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Healthbase is the trusted source for global medical choices, connecting patients to leading hospitals around the world, through secure and information-rich web portal. To learn more, visit: Login to get FREE quote. Access is free.Healthbase LogoHow Digestive System WorksProvided by: National Institute of Diabetes and Digestive and Kidney Diseases


The digestive system is a series of hollow organs joined in a long, twisting tube from the mouth to the anus (see figure). Inside this tube is a lining called the mucosa. In the mouth, stomach, and small intestine, the mucosa contains tiny glands that produce juices to help digest food.

Two solid organs, the liver and the pancreas, produce digestive juices that reach the intestine through small tubes. In addition, parts of other organ systems (for instance, nerves and blood) play a major role in the digestive system.

Why Is Digestion Important?

When we eat such things as bread, meat, and vegetables, they are not in a form that the body can use as nourishment. Our food and drink must be changed into smaller molecules of nutrients before they can be absorbed into the blood and carried to cells throughout the body. Digestion is the process by which food and drink are broken down into their smallest parts so that the body can use them to build and nourish cells and to provide energy.

How Is Food Digested?

Digestion involves the mixing of food, its movement through the digestive tract, and chemical breakdown of the large molecules of food into smaller molecules. Digestion begins in the mouth, when we chew and swallow, and is completed in the small intestine. The chemical process varies somewhat for different kinds of food.

Movement of Food Through the System

The large, hollow organs of the digestive system contain muscle that enables their walls to move. The movement of organ walls can propel food and liquid and also can mix the contents within each organ. Typical movement of the esophagus, stomach, and intestine is called peristalsis. The action of peristalsis looks like an ocean wave moving through the muscle. The muscle of the organ produces a narrowing and then propels the narrowed portion slowly down the length of the organ. These waves of narrowing push the food and fluid in front of them through each hollow organ.

The first major muscle movement occurs when food or liquid is swallowed. Although we are able to start swallowing by choice, once the swallow begins, it becomes involuntary and proceeds under the control of the nerves.

The esophagus is the organ into which the swallowed food is pushed. It connects the throat above with the stomach below. At the junction of the esophagus and stomach, there is a ringlike valve closing the passage between the two organs. However, as the food approaches the closed ring, the surrounding muscles relax and allow the food to pass.

The food then enters the stomach, which has three mechanical tasks to do. First, the stomach must store the swallowed food and liquid. This requires the muscle of the upper part of the stomach to relax and accept large volumes of swallowed material. The second job is to mix up the food, liquid, and digestive juice produced by the stomach. The lower part of the stomach mixes these materials by its muscle action. The third task of the stomach is to empty its contents slowly into the small intestine.

Several factors affect emptying of the stomach, including the nature of the food (mainly its fat and protein content) and the degree of muscle action of the emptying stomach and the next organ to receive the contents (the small intestine). As the food is digested in the small intestine and dissolved into the juices from the pancreas, liver, and intestine, the contents of the intestine are mixed and pushed forward to allow further digestion.

Finally, all of the digested nutrients are absorbed through the intestinal walls. The waste products of this process include undigested parts of the food, known as fiber, and older cells that have been shed from the mucosa. These materials are propelled into the colon, where they remain, usually for a day or two, until the feces are expelled by a bowel movement.

Production of Digestive Juices

The glands that act first are in the mouth–the salivary glands. Saliva produced by these glands contains an enzyme that begins to digest the starch from food into smaller molecules. The next set of digestive glands is in the stomach lining. They produce stomach acid and an enzyme that digests protein. One of the unsolved puzzles of the digestive system is why the acid juice of the stomach does not dissolve the tissue of the stomach itself. In most people, the stomach mucosa is able to resist the juice, although food and other tissues of the body cannot.

After the stomach empties the food and juice mixture into the small intestine, the juices of two other digestive organs mix with the food to continue the process of digestion. One of these organs is the pancreas. It produces a juice that contains a wide array of enzymes to break down the carbohydrate, fat, and protein in food. Other enzymes that are active in the process come from glands in the wall of the intestine or even a part of that wall.

The liver produces yet another digestive juice–bile. The bile is stored between meals in the gallbladder. At mealtime, it is squeezed out of the gallbladder into the bile ducts to reach the intestine and mix with the fat in food. The bile acids dissolve the fat into the watery contents of the intestine, much like detergents that dissolve grease from a frying pan. After the fat is dissolved, it is digested by enzymes from the pancreas and the lining of the intestine.

