Bile contains. Diseases associated with bile. Clinical significance of bile

Composition and properties of bile, functions of bile, types of bile (hepatic, cystic)

The gallbladder, vesica fellea, is a reservoir in which bile accumulates. It is located in the fossa of the gallbladder on the visceral surface of the liver, has a pear-shaped shape.

gallbladder has a blind extended end - the bottom of the gallbladder, fundus vesicae felleae, which comes out from under the lower edge of the liver at the level of the junction of the cartilages of the VIII and IX right ribs. The narrower end of the bladder, directed to the gates of the liver, was called the neck of the gallbladder, collum vesicae felleae. Between the bottom and the neck is the body of the gallbladder, corpus vesicae felleae. The neck of the bladder continues into the cystic duct, ductus cysticus, which merges with the common hepatic duct. The volume of the gallbladder ranges from 30 to 50 cm3, its length is 8-12 cm, and its width is 4-5 cm.

The wall of the gallbladder is similar in structure to the wall of the intestine. The free surface of the gallbladder is covered with peritoneum, passing to it from the surface of the liver, and forms a serous membrane, tunica serosa. In those places where the serous membrane is absent, the outer membrane of the gallbladder is represented by adventitia. The muscular coat, tunica muscularis, consists of smooth muscle cells. The mucous membrane, tunica mucosa, forms folds, and in the neck of the bladder and in the cystic duct it forms a spiral fold, plica spiralis.

The common bile duct, ductus choledochus, goes down first behind the upper part of the duodenum, and then between its descending part and the head of the pancreas, pierces the medial wall of the descending part of the duodenum and opens at the top of the major duodenal papilla, having previously connected with the pancreatic duct. After the confluence of these ducts, an extension is formed - the hepatic-pancreatic ampulla (Vater's ampulla), ampulla hepatopancreatica, which has the sphincter of the hepatic-pancreatic ampulla at its mouth, or the sphincter of the ampulla (sphincter of Oddi), m. sphincter ampullae hepatopancredticae, seu sphincter ampullae. Before merging with the pancreatic duct, the common bile duct has a sphincter of the common bile duct in its wall, i.e. sphincter ductus choledochi, which blocks the flow of bile from the liver and gallbladder into the lumen of the duodenum (in the hepato-pancreatic ampulla).

The bile produced by the liver is stored in the gallbladder by the cystic duct from the common hepatic duct. The exit of bile into the duodenum at this time is closed due to the contraction of the sphincter of the common bile duct. Bile enters the duodenum from the liver and gallbladder as needed (when food slurry passes into the intestine).

The composition of bile

Bile consists of 98% water and 2% dry residue, which includes organic substances: bile salts, bile pigments - bilirubin and biliverdin, cholesterol, fatty acids, lecithin, mucin, urea, uric acid, vitamins A, B, C; a small amount of enzymes: amylase, phosphatase, protease, catalase, oxidase, as well as amino acids and glucocorticoids; inorganic substances: Na +, K +, Ca2 +, Fe ++, C1-, HCO3-, SO4-, P04-. In the gallbladder, the concentration of all these substances is 5-6 times greater than in the hepatic bile.

properties of bile diverse and all of them play an important role in the course of the digestive process:

Emulsification of fats, that is, splitting them to the smallest components. Thanks to this property of bile, a specific enzyme in the human body, lipase, begins to dissolve lipids in the body especially effectively.

[The salts that make up bile break down fats so finely that these particles can enter the bloodstream from the small intestine.]

The ability to dissolve the products of lipid hydrolysis, thereby improving their absorption and transformation into end products of metabolism.

[The production of bile helps to improve the activity of intestinal enzymes, as well as substances secreted by the pancreas. In particular, the activity of lipase, the main enzyme that breaks down fats, is increased.]

Regulatory, since the liquid is responsible not only for the process of bile formation and its secretion, but also for motility. Motility is the ability of the intestine to push food through. In addition, bile is responsible for the secretory function of the small intestine, that is, for the ability to produce digestive juices.

Inactivation of pepsin and neutralization of the acid components of the gastric contents that enter the duodenal cavity, thereby protecting the intestine from the development of erosion and ulceration.

Bacteriostatic properties, due to which the inhibition and spread of pathogens in the digestive system occurs.

