Bile reflux
- Bile reflux means the flow of digestive fluid (bile) produced in the liver into the stomach or esophagus (the tube connecting the stomach and mouth)
- Bile reflux may also be accompanied by acid reflux, which means that stomach acids rise up into the esophagus. However, bile and acid reflux are different disorders
- In reflux, the role of bile is questionable Bile reflux is suspected if the patient still has a reflux problem despite taking strong antacid medications.
- Unlike acid reflux, bile reflux is more difficult to treat with diet or lifestyle changes. Treatment mainly includes medicines, but in severe cases, surgical intervention as well
Bile is a greenish-yellow fluid that is important for digesting fats and removing old blood cells and certain toxins from the body. Bile is produced in the liver and stored in the gallbladder
When the food contains at least a small amount of fat, the gallbladder receives a signal and releases bile, which flows through small tubes (bile ducts) into the upper part of the small intestine (duodenum).
Bile reflux into the stomach - Bile and food mix in the duodenum Food moves into the intestine through the pyloric valve This valve is a muscular tissue located at the opening of the stomach Normally, it is taken to pass a small amount of food at a time, which is not enough for the digestive juices to go up into the stomach from the duodenum. In most cases of bile reflux, the valve fails to close and bile backs up into the stomach
Bile reflux into the esophagus - Bile and stomach acid rise into the esophagus if the second muscular valve (lower esophageal sphincter) is also dysfunctional. The lower esophageal sphincter separates the esophagus from the stomach The valve normally opens to allow small amounts of food to pass from the esophagus to the stomach If the valve is weak or abnormally dull, bile and acid rise up into the esophagus
What causes bile reflux? Possible causes of bile reflux include:
- Surgical complications Stomach surgery, such as gastrectomy or narrowing of part of the stomach for weight loss, can be complicated by reflux.
- Stomach ulcer Stomach ulcers can block the pyloric valve, which prevents the stomach from emptying in time Delayed food increases pressure in the stomach, causing bile and acid to be regurgitated
- Gall bladder operations (cholecystectomy) Patients who have had their gallbladder removed often report reflux problems
Distinguishing bile reflux from acid reflux is difficult The signs and symptoms are generally similar, and the two conditions often occur together It is not known what role bile plays in the development of reflux
Signs and symptoms of bile reflux include:
- Pain in the upper abdomen, which may be severe
- Frequent heartburn – a burning sensation in the chest that spreads to the esophagus, often accompanied by a bitter taste in the mouth
- Nausea
- Vomiting,
- If you have been diagnosed with gastroesophageal reflux disease but medications are not helping you properly, contact your doctor You may need additional treatment for bile reflux
