Bile reflux is often confused with acid reflux or GERD. While the symptoms might be same for both of them, the causes are different. So what is bile reflux? What are the common symptoms with GERD? And what are the differences in the two? Is there a possible treatment for bile reflux? Here is an answer to all the questions.
What is Bile Reflux?
As the name suggests, it is when the bile "rises up" in the stomach. Bile is the liquid produced by the liver for digestion. The function of bile is to help in digestion of the fatty foods. Whenever one eats something fatty, the gallbladder gets the signal to release bile into the small intestines (duodenum) thereby helping in the digestion. After eating fatty foods, the pyloric valve (muscles around the stomach) opens slightly and lets very less quantity (less than 4 ml) of food and bile into the stomach. In case this valve does not function properly, the mixture or more so the bile will be in excess in the stomach causing bile reflux. Excess bile can also reflux into the esophagus through the esophagus sphincter (much like the case in GERD) causing bile reflux in the esophagus.
The other functions of bile are to remove dead RBCs (red blood cells) and some toxins (known as Ama in Ayurveda) from the body.
What causes bile reflux?
Here are the usual reasons that cause bile reflux:
- Post surgical complications
Weight loss surgeries or partial / total removal of the stomach can lead to the improper functioning of the pyloric valve causing bile reflux. Also, people who have undergone gallbladder removal surgeries are more prone to producing more bile resulting in bile reflux that someone who hasn't undergone any surgery.
- Peptic ulcers
Open sores in the lining of the stomach or the upper portion of intestines can lead to the pyloric valve not functioning properly leading to either food remaining in the stomach for longer than needed or closing to early and resulting in excess bile.
What are the symptoms of bile reflux?
As mentioned earlier, it is difficult to distinguish the symptoms of bile reflux and GERD. At times, one might suffer from both at the same time. Typical symptoms include:
- Burning in the upper stomach and chest region
- Perpetual sour taste in the mouth
- Upper abdominal pain
- Unintended weight loss
- Vomiting - greenish mucus like bile in the vomit
Not taking corrective action against bile reflux can lead to GERD, Barrett's esophagus and even esophageal cancer.
What are the treatments for bile reflux?
- Avoid eating fatty foods
Since the basic purpose of bile is to help digest fatty foods, by avoiding fatty foods, one can avoid the release and there bile reflux altogether
- Eat smaller meals and eat slowly
Smaller meals and slow chewing ensures proper digestion across the digestive system and thereby reduces the chances of suffering a reflux
- Stay upright while and after eating
Lying down anytime while eating or immediately after eating does not help with the natural flow of food through the digestive system. This creates added pressure on the organs to try and digest the food and might lead to excess bile (or other acids) being released
- Avoid smoking, alcohol and certain foods
Smoking increases the production of stomach acid and dries up saliva, which helps protect the esophagus. Drinking alcohol relaxes the lower esophageal sphincter and irritates the esophagus. Caffeinated and carbonated drinks, chocolate, citrus foods and juices, vinegar-based dressings, onions, tomato-based foods, spicy foods, and mint also result in increased production of stomach acids. All of these can lead to excess bile formation and thereby cause the reflux.
- Use relaxation methods when in stress
Stress causes the entire digestive system to go in a fizzy. This can cause not only bile reflux but a host of other digestive ailments. Hence, trying to relax under stressful conditions can help avoid bile reflux.
The good news about bile reflux is that by making changes to diet and lifestyle, the symptoms can be largely controlled. Having said that, it is advisable to take some medication along with the changes for quicker relief. Very rarely, bile reflux would need surgical treatment. Since the symptoms are very similar to GERD, similar lifestyle changes can help with bile reflux too. So, here are some of the lifestyle and diet changes that can help reduce the symptoms of bile.
Apart from these lifestyle changes, some medications that might help with bile reflux include sucralfate, sequestrants and ursodeoxycholic acid. In worst case scenarios, diversion surgery and anti-reflux surgery.
What does Ayurveda say about bile reflux? Are there any ayurvedic treatments for bile reflux?
Ayurveda lays a lot of emphasis on gut health. Most ailments, as per ayurveda, are related to gut health, either directly or indirectly.. Ayurveda attributes bile reflux to vitiation of Pitta dosha i.e. excess heat. Ayurveda suggests changes to Vihar (lifestyle) and Aahar (food) to control and cure bile reflux. Ayurveda also suggests Virechana (Panchkarma treatment), Yogasanas and pranayamas as ways to maintain a healthy lifestyle.
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