Bile acids are reduced. Bile acids: general information

Bile acids I Bile acids (synonym: cholic acids, cholic acids, cholenic acids)

organic acids that make up bile and are the end products of cholesterol metabolism; play important role in the processes of digestion and absorption of fats; contribute to the growth and functioning of normal intestinal microflora.

Bile acids- derivatives of cholanic acid C 23 H 39 COOH, in the molecule of which hydroxyl groups are attached to the ring structure. The main bile acids found in human bile (Bile) are (3α, 7α, 12α-trioxy-5β-cholanic acid), (3α, 7α-dioxy-5β-cholanic acid) and (3α, 12α-dioxy -5β-cholanic acid). Stereoisomers of cholic and deoxycholic acids - allocholic, ursodeoxycholic and lithocholic (3α-manooxy-5β-cholanic) acids - were found in significantly smaller quantities in bile. Cholic and chenodeoxycholic acids - the so-called primary digestive acids - are formed in the liver during the oxidation of cholesterol and , and deoxycholic and lithocholic acids are formed from primary digestive fluids in the intestine under the influence of enzymes from microorganisms of the intestinal microflora. Quantitative ratio Cholic, chenodeoxycholic and deoxycholic acids and bile are normally 1:1:0.6.

In gallbladder bile, bile acids are present mainly in the form of paired compounds - conjugates. As a result of the conjugation of fatty acids with the amino acid glycine, glycocholic or glycochenodeoxycholic acids are formed. When fatty acids are conjugated with taurine (2-aminoethane sulfonic acid C 2 H 7 O 3 N 5), a product of cysteine degradation, taurocholic or taurodeoxycholic acids are formed. Conjugation of fatty acids includes the stages of formation of fatty acid esters and the connection of the fatty acid molecule with glycine or taurine through an amide bond with the participation of the lysosomal enzyme acyltransferase. The ratio of glycine and taurine conjugates in bile, averaging 3:1, can vary depending on the composition of food and the hormonal status of the body. The relative content of glycine conjugates in bile increases with the predominance of carbohydrates in food, in diseases accompanied by protein deficiency, reduced function thyroid gland, and the content of taurine conjugates increases with a high-protein diet and under the influence of corticosteroids steroid hormones.

In the liver bile, bile acids are found in the form of bile acid salts (cholates, or choleates) of potassium and sodium, which explains alkaline reaction liver bile. In the intestine, fatty acid salts provide emulsification of fat and stabilization of the resulting fat emulsion, and also activate pancreatic lipase, shifting the optimum of its activity to the pH range characteristic of the contents duodenum.

One of the main functions of fatty acids is the transfer of lipids in the aquatic environment, which is ensured due to the detergent properties of fatty acids (see Detergents) , those. they form a micellar solution of lipids in an aqueous medium. In the liver, with the participation of fatty acids, micelles are formed, in the form of which micelles secreted by the liver are transferred into a homogeneous solution, i.e. in bile. Due to the detergent properties of fatty acids, stable micelles are formed in the intestine, containing products of fat breakdown by lipase, phospholipids, which are fat-soluble and ensure the transfer of these components to the absorptive surface of the intestinal epithelium. In the intestines (mainly in ileum) Bile acids are absorbed into, return with the blood to and are again secreted as part of bile (the so-called portal-biliary circulation of bile acids), therefore 85-90% of the total amount of bile acids contained in bile are fatty acids. ., absorbed in the intestines. Portal-biliary circulation of stomach acid is facilitated by the fact that conjugates of stomach acid are easily absorbed in the intestine, because they are water soluble. The total amount of fatty acids involved in metabolism in humans is 2.8-3.5 G, and the number of revolutions of the liquid circuit per day is 5-6. In the intestine, 10-15% of the total amount of bile acids is broken down by enzymes of microorganisms of the intestinal microflora, and the products of bile acid degradation are excreted in the feces. Fatty acids in the composition of bile and the transformation of fatty acids in the intestines play an important role in digestion (digestion) and cholesterol metabolism .

Normally, stomach acids are not detected in human urine. On early stages obstructive jaundice and acute pancreatitis small amounts of fatty acids appear in the urine. In the blood, the content and composition of fatty acids changes in diseases of the liver and gall bladder, which makes it possible to use these data in diagnostic purposes. Accumulation of bile in the blood is noted with lesions of the liver parenchyma and difficulty in the outflow of bile. An increase in the content of fatty acids in the blood has a damaging effect on liver cells, causes bradycardia and arterial hypotension, red blood cells, impaired blood clotting processes and a decrease in ESR. With an increase in the concentration of fatty acids in the blood, the appearance of skin itching is characteristic.

