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In the liver, bilirubin is conjugated with glucuronic acid by the enzyme glucuronyltransferase, first to bilirubin glucuronide and then to bilirubin diglucuronide, making it soluble in water: the conjugated version is the main form of bilirubin present in the "direct" bilirubin fraction. Much of it goes into the bile and thus out into the small ...
Enterohepatic circulation of drugs. Enterohepatic circulation is the circulation of biliary acids, bilirubin, drugs or other substances from the liver to the bile, followed by entry into the small intestine, absorption by the enterocyte and transport back to the liver.
Structural or functional abnormalities of the biliary system result in an increase in bilirubin and in bile acids in the blood. Bile acids are related to the itching which is common in cholestatic conditions such as primary biliary cirrhosis (PBC), primary sclerosing cholangitis or intrahepatic cholestasis of pregnancy. [24]
In the human liver, bile is composed of 97–98% water, 0.7% bile salts, 0.2% bilirubin, 0.51% fats (cholesterol, fatty acids, and lecithin), and 200 meq/L inorganic salts. [2] [3] The two main pigments of bile are bilirubin, which is orange-yellow, and its oxidised form biliverdin, which is green.
Bile consists of water, electrolytes, bile acids, cholesterol, phospholipids and conjugated bilirubin. [2] Some components are synthesized by hepatocytes (liver cells); the rest are extracted from the blood by the liver. [3] Bile is secreted by the liver into small ducts that join to form the common hepatic duct. [4]
Bilirubin metabolism. Haem is converted into unconjugated bilirubin then conjugated bilirubin. Conjugated bilirubin is then secreted along with bile into the intestine and is either excreted in faeces as urobilinogen or reabsorbed into blood and transported back to the liver.
Bile acid sequestrants are polymeric compounds that serve as ion-exchange resins. Bile acid sequestrants exchange anions such as chloride ions for bile acids. By doing so, they bind bile acids and sequester them from the enterohepatic circulation. The liver then produces more bile acids to replace those that have been lost.
The bilirubin results from the breakup of the hemoglobin of dead red blood cells; normally, the liver removes bilirubin from the blood and excretes it through bile. Other disorders caused by excessive alcohol consumption are grouped under alcoholic liver diseases and these include alcoholic hepatitis, fatty liver, and cirrhosis. Factors ...