Biology Year 11 · Module 2

Absorption and Elimination — The Mystery Solved

Digestion breaks food down. Absorption gets it into the body. Follow a glucose molecule from the inside of your small intestine all the way to a liver cell — and find out exactly why our patient from Lesson 11 is malnourished despite eating well.

Learning Intentions

  • Describe the structure of villi and microvilli and explain their role
  • Explain how glucose, amino acids, fatty acids, minerals and water are absorbed
  • Trace absorbed nutrients from intestinal lumen to bloodstream
  • Explain the role of the large intestine in water reabsorption
  • Describe faeces formation and elimination

Outcome Links

  • Absorption of nutrients, minerals, and water
  • Elimination of solid waste
  • Relate structure of small intestine to heterotroph nutrient acquisition
  • Apply hierarchical organisation — tissue and organ level

Success Criteria

  • Draw and label a villus with all absorption structures
  • Explain why villi and microvilli are essential using SA:V principle
  • Distinguish how glucose/amino acids vs fatty acids are absorbed
  • Resolve the L11 patient mystery with precise biological reasoning
  • Write a Band 6 response on small intestine absorption
HSC Exam Relevance

Content from this lesson that appears directly in HSC Biology exams

High Priority
Villi and microvilli — structure and function

Explaining how the structure of the small intestine maximises absorption surface area is tested in nearly every HSC paper — 3–5 marks in Section II. Must link finger-like projections → increased SA → more transport proteins → faster absorption rate.

High Priority
Absorption routes — blood vs lymph

Distinguishing glucose/amino acid absorption (capillary → portal vein → liver) from fatty acid absorption (lacteals → lymph → bloodstream) is a commonly tested 2–3 mark question. Must name the lacteal and explain why fats take a different route.

Medium Priority
Role of the liver in processing absorbed nutrients

The liver's role in regulating blood glucose (glycogen storage), amino acid processing (deamination, urea), and lipid metabolism. Appears as 2–3 mark application questions, often linked to homeostasis in Module 3.

Medium Priority
Large intestine — water reabsorption and faeces

Role of the colon in water reabsorption and faeces formation tested as 1–2 mark short answer. Common exam application: explaining why diarrhoea causes dehydration, or why constipation produces hard faeces.

The Absorption Surface

01

The Small Intestine — Built for Absorption

Three levels of folding create an extraordinary surface area

The small intestine faces a fundamental SA:V challenge identical to the one we explored in gas exchange (L10) — it needs to absorb nutrients from a relatively small tube into the bloodstream as efficiently as possible. Evolution's solution is the same: fold a large surface area into a small space. But in the small intestine, this folding happens at three distinct scales simultaneously.

The Small Intestine — 6–7 metres long

The inner wall of the small intestine is not smooth — it is thrown into large circular folds called plicae circulares (valves of Kerckring). These folds triple the surface area compared to a smooth tube and slow the passage of chyme, giving more time for absorption.

Villi — finger-like projections, 0.5–1.6mm tall

The surface of each plica is covered in thousands of villi — finger-like projections of the intestinal epithelium. Each villus contains a central capillary network and a lacteal (lymph vessel). The villus structure increases surface area by a further 10×. This is the scale where most absorption occurs.

Microvilli — "brush border", 1–2μm tall

Each epithelial cell on a villus has its own surface covered in microvilli — tiny hair-like projections visible only under electron microscopy. These form the "brush border" and increase surface area by a further 20×. The combined effect of all three levels of folding gives the small intestine a total surface area of approximately 250m² — roughly the size of a tennis court.

Each villus epithelial cell (enterocyte) is also packed with the transport proteins needed to move glucose, amino acids, and ions across the membrane — and has abundant mitochondria to power the active transport required.

SA:V Principle Applied
Without plicae + villi + microvilli, the small intestine would have approximately 0.5m² of absorptive surface — enough to absorb only a tiny fraction of daily nutrient intake. The three-level folding amplifies this to ~250m². This is why villous atrophy in Coeliac disease is so devastating — even partial flattening of villi collapses this surface area by orders of magnitude.

Follow the Molecule

02

From Lumen to Liver — A Glucose Molecule's Journey

Every stop from the intestinal lumen to your bloodstream

Digestion has done its job — the lumen of your small intestine now contains glucose, amino acids, fatty acids, glycerol, vitamins, minerals, and water. Here is what happens next, step by step, for a single glucose molecule.

