Gastrointestinal (GI) Hormones

Kaleb Martin Archer, MD

The Operative Review of Surgery. 2023; 1:52-58.

Table of Contents
Hormones of the Stomach
Hormones of the Small Intestine
Hormones of the Pancreas

Mnemonics
References

Hormones of the Stomach

Gastrin

• Functions:
o Stimulates Stomach Parietal Cells to Secrete HCl
§ Primarily Done by Stimulating Enterochromaffin-
Like (ECL) Cells to Release Histamine 2
§ Also Has Some Direct Stimulation
o Stimulates Stomach Chief Cells to Secrete Pepsinogen
o Trophic Effects on Enterochromaffin-Like (ECL) Cells
and Parietal Cells – Can Cause Mucosal Hyperplasia 3
• Produced by G Cells of the Stomach 4
• Stimulated By: Stomach 1
o Amino Acids in the Stomach from Protein Digestion –
Most Potent Stimulator
§ Phenylalanine and Tryptophan are the Strongest 5
o Alkaline Environment
o Acetylcholine from Vagal Stimulation
o Gastric Distention
o Bombesin (Gastrin-Releasing Peptide)
• Inhibited By:
o HCl in the Stomach – Negative Feedback
o Somatostatin
• Multiple Forms: G34 (Big Gastrin), G17 (Little Gastrin), etc

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Somatostatin (SS)

• Functions:
o Inhibits Stomach Parietal Cells to Decrease HCl Secretion 6
o Inhibits Gastric Emptying
o Inhibits Pancreatic Secretion (Insulin, Glucagon, and Pancreatic Enzymes)
o Inhibits Bile Secretion 7
o Inhibits Growth Hormone, Thyroid Stimulating Hormone, and Procalcitonin in the
Hypothalamus
o Inhibits Intestinal Transport of Nutrients
o Inhibits Splanchnic Blood Flow 8
• Produced by Delta (D) Cells of the Stomach, Duodenum, and Pancreas 9
• Stimulated By:
o Acid in the Duodenum 9
• Inhibited By:
o Acetylcholine from Vagal Stimulation 9
• Two Forms: SS-14 and SS-28
• Octreotide is a Somatostatin Analog Used for Various Treatments 10

Ghrelin

• Function:
o Stimulates Hunger – Primary Function
o Increases Gastric Emptying and Acid Secretion 9
o May Raise Blood Glucose 11
• Produced by Enterochromaffin Cells of the Stomach & Duodenum
• Levels are Highest Before Meals
• Levels are Significantly Decreased After Gastric Bypass – Enhances Weight Loss 12

Hormones of the Small Intestine

Cholecystokinin (CCK)

• Functions:
o Stimulates Gallbladder Contraction 13
o Stimulates Sphincter of Oddi Relaxation 14
o Stimulates Acinar Cells of the Pancreas to Secrete
Digestive Enzymes 15
o Suppresses Hunger 16
• Produced by I Cells of the Duodenum 17 Duodenum 1

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 • Stimulated By:
o Amino Acids and Fatty Acids in the Duodenum – Strongest Stimulator 17
o Acetylcholine from Vagal Stimulation 17
o CCK-Releasing Peptide (Monitor Peptide) 18
• Inhibited By:
o Somatostatin – By Inhibition of CCK-Releasing Peptide 19

Secretin

• Functions:
o Stimulates Bicarbonate Secretion in the Pancreas – Primary Action 20
o Stimulates Bile Secretion 20
o Inhibits Gastrin Secretion 21
o Inhibits Stomach Parietal Cells to Decrease HCl Secretion 21
o Inhibits Gastric Motility 21
• Produced by S Cells of the Duodenum 22
• Stimulated By:
o Acid in the Duodenum – Primary Stimulator 20
o Fatty Acids in the Duodenum 23
o Bile Salts in the Duodenum 23

