To Your Health

Is there a way I can reduce bile production?

Q. I recently caught salmonella food poisoning while on vacation. I have recovered from that problem, but my doctor tells me I am now producing too much bile and because of this I am losing a lot of weight. I am already thin, and the last thing I need is to lose weight. Is there any way I can reduce bile production?

A. The liver produces a greenish fluid called "bile" that is stored in the gall bladder. Bile assists in the absorption of dietary fats and fat-soluble vitamins, and it also carries away an assortment of the body's toxins that are then eliminated in stool. Beyond this, even among health professionals, the role of bile in our health is underappreciated.

The liver produces as much as a quart of bile per day, with about a quarter of this passing directly into the intestinal tract and the remainder stored in the gall bladder, where between meals it is concentrated about 10-fold. At mealtimes the gall bladder slowly squeezes about 90% of its concentrated bile into the intestinal tract to be used to aid in digestion, where some is lost by excretion but more than 90% is reabsorbed and taken back to the liver to be reused.

Bile consists mostly of various relatives of cholesterol, collectively known as "bile salts." There are many types of bile salts, and although some are considered "toxic," most have a useful function. For instance, to some extent, people with gall stones appear to lack the protection of glutathione and other important antioxidants, but there is increasing evidence bilirubin and biliverdin, once counted among the toxic bile salts, may instead be antioxidants that contribute to the defense of our bodies from free-radical damage.

Some bile salts may promote the self-destruction of cancer cells, known as apoptosis. In the test tube, deoxycholate, long recognized as one of the beneficial bile salts, induced apoptosis in two out of four colon cancer cell lines.

Even the salmonella infection you suffered could have been influenced by bile acids. In the presence of certain bile salts, expression of important genes in the salmonella organism change, and this makes it less able to invade the body.

Rather than curtail your liver's production of bile, consider improving the quality of the bile it produces. Two related foods, artichoke and milk thistle, are traditionally recommended to improve liver function and thereby improve the quality of bile it produces. The medicinal value of the beneficial "phytochemicals" in both of these foods has been well documented, and both are available in concentrated "pill" form. Also, two amino acids, glycine and taurine, are directly involved in production of high quality bile salts. Glycine is available as a powder, and it can also be used as a sugar substitute that is safer than most artificial sweeteners. Taurine can be found in pill form in health food stores.

Paradoxically, taking bile salts, which are available by prescription, might also be helpful. By reducing the reabsorption of the less beneficial bile salts you apparently produce, the level of the bile salts that are known to be beneficial is boosted.

More information on bile salts can be found in the "To Your Health" column at austinchronicle.com.

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