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