How digestion is affected after removal of gall bladder?

By | January 20, 2014

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Removal of the gall bladder affects the digestion of one component in the diet. Name the component and explain how digestion might be affected.

Please provide as much details as possible. Thank you!

Removal of the gallbladder is going to severly inhibit the digestion and absorption of fats (triglycerides, cholesterols, phospholipids) and other fat soluble substance. The gallbladder stores, concentrates and secretes bile. Bile, which is produced by hepatocytes, contains bile acids, cholesterol, phospholipids, and bile pigments.

What this mixture essentially does is causes emulsification of fats. Imagen the old oil and water in a bottle experiment that we all have seen in school. The water soluble and fat soluble substances are seperated into layers. The use of bile in the small intestine is the equivalent to shaking up the oil-water bottle; there are a bunch of small fat droplets distributed throughout the bottle. In the body these small droplets are called mixed micelles and are sustained by bile salts. This increases the surface area of the fat, which increases the ability of the lipolytic enzymes to act on the fats. Without bile the there is no formation of mixed micelles. I should note that the bile acids in bile are bipolar, allowing the non-polar end to interact with the fat and the polar end to interact with the non-polar substances.

The digested fat molecules are still contained in the mixed micelles and are released close to the brush border (at the “unstirred layer”), primarily in the duodenum and jejunum. The digested fats are then able to diffuse across the lipid membrane of the cells of the duodenum and jejunum.

With the reduction of bile due to the inablilty to store it, the surface area of fat is greatly reduced. This reduces digestion and thus absortion of fats. One symptom that would be present in the absence of the gallbladder would be steatorrhea (fat content in the feces).

However, there are lipolytic enzymes at work regardless. Also, triglycerides absorption operates at about 50%, which is one of the major ingested fat molecules. Once again, the activity of lipolytic enzymes are severly reduced due to a significant decrease in surface area. The effect on fat soluble vitamins (A, K, E,and D) are not as significant. I would speculate that enzymes don't act on these vitamins (I would need to verify this, however.)

Please note that I may have made some slight generalizations.

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