Bile reflux, also known as duodenogastric reflux, is a common physiological event in the post-meal period or during prolonged fasting, which may cause changes in the physico-chemical characteristics of the protective layers of mucus, raise the pH in the stomach and for these reasons, favor bacterial proliferation and cause symptoms such as upper abdominal pain, nausea and vomiting.
This phenomenon occurs when bile, which is a liquid produced by the liver to make digestion, goes back to the stomach or even to the esophagus, and can also be accompanied by acid reflux, although these are considered to be distinct problems.
The treatment consists of the ingestion of medicines and in more serious cases, surgery may be necessary.
What are the symptoms
Bile reflux can be difficult to distinguish from acid reflux because the signs and symptoms are very similar and can occur at the same time. The most common symptoms are:
- Upper abdominal pain;
- Burning sensation in the chest;
- Nausea;
- Yellow-green vomit;
- Cough or hoarseness;
- Weight loss.
Also know the characteristic symptoms of gastroesophageal reflux.
Possible causes
Bile is an essential fluid for the digestion of fats, to eliminate worn red blood cells and some toxins from the body. This substance is produced in the liver and stored in the gallbladder.
When fat foods are ingested, the gallbladder releases the bile that is transported to the duodenum. Bile and food mix in the duodenum and enter the small intestine through the pyloric valve, which usually opens only gently. However, in cases of biliary reflux, this valve does not close properly and the bile thus rises to the stomach.
In addition, bile and stomach acid can reflux into the esophagus, when the esophageal sphincter, which separates the esophagus from the stomach, does not function properly.
These problems that cause bile reflux can be caused by surgical complications such as gastric surgeries, peptic ulcers, which can block the pyloric valve or surgeries to the gallbladder.
What is the diagnosis
Generally, to diagnose bile reflux prob- lems, one can perform:
- Endoscopy, in which a tube is introduced with a camera and in which the stomach and the esophagus are observed;
- Esophageal impedance, which measures when there is reflux of fluid into the esophagus.
Find out how the endoscopy is done and what preparation is needed.
How is the treatment done?
Bile reflux has a cure and treatment can be done with medicines or surgery:
1. Medications
- Ursodeoxycholic acid, which is a medicine that helps promote the circulation of bile, thus reducing the frequency and intensity of symptoms;
- Sequestrants of bile acids, which bind to these in the gut, preventing their reabsorption;
2. Surgery
Surgery may be recommended in cases where the medications are not effective in treatment. This surgery, known as bypass surgery, may be recommended for people who have undergone previous gastric surgery with removal of the pylorus, in which doctors make a new connection for drainage of the bile further down the small intestine, by diverting bile from the bile stomach.
How to prevent
In order to avoid episodes of bile reflux, it is best to stop smoking, eat shorter meals, avoid bedtime at meal times, avoid fatty foods and alcohol intake, lose excess weight and relax, as the stress can worsen the symptoms of reflux.
Home Remedies
There are natural ways to reduce bile reflux, such as taking a slippery elm capsule or drinking a chamomile tea, alteia or licorice. Learn how to prepare licorice tea.
