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Chapter: Medical Physiology: Digestion and Absorption in the Gastrointestinal Tract

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Absorption in the Large Intestine: Formation of Feces

About 1500 milliliters of chyme normally pass through the ileocecal valve into the large intestine each day.

Absorption in the Large Intestine: Formation of Feces

About 1500 milliliters of chyme normally pass through the ileocecal valve into the large intestine each day. Most of the water and electrolytes in this chyme are absorbed in the colon, usually leaving less than 100 milliliters of fluid to be excreted in the feces. Also, essentially all the ions are absorbed, leaving only 1 to 5 milliequivalents each of sodium and chloride ions to be lost in the feces.

Most of the absorption in the large intestine occurs in the proximal one half of the colon, giving this portion the name absorbing colon, whereas the distal colon functions principally for feces storage until a propitious time for feces excretion and is therefore called the storage colon.

Absorption and Secretion of Electrolytes and Water. Themucosa of the large intestine, like that of the small intestine, has a high capability for active absorption of sodium, and the electrical potential gradient created by absorption of the sodium causes chloride absorp-tion as well. The tight junctions between the epithelial cells of the large intestinal epithelium are much tighter than those of the small intestine. This prevents signif-icant amounts of back-diffusion of ions through these junctions, thus allowing the large intestinal mucosa to absorb sodium ions far more completely—that is, against a much higher concentration gradient—than can occur in the small intestine. This is especially true when large quantities of aldosterone are available because aldosterone greatly enhances sodium trans-port capability.

In addition, as occurs in the distal portion of the small intestine, the mucosa of the large intestine secretes bicarbonate ions while it simultaneously absorbs an equal number of chloride ions in an exchange transport process that has already been described. The bicarbonate helps neutralize the acidic end products of bacterial action in the large intestine.

Absorption of sodium and chloride ions creates an osmotic gradient across the large intestinal mucosa, which in turn causes absorption of water.

Maximum Absorption Capacity of the Large Intestine. Thelarge intestine can absorb a maximum of 5 to 8 liters of fluid and electrolytes each day. When the total quan-tity entering the large intestine through the ileocecal valve or by way of large intestine secretion exceeds this amount, the excess appears in the feces as diar-rhea. As noted earlier, toxins from cholera or certain other bacterial infections often cause the crypts in the terminal ileum and in the large intestine to secrete 10 or more liters of fluid each day, leading to severe and sometimes lethal diarrhea.

Bacterial Action in the Colon. Numerous bacteria, especiallycolon bacilli, are present even normally in the absorbing colon. They are capable of digesting small amounts ofcellulose, in this way providing a few calories of extra nutrition for the body. In herbivorous animals, this source of energy is significant, although it is of negligi-ble importance in human beings.

Other substances formed as a result of bacterial activ-ity are vitamin K, vitamin B12, thiamine, riboflavin, and various gases that contribute to flatus in the colon, espe-cially carbon dioxide, hydrogen gas, and methane. The bacteria-formed vitamin K is especially important because the amount of this vitamin in the daily ingested foods is normally insufficient to maintain adequate blood coagulation.

Composition of the Feces. The feces normally are aboutthree-fourths water and one-fourth solid matter that itself is composed of about 30 per cent dead bacteria, 10 to 20 per cent fat, 10 to 20 per cent inorganic matter, 2 to 3 per cent protein, and 30 per cent undigestedroughage from the food and dried constituents of diges-tive juices, such as bile pigment and sloughed epithelial cells. The brown color of feces is caused by stercobilin and urobilin, derivatives of bilirubin. The odor is caused principally by products of bacterial action; these prod-ucts vary from one person to another, depending on each person’s colonic bacterial flora and on the type of food eaten. The actual odoriferous products include indole, skatole, mercaptans, and hydrogen sulfide.


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