Functions of bile.

replaces gastric digestion with intestinal by limiting the action of pepsin and creating the most favorable conditions for the activity of pancreatic enzymes, especially lipase;

due to the presence of bile acids, it emulsifies fats and, by reducing the surface tension of fat droplets, increases its contact with lipolytic enzymes; in addition, it provides better absorption in the intestines of water-insoluble higher fatty acids, cholesterol, vitamins D, E, K and carotene, as well as amino acids;

stimulates the motor activity of the intestine, including the activity of the intestinal villi, as a result of which the rate of absorption of substances in the intestine increases;

is one of the stimulants of the secretion of the pancreas, gastric mucus, and most importantly - the function of the liver responsible for bile formation;

due to the content of proteolytic, amylolytic and glycolytic enzymes, it participates in the processes of intestinal digestion;

has a bacteriostatic effect on the intestinal flora, preventing the development of putrefactive processes.

In addition to these functions, bile plays an active role in metabolism- carbohydrate, fat, vitamin, pigment, porphyrin, especially in the metabolism of protein and the phosphorus contained in it, as well as in regulation of water and electrolyte metabolism.

Types of bile.

Hepatic bile is golden yellow, cystic bile is dark brown; pH of hepatic bile - 7.3-8.0, relative density - 1.008-1.015; The pH of the cystic bile is 6.0-7.0 due to the absorption of bicarbonates, and the relative density is 1.026-1.048.

To understand the importance of this liquid for a person, you should read the list of its functions:

1. Acts as a stimulant of secretion and gastric mucus, but in priority - the function of the liver.
2. Bile is a catalyst that activates many enzymes (mostly intestinal or pancreatic lipase).
3. Responsible for the productive absorption of water-insoluble fatty acids, carotene, vitamins D, E, K, cholesterol into the intestine.
4. Produces a change in gastric digestion to intestinal and limits the effect of pepsin.
5. It starts the motor function of the intestine, including the work of the intestinal villi, as a result of which nutrients are absorbed faster.
6. Due to the composition of bile, under normal physiology, bacteria do not multiply in the intestine, putrefactive processes are prevented.
7. It has an irritating effect on the nerve endings of blood vessels, changes the excitability of the nervous system.
8. Takes an important part in metabolism.

Physical and chemical properties

Human bile is rich yellow in color, turning greenish-brown due to the decomposition of coloring matter. It is viscous in consistency, depending on how long it has been in the gallbladder. The taste of bile is very bitter, smells peculiar and has an alkaline reaction.

The specific gravity is about 1005, but it is possible that it can rise to 1030 after a long stay in the gallbladder. With regard to chemical properties, the pH of bile is 7.3-8.0, the relative density is 1.026-1.048.

If the stomach is empty (for example, after repeated vomiting), the color of the bile may be dark green. The shade is often compared to freshly cut grass.

bile pigments

Bile pigments are substances found in bile. Their color varies from yellow and transparent to green-blue. The process of oxidation in the liver and other organs, the breakdown of hemoglobin, is what causes pigments to form. There are only 11 of them, but they are divided into 4 groups depending on the color, parent structure and other parameters.

Normally, bile pigments that enter the intestine from the liver are excreted from the body with feces in the form of reduced bilirubin. They have the properties of acids, give metals and salts. Because of this, they are formed.

Of great importance is the level of pigments in the urine, blood and skin when the presence is suspected. This connection is explained by the fact that due to a violation of the metabolism of hemoglobin and pigments, bilirubin accumulates, due to which the integument turns yellow.

Your doctor may order stool, blood, or urine tests. If there is an increased content of pigments in the urine, this indicates excessive physical exertion, starvation, pathology associated with hemolysis of red blood cells. The feces contain a lot of pigments during menstruation, and few - in violation of the patency of the bile ducts.

The composition of bile

I wonder what this liquid is, what components it contains. So, the composition of human bile is 98% water and 2% solids. It includes substances such as bilirubin, fatty acids, cholesterol, urea, mucin, lecithin, vitamins A, B, C, bile enzymes - phosphatase, amylase, protease, oxidase, amino acids and glucocorticoids, inorganic substances.

If you disassemble the chemical composition - this is predominantly bile acids. They are made from cholesterol. When interacting with taurine and glycine, salts of glycocholic and taurocholic acids are formed. Cholesterol leaves the body in the form of bile acids, and unsplit cholesterol is insoluble in water, which is why it is produced by liver cells in the form of phospholipid vesicles.