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Stop 1 — Intestinal Lumen

Glucose floats free in the watery contents of the small intestine lumen, produced by the action of maltase on maltose. Concentration of glucose here is high — just produced by digestion. Concentration in the enterocyte cell is lower. This gradient initially favours passive diffusion, but the bulk of glucose absorption requires active transport.

Glucose present High concentration
⬆️

Stop 2 — Brush Border (Microvilli Membrane)

Glucose crosses the brush border membrane of the enterocyte via sodium-glucose co-transport (SGLT1) — a carrier protein that moves one glucose molecule and two Na⁺ ions together from lumen into cell. This is secondary active transport: the Na⁺ gradient (maintained by Na⁺/K⁺ ATPase pumps on the other side of the cell) provides the energy to pull glucose in, even when glucose concentration inside is already high.

Why active transport? After a large meal, glucose in the lumen may actually be lower concentration than inside the enterocyte (which has already accumulated glucose from previous absorption). Active transport ensures glucose continues to be absorbed against its gradient, maximising extraction efficiency.
SGLT1 co-transporter ATP required (indirectly) Na⁺ gradient drives entry
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Stop 3 — Inside the Enterocyte

Glucose is now inside the absorptive epithelial cell. It moves through the cytoplasm toward the basolateral (blood-side) membrane. The enterocyte's many mitochondria power the ion pumps that maintain the Na⁺ gradient required for continued co-transport. Glucose does not linger here — the cell is a throughway, not a store.

Enterocyte cytoplasm Mitochondria-rich cell
➡️

Stop 4 — Basolateral Membrane → Capillary

Glucose exits the enterocyte through the basolateral membrane via GLUT2 — a facilitated diffusion transporter (no ATP needed here because glucose moves down its concentration gradient from cell into the blood). It immediately enters the capillary network that runs through the villus core.

Amino acids follow the same route — active transport in at the brush border, facilitated diffusion out at the basolateral membrane into capillaries. Both glucose and amino acids travel the same path from this point onward.
GLUT2 transporter Facilitated diffusion Into villus capillary
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Stop 5 — Portal Vein → Liver

Capillaries from all the villi drain into the hepatic portal vein — a blood vessel that carries nutrient-rich blood directly from the intestine to the liver before it enters general circulation. This is a critical checkpoint: the liver gets first access to all absorbed nutrients.

What the liver does with glucose: If blood glucose is already high, the liver converts glucose to glycogen (glycogenesis) for storage. If blood glucose is low, it releases stored glycogen (glycogenolysis) or synthesises new glucose (gluconeogenesis). The liver is the body's primary blood glucose regulator — a function that becomes central in Module 3 (Homeostasis).

What the liver does with amino acids: Excess amino acids cannot be stored. The liver removes the nitrogen-containing amino group (deamination), converts it to urea (sent to kidneys for excretion), and uses the remaining carbon skeleton for energy or gluconeogenesis.
Hepatic portal vein Liver — first pass Glycogen storage Deamination of excess AA

Stop 6 — Systemic Circulation

Glucose processed by the liver enters the hepatic vein, then the inferior vena cava, then the heart, and from there is pumped through systemic arteries to every cell in the body. Every cell that needs glucose — muscle, brain, kidney — takes it up from the blood. This is how a bite of bread eventually fuels a contracting muscle fibre.

Hepatic vein Inferior vena cava Systemic distribution
03

Fat Absorption — A Different Route Entirely

Why fatty acids bypass the portal vein and travel via lymph

Fatty acids and glycerol — the products of fat digestion — cannot simply enter capillaries the way glucose and amino acids do. They are hydrophobic: they repel water and would disrupt blood plasma if released directly into capillaries in large quantities. Instead, fats take a completely different absorption route.

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Fatty acids enter the enterocyte by simple diffusion

Unlike glucose, fatty acids are lipid-soluble — they simply dissolve through the phospholipid bilayer of the enterocyte brush border membrane by passive diffusion. No transporter needed. This is one of the few cases in nutrient absorption where simple diffusion is the primary mechanism.