With cholecystitis, the content of bile acid in the gallbladder bile is significantly reduced due to a decrease in their formation in the liver and increased absorption of bile acid from the mucous membrane of the gallbladder.

J.k. have a strong choleretic effect, which determines their introduction into the composition choleretic drugs, and also stimulate intestinal motility. Their bacteriostatic and anti-inflammatory effects explain positive effect at local application bile for the treatment of arthritis. In the production of steroid hormone preparations, fatty acids are used as a starting product.

II Bile acids (acida cholica)

organic acids that make up bile and are hydroxylated derivatives of cholanic acid; play an important role in the digestion and absorption of lipids and are the end product of cholesterol metabolism.

1. Small medical encyclopedia. - M.: Medical encyclopedia. 1991-96 2. First health care. - M.: Great Russian Encyclopedia. 1994 3. encyclopedic Dictionary medical terms. - M.: Soviet Encyclopedia. - 1982-1984.

See what “Bile acids” are in other dictionaries:

Bile acids (synonyms: bile acids, cholic acids, cholic acids, cholenic acids) are monocarboxylic hydroxy acids from the class of steroids. Bile acids are derivatives of cholanic acid C23H39COOH, characterized in that... Wikipedia

bile acids- View fatty acids, secreted by the liver, providing emulsification of fats Biotechnology topics EN bile acid ... Technical Translator's Guide

Steroidal monocarboxylic acids, derivatives of cholanic acid, formed in the liver of humans and animals and excreted with bile into the duodenum. In the liver, fatty acids are formed primarily from cholesterol. J.k.,... ...

BILE ACIDS- bile acids, a group of steroid acids (cholanic acid derivatives) that make up bile, are formed in liver cells. The bile acids of mammals include cholic, deoxycholic, chenodeoxycholic, and lithocholic acids, which are in the bile... ...

- (synonyms: bile acids, cholic acids, cholic acids, cholenic acids) monocarboxylic hydroxy acids from the class of steroids. Bile acids are derivatives of cholanic acid C23H39COOH, characterized in that to its ring... ... Wikipedia

Bile, bile (Latin bilis, other Greek χολή) yellow, brown or greenish, bitter in taste, having a specific odor, liquid secreted by the liver and accumulated in the gallbladder ... Wikipedia

- (from other Greek ἀντι against, lat. acidus sour) medications intended for the treatment of acid-related diseases of the gastrointestinal tract by neutralizing hydrochloric acid, which is part of ... ... Wikipedia

Various antacid preparations Antacids (from the Greek ἀντἰ against, Latin acidus sour) medications intended for the treatment of acid-related diseases of the gastrointestinal tract by neutralizing hydrochloric acid, which is part of ... Wikipedia

FAT METABOLISM- fat metabolism, a set of processes for the transformation of neutral fats (triglycerides) in the human and animal body. J. o. consists of the following stages: breakdown of fats entering the body with food and their absorption in the gastrointestinal tract; ... Veterinary encyclopedic dictionary

A secretion continuously produced by the glandular cells of the liver of vertebrates and humans. The liver of an adult produces up to 1.2 liters of fluid per day; in some diseases, there may be an increase or decrease in the formation of glands... ... Great Soviet Encyclopedia

The liver produces bile acids from cholesterol, which are often added to various drugs that help in treatment specific symptoms. The liver is one of the most important organs a person who ensures the normal functioning of the body, therefore it is very important that a person treats liver diseases in a timely manner, takes tests, healthy image life to prevent the development of diseases.

Balance of bile secretion - important factor human health.

Description of elements

When digesting food, all gastrointestinal tract, and all organs perform their functions. In case of failures, in order to accurately establish a diagnosis, the doctor conducts a detailed diagnosis, including various types of tests. If this is not done, liver failure occurs, leading to failures of the entire body. Bile acids are also used in the production of drugs. Recently, drugs containing such acids have been found wide application in the fight against double chins or they are used if patients develop primary forms of cholangitis. Bile acids are solid active derivatives that are practically insoluble in water and come from cholesterol during processing. The process of their production is studied by the science of biochemistry. The structure contains several types of substance.