Motilin

• Primary Function: Stimulates Peristalsis and Gut Motility 21

o By Stimulating the Migrating Myoelectric Complex (MMC)
o Initiated in the Stomach Antrum and Propagates Distally 21
o Secretion Peaks Every 100 Minutes Between Meals to Control Inter-Digestive Phase III
Contractions 24
o “Housekeeper of the Gut” by Clearing Out and Making Ready for the Next Meal
• Produced by Mo Cells of the Duodenum and Jejunum 25
• Stimulated By: 26
o Bile
o Free Fatty Acids
o Duodenal Acid
o *Overall Stimulation is Poorly Understood
• Erythromycin (Antibiotic) Stimulates Motilin and is Often Used to Stimulate GI Motility 27

Incretins (GIP and GLP-1)

• Definition: Hormones That Augment Insulin to Decrease Blood Glucose Levels

• Gastric Inhibitory Peptide (GIP)
o Also Known As: Glucose-Dependent Insulinotropic Polypeptide
o Functions:
§ Stimulates Insulin Secretion – Primary Function 28
§ Weak Gastric Acid Inhibitor – Traditional Effect the Peptide Was Named For 29
o Produced by K Cells of Duodenum 30
o Stimulated by Glucose in the Duodenum
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 • Glucagon-Like Peptide-1 (GLP-1)
o Primary Function: Stimulates Insulin Secretion 31
o Produced by L Cells of the Ileum and Colon 32
§ Some in the Duodenum and Jejunum as Well
o Stimulation Not Inhibited by Type 2 Diabetes 33

Additional Hormones

• Glucagon-Like Peptide-2 (GLP-2)

o Functions: 34
§ Enhancement and Growth of Intestine
§ Stimulates Gastric Acid Secretion
o Produced by L Cells of the Ileum and Colon (Co-Secreted with GLP-1) 34
o Analogs Used to Treat Short Bowel Syndrome 35
• Vasoactive Intestinal Polypeptide (VIP)
o Functions: 36
§ Stimulates Intestinal Secretion and Absorption
§ Stimulates Bile Secretion
§ Stimulates Vasodilation
§ Relaxes Smooth Muscle (Lower Esophageal Sphincter and Colon)
o Primarily Secreted by Neurons 37
• Peptide YY (Peptide Tyrosine Tyrosine)
o Functions:
§ Inhibits Gastric Emptying and Intestinal Motility 38
§ Inhibits Pancreatic Secretion 39
§ Inhibits Gallbladder Contraction 40
§ Stimulates Water and Electrolyte Absorption in the Colon
§ Inhibits Appetite 41
o Produced by L Cells of the Ileum and Colon 42
o Stimulated by Protein and Fat 43
• Bombesin
o Functions:
§ Stimulates Gastrin Release and Gastroprotection 44
§ Stimulates Cholecystokinin (CCK) Release 45
§ Negative Feedback to Stop Eating Behavior – Second Only to CCK 46,47
o Produced Throughout the GI Tract and Brain

Hormones of the Pancreas

Hormones of the Pancreas

• *See Pancreas Physiology

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Mnemonics
Hormone Secreting Cells

• G-G: G Cells Secrete Gastrin

• D (Double-SS): D Cells Secrete Somatostatin
• S (Single-S): S Cells Secrete Secretin
• I-CCK (“Icky”): I Cells Secrete CCK

Gastric Hormone Functions

• Gastrin: “Gastrin-Gastric”
o Gastrin Stimulates Gastric Specific Functions
• Somatostatin: S-STATIN – STASIS
o “Stasis” Inhibits All Other Functions
o Known as “The Great Inhibitor”
• Ghrelin: “Ghrelin Growls”
o Ghrelin Stimulates Hunger

Small Intestine Hormone Functions

• Cholecystokinin: Chole, “Bile”; Cysto, “Sac”; Kinin, “Move”

o Greek Origin Equates to Gallbladder Contraction
• Secretin: Secretin-Secretes
o Stimulates Bile and Pancreatic Bicarbonate Secretion
• Motilin: Motilin-Motility
o Stimulates Motility

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