From Big Medical Encyclopedia

BILE — the liquid secret of yellowish-brown color separated by hepatic cells; in intestines of animals and the person plays an important role in physical. - chemical processing, digestion and absorption of fat and other substances of the lipidic nature. In structure. end products of exchange of hemoglobin and other porphyrines, and also end products of exchange of cholesterol are excreted; the chemical composition and amount of bile serve one of diagnostic tests at a number of diseases; bile of animals is used as medicine.

Main components Zh. are: salts bile acids (see), phospholipids (see. Phosphatides ), bilirubin (see), proteins and number of physiologically active agents: hormones of a thyroid gland — triiodothyronine (see), thyroxine (see) and vitamins — cyanocobalamine (see), folic acid (see), Retinolum (see) and alpha tocopherol (see. Tokoferola ). Zhelchnokisly salts make the main part of the dense rest. (see the tab.). V Zh. there are also a cholesterol and small amounts of other lipids (fat and fat to - t).

Table. Maintenance of the main components of bile of the person

With fiziol, points of view different components Zh. have unequal appointment. Among them there are cosecreted substances which are carrying out an important role in digestion (e.g., zhelchnokisly salts), and the excreted substances which overwhelming part after the known turning into intestines is brought out of an organism (e.g., bilious pigments). Some of these substances have both fiziol, appointment (e.g., bilious to - you). At last, in. the agents influencing metabolic processes in a mucous membrane of intestines, and after absorption used in the general metabolism contain (hormones, vitamins, phospholipids, etc.). Due to the improvement of methods of a research in. higher content of phospholipids is established, than was accepted earlier: in hepatic. — 0,6 g of %, and in vesical — to 5,8 g of %. An overwhelming part them belongs to phosphatidylsincalines. After absorption in intestines these substances are a source of irreplaceable substance — sincaline (see)

. cosecretes liver continuously. Out of digestion hepatic. passes into a gall bladder. Specific weight of hepatic. it is equal 1,01, and vesical — 1,04. Concentration of the main components in vesical. is 5 — 10 times higher, than in hepatic Zh. Isklyucheniye represents bilirubin which in a gall bladder in a nek-swarm of degree is soaked up and therefore concentrates less. The albumine which is constantly present at hepatic., in vesical. in normal conditions are not found. The most part of mineral substances, including bicarbonate, is also soaked up in a gall bladder. Reaction of vesical. it is close to neutral (pH 6,0 — 7,0); hepatic. has alkali reaction (pH 7,5 — 8,0).

Fiziol, role. hl. obr. it is connected with processes of digestion and absorption of fat and other substances of the lipidic nature. Coming to intestines. activates steapsin since in the presence of bilious to - t the optimum of pH for action of a lipase is displaced with 8,0 to 6,0, i.e. to the level observed in a duodenum after reception of greasy food. Besides. participates in emulsification of food fat in intestines and provides formation of micellar solution of lipids that does possible their absorption in intestines (see. Digestion )

. carries out also some other functions. In its structure the excreted substances are emitted: end products of exchange of hemoglobin and other porphyrines (see. Bilious pigments ), end products of exchange of cholesterol (see. Bile acids ). In intestines these substances undergo transformations under the influence of microorganisms with what, apparently, hl. obr. also ability is connected. to stimulate activity of intestinal microflora. bears in the structure the substances stimulating various functions of a small bowel (formation of enzymes, motor function), and the substances participating in the general metabolism. Besides. promotes neutralization of the acid gastric contents coming to a duodenum. At the same time proteins Zh. form the deposit connecting pepsin and to these promoting protection of a mucous membrane of a duodenum against the destroying effect of gastric proteinases.

In secretion. an exclusive role is played by hepatoenteric circulation of its components. In this process active function is born bilious to - you. Also the hormones of a thyroid gland which are in participate in circulation between a liver and intestines. vitamins, in a nek-swarm of degree phospholipids and a small part of bilious pigments. Such circulation unloads a metabolism, facilitates synthetic work of a liver and by that plays a role of one of the most important mechanisms of vneshnesekretorny activity of a liver and its adaptation to environmental factors.

At the heart of allocation. from hepatocytes processes of active transport of some of its components — organic and inorganic lie. These processes are connected with action of specific carriers in a membrane of hepatocytes and energy release due to disintegration of ATP. Similar processes are the cornerstone of transition of components Zh. from blood in hepatocytes (see. Bile production ). A striking example of actively transported connections are bilious to - you. There is also a fraction Zh., independent from bilious to - t. It is connected with active transport of inorganic components. Believe that at the person such components are ions of chlorine and sodium (but not bicarbonate, as at dogs and some other animals).

Transport mechanisms in a liver are independent for a number of substances, however the same mechanism can carry out transport of several relatives among themselves of connections. The mechanism of transport of lipids differs from other transport mechanisms in a liver. Lipids collect in vakuolepodobny structures, in the course of their secretion there is an extrusion of contents of these structures in a gleam of bilious capillaries. In education. a nek-swarm part is taken by an epithelium of bilious channels. In small channels the active transport of inorganic components accompanied with allocation of the corresponding quantity of liquid part Zh is carried out., exchange of ions between. and intercellular liquid, absorption of some substances an epithelium of channels from. in blood and, at last, allocation in. mucin.

In normal conditions, at a reabsorption of components Zh. in intestines, the quantity makes it 1500 — 2000 ml a day.

