A patient undergoes a total gastrectomy because of a proximally located gastric cancer. After the surgery, which of the following digestive enzymes will be produced in inadequate amounts?
Pepsin is secreted (in an inactive or zymogen form as pepsinogen) by the chief cells of the stomach. Pepsinogen is activated by contact with stomach acid. Although protein digestion usually begins with the actions of hydrochloric acid and pepsin, pancreatic enzymes complete the job as the food passes into the small intestine. Amylases hydrolyze 1->4 glycosidic linkages of starches to produce oligosaccharides, maltose, maltotriose, and limit dextrins. These enzymes are produced by the pancreas and salivary glands. Chymotrypsin is a proteolytic enzyme released by the pancreas as the inactive proenzyme, chymotrypsinogen. Lipases are mostly released by the pancreas, and serve to digest various lipids, including triacylglycerols. Ref: Barrett K.E., Barman S.M., Boitano S., Brooks H.L. (2012). Chapter 25. Overview of Gastrointestinal Function & Regulation. In K.E. Barrett, S.M. Barman, S. Boitano, H.L. Brooks (Eds), Ganong's Review of Medical Physiology, 24e.
Amylase
Chymotrypsin
Lipase
Pepsin