Bile in the stomach and duodenum. Bile in the stomach: treatment with folk remedies and with the help of a special diet

A bitter taste in the mouth, heartburn, burning and pain in the hypochondrium - all this can be a sign of bile entering the stomach. Despite the apparent simplicity and harmlessness, this condition can cause quite unpleasant complications, up to the development of gastritis, stomach ulcers and precancerous changes. Therefore, this state should not be taken lightly.

How should everything be in order? Bile is an important part of the digestive system. It is produced by the liver and enters the gallbladder. From there, if necessary, it is thrown into the duodenum, where it participates in the breakdown of food processed by bile juice.

Normally, food moves through the esophagus in only one direction. Reverse throwing (reflux) is prevented by sphincters - muscle rings that separate the esophagus from the stomach, and the stomach from the duodenum. Normally, they prevent the reflux of the contents of the duodenum, including bile, into the stomach.

But with some disorders and diseases, the sphincter does not perform its function well, as a result of which bile can enter the stomach. The problem is that interacting with gastric juice containing hydrochloric acid, bile can irritate the walls of the stomach.

If bile is thrown into the stomach once, and no more than a few times a year, this is not a serious problem, but regular repetition should be a serious concern.

Reasons for hit

Many factors can lead to this condition, but the following are the most common:

Excessive pressure in the duodenum. It can be caused by tumors, hernias or other formations that compress the duodenum.

Pregnancy. In late pregnancy, the fetus compresses the intestines, causing similar symptoms.

Transferred operations. If the sphincter is damaged during stomach surgery, it may not close completely.

Medical preparations. Long-term use of antispasmodics and muscle relaxants sometimes causes relaxation of the muscle sphincter.

Duodenitis. Chronic inflammation of the duodenum can lead to its swelling and increased pressure in it.

Depending on the causes of the disease, the symptoms will partially differ. But most often this condition has certain manifestations, which make it possible to make a diagnosis.

Symptoms of the release of bile into the stomach

Most people suffering from reflux of bile into the stomach note the following symptoms:

Belching. The reaction of bile and gastric juice leads to the formation of gases. Such belching may have an unpleasant odor and a bitter taste.

Bitterness in the mouth. A characteristic sign of the reflux of bile into the stomach is bitterness in the mouth. This can be especially pronounced on an empty stomach or in the morning.

Vomiting bile. Frequent and abundant reflux of bile into the stomach can lead to stomach irritation and vomiting.

Plaque on the tongue. This condition leads to the appearance of a yellow coating on the root of the tongue.

. The reaction of bile and gastric juice leads to irritation of the gastric mucosa, causing heartburn.

Pain in the epigastric region. Often the repetition of reflux of bile can lead to pain in the stomach. A characteristic feature is the lack of a clear localization.

Subsequently, new signs characteristic of gastritis or peptic ulcer may appear. They occur if the reflux of bile into the stomach is ignored for a long time.

Necessary diagnostics

If such signs persist for several days or begin to appear quite often, it is necessary to contact a gastroenterologist for diagnosis and treatment. In most cases, the following methods are used:

Ultrasound of the abdominal organs. It allows you to detect possible pathologies of the liver, gallbladder and biliary tract, pancreas, find tumors and cysts.

Gastroscopy. Using a miniature camera on a flexible endoscope, the doctor can examine the esophagus, gastric mucosa, sphincters and duodenum, fixing any deviations and disorders, for example, the presence of bile in the stomach, gaping sphincters, altered mucosa, the presence of defects. At the same time, you can take a sample of gastric juice, determining its acidity and the presence of the Helicobacter bacterium, which increases the likelihood of developing gastritis and peptic ulcer.

X-ray with barium. This rather simple and informative diagnostic method allows you to determine the shape and localization of different parts of the intestine, primarily the duodenum.

It must be understood that the reflux of bile into the stomach is not an independent disease, but only a symptom. And first of all, diagnostics are needed to find the root causes. Without their elimination, bile reflux will continue, and this can lead to quite serious consequences.