The first type includes cholic and chenodeoxycholic acids, which are produced from cholesterol, added to glycine and taurine, and then excreted along with bile.
Secondary elements, such as deoxycholic and lithocholic compounds, are formed from the previous species in the large intestine under the influence of bacteria. The absorption process of the lithocholic compound is much worse than that of the deoxycholic compound.

Acid secretion in gallbladder may be disrupted, leading to unhealthy blood composition and disruption of the gastrointestinal tract.

If the patient has chronic cholestasis, then they are produced in large quantities ursodeoxycholic components. By its nature, cholesterol is poorly soluble in water, because the degree of its solubility directly depends on the concentration of lipids and the concentration ratio between lecithin and molar compounds. If the ratio is within normal limits, then micelles are produced. But if the ratio is violated, precipitates of cholesterol crystals form.

In addition to all of the above, bile acids occupy an important position in the absorption of fats in the intestines. Thanks to the transportation of substances, the production of bile secretions is ensured. In the small and large intestines, acids actively influence the transport of water and electrolytes. IN modern times This enzyme is widely used to create drugs that are used to treat ailments associated with the gallbladder. For example, a drug containing ursodeoxycholic acid helps in the treatment of bile reflux.

What function do they perform?

Exist various functions bile acids, including metabolism, which results in the breakdown of fats and the absorption of lipids. The determination of bile acids is quite complex, but it is well studied by biochemistry. Similar connections have great importance when digesting food. The structure consists of primary and secondary compounds that help remove unprocessed particles from the body.

The acids produced by the gallbladder are mainly responsible for the processes of food digestion.

The formation of elements occurs during the processing of cholesterol by the liver, in which it is included in the bile as bile salts. If the patient eats food, the bladder contracts and bile is released into the digestive tract, namely in the duodenum. At this stage, the process of processing fats and assimilation of lipids occurs, and they begin to be absorbed fat soluble vitamins: A, K, D, E.

When the end point is reached small intestine, bile acids begin to enter the blood. Next, the blood ducts flow into the liver, where they become part of the bile, and in the end they are completely eliminated from the body. In addition, bile acids are able to function in other directions. They can be removed from the body only by eliminating excess cholesterol, which is supported by the work of the gastrointestinal tract and the state of the microflora. This may result in properties that are somewhat similar to hormone-like substances. As a result of research, it has been proven that these components can affect the operation of some areas nervous system. At normal conditions urine contains bile acids in small doses.

Synthesis and metabolism

The synthesis of bile acids has two stages of development. The first phase is characterized by the formation of acid esters, after which the connection with glycine or taurine begins, resulting in the appearance, for example, of glycocholic or taurocholic acid. At this time, the process of bile moving through the ducts located inside the liver occurs. In the gallbladder, enzymes are absorbed only in small quantities. After food enters the gastrointestinal tract, the metabolic process begins, in which acids enter the duodenum. As a result of a similar process, when removing from the body 30 grams of enzymes produced in the human body from 2 to 6 times per day, stool about 0.5 grams remain.

Metabolic disorders

Medicine knows cases where the metabolism of bile acids is disrupted. This can be observed if the patient has cirrhosis of the liver, in which hydroxylase activity is reduced. As a result, there is a disruption in the production of cholic acid, which is excreted by the liver. These are factors that contribute to the development of hypovitaminosis or vitamin deficiency in a patient, which leads to blood clotting. Most liver diseases are accompanied by damage to hepatocytes and disruption of their functioning.

Liver diseases, heredity, others external factors can disrupt the normal production of bile acids.

In addition, the main role of paired bile acids in cholestasis is emphasized, that is, a violation of the secretory function of the liver, which begins from the moment bile appears in the bile membrane until the time of the final removal of bile from the duodenal papilla. Decreased performance are also observed with obstruction of the pathways capable of removing bile. Gallstones or pancreatic cancer can reduce the level of bile secretion as the patency of the ducts deteriorates.

Another reason for disruption of the normal production of bile acids is dysbiosis. The disease lowers the level of acidity, resulting in the appearance of a large number of bacteria. As a result of all these factors, deficiency of enzymes such as bile acids occurs. The appropriate drugs for treatment are selected only by the attending physician, who will conduct detailed analysis, and independent therapeutic effects may lead to complications.

