Bile – The Detergent of Your Bowels

Bile is that yellow-green fluid that comes up when you have no food left in your stomach to throw up but keep vomiting. A pretty nasty thing when mixed with gastric acids and in your mouth.
It is vitally important for your survival, as you’ll see.
Bile is made in the cells of the liver transported through the bile ducts to the gallbladder where it’s stored and concentrated, waiting for the next meal to release it into the duodenum.

Bile is mainly consisting of bile acids, cholesterol, lecithin and phospholipids, a special kind of lipid that is a main molecule in cell walls all over the body. It also contains Immunoglobulin A (IgA), which important for inhibiting bacterial growth in the bile.
It has two main, and very important, functions.

1. Providing a sole route for excreting many waste products, toxins and other solutes that the kidney can’t handle. Examples are fat soluble drug metabolites, plant sterols and break down products from red blood cells, also called billirubin – giving the bile it’s yellow color.
2. Making digestion of fats and fat soluble substances possible through the bile acids or the bile salts.
   The bile salts consist of conjugated cholesterol that act as an emulsifier in the intestine and makes it possible for the digestive enzymes from the pancreas to act on the fats in the food.

When secreted into the dudoenum and mixed by the peristalsis of the bowels with the food the bile salts form lipid droplets, called micelles, together with the fats. The salts have an hydrophilic (water loving) and an hydrophobic (water repelling) side and collect the fats on the inside. The phospholipids and the lecithin have similar actions and together they make the break down and absorption of fats and the fat soluble vitamins A, D, E and K possible.
The electrical charges of the bile salts also prevents the micelles to aggregate into bigger fat molecules again and thus gives a bigger surface area for the pancreatic enzymes to work on and thus facilitating the digestion of lipids.
Without bile most of the fat content of our food would pass through our intestines untouched, giving rise to fatty stools, or steatorrhea.

Bile is secreted in response to food in the bowels through a hormone called cholecystokinin. This hormone is secreted mainly in the duodenum in response to the fat contents of the food and acts on the sphincter (ring formed muscle) so that bile can pass from the bile duct into the bowels.

We use between 12 to 36 grams of bile acids during the day, depending how much fat you eat and how many meals you have. The liver usually makes about 600 mg salts/day, so they are recycled in a process called enterohepatic circulation.
This has to happen very effectively, because the pool of salts isn’t bigger than 3 g, so they take many turns in a day. They are mainly reabsorbed in the terminal ileum (where the small intestine meets the colon) but also, to a lesser extent, in the colon.

Gallstones usually appear when there is an imbalance between the amount of cholesterol, phospholipids and bile acids. If there is to little acids/salts in comparison with the amount of cholesterol and phospholipids the cholesterol might not stay in the fat droplets they are supposed to some of it is left behind and can react with each other to form crystals, that then can grow into stones.

A gallstone attack is when these stones are trying to pass through the biliary duct and either get stuck or irritates the cells in the duct.
The risk of crystal and stone formation is higher if you have low biliary flow, a high contents of mucus in your gall bladder or if the bile isn’t acidified enough while being stored in the gall bladder (which allows for calcium to precipitate into the bile).

Fat is the main trigger of bile release into the duodenum, so it’s not impossible to think that a diet low in fats might actually make you more prone to build gallstones and thus suffer from gallstone attacks. You also need cholesterol to be able to build the bile salts and secrete cholesterol into the bile, so too low cholesterol content in your diet might actually be a problem when it comes to hepatic and gall bladder health.
If you already suffer from gallstone issues, and have to be careful with fats because of the pain that ensues when the bile is being emptied, you can still raise the fat content of your food and lower the risk of building more stones. But you have to go slow.

Enjoy your fats!

Gut Bacteria – The Million Secret Agents of Your Intestines

You are never alone. No really!
You are the host of a micro cosmos of bacteria, living a symbiotic relationship in and on your skin, eyes, respiratory system and excretory organs. We have been evolving with these tiny, for us invisible, creatures for so long, that our lives depend on them. They work closely with our cells and fulfill functions that we cannot do on our own.
The largest colonies of these bacteria are living in our gut, they actually out-number the cells within our body by far! Most of you, if you are healthy, carry about 1,5 kg (3,3 lb) of bacteria in your guts. Remember that these guys are microscopic and together they weigh that much!