It is important to know not only the composition, but also the properties of bile:

1. emulsification of fats. This means that the enzymes found in bile are able to break down fats, allowing them to pass from the small intestine into the bloodstream.
2. Dissolution of products of lipid hydrolysis.
3. regulatory property. The fluid is also responsible for motility - the ability of the intestine to push food further.

Normally, a person secretes about 500 ml to 1.2 liters of bile per day. In the case of pathology, these indicators may change.

Regulation of secretion and excretion of bile

The secretion process is continuous, but its intensity increases due to the action of bile acids, secretin and some other hormones. Approximately 94% of bile acids are absorbed in the upper small intestine. Before they are removed from the body, the circulation of the molecule can occur about 18-20 times.

The conclusion is as follows - the greater the amount of bile secreted, the more fatty acids are absorbed. Then they again enter through the blood to the liver, stimulating the formation of the next portions of bile.

The secretion of bile occurs in the duodenum. This process depends on the tone of the smooth muscles of the biliary tract, the gallbladder wall and the work of the sphincter muscles. The way bile moves into the duodenum from the liver is a consequence of different pressures at the beginning of the bile excretion system, the ducts and the duodenum. It arises as a result of the secretory activity of hepatocytes.

Half an hour after eating, incompletely digested food enters the duodenum from the stomach. Fatty foods stimulate gallbladder contraction due to the effects of cholecystokinin. Another reason for this is the nerve impulses coming from the vagus nerve and the enteric system. Also, bile secretion is enhanced due to secretin, which stimulates the secretion of the pancreas.

A weakened valve, taking any medications or alcohol, exposure to muscle contractions, and duodenal spasm are a list of possible reasons why bile can enter the stomach.

If cholesterol compresses with bilirubin or calcium, stones form. This condition is treated only. In rare cases, stones can be managed with the help of drugs.

Metabolic functions of the liver

This unique organ can be compared to a laboratory where work never stops. The liver affects the metabolism of fats, proteins and carbohydrates. Due to the metabolic rate in the liver, energy is distributed between all organs.

Its role in carbohydrate metabolism can be described in several points:

1. The conversion of fructose to glucose.
2. Deposition of a large amount of glycogen.
3. Gluconeogenesis.
4. Formation of glucose resistance due to chromium and glutathione.
5. The process of formation of other chemical compounds. Their formation occurs at intermediate stages of carbohydrate metabolism.
6. Urea formation.

Proper liver function is a very important factor in maintaining normal blood glucose levels. If it is not enough for the body, iron begins to use glycogen stores.

Gluconeogenesis occurs when there is a clear decrease in the concentration of glucose in the human blood. In this case, the formation of glucose comes from amino acids and glycerol, which are based on triglycerides.

Metabolism in the liver plays a role in fat metabolism. Such reactions occur in almost all tissues, but there are those that affect only the liver.

Regarding metabolism, the liver is responsible for the production of:

• Fats and carbohydrates from those proteins that subsequently pass into adipose tissue.
• Cholesterol, phospholipids and most of the lipoproteins that take part in the formation of cell membranes and other important substances.
• Oxidative reactions of fatty acids, which are responsible for the supply of energy.

The liver is directly related to the work of the thyroid gland due to the fact that it is responsible for the conversion of thyroxine to triiodothyronine. If the metabolic function of the liver is disturbed, it threatens with hypothyroidism. The gland also produces hormones such as adrenaline, insulin, estrogen.

Every day, the metabolic function of the liver is under a powerful attack due to exposure to viruses, harmful substances, drugs. If the ability of the gland to metabolism decreases, this indicates a lack of proper nutrition, fatty acids, vitamins, and trace elements. The appearance of chronic pathologies in the liver significantly impairs its metabolic function.

In the event that a specialist detects deviations, he can prescribe a remedy that normalizes the composition of bile. To diagnose, fractional duodenal sounding is used. As a result of a lack of useful elements, steatorrhea may develop.

This is a condition in which food travels through the small intestine and disturbs the intestinal microflora. The stool becomes white or just light, more oily. In this case, you need to contact a specialist as soon as possible.

Modern methods of treatment are so safe for the body that they can be used absolutely calmly. It is important to follow all doctor's recommendations. Now it becomes clear not only the composition of bile, but also its role in digestion.

Useful video about the work of the gallbladder

Bile is a liver secret that regulates metabolism and affects the state of the nervous system. Normal bile secretion determines the health and function of the liver. Let us consider in more detail what is the value of bile and how much bile secretion is produced per day in our body.