Treatment of reflux of bile into the stomach

For each patient with documented reflux of bile into the stomach, it is necessary to develop an individual treatment strategy. It has two main areas:

Mitigation of manifestations of reflux of bile into the stomach. To do this, various methods are used, for example, diet correction, agents that reduce the acidity of the stomach or convert bile juice into a water-soluble acid. Separately, drugs that stimulate intestinal motility and accelerate the release of the intestine are used. Special attention is paid to the correction of nutrition. The diet should contain mucous products and as little as possible fats, smoked, salty, alcohol. The food itself should be fractional and frequent.

Elimination of the causes of reflux of bile. At the same time, it is necessary to detect and eliminate the cause of bile reflux. With daudenitis, antibacterial and anti-inflammatory drugs are used, tumors and hernias are excised, and so on. Most often, the treatment is medical, but sometimes surgical plastic surgery of the sphincters may be required.

In any case, the goal of therapy is the same: to stop the reflux of bile into the stomach, which means getting rid of the constant irritation of the mucous membrane and the dangers associated with it.

During the normal functioning of the body, bile is transported through the ducts to the gallbladder and duodenum to break down fats, vitamins and amino acids. But sometimes there is a reflux of bile into the esophagus.

The reasons

The reasons for the release of bile can be divided into 2 groups: requiring and not requiring treatment. Reasons that do not require treatment:

malnutrition (the presence in the diet of fatty, fried, spicy, smoked foods);
bad habits (frequent alcohol intake, smoking, overeating);
the use of strong coffee, tea and carbonated drinks;
last trimester of pregnancy;
uncomfortable posture during sleep;
taking certain medications;
physical activity immediately after eating.

These causes are eliminated by lifestyle changes.

But there are causes of reflux that require adjustment with medical intervention:

various inflammations of the liver, gallbladder (cholecystitis, hepatitis);
obesity 2 or 3 degrees;
disruption of the sphincter located between the duodenum and stomach;
hernia located in the digestive department;
increased pressure inside the stomach;
biliary dyskinesia.

Most often, the release of bile occurs under the influence of several reasons. You also need to remember that this is not an independent disease, but only a consequence of some disturbances in the body, therefore, it is necessary to treat not the release of bile, but to eliminate the cause.

Symptoms of reflux of bile into the esophagus

In the early stages, the disease is not noticeable to a person and does not manifest itself in any way, it can only be detected during a routine examination. With the progression of this condition, clinical signs will already be noticeable.

If even not very strong and inconsistent signs are found, it is better not to wait for self-healing (of course, if bile reflux is not associated with pregnancy), but to seek medical help. With early diagnosis, the doctor will prescribe a treatment that will be more effective than with advanced cases.

Possible signs that may indicate the reflux of bile into the esophagus:

heartburn - it is felt strong and behind the sternum. Most often happens after meals or at night;
incessant hiccups is another typical sign. Most often appears with a full stomach;
the pain is moderate, similar to heart pain, but occurs after eating. A strong pain syndrome occurs with serious changes in the gastric mucosa - ulcers, erosions and atrophies;
belching with a bitter or sour taste, it happens even with little physical exertion, overeating or stress;
vomiting with bile occurs already in the later stages and indicates serious pathological disorders in the digestive tract;
also in the later stages, a narrowing of the food tube appears, which is expressed by the sensation of a foreign body;
tooth enamel deteriorates;
prolonged cough.

If signs appear, it is not necessary to postpone a visit to the doctor, inaction in this case can lead to attacks of angina pectoris and tachycardia, to the formation of adhesions in the esophagus. These adhesions can eventually lead to cancer of the esophagus or stomach.

Diagnosis of the disease

If the symptoms of reflux do not go away within a few days, you should consult a gastroenterologist. The doctor will prescribe a general urinalysis, a biochemical and a general blood test.

But the most informative will be the following diagnostic methods:

Ultrasound of the abdominal organs. The accuracy and correctness of the study depends primarily on the preparation of the patient himself for the procedure. The day before, you need to follow a special diet, which excludes foods that promote gas formation in the intestines.
contrast radiography. This method of determining the reflux of bile into the esophagus using a contrast agent. The study is performed on an empty stomach, you can not eat food 7 hours before the x-ray.
Gastroscopy - using this method, the doctor evaluates the entire digestive tract. The procedure is performed using a gastroscope and a computer monitor. A camera is installed at the end of the flexible hose, which transmits images to the screen. Using this method, you can fix all changes in the digestive tract, including reflux.

