From the Guidelines
Ox bile supplements can improve fat absorption in patients with short bowel syndrome, particularly those with a depleted bile salt pool due to the loss of over 100 cm of ileum. The use of ox bile supplements has been found to improve fat absorption 1 without aggravating stool losses. This is because ox bile provides bile acids that help break down dietary fats in the small intestine, making them easier to digest and absorb.
Key Benefits of Ox Bile Supplements
- Improve fat absorption in patients with short bowel syndrome
- particularly beneficial for those with a depleted bile salt pool due to ileum loss
- Help reduce symptoms like bloating, gas, and fatty stools
- Improve absorption of fat-soluble vitamins (A, D, E, and K)
Important Considerations
- Ox bile supplements should be used with caution in patients with certain gastrointestinal conditions
- Starting with a lower dose and gradually increasing it can help minimize potential side effects like digestive discomfort or diarrhea
- The availability of ox bile supplements may be limited 1
Dosage and Administration
- Typical dosages range from 125-500mg taken with meals containing fat
- Individual needs may vary, and dosage should be guided by a healthcare professional
- Ox bile supplements should be administered about 30 minutes before meals and at bedtime to maximize their effectiveness 1
From the FDA Drug Label
The sites of the drug’s therapeutic actions are in the liver, bile, and gut lumen. Ursodiol suppresses hepatic synthesis and secretion of cholesterol, and also inhibits intestinal absorption of cholesterol
The beneficial effects of ox bile (which contains ursodeoxycholic acid) on digestion are:
- Suppression of hepatic synthesis and secretion of cholesterol
- Inhibition of intestinal absorption of cholesterol
- Solubilization of cholesterol in bile, making it less likely to form gallstones 2
From the Research
Beneficial Effects of Ox Bile on Digestion
The beneficial effects of ox bile on digestion can be summarized as follows:
- Ox bile can reduce steatorrhea (excess fat in the stool) in patients with bile acid depletion due to ileectomy 3, 4.
- It can improve the digestion of fat, with one study showing a 50% increase in fat digestion when bile was given by mouth in pill form 5.
- Ox bile can also improve the digestion of nitrogenous food, possibly due to better digestion of fat, which allows for more thorough exposure of protein elements to digestive juices 5.
- It has a cholagogue effect, increasing the secretion of bile solids, which can aid in digestion and absorption of nutrients 5.
- Ox bile may not necessarily increase stool weight in patients with defective fat absorption due to bile acid malabsorption, and can be tried with caution to diminish steatorrhea 3.
- In some cases, ox bile can improve diarrhea by correcting fat malabsorption, which can mitigate the deleterious effect of bile salts on small bowel absorption of water and electrolytes 4.