The liver not only performs the function of detoxifying the body, but also produces bile. This component is necessary for the digestion process, but how exactly it affects it, what its composition is, not everyone knows.

What is bile

The word bilious is usually used in relation to a person who is gloomy, irritable, and prone to aggression. Such people usually have a dull complexion, and this is no coincidence. Most often, their function of the outflow of bile is impaired, as a result of which it enters the blood, and the presence of bilirubin in it provides the skin and mucous membranes with a characteristic yellow tint. The cause of this pathology is usually liver disease or gallstone disease.

Bile is produced in liver cells and stored in the gallbladder. She has complex composition, includes proteins, bile acids, amino acids, some hormones, inorganic salts, bile pigments. At each meal, it is released into the intestines to crush or emulsify fats and further transport them and bilirubin into the intestines. In the intestine, bile promotes the absorption of fatty acids, calcium salts and fat-soluble vitamins, and participates in the decomposition of triglycerides. In addition, it is the small intestine, as well as the production of pancreatic secretions and gastric mucus.

Having fulfilled its functions, bile is not completely utilized by the body; some of its components are absorbed into the blood and returned through the portal vein back to the liver. These components include bile acids, thyroid hormones, and some pigments.

Cholic acid

Cholic acid is one of the two primary bile acids and is one of the most important components bile. Her chemical formula— C24H40O5, belongs to the group of monocarboxylic acids. In the liver it is synthesized from cholesterol, but not directly, but through several intermediate reactions. The liver of an adult produces approximately 250 mg of this substance per day. It does not enter the gallbladder pure form, and in compounds with taurine (taurocholic acid) and glycine (glycocholic acid). IN small intestine, under the influence of microflora they are converted into deoxycholic acid, most of which (up to 90%) is absorbed through the blood and again enters the liver (approximately 5-6 such turnovers occur per day). The rest of the bile acids are excreted through, and its loss is replenished by the synthesis of new bile acids, including cholic acid, by liver hepatocytes. This acid, along with other bile acids, performs the following functions:

grinding, emulsification and solubilization of fats in the intestines;
participation in the regulation of cholesterol synthesis in the liver;
regulation of bile formation;
has a bactericidal effect;
transport to the intestine of the final product metabolic processes related to hemoglobin (bilirubin);
stimulates intestinal motility;
activates pancreatic lipase;
surfactant effect on cell membranes;
participation in fat absorption;
formation of some steroid hormones;
influence on the nervous system.

With insufficient formation of cholic acid or its complete absence, fats cease to be absorbed and are completely excreted along with feces, which in this case becomes light-colored. Bile with a low content of cholic and other bile acids is usually produced by the body of a person who abuses alcohol. As a result, a person does not receive many things necessary for normal functioning substances, including fat-soluble vitamins, he may develop diseases of the lower intestine, which is not designed for such secretions. Cholic acid is part of the drug Panzinorm Forte, intended to facilitate the digestion of fatty foods.

Food supplement

Dietary supplement E - 1000, sometimes also called cholic acid, bile acid, Cholic Acid, in Russian Federation excluded from the list of approved products because its effect on human health has not been sufficiently studied. There are supplements that have been scientifically proven to be harmful, but cholic acid is not one of them. North America, EU countries, Australia and New Zealand also prohibit its use in Food Industry. However, its use in the preparation of animal feed is permitted.

Bile acids- monocarboxylic hydroxy acids from the class of steroids, derivatives of cholanic acid C 23 H 39 COOH. Synonyms: bile acids, cholic acids, cholic acids or cholenic acids.

The main types of bile acids circulating in the human body are the so-called primary bile acids, which are primarily produced by the liver, cholic and chenodeoxycholic, as well as secondary, formed from primary bile acids in the colon under the influence of intestinal microflora: deoxycholic, lithocholic, allocholic and ursodeoxycholic. Of the secondary acids, only deoxycholic acid participates in the enterohepatic circulation in noticeable quantities, absorbed into the blood and then secreted by the liver as part of bile. In the bile of the human gallbladder, bile acids are found in the form of conjugates of cholic, deoxycholic and chenodeoxycholic acids with glycine and taurine: glycocholic, glycodeoxycholic, glycochenodeoxycholic, taurocholic, taurodeoxycholic and taurochenodeoxycholic acid - compounds also called paired acids. Different mammals have different sets of bile acids.

