Heartburn isn't just uncomfortable - it can also be painful and distressing. This burning sensation in the chest or throat can be caused by either acid reflux, or bile reflux, or a combination of them both.
Though they can be present at the same time, making diagnosis difficult, bile and acid reflux are caused by different things. The main difference is that acid reflux can be the result of lifestyle and can be triggered and worsened by poor diet.
Bile reflux is more the result of structural faults in the digestive tracts. Lifestyle plays no significant role in its occurrence.
So, can changing eating habits ease bile reflux? Actually, as both types of reflux usually occur together, treatment is often the same, and a healthy diet is believed to help alleviate the general discomfort created.
Acid reflux occurs when stomach acids (used to break down food) flow back into the esophagus (the muscle tube that connects the stomach to the mouth, via the throat).
Bile is a substance which has a role further along in the digestive process. It is made in the liver and is used to break down fats and remove toxins. It usually travels from the liver, along the bile duct, to the duodenum (small intestine) just below the stomach.
However, if the valve between the duodenum and stomach is faulty, bile travels further along and into the stomach.
Just like stomach acid, if the ring of muscle between the stomach and the esophagus is leaking, then bile can travel right up to the throat.
The symptoms (as well as heartburn) can include stomach ache, hoarseness, a cough and difficulty in swallowing caused by esophagus inflammation. This could result in permanent damage, which is why it’s important for doctors to differentiate between acid and bile reflux.
Acid blocking medication will usually be recommended for both acid and bile reflux. If the issue is severe then surgery may be the only option. But there are lifestyle and diet changes that may well manage the condition.
For example, it helps with both if you reduce portion sizes of meals. Smaller amounts of food put less pressure on the lower esophageal sphincter. This makes it less prone to leaking acid and bile from the stomach.
Staying upright after meals (rather than laying down) can also help, as it ensures that food flows towards through the digestive system, making it less likely bile will flow back up. This means eating evening meals well in advance of going to bed, to allow digestion to be completed before you lay down.
Managing body weight is important to controlling the problem too, as obesity puts pressure on organs and bodily processes.
Foods that are high in fat take longer to digest, leaving you more vulnerable to bile and acid reflux. The muscles involved in the process of digestion also relax more to accommodate fat, and this can also result in more substances flowing back up.
You may well find that other foods trigger reflux and make discomfort worse, as they relax the lower esophagus sphincter allowing more acid and bile up into the throat. This includes, for example, alcohol, caffeine and chocolate.
Spicy or acidic foods, such as citrus fruits, can also irritate the digestive system, making reflux feel even worse.
There are foods that are good for general health, which also reduce the impact of reflux.
One group of foods that you should include in your diet for bile reflux is those containing soluble fiber. This absorbs bile during digestion and carries it out as a waste product.
The best sources of soluble fiber are whole grains – which as oatmeal, oat bran, barley and rye – and beans.
Perhaps less obvious sources of soluble fiber include Brussels sprouts, eggplant, okra, oranges, grapes, strawberries, and apples.
Adding these things to your meals can help you digest food in a way to reduces the chance of bile reflux.