Bile reflux, but not acid reflux, causes injury

Bile reflux, but not acid reflux, causes injury

Contrary to the common belief that heartburn is only caused by acid reflux, doctors discovered that it can also be caused by bile reflux, also known as duodenogastric bile reflux.

There are two critical situations in which we need to seriously think about reflux. The first case is when a person has chronic heartburn and heartburn medications do not work. Second is the condition when one experiences pain, heartburn and indigestion after gallbladder removal.

Bile reflux is nothing new; Surgeons have found bile in the stomach with ulcers during surgery for over a hundred years. Bile is a common gastroscopic finding in people with gastritis, ulcers, and gastroesophageal reflux disease (GERD). There is a high chance that bile reflux, not acid reflux, will cause injury.

Thanks to technology, doctors began to detect bile in the esophagus in 70% stubborn chronic cases of heartburn and Barrett's esophagus. About 10-15% of people with chronic symptoms of GERD get Barrett's esophagus. This is a serious precancerous complication of gastroesophageal reflux disease. There are many articles and books about possible injuries to the stomach and esophagus that could be caused by bile due to bile reflux.

What can cause bile reflux?

More precisely, bile reflux is also pancreatic reflux. This means that the mixture of bile and pancreatic juice can cause injury. Many people know that the liver produces bile and the pancreas produces pancreatic juice full of digestive enzymes. However, not too many people know that bile and pancreatic juice are strongly alkaline solutions. The alkalinity of these solutions means healthy digestion, while acidic changes lead to poor digestion. My articles and book provide medical support for this idea.

Bile is an alkaline solution with a gentle balance of water, minerals, bicarbonates, cholesterol, lecithin and bile acids and bile salts. When bile is acidic, it contains more precipitated bile acids. Bile acids are extremely “aggressive” chemical substances that make acidic bile so irritable. Acid bile irritates the surrounding tissue, mucous membranes and sphincters and leads to bile reflux.

In a healthy person, the mixture of alkaline bile and pancreatic juice extends to the beginning of the small intestine - duodenum. The alkaline environment in the duodenum is a crucial factor for good digestion and the proper transfer of digested food to the lower part of the small intestine. Acidification makes the bile particularly “aggressive”. The acidity of the entire body leads to acidic changes in the bile with precipitation of bile acids, which irritate the walls of the duodenum and cause rough contractions and spasms. This throws the contents of the small intestine into the stomach with an aggressive mix of bile acids and pancreatic enzymes.

Acid bile irritates valves, ducts, duodenal wall and causes “wrong-way traffic” – bile/pancreatic reflux into the stomach or even esophagus.

Nearly 40-50% of all adults in the United States report symptoms of gastroesophageal reflux disease (GERD), commonly referred to as acid reflux.

The usual treatment for acid reflux is medication that suppresses stomach acid. In many situations with persistent, chronic heartburn, patients respond poorly to acid-suppressive medications because acid reflux is only part of the problem. The main culprit is bile/pancreatic reflux.

Another situation in which bile reflux may be observed is often in individuals with a sphincter with Oddi dysfunction following gallbladder removal. When the sphincter of Oddi is closed, bile from the liver normally passes into the gallbladder. The lack of buffering capacity of the gallbladder can increase the pressure in the bile ducts and pancreatic duct. Acid, offensive bile promotes more spasms of the sphincter of Oddi. It can cause bile reflux into the pancreas and possible pancreatitis.

Under normal conditions, the gallbladder contracts and pushes out concentrated bile in the duodenum as food arrives for digestion. After the gallbladder is removed, bile from the liver drips into the duodenum even though there is no food in the intestines. Acid bile corrodes the wall of the empty duodenum, causing bile reflux in the stomach.

It is becoming clear that restoring a normal, slightly alkaline environment throughout the body and particularly in the liver and pancreas can reduce bile/pancreatic reflux in the stomach and esophagus. This, in turn, can reduce bile reflux and chronic heartburn.

Controlling the acidity of the whole body can be done in three ways:

1. Eat natural, alkaline foods

2. Drinking Karlovy Vary healing mineral water

3. Taking mineral supplements such as cellular magnesium-potassium

I focus extensively on these three options in my book.

Although most people are familiar with the alkaline diet and mineral supplementation, Karlovy Vary's healing mineral water is almost unknown to Americans. The use of healing mineral water has expanded medical practice in Europe. Karlovy Vary in the Czech Republic is a famous health mineral spa in the middle of Europe.

Millions of people with digestive symptoms such as heartburn, stomach fullness, nausea, cramps and chronic abdominal pain, diarrhea and constipation find relief by drinking this healing mineral water. For people who couldn't go there, geyser water was evaporated to make mineral salt.

Drinking mineral water made from real Karlovy Vary salt has been a centuries-old remedy for heartburn. According to European doctors, minerals and bicarbonate in this water can do double work. Firstly, it can normalize acidity in the stomach. Secondly, the healing mineral water of Carlsbad alkalizes the body and body fluids such as bile and pancreatic juice.

Speaking of biliary/pancreatic reflux, it also needs to focus on Candida yeast overgrowth and small intestinal bacterial overgrowth (SIBO) after taking antibiotics, some medications, alcohol, lots of sugar or soda, etc. This leads to constant fermentation in the intestines and produces a lot of gas. On the way out, gas can open the valve between the esophagus and stomach. Move stomach contents up with severe heartburn.

This special valve is known as the lower esophageal sphincter (LES). The LES is so strong that even when healthy, experienced yoga people stand upside down, the sphincter retains stomach contents and protects the esophagus.

The LES relaxes at inappropriate times when the pressure in the stomach is high. The valve cannot hold the increased pressure in the stomach and unlocks. Large dinners or lying down after large meals and wearing tight clothing can increase pressure in the stomach. Improper food combinations of proteins, starches and sugars can also cause a lot of gas and heartburn.

If you suffer from long-term heartburn and cannot get help from medications that suppress stomach acid, there is a high chance that you have bile reflux. Bile reflux is not easy to treat. In this situation, a non-drug, natural approach may be beneficial. The goal is to find knowledgeable licensed health practitioners.

Misdiagnosis or failure to control bile reflux can lead to serious problems such as gastritis, duodenitis, ulcers and Barrett's esophagus. a possible precursor to esophageal cancer.

The information in this article is for informational purposes only. It is not intended to be a substitute for the diagnosis, treatment and advice of a qualified licensed professional.

Inspired by Peter Melamed Ph.D.