It is gastroscopy that gives a 100% opportunity to see deviations and problems in the gastrointestinal tract. Also, the presence of bile can be determined using the study of gastric juice in the laboratory.

Treatment of bile reflux into the esophagus

Regardless of the causes that caused this disease, the patient will have to switch to a diet to eliminate irritation of the mucosa from the effects of bile. Nutrition should be divided into 6-7 meals, while fried, spicy, smoked, sour, chocolate should be completely excluded.

Vegetables and fruits should also be temporarily excluded from the diet. It is better to give preference to liquid food - cereals and kissels, dairy and sour-milk products. You will also have to exclude excessive loads - you should not lift weights and play sports.

Simultaneously with the changed diet, the doctor will prescribe medication.

Several groups of drugs are used to treat reflux:

prokinetics ("Motilium", "Ganaton"). These funds are used to normalize intestinal motility;
antacids ("Maalox", "Almagel") reduce the acidity of the stomach;
proton pump inhibitors ("Omez", "Gastrozol") - reduce the acidity and aggressive effects of gastric juice.
preparations containing ursodeoxycholic acid ("Ursosan", "Ursofalk") - normalize the secretion of bile and relieve bitter belching;
with spasm and pain, the doctor will prescribe antispasmodics ("No-shpa", "Baralgin").

Treatment of reflux with folk methods

Traditional methods of treatment can be supplemented with folk remedies. Alternative methods of treatment are aimed at expelling bile from the stomach. For this, herbal decoctions and blind probing are best suited. Instead of tea and water, it is better to drink decoctions from various choleretic herbs - currants, cranberries, raspberries, lingonberries.

Blind probing is carried out in several stages;

Drink 10 drops of wormwood tincture and then eat 0.5 tsp. honey.
After 20 minutes, repeat the procedure, at the end you need to drink a little hot water.
After that, heat the liver area with a warm heating pad for 2 hours.
After 2 hours, drink activated charcoal at the rate of 1 tablet for every 15 kg of weight.
Repeat this procedure for 4 days in a row. Repeat after 2 weeks.

Surgical intervention

In cases where the release of bile is caused by a hernia or tumor in the duodenum, surgical intervention is necessary. During the operation, the formation that caused the reflux is removed.

To date, the safest is considered laparotomy. Thanks to it, it reduces the risk of side effects after surgery.

Prevention of bile reflux into the esophagus

At the first sign of a bile rush, you should drink 2 glasses of water. This promotes the return of bile to the stomach.
If you are prone to this disease, you need to change your usual diet. In the morning you can drink kefir, jelly or cook oatmeal.
It is strictly forbidden to overeat, it causes a strong release of bile;
Stop smoking and drinking alcohol;

Bile reflux negatively affects the human body, causing many problems - abdominal pain, heartburn, a feeling of heaviness, nausea, vomiting. All this disrupts the digestive system, which affects the overall well-being and health. To avoid negative consequences, you must consult a doctor to receive adequate treatment and adhere to a strict diet.

Reflux esophagitis is one of the most common digestive disorders. When bile is released into the esophagus, and then into the oral cavity, the contents of the stomach corrode the mucous membrane, causing severe pain and heartburn.

The main causes of choledochal spasm are biliary dyskinesia, inflammation of the gallbladder and liver, and oncological processes. As soon as symptoms of the release of bile into the stomach appear, it is necessary to begin treatment of the condition. The chance to get rid of the disease increases if it can be caught at the very beginning.

Physiology of bile movement

The liver produces bile, which rises to the gallbladder due to the work of the sphincter of the gallbladder and the contraction of the bile ducts.

In the gallbladder, bile accumulates, and as soon as the process of eating begins, it is reflexively thrown into the stomach through the sphincter of Oddi. In the stomach, the digestive juices mix and the digestion process begins.

With the removal of the gallbladder, dyskinesia of the bile ducts and liver diseases, the functions of the sphincter of Oddi are impaired. The discharge of contents no longer depends on impulses - the signals of the brain that it produces when food enters the stomach.

The sphincter contracts arbitrarily, bile accumulates in the stomach, and under the influence of negative factors is thrown into the intestines and esophagus, enters the oral cavity, injuring the delicate mucous membrane.

