Table of Contents
The body requires theΒ gutΒ and theΒ intestinesΒ (both small and large) to store, digest, and transport the nutrients from food to all the bodyβs organs, tissues, muscles, and cells. These nutrients help the body by keeping it functional and promoting growth, metabolism, and immune support. When the food is being digested, theΒ liverΒ sends out bile acids to aid in the digestion process to break food particles and transport them and secreting them out of the body. Sometimes specificΒ gut issuesΒ can start to affect both the intestines and gut, causing discomfort to the body. In this 2 part series, we will be looking at how bile acids are hormones, sterolbiome, and bile reflux.Β Part 1Β looks at what bile acids are, their role in the gut, and what gall sludge is. By referring patients to qualified and skilled providers who specialize in gastroenterology services. To that end, and when appropriate, we advise our patients to refer to our associated medical providers based on their examination. We find that education is the key to asking valuable questions to our providers. Dr. Alex Jimenez DC provides this information as an educational service only.Β Disclaimer
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Can my insurance cover it? Yes, it may.Β If you are uncertain, here is the link to all the insurance providers we cover. If you have any questions, please call Dr. Jimenez at 915-850-0900.
Research studies have foundΒ that the bile salts from bile acids are considered nutrient signaling hormones. They play a crucial role by allowing theΒ gastrointestinal systemΒ to digest, transport, and metabolize nutrients throughout the entire body. Bile acids are hormones that regulate:
Other research studies have found that the essential role of bile acids is that they act as regulators for energy metabolism by acting as emulsifiers to cholesterol in the intestines. They can act like typical steroid hormones by having specific intracellular receptors in the target cells. When bile acids are in the intestines, they ensure that the particles are broken down and secreted into the bloodstream.
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The gut microbiome or sterolbiome produces endocrine molecules from cholesterol-based molecules in the gut known as bile acids. Bile acids are also known to shape the gut microbiome fundamentally and vice versa, asΒ studies showΒ that bile acids can facilitate fat absorption while playing a role in glucose and metabolism regulation. This is important for bile acids mechanics because it can help stimulate the secretion of gut hormones. Other bacteria in the gut known as Clostridium scindens can help both the male and female bodies. This bacteria can increase blood estrogen levels and convert cortisol toΒ male sex hormonesΒ while deconjugating theΒ estrogen, allowing theΒ hormoneΒ to be absorbed from the gut, advancing a more active serum estrogen.
Other studies have found that when bile acids are returned to the liver after circulating throughout the intestines and the body and accumulating in the biliary pool, the gut microbial community will produce bile acid metabolites through their capacity from the liver as an endocrine hormone.
When bile acids are abundant in the gastrointestinal tract, it can cause a backup to the stomach organ and cause damage to the wall linings to the stomach and esophagus. It can cause tissue damage and inflammation in the gut system when this happens. If left untreated, it can turn into GERD or SIBO, causing more gut inflammation and making a personβs life miserable. However, there are some ways to dampen the effects of bile reflux by utilizing anti-inflammatory therapy treatments.
When the role of bile acids is a cause of esophageal inflammation or Barrettβs esophagus, a condition in which the esophageal lining cells become transformed (pre-cancerous). This is known asΒ GERDΒ or gastroesophageal reflux disease.Β Research studies have shownΒ that GERD usually occurs when stomach acid frequently flows back and forth into the tube that connects the mouth and stomach, which can irritate the esophagus lining. So bile acids will be exclusively in conjugated form unless there is abnormal bacterial deconjugation in the duodenum.
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There is little reflux of duodenal fluid into the stomach or esophagus in a healthy person because intragastric pressure is higher than intraduodenal pressure. However, in individuals with disordered gastroduodenal motility or pyloric sphincter dysfunction, there may be duodenal reflux that leads to reflux from the stomach to the esophagus.Β Other research studies showΒ that now and then, mostly everyone has acid reflux and heartburn, which is entirely normal. However, if a person has acid reflux or heartburn more than twice a week, they are developingΒ GERDΒ in their gut system.
Reflux of duodenal contents through the pyloric valve is purported to be more common after cholecystectomy but is also seen in individuals with an intact gall bladder. Bile reflux, asΒ research shows, can occur when the bile acids are backed up in the stomach and can be accompanied by stomach acid reflux into the esophagus. There are many ways this can happen to the gut as bile acids are produced in the liver, and their job is to break down food into particles.Β Other research studies have shownΒ that when the valves in the digestive tract are not functioning right, bile reflux can happen and flow right back into the organs where they donβt belong.
