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hormones.html
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<h1>Digestive Hormones</h1>
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<ol>
<li>Cell to cell communication in the GI system is mediated by ENS, modulated by hormones</li>
<li>Hormones and endocrine work through secretion, paracrine works through diffusion, neurocrine through action potentials</li>
<li>Hormones released into blood in response to changes in luminal composition</li>
<li>ECL cells are of a closed type</li>
<li>Incretins are GIP (gastric inhibitory peptide) and GLP-1 (glucagon-like peptide-1)</li>
<li><b>Gastrin</b> family includes gastrin and cholecystokinin (CCK)</li>
<li><b>Secretins</b> include secretin, VIP, GIP, GLP-1</li>
<li><b>Motilins</b> are secreted between meals, and activate MMC to sweep remnants from antrum to terminal ileum to colon</li>
<li>Gastrin (G cells) are released by peptides in the stomach and neural reflexes and target ECL and parietal cells - they stimulate gastric acid production and are inhibited by somatostatin release</li>
<li>Cholecystokinin (I cells) are released by fatty acids and target the gallbladder, pancreas, stomach - they promote satiety and inhibit gastric emptying while stimulating pancreatic enzyme secretion</li>
<li>Secretin (S cells) is released due to acid in small intestine and targets pancreas and stomach - stimulates bicarbonate secretion to protect GI tract</li>
<li>Motilin (M cells) is released from fasting and targets smooth muscle to stimulate MMC - inhibited by eating</li>
<li>GIP (K cells) is released by glucose and targets beta cells of pancreas - stimulates insulin release</li>
<li>GLP-1 (L) is released by mixed meals of carbohydrates and fats and targets endocrine pancreas - stimulates insulin release, promotes satiety</li>
<li>Long reflexes are in CNS, short reflexes are in ENS</li>
<li>Ghrelin is the hunger hormone - lower in patients who've had gastric bypass surgery</li>
<li>Peptide YY, CCK, and insulin all promite satiety</li>
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