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Physiology of Bile Salts and The Enterohepatic Circulation - Coggle Diagram
Physiology of Bile Salts and The Enterohepatic Circulation
Bile
Components of Bile
Bile Acid Salts: Cholic Acid, Deoxicholic Acid, Chenodeoxicholic Acid, Lithocholic Acid
Form micelles with dietary lipids that facilitate attach by lipases, and are formed with MonoG and FFA facilitate lipid reabsorption
Phospholipids
Cholesterol
DIsolved in Micelles containing lecithin and Bile salts
Production of Bile Acid
Acetyl CoA -> HMG CoA -> Mevalonate -> Cholesterol -> Hydroxylation -> Bile Acids
Gallbladder
Gallbladder cna only store up to 60 ml of fluid, it is concentrated up to 20x in the gall bladder, electrolytes are absorbed from the gallbladder
Bile in ducts becomes converted to deoxycholic and lithocholic in feces
Gall Stones
Cholesterol solubility in bile depends on mixture of bile salts and lecithin
Common cause of biliary tract disease in adults
Forms anywhere in biliary system (mainly gallbladder)
Risk Factors (Age, Sex (female), Obesity, Stasis (Fourty)
Causes
Too much absorption of water or bile acids from bile, too much cholesterol in bile, inflammation of epithelium
Treatment
Oral bile acids, SOund wave lihtotripsy, laparoscopy or open surgical removal, endoscopic removal
Cholestasis
Bile from liver to duodenum is slowed or blocked
4 Features: Jaundice, Pruritius, Xanthomas, Steatorrhea
Bile salts do not reach small intestine
Fat and fat-soluble vitamin malabsorption, steatorrhea, kidney stones, weight loss
Bile Salts not Reabsorbed
Toxic to colonic mucosa cells, stimulate CL secretion and impair Na reabsorption -> Secretory diarrhea
Enterohepatic Circulation
CCK stimulates bile acid into duodenum by relaxing the sphincter of Oddi and contracting the gallbladder
Secretin: Causes NaHCO3 and H2O secretion