Key Points

• Almost all physiologically significant digestion and absorption occurs in the small intestine.

• Digestion is the chemical breakdown of food by enzymes secreted into the lumen or associated with the brush border membrane of enterocytes.

• Amylase catalyzes the luminal digestion of carbohydrates; the brush border membrane contains specific enzymes to digest disaccharides and remaining polymers of glucose.

• Glucose and galactose are absorbed actively by a Na -dependent carrier.

• The major enzymes that digest protein within the lumen of the gut are secreted in inactive forms by the pancreas and then activated by trypsin, which is itself activated by enterokinase on the brush border.

• A membrane-bound peptidase aids in the digestion of large peptides to di- and tripep-tides, which are absorbed across the brush border membrane along with free amino acids by a variety of specific transporters.

• Within the cytoplasm most peptides are digested to free amino acids that exit the basolateral membrane via a number of carriers with different specificities.

• Fat digestion is primarily carried out by the pancreatic enzymes, lipase, phospholipase A2, and cholesterol ester hydrolase.

Essential Medical Physiology, Third Edition

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