What is bile

Bile is a yellow, brown, or green liquid with a pungent odor and a bitter taste. Bile excretion is the process of excretion of a substance in the liver.

REFERENCE! The normal volume of excreted bile secretion per day is 2 liters.

The secret is secreted by liver cells (hepatocytes) and through the choleretic ducts enters the gallbladder and duodenum. The functions of bile in the human body are reduced to the digestion of food, the transport of nutrients, and the normalization of metabolism.

Not all substances are the same in composition. Types of bile:

• "hepatic" or "young" - secreted by the liver;
• "vesicular" or "mature" - is excreted by the gallbladder.

The color of the liquid depends on the state of human health (it can be determined by the color of the feces).

The secret contains the following enzymes:

• amylase,
• phosphatase;
• protease;
• catalase;
• oxidase.

These enzymes (enzymes) of bile are needed for the digestion of nutrients - proteins, fats, carbohydrates. In case of violations of the normal function of bile and the enzymatic composition, intolerance to certain products is noted. For example, a person refuses protein food because after it he feels heaviness in the stomach. There is a direct violation of the enzymatic composition of the secret, namely the deficiency of protease, an enzyme that is involved in the digestion of proteins.

Where is it produced and how does it leave the body?

In the human body, bile is produced and stored in the liver. Depending on when the last meal was and the next portion of the secret was developed, the body determines where to direct the substance - into the duodenum, intestines or stomach. If the composition of the bile does not pass through the ducts, inflammation begins (to relieve the situation, choleretic drugs are used that forcefully push the liquid, changing the consistency or expanding the duct).

The structure of the bile ducts easily changes its size and throughput. If the body considers the consistency of bile or its amount unacceptable, the channels will not let the secret pass, up to a complete blockage. In this case, bile comes out along with decay products through the lymphatic system.

Why is bile needed in the body?

The liver secret is involved in digestion and regulates metabolism. The normal concentration of bile allows the functioning of other trace elements such as gastric juice, lymph fluid, enzymes, etc. If it is released excessively or insufficiently, the production of other elements of the digestive system is also disrupted and the body begins to have problems.

The secret is 98% water, and the rest falls into solid components. The chemical composition of bile includes enzymes, liver secretions - bilirubin, biliverdin, cholesterol, a small part of vitamins, inorganic minerals. Bile enzymes are needed to digest food.

Impaired bile production

Abnormal production of a secret entails the following consequences.

• Failure of the gastrointestinal tract, as a result of problems with the digestion of food and the formation of constipation.
• Violation of the lymphatic system and edema. Due to the fact that fluid accumulates in the gastrointestinal tract, the natural balance between the intracellular and intercellular spaces is disturbed, and fluid pressure increases. The swelling may be blue or purple.
• Increased acidity of the blood or a change in the acid-base balance. The absorption of nutrients into the blood occurs in the stomach and intestines. If the amount of bile or other digestion catalysts is not normal, this will affect the condition of the body.
• Violation of the central nervous system. At first glance, the gastrointestinal tract is not related to the nervous system. But this is far from true. The dimensions, area, length of our intestines are several times larger than the rest of the body. All organs are covered with nerve endings and form part of the nervous system. It turns out that the stomach contains more elements of the nervous system than the rest of the body. Resources for the functioning of the central nervous system are unevenly distributed, if digestion or bile formation is disturbed, the entire nervous system suffers.

Symptoms of violation of the production of bile secretion:

• blanching of skin color;
• change in blood pressure;
• violation of urination and stool;
• heaviness in the stomach and intestines;
• weakness and drowsiness;
• loss of appetite;
• heaviness in the left hypochondrium;
• change in the smell and consistency of sweat (sweat looks like a sticky viscous liquid);
• bad breath, as a result of gases released during the digestion of food (the smell does not come from the mouth, but from the stomach, because the food begins to ferment due to slow digestion).

Violations of secretion production entail serious illness. Black bile is a substance secreted by the spleen. Its black color is due to its low water content, which results in the oxidation of bilirubin and biliverdin pigments. A black substance is a sign of stagnation or liver disease, as a result of which the liquid mixes with dying tissue and enters the stomach. A malfunction causes dehydration or kidney dysfunction: the primary fluid is excreted from the body, and the secondary fluid accumulates. In this case, the secret is dark purple, similar to black. In both cases, the properties of bile will be violated.

REMEMBER! Bile plays an equally important role in digestion as gastric juice and enzymes.

