Bile Acid Malabsorption (BAM)

by Carlo Raj, MD

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    Bile Acid Malabsorption Where bile acid would be and it's normal physiology, would be down in the terminal ileum. Do not get your bile acid confused with your bilirubin. One has nothing to do with the other even though bile is a constituent, or excuse me, bilirubin is a constituent of bile. In terms of its biochemisty and physiology, they could not be any more different. Our topic here is bile acid malabsorption. Keep in mind that bile synthesis will take place in the liver with the help of cholesterol. And bile eventually gets stored in your gallbladder as you know. Gets then secreted into or enters the second part of the duodenum. Will do its job in terms of emulsification of your lipid. And then finally the bile acids and you should know some of your conjugating enzymes and taurocholic acid so on and so forth and finally make your way down into the terminal ileum where 80%, if not more, of your bile acid undergoes what's known as, well, one thing for sure that should ring a bell is enterohepatic circulation, right? So enterohepatic circulation, where does this occur? The recycling takes place in the terminal ileum. With all that in your head, now I give you permission to move on. Caused by ileal resection or disease. Does that make sense to you? If you're removing the ileum for whatever reason, maybe it's small bowel infarction, maybe it's Crohn's disease; if that ileum is gone, gone is the recycling and results in bile acid malabsorption. What's the problem? You can't properly reabsorb or metabolize your lipid, correct? Keep going. Limited resection, less than 100 centimeters, impairs bile acid absorption causes diarrhea. Liver compensates and prevents steatorrhea if we're talking about limited resection. And the treatment here could be...

    About the Lecture

    The lecture Bile Acid Malabsorption (BAM) by Carlo Raj, MD is from the course Small and Large Intestine Diseases.

    Included Quiz Questions

    1. Steatorrhea
    2. Hyperbilirubinemia
    3. Iron deficiency anemia
    4. Ascites
    5. Blood in stool
    1. Liver compensates the production of bile salts
    2. Liver compensates the bile pigments
    3. Fat gets absorbed in other places of the body
    4. Fat gets broken down before absorption in intestine
    5. Fat gets mixed with proteins to form apolipoproteins

    Author of lecture Bile Acid Malabsorption (BAM)

     Carlo Raj, MD

    Carlo Raj, MD

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