Such casting causes serious complications:

reflux gastritis - the gastric mucosa becomes inflamed, after eating, the contents of the stomach are thrown back into the esophagus;
if treatment does not start on time, the condition worsens, gastroesophageal reflux disease begins - erosive and ulcerative lesions of the stomach and duodenum occur, the esophagus becomes inflamed;
in the future, the functional epithelium is replaced by a cylindrical analogue, and a diagnosis can be made "Baret's esophagus". This is the stage of a precancerous condition of the digestive organ.

Many factors that are not even related to a violation of the diet can influence the deterioration of the condition.

Causes of bile reflux into the esophagus

Food in a person should only pass from top to bottom - from the mouth to the esophagus, from the esophagus to the stomach and further into the intestines. Gagging is not considered a normal condition - they occur when the body is intoxicated, when the stomach urgently needs to be cleared of toxins. With the help of vomiting, the body protects itself from poisoning.

Digestive juices - hydrochloric acid, bile and pancreatic secretion enter the stomach - with their help food is digested. The sphincter keeps the food lump from rising up the esophagus. Under the influence of negative factors, the digestive balance can be disturbed.

Causes of the release of bile from the stomach that do not require treatment:

violation of the diet - the abuse of carbonated drinks and products that stimulate bile secretion - fatty, smoked foods, strong coffee and tea;
the use of certain medical devices;
smoking;
physical activity and increased physical activity after eating;
pregnancy;
uncomfortable position while sleeping.

But there are conditions that cannot be dealt with without medical help.

These include:

obesity 2-3 degrees;
enterocolitis of various etiologies, causing bloating;
insufficiency of the pylorus of the stomach;
biliary dyskinesia;
hernia of the esophageal part of the diaphragm in the lower part of the esophagus;
ascites in cardiovascular diseases and lesions of the respiratory system;
pathological changes in the duodenum;
diseases of the intestines and digestive organs.

With these diseases, conservative treatment does not always help; in severe cases, surgical intervention is required. It should be taken into account that after surgery on the digestive organs, reflux symptoms also occur - bitterness is felt in the mouth.

Characteristic symptoms of the release of bile from the intestines into the esophagus

The following symptoms may indicate inflammation of the esophagus in the lower section - bile flow is disturbed, and there are:

heartburn - that is, a feeling that behind the sternum - under the pit of the stomach - as if baking, the pain rises from the bottom up, more often appears after sudden movements or at night;
bitterness in the mouth and burning of the larynx - begins after tilting, with physical effort, when moving to a horizontal position;
gagging or bitter vomiting after eating;
severe pain in the diaphragm;
hiccups with full stomach.

Don't expect complications. Reflux can cause attacks of tachycardia and angina pectoris, adhesions appear in the esophagus due to constant irritation, normal mucosa is replaced by scar tissue - there is a high risk of cancer of the esophagus and stomach. Do not wait for the manifestations of serious pathologies - be sure to consult a doctor at the first symptoms of an unpleasant condition.

Diagnosis of the disease

The therapeutic regimen for eliminating bile reflux is prescribed after examination and diagnosis. Currently, first of all, a patient with suspected reflux is sent to FGS, where the presence of bile in the stomach is immediately visible outside the process of eating and you can immediately take a piece of mucous for biopsy.

Abdominal ultrasonography, echography, ultrasound examination, radiography with a coloring agent are also performed. An endoscopic examination may be required.

Treatment of reflex disease

Regardless of the reasons that caused the reflux, the patient will have to go on a special diet, the purpose of which is to protect the mucous membrane of the digestive organs from the aggressive effects of bile.

The diet is fractional, in small portions, up to 6-7 times a day (by the way, in the second half of pregnancy, regardless of the pressure on the diaphragm, it is advisable to switch to such a diet).

All foods that stimulate bile secretion are excluded from the diet - sour, fatty, spicy, smoked, sweet, carbonated drinks, chocolate, rich nutritious broths.

During treatment, you will have to eat viscous food - jelly, cereals; it is recommended to increase the amount of dairy and sour-milk products in the daily menu. Fresh vegetables and fruits will temporarily have to be abandoned.