Bile acids in medicines

Bile acids, chenodeoxycholic and ursodeoxycholic, are the basis of drugs used in the treatment of gallbladder diseases. IN Lately Ursodeoxycholic acid is recognized effective means in the treatment of bile reflux.

In April 2015, the FDA approved the use of Kybella for non-surgical treatment double chins, active substance which is synthetic deoxycholic acid.

At the end of May 2016, the FDA approved the use of the obeticholic acid drug Ocaliva for the treatment of primary biliary cholangitis in adults.

Metabolism of bile acids with the participation of intestinal microflora

Bile acids and esophageal diseases

In addition to hydrochloric acid and pepsin a, secreted in the stomach, components of the duodenal contents: bile acids, lysolecithin and trypsin can have a damaging effect on the mucous membrane of the esophagus when they enter it.

Of these, the most well studied is the role of bile acids, which apparently play a major role in the pathogenesis of esophageal damage during duodenogastric-esophageal reflux. It has been established that conjugated bile acids (primarily taurine conjugates) and lysolecithin have a more pronounced damaging effect on the esophageal mucosa at acidic pH, which determines their synergy with hydrochloric acid in the pathogenesis of esophagitis. Unconjugated bile acids and trypsin are more toxic at neutral and slightly alkaline pH, i.e. their damaging effect in the presence of duodenogastroesophageal reflux is enhanced by drug suppression of acid reflux. The toxicity of unconjugated bile acids is primarily due to their ionized forms, which more easily penetrate the esophageal mucosa. These data may explain the lack of an adequate clinical response to monotherapy with antisecretory drugs in 15-20% of patients. Moreover, long-term maintenance of esophageal pH close to neutral values can act as a pathogenetic factor for epithelial metaplasia and dysplasia (Bueverov A.O., Lapina T.L.).

In the treatment of esophagitis caused by refluxes in which bile is present, it is recommended, in addition to inhibitors proton pump in parallel, prescribe ursodeoxycholic acid drugs. Their use is justified by the fact that under its influence the bile acids contained in the refluxate are converted into a water-soluble form, which is less irritating to the mucous membrane of the stomach and esophagus. Ursodeoxycholic acid has the property of changing the pool of bile acids from toxic to non-toxic. When treated with ursodeoxycholic acid, in most cases symptoms such as bitter belching disappear or become less intense. discomfort in the abdomen, vomiting bile. Research recent years showed that for bile reflux, the optimal dose should be 500 mg per day, divided into 2 doses. The duration of treatment is at least 2 months (Chernyavsky V.V.).

Portosystemic (portocaval) shunts are irregular vascular connections between the hepatic portal vein ( blood vessel, which connects the gastrointestinal tract to the liver) and systemic circulation.

The study of bile acids in blood serum in animals is a highly sensitive and specific method for diagnosing portosystemic shunts in dogs, both extrahepatic and intrahepatic.

Bile acids are the main component of bile. They are formed in the liver, in hepatocytes as a result of cholesterol metabolism. The process of formation of bile acids from cholesterol is multistage. This process is catalyzed by the enzyme 7α-hydroxylase. The activity of this enzyme will depend on the period of starvation of the animal, the presence of cholestasis, liver failure, effects of glucocorticoids. There are primary (cholic and chenodeoxycholic) and secondary bile acids (deoxycholic and lithocholic). Bile acids accumulate in the gallbladder, enter the intestines with bile, and their excess is removed from the body in the urine.

When should serum bile acid testing be used in cats and dogs?

studies often do not reveal changes in the main “liver” parameters. In birds there is an increase liver enzymes(especially AST) is not always associated with liver disease. In horses, hepatobiliary diseases are very often accompanied by increased levels of bile acids. In cows, the level of bile acids can be very variable, so this test is not always effective in animals of this species.

As a rule, many liver diseases are diagnosed very late, with severe damage to the liver parenchyma. Routine biochemical research often do not detect changes in the main “liver” parameters. In birds, an increase in liver enzymes (especially AST) is not always associated with liver disease. In horses, hepatobiliary diseases are very often accompanied by increased levels of bile acids. In cows, the level of bile acids can be very variable, so this test is not always effective in animals of this species.