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Since the liver is the one to produce bile acids, it is known as a nutrient signaling hormone that is essential for gut metabolism, energy balance, and homeostasis to glucose and lipids. All in all, bile acids are part of the digestive system as they help break down foods into particles and help them be transported throughout the entire body. When there is little bile fluid in the intestines, it can cause gut disorders like GERD or bile reflux, causing the bile acid to go into the stomach and causing irritation to the wall linings esophagus, causing discomfort to the individual. Incorporating anti-inflammatory treatments into the gut system can help the bile acids return to normal and make the body functional.
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Kuhre, Rune E, et al. βBile Acids Are Important Direct and Indirect Regulators of the Secretion of Appetite- and Metabolism-Regulating Hormones from the Gut and Pancreas.β Molecular Metabolism, Elsevier, May 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6001409/.
Medical Professionals, Cleveland Clinic. βBile Reflux: Symptoms, Treatment, Causes & What It Is.β Cleveland Clinic, 18 Nov. 2021, my.clevelandclinic.org/health/diseases/22056-bile-reflux.
Medical Professionals, Cleveland Clinic. βGerd (Chronic Acid Reflux): Symptoms, Treatment, & Causes.β Cleveland Clinic, 6 Dec. 2019, my.clevelandclinic.org/health/diseases/17019-gerd-or-acid-reflux-or-heartburn-overview.
Ridlon, Jason M, and Jasmohan S Bajaj. βThe Human Gut Sterolbiome: Bile Acid-Microbiome Endocrine Aspects and Therapeutics.β Acta Pharmaceutica Sinica. B, U.S. National Library of Medicine, 9 Feb. 2015, pubmed.ncbi.nlm.nih.gov/26579434/.
Staff, Mayo Clinic. βBile Reflux.β Mayo Clinic, Mayo Foundation for Medical Education and Research, 6 Jan. 2022, www.mayoclinic.org/diseases-conditions/bile-reflux/symptoms-causes/syc-20370115.
Staff, Mayo Clinic. βGastroesophageal Reflux Disease (GERD).β Mayo Clinic, Mayo Foundation for Medical Education and Research, 22 May 2020, www.mayoclinic.org/diseases-conditions/gerd/symptoms-causes/syc-20361940.
Zagoskin, P P, and E I Erlykina. βBile Acids as a New Type of Steroid Hormones Regulating Nonspecific Energy Expenditure of the Body (Review).β Sovremennye Tekhnologii v Meditsine, Privolzhsky Research Medical University, 28 Oct. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC8596256/.
Zhou, Huiping, and Phillip B Hylemon. βBile Acids Are Nutrient Signaling Hormones.β Steroids, U.S. National Library of Medicine, Aug. 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4073476/.
Professional Scope of Practice *
The information herein on "How Sterolbiome & Bile Reflux Affect The Gut | Part 2" is not intended to replace a one-on-one relationship with a qualified health care professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional.
Blog Information & Scope Discussions
Our information scope is limited to Chiropractic, musculoskeletal, acupuncture, physical medicines, wellness, contributing etiological viscerosomatic disturbances within clinical presentations, associated somatovisceral reflex clinical dynamics, subluxation complexes, sensitive health issues, and/or functional medicine articles, topics, and discussions.
We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system.
Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.*
Our office has reasonably attempted to provide supportive citations and has identified the relevant research studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.
We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez, DC, or contact us at 915-850-0900.
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Dr. Alex Jimenez DC, MSACP, RN*, CCST, IFMCP*, CIFM*, ATN*
email: coach@elpasofunctionalmedicine.com
Licensed as a Doctor of Chiropractic (DC) in Texas & New Mexico*
Texas DC License # TX5807, New Mexico DC License # NM-DC2182
Licensed as a Registered Nurse (RN*) in Florida
Florida License RN License # RN9617241 (Control No. 3558029)
Compact Status: Multi-State License: Authorized to Practice in 40 States*
Presently Matriculated: ICHS: MSN* FNP (Family Nurse Practitioner Program)
Dr. Alex Jimenez DC, MSACP, RN* CIFM*, IFMCP*, ATN*, CCST
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