Editing Bile (section)

==Clinical significance==

In the absence of bile, fats become indigestible and are instead excreted in [[feces]], a condition called [[steatorrhea]]. Feces lack their characteristic brown color and instead are white or gray, and greasy.<ref>{{cite journal |vauthors=Barabote RD, Tamang DG, Abeywardena SN |title=Extra domains in secondary transport carriers and channel proteins |journal=Biochim. Biophys. Acta |volume=1758 |issue=10 |pages=1557–79 |year=2006 |pmid=16905115 |doi=10.1016/j.bbamem.2006.06.018|display-authors=etal|doi-access= }}</ref> Steatorrhea can lead to deficiencies in [[essential fatty acid]]s and [[fat-soluble vitamins]].<ref>{{Citation|last1=Azer|first1=Samy A.|title=Steatorrhea|date=2019|url=http://www.ncbi.nlm.nih.gov/books/NBK541055/|work=StatPearls|publisher=StatPearls Publishing|pmid=31082099|access-date=2020-01-20|last2=Sankararaman|first2=Senthilkumar}}</ref> In addition, past the small intestine (which is normally responsible for absorbing fat from food) the [[gastrointestinal tract]] and [[gut flora]] are not adapted to processing fats, leading to problems in the large intestine.<ref>{{Cite journal|last=Gorbach|first=Sherwood L.|date=1971-06-01|title=Intestinal Microflora|url=https://www.gastrojournal.org/article/S0016-5085(71)80039-2/pdf|journal=Gastroenterology|language=en|volume=60|issue=6|pages=1110–1129|doi=10.1016/S0016-5085(71)80039-2|pmid=4933894|issn=0016-5085|doi-access=free}}</ref>

The [[cholesterol]] contained in bile will occasionally accrete into lumps in the gallbladder, forming [[gallstone]]s. Cholesterol gallstones are generally treated through surgical removal of the gallbladder. However, they can sometimes be dissolved by increasing the concentration of certain naturally occurring bile acids, such as [[chenodeoxycholic acid]] and [[ursodeoxycholic acid]].<ref>{{Citation |last=Bell |first=G. D. |title=Drugs used in the management of gallstones|date=1980-01-01|url=http://www.sciencedirect.com/science/article/pii/S0378608080800420|series=Side Effects of Drugs Annual |volume=4 |pages=258–263 |editor-last=Dukes |editor-first=M. N. G.|publisher=Elsevier|doi=10.1016/S0378-6080(80)80042-0 |isbn=9780444901309 |access-date=2020-01-20}}</ref><ref>{{Cite journal |last1=Guarino|first1=Michele Pier Luc a |last2=Cocca |first2=Silvia |last3=Altomare |first3=Annamaria |last4=Emerenziani |first4=Sara |last5=Cicala |first5=Michele |date=2013-08-21 |title=Ursodeoxycholic acid therapy in gallbladder disease, a story not yet completed |journal=World Journal of Gastroenterology |volume=19 |issue=31 |pages=5029–5034 |doi=10.3748/wjg.v19.i31.5029 |issn=1007-9327 |pmc=3746374 |pmid=23964136 |doi-access=free }}</ref>

On an empty stomach – after repeated [[vomiting]], for example – a person's vomit may be green or dark yellow, and very bitter. The bitter and greenish component may be bile or normal digestive juices originating in the stomach.<ref>{{Cite web|url=http://www.nhs.uk/conditions/vomiting-adults/Pages/Introduction.aspx|title=Nausea and vomiting in adults - NHS Choices|last=Choices|first=NHS|website=www.nhs.uk|access-date=2016-06-05}}</ref> Bile may be forced into the stomach secondary due to a weakened valve ([[pylorus]]), the presence of certain drugs including [[Alcohol (drug)|alcohol]], or powerful muscular contractions and duodenal spasms. This is known as [[biliary reflux]].<ref>{{Cite book|url=https://books.google.com/books?id=UeYJEAIG3HQC&pg=PA71|title=Gastrointestinal and Liver Pathology E-Book: A Volume in the Series: Foundations in Diagnostic Pathology |last1=Iacobuzio-Donahue |first1=Christine A. |last2=Montgomery |first2=Elizabeth A. |date=2011-06-06 |publisher=Elsevier Health Sciences |isbn=978-1-4557-1193-2 |pages=71 |language=en}}</ref>

===Obstruction===
Biliary obstruction refers to a condition when [[bile duct]]s which deliver bile from the gallbladder or liver to the duodenum become obstructed. The blockage of bile might cause a buildup of [[bilirubin]] in the [[bloodstream]] which can result in [[jaundice]]. There are several potential causes for biliary obstruction including gallstones, cancer,<ref>{{Cite journal |last1=Boulay |first1=Brian R |last2=Birg |first2=Aleksandr |date=2016-06-15 |title=Malignant biliary obstruction: From palliation to treatment |journal=World Journal of Gastrointestinal Oncology |volume=8|issue=6|pages=498–508 |doi=10.4251/wjgo.v8.i6.498 |issn=1948-5204 |pmc=4909451|pmid=27326319 |doi-access=free }}</ref> trauma, [[choledochal cysts]], or other benign causes of bile duct narrowing.<ref>{{Cite journal |last1=Shanbhogue |first1=Alampady Krishna Prasad |last2=Tirumani|first2=Sree Harsha |last3=Prasad |first3=Srinivasa R. |last4=Fasih |first4=Najla|last5=McInnes |first5=Matthew |date=2011-08-01 |title=Benign Biliary Strictures: A Current Comprehensive Clinical and Imaging Review|journal=American Journal of Roentgenology |volume=197 |issue=2 |pages=W295–W306 |doi=10.2214/AJR.10.6002 |pmid=21785056 |issn=0361-803X}}</ref> The most common cause of bile duct obstruction is when gallstone(s) are dislodged from the gallbladder into the cystic duct or common bile duct resulting in a blockage. A blockage of the gallbladder or [[cystic duct]] may cause [[cholecystitis]]. If the blockage is beyond the confluence of the pancreatic duct, this may cause gallstone [[pancreatitis]]. In some instances of biliary obstruction, the bile may become infected by bacteria resulting in [[ascending cholangitis]].