Re: about bile reflux .
Bile reflux has been on my mind a lot lately.
Bile is released by the liver and stored in the gallbladder to help digest fat. The gallbladder releases the bile when you eat fatty foods. If you don't have a gallbladder anymore (i.e. if you had gallstones or had it removed for other reasons), then the bile has nowhere else to go and tends to backwash into the stomach and can then reflux up into the esophagus. Unfortunately, the liver has no way of knowing that the gallbladder is no longer present, and just keeps on producing bile.
It can also happen if your lower esophageal sphincter doesn't close properly, just like acid reflux.
Diagnosis can be made based on description of symptoms. If you cough any up or vomit, it would be yellowish in color. I would imagine the same tests used to confirm the presence of reflux could detect bile, but I'm not sure.
Unfortunately, it seems like bile reflux is still a "new" condition and therefore information is limited. Not a lot of research has been done on it. Based on the research I've done (and I encourage you to do your own), bile appears to be even more toxic to the esophagus than stomach acid. It has been shown to cause Barrett's esophagus in lab animals even without the stomach acid component (Barrett's is a change in the lining of the esophagus due to erosion by stomach acid and bile; there is both benign and malignant, the latter of which can become precancerous and eventually cancerous).
Because bile reflux is still being studied and understood, there aren't many effective treatments for it. I've seen cases of people being prescribed PPI's to stop the acid backwash in the hopes the bile stays down, too. I also understand there's a surgical procedure that creates a "new connection" to reroute the bile away from the stomach. The other surgical option is the "reflux" surgery. I'm not familiar with it, but I know it involves moving the stomach so that the esophagus is better protected. I think they do that in cases where the PPI's don't work or the issue is with the esophageal sphincter.
I was diagnosed with benign Barrett's back in 2005, and I'm currently having gallbladder problems that are increasingly getting worse. However, I have been trying to hold off getting the surgery until a better solution is found for bile reflux. One thing research has shown is that benign Barrett's can stay that way absent any further damage. But the fact that I have it at all is one strike - removing my gallbladder and risking bile reflux would almost certainly worsen my Barrett's and much quicker than in a person who does not have Barrett's. So - yeah.
I've unfortunately found my gastro docs are not much help when it comes to Bile reflux but there is information out there. There seems to be a tendency to treat it very casually because there's no "proof" yet that it's the bile versus the acid that is causing damage. It's frustrating for people in my position, where I need the gallbladder surgery but don't want to get it because the bile could worsen my Barrett's. If we had a reliable treatment for bile reflux, I'd be more willing to get my gallbladder out. I realize I may someday have no choice, and that concerns me.
Sorry for the personal tangents; I hope the info was helpful, but I encourage to do your own research. Just take it all with a grain of salt. The hard truth is, there are no good answers right now when it comes to bile reflux.
Last edited by jdmaley; 11-17-2012 at 04:55 PM.