Digestion, Skin Conditions, Constipation | January 22, 2020 | Author: Naturopath
Bile is a fluid produced in the liver and stored in the gallbladder containing primarily cholesterol, bile acids and bilirubin (a product from the breakdown of red blood cells).You may think that bile is just a bitter acid you taste letting you know when you have eaten too many fats. It actually plays an important role in digestion. The digestion of fats and fat-soluble vitamins – A, D, E and K for absorption in the small intestine and helping in the elimination of bilirubin and wastes are all the responsibility of bile.
Bile is a secretion from hepatocytes (liver cells) consisting of water, cholesterol, lecithin (phosphatidylcholine), bile salts, bile pigments and several ions.
The colour of bile is described as anywhere from olive green, yellow to brown. The principal pigment is bilirubin, derived from heme (an iron-containing compound) which is released from the breakdown of aged red blood cells, secreted into the bile and eventually broken down by the intestines.
Bile acids and their salts are the most important solutes determining the extent of bile flow and the management of cholesterol levels.
Secondary bile salts are created by the action of intestinal bacteria on primary bile salts in the intestine. Bile salts play crucial roles in allowing the gastrointestinal system to digest, transport and metabolize nutrients.
The secreted bile enters small canals into bile ducts within the liver and exit through the common hepatic ducts.The gall bladder stores and concentrates bile from the liver until it is needed by the small intestine. The gall bladder is lined with columnar epithelium which absorbs ions and water during the concentration process.
Digestion of fats and fat-soluble vitamins. The primary role of bile is to emulsify (blend) lipids (fats) prior to digestion.
The hepatocytes secrete around 800 – 1000mLs of bile. Bile salts (potassium and sodium salts) are important for the emulsification of dietary fats. Emulsification is the breakdown of large globules of lipids into a suspension of small lipid globules. This allows pancreatic enzymes (lipases) to more quickly complete the digestion of triglycerides. Bile salt continue to help with the absorption of lipids thoughout the digestive process.
The hepatocytes are continuously releasing bile and production is increased throughout digestion and absorption. After which (between meals) bile is stored in the gall bladder and the passage through to the small intestine is closed.
As you might presume, due to bile being composed primarily of cholesterol, keeping its flow into the small intestine and, by elimination through faeces, aids in reducing excess cholesterol from the body.
Improving bile flow can result in lowered cholesterol levels.
Toxin removal. Bile plays an important role in the removal of toxins from the body. Toxins from liver detoxification processes are secreted into bile and eliminated through faeces (bowel function).
Hormonal function. Bile salts function as "nutrient signalling hormones" activating specific receptors. Bile salts also are presumed to collaborate with insulin in the regulation of the metabolism of nutrients into the liver.
The importance of bile secretion to health is usually evident when its secretion is impaired. This can occur do to developmental, genetic or acquired cholestatic diseases.
There are three main types:
These can occur due to too much secretion of cholesterol (hypersecretion) and too little secretion of bile salts and lecithin (hyposecretion) which reduces the ability of the bile salts and lecithin to solubilise cholesterol. This then causes a precipitation of chemical compounds of bile into vesicles (gallstones) throughout the gallbladder and sometimes the bile duct. Precipitation is the formation of stones. Chronic cholecystitis (inflammation of the gallbladder) is the most common presentation of pain in the right upper abdominal area.
Impaired gallbladder emptying has been linked with the pathogenesis of cholesterol gallstones
Risk factors for gallstones include:
Bile acids may be a causative factor in chronic gastritis. Food mixes with bile acids in the duodenum and enter the small intestine through a valve called the pyloric valve.
Reflux can occur when digestive liquid “backs-up’ into the stomach and in some cases, the oesophagus (the tube from your stomach to the mouth). This can lead to gastrointestinal reflux disease (GERD), causing irritation and inflammation. Although bile itself is not considered in most cases to be responsible for GERD, gastric acid is the usual culprit. In cases of bile reflux, the pyloric valve doesn't close properly, allowing bile to wash back into the stomach. This can lead to inflammation of the stomach lining.