The therapeutic regimen for conservative treatment includes the following drugs.

proton pump inhibitors - "Omez", "Gastrozol", "Ranitidine", "Omezol", "Pepticum" or similar;
Antacids that protect the mucosa from damage and reduce the secretion of the digestive organs - "Maalox", "Almagel", "Gastrofarm";
Selective drugs that enhance the evacuation function and accelerate the flow of bile from the stomach into the intestines - "Motilium", "Cisapride";
To eliminate bitter belching and normalize bile secretion, drugs with ursodeoxyoleic acid are used - Ursosan, Ursofalk, Ursoliv;
To relieve spasm and eliminate pain, use antispasmodics - "No-shpu", "Spazmalgon", "Baralgin". It is desirable to use drugs of this group in injections to reduce the load on the stomach.

If the reflux of bile is caused by organic pathologies, then surgical intervention is necessary. The safest operation currently being attempted is laparotomy. It is carried out by the endoscopic method - thanks to such operations, the possibility of side effects is reduced.

Bile in the stomach is a specific manifestation that is a sign of the reflux of bile from the duodenum into the stomach cavity.

With proper functioning of the gastrointestinal tract, bile enters from the liver into the duodenum and further, along with food, through the lower intestines. With the development of some pathologies, failures may occur in this process - the functionality of the pylorus is disturbed, pressure in the duodenum increases, there may be a duodenal release of contents into the stomach.

Etiology

With the development of characteristic symptoms, the doctor prescribes a laboratory and instrumental examination in order to understand why bile enters the gastric contents. There can be many reasons for such a violation.

The human gastrointestinal tract is designed in such a way that normally food can be transported through the stomach and intestines exclusively from top to bottom. Sphincters do not allow food to go backwards, but this effect can be with vomiting, when the body is trying to get rid of toxic substances. If the contents of the liver are in the stomach, it means that the muscular valve is weakened or a pathological effect has been exerted on it.

The appearance of bile in the stomach has a variety of causes, which are often associated with diseases of the liver or gallbladder.

Provoking factors for the appearance of anomalies can be such indicators:

pregnancy - the uterus increases, begins to put pressure on the duodenum 12, and therefore there is a release of duodenal contents into the stomach;
hereditary anatomical disorders;
mechanical damage, tumors and hernias;
excessive use of certain drugs;
complications after surgery.

The following factors can contribute to the progression of bile reflux into the stomach:

regular consumption of food in large quantities;
unbalanced diet;
eating before bed;
excessive drinking of water during meals;
sudden movements or sports after eating.

Symptoms

The release of bile into the stomach is often manifested in quite healthy people. If a person found such a sign only once, then the symptoms are not particularly manifested. But if the progression of duodenogastric reflux occurs several times, then the patient begins to form characteristic signs. The clinical picture of the disease is in the following indicators:

pain syndrome of a constant or periodic nature;
belching with a fetid odor or bitter taste;
heartburn appears at the moment when a lot of bile accumulates in the stomach and esophagus;
feeling of heaviness in the abdomen;
a yellow coating appears on the tongue;
nausea;
vomiting with an admixture of bile.

Bile, when accumulated in the stomach, has an aggressive effect, and for this reason, the mucosa of the organ begins to become inflamed. If therapy is not started on time, then the patient begins to develop a clinical picture of gastritis and ulcers.

Diagnostics

To identify a problem in the biliary tract and understand why such a pathology has formed, the doctor uses many examination methods. First of all, you need to collect an anamnesis, identify the presence of other ailments, determine the clinical picture and establish a presumptive diagnosis. For a complete examination, the patient is prescribed the following examination:

biochemical analysis of the liver;
Ultrasound of the abdominal organs;
fibroesophagogastroduodenoscopy (FEGDS);
duodenal sounding;
endoscopic ultrasonography;
cholecystography;
choledochoscintigraphy.

Only after all the above examinations have been carried out, the doctor can establish a diagnosis and prescribe therapy.

Treatment

With bile in the stomach, doctors first try to eliminate not the symptom itself, but the cause of its appearance. But if you use symptomatic treatment, it is possible to prevent the occurrence of reflux, to help improve the patient's well-being.

To achieve this goal, after the examination, the attending physician decides how to get rid of bile in the stomach and what medicines will be most effective. Therapy is prescribed on an individual basis, depending on the characteristics of the body. Often prescribed the use of such drugs:

selective prokinetics - allow you to improve the evacuation of food from the stomach and empty it. Helps to get rid of accumulated bile and improve sphincter tone;
proton pump inhibitors - therapy occurs by reducing the level of hydrochloric acid;
non-selective blockers - are prescribed to relax smooth muscles;
antispasmodics - normalize the tone of the smooth muscles of the biliary tract;
antacids - lower the level of hydrochloric acid.

