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Synthesis of bile acids is a major route of cholesterol metabolism in most species other than humans. The body produces about 800 mg of cholesterol per day and about half of that is used for bile acid synthesis producing 400–600 mg daily. Human adults secrete between 12 and 18 g of bile acids into the intestine each day, mostly after meals.
[2] [3] The two main pigments of bile are bilirubin, which is orange-yellow, and its oxidised form biliverdin, which is green. When mixed, they are responsible for the brown color of feces. [4] About 400 to 800 milliliters (14 to 27 U.S. fluid ounces) of bile is produced per day in adult human beings. [5]
Primary bile acid diarrhea (Type 2 bile acid "malabsorption") may be caused by an overproduction of bile acids. [5] [9] Several groups of workers have failed to show any defect in ileal bile acid absorption in these patients, and they have an enlarged bile acid pool, rather than the reduced pool expected with malabsorption. [10]
UDCA should be taken at a dose of 13 to 15 mg per kg of body weight per day, [34] usually in two divided doses each day. [33] Liver chemistries usually improve within a few weeks of starting UDCA, and 90% of any benefit is observed after 6–9 months of therapy. [33] Liver chemistries should be re-evaluated after 1 year of treatment. [33]
[8] [9] Gallstones are more common among women than men and occur more commonly after the age of 40. [2] Gallstones occur more frequently among certain ethnic groups than others. [2] For example, 48% of Native Americans experience gallstones, whereas gallstone rates in many parts of Africa are as low as 3%.
Risk factors known as of 2010 are: Quantity of alcohol taken: Consumption of 60–80 g per day (14 g is considered one standard drink in the US, e.g. 1 + 1 ⁄ 2 US fl oz or 44 mL hard liquor, 5 US fl oz or 150 mL wine, 12 US fl oz or 350 mL beer; drinking a six-pack of 5% ABV beer daily would be 84 g and just over the upper limit) for 20 years or more in men, or 20 g/day for women ...
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Bilirubin is conjugated with glucuronic acid in the liver by the enzyme glucuronyltransferase, making it soluble in water. Much of it goes into the bile and thus out into the small intestine. Although 20% of the secreted bilirubinoid bile is reabsorbed by the small intestine, [2] conjugated