Simple diffusion Lipid-soluble — crosses membrane directly
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Re-assembled into triglycerides inside the enterocyte

Once inside the enterocyte, fatty acids and glycerol are reassembled into triglycerides in the smooth endoplasmic reticulum. These triglycerides are then packaged with cholesterol and proteins into large particles called chylomicrons by the Golgi apparatus.

Smooth ER Triglycerides re-formed Chylomicrons packaged (Golgi)
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Chylomicrons enter the lacteal — not the capillary

Chylomicrons are too large to enter capillaries directly. Instead they are secreted into the lacteal — the blind-ended lymph vessel running through the core of each villus. Lacteals have large gaps between their endothelial cells that allow chylomicrons to enter. Lymph from the lacteals drains into the lymphatic system.

Why the lymphatic route? The lymphatic system bypasses the hepatic portal vein entirely — chylomicrons eventually drain via the thoracic duct into the subclavian vein, entering circulation near the heart rather than being first-passed through the liver. This means dietary fats are distributed to tissues before liver processing, allowing adipose tissue and muscles to take up triglycerides directly.
Lacteal (lymph vessel) Lymphatic system Bypasses hepatic portal vein
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Chylomicrons enter bloodstream via thoracic duct

Lymph carrying chylomicrons travels through the lymphatic system and empties into the thoracic duct, which drains into the left subclavian vein — bypassing the liver entirely for first pass. Fat-soluble vitamins (A, D, E, K) also travel this route, packaged with chylomicrons.

Thoracic duct Left subclavian vein Fat-soluble vitamins co-transported
The Key Contrast
Glucose and amino acids: active/facilitated transport → villus capillary → hepatic portal vein → liver first → systemic circulation.

Fatty acids: simple diffusion → re-packaged as chylomicrons → lacteal → lymphatic system → thoracic duct → subclavian vein → heart → systemic circulation (liver not first).
04

Large Intestine — Water Recovery and Elimination

What happens to what you can't absorb

By the time intestinal contents pass from the small intestine into the large intestine, essentially all useful nutrients have been absorbed. What remains is a watery mixture of indigestible material (dietary fibre, dead cells, bacteria), water, electrolytes, and bile pigments. The large intestine's job is to recover as much water and electrolyte as possible before elimination.

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Water and electrolyte reabsorption

The colon absorbs approximately 1.3–1.8 litres of water per day from intestinal contents. Water follows sodium ions that are actively pumped out of the colon lumen into the bloodstream — osmosis then pulls water out passively. Electrolytes (Na⁺, K⁺, Cl⁻) are also recovered. This is why the colon's contents gradually thicken from liquid to semi-solid faeces as they move through.

~1.5L water recovered daily Na⁺/K⁺ reabsorbed Osmotic water follows ions
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Bacterial fermentation

The large intestine contains over 1000 species of resident bacteria (gut microbiome) that ferment undigested material — primarily dietary fibre. Fermentation produces short-chain fatty acids (absorbed and used as energy), gases (methane, CO₂ — responsible for flatulence), and vitamins K and B12 that are absorbed here.

Gut microbiome Vitamin K and B12 produced Short-chain fatty acids absorbed
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Faeces formation and elimination

The remaining material — indigestible fibre, dead bacteria (~30% of faecal mass), dead intestinal cells, bile pigments (giving faeces its brown colour), mucus, and small amounts of fat and protein — is compacted into faeces in the rectum. Defecation is triggered by rectal distension, controlled by the internal (involuntary) and external (voluntary) anal sphincters.

Clinical connections: Diarrhoea occurs when water reabsorption in the colon is impaired or contents move through too fast — water is lost in faeces, causing dehydration. Constipation occurs when colon transit is slow — excessive water is reabsorbed, producing hard, dry faeces.
Bile pigments → brown colour ~100–200mL water in faeces daily Rectal distension triggers defecation
05

Case Closed — The Patient Mystery Resolved

You now have everything you need

Return to the patient from Lesson 11. You now have the biological knowledge to explain every one of her symptoms precisely. Here is the resolution.

Case Resolution — Coeliac Disease
The Mechanism
In Coeliac disease, the immune system mounts an abnormal response to gluten — a protein in wheat, rye, and barley. The immune attack damages the intestinal epithelium, causing villous atrophy — the villi flatten and microvilli are lost.