Chronic gastritis can be cured with a conservative method, while many ailments that provoke the reflux of bile into the stomach require prompt assistance. As a rule, during surgery, doctors use the method of laparoscopic correction of duodenogastric reflux. Laparoscopy is a minimally invasive therapy technique that can be used to correct the malfunctioning of the sphincter. The operation is performed with minimal impact on the body and injury to the skin.

Also in medicine, traditional methods of providing surgical care through an incision in the anterior wall of the abdominal cavity are used. The method of radical treatment is chosen depending on the cause of the accumulation of bile in the stomach. Often, this surgical method of therapy is used to remove the tumor and hernia.

There are quite a few methods for removing bile from the stomach, and one of them is diet. To effectively eliminate the symptom, doctors prescribe complex therapy to patients, which consists in using all methods of treatment. Diet with bile in the stomach is based on proper nutrition. The patient is advised to start the day with healthy products that have a gentle effect on the lining of the gastrointestinal tract, for example, kefir, oatmeal, jelly. Portions should be small. Meals per day should be at least five, so that the patient does not overcome the feeling of hunger, and not too much hydrochloric acid is released.

The patient's diet should not contain such dishes:

fatty;
fried;
salty;
acute;
smoked;
alcoholic drinks and soda;
vegetable oils;
animal fat.

For the normal functioning of the gastrointestinal tract and the restoration of the general condition, it is advisable to eat more products with bran per day. The daily diet should be based on the following products:

pears;
dried apricots;
prunes;
watermelon;
carrot;
pumpkin;
zucchini.

With the correct elimination of the disease, the patient will be able to stop the development of symptoms and get rid of the cause of bile reflux into the stomach.

Complications

Reflux of bile into the stomach with improper therapy can provoke the appearance of other pathologies:

Barrett's esophagus - the condition is characterized as precancerous. It develops as a result of the constant ingress of bile into the esophagus, because of which the membrane of the lower sections is injured;
reflux gastritis - inflammation of the walls of the stomach;
gastroesophageal reflux disease - the contents from the stomach enters the esophagus, and damages its membrane.

Prevention

Bile in the stomach begins to significantly irritate the mucous membrane of the organ, which provokes the appearance of unpleasant symptoms and discomfort. To prevent the occurrence of such a symptom, doctors recommend giving up all negative habits, reviewing and balancing your diet, and regularly seeing a doctor.

The structure and function of the upper gastrointestinal tract

The task of the digestive system is to ensure the normal digestion and assimilation of food. These processes begin in the oral cavity. A person swallows a food bolus, after which it enters the esophagus. Contracting, the esophagus carries out antegrade (direct) movement of the lump to the stomach.

Having descended into the lower third of the esophagus, food puts pressure on the cardiac sphincter. It opens and passes the food bolus into the stomach cavity. Under the influence of digestive enzymes, food is digested and chyme is formed. When the stomach is full, receptors give a signal to the pyloric sphincter. It opens and chyme enters the duodenum. After the passage of the food bolus, the lumen closes tightly.

If the work of the esophageal sphincters is disturbed, there is a retrograde (reverse) movement of chyme, bile and hydrochloric acid. Muscle structures relax, opening the lumen of the lower gastrointestinal tract.

Causes of bile reflux into the stomach and esophagus

In a healthy body, food goes in the antegrade direction. Single casts are not dangerous. Vomiting is an exception, as it is a physiological reflex to cleanse the body of toxins.

This passage of food is controlled by the esophageal sphincters. Harmful factors cause pathology of the digestive canal. There is a violation in the work of muscle sphincters, provoking the release of bile into the esophagus.

Factors affecting the functioning of the digestive tract:

unbalanced diet;
abuse of coffee, alcohol, strong tea, smoked meats, spices, sweet soda;
smoking;
heavy physical activity associated with lifting weights;
lying position after eating;
taking certain medications (for example, analgesics);
binge eating.

Physiological and pathological conditions characterized by failure of the muscular structures of the esophagus:

pyloric stenosis;
dyskinesia of the gallbladder and biliary tract;
obesity II and III degree;
ascites and edema of internal organs;
flatulence;
diaphragmatic hernia;
pregnancy.

