What Is Bile Reflux

We are all familiar with the condition acid reflux Bile reflux is another condition that is not discussed as much, but is very similar and sometimes can be confused with acid reflux.

First, let me educate you a little bit about what bile is. Bile is a digestive fluid produced in the liver. Some of the components that make up bile are:

  • Water
  • Cholesterol
  • Bile pigments
  • Bile salts

Bile is placed in the gallbladder and while eating is discharged into the duodenum where the bile aids the process of digestion of fats.

Bile reflux is the result of bile that travels up from your small intestine into your stomach and esophagus BR is sometimes confused with acid reflux because a person can experience some of the same symptoms and bile (like GERD) irritates the lining of your esophagus, potentially increasing your risk of esophageal cancer.

One thing that makes bile reflux different from acid reflux is that it can't be treated with little lifestyle changes or diet. It has to be treated with prescribed medication or, in severe cases, with surgery.

Another thing that makes BR different is this condition irritates the stomach, which causes a gnawing or burning sensation in your upper abdomen.

Because acid reflux and BR are pretty similar it can sometimes be a bit confusing to identify the symptoms. Here are a few symptoms that will help you to detect BR:

  • Nausea
  • Vomiting bile
  • Hoarseness
  • Unintentional weight loss

Some of the causes of this condition are a peptic ulcer and gallbladder removal. A peptic ulcer obstructs the pyloric valve. When this happens the valve doesn't open enough to allow your stomach to empty as quickly as it should.

As a result, foods and beverages will lead to increased gastric pressure that causes the refluxed bile and stomach acid to back up into your esophagus.

If you had your gallbladder removed then there's a good chance that your body produces more bile than those who haven't had their gallbladders removed.

Diagnosing BR is a more difficult procedure than acid reflux, so it requires more exams. Your doctor will also check for damage to your esophagus and for any pre-cancerous changes. Here are some of the exams doctors use to diagnose BR:

  • Ambulatory Acid Tests - These exams use an acid-measuring probe to identify when, and for how long, acid regurgitates into your esophagus. Ambulatory acid tests are negative in people with bile reflux.

  • Endoscopy - In this test, your doctor places a thin, flexible tube with a light and camera (endoscope) down your throat. The endoscope can show ulcerations or inflammation in your stomach or esophagus and can reveal a peptic ulcer.

  • Esophageal impedance - Rather than measuring acid, this test can measure whether gas or liquids reflux into the esophagus. It's helpful for people who have regurgitation of substances that aren't acidic and therefore wouldn't be detected by a pH probe.

If not properly treated there can be some serious complications to your health. BR and GERD can cause serious harm to the tissue in your esophagus. The combination of these two conditions can cause other problems like:

  • Heartburn
  • Esophageal narrowing
  • Barrett's esophagus
  • Esophageal cancer
  • Gastritis

As I said before lifestyle changes can't control BR. One prescribed medication that is more used to treat BR is Ursodeoxycholic acid. This medication helps promote bile flow. UA will also help to reduce the constant symptoms and the severity of pain.

Even though proton pump inhibitors (or PPI's) are used to treat symptoms of acid reflux, the main reason for these type medicines is to reduce acid production, that may also help to reduce BR.

If taking medicine doesn't help or if there are pre-cancerous changes in your esophagus, then your next option is to try surgery. Diversion is a type of surgery that doctors use to treat BR.

Your doctor will make make a new connection for bile drainage further down in your intestine, thereby diverting bile away from your stomach. This procedure is known as Roux-en-Y (roo-en-wi).

Because some types of operations are often more successful than others, it's always a good idea to discuss the pros and cons very carefully with your doctor.

Return to Acid Reflux Blog

Return to Homepage From Bile Reflux

Privacy Policy

Notice & Disclaimer: Acid Reflux Tips is for educational purposes only and is not intended for medical advice. Always consult your doctor with health questions about specific medical conditions.