If there are disturbances in the functioning of the mucous membranes, the hepatic secret accumulates in the stomach or intestines. It stagnates and thickens, reducing the cross section of the intestine. In this case, the particles of digested food sink in a black viscous mass, gradually clogging the intestines.

Typical symptoms:

• bloating;
• nausea;
• difficulty in defecation and urination;
• unpleasant taste in the mouth, more often after sleep;
• a feeling of heaviness in the stomach and a feeling of filling the stomach with a foreign object.

At the first symptoms, it is recommended to consult a doctor for the purpose of diagnosis. This problem is not always solved by a banal gastric lavage and bowel cleansing; in some cases, surgical intervention and subsequent therapy are required.

Prevention measures

To prevent diseases of the liver, gallbladder, impaired secretion, it is recommended:

• observe the correct diet;
• do not consume large amounts of simple sugars and carbohydrates;
• limit the consumption of alcoholic beverages and fatty foods.

Carbohydrates stimulate inflammatory processes in the human body. If there are disturbances in the gallbladder or choleretic channels, carbohydrates increase them. This also applies to refined fried foods: it is digested by the liver, and this is an additional burden that reduces the production of bile secretions.

Means that return the secretion to its normal state.

• Garlic. Whole and granular, and the advantage of the granular form is that after consumption there is no bad breath.
• Cholagogue pharmacy fees. They mainly consist of wooden elements and do not harm the body, because. the incidence and intensity of side effects are reduced.
• Poorly acting medicines that are dispensed in a pharmacy without a prescription.

Powerful drugs:

• Allochol is a preparation based on garlic, which has a complex effect on the body and on the state of the choleretic tract, restores the functions of the secretion of bile fluid;
• Holosas has a positive effect on the state of the gallbladder (it is recommended to take it in liquid form, so it is absorbed much faster);
• Gepabene and Karsil are drugs aimed at maintaining normal bile secretion and restoring its enzymatic profile.

ATTENTION! It is recommended to use weak drugs or herbal medicines, because. drugs harm the gastric mucosa and the kidneys, where they are metabolized. Consult your doctor before taking medication – by curing one organ system, you can cause irreparable harm to another organ system.

conclusions

It does not matter which organ system has been affected by the disease - it is easier to prevent the disease than to treat the consequences later. Do not give up preventive measures, risking your health. The main principle of maintaining health is that everything should be in moderation and the health of the gastrointestinal tract is no exception. If signs of illness are found, it is recommended to go to the hospital for diagnosis. A banal violation of the function and properties of the bile secretion become signals of a serious systemic disease (diseases of the gastrointestinal tract, impaired blood clotting in the liver).

Project consultant, co-author of the article:
Balyberdina Maria Vyacheslavovna| Gastroenterologist
Experience 26 years / Doctor of the highest category

Education:

• Diploma in the specialty "Medicine (Medical and preventive care)", Saratov State Medical University (1992)
• Residency in "Therapy", Saratov State Medical University (1994)

The human body produces from 1 to 1.8 liters of bile daily. We tell you what role it plays in the body, and how dangerous the failure of its production is.

What is bile?

A yellow-green bitter liquid that As soon as the body begins to digest food, bile goes to the intestines and begins its work:

• Neutralizes hydrochloric acid residues;
• Breaks down fats;
• Increases the activity of pancreatic and intestinal enzymes;
• Neutralizes the action of gastric juice, if necessary;
• Fights pathogens.

Together, this allows the body to process and assimilate food normally.

How does the body regulate bile production?

In a healthy person, the gallbladder doses its release with the help of special ducts and valves. In some diseases, this mechanism is violated:

• If bile becomes more than necessary, gallstones can form in the body, and after them there will be a violation of fat metabolism and obesity.
• If there is not enough bile or it is completely absent, a lack of fatty acids and vitamins is formed. Thus, the entire work of the digestive system is disrupted: vitamin deficiency develops, blood clotting decreases, intestinal peristalsis is weakened, and as a result, poisoning of the body occurs.

What happens when bile stagnates?

This condition is called cholestasis. With it, bile loses its ability to move along the biliary tract: because of this, it penetrates into the liver tissues and causes cell destruction.

This can happen due to alcoholism, hepatitis, liver disease, sepsis, congestive heart failure, cancer, and some other diseases. To cure cholestasis, you must first deal with the root cause.

Is it possible to drink cholagogue on your own?

