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Answer- The digestion of carbohydrates involves hydrolysis to liberate oligosaccharides, disaccharides and finally monosaccharides. The hydrolysis of starch is catalyzed by salivary and pancreatic amylases, which catalyze random hydrolysis of ? (1-›4) glycoside bonds, yielding dextrins, then a mixture of glucose, maltose, and isomaltose (from the branch points in amylopectin).
The process of digestion starts in mouth by salivary alpha amylase, however due to shorter duration of stay of food in mouth, the digestion is left incomplete.
Gastric HCl causes hydrolysis of sucrose, while there is no hydrolytic enzyme present  in gastric juice for the digestion of carbohydrates. Pancreatic amylase, an isoenzyme of salivary amylase, differs only in the optimum pH of action.
The disaccharidases, maltase, sucrase-isomaltase (a bifunctional enzyme catalyzing hydrolysis of sucrose and isomaltose), lactase, and trehalase are located on the brush border of the intestinal mucosal cell where the resultant monosaccharides and others arising from the diet are absorbed. This type of co transport is also utilized to reabsorb glucose from kidney tubules, involving SGLT2 Transporter.
The absorbed glucose is transported to portal blood  from intestinal cell by specific GLUT-2 transporters (Facilitated diffusion). Answer- Lactose intolerance is caused by a deficiency of lactase enzyme, which is produced by the cells lining the small intestine. The osmotic load of the unabsorbed lactose causes secretion of fluid and electrolytes until osmotic equilibrium is reached. Primary lactase deficiency develops over time and begins after about age 2 when the body begins to produce less lactase. Secondary, or acquired, lactase deficiency may develop in a person with a healthy small intestine during episodes of acute illness. It is a genetic disorder which prevents enzymatic production of lactase.  It is present at birth, and is diagnosed in early infancy. The person drinks a lactose-loaded beverage and then the breath is analyzed at regular intervals to measure the amount of hydrogen. The stool acidity test is used for infants and young children to measure the amount of acid in the stool. Besides these tests, urine shows- positive test  with Benedict’s test, since lactose is a reducing sugar and a small amount of lactose is absorbed in the intestinal cell by pinocytosis and is rapidly eliminated through kidneys in to urine.
Although the body’s ability to produce lactase cannot be changed, the symptoms of lactose intolerance can be managed with dietary changes. Figure-4-Insulin regulates glucose uptake into these cells(They are present in skeletal, cardiac muscles and adipose tissue) by recruiting membrane vesicles containing the GLUT4 glucose transporters from the interior of cells to the cell surface, where it allows glucose to enter cells by facilitative diffusion.  Once in the cytoplasm, the glucose is phosphorylated and thereby trapped inside cells. There is increased expression of GLUT1 and GLUT3 transporters on the surface of cancer cells. Pourquoi le depistage organise du cancer colorectal ne concerne-t-il que les personnes de 50 a 74 ans ? Des parents proches sont atteints de polypes ou de cancer du colon, dois-je faire le test ? Depuis quelques temps, j'ai mal au ventre ou bien j'ai une diarrhee ou une constipation recente; dois-je faire le test ?
The digestive tract begins at the mouth and ends with the anus and incorporates all the organs in between, including the esophagus, stomach, and intestines. Disorders such as Crohn's disease and ulcerative colitis can lead to malnutrition in a number of ways. It's important that a physician removes polyps from the digestive tract, as they are believed to be the initial stages of colon cancer. The digestive tract is a long tube within the body that consists of organs that aid in the digestion of food.
This food moves through the small intestine to the bowel where the food is completely digested and nutrients are absorbed. The digestive tract, which is the main component of the digestive system, is an important part of the body. People who suffer from irritable bowel syndrome may suffer from painful constipation, frequent diarrhea, or alternating bouts of both constipation and diarrhea.
Other people who experience problems with the digestive tract may be afflicted with Crohn's disease, proctitis, or colitis. Another disorder of the digestive tract is intestinal polyps, growths that occur in the digestive tract.
Colon cancer, one of the most serious disorders of the digestive tract, must be treated by a doctor as soon as possible.