Why Each Symptom Occurs
Iron-deficiency anaemia (unresponsive to oral supplements):
Iron is absorbed in the duodenum and upper jejunum — the regions with the highest villus density. Villous atrophy in these regions dramatically reduces the absorptive surface area for iron. Even oral supplements provide iron in the lumen, but if the villus surface area is destroyed, there are insufficient transport proteins to absorb it. IV iron (bypassing the gut) would be required.

Weight loss despite adequate dietary intake:
Digestion is intact — starch, protein, and fat are all being broken down to their monomers. But absorption is catastrophically impaired. Glucose, amino acids, and fatty acids remain in the intestinal lumen and are eliminated in faeces rather than being absorbed. The patient effectively starves despite eating adequately.

Chronic fatigue:
Glucose is not being absorbed → cells throughout the body receive insufficient glucose for cellular respiration → ATP production is reduced → fatigue results. The anaemia (low haemoglobin → reduced oxygen delivery) compounds this further.

Abdominal bloating:
Unabsorbed carbohydrates (glucose, maltose) reach the large intestine where they are fermented by bacteria, producing gas. This fermentation also draws water into the colon by osmosis, causing the loose stools characteristic of Coeliac disease.

Low calcium and vitamin B12:
Calcium is absorbed in the duodenum and jejunum via villus transport proteins. Vitamin B12 is absorbed in the ileum. Both require functional villus epithelium. Villous atrophy impairs both.
✓ Treatment: strict lifelong gluten-free diet → immune attack stops → villi regenerate over 6–24 months → absorptive surface area restored → all symptoms resolve. This case demonstrates that the digestive system requires both intact digestion AND intact absorption to sustain life.

Copy into your books

Three-Level SA Amplification

  • Plicae circulares (large folds) → 3× surface area.
  • Villi (finger projections) → 10× additional.
  • Microvilli/brush border → 20× additional.
  • Total: ~250m² — tennis court surface in 6m of tube.

Glucose/Amino Acid Route

  • SGLT1 (active co-transport with Na⁺) → into enterocyte.
  • GLUT2 (facilitated diffusion) → into capillary.
  • Hepatic portal vein → liver (first pass).
  • Hepatic vein → vena cava → systemic circulation.

Fat Absorption Route

  • Simple diffusion (lipid-soluble) → enterocyte.
  • Reassembled into triglycerides → chylomicrons (Golgi).
  • Lacteal → lymphatic system → thoracic duct.
  • Left subclavian vein → heart → systemic (bypasses liver).

Large Intestine

  • Reabsorbs ~1.5L water/day by osmosis following Na⁺ pumping.
  • Bacterial fermentation of fibre → vitamins K and B12.
  • Faeces = fibre + bacteria + dead cells + bile pigments.
  • Diarrhoea = insufficient water reabsorption → dehydration.

Activities

Activity 01

Villus Diagram and Annotation

The most important structural diagram in this lesson.

In your book, draw a single villus in cross-section and longitudinal section. Label: microvilli (brush border), enterocytes, capillary network, lacteal, basement membrane, and smooth muscle. Annotate each with one function. Then answer the questions below.

  1. Explain why enterocytes have abundant mitochondria. What specific process requires this ATP?
  2. Explain why the lacteal has larger gaps between its endothelial cells than a blood capillary.
  3. Predict what would happen to glucose absorption if the Na⁺/K⁺ ATPase pumps in enterocytes were inhibited by a drug. Trace the full effect.
  4. A patient has a condition where their lacteals are blocked. Which nutrients would be most affected and how would their absorption change?

Type here or answer in your book.

Activity 02

Absorption Route Comparison

Map the route for each nutrient type from lumen to systemic blood.

NutrientMechanism crossing brush borderEnters (capillary or lacteal?)Route to systemic bloodPasses through liver first?
Glucose
Amino acids
Fatty acids
Water
Activity 03

Clinical Application — Explaining Digestive Conditions

Apply your understanding of absorption and elimination to explain real conditions.

  1. A patient with Crohn's disease has severe inflammation of the ileum (final section of small intestine). Predict which specific nutrient deficiency would be most likely, and explain why this region is critical.
  2. A patient takes antibiotics for 3 weeks and develops a vitamin K deficiency. Explain the connection between antibiotic use and vitamin K levels, referring to the role of the large intestine.
  3. A person who consumes excessive alcohol over many years develops liver cirrhosis — a condition where liver tissue is replaced by scar tissue and liver function is severely reduced. Explain how this would affect: (a) blood glucose regulation, and (b) amino acid processing.
  4. Cholera is a bacterial infection that causes the small intestine to secrete massive amounts of Cl⁻ ions into the lumen. Predict the effect on water movement and explain the resulting symptom using your knowledge of osmosis.

