Bile Reflux

Bile reflux is a condition in which bile — a digestive fluid produced in the liver — flows up into the stomach and esophagus, the tube that leads from the throat to the stomach. Bile reflux is similar to acid reflux, the primary difference being that bile reflux involves the backflow of bile from the small intestine into the stomach and esophagus. The risk factors for bile reflux are similar to those for acid reflux. These include obesity, pregnancy, smoking, certain medications, and certain foods. People may also be more likely to develop bile reflux if they have had surgery on the stomach or gallbladder, or if they have a hiatal hernia. The symptoms of bile reflux are similar to those of acid reflux, and may include burning sensations in the chest, abdominal pain, nausea, vomiting, and a sour taste in the mouth. The presence of bile in the stomach can lead to the formation of ulcers and inflammation of the stomach lining, which can cause further discomfort. The diagnosis of bile reflux may involve medical imaging tests such as an upper gastrointestinal (GI) series or an endoscopy. During an endoscopy, a flexible tube with a camera is inserted into the esophagus to allow the doctor to inspect the area and take tissue samples if needed. Bile reflux is usually treated with lifestyle changes and medications. Lifestyle changes may include avoiding certain foods, avoiding smoking, and exercising regularly. Medications may include proton pump inhibitors, H2 blockers, or bile acid sequestrants, which help to reduce the amount of bile in the stomach. In severe cases, surgery may be recommended to repair or reconstruct the sphincter muscle that separates the stomach from the esophagus, or to correct any anatomical abnormalities that could be contributing to bile reflux. Surgery is usually only recommended if lifestyle changes and medications have not been effective.