Small intestine surface area

The choice of flow rates in perfusion experiments is an important consideration as it may affect hydrodynamics [35], ABL thickness [30], intestinal radius [34], intestinal surface area [45], and time to reach steady-state conditions [32], all of which can impact on Peff estimates. The intestinal radius has implications for the estimation of the permeability coefficient. The most widely used estimate for the rat intestinal radius is 0.18 cm [34], These authors found that there was a small change in intra-luminal pressure with an increase in flow... 

The large internal surface area of the small intestine is attributable to its length, folding, and the presence of villi and microvilli within its lumen. The villi contain capillaries and protrude into the lumen of the small intestine. There are approximately four to five million villi in the small intestine. Each villus has many microvilli as its outer surface (Figure 11.3). The microvilli represent the absorptive barrier of the small intestine. The stomach and large intestine do not contain villi and, therefore, have a small absorptive surface area compared with the small intestine. 

Diarrhea is a common problem that is usually self-limiting and of short duration. Increased accumulations of small intestinal and colonic contents are known to be responsible for producing diarrhea. The former may be caused by increased intestinal secretion which may be enterotoxin-induced, eg, cholera and E. col] or hormone and dmg-induced, eg, caffeine, prostaglandins, and laxatives decreased intestinal absorption because of decreased mucosal surface area, mucosal disease, eg, tropical spme, or osmotic deficiency, eg, disaccharidase or lactase deficiency and rapid transit of contents. An increased accumulation of colonic content may be linked to increased colonic secretion owing to hydroxy fatty acid or bile acids, and exudation, eg, inflammatory bowel disease or amebiasis decreased colonic absorption caused by decreased surface area, mucosal disease, and osmotic factors and rapid transit, eg, irritable bowel syndrome. 

The use of a bioadhesive, polymeric dosage form for sustained dehvery raises questions about swallowing or aspirating the device. The surface area is small, and patient comfort should be addressed by designing a small (less than 2 cm ), thin (less than 0.1 mm (4 mil) thick) device that conforms to the mucosal surface. The buccal route may prove useful for peptide or protein dehvery because of the absence of protease activity in the sahva. However, the epithelium is relatively tight, based on its electrophysiological properties. An average conductance in the dog is 1 mS/cm (57) as compared to conductances of about 27 and 10 mS/cm in the small intestine and nasal mucosa, respectively (58,59) these may be classified as leaky epitheha. 

Drugs taken orally are slow to act. Most are absorbed in the small intestine where the villi, which penetrate into the lumen, present a large surface area. Unfortunately in order to pass through the gut wall into the bloodstream the drug has to become dissolved in its cell s membranes and to achieve this it needs to be lipid-soluble. 

The surface area in the luminal side of the small intestine per unit length of the serosal (blood) side is enormous in the proximal jejunum, and steadily decreases (to about 20% of the starting value [62]) in the distal portions of the small intestine. The surface area is increased threefold [69] by ridges oriented circumferentially around the lumen. Similar folds are found in all segments of the GIT, except the mouth and esophagus [66]. Further 4—10-fold expansion [62,69] of the surface is produced by the villi structures, shown schematically in Fig. 2.4. The layer of epithelial cells lining the villi structures separate the lumen from the circulatory system. Epithelial cells are made in the crypt folds of the villi, and take about... 

The small intestine is assumed to be a cylindrical tube with a surface area of 2kRL, where R is the radius and L is the length of the tube (Fig. 4). The rate at which the drug enters the tube is the product of the inlet concentration, C0, and the volumetric flow rate, Q. The rate at which it exits the tube is the product of the outlet concentration, Cout, and the volumetric flow rate, Q. The absorption flux across the small intestinal membrane, , is the product of the effective permeability, Peff, and concentration, C. The total drug loss by absorption from the... 

The plicae circulares, or circular folds, form internal rings around the circumference of the small intestine that are found along the length of the small intestine. They are formed from inward foldings of the mucosal and submucosal layers of the intestinal wall. The plicae circulares are particularly well developed in the duodenum and jejunum and increase the absorptive surface area of the mucosa about threefold. Each plica is covered with millions of smaller projections of mucosa referred to as villi. Two types of epithelial cells cover the villi ... 

The gut wall within the small intestine is particularly well adapted for its role as an absorptive surface. Absorption rate is proportional to the area of the surface that is available for absorption. Thus, the internal surface of the small intestine is folded towards the lumen of the gut. This folding increases the surface area of the gut by approximately 3-fold. In this area, the gut wall is covered with many fingerlike projections called villi, and these provide a further 10-fold increase in surface area. In addition, the gut wall epithelial cells are polarized such that on the luminal surface there are millions of microvilli providing a further 20-fold increase in surface area for absorption. In all, these surface area modifications provide an absorptive area which is some 600-fold higher than would be provided by a simple cylinder. Thus, the estimated surface area of the human gut is approximately 200 m2 [1],... 

Thus, the apparent membrane permeability characteristics of hydrophilic compounds listed in Table 3.4 indicate that colonic epithelium is different from small intestinal epithelium in selectivity, or size or density distribution of the paracellular pathway. This is further complicated because of the possible involvement of unidentified carriers or channels for some compounds, as suggested for glycerol and D-xylose. However, the colon-to-SI ratios of the apparent membrane permeability are generally comparable with (or lower than) those calculated considering the morphological surface area, suggesting that such factors are not in favor for colonic absorption in most cases. Matching... 

---