BILE

also called Gall, greenish yellow secretion that is produced in the liver and passed to the gallbladder for concentration, storage, or transport into the first region of the small intestine, the duodenum. Its function is to aid in the digestion of fats in the duodenum. Bile is composed of bile acids and salts, cholesterol, pigments, water, and electrolyte chemicals that keep the total solution slightly acidic (with a pH of about 5 to 6). Bile is continually secreted from the cells of the liver into the common bile duct and gallbladder; once in the gallbladder it is usually concentrated to about 5 timesand sometimes as high as 18 timesthe strength of the original secretion. The amount of bile secreted into the duodenum is controlled by the hormones secretin, gastrin, and cholecystokinin and also by the vagus nerve. About 250 to 1,000 millilitres of bile (before concentration) are produced daily by the liver. Bile salts are composed of the salts of four different kinds of free bile acids (cholic, deoxycholic, chenodeoxycholic, and lithocholic acids); each of these acids may in turn combine (conjugate) with glycine or taurine to form more complex acids and salts. Bile salts and acids can be synthesized from cholesterol or extracted from the bloodstream by the liver. They pass from the liver into the intestine, where they act as detergents to emulsify fat and reduce the surface tension on fat droplets to prepare them for the action of pancreatic and intestinal fat-splitting enzymes. The salts are large, negatively charged ions that are not readily absorbed by the upper region of the small intestine; consequently, they remain in the intestine until most of the fat is digested. In the lower intestine, the salts and acids are absorbed and passed back into the bloodstream until they are once again extracted by the liver; this cycle, from the liver to the intestine and blood and then back to the liver, is called enterohepatic circulation. Some salts and acids are lost during this process; these are replaced in the liver by continual synthesis from cholesterol. The rate of synthesis is directly related to the amount of acids and salts lost. Bile salts do not normally reach the colon; when they do, however, they inhibit the absorption of water and sodium, causing a watery diarrhea. Bile salts and acids are transported in a fluid that contains water, sodium, chloride, and bicarbonates. This fluid is produced in the liver, and it serves to neutralize hydrochloric acid passed from the stomach into the small intestine. Water-insoluble wastes that the liver removes from blood, such as cholesterol, steroids, drugs, and hemoglobin pigments, are carried in the fluid to the excretory system. Hemoglobin pigments are broken down, producing several bile fluid compounds, including bilirubin (q.v.), which has no known function other than that of a colouring agent. Traces of other substances can also be found in bile, but their significance there is not fully understood; a few of these substances are mucus, serum proteins, lecithin, neutral fats, fatty acids, and urea.