Understanding Bile and Bile Reflux
Bile consists of water, electrolytes, cholesterol, and phospholipids. Your gallbladder stores it until you eat, then secretes bile into your small intestine to help you digest the fat in your food.
Bile helps your body break down fat by emulsifying it and making it more soluble for digestion. Once the digestive system has processed your food, the body either recycles or eliminates the by-products of stomach bile, like cholesterol.
Bile reflux occurs when bile backs up into your stomach and flows into your esophagus (the tube connecting your mouth and stomach). People who have had gallbladder or stomach surgery may have more of a predisposition to bile acid reflux.
Diagnosing bile reflux can be very challenging. It can cause uncomfortable symptoms, including the following:
- Severe upper abdominal pain
- Frequent heartburn (a burning sensation in the chest that can reach the throat and cause a sour taste in your mouth)
- Nausea
- Vomiting bile, which appears as a yellow-green fluid
- Coughing or hoarseness
- Unintended or unwanted weight loss
Treating bile reflux is complex, and the first step is usually to implement anti-reflux strategies, as bile reflux often occurs in conjunction with the reflux of stomach acid and other stomach contents. Doctors may prescribe several medications, including ursodeoxycholic acid, bile acid sequestrants, prokinetic agents, and baclofen. However, few studies have strongly supported the effects of these drugs, and it may take some trial and error until you find one that provides relief.
If medication doesn’t work for you, anti-reflux surgery can strengthen the lower esophageal sphincter to prevent stomach contents and bile from flowing the wrong way.
Making specific changes to the way you eat may help relieve some digestive discomforts, but it can’t completely treat bile reflux.
Work with your doctor or a dietitian to ensure you’re eating foods that meet your nutritional needs while you undergo treatment for bile reflux.