There are, of course, many different strains of bacteria and they all have their niches:

• The beneficial bacteria or flora – are the ones you want to have in your gut and keep happy. Some of their names are: Bifidobacteria, Lactobacteria, Propionobacteria and some strains of E.coli, Peptostreptococci and Enterococci. They perform a multitude of functions that I will return to later, but one of the most important ones is keeping the opportunistic and pathogenic bacterias in check.
• The opportunistic bacteria or flora – There are about 500 various species that we know off that can reside in our gut and they are usually controlled by the beneficial flora. They are usually only found in small amounts, but if they, for whatever reason, start multiplying and growing, they can give raise to a number of symptoms, both from the gut and the body in general. A couple of names: Bacteroides, Staphylococci, Streptococci, Bacilli, Clostridia, Enterobacteria.
• The transitional flora or the pathogens (disease causing agents) – They get into your gut through your food and usually pass through the healthy  GI-tract without causing any problems. If the beneficial flora is deficient or non-functioning they can find rooting grounds and start growing, giving rise to disease and various symptoms. Some of them are: Salmonella, Shigella, Campylobacter, pathogenic strains of E.Coli, various fungi and viruses.

As I mentioned, the beneficial flora has many tasks to fulfill and are of vast importance for our health and longevity. They make up a physical barrier that keeps the opportunistic flora and the pathogens and their toxins from gaining access to the gut wall and the blood and lymph systems on the other side.
They also secrete antibiotic-like, anti-viral and anti-viral substances, and through that keep the disease causing agents from our environment in check. Many of the beneficial bacteria in our gut flora can also neutralize toxins, that come with our food and from disease causing bacteria. These anti-toxic properties might be a part of helping the immune system to keep cancer from growing.

The beneficial bacteria are vital for nutritional purposes as well. They use some of the foods that we normally wouldn’t be able to digest, such as starches, fibers (preferably from  and some long-chained carbohydrates that passed through without being processed. This happens through fermentation and the end product is short-chained fatty acids that can be used as a fuel source for the cells in the gut and the body. In fact, the cells lining the gut receive approximately 60-70 % of their nutrients and energy from the products formed by the gut flora.
They also produce and help the uptake of amino acids and vitamins such as K2, B1, B2, B6, B12, folic acid. They also facilitate the uptake minerals, such as magnesium, iron and copper and of fats and fat-soluble vitamins, A, D, E and K1.
Another break down product from the beneficial bacteria are organic acids that lower the pH in the gut and makes it a hostile environment for pathogens and opportunistic bacteria.

Your immunologic health is deeply tied to your gut flora. If it’s healthy there is a big chance that your whole immune system is functioning well.
The beneficial bacteria stimulate the production of IgA, an antibody that is excreted by certain immune cells in the gut wall and serves as a selector of which bacteria are to remain in the gut and not. It’s a kind of communication molecule between the beneficial gut bacteria and the immune system of your body. This creates a barrier where only the nice bacteria are allowed to live and roam and they repay their host by keeping other, not welcome, bacteria and substances out.
If this delicate balance brakes down, as usually happens when antibiotics are given, the whole immune system is affected, not only the gut. If you have eaten antibiotics you probably had some gut issues, maybe some flatulence and blotaing or full on diarrhea that would keep on even after you had finished the treatment.
The antibiotics that are helping you deal with your chest, ear or urinary infection also kills the beneficial flora and gives room for the opportunistic bacteria and the pathogens. It takes 2-4 weeks for the original gut flora to grow back after being diminished, and they require good nutrition. During this time you will be more susceptible to toxins and other infections and your immune system will be struggling with getting back to normal.
Eating probiotics (adding the good bacteria through food or supplements) during and after the treatment with antibiotics will lessen the impact of the antibiotics and help restore the normal flora faster.
Prebiotics are substances that help feed the beneficial bacteria and can help restore a dysfunctional gut flora.

Each one of us have our distinct bacterial make up, just like we have different finger prints. We do inherit the flora from our moms, when we are breast feeding (our guts are sterile when we are born) or getting bottle fed. And the flora changes with our life style, dietary choices and stress.
The bacteria needs good food to be able to do their magic. Next time you eat, remember your not only feeding your self, but also the millions of secret agents living with you, keeping you healthy.
Make sure you give them what they need, they will reward you greatly!