When gallstones block the bile salts from moving from the gallbladder into the small intestine, it impairs fat digestion and absorption. Bile salts play a crucial role in fat digestion as they help in emulsifying fats, breaking them down into smaller droplets. This process is important because it increases the surface area of fats available for the lipase enzyme to act upon.

Lipase enzymes are responsible for breaking down fats (triglycerides) into fatty acids and glycerol, which can then be absorbed by the body. However, lipase enzymes are water-soluble, while fats are insoluble in water. This is where bile salts come in. Bile salts act as emulsifiers, which means they surround the fat droplets, breaking them down into smaller droplets called micelles. These micelles can mix with water, allowing the lipase enzyme to access and digest the fats more efficiently.

Without sufficient bile salts reaching the small intestine due to gallstone blockage, fat digestion is impaired. The fat globules remain large and are not adequately emulsified. As a result, the lipase enzymes cannot efficiently act on these large globules and break them down into fatty acids and glycerol. Consequently, the absorption of fats is reduced, leading to malabsorption and potential symptoms such as greasy stools, nutrient deficiencies, and weight loss.

In summary, bile salts play a crucial role in fat digestion by emulsifying fats, increasing their surface area, and enabling lipase enzymes to efficiently break them down into absorbable fatty acids and glycerol. When gallstones block the movement of bile salts, fat digestion is impaired, leading to malabsorption of fats.

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