Bile Physiology and Pathophysiology: A Comprehensive Narrative Review

Alexandre Tavartkiladze, Russel J. Reiter

Abstract: Bile is a complex biological fluid produced by the liver and delivered to the intestine through a highly regulated hepatobiliary network. Beyond its classical role in lipid emulsification and absorption, bile acids act as endocrine signals that integrate hepatic metabolism, intestinal barrier function, and the gut microbiome. This review summarizes key aspects of bile composition, cellular mechanisms of bile formation by hepatocytes and cholangiocytes, enterohepatic circulation, neuro-hormonal regulation, and clinically relevant consequences of dysregulation, including cholestasis, bile acid diarrhea, gallstone disease, malabsorption of fat-soluble vitamins, and post-cholecystectomy physiology. Special attention is given to the bidirectional crosstalk between bile acids and the intestinal microbiota and to age-, stress-, and inflammation-related modifiers of biliary homeostasis.

Keywords: bile physiology, enterohepatic circulation, bile acids, cholestasis, microbiome interaction

How to Cite?: Alexandre Tavartkiladze, Russel J. Reiter, "Bile Physiology and Pathophysiology: A Comprehensive Narrative Review", Volume 14 Issue 12, December 2025, International Journal of Science and Research (IJSR), Pages: 2189-2197, https://www.ijsr.net/getabstract.php?paperid=SR251219204625, DOI: https://dx.doi.org/10.21275/SR251219204625