Absorption and Transport of Nutrients

Carbohydrates: Based on a 2,000-calorie diet, it is recommended that 55 to 60 percent of total daily calories be from carbohydrates. Some of our most common foods contain mostly carbohydrates. Examples are bread, potatoes, legumes, rice, spaghetti, fruits, and vegetables. Many of these foods contain both starch and fiber.

The digestible carbohydrates are broken into simpler molecules by enzymes in the saliva, in juice produced by the pancreas, and in the lining of the small intestine. Starch is digested in two steps: First, an enzyme in the saliva and pancreatic juice breaks the starch into molecules called maltose; then an enzyme in the lining of the small intestine (maltase) splits the maltose into glucose molecules that can be absorbed into the blood. Glucose is carried through the bloodstream to the liver, where it is stored or used to provide energy for the work of the body.

Table sugar is another carbohydrate that must be digested to be useful. An enzyme in the lining of the small intestine digests table sugar into glucose and fructose, each of which can be absorbed from the intestinal cavity into the blood. Milk contains yet another type of sugar, lactose, which is changed into absorbable molecules by an enzyme called lactase, also found in the intestinal lining.

Protein: Foods such as meat, eggs, and beans consist of giant molecules of protein that must be digested by enzymes before they can be used to build and repair body tissues. An enzyme in the juice of the stomach starts the digestion of swallowed protein. Further digestion of the protein is completed in the small intestine. Here, several enzymes from the pancreatic juice and the lining of the intestine carry out the breakdown of huge protein molecules into small molecules called amino acids. These small molecules can be absorbed from the hollow of the small intestine into the blood and then be carried to all parts of the body to build the walls and other parts of cells.

Fats: Fat molecules are a rich source of energy for the body. The first step in digestion of a fat such as butter is to dissolve it into the watery content of the intestinal cavity. The bile acids produced by the liver act as natural detergents to dissolve fat in water and allow the enzymes to break the large fat molecules into smaller molecules, some of which are fatty acids and cholesterol. The bile acids combine with the fatty acids and cholesterol and help these molecules to move into the cells of the mucosa. In these cells the small molecules are formed back into large molecules, most of which pass into vessels (called lymphatics) near the intestine. These small vessels carry the reformed fat to the veins of the chest, and the blood carries the fat to storage depots in different parts of the body.

Vitamins: Another vital part of our food that is absorbed from the small intestine is the class of chemicals called vitamins. The two different types of vitamins are classified by the fluid in which they can be dissolved: water-soluble vitamins (all the B vitamins and vitamin C) and fat-soluble vitamins (vitamins A, D, and K).

Water and salt: Most of the material absorbed from the cavity of the small intestine is water in which salt is dissolved. The salt and water come from the food and liquid we swallow and the juices secreted by the many digestive glands.

How Is the Digestive Process Controlled?

Hormone Regulators

A fascinating feature of the digestive system is that it contains its own regulators. The major hormones that control the functions of the digestive system are produced and released by cells in the mucosa of the stomach and small intestine. These hormones are released into the blood of the digestive tract, travel back to the heart and through the arteries, and return to the digestive system, where they stimulate digestive juices and cause organ movement. The hormones that control digestion are gastrin, secretin, and cholecystokinin (CCK).

  • Gastrin causes the stomach to produce an acid for dissolving and digesting some foods. It is also necessary for the normal growth of the lining of the stomach, small intestine, and colon.
  • Secretin causes the pancreas to send out a digestive juice that is rich in bicarbonate. It stimulates the stomach to produce pepsin, an enzyme that digests protein, and it also stimulates the liver to produce bile.
  • CCK causes the pancreas to grow and to produce the enzymes of pancreatic juice, and it causes the gallbladder to empty.

Nerve Regulators

Two types of nerves help to control the action of the digestive system. Extrinsic (outside) nerves come to the digestive organs from the unconscious part of the brain or from the spinal cord. They release a chemical called acetylcholine and another called adrenaline. Acetylcholine causes the muscle of the digestive organs to squeeze with more force and increase the “push” of food and juice through the digestive tract. Acetylcholine also causes the stomach and pancreas to produce more digestive juice. Adrenaline relaxes the muscle of the stomach and intestine and decreases the flow of blood to these organs.

Even more important, though, are the intrinsic (inside) nerves, which make up a very dense network embedded in the walls of the esophagus, stomach, small intestine, and colon. The intrinsic nerves are triggered to act when the walls of the hollow organs are stretched by food. They release many different substances that speed up or delay the movement of food and the production of juices by the digestive organs.

