Although carbonated beverages cause acid reflux, this isn't the only problem that some acid reflux sufferers are faced with. Bile reflux is another uncomfortable backflow of fluid that often accompanies acid reflux. However, instead of thrusting stomach acid back into the esophagus as is the case with acid reflux, bile reflux throws bile (a digested fluid that is made by the liver) up from the small intestine into the stomach and esophagus, causing inflammation to both.
Due to the fact that bile reflux and acid reflux can occur together, this means that the esophagus is doubly assaulted, which causes more inflammation to its lining, and puts a person at a higher risk for developing complications.
What are the symptoms of bile reflux?
The signs and symptoms associated with bile reflux are similar to acid reflux, making it difficult to distinguish one from the other, especially when both conditions tend to occur simultaneously. That being said, unlike acid reflux, bile reflux causes inflammation within the stomach, which creates a biting, or burning pain in the upper part of the abdomen.
Other symptoms that are characterized by the condition can include:
- Frequent heartburn
- Nausea
- Vomiting bile
- An occasional cough or croakiness in the throat
Along with symptoms, bile reflux teamed with acid reflux can eventually create complications including:
- Gastritis - This is a complication that is caused by bile reflux alone. Gastritis is characterized by irritation and inflammation within the stomach. Although this isn't typically a serious condition, in some cases it can cause stomach ulcers, bleeding, and chronic gastritis increases the risk of stomach cancer.
- GERD (gastroesophageal reflux disease) - Frequent attacks of heartburn may be a sign of GERD. This is when a person suffers from chronic acid reflux which can be a potentially serious issue as it may lead to a condition known as esophagitis - the inflammation of esophageal tissue.
- Barrett's esophagus - This is a condition that occurs after long term exposure to stomach acid and/or bile and results in a change of color and tissue composition in the lower esophagus. The new cells are resistant to stomach acid but they have an increased risk of becoming cancerous.
- Esophageal stricture - Scar tissue can form in the lower esophagus, which results from frequent exposure to stomach acid and/or bile. The scar tissue can cause a stricture (a narrowing in the tube) which can lead to trouble swallowing and increase the risk of choking.
- Esophageal cancer - When the esophagus has been exposed to prolonged repetitive stomach acid and/or bile, cancer has the potential to form practically anywhere along the length of the esophagus. This is a serious and difficult form of cancer to treat.
How do you treat bile reflux and acid reflux together?
Proton Pump inhibitors - The best way to treat these conditions, especially for those who suffer from GERD and Barrett's esophagus, is proton pump inhibitors. These are medications that are designed to block acid production. These meds can sometimes also help reduce the effects of bile reflux.
Ursodexycholic acid - This is the most common medication for treating bile reflux. Ursodexycholic acid helps to encourage bile flow.
Other medications - If bile reflux is the result of the stomach taking too long to empty, other drugs may be prescribed to improve the flow of food through the stomach.
The real trouble with bile reflux is that it is hard to control. Unlike acid reflux which can be managed through diet and lifestyle changes, bile reflux can really only be controlled through specific medications or by surgery in severe cases. Unfortunately, sometimes even after treatment, bile reflux continues to plague sufferers. Thus, bile reflux may need to be treated separately from acid reflux.
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