to 12 per minute), haustral contractions occur much less frequently (up to 30 min between contractions). These very slow movements allow for the growth of bacteria in the large intestine. Normally, the bacterial flora in this region is harmless. In fact, some of the bacteria produce absorbable vitamins, especially vitamin K. 

The bacteria in the intestinal tract serve as another well-known source of luminal drug degradation [61], though this is only important for the colon region as the luminal concentration of bacteria is 104 to 109-fold higher in the colon compared with the small intestine. Thus, this aspect is only relevant for drugs that reach this region, for example, due to poor permeability, slow dissolution or delivery by modified-release formulations. Hydrolytic and other reductive reactions are predominantly mediated by bacterial enzymes, and a list of the most prominent types... 

---