Skip to main content
SpringerLink
Log in
Book cover

Integrative and Functional Medical Nutrition Therapy pp 221–233Cite as

The Enterohepatic Circulation

  • Chapter
  • First Online:

  • 2529 Accesses

Abstract

The term “Enterohepatic circulation” (EHC) refers to the circulation of metabolites from the intestine to the liver and back to the intestine. Since the first use of the term in 1923, understanding of the detailed physiology, microanatomy, and biochemistry, and of interactions between organs and tissues, has grown dramatically. There are many known approaches to improve the health of the EHC, but most are not taught as widely as they could be. Learning to apply principles of nutritional therapeutics will make these approaches available to more physicians and health care providers and their patients.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Malik MY, Jaiswal S, Sharma A, Shukla M, Lal J. Role of enterohepatic recirculation in drug disposition: cooperation and complications. Drug Metab Rev. 2016;48(2):281–327. https://doi.org/10.3109/03602532.2016.1157600.

    Article  CAS  PubMed  Google Scholar 

  2. Broun GO, McMaster PD, Rous P. Studies on the total bile: IV. The enterohepatic circulation of bile pigment. J Exp Med. 1923;37(5):699–710. PMID: 19868754.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Manwaring WH. Enterohepatic circulation of estrogens. Cal West Med. 1943;59(5):257. PMID: 18746637.

    CAS  PubMed  PubMed Central  Google Scholar 

  4. Lorber SH, Shay H. Enterohepatic circulation of bromsulphalein. J Clin Invest. 1950;29(6):831. PMID: 15436781.

    CAS  PubMed  Google Scholar 

  5. Siperstein MD, Hernandez HH, Chaikoff IL. Enterohepatic circulation of carbon 4 of cholesterol. Am J Phys. 1952;171(2):297–301. https://doi.org/10.1152/ajplegacy.1952.171.2.297.

    Article  CAS  Google Scholar 

  6. Myant NB. Enterohepatic circulation of thyroxine in humans. Clin Sci. 1956;15(4):551–5. PMID: 13374940.

    Article  CAS  PubMed  Google Scholar 

  7. Acocella G, Muschio R. Demonstration of the existence, in man of an entero-hepatic circulation of rifamycin SV. Riforma Med. 1961;75:1490–3. PMID: 13859193.

    CAS  PubMed  Google Scholar 

  8. Krebs M. The enterohepatic circulation of endogenous and exogenous substances. Med Welt. 1963;39:1967–72. PMID: 14087819.

    CAS  PubMed  Google Scholar 

  9. Mason HS, North JC, Vanneste M. Microsomal mixed-function oxidases: the metabolism of xenobiotics. Fed Proc. 1965;24(5):1172–80. PMID:4378722.

    CAS  PubMed  Google Scholar 

  10. Shanahan F. The host-microbe interface within the gut. Best Pract Res Clin Gastroenterol. 2002;16(6):915–31. PMID: 12473298.

    Article  PubMed  Google Scholar 

  11. Furness JB, Callaghan BP, Rivera LR, Cho HJ. The enteric nervous system and gastrointestinal innervation: integrated local and central control. In: Lyte M, Cryan JF, editors. Microbial endocrinology: the microbiota-gut-brain axis in health and disease. Advances in experimental medicine and biology, vol. 817. New York: Springer; 2014. p. 39–71.

    Chapter  Google Scholar 

  12. Furness JB. Integrated neural and endocrine control of gastrointestinal function. In: Brierley S, Costa M, editors. The enteric nervous system, advances in experimental medicine and biology 891. Cham: Springer; 2016. p. 159–73.

    Chapter  Google Scholar 

  13. Pavlovic N, Stanimirov B, Mikov M. Bile acids as novel pharmacological agents: the interplay between gene polymorphisms, epigenetic factors and drug response. Curr Pharm Des. 2017;23(1):187–215. https://doi.org/10.2174/1381612822666161006161409.

    Article  CAS  PubMed  Google Scholar 

  14. Zhu C, Fuchs CD, Halibasic E, Trauner M. Bile acids in regulation of inflammation and immunity: friend or foe? Clin Exp Rheumatol. 2016;34(4 Suppl 98):25–31. PMID: 27586800.

    PubMed  Google Scholar 

  15. Feldman M, Friedman LS, Brandt LJ, editors. Sleisenger and Fordtran’s gastrointestinal and liver disease: pathophysiology, diagnosis, management. 10th ed. Saunders; 2016.

