Constipation and bile acids

We are continuing our conversation about constipation.  In particular, we are exploring the connection with bile acids.   What is the connection with constipation?

First, what are bile acids?

Bile acids are synthesized in the liver from cholesterol.   In fact, 95% of bile acids are absorbed by transporters and recycled back to the liver.  Very efficient process.  The remaining 5% pass into the colon and disrupted by intestinal bacteria.

Second, bile acid primary functions

The primary functions of bile acids are:

• intestinal fat absorption
• assist in absorption of vitamins A, D, E & K
• Act as signaling molecules with numerous endocrine and paracrine functions 
• Play a crucial role in the metabolism of lipids and glucose, as well as maintaining the balance of temperature and energy levels 
• Act as natural laxatives and influence your colon motor activity 
• Act as a hormone in its ability to modulate a variety of metabolic effects on lipid metabolism, glucose homeostasis, and gut microbiota alterations after metabolic surgery

This is something that needs to be considered after gastric sleeve & gastric bypass surgery.  Because absorption of nutrition is altered with both surgeries.

Gastric bypass creates malabsorption.  Gastric sleeve is altered secondary to the alterations in stomach acid.  Stomach acid is important because it signals the release of all of enzymes that digest food.  If you would like to learn more about this important occurrence and consequences, check out this podcast to learn more. 

Third, bile acids and motility

Some bile acids are natural laxatives.  They influence colon motor activity.  This is already well known and associated with bile acid diarrhea(BAD).  Check out this podcast about BAD and bloating to learn more. 

Another study published in 2013 in the Journal of Clinical Gastroenterology & Hepatology.  This found that bile acid concentration in the colon may cause diarrhea OR constipation.

Fourth, 2008 Study

According to one study published in the “Scandinavian Journal of gastroenterology” in 2008, patients with IBS-C and functional constipation(FC) have marked changes in their bile acid synthesis and colonic transit.

In relation to colonic transit, bile acid synthesis is markedly altered in patients with IBS-C and FC. There is evidence that altered bile acid metabolism contributes to constipation pathophysiology.

Fifth, improving bile flow

Several studies have shown that improving bile flow can help relieve constipation. Thus, if fiber and fluids don’t work for you in increasing bowel movement. It might be a good idea to increase bile flow through diet and supplements in order to help you with constipation.

In fact, bitter foods can stimulate bile production.  In addition to green leafy vegetables, you can choose beetroot, artichokes, and citrus. Several drinks also stimulate bile production, including roasted dandelion root tea, lemon tea and coffee.

Sixth, 2021 study

A recent study 2021 defined bile as a hormone in its ability to modulate a variety of metabolic effects on lipid metabolism, glucose homeostasis, and gut microbiota alterations after metabolic surgery.

If you’re struggling with constipation?

Are you struggling with chronic constipation?  I would love working with you to get to the root cause and leave no stone unturned.  Check out my packages and schedule a time for a Free chat.

Your future health awaits