A patient has a gallstone blocking the common bile duct. Analyze the expected effects on lipid digestion and fat-soluble vitamin absorption and select the best downstream consequences.

• A. Bile blockage only affects carbohydrate absorption because bile directly hydrolyzes starch into glucose, so only glycemic control will be altered
• B. Bile duct blockage increases gastric pH which causes proteases to inactivate and therefore only protein digestion is impaired while fat digestion remains normal
• C. Complete blockade will cause immediate increases in small intestinal lipase activity that fully compensate for lost bile, preventing any fat malabsorption or vitamin deficiency
• D. Impaired bile delivery to the duodenum reduces fat emulsification and micelle formation, leading to poor triglyceride digestion by pancreatic lipase, decreased absorption of fat-soluble vitamins (A, D, E, K), and likely steatorrhea and vitamin deficiencies

Answer: (D)