Table of ContentsView AllTable of ContentsSymptomsCausesTreatmentComplicationsDiagnosisWhen to Seek Care
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Treatment
Complications
Diagnosis
When to Seek Care
Changing the diet or making lifestyle changes may not help with the symptoms of bile reflux. The condition may be managed with medications, but in some cases surgery could also be needed.
This article discusses the symptoms and potential causes of bile reflux. It also covers risk factors and when to seek tests or treatment for your symptoms.
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Bile Reflux vs, Acid RefluxAcid reflux is a condition that causes stomach acid to flow back up into the esophagus. Bile reflux is a different condition because it occurs when bile flows into the stomach or esophagus. However, both conditions can be present in the same person.
Bile Reflux vs, Acid Reflux
Acid reflux is a condition that causes stomach acid to flow back up into the esophagus. Bile reflux is a different condition because it occurs when bile flows into the stomach or esophagus. However, both conditions can be present in the same person.
Symptoms of Bile Reflux
Some of the symptoms of bile reflux include:
Causes of Bile Reflux
There are several reasons that someone might develop bile reflux. The underlying cause may be:
Surgical complications: People who have had surgery on their stomach may develop bile reflux. Weight loss procedures (bariatric surgery) are the most common surgeries resulting in bile reflux. Surgery to remove the gallbladder is also associated with a higher risk of bile reflux.
Stomach reflux: The pyloric valve is located where the stomach meets the small intestine. It opens to allow food to pass from the stomach into the first part of the small intestine (the duodenum).
It’s a small opening, and it’s only supposed to allow the stomach contents to pass one way. However, if the pyloric valve doesn’t close all the way, it could allow bile to flow into the stomach instead of the small intestine.
Apeptic ulceris a sore in the lining of theesophagus, stomach, or duodenum. If an ulcer affects the pyloric valve, it could prevent the valve from opening and closing properly. This could allow bile to back up into the stomach.
Esophageal reflux:The lower esophageal sphincter is a valve at the bottom of the esophagus. It opens up to allow food to pass from the esophagus into the stomach. Food is not supposed to come back up into the esophagus. However, if the lower esophageal sphincter is weak or too relaxed, food and bile can come back up into the esophagus.
How to Treat Bile Reflux
With other types of reflux, treatment often focuses on changing the diet or other lifestyle factors. However, that won’t help with bile reflux. This is why it’s important to get a diagnosis. However, determining whether symptoms are from bile reflux—and not another type of reflux or a different condition—can be challenging.
Some medications are used to treat bile reflux. Bile reflux isn’t well studied, so it may take some trial and error to find the medication that will work to help get symptoms under control.
Medications
Bile acid sequestrants: These medications might also be called bile acid resins (BAR). They bind with the bile. That causes the bile to become ineffective, and it passes out of the body in stool. These include:
These medications might cause symptoms such as nausea, bloating, or gas that are severe enough that some people may not want to take them.
Actigall or Urso 250 or Urso Forte (ursodiol): This is a type of a bile acid that has an effect on the liver. It is a small part of the overall composition of bile. It has been used to treat certain liver diseases and disorders of the bile ducts. It can have side effects of diarrhea, nausea, or vomiting.
Surgery
Having bile acids flow into the stomach or esophagus can cause damage and inflammation. If this continues for a long time, it can increase cancer risk. Surgery might be considered for people still having symptoms even after trying to treat them with medications. The types include:
Complications and Risk Factors of Bile Reflux
Over time, having bile reflux can lead to problems in the stomach and esophagus. Exposure to bile can cause inflammation in those areas. This inflammation could lead to complications such as ulcers. Bile reflux could be complicated with also havinggastroesophageal acid reflux (GERD).
Havingulcersand inflammation (gastritis) in the stomach from reflux is associated with developinggastric cancer. Ongoing inflammation in the esophagus can lead to a condition calledBarrett’s esophagus, which also may increase the risk of cancer.
How Gastritis Is Treated
Are There Tests to Diagnose Bile Reflux?
Bile reflux isn’t always easy to diagnose. Reflux might be suspected or diagnosed based on the symptoms. But knowing that it is from bile reflux may take more investigating.
Some of the tests that might be used include:
When to See a Healthcare Provider
Acid reflux is a common problem and has symptoms that are similar to bile reflux. It might not be possible to tell the difference between the two without testing.Treatments meant for acid refluxmay not be helpful for bile reflux.
People should think about seeing a healthcare provider when they’re having upper abdominal symptoms that are ongoing and aren’t getting any better with changing the diet. Bile reflux isn’t treatable with home remedies, so getting a diagnosis from a healthcare provider is going to be the way to get it under control.
Red Flag SymptomsIf abdominal pain is severe or there are symptoms such as bleeding, vomiting, or diarrhea that won’t stop, see a healthcare provider immediately or go to the emergency room (ER).