    Google Scholar 

  16. Katz N, Jungermann K. Autoregulatory shift from fructolysis to lactate gluconeogenesis in rat hepatocyte suspensions. The problem of metabolic zonation of liver parenchyma. Hoppe Seylers Z Physiol Chem. 1976;357(3):359–75.

    Article  CAS  PubMed  Google Scholar 

  17. Gebhardt R, Matz-Soja M. Liver zonation: novel aspects of its regulation and its impact on homeostasis. World J Gastroenterol. 2014;20(26):8491–504.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Rappaport AM. The structural and functional unit in the human liver (liver acinus). Anat Rec. 1958;130(4):673–89.

    Article  CAS  PubMed  Google Scholar 

  19. Matsumoto T, Kawakami M. The unit-concept of hepatic parenchyma – a re-examination based on angioarchitectural studies. Acta Pathol Jpn. 1982;32(Suppl 2):285–314. PMID: 7187579.

    Google Scholar 

  20. Matsumoto T, Komori R, Magara T, Ui T, Kawakami M, Tokuda T, Takasaki S, Hayashi H, Jo K, Hano H, Fujino H, Tanaka H. A study on the normal structure of the human liver, with special reference to its angioarchitecture. Jikeikai Med. 1979;26:1–40.

    CAS  Google Scholar 

  21. Miller-Keane OM. Miller-Keane encyclopedia and dictionary of medicine, nursing, and allied health. 7th ed. Saunders; 2003.

    Google Scholar 

  22. Centers for Disease Control and Prevention (CDC). Fourth national report on exposure to environmental chemicals. February 2015. https://www.cdc.gov/biomonitoring/pdf/FourthReport_UpdatedTables_Feb2015.pdf.

  23. Herbst AL, Ulfelder H, Poskanzer DC. Adenocarcinoma of the vagina. Association of maternal stilbestrol therapy with tumor appearance in young women. N Engl J Med. 1971;284(15):878–81. https://doi.org/10.1056/NEJM197104222841604.

    Article  CAS  PubMed  Google Scholar 

  24. Wingspread Conference 1991. Our stolen future: consensus statements. Wingspread Conference Center, Racine, Wisconsin. July 1991. Accessed: http://www.ourstolenfuture.com/consensus/wingspread1.htm.

  25. Anzenbacher P, Zanger UM, editors. Metabolism of drugs and other xenobiotics. Weinheim: Wiley-VCH Verlag & Co. KGaA; 2012.

    Google Scholar 

  26. Genetics Home Reference. Your guide to understanding genetic conditions. U.S. National Library of Medicine. Accessed: https://ghr.nlm.nih.gov/

  27. Sim SC, Ingelman-Sundberg M. The human cytochrome P450 (CYP) allele nomenclature website: a peer-reviewed database of CYP variants and their associated effects. Hum Genomics. 2010;4(4):278–81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Rodriguez-Arcas MJ, Garcia-Jimenez E, Martinez-Martinez F, Conesa-Zamora P. Role of CYP450 in pharmacokinetics and pharmacogenetics of antihypertensive drugs. Farm Hosp. 2011;35(2):84–92.

    Article  CAS  PubMed  Google Scholar 

  29. Lee SST, Buters JTM, Pineau T, Fernandez-Salguero P, Gonzalez FJ. Role of CYP2E1 in the hepatotoxicity of acetaminophen. J Biol Chem. 1996;271:12063–7.

    Article  CAS  PubMed  Google Scholar 

  30. Iida A, Saito S, Harigae S, Osawa S, Mishima C, Kondo K, Kitamura Y, Nakamura Y. Catalog of 46 single-nucleotide polymorphisms (SNPs) in the microsomal glutathione S-transferase 1 (MGST1) gene. J Hum Genet. 2001;46(10):590–4.

    Article  CAS  PubMed  Google Scholar 

  31. Hollman AL, Tchounwou PB, Huang HC. The association between gene-environment interactions and diseases involving the human GST superfamily with SNP variants. Int J Environ Res Public Health. 2016;13(4):379.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Stocker R. Antioxidant activities of bile pigments. Antioxid Redox Signal. 2004;6(5):841–9.

    CAS  PubMed  Google Scholar 

  33. Streutker CJ, Huizinga JD, Driman DK, Riddell RH. Interstitial cells of Cajal in health and disease. Part I: normal ICC structure and function with associated motility disorders. Histopathology. 2007;50(2):176–89. https://doi.org/10.1111/j.1365-2559.2006.02493.x.

