Cholemia


Cholemia

Description, Causes and Risk Factors:

The presence of bile salts in the circulating blood.

Bile is a thick yellow fluid made by the liver. It helps you digest the fat in your diet. Between meals, liver bile is stored in the gallbladder, a little sac beneath the liver. When you eat, the gallbladder squeezes and releases the stored bile salts into the small intestine to help with digestion. After food is digested and absorbed, the bile salts are reabsorbed at the end of the small intestine and recycled to be used over and over again. When the gallbladder is surgically removed, the liver must make more bile salts, and more are released between meals beca use there is no place to store them. The increased amount of bile salts can sometimes overwhelm the small intestines' capacity to reabsorb them. The excess spills over into the large intestine, or colon, where bile acts somewhat like a laxative, leading to diarrhea.

Formerly the occurrence of either bile pigments or bile salts in the blood would have been regarded as indicative of abnormal conditions. The bile pigments were assumed to be formed almost exclusively in the liver from hemoglobin liberated on disintegration of red blood cells and then discharged in the bile. Bile pigments in the blood thus became an index of some interference with the normal secretion and discharge of the hepatic secretion in which they are present. Today, thanks to the work of several investigators, it seems assured that bile pigments may have an extrahepatogenous origin. They can be formed in the body even under conditions in which the liver is excluded from participation. The occurrence of bile pigment in the blood in some quantity thus becomes an inevitable consequence; abnormality consists in an excessive content in the circulating medium.

The supposition that there might be small amounts of bile salts in normal blood arose from certain considerations which are not pertinent to the present communication. The known association between bile salts and lipoids makes the supposition plausible, particularly when considering how the latter are transported in the blood. Furthermore it is at least conceivable that the liver fails to pick out quantitatively the bile salts in the portal circulation; or that bile salts might find their way into the systemic circulation via the lymphatic system. The relatively large amounts of cholesterol and of cholesteryl esters in blood would be expected to counteract any haemolytic effect of bile salts.

RESEARCH:Laboratory investigations into cholestatic liver disease and the effects of cholemia on organ function are long-standing subjects of scientific enquiry. A widely-used strategy to investigate these topics relies on animal-based research using experimental animal models. Targeted inactivation of the spgp gene, the gene responsible for expressing the bile salt export pump (BSEP) in the hepatocyte canalicular membrane impairs the canalicular secretion of bile salts resulting in systemic cholemia. The results of in vitro experiments have established bile acids as pro-oxidants and the collection of unambiguous in vivo data on the pro-oxidant activity of bile acids in the existing models of cholemia cannot be done. Therefore, we decided to use these genetically modified mice to determine whether this model of cholemia has evidence of extrahepatic or systemic oxidative stress, one of the features of cholestatic liver disease.

Cholemia

The transgenic mouse model of cholemia has an intact enterohepatic circulation and is uncomplicated by the adverse consequences of hepatotoxins or biliary surgery. Hepatocellular injury, as well as plasma and tissue accumulation of bilirubin and other liver-derived compounds are also negligible. Although this preliminary study could not establish a causal relationship between cholemia and oxidative stress, we believe this model is worthy of further investigation to study the impact of short-term and long-term cholemia on diverse physiological and biochemical functions such as trying to establish a causal role for bile acids in the development of oxidative stress in cholestatic liver disease.

Symptoms:

    Yellow tinge to skin and whites of eyes.

  • Scleral jaundice.

  • Fatigue.

  • Nausea.

Diagnosis:

Since there is no specific diagnostic test for this condition. The physician usually ask questions about your health history in general and specifically about the change in bowel habits. A physical examination is then performed. Special tests of blood and stool samples may be requested. In most cases, the doctor will need to examine the lining of the colon with a "scope" test such as colonoscopy to be sure that colitis and cancer are not present. Every case is a little different and it is the doctor's job to determine which tests are necessary to confirm the diagnosis.

Treatment:

In treating Cholemia the objective is to prevent the rapid breakdown of red blood cells that's causing the level of bile salts to build up in the blood. In cases of infections, such as malaria, the use of medication to treat the underlying infection is usually recommended. For genetic blood disorders, such as sickle cell anemia or thalassemia, blood transfusions may be required to replace the red blood cells. Gilbert's syndrome doesn't usually require treatment because the jaundice associated with the condition isn't particularly serious and doesn't pose a serious threat to health.

In severe cases, there's little that can be done to repair any liver damage, although the liver can often repair itself over time. Therefore, the aim of treatment is to prevent any further liver damage occurring. For liver damage that's caused by infection, such as viral hepatitis or glandular fever, anti-viral medications may be used to help prevent further damage. If the damage is due to exposure to harmful substances, such as alcohol or chemicals, avoiding any further exposure to the substance is recommended. In severe cases of liver disease, a liver transplant is another possible option. However, only a small number of people are suitable candidates for a transplant and the availability of donated livers is limited.

There are no special foods to eat or to avoid. It is important that you eat a well-balanced diet which includes lots of vegetables, fruit and whole wheat cereals, including bread.

NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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