Access to the supplemental resources for this session is password-protected and restricted to University of Michigan students. Know the location and histological similarities and dissimilarities among the different types of oral mucosae (lining, masticatory, specialized). Know the histology of the adult tooth and name the cells responsible for the production of enamel, dentin, and cementum.
Know the structure of the epithelial attachment and understand its significance in protecting the periodontal space.
The oral cavity is lined by a mucous membrane (the oral mucosa) consisting of a stratified squamous epithelium, which may or may not be keratinized, and an underlying connective tissue layer, the lamina propria. A stratified squamous non-keratinized epithelium lines the oral surface of the lips, cheeks, floor of mouth, and covers the ventral surface of the tongue In slide 114 (human) and 114M (monkey) of the lip, note that skin (stratified, keratinized squamous epithelium with hair follicles) covers the external surface [example], skeletal muscle (orbicularis oris muscle) forms the core [example], and a mucosal epithelium(stratified, non-keratinizing squamous epithelium) covers the internal surface [example]. The dorsal surface and lateral borders of the tongue (W pgs 258-9, 13.10-12) are covered by a mucous membrane that contains nerve endings for general sensory reception and taste perception. Slide 117 and especially slide 117N contain examples of circumvallate papillae (W pg 259, 13.12) [example]. The tooth in these sections lacks its outer layer of enamel because the tissue has been decalcified (recall that enamel is ~95% mineral); however, the matrix of the dentin is well preserved as is the cementum and adjacent matrix of the alveolar bone of the mandible.
Find the cemento-enamel junction [example] and trace the acellular cementum toward the root apex where there is a transition [example]to cellular cementum [ORIENTATION]. The region of greatest clinical importance is the site of gingival attachment to the tooth [example] --again, since the enamel has been removed, the actual attachment cannot be seen, but you should be able to discern the approximate area where this occurs.
Note the abundant deposit of keratin on the surface of the tongue and the characteristic shape of the filiform papilla show in this electron micrograph. Note the difference in cell shape and cell aggregation of the taste bud and the oral epithelium. Know the histological differences in the pharynx and the upper, middle and lower portions of the esophagus. Be able to recognize gastric glands, identify their constituent cells, and know their secretory products. The wall of the gastrointestinal tube consists of 4 major layers (W pgs 263-266): the mucosa, the submucosa, the muscularis (also called muscularis propria or muscularis externa) and the serosa (if covered by peritoneum) or adventitia (if retroperitoneal). To help you keep track of changes in the various layers, you can fill in this spreadsheet as you work through today's and next week's labs. The oral pharynx is lined by a stratified squamous non-keratinizing type of epithelium and lacks both muscularis mucosae and submucosa.
For the purpose of histological descriptions, the esophagus is subdivided into upper (entirely skeletal muscle in the muscularis externa),middle (mixed smooth and skeletal muscle) and lower (entirely smooth muscle) portions. In the upper esophagus, the muscularis externa consists of both inner and outer layers of skeletal muscle only. On the basis of differences in the types of glands present in the mucosa, three histological regions can be distinguished in the stomach.
These mucosal glands are composed mainly of mucous cells with pale staining cytoplasm and basally located nuclei.
Since the cardiac gastric glands are primarily mucous, they can also be be demonstrated with the PAS stain, as shown in slide 160. Other cells of the gastric glands, such as undifferentiated (stem) cells and various endocrine cells, will NOT be studied in this laboratory session as they are not readily identifiable in the stomach, but you should be aware of their general characteristics. In slide 162, you can see the transition from pylorus of the stomach to duodenum of the small intestine. Just in case you are worried about identifying cardiac glands versus pyloric glands, it is admittedly very difficult to tell these two apart based only on high-mag views, but you can always use contextual information to help you out: cardiac glands will be right near the gastro-esophageal junction whereas pyloric glands are at the gastro-duodenal junction. Note that there is only one cell type, a mucous cell, in the surface epithelium of the stomach. Note the abundant vesicles and tubules of the parietal cell, which are involved in HCl production. The basophilic materials represent a large amount of rough endoplasmic reticulum present in this region of the cytoplasm, a characteristic appearance of a cell very active in protein synthesis.
Developed for U-M Medical School by Michigan MultiMedia Medical School Information Services. In most people, apart from those of northern European origin, lactase is gradually lost through adolescence, leading to lactose intolerance.
