It’s bad enough to have acid reflux–the backflow of stomach acid into the esophagus that causes heartburn and discomfort for millions. Add on bile reflux, where digestive fluid from the liver flows into the stomach and esophagus, and you’ve got a recipe for major discomfort that can be difficult to treat.
Many people who have acid reflux also have bile reflux, and it can be difficult to distinguish them, since both have heartburn as a major symptom.
People with bile reflux often also have a burning pain in the upper abdomen, nausea or vomiting of bile. Sometimes they will also have a cough or sound hoarse. It can be caused by a peptic ulcer, having had your galbladder removed, or having damage to the valve that keeps bile from getting into the stomach. This damage often occurs during gastric surgery such as gastric bypass.
Drugs known as proton pump inhibitors (Prevacid and Nexium are two popular ones) are normally prescribed for bile reflux, even though the drugs are technically designed to reduce acid. Ursodeoxycholic acid is a very common treatment, as it reduces the amount of bile that is produced, which limits opportunities for reflux.
There are also surgical options when it comes to treating bile reflux. Bile can be diverted away from the stomach by making a new connection lower down in the intestine. Part of the stomach may be sewn around the lower esophageal sphincter. This surgery is most often used to treat acid reflux, as it increases pressure at the lower end of the esophagus, making it difficult for acid to rise. It may be helpful for bile reflux, but some people still have symptoms after surgery.
Bile reflux does not seem to be as positively affected by lifestyle changes as acid reflux does, but since many people have both, the same recommendations apply. Some people get relief from eating smaller meals or avoiding acidic and spicy foods, but just as with treating acid reflux, these remedies don’t work for everyone. My father actually had both after a bile duct was attached to his stomach instead of his intestine during a surgery.
Quite by accident after trying just about everything you always hear recommended for acid reflux, GERD and bile reflux, he found a really simple treatment at his local grocery store that has kept him pain-free for decades. So it certainly is possible to get rid of your bile reflux without resorting to surgery and a life of drugs.