This can occur due to:
Treatment for bile acid reflux is different from gastric acid reflux. In all cases a medical diagnosis should be sort.
Jaundice can occur when there is a build-up of a yellow compound bilirubin. Symptoms include a yellow colouring of the skin, whites of the eyes, the mucous membranes and urine. Skin may itch. It usually indicates there is a problem with the liver or bile duct. This could be due to many reasons, such as an inflamed liver or obstructed bile duct for instance. Bilirubin is formed from the heme pigment from the breakdown of aged red blood cells. This pigment is transported to the liver and eventually excreted in bile. Jaundice is a common condition in newborns and usually due to an immature liver unable to remove bilirubin in the bloodstream system. Jaundice is a medical conditions and treatment is based on the cause.
Not enough bile acid can result in malabsorption of dietary fats and fat-soluble vitamins and mainly occurs in people who have had their gallbladders removed.
Fats and fat-soluble vitamins play many important roles in the body. The fat-soluble vitamins - A, D, E and K are needed for such things as vision, immune health, bone formation, blood clotting and as an antioxidant against free-radical damage to cells. Dietary fats are needed for the absortion of many important nutrients and the production of important hormones. They are essential to for energy, to support cell growth, to help cushion and protect organs and help keep warmth in the body.
Naturopathic consideration in the prevention of gallstones and to encourage good bile flow include:
The gall bladder stores and concentrates bile salts during fasting and releases them into the duodenum in response to gastric emptying of a meal. The hormone, cholecystokinin (CCK), is responsible for regulation of this process in response to macronutrients, especially fat, in digestion. Dietary protein stimulates CCK secretion.
Turmeric, coffee, tea, fat, semi-skimmed milk and dairy products in studies have been found to increase gallbladder emptying.
Long-chain fatty acids were found to be the best fats to help gallbladder constriction. These includes fatty fish such as salmon and mackerel; shellfish such as shrimps, prawns, crabs, and also algae from clean sources. Flaxseeds and flax oil and chia seeds.
Avoid sudden weight reduction or severe reduction in dietary fats
Bilious conditions – nausea, feeling full after meals, headaches associated with alcohol and fatty foods
Sluggish bowel - constipation
Skin conditions associated with toxins such as– acne and eczema and autoimmune disorders
Non-impacted gallstones – but not obstructed bile ducts
Jaundice – but not unconjugated hyperbilirubinemia
The liver is able to sense the loss of bile salt in the faeces and will increased synthesis of cholesterol to equal loss. By increasing cholesterol elimination through the bowel, will also help in the reduction of stored cholesterol, thus reducing levels in the body.
Increase elimination by using:
Adopt a healthy diet and lifestyle. Bile formation and secretion is a unique and vital function of the liver. Taking care of your liver by be avoiding toxins - such as alcohol, processed foods, and foods containing artificial flavours, preservatives and colours. Instead eat mainly wholesome whole foods - vegetables, fruits, nuts, seeds and grains.
Click Here for further reading
Bile Formation and Secretion https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4091928/
Cholesterol crystallisation in bile https://gut.bmj.com/content/41/2/138
Bile Acids are Nutrient Signaling Hormones https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4073476/
Complementary and alternative treatment in functional dyspepsia https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5802680/
Berberis vulgaris: specifications and traditional uses https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5478785/
Blocking intestinal cholesterol absorption for optimal lipid lowering https://www.ajmc.com/journals/supplement/2004/2004-06-vol10-n1treatmentsofdyslipidemiatabloid/jun04-1805p2
Effects of various food ingredients on gall bladder emptying https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3898429/
Long-chain polyunsaturated fatty acid sources and evaluation of their nutritional and functional properties https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4237475/
Mills, Simon and Bone, Kerry; 2000, Principles and practice of Phytotherapy, Churchill Livingstone, Aust
Sarris, Jerome and Wardle, Jon; 2014, Clinical Naturopathy 2e, Elsevier, NSW Australia