They are carried by the same transport protein (SGLT 1), and compete with each other for intestinal absorption.
SGLT-1 are  present on the intestinal cells while SGLT-2 are  present on the proximal tubular cells.
Because they are not actively transported, fructose and sugar alcohols are only absorbed down their concentration gradient, and after a moderately high intake, some may remain in the intestinal lumen, acting as a substrate for bacterial fermentation.
Disaccharides cannot be absorbed through the wall of the small intestine into the bloodstream, so in the absence of lactase, lactose present in ingested dairy products remains uncleaved and passes intact into the colon.

Dilation of the intestine caused by the osmosis induces an acceleration of small intestinal transit, which increases the degree of maldigestion. Most children who have lactase deficiency do not experience symptoms of lactose intolerance until late adolescence or adulthood.
This occurs because of mucosal damage or from medications resulting from certain gastrointestinal diseases, including exposure to intestinal parasites such as Giardia lamblia. Normally, very little hydrogen is detectable in the breath, but undigested lactose produces high levels of hydrogen. Undigested lactose creates lactic acid and other short chain fatty acids that can be detected in a stool sample.
GLUT1 and GLUT3, present in nearly all mammalian cells, are responsible for basal glucose uptake. GLUT2, present in liver and pancreatic beta cells, are distinctive in having a very high K m value for glucose (15 20 mM). GLUT5, present in the small intestine, testes, seminal vesicles and kidney, function  primarily as  fructose transporters.
Cancer cells grow more rapidly than the blood vessels to nourish them; thus, as solid tumors grow, they are unable to obtain oxygen efficiently.
Any undigested food travels to the large intestine where water and salt is eliminated from it. This is because it converts food into a material that makes it easier for the body to use for nourishment. A proctitis sufferer will have difficulty with bowel movements despite the frequent urge to do so. Treatment includes surgery to remove the cancer in addition to radiation and chemotherapy treatment. If you are a University of Michigan student enrolled in a histology course at the University of Michigan, please click on the following link and use your Kerberos-password for access to download lecture handouts and the other resources. The surface is kept moist with mucus produced by the major and numerous minor salivary glands.
A lamina propria underlies the mucosa and small salivary glands (labial salivary glands) [example] are present in the submucosa.
Slide 115, which you used to study bone and the respiratory system, is a longitudinal section through the palate and includes the lip, gingiva, hard palate, and a portion of the soft palate [ORIENTATION].
In slide 116, the dorsal surface of the tongue is covered with tiny projections called papillae [example], which are lacking on the ventral surface.
Locate the numerous filiform papillae [example], that appear as conical structures with a core of lamina propria covered by a keratinized epithelium. These slides need some understanding of sectioning a three dimensional object in two dimensions! The cellular cementum may be identified by the presence of cementocytes which, much like osteocytes, reside within lacunae (you will need to use your microscopes and glass slides to see this well). This epithelial attachment (W pg 257, 13.9) to the enamel surface can break down leading to a chronic infection (periodontal disease). The mucosa, in turn, consists of an epithelium, a supporting lamina propria of loose connective tissue and a thin, usually double, layer of smooth muscle, themuscularis mucosae.
The epithelium rests on a lamina propria that contains a thick layer of longitudinally oriented elastic fibers (a useful diagnostic feature). We don't have any slides showing purely upper esophagus, but you can use slides 126 (mid-upper), 153 (mid-lower) and 155 (esophageal-cardiac junction) to study the basic histology and regional variations of the esophagus. In the middle esophagus, the muscularis externa contains a mixture of skeletal and smooth muscle as seen in slide 126 [example], whereas in the lower esophagusonly smooth muscle is found as seen in slide 155 [example]. The wall of the stomach consists of the usual four layers present in other parts of the gastrointestinal tract. In this slide, the cells lining the gastric pits [example] stain very intensely with PAS due to the carbohydrate-rich, viscous mucus they secrete.
At low magnification, notice that the gastric pits are relatively more shallow here [example] and the tubular gastric or fundic glands are relatively much longer than those in the cardia or pylorus. Parietal cells are large, ovoid to pyramidal shaped cells with their broad side adjacent to the basement membrane. Notice the presence of a large number of lymphocytes and plasma cells in the lamina propria between the gastric glands, and, in some areas, aggregated aslymphoid nodules [example] (which will be studied in greater detail along with other lymphatic tissues but you should at least be able to identify them here). The pyloric region of the stomach is characterized by a thick wall due to the presence of the pyloric sphincter muscle [example], which is comprised primarily of the inner circular layer of the muscularis externa.
