BILE – a familiar Stranger.
Bile is a greenish liquid produced in the liver that is essential for normal digestion. It removes toxins and excess cholesterol from the body. Stagnation of bile or scientifically “cholestasis” is a very dangerous, but, unfortunately, a common disease. Poor bile flow leads to gallstones, cholecystitis, and even cancer. Due to insufficient flow of bile into the intestines, a chronic disorder may appear.
What does bile stasis lead to, what are its symptoms, and what can be done to improve the outflow of bile from the liver and gallbladder?
BILE. How is it formed and where is it stored?
The secretion of bile is produced by hepatocytes – liver cells. Bile is collected in the bile ducts of the liver, and from there, through the common bile duct, it enters the gallbladder (also known as the cholecyst) and the duodenum, where it participates in the processes of digestion. In the absence of food, bile temporarily accumulates in the gallbladder. Bile is mainly composed of water and bile acids. It contains cholesterol, bilirubin, and some metals and toxins.
IMPORTANT: All bile in the body is produced only in the liver, and the gallbladder is only a reservoir for its storage and concentration.
Interesting fact: The liver of an adult produces up to 1,5-1,8 liters of bile daily (average 500 – 800 ml), while the volume of the gallbladder is only 40-70 ml.
How bile enters the intestines.
Bile is produced by the liver 24 hours a day without interruption. When food enters the gastrointestinal tract, the liver and gallbladder begin to secrete bile into the duodenum through the bile ducts and major duodenal papilla, where it mixes with food.
What do we need bile for?
Bile performs a number of vital functions, which makes it completely indispensable, namely:
* Emulsifies, that is, grinds fat to microscopic particles, making it possible to be absorbed. Without bile, fats in the intestines are practically not absorbed and are excreted from the body in an undigested form, creating conditions for the absorption of fat-soluble vitamins A, D, E, I, K.
* Activates the motility of the small intestine.
* Neutralizes the action of gastric juice, alkalizing the food lump, protects the duodenum from peptic ulcer.
* Activates the enzymes necessary for the digestion of proteins.
* Removes from the body excess substances that are not filtered by the kidneys, in particular cholesterol, bilirubin, lipophilic toxins, some metals such as copper, zinc, lead, magnesium and mercury.
* Bile acids destroy pathogenic bacteria contained in food.
Interesting fact: • Bile does not contain digestive enzymes. • Bile is a secrete and an excrete. • Bile is formed constantly, but is secreted periodically.
Causes of bile stagnation.
Stagnation of bile occurs due to one of thetwo reasons: blockage of the bile ducts and liver disease, leading to a violation of the formation of bile. Moreover, liver diseases are often complicated by blockage of the bile ducts, so both causes can be the reason of cholestasis at the same time.
Bile stasis most often develops as a result of the following diseases or conditions:
- viral and bacterial infections,
- autoimmune diseases,
- medication,
- pregnancy,
- inflammatory bowel disease,
- biliary dyskinesia,
- gallstones,
- infection of the bile ducts, most commonly with toxoplasma, which is carried by cats.
Why is stagnation of bile dangerous?
The gallbladder not only stores bile, but also makes it more concentrated by drawing water out of it. 
The longer bile remains in the gallbladder, the higher the concentration of bile acids, cholesterol and bilirubin in it. With constant stagnation of bile in the gallbladder, a precipitate forms, the so-called biliary sludge. In fact, these are crystals of cholesterol, calcium salts, bilirubin pigments, mucins and other components. Over time, these crystals accumulate and form stones, gallstone disease develops. Gallstones can block the bile ducts, causing severe pain in the right hypochondrium and further aggravating bile stasis. Gallstone disease can lead to serious complications such as gallbladder cancer, hepatitis, and necrotizing pancreatitis. Over time, cholelithiasis turns into cholecystitis, which can be complicated by peritonitis, gangrene and perforation of the gallbladder.
IMPORTANT: Rapid weight loss can lead to the formation of gallstones.
Interesting fact: Gallstones are several times more common in women than in men.
Interesting fact: Historians suggest that the cause of death of Alexander the Great, who died at only 34 years old, was acute cholecystitis, which led to peritonitis.
Symptoms of bile stasis.
Cholestasis is a very insidious disease, it can be asymptomatic for years, but in some cases it is accompanied by the following symptoms:
› jaundice
› dark urine
› light chair
› abdominal pain
› fatigue and lethargy
› nausea
› excessive itching
If you suspect bile stasis, you should immediately consult a doctor. However, for the purpose of familiarization, it is useful for everyone to know what exactly can be done to improve the production and outflow of bile from the gallbladder and liver.
How to improve the outflow of bile?
Fatty foods: The most obvious way to increase the flow of bile is to consume healthy fats, because fats naturally stimulate the production and flow of bile. Avocados, oily fish such as salmon, nuts are best suited for this purpose. IMPORTANT: In the presence of gallstones, the consumption of fatty foods in large quantities can lead to severe pain in the right side.