On secretion. and its increase hl influence. obr. impulses of a vagus nerve, secretin, gastrin and bilious to - you, reabsorbiruyemy of intestines. Action of all these factors variously. Exists: a) gidrokholeretichesky action (e.g., under the influence of secretin), a cut causes increase in volume of separated., but does not influence quantity of its organic components which concentration decreases, and the quantity excreted in unit of time does not change; b) truly holeretichesky action (under the influence of a vagus nerve, coming to blood bilious to - t, etc.), at Krom amplifies department as liquid part Zh., and its organic components which concentration keeps on a high level; c) the holepoetichesky action which is characterized by increase in department and concentration in. the main organic components, especially bilious to - t, without essential change of its volume (under the influence of a diet with the high content of complete animal protein).

Feature. the fact that in its structure also various substances coming to an organism can be excreted is: various xenobiotics, medicinal substances and antibiotics. All of them are subdivided into three groups.

Substances which concentration in concern to the first group. quite often by 10 — 100 times exceeds their concentration in a blood plasma, treat them: some antibiotics and other medicinal substances, bromsulfalein, n-aminobenzaminoacetic to - that, flyuorestsein, phenol red, etc. These substances are emitted in. by means of active transport. Connections which concentration in concern to the second group. it is close to their concentration in a blood plasma (e.g., the mannitol entered into blood, some electrolytes and so forth). Permeability of tissue of liver for these substances is high. Preservation of invariable concentration of substance is possible only upon its very bystry transition from a blood plasma to Zh. Nakonets, the substances emitted with concern to the third group. in very low concentration it is relative to their concentration in a blood plasma (e.g., the inulin entered into blood though is emitted with., but its concentration in it is 10 times lower, than in a blood plasma).

In clinic for a research Zh. with the diagnostic purpose receive duodenal contents (see. Duodenal sounding ). Three portions of these contents represent mix of several digestive juices — bile, pancreatic and intestinal juice, sometimes with impurity of gastric contents. Nevertheless thanks to preferential contents hepatic or vesical. in certain portions they are successfully used for the analysis.

At morbid conditions structure. can sharply change. Especially considerable changes of its structure are observed at allocation of so-called white., what can be connected or with disturbance of mechanisms of education and excretion of bilious pigments from hepatocytes at preservation of secretion of other components, or with full frustration of a zhelchevydeleniye — a cholestasia when the colorless liquid represents a product of secretion of bilious channels, free of specific components Zh.

Medical tinned bile (a synonym biliarin, Chole conservata medicata) — the drug containing natural bile of cattle; a colloido-dispersion emulsion from golden-yellow till dark green color.

Apply as anesthetic and resorptional means at acute and hron, arthritises, arthroses, a bursitis, a tendovaginitis, spondylarthroses, secondary radiculitises. The anesthetizing (distracting) action is caused substantially fiziol, the reactions arising in connection with irritation of nerve terminations of skin. Appoint in the form of compresses: 4 — 6 layers of a gauze impregnate. also impose on skin in the affected joint, cover with wax paper with a thin coat of cotton wool and fix a bandage. During the drying humidify a gauze napkin with water of room temperature and again fix a bandage. Compresses change daily. Course of treatment of 6 — 30 days. In case of need conduct a repeated course after the break lasting 1 — 2 month.

At use of medical. in some cases there are phenomena of irritation of skin which usually disappear at drug withdrawal. Drug is contraindicated at disturbance of an integrity of skin, pustulous diseases of skin, limfangita, lymphadenites.

Form of release: bottles on 250 ml. Store in the dark cool place, before the use shake up.

See also Zhelchevydeleniye , Liver .

Bibliography: Vasilyeva E. N. Value of hepatoenteric circulation of substances for vneshnesekretorny function of a liver, in book: Progress Hypatolum., under the editorship of E. M. Tareeva and A. F. Blyuger, century 4, page 141, Riga, 1973; Gorshkova S. M. and Kurtsin I. T. Mechanisms of a zhelchevydeleniye, L., 1967, bibliogr.; Neste-r and N M. F., Narodetskaya R. V. and Shlygin G. K. Department liver as a part of bile of lipoprotein complete connection, Fiziol, zhurn. USSR, t. 51, No. 12, page 1487, 1965; Bile acids, chemistry, physiology and metabolism, ed. by P. P. Nair a. D. Kritchevsky, y i — 2, N. Y., 1971 — 1973; The biliary system, ed. by W. Taylor, p. 117, 293, Oxford, 1965, bibliogr.; Davidson C. S. Liver pathophysiology, Boston, 1970; Hargreaves T. The liver and bile metabolism, N.Y., 1968, bibliogr.; Haslewood G. A. D. Bile salts, L., 1967; Heaton K. W. Bile salts in health and diseases, Baltimore, 1972, bibliogr.; S with h a n-ker L. S. Secretion of organic compounds in bile, Handbook Physiol., Sec. 6, ed. by C. F. Code, v. 5, p. 2433, Washington, 1968; S h 1 at g i n G. K. The physiology of intestinal digestion, Progr, food nutrition science, v. 2, p. 249, 1977, bibliogr.; W h e-eler H. O. Secrption of bile acids by the liver and their role in the formation of hepatic bile, Arch, intern. Med., v. 130, p. 533, 1972, bibliogr.

G. K. Shlygin; V. V. Churyukanov (pharm.).