Gastrointestinal G a s t Anatomy and Physiology r o i n t e The Essentials s t i n a l A Edited by n Gastrointestinal a John F. Reinus, MD, to m Montefiore Medical Center and The Albert Einstein College of Medicine, NY, USA y Anatomy and Physiology a Douglas Simon, MD, n d Jacobi Medical Center and The Albert Einstein College of Medicine, NY, USA P The Essentials h y s Gastroenterologists require detailed knowledge regarding the Titles of i o anatomy of the GI system in order to understand the disturbances Related Interest lo g caused by diseases they diagnose and treat. y To make that information easily accessible, Gastrointestinal T Yamada’s Handbook of h Anatomy and Physiology: The Essentials brings together the world’s e Gastroenterology E leading experts who present a comprehensive overview of the s anatomic and physiologic features of the gastrointestinal tract. Yamada se ISBN 978-0-470-65620-4 n Full color and with excellent anatomical and clinical figures tia throughout, it provides succinct, authoritative, and didactic ls Essentials of anatomic and physiologic information on all the key areas, including: Gastroenterology, • GI motility E Friedman d • hepatic structure it ISBN 978-0-470-65625-9 e d • GI hormones b • gastric secretion y R • absorption of nutrients e i n GI trainees will value the clear-cut, straightforward guidance, as u well as the self-assessment questions written to the level they s will encounter during Board exams, and gastroenterologists will a n find it useful as a handy refresher on the key topics ahead of re- d S certification exams. i m o Edited by n Gastrointestinal anatomy and physiology has its own resources website: John F. Reinus and www.wiley.com/go/reinus/gastro/anatomy Douglas Simon This companion website includes all figures from the book www.wiley.com/go/gastro Reinus_pbk_9780470674840.indd 1 04/02/14 15:00 Gastrointestinal Anatomy and Physiology We dedicate this book to our teachers and students, and to our families, especially our wives: Enid and Doreen, this book is for you with our undying gratitude for your boundless love and support. Gastrointestinal Anatomy and Physiology The Essentials EDiTED by John F. Reinus, MD Chief of Clinical Hepatology Division of Gastroenterology and Liver Diseases Montefiore Medical Center Professor of Clinical Medicine The Albert Einstein College of Medicine bronx, Ny, USA Douglas Simon, MD, FACG Chief of Gastroenterology and Hepatology Jacobi Medical Center Professor of Clinical Medicine The Albert Einstein College of Medicine bronx, Ny, USA This edition first published 2014 © 2014 by John Wiley & Sons, Ltd. Registered office John Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK Editorial offices 9600 Garsington Road, Oxford, OX4 2DQ, UK The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK 111 River Street, Hoboken, NJ 07030–5774, USA For details of our global editorial offices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell The right of the author to be identified as the author of this work has been asserted in accordance with the UK Copyright, Designs and Patents Act 1988. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher. 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The fact that an organization or Website is referred to in this work as a citation and/or a potential source of further information does not mean that the author or the publisher endorses the information the organization or Website may provide or recommendations it may make. Further, readers should be aware that internet Websites listed in this work may have changed or disappeared between when this work was written and when it is read. No warranty may be created or extended by any promotional statements for this work. Neither the publisher nor the author shall be liable for any damages arising herefrom. Library of Congress Cataloging-in-Publication Data Gastrointestinal anatomy and physiology : the essentials / edited by John F. Reinus, Douglas Simon. p. ; cm. includes bibliographical references and index. iSbN 978-0-470-67484-0 (pbk. : alk. paper) i. Reinus, John, editor of compilation. ii. Simon, Douglas, 1956– editor of compilation. [DNLM: 1. Digestive System–anatomy & histology. 