Question

Alex was prescribed a new medication for headaches that seems to have affected his ability to properly digest or absorb fats. When he returned to his doctor for further analysis, an initial test demonstrated that the enterocyte border appeared healthy and intact. When Alex was dosed with a bolus of triglycerides, it was discovered that the fats were being emulsified into smaller fat droplets in the small intestine, but little to no chylomicrons were found within the lymphatics. However, enterocyte cellular function appeared to be normal because when Alex was dosed with a bolus of free fatty acids, chylomicrons were observed to be formed and were found within Alex's lymphatics. With which aspect of fat digestion has this new medication interfered?

Answer 1

The new medication has interfered in the convertion of triglycerides to fatty acids. We can see that the free fatty acid given is absorbed and seen as chylomicrons in the lymphatic system. But when triglyceride was given no chylomicrons are seen. So from this we can confirm that the convertion of triglyceride is affected. As far fat emulsification is done there is no problem with the bile salt production as they are responsible for the emulsification. The problem is with the action of pancreatic lipase which converts the triglyceride to fatty acids. Either the production of this from the pancreas is altered or the enzyme structure is altered so that it is not able to bind to the substrate. So may sometimes the pH required for the activation may be changed or the enzyme may be degraded.