    Article  CAS  PubMed  Google Scholar 

  34. Harmsen HJ, de Goffau MC. The human gut microbiota. Adv Exp Med Biol. 2016;902:95–108.

    Article  PubMed  Google Scholar 

  35. Jandhyala SM, Talukdar R, Subramanyam C, Vuyyuru H, Sasikala M. Role of the normal gut microbiota. World J Gastroenterol. 2015;21(29):8787–803.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Konkel L, Danska J, Mazmanian S, Chadwick L. The environment within: exploring the role of the gut microbiome in health and disease. Environ Health Perspect. 2013;121(9):a276–1281.

    PubMed  PubMed Central  Google Scholar 

  37. Krautkramer K, et al. Diet-microbiota interactions mediate global epigenetic programming in multiple host tissues. Mol Cell. 2016;64(5):982–92.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Langhendries JP, Paquay T, Hannon M, Darimont J. Intestinal flora in the neonate: impact on morbidity and therapeutic perspectives. Arch Pediatr. 1998;5(6):644–53. PMID: 9759211.

    Article  CAS  PubMed  Google Scholar 

  39. Kell DB, King RD. On the optimization of classes for the assignment of unidentified reading frames in functional genomics programmes: the need for machine learning. Trends Biotechnol. 2000;18(3):93–8. PMID: 10675895.

    Article  CAS  PubMed  Google Scholar 

  40. Gerson M. The second brain. New York: Harper Collins; 1998.

    Google Scholar 

  41. Parzanese I, Qehajaj D, Patrinicola F, Aralica M, Chiriva-Internati M, Stifter S, Elli L, Grizzi F. Celiac disease: from pathophysiology to treatment. World J Gastrointest Pathophysiol. 2017;8(2):27–38. https://doi.org/10.4291/wjgp.v8.i2.27.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Bland J. The gut mucosal firewall and functional medicine. Integr Med (Encinitas). 2016;15(4):19–22.

    Google Scholar 

  43. Damms-Machado A, Louis S, Schnitzer A, Volynets V, Rings A, Basral M, Bischoff SC. Gut permeability is related to body weight, fatty liver disease, and insulin resistance in obese individuals undergoing weight reduction. Am J Clin Nutr. 2017;105(1):127–35.

    Article  CAS  PubMed  Google Scholar 

  44. Latorre R, Sternini C, De Giorgio R, Greenwood-Van Meerveld B. Enteroendocrine cells: a review of their role in brain-gut communication. Neurogastroenterol Motil. 2016;28(5):620–30. https://doi.org/10.1111/nmo.12754.

    Article  CAS  PubMed  Google Scholar 

  45. Campana A, editor. Steimer Th. Steroid hormone metabolism. Geneva Foundation for Medical Education and Research; 2016.

    Google Scholar 

  46. Cuvelier C, Demetter P, Mielants H, Veys EM, De Vos M. Interpretation of ileal biopsies: morphological features in normal and diseased mucosa. Histopathology. 2001;38(1):1–12.

    Article  CAS  PubMed  Google Scholar 

  47. Cho I, Blaser MJ. The human microbiome: at the interface of health and disease. Nat Rev Genet. 2012;13(4):260–70. https://doi.org/10.1038/nrg3182.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Cummings JG. The colon: absorptive secretory and metabolic functions. Digestion. 1975;13(4):232–40.

    Article  CAS  PubMed  Google Scholar 

  49. The digestive system anatomical chart. ISBN: 9781587790072.

    Google Scholar 

  50. Schiff ER, Maddrey WC, Sorrell MF, editors. Schiff’s diseases of the liver. 11th ed. Wiley-Blackwell; 2012.

    Google Scholar 

  51. Furness JB. The enteric nervous system. Oxford: Wiley-Blackwell; 2006.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Family Medicine, Northridge, CA, USA

    Robert C. Barton Jr.

Authors
  1. Robert C. Barton Jr.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Robert C. Barton Jr. .

Editor information

Editors and Affiliations

  1. Noland Nutrition, Burbank, CA, USA

    Diana Noland

  2. Professor Emeritus, School of Medicine, University of Kansas Health System, Kansas City, KS, USA

    Jeanne A. Drisko

  3. Department of Dietetics & Nutrition, University of Kansas Medical Center, Kansas City, KS, USA

    Leigh Wagner

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Barton, R.C. (2020). The Enterohepatic Circulation. In: Noland, D., Drisko, J., Wagner, L. (eds) Integrative and Functional Medical Nutrition Therapy. Humana, Cham. https://doi.org/10.1007/978-3-030-30730-1_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-30730-1_16

  • Published:

  • Publisher Name: Humana, Cham

  • Print ISBN: 978-3-030-30729-5

  • Online ISBN: 978-3-030-30730-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation