Bile Acids in Health and Disease

1. Front Matter

   Pages i-x

   PDF

2. Overview

   1. Overview: Enterohepatic Circulation of Bile Acids — a Topic in Molecular Physiology

      • A. F. Hofmann

      Pages 1-18

3. Biliary Chemistry and Physiology

   1. Front Matter

      Pages 19-19

      PDF

   2. Hepatic Bile Acid Transport and Secretion

      • S. Erlinger

      Pages 21-26

   3. Hepatic Biliary Lipid Synthesis and Transport

      • J. M. Graham, H. Ahmed, T. C. Northfield

      Pages 27-41

   4. Biliary Lipid Secretion and its Control

      • R. Coleman, K. L. Rahman, M. E. Bellringer, M. Carrella

      Pages 43-60

   5. Lipid Solubilisation in Bile

      • M. C. Carey

      Pages 61-82

   6. Gallbladder Motor Function in Man

      • A. Lanzini, T. C. Northfield

      Pages 83-96

4. Pathogenesis of Cholesterol Gallstone Disease

   1. Front Matter

      Pages 97-97

      PDF

   2. The Secretory Defect

      • K. Einarsson, B. Angelin

      Pages 99-116

   3. The Physico-chemical Defect

      • R. T. Holzbach, R. L. Barnhart, J. M. Nader

      Pages 117-133

   4. The Motility Defect

      • I. C. Forgacs

      Pages 135-153

5. Gallstone Prevention

   1. Front Matter

      Pages 155-155

      PDF

   2. Clues from Epidemiology

      • K. W. Heaton

      Pages 157-169

   3. Post-dissolution Trials

      • K. A. Hood

      Pages 171-180

6. Non-Surgical Treatment of Gallstones

   1. Front Matter

      Pages 181-181

      PDF

   2. Cheno-versus Ursodeoxycholic Acid

      • L. Barbara, F. Bazzoli, E. Roda

      Pages 183-186

   3. Cheno- plus Ursodeoxycholic Acid

      • M. Podda, M. Zuin, P. M. Battezzati

      Pages 187-194

   4. Methyl Tert-Butyl Ether

      • J. L. Thistle

      Pages 195-200

   5. Lithotripsy

      • G. Paumgartner, M. Sackmann, J. Holl, T. Sauerbruch

      Pages 201-204

Bile acids occupy a central position in in the absorption, excretion and metab­ olism of lipids within the body. Our understanding of their unique properties has illuminated many biochemical and biophysical processes. Animals have evolved a unique system of preserving these important detergent-like molecules within the body and reusing them many times - the enterohepatic circulation. Disorders of the enterohepatic circulation contribute to a correspondingly wide range of diseases, and recent developments have centred in particular on cholesterol gallstone disease and bile acid diarrhoea. Successful manage­ ment of these diseases is increasingly based on an understanding of the physicochemical and biochemical properties of bile acids, and of their pathophysiological role in disease. Professor Alan Hofmann starts this book with an overview of the enterohepatic circulation of bile acids. The first section then discusses biliary lipid synthesis, transport and secretion by the liver and the solubilisation of cholesterol in the bile. The next section applies this knowledge to the pathogenesis of cholesterol gallstones. Separate chapters focus on defects in biliary lipid secretion, in cholesterol solubilisation and in gallbladder motility. The succeeding sections then review posssible approaches to gallstone prevention, and assess recent developments in non-surgical forms oftreatment. Two exciting new therapies that receive particular attention are contact dissolution therapy with methyl tert-butyl ether and extracorporeal shock wave lithotripsy. Further sections turn to the absorptive functions of bile acids in health.

• absorption
• attention
• bile
• bile acid
• diagnosis
• diseases
• enterohepatic circulation
• epidemiology
• gallbladder
• gallstone
• health
• irritable bowel syndrome
• liver
• molecule
• physiology
• hepatology

• Department of Medicine, St. George’s Hospital Medical School, London, UK

  Tim Northfield, Riadh Jazrawi, Patrick Zentler-Munro

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