Effects on Biliary Secretion

Bile salts appear to have a central role in the biliary secretion of water and solutes (103,104). Thus about half of biliary water secretion is bile acid dependent and the other half bile acid independent (104,105). In addition, cholesterol and lecithin secretion is also, at least in part, bile acid dependent. Feeding of bile acids to patients with interrupted enterohepatic circulation has a normalizing effect on the biliary secretion of bile acids, cholesterol and lecithin, so that despite an augmented cholesterol output its solubilization is improved (106,107). When the variation in the biliary bile acid secretion 

Jejunocolic bypass, which interrupts enterohepatic circulation and which has been used in the treatment of intractable obesity, is occasionally associated with the development of fatty liver (109,110). It can be speculated that the disturbance in bile acid metabolism might be associated with a disturbed release of lipids not only into the bile but also in the form of lipoproteins into the circulation, thus contributing to the development of fatty liver. 

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