Type here or answer in your book.

Assessment

MC

Multiple Choice

Select the best answer — feedback shown immediately

1. Why do fatty acids enter the lacteal rather than the capillary after absorption?

A
Fatty acids are water-soluble and capillaries only transport water-insoluble molecules.
B
Fatty acids are packaged into chylomicrons that are too large to enter blood capillaries directly, but can enter the larger-gapped lymph vessel (lacteal).
C
The liver would destroy fatty acids if they entered the hepatic portal vein, so fats must bypass the liver via the lacteal.
D
Capillaries in the small intestine are only permeable to glucose and amino acids due to their basement membrane.

2. Glucose crosses the brush border of enterocytes via sodium-glucose co-transport (SGLT1). Which of the following correctly explains the energy source for this process?

A
ATP is directly consumed by SGLT1 to move glucose against its concentration gradient.
B
Glucose moves by simple diffusion — no energy is required because glucose moves down its concentration gradient.
C
The SGLT1 protein generates its own energy by splitting water molecules as glucose passes through it.
D
ATP powers Na⁺/K⁺ ATPase pumps that maintain a low intracellular Na⁺ concentration; the resulting Na⁺ gradient provides the driving force for SGLT1 to co-transport glucose into the cell.

3. Which of the following correctly traces the route of absorbed amino acids from the intestinal lumen to systemic circulation?

A
Intestinal lumen → enterocyte (active transport) → villus capillary → hepatic portal vein → liver → hepatic vein → vena cava → systemic circulation.
B
Intestinal lumen → enterocyte → lacteal → thoracic duct → subclavian vein → heart → systemic circulation.
C
Intestinal lumen → enterocyte → villus capillary → systemic artery → liver → hepatic portal vein → vena cava.
D
Intestinal lumen → lacteal → hepatic portal vein → liver → vena cava → systemic circulation.

4. Diarrhoea can cause dangerous dehydration even when a patient continues to drink water. Which explanation best accounts for this?

A
Diarrhoea destroys the enterocytes of the small intestine, permanently preventing water absorption.
B
The water lost through diarrhoea contains more water molecules than can be produced by cellular respiration.
C
Diarrhoea accelerates transit through the large intestine, reducing the time available for water reabsorption in the colon — large volumes of water are lost in watery faeces faster than drinking can replace them.
D
Diarrhoea blocks the lymphatic vessels, preventing water from re-entering the bloodstream after absorption from the small intestine.

5. A drug blocks the enzyme that assembles triglycerides in enterocytes. Which of the following correctly predicts the result?

A
Glucose absorption would be impaired because glucose and fat share the same transport pathway through the enterocyte.
B
Fat absorption would be completely prevented because fatty acids cannot cross the enterocyte brush border without being assembled first.
C
Fat absorption would be impaired — fatty acids would enter enterocytes normally but could not be packaged into chylomicrons, preventing them from entering the lacteal and being transported via lymph.
D
Protein absorption would be impaired because triglyceride assembly provides the energy for amino acid co-transport.
SA

Short Answer

6. Explain how the structure of the small intestine is adapted to maximise nutrient absorption. In your answer, refer to three structural features at different scales and explain how each increases absorption efficiency. 5 MARKS

Three scales: plicae → villi → microvilli. Each needs structure + function + why it improves efficiency.

7. Compare the absorption routes of glucose and fatty acids. In your answer, identify where each enters the transport system, the vessel type involved, and whether each passes through the liver before entering systemic circulation. 4 MARKS

Two routes × two marks each — structure + hepatic portal comparison

8. Explain the role of the large intestine in maintaining water balance in the body. In your answer, describe the mechanism of water reabsorption and explain what happens when this process is disrupted. 3 MARKS

Comprehensive Answers

Multiple Choice

1. B — Fatty acids are reassembled into triglycerides and packaged into chylomicrons inside the enterocyte. Chylomicrons are too large (~80–1200nm) to squeeze through the tight junctions of blood capillary endothelium. Lacteals have looser endothelial junctions that accommodate chylomicron entry. The liver bypass is a consequence of the lymphatic route, not the reason for it.

