Assignment Case 3: The Liver
Instructions:
Answer this question : Case 3: What is the digestive function of the liver?
Describe the role of bile and how its release is controlled. How does liver cirrhosis disrupt this function? (500 words, +/- 10%)
Solution
Assignment Case 3: The Liver
Introduction
Science has proven the fact that the liver is responsible for better functioning of the digestive system. As such the liver is associated with the production of bile which has proven useful in digestion. This essay transcends a discussion of the basic function of the liver in digestion, the role of bile as well as how it is controlled, and a discussion of how liver cirrhosis is responsible in the disruption of bile production.
Part A: Digestive Function of The Liver
According to Hendry, Farley, McLafferty, and Johnstone (2014), the liver, one of the second largest glands in the body, plays a major role in digestion through its production of bile. As such, its function in the production of bile makes it an endocrine gland. As such, the core functions of liver in the digestion system of an individual’s as stipulated by Sherwood (2013), includes; metabolism of food nutrients such as lipids, protein, and carbohydrates from the digestive system as well as the secretion of bile, a salt which is imperative in the absorption and digestion of fat in our bodies. Furthermore, the liver takes parts in synthesising plasma proteins such as albumin, globulins, prothrombin and fibrinogen (Tortora & Derrickson, 2013).
Part B: Role of Bile and How it is Controlled
Hendry, Farley, McLafferty, and Johnstone (2014) suggest that bile has no enzymes and it is vital in the digestion process as it dilutes and neutralises stomach acids. Bile has two significant roles in digestion. First, it emulsifies lipid aggregates which in turn increases the surface area of fat to allow for digestion of lipases. Second, the liver plays a role in transporting lipids as well as solubilising them to micelles.
In defining the dynamics of bile, Sherwood (2013) suggests that bile is secreted due to liver response to hormones secretin and cholecystokinin. Hormone cholecystokinin is responsible for gall bladder contraction to trigger bile production into the duodenum. As mentioned earlier bile breaks down fats mechanically through emulsification process. As such, bile salts are reabsorbed in the ileum and re-absorbed back into the liver. Furthermore, since cholesterol excreted in bile, excessive cholesterol can trigger gallstones. Bile is controlled the release of cholecystokinin and secretin.
If fat is present in the duodenum, cholecystokinin is produced and contracts the bile duct and gallbladder to be delivered to the gut. On the other hand, the presence of an acid in the duodenum will trigger secretin which stimulates the bile duct to release water and bicarbonate that expands the volume bile and increases flow into the ileum.
Part C: How Liver Cirrhosis Disrupts Bile Production
According to Tortora and Derrickson (2013), liver cirrhosis occurs when liver cells undergo necrosis and the hepatocytes are substituted with fibrosis- congealed and scarred tissue. As such, these alterations change the normal functioning of the liver. As such, fibrosis can make the liver to alter the productions of bile. Under normal conditions, bile is reabsorbed into the bloodstream and goes back to the liver from the ileum. Individuals with liver cirrhosis will have difficulties in reabsorbing the bile salts as such it will lead to unequal distribution of bile salts to emulsify fats in the body. Furthermore, Zhou, Zhang, and Qiao (2014) indicate that bile ducts become faulty in a patient suffering from liver cirrhosis. As such, the flow and production of bile to a patient suffering from Liver Cirrhosis will be altered significantly leading to accumulation of fat and irregular endocrine system in the body.
Conclusion
After
an intensive research regarding the liver and its salient function of
digestion, evidence-based practice entails that nurses must have the necessary
knowledge involved in human physiology to understand the patient suffering from
any type of liver disease. As such, gaining knowledge regarding the function of
the liver and understanding how bile is controlled as well as altered by
diseases such as liver cirrhosis is imperative. Evidently, liver also performs
other function in relation to the endocrine system, not just the digestive
system.
References
Hendry, C., Farley, A., McLafferty, E., & Johnstone, C. (2014). The digestive system: part 2. Nursing Standard, 28(25), 37–44. https://doi.org/10.7748/ns2014.02.28.25.37.e7459
Sherwood, L. (2013). Human Physiology : From Cells to Systems (8th ed.). Belmont CA: Brooks/Cole, Cengage Learning.
Tortora, G. J., & Derrickson, B. (2013). Essentials of anatomy and physiology. Wiley.
Zhou, W. C., Zhang, Q. B., & Qiao, L. (2014). Pathogenesis of liver cirrhosis. World Journal of Gastroenterology, 20(23), 7312–7324. https://doi.org/10.3748/wjg.v20.i23.7312