This is the lining of the esophagus, where it is no longer necessary to have an outer keratinized layer to protect against desiccation, as it was for skin. The gastric pits lead into the gastric glands proper, where there are several cell types present. It is essentially that of an exocrine gland cell - as seen in the salivary glands and the pancreas.
Note the numerous giant mitochondria in the parietal cell as opposed to the small and sparse mitochondria in the chief cells. They are usually found adjacent to the basal and lateral sides of the cell, not the apical aspect, which is facing the lumen of the gastrointestinal tract. The University of Michigan Health System site does not provide specific medical advice and does not endorse any medical or professional service obtained through information provided on this site or any links to this site.
Lactose remains in the intestinal lumen, where it is a substrate for bacterial fermentation to lactate, resulting in discomfort and diarrhea. The operons of enteric bacteria quickly switch over to lactose metabolism, and the resulting in-vivo fermentation produces copious amounts of gas (a mixture of hydrogen, carbon dioxide, and methane).
The combined increase in fecal water, intestinal transit, and generated hydrogen gas accounts for the wide range of gastrointestinal symptoms. Gradually introducing small amounts of milk or milk products may help some people adapt to them with fewer symptoms.
Hence, glucose enters these tissues at a biologically significant rate only when there is much glucose in the blood. The presence of insulin, which signals the fed state, leads to a rapid increase in the number of GLUT4 transporters in the plasma membrane (Figure-4). This material is then transformed into a brown solid material that is stored in the rectum so it can be expelled as feces.
The digestive system breaks down food into the smallest particles so they can be absorbed into the blood stream.
Changes in diet and the attention of a physician are needed for those who suffer from any of these inflammatory bowel diseases. It's important that a physician removes polyps from the digestive tract, as they are believed to be the initial stages of colon cancer. Symptoms of colon cancer are abdominal pain, rectal bleeding, a decline in health, weight loss, decrease in appetite, and fatigue.
The oral mucosa is well supplied with nerve endings and, on the dorsal surface of the tongue, special sensory endings for taste. Note the transition zone between the keratinized epithelium of the skin and the nonkeratinized epithelium of the mucosa. This tissue is from a term fetus (with unerrupted teeth) and the epithelium over the hard palate is not yet fully differentiated (i.e. The body of the tongue is composed of interlacing bundles of skeletal muscle [example] that cross one another at right angles.
However, you should be able to see excellent regions of theperiodontal ligament [example] connecting the root cementum to the alveolar bone (W pg 257, 13.8). This monkey tooth has tortuous roots and the cellular cementum is usually present in a tangential section. If the disease persists, the attachment epithelium and subjacent connective tissue become heavily infiltrated with white cells (you won’t see this in your slides as the tissue was healthy when the slides were prepared –you may see a few WBCs, but this is normal). Be able to recognize a taste bud as such, but you will not be required to know its detailed structure and recognize different cell types.
The fibers, which stain deep purple with aldehyde fuchsin, are readily recognized in slide 152AF whereas in the H&E-stained slide the elastic fibers appear dark, glassy red. The esophageal epithelium [example] is the non-keratinized stratified squamous type and is supported by a connective tissue lamina propria. Present in all regions of the esophagus (upper, mid, and lower) is the myenteric (Auerbach’s) plexus [example] between the two layers of the muscularis externa (W pg 267, 14.3). The second region, which includes the fundus and corpus, contains the gastric glands proper (also called fundic glands).
The secretion of the cardiac glands is a bit more watery so they do not stain quite as intensely [example]. Observe that the tall columnar cells lining the luminal surface and pits have basally located nuclei and lightly staining cytoplasm (W pg 270, 14.10 a, b).
Each cell contains a round, centrally located nucleus and reveals a lightly eosinophilic cytoplasm that appears granular due to the presence of many mitochondria.