Any drugs that affect the gallbladder should be selected by a doctor. Only he will be able to choose the right active substance and dosage. This also applies to herbal preparations. Self-medication can lead to exacerbation of chronic diseases and the development of new ones.

How to prevent the development of pathologies?

Stick to a healthy lifestyle. Common risk factors for liver and gallbladder disease include:

• Bad habits;
• Passive lifestyle - the tone of the gallbladder depends on physical activity;
• infections;

Moreover, for prevention it is necessary to undergo all planned examinations. Especially if you are over 40 years old.

How can I check if everything is ok?

Contact your doctor. Depending on what is bothering you, he will prescribe several procedures:

In some cases, doctors can send for additional examinations - fibrogastroduodenography, diagnostic laparoscopy, tomography.

How are gallbladder diseases treated?

During the period of exacerbation, the patient is admitted to the hospital to prevent intoxication. The rest of the time, doctors normalize the level of bile with the help of special ones. They may also prescribe antispasmodics and antibiotics. In severe cases, urgent surgery to remove the gallbladder may be necessary.

Learn how to avoid kidney stones at

Bile or bile(lat. bilis, other Greek chole) is a fluid produced by the liver and stored in the gallbladder. It has a yellow, brown or greenish color, a bitter taste and a specific smell.

Bile ensures the change of gastric digestion to intestinal, eliminates the action of pepsin, which is dangerous for pancreatic enzymes, and creates favorable conditions for these enzymes.

Bile performs the following functions (Makhov V.M.):

• fat emulsification
• hydrolysis and absorption of fats
• activation of pancreatic and intestinal enzymes
• participation in hydrolysis and absorption
• participation in the assimilation of fat-soluble vitamins, cholesterol, calcium salts.

Bile is a stimulant of intestinal motility, and its deficiency contributes to the development of constipation. Bile is a powerful bacteriostatic, it promotes the proliferation and desquamation of enterocytes. The alkaline pH of bile is important, and its entry into the duodenum contributes to the neutralization of hydrochloric acid and the inactivation of pepsin. The presence of bile in the intestine leads to stimulation of bile formation and bile secretion (Makhov V.M.).

The composition of bile

Bile has a complex composition. This ensures that it performs various functions related to the process of digestion, but not limited to it. Bile acids (primary: cholic and chenodeoxycholic; secondary and tertiary: deoxycholic, lithocholic, ursodeoxycholic and sulfolitocholic) promote lipid solubilization (emulsification, emulsion stabilization, micellization), activate the motor function of the digestive tract, stimulate the release of gastrointestinal hormones (cholecystokinin or cholecystokinin-pancreozymin, secretin), mucus secretion. The absorption of fat-soluble vitamins (A, E, K) depends on the presence of bile acids. Phospholipids perform a protective function in the biliary tract, provide solubilization of cholesterol. The bacteriostatic properties of bile are associated with immunoglobulins. Mucus prevents bacterial adhesion. The presence of cholesterol, bilirubin, metals and organic anions (glutathione and plant steroids) is due to their excretion with bile.

Bile enhances the activity of pancreatic enzymes (mainly lipase), maintaining an optimum pH = 6.0 for its functioning. The acid-base properties of bile are less important for trypsin and amylase, although enterokinase, which activates trypsinogen, works actively only in an alkaline environment. Bile is involved in abdominal digestion due to its own amylase and proteases contained in it in small quantities.

The composition of bile includes components that are detergent for mucous membranes, the damaging effect of which is reduced in the presence of lecithin. The absence of bile acids, as well as excessive acidification of the duodenum and bacterial contamination reduce the absorption of hydrophobic substances to almost zero (Serebrova S.Yu.).

Bile in children

Bile is secreted by the liver from the first day after birth. During this period, bile is distinguished by the maximum concentration of bile acids (2.0–26.7 meq/l). By the year, the concentration of bile acids decreases to 2.2–19.7 meq/l. The concentration of bile acids in the bile of 4-10-year-old children is even lower - 2.4-5.2 mgeq / l. In adults - 2.8–20.0 meq / l. The biochemical composition of the bile of children and adolescents is presented in the table (Kozlov V.I., Farber et al., 1983):

Indicators, mgeq/l	Cystic bile		Hepatic bile
	5–10 years	11–15 years old	5–10 years	11–15 years old
Lipids	1583 ± 569	1182 ± 284	594 ± 188	366 ± 144