- This is done in the urine.
- Bile salts are detected in the urine to diagnose various conditions of liver diseases (Jaundice).
- To diagnose obstructive jaundice.
- The postprandial sample is preferred that allows a more sensitive distinction between normal abnormal results as compared to the fasting sample.
- Eating will stimulate secretion.
- The liver assists intestinal digestion by secreting 700 to 1200 mL of bile acids per day.
- Bile is an alkaline, bitter taste, the yellowish-green fluid. Bile salt contains:
- Conjugated bile acids.
- Bile acid is generated from an amino acid, Glycine, and Taurine.
- Definition of bile salts:
- Bile acids conjugated with taurine or glycine in the liver. Sodium or potassium conjugates of these bile acids are called bile salt.
- Primary bile acids are synthesized in the liver.
- Secondary bile acids are produced in the colon by the bacterial action.
- Bile salts are formed when an acid is neutralized by a base.
- Bile salt consists of:
- Sodium glycocholate.
- Sodium taurocholate.
- Potassium and calcium bile salts are also common.
- Bile salts are needed for:
- Facilitate fat absorption.
- Intestinal emulsification.
- Most of the bile salt is actively absorbed in the terminal ileum and return to the liver through the portal circulation for resecretion.
- The recycling of bile salts is termed the enterohepatic circulation.
- Bile salts are made in the liver from cholesterol and these help in the fat absorption. They make them more soluble.
- Bile salts appear in the urine when there is an obstruction to the biliary tract and that will leads to an increase in the bile acids in the blood.
- Bile salts are positive in urine in other liver diseases.
- Cholestasis, retention of bile and bile salts leads to Itching (Pruritus).
- The biliary obstruction prevents the bile salts from entering the duodenum leads to their accumulation in the blood.
- Serum bile salts may increase in liver diseases.
- The level of bile salts correlates with itching.
- This cholestatic itching may be seen in:
- Primary biliary cirrhosis.
- Primary sclerosing cholangitis.
- Intrahepatic cholestasis of pregnancy.
- Hereditary cholestatic syndrome.
- In the bile, deficiency of the bile salt allows cholesterol to precipitates as gall stones.
- Normally bile salts are negative in the urine.
Procedure to detect bile salts in the urine:
- Bile salts can be quantified by:
- Bile salts reduce the surface tension of liquids.
- On this principle, HAY’s test is done.
- Sulfur powder is sprinkled over the surface of urine and it sinks if bile salts are present.
- Sulfur will remain on the surface when bile salts are absent.
Positive bile salt test is seen in:
- Obstructive jaundice.
- Liver diseases with the appearance of jaundice.
Possible References Used
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