Bile Reflux

What is Bile Reflux?

Bile reflux happens when bile, the digestive fluid produced in the liver, backs up into the stomach and esophagus. While it can produce symptoms similar to acid reflux, when stomach acid backs up into the esophagus, bile reflux isn’t as easy to treat with medications.

The pyloric valve between the stomach and small intestine, and the lower esophageal sphincter between the esophagus and stomach, normally close in a way that prevents bile from backing up. When they don’t function correctly, and bile reflux occurs, it is often because of a complication from gastric bypass surgery for weight loss, the result of surgery to remove the gallbladder that traditionally stores bile, or a sign of a peptic ulcer.

Bile can be corrosive and can damage your stomach and esophageal linings, which can lead to other issues including increased cancer risk and weight loss. Your doctor can perform tests to determine if you are suffering from bile reflux exclusively or in combination with acid reflux.

What are the Symptoms of Bile Reflux?

The symptoms of bile reflux and acid reflux are very close, and you may actually experience both.

Symptoms include

The most common signs include consistent heartburn; moderate to severe pain in your upper abdomen; nausea and vomiting, especially of yellow-green bile; and throat irritation that causes a cough or hoarseness.

If you are suffering from bile reflux instead of acid reflux, you may notice more severe symptoms after eating fatty meal, as fat triggers increased release of bile to aid digestion.

Bile Reflux Causes

The greenish-yellow liquid known as bile is essential to proper food digestion in the human body, but there can be some troubling complications when things go amiss. The pyloric valve is the name of the heavy muscle ring which regulates the release of food into the upper portion of the small intestine known as the duodenum where it mixes with bile in order to digest the food. However, bile reflux can occur when this bile is allowed to seep into the stomach. Surgery complications are some of the most prevalent causes of bile reflux with procedures such as gastric surgery, even a gastrectomy or total removal of the stomach, as well as gastric bypass surgery for weight loss leading to the majority of cases. Also, peptic ulcers and gallbladder surgery can lead to similar issues. The lower esophageal sphincter can also malfunction which leads to a case of bile reflux into the esophagus rather than the stomach.

How is Bile Reflux Treated?

It’s important to treat reflux because, in addition to causing discomfort, it can increase your chances of developing esophageal cancer. Treating bile reflux is more difficult than managing acid reflux, and traditional reflux medications may not help.

Treatment includes

Your doctor may prescribe a drug that will reduce your body’s production of bile.

Diversion surgery can also help bile reflux. A procedure that diverts bile from the stomach and moves it further into the small intestine can often reduce symptoms and discomfort.

Bile Reflux Prevention

Bile reflux can be quite difficult to prevent, but there are some ways to limit the body’s vulnerability. First, alcohol consumption should be very limited, and this is especially true if a person has undergone one of the medical procedures mentioned above. Too much alcohol can irritate the esophagus which also relaxes that aforementioned lower sphincter which makes it easier for bile to go where it is not desired. Smoking is also another habit which can cause trouble with the esophagus by increasing the production of stomach acid and drying up saliva. It is best to avoid tobacco altogether. A tilted bed with the head raised about 4 to 6 inches using something like wedges or blocks can help to control some of the bile reflux symptoms while sleeping as well. Finally, maintaining a healthy body weight is an important factor when trying to control and prevent bile reflux.