Biliary function - Heads-up

Here is a simple diagram showing the biliary system at rest; the fasting state. Bile flows from the liver into the gallbladder because the sphincter valve is closed. The gallbladder removes water from the liver bile so that the bile in the gallbladder is concentrated. When the maximum concentration level in the gallbladder has been reach the pressure in the biliary increases until it starts to seep out of the sphincter valve into the duodenum. Bile will continue to seep out the valve until you consume something that requires bile. Sometimes the smell of cooking can trigger the release of bile.

When you eat something that requires bile, particularly fat, the gallbladder contracts and at the same time the sphincter valve tightens causing the pressure in the biliary system to increase about 18 times. This causes the bile ducts to increase in diameter because they are now holding the bile that was in the gallbladder. This getting bigger is called dilation; hence we often say in this forum that the flush potion causes the bile ducts to dilate. Bile is released into the duodenum as a series of spurts about 10 seconds apart, as the fat becomes emulsified the demands for bile decrease. Also at the same time bile is still flowing from the liver. As bile is used up the gallbladder contracts more to maintain the pressure inside the biliary system.

Bile is prevented from entering the pancreatic duct because the sphincter valve is a complicated twin valve that directs both pancreatic juices and bile to the duodenum.

The contraction of the gallbladder doesn’t cause the spurts of bile into the duodenum it is the sphincter valve that does this. The gallbladder provides and maintains the internal pressure; as the pressure reduces because bile is being used the gallbladder contracts more. The pressure exerted by the gallbladders muscles is fairly constant but it gets smaller or contracts because the bile moves into the bile ducts and as the bile gets used the gallbladder gets smaller in volume until its maximum contraction of about 75% is reached

If the food entering the duodenum is acid it has to be neutralised before it enters the small intestines. This is achieved by bicarbonate that comes mainly from the pancreatic duct but also from liver bile and the duodenum itself. Acid in the duodenum triggers the liver to excrete bicarbonate into the bile ducts and this swells the volume of bile; hence the bile-flow from the liver increases. This in turn increases the flow of bile in the common bile duct and into the duodenum.

After the meal passes through the duodenum the sphincter valve stops releasing bile and hence the flow of bile into the duodenum ceases and the bile ducts start to refill with bile from the liver. The gallbladder start to fill with bile also and sometime later the gallbladder muscle relaxes, it expands and a rapid refilling with bile occurs. Much of this bile is normally recycled bile which is reabsorbed through the intestines and liver but under the Liver Flush protocol the liver is forced to make fresh bile. In time the sphincter valve returns the system to its normal pressure in a way that prevents a negative pressure allowing food in the duodenum flowing into the bile duct. This is why the gallbladder stays contracted for a long time, 60 to 120 minutes or more. Consequently the peak flow of bile which can occurs 10 to 20 minutes after eating which is well before the maximum contraction time of the gallbladder.

Without a gallbladder you are dependant upon the liver producing all the bile but the biliary system pressure still increases and there is a peak flow of bile around 10 to 20 minutes. For people without a gallbladder it could be argued that consuming a series of smaller flush potion every 30 minutes may be more beneficial. I don’t know for sure.

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