Red Flag Symptoms
If abdominal pain is severe or there are symptoms such as bleeding, vomiting, or diarrhea that won’t stop, see a healthcare provider immediately or go to the emergency room (ER).
Summary
Bile reflux has symptoms that are similar to other, more common conditions such as GERD. However, this condition is more difficult to diagnose and treat, and may be associated with more risks of complications. For that reason, symptoms of reflux that aren’t getting any better may be a reason to seek out a healthcare provider for a diagnosis, to either rule out or diagnose bile reflux.
6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Shi X, Chen Z, Yang Y, Yan S.Bile reflux gastritis: insights into pathogenesis, relevant factors, carcinomatous risk, diagnosis, and management.Gastroenterol Res Pract. 2022;2022:2642551. doi:10.1155/2022/2642551.Ahmed M.Functional, diagnostic and therapeutic aspects of bile.Clin Exp Gastroenterol. 2022;15:105-120. doi:10.2147/CEG.S360563.McCabe ME 4th, Dilly CK.New causes for the old problem of bile reflux gastritis.Clin Gastroenterol Hepatol. 2018;16:1389-1392. doi:10.1016/j.cgh.2018.02.034.Eldredge TA, Bills M, Ting YY, et al.Once in a bile - the incidence of bile reflux post-bariatric surgery.Obes Surg. 2022;32:1428-1438. doi:10.1007/s11695-022-05977-2.Sifrim D.Management of bile reflux.Gastroenterol Hepatol (N Y). 2013;9:179-180.Mount Sinai.Esophageal pH monitoring.
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Shi X, Chen Z, Yang Y, Yan S.Bile reflux gastritis: insights into pathogenesis, relevant factors, carcinomatous risk, diagnosis, and management.Gastroenterol Res Pract. 2022;2022:2642551. doi:10.1155/2022/2642551.Ahmed M.Functional, diagnostic and therapeutic aspects of bile.Clin Exp Gastroenterol. 2022;15:105-120. doi:10.2147/CEG.S360563.McCabe ME 4th, Dilly CK.New causes for the old problem of bile reflux gastritis.Clin Gastroenterol Hepatol. 2018;16:1389-1392. doi:10.1016/j.cgh.2018.02.034.Eldredge TA, Bills M, Ting YY, et al.Once in a bile - the incidence of bile reflux post-bariatric surgery.Obes Surg. 2022;32:1428-1438. doi:10.1007/s11695-022-05977-2.Sifrim D.Management of bile reflux.Gastroenterol Hepatol (N Y). 2013;9:179-180.Mount Sinai.Esophageal pH monitoring.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Shi X, Chen Z, Yang Y, Yan S.Bile reflux gastritis: insights into pathogenesis, relevant factors, carcinomatous risk, diagnosis, and management.Gastroenterol Res Pract. 2022;2022:2642551. doi:10.1155/2022/2642551.Ahmed M.Functional, diagnostic and therapeutic aspects of bile.Clin Exp Gastroenterol. 2022;15:105-120. doi:10.2147/CEG.S360563.McCabe ME 4th, Dilly CK.New causes for the old problem of bile reflux gastritis.Clin Gastroenterol Hepatol. 2018;16:1389-1392. doi:10.1016/j.cgh.2018.02.034.Eldredge TA, Bills M, Ting YY, et al.Once in a bile - the incidence of bile reflux post-bariatric surgery.Obes Surg. 2022;32:1428-1438. doi:10.1007/s11695-022-05977-2.Sifrim D.Management of bile reflux.Gastroenterol Hepatol (N Y). 2013;9:179-180.Mount Sinai.Esophageal pH monitoring.
Shi X, Chen Z, Yang Y, Yan S.Bile reflux gastritis: insights into pathogenesis, relevant factors, carcinomatous risk, diagnosis, and management.Gastroenterol Res Pract. 2022;2022:2642551. doi:10.1155/2022/2642551.
Ahmed M.Functional, diagnostic and therapeutic aspects of bile.Clin Exp Gastroenterol. 2022;15:105-120. doi:10.2147/CEG.S360563.
McCabe ME 4th, Dilly CK.New causes for the old problem of bile reflux gastritis.Clin Gastroenterol Hepatol. 2018;16:1389-1392. doi:10.1016/j.cgh.2018.02.034.
Eldredge TA, Bills M, Ting YY, et al.Once in a bile - the incidence of bile reflux post-bariatric surgery.Obes Surg. 2022;32:1428-1438. doi:10.1007/s11695-022-05977-2.
Sifrim D.Management of bile reflux.Gastroenterol Hepatol (N Y). 2013;9:179-180.
Mount Sinai.Esophageal pH monitoring.
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