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Production rate of bile?
between 500ml and 1500mL per day.
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Bile is composed of?
bile salts, bicarbonate, cholesterol, steroids and water.
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Main factors regulating bile flow?
3 - hepatic secretion, gall bladder contraction and sphincter of oddi resistance.
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Where are bile salts are absorbed?
- in the terminal ileum (and recycled to the liver).
- Over 90% of all bile salts are recycled in this way, such that the total pool of bile salts is recycled up to six times a day.
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Primary bile salts?
Cholate and chenodeoxycholate
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Secondary bile salts - formed by?
Formed by bacterial action on primary bile salts.
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Secondary bile salts - what? which reabsorbed/insoluble?
- These are deoxycholate and lithocholate.
- Of these deoxycholate is reabsorbed, whilst lithocholate is insoluble and excreted.
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Pathophysiology of gallstones
- - Bile salts have a detergent action.
- - They aggregate to form micelles and these have a lipid centre in which fats may be transported.
- - Excessive quantities of cholesterol cannot be transported in this way and will tend to precipitate, resulting in the formation of cholesterol rich gallstones.
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