Also, notice that the strands of smooth muscle fibers from the inner layer of the muscularis mucosae extend between the glands toward the surface. The flow of sodium is down the concentration gradient, while glucose is transported against the concentration gradient. This, in turn, may cause a range of abdominal symptoms, including abdominal cramps, bloating, and flatulence.

A very common cause of temporary lactose intolerance is gastroenteritis, particularly when the gastroenteritis is caused by rotavirus. Hence, GLUT1 and GLUT3 continually transport glucose into cells at an essentially constant rate. The pancreas can thereby sense the glucose level and accordingly adjust the rate of insulin secretion. Under these conditions, glycolysis leading to lactic acid fermentation becomes the primary source of ATP. If the digestive system is not working properly, a person can experience nausea, irritable bowel syndrome, a virus, or other problems that relate to the digestive system. The dense lamina propria of the mucosa is continuous with the connective tissue of the muscle, tightly binding the mucous membrane to the muscle.
Taste buds (W pg 400, 21.1) [example], the chemoreceptors for the sense of taste, are located on the lateral borders.
If you use a light microscope and close down the iris diaphragm you can see Sharpey’s fibers inserting into both the alveolar bone and root cementum.
In most sections, a series of longitudinally oriented increments of bone line the alveolar socket (where periodontal ligament fibers insert). The disease can progress resulting in loss of alveolar bone, periodontal ligament and, eventually, the tooth. The mucosa differs considerably from region to region, reflecting changing functional activity.
Note that these fibers are located in the lamina propria near the underlying muscularis externa. Note the presence of isolated lymphoid nodules [example] and scattered leukocytes in the lamina propria. For most of its extent, the esophagus is retroperitoneal, so its outermost layer consists of a connective tissue adventitia which merges with the adjacent connective tissue associated with nearby structures (such as the trachea as shown in slide 126). The muscularis mucosae is also thick and, in some areas, it consists of 3 layers of smooth muscle, although this layering is not always visible.
Note the abrupt transition from the mucosa of the esophagus with its stratified squamous epithelium to the glandular mucosa of the stomach. The pyloric glands [example] at the base of each gastric pit [ORIENTATION] are also composed again of a mostly HOMOGENEOUS population of mucous cells that are similar in appearance to those in cardiac glands although the pits are much deeper compared to cardiac glands. In addition, as with other unabsorbed sugars (such as Sorbitol, Mannitol, and xylitol), the presence of lactose and its fermentation products raises the osmotic pressure of the colon contents. Insulin signals the need to remove glucose from the blood for storage as glycogen or conversion into fat. The number of these transporters present in muscle membranes increase in response to endurance exercise training. Glycolysis is made more efficient in hypoxic tumors by the action of a transcription factor, hypoxia–inducible transcription factor (HIF-1).
At times the lamina propria and submucosa are substantively so similar that they merge imperceptibly. The slide is, however, a good overall orientation to the histology of the hard and soft palate.
Some glass slides in our collection show mucous glands in the submucosa, which are found only on the ventral side of the tongue. In young children, the fungiform papillae can be seen with the naked eye as red spots on the dorsum of the tongue (because the non-keratinized epithelium is relatively translucent). Each taste bud contains about 50 spindle shaped cells that are classically described based on their appearance as “light” (receptor) cells, “dark” (supporting) cells, and “basal” (stem) cells, although these distinctions are difficult to see in your slides so we do not require you to identify the cell types. Note the extensive vascular supply to the periodontal ligament that travels in (an interconnected network of) loose connective tissue.
Alveolar bone appears more like immature, or woven, bone and can be distinguished from the Haversian systems deeper within the bone, is particularly labile and is easily resorbed and deposited as a consequence of tooth movement.
The muscularis externa is composed of somewhat irregularly arranged skeletal muscle, the longitudinal and constrictor muscles of the pharynx. In additiona to the characgteristic submucosal glands of the esophagus, small mucous glands may be found scattered in the lamina propria of the upper and lower esophagus in some of our glass slides. Below the diaphragm, however, the esophagus is suspended within abdominal cavity and is therefore covered by a connective tissue serosa as shown in slide 155.
The cardiac gastric glands [example] are present only in a very small segment of the stomach mucosa adjacent to this junction. You can see these cells in the stomach preparation stained with PAS (which will stain mucus and other glycoproteins) in slide 160 and in Wheater's pg. The apical cytoplasm of these cells may appear granular due to the presence of zymogen granules, that may stain bright red in H&E preparations (as in slide 157).
