Bile-Expelling Agent Drugs

Bile-Expelling Agent

Bile (or gall) is a bitter, greenish-yellow alkaline fluid secreted by hepatocytes from the liver of most vertebrates. In many species, it is stored in the gallbladder between meals and upon eating is discharged into the duodenum where it aids the process of digestion.

• Water
• Cholesterol
• Lecithin (a phospholipid)
• Bile pigments (bilirubin & biliverdin)
• Bile salts (sodium glycocholate & sodium taurocholate)

Bile acts to some extent as a detergent, helping to emulsify fats (increasing surface area to help enzyme action), and thus aid in their absorption in the small intestine. The most important compounds are the salts of taurocholic acid and deoxycholic acid.

Bile salts combine with phospholipids to break down fat globules in the process of emulsification by associating its hydrophobic side with lipids and the hydrophilic side with water. Emulsified droplets then are organized into many micelles which increases absorption. Besides its digestive function, bile serves as the route of excretion for the hemoglobin breakdown product (bilirubin) which gives bile its colour; it also neutralises any excess stomach acid before it enters the ileum. Bile also contains cholesterol, which occasionally accretes into lumps in the gall bladder, forming gallstones.

In species with a gall bladder (humans and most domestic animals, excluding horses and rats), further modification of bile occurs in that organ. The gall bladder stores and concentrates bile during the fasting state. Typically, bile is concentrated five-fold in the gall bladder by absorption of water and small electrolytes - virtually all of the organic molecules are retained.

The human liver produces about 1 L (1.1 quart) of bile per day. 95% of secreted bile salts are reabsorbed in the terminal ileum and re-used. Since bile increases the absorption of fats, it is an important part of the absorption of the fat-soluble vitamins D, E, K and A. In the absence of bile, fats become undigestible and are instead excreted in feces. In this case, the feces lacks its characteristic brown colour and instead are white or grey, and greasy. This causes significant problems in the distal parts of the intestine as normally virtually all fats are absorbed in the duodenum and the intestines and bacterial flora are not adapted to processing fats past this point.