Anatomy and Physiology Questions

Question

On slide 06 and 21, you mention that one of the main functions of the large intestine is the reabsorption of water, ions, and minerals. What’s the purpose of reabsorption if these 3 things continually cycle through your system? At least the term ‘reabsorption’ makes me think this is a continual cycle. This NCBI article mentions the vitamins produced from bacteria in the gut help minimize vitamin disparity when vitamin intake is low.

Answer

So yes… the body is constantly bringing the same minerals in an out of the body… the reason for this is for several reasons. The major one though is that a lot of these minerals are coupled to the transport of other molecules. So for example, there is a sodium/potassium “antiporter” which is responsible for moving different molecules through the GI barrier (including in the large intestine)

the other reason is that there’s actually a good amount of minerals that are used in the making of bile. The body doesn’t really want to lose these though, so its developed or evolved the ability to reabsorb those in the large intestine. In fact, a lot of bile is actually reabsorbed as well.

This is why one of the major ways to TRULY detox someone is to try and bind bile in the intestine so that is is excreted instead of reabsorbed

Question

Question on Gastric Inhibitory Peptide and what could reduce it’s availability (ie, leading to faster emptying of stomach or less insulin secretion). What is GIP role with regards to insulin resistance?

Answer

OK, so GIP is typically released ud to distension of the duodenum as well as the presence of acidic chyme Coach Mike 1 day ago I also know for a fact that short chain fatty acids, something we’ll talk about a TON, also influences GIP production Coach Mike 1 day ago OK, but to get to your question about insulin resistance, remember that GIP is also know as glucose-dependnet insulinotrophic polypeptide so they are closely tied Coach Mike 1 day ago https://pubmed.ncbi.nlm.nih.gov/31733230/ This paper just published indicates that decreasing GIP signaling would actually improve insulin resistance along with several other aspects of metabolic syndrome Claudia Ragsdale 23 hours ago OK so GIP stimulates insulin secretion so if insulin is higher it can balance glucose but this paper states blocking GIP helps insulin resistance. My understanding is if there isnt enough insulin to signal the body to store glucose in the liver that the body converts the glucose to fat. How does reducing insulin secretion help. Can you explain that a bit more?

Coach Mike 23 hours ago My guess is its a bit more complex than what we TRULY understand, but GIP does more than just impact insulin.

Coach Mike 23 hours ago GIP is known to increase lipoprotein lipase activity, fatty acid glucose uptake, as well as augmenting insulin-induced fatty acid incorporation into adipocytes, in addition to inhibiting lipolysis

Coach Mike 23 hours ago More recently, GIP has been shown to induce cytokine expression and insulin resistance in adipocytes as well, and I think this is the mechanism at play. SO… reducing inflammation and altering the biology of adipocytes

Question

how is digestion impacted by removal of the gall bladder since it’s responsible for the storage of bile. My basic understanding is that the bile is just continuously dripped directly into the small Intestine rather than being released at appropriate levels when fatty foods are present… is that correct? I was just wondering how this would negativity impact the normal process? Assuming it would be negative since we have a gallbladder for a reason

Answer

The gallbladder is definitely one of those organs we can live without….. but that we definitely want to have. Generally, as you might expect, the ability to digest and absorb fats is compromised. However, there are some studies that counter-intuitively indicate that this leads to an INCREASE in BMI, fat gain, and all that sort of fun stuff. 7:11 The general recommendation is to avoid fatty meats, most dairy, and then caffeine and alcohol since this seem to cause more pain, more often after the gallbladder is removed 7:13 Interestingly… gallbladder removal generally leads to a shift in the microbiome, and not a favorable one it seems 7:14 As for your second question, low stomach aid, or hypochlorhydia, is associated with aging, stress, zinc and B vitamin deficiency and then medicatoins such as protein pump inhibitors

As for repercussions, all sorts of things are possible, but the most serious ones are all connected to poor absorption/digestion of food, micronutrient deficiences, and then general bloating

Question

Question regarding H. Pylori. - Can this bacteria be “dormant” in the gut until the conditions allow it to proliferate? Or its more likely introduced from food source? Dealing with eradicating this bugger in my gut right now so curious about this.

