Bile reflux

background

Bile is a digestive fluid composed of bile salts, bile pigments, cholesterol, and fatty acids. Bile is produced by the liver, stored in the gallbladder, and released into the duodenum (the upper section of the small intestine) when needed to aid the digestion of fats. Bile is essential for digesting fats and for eliminating aged red blood cells and certain toxins from the body.
Bile reflux, also called duodenogastric reflux, occurs when bile flows upward from the small intestine into the stomach. Bile reflux is caused by damage to the pyloric valve, which is a ring of muscle that separates the stomach from the duodenum. When the pyloric valve fails to close properly, bile flows into the stomach, causing pain and inflammation.
Bile reflux and acid reflux (also called gastroesophageal reflux disease (GERD)) have similar signs and symptoms, and the two conditions may occur at the same time. When bile reflux and acid reflux occur together, the mixture of bile and stomach acids flows backwards further into the esophagus (the tube that connects the throat to the stomach), causing heartburn and damage to the esophagus. Unlike acid reflux, bile reflux often causes a burning or gnawing pain in the stomach.
Diagnosing bile reflux is often difficult, because bile reflux and acid reflux have similar signs, and it is not uncommon for symptoms of the two conditions to occur at the same time. Since acid reflux is more common, bile reflux is often overlooked or mistaken for acid reflux and improperly treated.
Unlike acid reflux management, changes in diet or lifestyle are usually ineffective in the prevention or treatment of bile reflux. Instead, bile reflux is most often managed with medications or, in severe cases, with surgery. Many of the therapies used to manage bile reflux will also reduce acid reflux. This distinction is important, because these two conditions often occur at the same time and together result in serious complications if not treated.
Bile reflux causes damage to the lining of the stomach (called gastritis), which may progress to sores in the stomach (known as ulcers), bleeding, and stomach cancer. In patients that have both bile reflux and acid reflux, the combination seems to be particularly harmful, increasing the risk of damage to the esophagus, including conditions such as Barrett's esophagus and esophageal cancer.

Related Terms

Acid reflux, antroduodenal motility disorder, bile, bile reflux gastritis, biliary reflux, duodenogastric reflux (DGR), gastritis, gastroesophageal reflux disease (GERD), pyloric valve.

types of the disease

Primary bile reflux: Primary bile reflux is caused by improper formation of the pyloric valve, which separates the stomach from the small intestine.
Secondary bile reflux: Secondary bile reflux is caused by pyloric valve damage, which may occur due to gallbladder removal, gastric surgery, a peptic ulcer, or the use of certain medications.