Wednesday, June 19, 2024

Gastric Secretions - Gastric Fluids Daily Produced

I read somewhere that daily 5 gallons of water is dumped into the intestine. So enquired further.


Daily Fluid Secretion

 Volumes (ml/day) Composition Regulation

Oral secretions

1500 ml

99.8% water; low in sodium

high in calcium and phosphate to help remineralise tooth enamel

Mucin, IgA, amylase, lipase

Stimulated by eating; markedly decreased in patients who are fasted, asleep, sedated or intubated

Oesophageal secretions

Minimal

Thick bicarbonate-rich mucus

Vagal regulation

Gastric acid

2000 ml

Cl- 170mmol/L, K+ 12-20 mmol/L

pH ~ 1.5

Mucus, pepsin, gastric lipase, intrinsic factor

Stimulated by gastrin, histamine, and vagal activity (M3 receptors)

Inhibited by somatostatin, VIP, cholecystokinin and secretin

Bile

600 ml

95% water; concentrated (~ 600 mOsm/kg), alkaline (pH ~ 7.5-8.0)

Bile acids, phospholipids, cholesterol and bilirubin

Secretion is increased by catecholamines, secretin, cholecystokinin, gastrin and glucagon

Release from the gallbladder is mainly mediated by cholecystokinin

Pancreatic exocrine secretions

2500 ml

Isotonic with plasma, but markedly alkaline (pH up to 8.3) 

Cl- 30mmol, HCO3- 140 mmol

Enzymes: lipase, amylase, trypsin, numerous others

Stimulated by vagus,  enteropancreatic reflexes, gastrin, cholecystokinin, and secretin

Inhibited by sympathetic stimulation and somatostatin

Intestinal secretions

2000 ml

Bicarbonate-rich mucus

pH ~ 7.5-8.0

Mainly originating from the duodenum

Stimulated by gastrin, histamine, and vagal activity (M3 receptors)

Inhibited by somatostatin, VIP, cholecystokinin and secretin




https://derangedphysiology.com/main/cicm-primary-exam/required-reading/gastrointestinal-system/Chapter%20110/composition-volumes-and-regulation-gastrointestinal-secretions










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