Answer

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5526757/pdf/WJG-23-4867.pdf

Can be found in the oral cavity H.pylori DOES have a dormant state

Question

Hi. I am curious how sympathetic nervous system inhibits digestion when we are on a stress/alert state, but at the same time for some people (me) some anxiety/stress can trigger the need to go. I know passing stool not necessarily means good digestion but what does it trigger? Does it trigger only muscle contractions on the large intestine? Any recommendations on this? (I hope I explained myself :blush:)

Answer

You definitely did!!! 12:47 So you’re 100% right that it can have BOTH effects. Think of it like this: Stress reduces the desire to eat so that you have less food in your digestive system. The result is that significantly less energy needs to be spent digesting food. Stress also tries to get RID of the material that is in the GI tract as quickly as possible such that you don’t have to energetically deal with the processing of that food-remnants 12:48 Basically the body wants an empty GI tract when you’re overly stressed.

Question

Another question (from “improving digestion doc”). It mentions how low digestive enzymes can be found on people with IBS and IBD. Would you think that may be a cause or an effect of it? It is so frustrating when doctors only seem to treat symptoms instead of causes. In my case, my symptoms are similar mostly to the ones described from incomplete digestion of carbs. Interestingly I removed gluten from my diet and saw a significant improvement, But I do have to control the intake of other carbs, even fruits… As well as animal fats and dairy.

Answer

Yea, I do think it can be a cause as well. Lets say that you’re not digesting fructose and lactose well (which it seems as though you might). This could result in these sugars being instead fermented by the microbiome either in the distal part of the small intestine or in the large intestine (not where we want this to happen).

This could easily lead to bloating, gas pain, and potentially outgrowth of proinflammatory bacteria that would exacerbate IBD/IBS. Now… I DO think there’s probably a big genetic component on top of this for most people as well. So its like a “three strike” policy. Wrong digestive enzymes, wrong bacteria, wrong genetics and you unfortunately end up with IBD

Question

So it sounds like PH Balance plays a pretty significant role. What is happening when we’re drinking (ph+ or ph “infused”) water products. I know a lot of times at sports events they’re handing out “ph water” or Whole Foods always has ph water. What is that doing for our digestion?

Answer

So, the pH of water and things like that has a minimal effect really. The stomach has mechanisms that sense the pH and simply produce more acid to get things into the range that we want it in. That said, if you drink something ESPECIALLY basic (not like a pumpkin spiced latte, but meaning a pH above 7) like milk, then it can take longer to get the pH back into the right range for the stomach.

Whats interesting is that the LOW pH of the stomach is neutralized pretty quickly as soon as the chyme is dumped into the duodenum 7:28 as the pH needs to come up drastically before the pancreatic enzymes can function properly. So… pH is controlled tightly

Question

Is there ever an instance where you body can’t control the ph?

Answer

There are diseases where pH gets out of whack in the gut 7:42 Hypochlorhydria is a lack of appropriate stomach acid, and as a result, elevated stomach pH 7:47 Also, pH changes definitely can lead to outgrowth of bacteria in the stomach as well 7:48 https://pubmed.ncbi.nlm.nih.gov/7859586/ https://www.sciencedirect.com/science/article/pii/S1590865801800505 And lastly… there are drugs that are called PPI’s, or protein pump inhibitors, which artificially alter the pH of the stomach by blocking the function of the cells that produce the stomach acid. S

Question

for people who need to supplement digestive enzymes in pill form, is this because they aren’t producing enough of a specific enzyme on their own ? And what would cause this?

Answer

There are a number of different things that can cause it, but the most common in my experience is micronutrient deficiencies and then a disrupted gut barrier (mild leaky gut symptoms). 8:17 most notably zinc deficiency 8:17 https://pubmed.ncbi.nlm.nih.gov/27230230/ So often Zinc is a go to supplement… for many reasons that we will actually explore in the last lecture as well