Hormones and associated disorders
There are a myriad of hormones that are secreted by the GI tract. Most act locally within the GI tract to regulate the digestion process. We summarise the action of these hormones in the table below.
| Hormones | Site of secretion | Stimulus for secretion | Action |
| Gastrin | G cells of the stomach | Stomach distension
Vagal innervation Small peptides and amino acids (Inhibited by H+ in stomach and somatostatin) |
Stimulates gastric H+, pepsin and intrinsic factor secretion
Stimulates gastric emptying Stimulates pancreatic HCO3- and enzyme secretion |
| Cholecystokinin (CKK) | I cells of duodenum and jejunum | Small peptides and amino acids
Fatty acids Some cations, e.g., Ca2+ and Mg2+ |
Stimulates pancreatic enzyme and HCO3- secretion
Stimulates gallbladder contraction and Sphincter of Oddi relaxation Inhibits gastric emptying |
| Secretin | S cells of the duodenum | H+ in duodenum | Stimulates pancreatic HCO3- secretion
Inhibits gastric H+ secretion Inhibits gastric emptying and small intestine motility |
| Gastric Inhibitory Peptide
(GIP) |
K cells of duodenum and jejunum | Amino acids, fatty acids and glucose | Stimulates insulin secretion
Inhibits gastric H+ secretion and motility |
| Motilin | Duodenum and jejunum | Stimulates gastric and intestinal motility | |
| Pancreatic Peptide
(PP) |
Pancreas | Inhibits pancreatic enzyme secretion
Relaxes gallbladder |
|
| Vasoactive Intestinal Peptide
(VIP) |
Small intestine | Stimulates pancreatic and intestinal secretion
Inhibits gastric H+ and pancreatic secretion |
|
| Somatostatin | D cells throughout the GI tract | Inhibited by vagal stimulation | Inhibits the release of all GI hormones
Inhibits gastric H+ secretion |
Table 4: Summary of hormones secreted by the GI tract. Own table.
In most conditions, pathology develops in excess of these hormones rather than deficiencies. Increased gastrin levels can be found in gastrinomas, Zollinger-Ellison syndrome, achlorhydria, vagotomy, short bowel syndrome and iatrogenic ( PPI/H2 antagonist). Increased VIP can be seen in VIPoma. Increased PP can be seen in pancreatic malignancies. Decreased gastrin levels can be found in fasting patients and conditions stimulating hyperacidity.
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