Release of Cholecystokinin (Nursing)

00:00 Now, what signals bile release? What makes my body say, "Hey, it's time to squish that out." Well, look at that deliciousness in those three circles.

00:11 Cheeseburger, pizza, these are all fatty foods.

00:17 And when stomach contents, especially fats and protein, which is why we selected today's menu specifically for you.

00:25 Fats and proteins when they enter the duodenum, and cholecystokinin is released from the duodenal mucosal cells.

00:34 Okay, "Whoa, that's a lot of words."" Let's swim back through it, right? Look at our person there.

00:41 Don't get distracted by the deliciousness, especially if you're hungry.

00:44 But look at that picture, we got the lungs, the rib cage, the liver, the stomach.

00:50 So when I take a bite of that giant cheeseburger in my mouth down into my stomach, once it makes it through my stomach to the duodenum at the end of the stomach - duodenum is where it's entering the intestines, cholecystokinin is released from the mucosal cells in the duodenum.

01:13 Eat fat and protein, down to your stomach, into your duodenum, then the duodenum is stimulated to release cholecystokinin.

01:21 So why do you care? Well, this can become kind of problematic in patients with gallbladder disease.

01:28 Cholecystokinin stimulates the contraction of the gallbladder and the relaxation of the sphincter of Oddi.

01:36 Okay, think that through.

01:38 So when I eat something particularly fatty and with protein, food moves through my system, when it hits my small intestine, cholecystokinin is released.

01:49 Well, that causes my gallbladder to - so my gallbladder is going to to release all the bile that's been stored there.

01:58 It's concentrated or less concentrated depending on how long it was there.

02:02 So the bile is being squirted out.

02:05 Now, how do I get the bile from the common bile duct into the small intestine to mix with the food? Well, the sphincter of Oddi needs to relax.

02:16 So cholecystokinin does two things: stimulates the gallbladder dip and it stimulates the sphincter of Oddi to open.

02:25 Take a look at the picture.

02:27 Now you see that we have that sphincter of Oddi right there.

02:30 You see, that's the relief valve to let that bile drain into the duodenum.

02:36 So the sphincter of Oddi surrounds the ampulla of Vater.

02:39 Have you heard those? No, it's not a Star Wars movie.

02:42 But the ampulla of Vater is just this little projection.

02:46 It sticks into the duodenum.

02:48 The sphincter of oddi is the gatekeeper that releases it or opens that opening.

02:53 That's where bile and pancreatic secretions, we will get into those later, but that's where bile and the juices from the pancreas flow when the sphincter relaxes and bile can actually enter the small intestine.

03:06 So think of it as like a muscular valve.

03:10 Before we move on, what do you need to take away from this slide? You probably already knew that food goes in your mouth, to your stomach and then enters the intestine through the duodenum.

03:21 But did you know that that's what stimulates cholecystokinin.

03:25 And cholecystokinin does two things: it tells your gallbladder to push it out, and it tells the release valve, the gate keeper, the sphincter of Oddi, to open up and to drain the bile and the pancreatic juices into the intestine to start ripping apart that food.

03:45 So cholecystokinin stimulates the secretion of bile salts into the biliary system.

03:51 It stimulates the secretion of pancreatic enzymes.

03:55 It induces satiety.

03:57 That means that tells me, I am full.

04:00 I should no longer be hungry.

04:02 Now, that makes sense because when I eat food, I need to not just keep eating.

04:06 I just need to eat what my body needs.

04:09 Cholecystokinin is part of that process.

04:12 It also helps me modulate hormones and neuropeptides.

04:16 That's pretty impressive and look where it comes from: your gut.

04:21 But I want to go back to that pancreas for just a minute.

04:25 Start at the top of the picture.

04:26 Liver, then you see the hepatic ducts, the common duct connecting to the gallbladder.

04:33 Now, there you just have the duodenum.

04:35 We've left the stomach off of this drawing just so you can see it.

04:38 It comes down and it is going to stop right there at the pancreas, right? So where the pancreas connect to the biliary system the pancreas is going to drain those digestive enzymes - the pancreatic enzymes right there.

04:54 So what actually goes into your duodenum is a combination of bile from the liver and pancreatic juices from the pancreas.

05:03 Cholecystokinin stimulates that release by the pancreas too.

05:08 So it's pretty complex result when cholecystokinin is stimulated.