Why does bile reflux into the stomach? Normally, bile enters the duodenum. To get into the esophagus, she needs to bypass two "checkpoints" - the pyloric and cardiac sphincters. If the functions of both structures are impaired, bile enters the lumen of the esophagus.

Heartburn in pregnancy is often associated with acid reflux into the lower third of the esophagus. An enlarged uterus increases pressure in the abdominal cavity, which leads to disruption of the functioning of the sphincters.

Reflux threatens with peptic esophagitis - inflammation of the walls of the esophagus. A possible consequence of the disease is the formation of adhesions that narrow the lumen of the organ.

Possible Complications

Throwing the contents of the stomach into the esophagus threatens with serious consequences. The mucosa of the organ is very delicate and is thoroughly permeated with nerve endings. Bile enzymes and hydrochloric acid damage all tissues of the esophagus.

With constant exposure to acidic pH, peptic esophagitis develops. There are multiple erosions and ulcerations. With a long-term disease, Barrett's esophagus is formed. Pathology refers to precancerous and requires mandatory surgical intervention. If Barrett's esophagus is not treated, then malignancy of the wall will occur, that is, a malignant tumor will form.

Also, esophagitis is often complicated by stenosis. The lumen of the esophagus narrows due to the formation of connective tissue strands.

Since the esophagus has a rich blood supply, with its pathology there is a high risk of bleeding. It is very difficult to stop profuse blood loss in this localization. A complication is posthemorrhagic anemia.

Symptoms

At the beginning of the disease, the patient is not disturbed by anything. Sometimes patients complain of discomfort in the upper abdomen. Over time, more severe symptoms appear.

The manifestation of reflux can be:

Bitterness in the mouth. The symptom is characteristic of obstruction of the bile ducts and pathology of the gallbladder.
Vomiting of bile. It occurs due to the abuse of alcohol and fatty foods.
Pain in the epigastrium. Especially characteristic is the appearance of pain at night. It is important to differentiate the symptom from a duodenal ulcer.
Sensation of a lump in the throat.
Belching with a bitter taste.
Heartburn. Especially often appears after eating.

Reflux should not be confused with vomiting. With vomiting, a reflex act occurs, stimulating the reverse movement of food. Reflux is characterized by the release of food into the larynx. Symptoms of bile reflux into the esophagus are nonspecific, therefore, when the first signs appear, a complete diagnosis of the body is required.

Modern diagnostic methods

The diagnosis of bile reflux into the esophagus is established by clinical signs and data from additional studies.

For a complete picture of the disease, the doctor needs to collect all complaints and study the patient's history in detail.

For diagnostics are performed:

Daily measurement of pH in the esophagus. The method allows you to establish the nature of reflux, its relationship with meals and physical activity.
X-ray with contrast. Diaphragmatic hernia, deep ulcers and strictures of the organ are revealed.
Endoscopy. Esophagoscopy allows you to assess the mucosa of the esophagus. In real time, the doctor notes inflammatory changes, Barrett's syndrome, ulcers, cancer. During the study, bile is visible in the stomach and esophagus.
sphincter manometry. A very informative way. With its help, the quality of the work of the esophageal sphincters is assessed.
Radionuclide research. Allows you to evaluate the rate of passage of food through the gastrointestinal tract.
ultrasound. Indirect diagnostic method.
Impedance meter. Allows you to identify pathological contractions of the esophagus and the nature of reflux.

Scheme of therapy

Treatment of bile reflux into the esophagus requires an integrated approach. To prevent complications, it is necessary to start therapy as soon as possible.

First aid

Emergency care is provided before the arrival of doctors or before the patient enters the hospital. It is carried out in order to prevent mucosal burns.

First aid algorithm for bile reflux:

Drink a lot. Normal water at room temperature is suitable for drinking. To relieve pain, dissolve an ampoule of lidocaine in 1 liter of water and drink the solution in small sips.
Removal of pain. Anesthetize with combined analgesics. Spazmalgon is perfect. The drug has an analgesic and antispasmodic effect. In the pathology of the gastrointestinal tract, it is better to administer the drug parenterally (intravenously or intramuscularly).
Neutralization. Bile and stomach acid are extremely aggressive substances. They can be neutralized with whole milk, alkaline water (Borjomi, Essentuki), as well as nonabsorbable antacids (Almagel, Gaviscon).

