What is bile reflux?

Bile reflux is a potentially serious condition that occurs when bile flow within the upper digestive system is disturbed. Often presenting with acid reflux, bile reflux symptoms cause stomach upset and inflammation. Treatment generally involves the administration of medications to relieve symptoms. Severe presentations of bile reflux may require surgery to prevent further damage to the upper digestive system.

To help with digestion, the liver produces an acidic substance known as bile, which remains in the gallbladder until it is needed to metabolize digested food. The pyloric valve, located between the bile duct and the duodenum, serves as the main tributary that controls the flow of bile into the upper digestive system. When the pyloric valve malfunctions, the back flow resulting from excessive bile can cause stomach inflammation. If the backwash of the bile is sufficient and one's esophageal sphincter is not working properly, it can also lead to esophageal inflammation and erosion. In most cases,

Symptomatic individuals will generally receive a diagnosis of bile reflux after extensive diagnostic testing. Imaging tests, including an endoscopy, are generally employed to assess the condition of one's upper digestive system by checking for signs of inflammation and ulceration. Due to the associated risk of esophageal cancer, tissue samples from the esophagus may also be obtained to check for markers indicative of malignancy.

People with this condition will often experience signs and symptoms with patterns that can easily be mistaken for those associated with acid reflux. Usually someone with bile reflux will experience abdominal discomfort accompanied by recurring episodes of heartburn. Some people may develop nausea or show hoarseness. Due to the unpleasantness of the symptoms, people can even alter their eating habits to avoid the onset of symptoms, which can lead to unintended weight loss.

The symptoms of bile reflux should not be ignored due to the serious risks of complications. Those who experience chronic symptoms are considered to be at increased risk of developing gastritis or stomach inflammation and gastroesophageal reflux disease (GERD). Extensive esophageal damage can also contribute to the development of esophageal stricture and malignancy.

In general, people with bile reflux will experience relief with the use of prescription medications designed to inhibit bile production and reflux. Medications, such as ursodeoxycholic acid, may be given to promote digestion and relieve abdominal discomfort. Those who demonstrate severe reflux symptoms can undergo surgery. A common procedure known as bypass surgery involves redirecting the flow of bile from the stomach to the lower part of the intestine. People with esophageal damage may undergo a surgical procedure known as a fundoplication to increase their lower esophageal pressure, which inhibits the reflux of acid from the stomach into the esophagus.

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