08 Bile

Synthesis

  • bile salts made from bile acids (cholic acid, cheno)

  • made from cholesterol

  • bile acids conjugated to another hydrophilic structure

Function

Cholesterol

  • can’t excrete via urine

Antimicrobial

Lipid Absorption

  • bile main way bilirubin eliminated

  • increase SA for pancreatic lipase to work
  • emulsify lipids

  • bile salt surround lipids with hydrophobic and hydrophilic sides

  • enterohepatic circulation: some reabsorbed
  • 5%: cholesterol elimination

Cholestasis

  • caused by stones, mass, strictures
  • alk phosphatase: synthesized by bile duct epithelium

  • dilated bile duct from obstruction
  • epithelium creates alk phos
  • some liver damage due to back flow

  • intrahepatic: nl bile duct
  • extrahepatic: dilated bile duct

  • estrogen can lead to bile flow obstruction