The test is carried out:

In dogs of breeds predisposed to the development of congenital portocaval anastomosis (anastomoses), as a method early diagnosis bypass followed by closure of the abnormal vessel.
In puppies miniature breeds with retarded growth and development, as a method for diagnosing congenital portosystemic shunts.
If you suspect hidden diseases liver in monogastric animals and birds.
If ammonium urate crystals are detected in the urine (with the exception of dogs of the Dalmatian and English bulldog breeds).
In animals with neurological disorders.
For monitoring in patients with established liver disease.

Dog breeds predisposed to congenital extrahepatic anastomosis:

Yorkshire Terrier
Cairn Terrier
Miniature Schnauzer
Lhasa apso

Dog breeds predisposed to congenital intrahepatic anastomosis:

Retrievers
Irish Wolfhound

Portocaval anastomoses are rare in cats; cases have been described in the literature. of this disease in cats of Persian and Himalayan breeds.

Advantages of the test

The test is easy to perform, few factors unrelated to the liver can affect its results, and is highly sensitive.

Disadvantages of the test

Unable to accurately differentiate various diseases liver.

How to test blood serum for bile acids?

Blood sampling from the animal is carried out strictly on an empty stomach (at least 12 hours of strict fasting). During this period, the animal is prohibited from giving treats and even gnawing on toys. Blood is taken into a special biochemical tube with a separating gel (with a red or yellow cap) in a volume of 0.5-1 ml (only 50 μl of serum is required for the study), a second blood sample is taken 2-4 hours after giving food to the animal. The main thing is that at least 2 hours have passed after eating food and no more than 4! It is acceptable, but not advisable, to conduct a study 6-8 hours after eating food. Within 24 hours, samples must be delivered to the laboratory; if this is not possible, it is recommended to obtain the serum yourself by centrifugation and freeze it (frozen serum can be stored for 5-7 days).

The animal is offered its usual diet or canned food with moderate or even high level fat and protein.

Options for ready-made diets:

Hill's a/d
Roal Canin Convalescence or Recovery
Purina CN

To avoid afternoon lipemia, it is important not to overfeed the animal (otherwise, this will lead to a falsely elevated result)! In horses and birds, the test is performed once on an empty stomach.

Reference intervals for the content of bile acids in blood serum for animals of different species (enzymatic method).

An increase in the level of bile acids after eating more than 25-30 µmol/l in dogs and more than 25 µmol/l in cats is the basis for a liver biopsy.

It is always necessary to conduct a study of paired blood serum samples - this condition is mandatory!!!

Causes of increased serum bile acid levels in dogs

Congenital and acquired portosystemic shunts (PSS)
Cirrhosis of the liver
Liver fibrosis
Microvascular dysplasia of the liver (MVD)
Hepatic neoplasia
Metastatic neoplasia
Chronic active hepatitis
Cholestasis
Steroid hepatitis
Toxic and viral hepatitis

Causes of increased bile acid levels in cats

Cholangiohepatitis
Hepatic lipidosis
Infectious peritonitis (FIP)
Portosystemic shunts

Medicines that affect bile acid levels

Anticonvulsants (phenobarbital)
Cytostatics
Glucocorticoids
Sulfonamides
Mycostatics (intraconazole, ketoconazole)
Antihelmintics (mebendazole)
Respiratory anesthetics (halothane, methoxyflurane)

Factors that reduce bile acid levels

Ileal resection
Malabsorption syndrome
Heavy inflammatory processes in the ileum
Cholecystectomy
Hypotension of the stomach, gallbladder and intestines
Long-term anorexia

Reasons for lower levels of bile acids after meals compared to fasting levels:

Periodic spontaneous contractions of the gallbladder
outside food intake in individual animals
Decreased gastric and intestinal motility

Factors that increase bile acid levels

Pancreatitis
Hyperadrenocorticism
Enterocolitis
SIBO (overgrowth of bacteria in thin section intestines)
Serum hemolysis and chylosis

There is no point in performing a bile acid test in patients with jaundice (bile acid levels will always be high)!

Determination of bile acid levels in puppies is carried out no earlier than sixteen one week old, in foals no earlier than six weeks of age!!!

When prescribing drugs based on ursodeoxycholic acid (Ursofalk, Ursodiol) to animals, it is recommended to discontinue the drug 2 weeks before testing for bile acids!

Dear doctors, remember that there will always be a small percentage of animals with disorders in the system portal vein or liver diseases in which the level of bile acids will not be changed!