2. D — SGLT1 is secondary active transport — it doesn't directly use ATP. Instead, Na⁺/K⁺ ATPase pumps on the basolateral membrane continuously pump Na⁺ out of the enterocyte, maintaining a low intracellular Na⁺ concentration. The resulting electrochemical gradient drives Na⁺ into the cell via SGLT1, and glucose is co-transported in the same direction.

3. A — Amino acids follow the same route as glucose: enterocyte → villus capillary → hepatic portal vein → liver (first pass) → hepatic vein → vena cava → systemic circulation. The hepatic portal vein is the key distinguishing feature from fat absorption.

4. C — The large intestine reabsorbs approximately 1.5L water per day. Diarrhoea accelerates transit time, leaving insufficient time for water reabsorption — large volumes of water pass through in liquid faeces. Drinking cannot keep pace because water must still be absorbed from the small intestine and this too may be impaired in conditions causing diarrhoea.

5. C — Fatty acids enter the enterocyte normally by simple diffusion (they are lipid-soluble and cross membranes directly without transport proteins). The problem occurs inside the enterocyte — without triglyceride assembly, chylomicrons cannot form, and without chylomicrons, fats cannot enter the lacteal. Fat would accumulate inside enterocytes or be lost.

Q6 — Model Answer

At the macroscopic scale, the inner wall of the small intestine is folded into plicae circulares — large circular folds that triple the surface area compared to a smooth tube and slow chyme transit, increasing contact time between digestive contents and the absorptive surface.

At the tissue scale, each plica is covered in villi — finger-like projections approximately 0.5–1.6mm tall extending into the lumen. Each villus contains a capillary network and a lacteal. The villus structure increases surface area by approximately 10 times compared to the plica surface alone, and positions transport proteins close to the lumen where nutrients are present.

At the cellular scale, each enterocyte on the villus surface has its own surface covered in microvilli — tiny projections forming the brush border visible only by electron microscopy. The brush border increases absorptive surface area by approximately 20 times compared to a flat cell surface, and is the location of the transport proteins (SGLT1, GLUT2, amino acid transporters) responsible for moving nutrients into enterocytes.

The combined effect of all three levels of folding produces a total absorptive surface area of approximately 250m² — sufficient to absorb the full range of nutrients from a typical daily diet.

Q7 — Model Answer

Glucose crosses the brush border into enterocytes via SGLT1 (sodium-glucose co-transport — secondary active transport driven by the Na⁺ gradient) and exits into the villus blood capillary via GLUT2 (facilitated diffusion). Capillaries drain into the hepatic portal vein, which carries glucose directly to the liver before it enters systemic circulation — the liver gets first pass and can store glucose as glycogen or allow it to pass through depending on blood glucose levels.

In contrast, fatty acids enter the enterocyte by simple diffusion (they are lipid-soluble and cross the membrane directly without transporters). Inside the enterocyte they are reassembled into triglycerides and packaged into chylomicrons by the Golgi apparatus. Chylomicrons are too large to enter blood capillaries and instead enter the lacteal — the lymph vessel in the villus core. They travel via the lymphatic system and thoracic duct into the left subclavian vein, entering systemic circulation near the heart and bypassing the liver entirely on first pass.

Q8 — Model Answer

The large intestine reabsorbs approximately 1.3–1.8 litres of water per day. The mechanism is osmotic — Na⁺ ions are actively pumped from the colon lumen into the bloodstream by Na⁺/K⁺ ATPase pumps in the colon epithelium. This lowers the water potential of the blood and raises it in the colon lumen, causing water to move by osmosis from lumen to blood down its water potential gradient. Electrolytes (Cl⁻, K⁺) are also reabsorbed, further driving osmotic water movement.

When this process is disrupted — for example in diarrhoea caused by infection or gut motility disorders — intestinal contents pass through the colon too quickly for sufficient water reabsorption to occur. Large volumes of water remain in the faeces and are eliminated. This causes dehydration because more water is lost through the gut than can be replaced by drinking, particularly in severe cases where the infection also impairs small intestinal absorption.

Mark lesson as complete

Mystery solved. Tick when you've finished all activities and checked your answers.

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