Polyunsaturated fatty acids: Polyunsaturated fats lower cholesterol levels in the body and at the same time stimulate bile synthesis in the liver, so they improve bile flow and at the same time prevent the formation of cholesterol gallstones. Champions in the content of polyunsaturated fats are walnuts, sunflower seeds, olive, rapeseed, corn and soybean oils, as well as some varieties of fish, such as salmon, mackerel, herring, tuna and trout.
Goat’s milk: Drinking just 200 milliliters of goat’s milk empties the gallbladder by almost half. Moreover, this happens in just 40 minutes, while it should be borne in mind that milk does not affect the production of bile in the liver in any way and only affects the emptying of the gallbladder.
Onions, Garlic and Celery: These three products can increase the secretion of bile in the liver, and studies show that onions and garlic contain substances that prevent the formation of gallstones and sludge.
Changing unhealthy eating habits: Take the load off the liver – the liver does the hard work of breaking down excess lactic acid in the body. To reduce the load on the liver, avoid anything that increases the flow of lactic acid into the body. It is recommended to avoid the following foods: coffee, sugar, alcohol, highly processed foods and semi-finished products.
Drink more water: The main component of bile is water. Therefore, it is quite natural that with dehydration, the secretion of bile worsens. An adult should drink at least two liters of water per day. It is especially useful to drink a large glass of warm water in the morning on an empty stomach.
IMPORTANT: We get liquid not only with water, but also with other drinks and foods. For example, with vegetables, fruits, soups, cereals, tea or coffee. Therefore, in order to maintain the water balance in the body, it is not necessary to consume two liters of pure water every day. Enough to drink when you feel thirsty. Water should be drunk during the day gradually, in several sips, without leading to strong thirst and without drinking a glass right away, if it is not morning.
Avoid stress: Under stress, the hormones cortisol, nitric oxide and adrenaline are released into the blood, which greatly increase the load on the liver and is responsible for their excretion, moreover, nitric oxide and cortisol are excreted from the body with bile, so stress can contribute to their accumulation. Reducing stress and increasing bile production improves the body’s ability to eliminate toxins and balance hormones.
Intermittent fasting: is the observance of a large fasting interval during the day. For example, if you have breakfast at 9 and dinner at 17:00, then your meal is at 8:00, and the rest of the body rests from eating for the remaining 16 hours. Between meals, bile is actively produced by the liver and stored in the gallbladder. By allowing the gastrointestinal tract to rest from eating, you also allow bile to accumulate in the gallbladder in sufficient volume and concentration. IMPORTANT: Study the existing contraindications. Before starting fasting according to the interval system, check yourself for contraindications, consult your doctor.
Diaphragmatic breathing: The liver is located just below the diaphragm. Most modern people breathe shallowly and the diaphragm does not affect the liver in any way. When you breathe deeply into your belly, the diaphragm massages your liver and gallbladder, stimulating the production of bile and removing toxins from your body. This is, in essence, breathing with the stomach, it is performed very simply when inhaling, inflate the stomach, and when exhaling, relax, while the chest should not expand.
Interesting fact: Belly breathing has been practiced by yogis for over two millennia. It is believed that it contributes to the effective ventilation of the lower parts of the lungs, in which, under the influence of gravity, most of the metabolic by-products accumulate.
What type of doctor deals with diseases of the gallbladder?
If you notice symptoms of bile stasis, consult a Gastroenterologist. The doctor will perform a visual examination and order a blood test for liver enzymes. To clarify the diagnosis, ultrasound, MRI, or liver biopsy may be prescribed. Do not apply any recommendations without consulting your doctor. Also consult an Ayurvedic doctor. Thus, by joining forces, you can not only relieve the symptoms, but significantly affect the very cause of the disease.
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Interesting fact: Bile pigments (bilirubin and biliverdin) are breakdown products of hemoglobin (erythrocytes). They give bile the appropriate color. Herbivores have green bile (more bilirubin), while carnivores have red-yellow bile (more biliverdin).
Interesting fact: There are two types of bile: hepatic and cystic bile. Hepatic bile is located in the bile ducts, its density is 1.010-1.015 and pH 7.5-8. Cystic bile, located in the gallbladder, due to the absorption of water in it, acquires a darker color, its density is 1.026-1.048 and pH 6.5-5.5.
Interesting fact: Bile is both secrete and excrete of hepatocytes (hepatic parenchyma cells). But in fact, the true secrete of hepatocytes is not bile itself, but bile acids – cholic, deoxycholic, lithocholic.
· Why secrete? Bile performs the functions of participation in digestion, stimulates intestinal motility, activates pancreatic lipase, emulsifies fats and facilitates their breakdown by lipase.
· Why excrete? Bile contains substances intended for excretion from the body: cholesterol, bilirubin, drugs, metals.
Interesting fact: Among mammals, many rodents (mice, rats, hamsters), cetaceans, elephants, equids (horses, tapirs, rhinos), and some artiodactyls (deer, camels) do not have a gallbladder.