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Anatomy and Physiology of the Gastrointestinal Microcirculation

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PanVascular Medicine

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Abstract

The gastrointestinal microcirculation subserves the functional activities of the gastrointestinal tract (transport and motor) that allow for the efficient assimilation of ingested nutrients. Intrinsic regulatory mechanisms ensure that local perfusion and oxygenation is adequate to support gastrointestinal function. The myogenic mechanism contributes to basal vascular tone, while the metabolic mechanism matches blood flow and O2 delivery to the metabolic demands of the postprandial state. Exposure of the gastrointestinal mucosa to noxious material (acid or lipids) elicits a neurogenic hyperemia to wash out and/or neutralize the threat. The mucosal capillaries are of the fenestrated type, allowing for the efficient transendothelial movement of small solutes (e.g., hydrolytic products of food digestion) while restricting the transendothelial movement of plasma proteins. In the preprandial state (nontransporting), the balance of hydrostatic and oncotic pressures across the capillaries ensures the maintenance of a normal interstitial hydration, i.e., the small net capillary filtration is balanced by an equal volume of lymphatic effluent. Solute-coupled fluid transport (absorption/secretion) is associated with appropriate adjustments in transcapillary forces and flows to minimize drastic changes in interstitial volume.

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Abbreviations

Acute arterial hypotension:

Abrupt decrease in arterial pressure.

Acute venous hypertension:

Abrupt increase in venous pressure.

Gastrointestinal oxygenation:

O2 level determined by ratio of O2 demand to delivery.

Metabolic vasoregulation:

Response of arterioles to alterations in O2 demand/O2 delivery ratio.

Mucosal microcirculation:

Arterioles, capillaries, and venules of the mucosa.

Myogenic vasoregulation:

Response of the arterioles to stretch of vascular smooth muscle.

Neurohumoral regulation of microcirculation:

Regulation of tissue blood flow by nerves.

Osmotic reflection coefficient (σd):

A unitless indicator of osmotic pressure across membrane.

Postprandial hyperemia:

Gastrointestinal hyperemia in response to meals.

Pressure-flow autoregulation:

Maintenance of blood flow during alterations of arterial pressure.

Reactive hyperemia:

Hyperemia upon release of a brief arterial occlusion.

Safety factors against edema:

Transcapillary forces & factors that can prevent tissue edema.

Safety factors against interstitial dehydration:

Forces and factors that can prevent tissue dehydration.

Sensory C fibers:

Unmyelinated afferent fibers responding to various stimuli (e.g., pain).

Tissue pO2 :

Partial pressure of O2 in tissue.

TRPV1 receptor:

Transient receptor potential cation channel subfamily V member 1.

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Acknowledgments

This work was supported by a grant from King Abdulaziz City for Science and Technology (KACST). Some of the illustrations and graphics were generated by Mohammad Tazim Khan and Adel A. AlGahtani.

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  1. Department of Physiology & Biochemistry, College of Medicine, Alfaisal University, 50927, 11533, Riyadh, Saudi Arabia

    Peter R. Kvietys

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Correspondence to Peter R. Kvietys .

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  1. Division of Cardiovascular Disease Department of Internal Medicine, Health Care Center Bitterfeld, Bitterfeld-Wolfen, Germany

    Peter Lanzer

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Kvietys, P.R. (2015). Anatomy and Physiology of the Gastrointestinal Microcirculation. In: Lanzer, P. (eds) PanVascular Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37078-6_141

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  • DOI: https://doi.org/10.1007/978-3-642-37078-6_141

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