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Eat Smart

By Ms Melissa Aiyathurai-Johnston
Dietitian, Raffles Hospital

Brought to you by Healthbase


Food, food, glorious food! Food makes up a big part of our life. Besides providing nutritional benefits, food is also a source of enjoyment, an adventure and it tastes great!

Despite huge and beneficial gains in knowledge about nutrition over recent years, healthy eating has become harder because of the way we live and eat today. There is less reliance on home cooked meals and if we are not mindful, our meals may not be necessarily healthy. They may not be complete (e.g. not being served with enough vegetables) or the portion sizes may be too large.

In addition, the modern diet is usually overloaded with calories for energy compared to the amount we expend, has too much fat (especially saturated fat), sugar and salt and lacking in fruits, vegetables, fibre and dairy products.

This state of “over nutrition” has seen an alarming rise in the incidence of chronic lifestyle diseases. Today 1 out of 3 Singaporeans are overweight or obese which sets the scene for other conditions such as diabetes and heart disease. Excessive fat or salt and the lack of fibre have also been linked with an increase risk of certain cancers (e.g. breast, bowel, stomach), diabetes, stroke, hypertension and osteoporosis to name a few.

There is no secret to healthy eating. You just need to “eat smart”!

Enjoy a wide variety of foods
Add the grains and legumes
Trim the fat

Shake the habit – reduce your salt intake
Munch those fruits and vegetables
Alcohol – enjoy in moderation
Reduce your sugar intake
Track your weight

Enjoy a wide variety of foods
Variety is the spice of life! Everyday your body needs nutrients and other healthful substances (such as antioxidants) that only a wide variety of foods can provide. Most foods and beverages are made up of more than one nutrient, however no one food or food category has them all.

Add grains and legumes
These low fat foods should make up a large proportion of your meals. This group including bread, cereals, rice, pasta and other foods made from grains provides you with carbohydrate (your body’s fuel), B vitamins, fibre and a number of minerals. Legumes (e.g. peas, beans and lentils) provide you with good amounts of protein (important for vegetarians), B vitamins and fibre.

Having more soluble fibre in your diet, such as the type found in legumes will help to lower your cholesterol. The slow digesting carbohydrate they contain will also help those trying to control their weight or diabetics with their blood sugar control.

Trim the fat
Reducing your fat intake will lower your risk of becoming overweight which reduces your chance of certain conditions such as diabetes, heart disease, hypertension and certain cancers. Reducing your saturated fat intake will also go a long way to help keep your cholesterol in check.

Removing the skin from poultry and limit your intake of fatty meat such as pork belly, luncheon meat. When dining away from home choose more soup based dishes which are low in fat and limit those dishes made with coconut milk.

Shake the habit – reduce your salt intake
Too much salt has been linked to the development of high blood pressure or hypertension. The average diet contains more sodium than actually required.

One way to reduce your sodium intake is by tasting your food before adding salt. Also limit or avoid high sodium condiments such as soy sauce, oyster sauce, tomato ketchup. Opt for herbs, spices, chili or lime juice to add flavour instead.

Munch those fruit and vegetables
Besides being an excellent source of fibre, this low calorie, nutrient dense group provides you with essential vitamins and minerals, antioxidants, and phytochemicals that may not be present in other groups of food. Studies have shown that those people with a high intake of fruits and vegetables have a low rate of heart disease and cancer. Aim for 2 servings of fruit and vegetables daily.

Alcohol – enjoy in moderation
A moderate to heavy intake of alcohol has been associated with high blood pressure and certain cancers. An excessive intake can also lead to weight gain as gram for gram alcohol has almost twice the calories of carbohydrate or protein.

A safe intake would be no more than 2 standard drinks a day for women and no more than 4 for men with 2 alcohol free days per week.

Reduce the sugar intake
Food high in sugar tend to be “empty calories” as they have no essential fibre, vitamins or minerals and can sometimes displace more nutritious food. Most foods high in sugar also tend to also be high in fat, which if taken in excess can lead to weight gain. It is best to enjoy these foods in moderation.

Track your weight
A balance between the right food and regular exercise will ensure that your weight is healthy. Choosing low fat meals with ample carbohydrates, vegetables, fruit and protein will help you lose excessive weight, if you need to and help you to stay slim if you do not.

Be careful of fad diets or diets that offer fast weight loss as they more often do not change your eating habits and are nutritionally unbalanced. Once you go off them, the weight tends to come back straight away.

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