2. Digestive System Physiological Phenomena. Wi 101] QP145 612.3–dc23 2013034304 A catalogue record for this book is available from the british Library. Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books. Cover image: © Dream Designs image iD: 97229036 Cover design by Garth Stewart Set in 9.5/13pt Meridien by SPi Publisher Services, Pondicherry, india 1 2014 Contents Contributors, vi Preface, ix About the companion website, x 1 Structure and innervation of hollow viscera, 1 Laura D. Wood & Elizabeth A. Montgomery 2 Gastrointestinal hormones in the regulation of gut function in health and disease, 15 John Del Valle 3 Gastrointestinal motility, 33 Ikuo Hirano & Darren Brenner 4 Gastrointestinal immunology and ecology, 46 Shehzad Z. Sheikh & Scott E. Plevy 5 Gastric physiology, 58 Mitchell L. Schubert 6 Structure and function of the exocrine pancreas, 78 James H. Grendell 7 Absorption and secretion of fluid and electrolytes, 92 Lawrence R. Schiller 8 Absorption of nutrients, 108 Lawrence R. Schiller 9 Hepatic structure and function, 129 Michelle T. Long & Lawrence S. Friedman 10 The splanchnic circulation, 149 Peter R. Kvietys & D. Neil Granger 11 Composition and circulation of the bile, 164 Allan W. Wolkoff 12 bilirubin metabolism, 173 Allan W. Wolkoff index, 183 v Contributors Darren Brenner, MD Assistant Professor of Medicine Division of Gastroenterology Northwestern University Feinberg School of Medicine Chicago, iL, USA John Del Valle, MD Professor and Senior Associate Chair of Medicine Department of internal Medicine Division of Gastroenterology University of Michigan Medical Center Ann Arbor, Mi, USA Lawrence S. Friedman, MD Professor of Medicine Harvard Medical School Professor of Medicine Tufts University School of Medicine Assistant Chief of Medicine Massachusetts General Hospital boston, MA, USA The Anton R. Fried, MD, Chair Department of Medicine Newton-Wellesley Hospital Newton, MA, USA D. Neil Granger, PhD boyd Professor & Head Department of Molecular & Cellular Physiology LSU Health Sciences Center Shreveport, LA, USA James H. Grendell, MD Professor of Medicine School of Medicine State University of New york at Stony brook Stony brook, Ny, USA Chief, Division of Gastroenterology, Hepatology & Nutrition Winthrop University Hospital Mineola, Ny, USA vi Contributors vii Ikuo Hirano, MD Professor of Medicine Fellowship Program Director Division of Gastroenterology Northwestern University Feinberg School of Medicine Chicago, iL, USA Peter R. Kvietys, PhD Professor of Physiology College of Medicine Alfaisal University Riyadh, Saudi Arabia Michelle T. Long, MD Fellow, Division of Gastroenterology boston University School of Medicine and boston Medical Center boston, MA, USA Elizabeth A. Montgomery, MD Professor of Pathology, Oncology, and Orthopedic Surgery Department of Pathology Johns Hopkins Hospital baltimore, MD, USA Scott E. Plevy, MD Associate Professor Departments of Medicine, Microbiology and immunology University of North Carolina School of Medicine Chapel Hill, NC, USA Lawrence R. Schiller, MD Professor of Medicine Dallas Campus, Texas A&M College of Medicine Attending Physician Digestive Health Associates of Texas Program Director Gastroenterology Fellowship baylor University Medical Center Dallas, TX, USA Mitchell L. Schubert, MD Professor of Medicine and Physiology Virginia Commonwealth University’s Medical College of Virginia Chief, Division of Gastroenterology McGuire Veterans Affairs Medical Center Richmond, VA, USA viii Contributors Shehzad Z. Sheikh, MD, PhD Assistant Professor of Medicine Division of Gastroenterology and Hepatology University of North Carolina School of Medicine Chapel Hill, NC, USA Allan W. Wolkoff, MD The Herman Lopata Chair in Liver Disease Research Professor of Medicine and Anatomy and Structural biology Associate Chair of Medicine for Research Chief, Division of Gastroenterology and Liver Diseases Director, Marion bessin Liver Research Center Albert Einstein College of Medicine and Montefiore Medical Center bronx, Ny, USA Laura D. Wood, MD, PhD Assistant Professor of Pathology and Oncology Department of Pathology Johns Hopkins Hospital baltimore, MD, USA