Secondary lactase deficiency also results from injury to the small intestine that occurs with celiac disease, Crohn’s disease, or chemotherapy.
Getting enough calcium is important for people with lactose intolerance when the intake of milk and milk products is limited. The high Km value of GLUT2 also ensures that glucose rapidly enters liver cells only in times of plenty. In the absence of oxygen, HIF-1 increases the expression of most glycolytic enzymes and the glucose transporters GLUT1 and GLUT3.
In your slides, the submucosa will be distinguished from the lamina propria only by the presence of minor salivary glands in a loose textured tissue, and we do not ask you to recognize this distinction microscopically.
These papillae are less readily observed in adults, because of slight keratinization of the epithelium. Non-myelinated nerves from cranial nerves VII, IX, or X (depending on the location of the taste bud) synapse with the receptor and, to some extent, supporting cells of the taste bud.
The gingiva is the highly keratinized epithelium and underlying connective tissue lamina propria that surrounds the teeth.
The other layers in the wall change rather little, although there are subtle differences also in these layers that can also help you identify particular regions of the GI tract. Mucous glands seen in this muscular layer in some of our glass slides are the extensions of those present in the lamina propria. A rather thick layer of longitudinally arranged smooth muscle fibers form the muscularis mucosae [example].
In the empty contracted stomach, the mucosa is thrown into longitudinal folds (rugae) because of the contraction of the muscularis mucosae and the loose consistency of the submucosa. They are mucous glands comprised of a HOMOGENEOUS population of pale-staining columnar cells with a “bubbly” supranuclear cytoplasm. However, in other preparations (slides 155 and 156), the pepsinogen has been extracted and the empty secretory granules resemble many glass beads in the supranuclear cytoplasm. A balanced diet that provides an adequate amount of nutrients—including calcium and vitamin D—and minimizes discomfort is to be planned for the patients of lactose intolerance. Because the epithelium is very thin in this region, the lips appear red (this arrangement may or may not be apparent in your glass slides).
Identify respiratory epithelium, bone(hard palate), forming tooth [example], and skeletal muscle in the lip[example] and the soft palate [example]. Some slides show serous glands (of von Ebner) [example] in the lamina propria and interspersed between the bundles of muscle beneath the papillae. The extensive interdigitation with the lamina propria increases the surface area for epithelial attachment to the connective tissue. Odontoblasts and dentinal tubules can be seen very well in slide 123, which is of a tooth that is just about to erupt --ameloblasts can also be seen although the enamel is lacking since this section was also decalcified during processing. The outer fibrous layer, which connects the pharynx to the adjacent structures, is not included in many of your slides.
The connective tissue of the submucosa consists of mostly collagenous fibers with some elastic fibers and varying amounts of fat as well as submucosal sero-mucous glands which can be readily observed in both slide 126 [example] and slide 153 [example] (those in slide 155 are not very well preserved). As you move further into the stomach, the cardiac glands are very quickly replaced by gastric proper (or fundic) glands which, as described below, consist of a notably HETEROGENEOUS mixture of basophilic chief cells and eosinophilic parietal cells. Note that the bases of the pyloric glands abut the muscularis mucosae whereas in the duodenum, you will see abundant glands (Brunner's glands) DEEP to the muscularis mucosae (i.e. Salivary glands are lacking in the vermillion zone, therefore, the lips must be continuously moistened (by the tongue) to prevent drying out.
On one side of the section you can trace the transition from keratinized gingiva to nonkeratinized mucosa (in the PAS slide, some glycogen is stained in the mucosa). These funnel-shaped invaginations of the epithelium are continuous at their base with the tubular glands. Also identifiable are lighter-staining "mucous neck cells" present in the neck region of the gastric glands and mucus-secreting cells of the cardiac glands found near the gastro-espophageal junction.
The middle circular layer of the muscularis is thickened to form thepyloric sphincter, which is an “anatomic” sphincter (W pg 273, 14.15). The lower (gastro-)esophageal sphincter does not have this thickening of the muscularis, so this is why it is called a “physiological” sphincter.

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