After these events, the patient is sent to a therapeutic hospital for further diagnosis and treatment.

Conservative drug treatment

In the treatment of bile reflux, special attention is paid to lifestyle changes and diet. However, if episodes occur once a week or more often, drug therapy is recommended. Treatment is aimed at healing erosions and ulcers, reducing the number of casts, neutralizing acid and bile.

Before starting medication, consult with your doctor. All drugs used to treat the gastrointestinal tract are associated with digestive processes. If the instructions are violated, the effectiveness of the drug is reduced.

3 groups of drugs are used:

Antisecretory agents. Proton pump inhibitors are predominantly prescribed. Representatives: Lansoprazole, Omeprazole, Pantoprazole, Rabeprazole, Esomeprazole. The course of treatment is selected by the attending physician. Usually recommend long-term use of this group.
Nonabsorbable antacids of the I-III generation. The most modern are aluminum-magnesium complexes with alginate. These include Gaviscon and Topalkan. However, second-generation drugs (Maalox, Almagel) are clinically more effective. Assign from 4 to 8 weeks.
Prokinetics. Assign domperidone (Motilium, 1 tablet contains 10 mg of active ingredient). The course of therapy is 1-1.5 months. In rare cases, it can be extended up to 3 months.

Surgical intervention

Surgery is indicated when medical therapy fails. Surgical treatment involves plastic surgery of the esophagus, as well as suturing the lumen of its sphincters.

Indications for surgery:

massive reflux of bile from the stomach;
adhesive stenosis;
profuse bleeding;
Barrett's esophagus;
suspicion of tumor degeneration of the tissue.

The intervention is carried out under the control of the endoscope. If histology confirms Barrett's esophagus or cancer, then radical surgery is performed with the removal of regional lymph nodes.

How to treat folk methods

The use of folk remedies is agreed with the doctor. Some medicines are incompatible with medicines.

Effective Recipes:

1 tsp flax seeds are brewed in a glass of boiling water. It languishes for 5 minutes in a water bath. Infused for 30-40 minutes. Drink 1/3 cup 3 times a day before meals.
4 tsp St. John's wort, 2 tsp calendula flowers, 2 tsp plantain leaves, 2 tsp licorice root, 2 tsp calamus and 1 tsp. tansy and menthol mint. Mix dry ingredients, take 1 tsp. vegetable raw materials and pour a glass of boiling water. Insist 1 hour. Drink the resulting drug half a cup 2 times a day.
On an empty stomach drink 1 tsp. sea buckthorn and rosehip oil.

Phytotherapy is effective for long-term use. Usually, treatment with folk remedies lasts from 3 to 6 months.

What happens when stomach acid backs up into the esophagus

The intake of food in the stomach causes a reflex release of hydrochloric acid. When the cardiac sphincter relaxes, food is thrown from the stomach into the esophagus. This is called the retrograde movement of the food bolus. Stomach acid is also expelled along with undigested food.

The reflux of acid from the stomach into the esophagus is accompanied by destructive changes in the mucosa. Under the action of low pH, multiple erosions and ulcers occur. Vessels are exposed, begin to bleed. Under the constant influence of the acidic contents of the stomach, adhesions of the organ are formed. The lumen of the esophagus narrows. Such changes lead to the development of Barrett's syndrome, stenosis and cancer.

Proper nutrition

A balanced diet is the key to successful treatment. It is necessary to eat only healthy foods, as well as observe the regimen.

Reduce the amount of food you eat. Eat small meals 3-6 times a day. Do not eat 2 hours before bed.
Reduce fat, increase protein intake.
Avoid spicy, hot, spicy foods.
Limit carbonated water.
Food should be mechanically gentle. Before serving, food must be cooled, and also chopped in a blender.
Avoid foods that provoke flatulence (cabbage, beans, spinach, etc.).

Nutrition should be balanced in proteins, fats and carbohydrates. It is also important to consume the proper amount of vitamins and minerals.

How to prevent the reverse movement of food bile and acid

Sleep on a big pillow. The head end should be raised by 15-20 cm.
Slimming. Abdominal (on the stomach) obesity contributes to an increase in pressure in the abdominal cavity. Weight loss eliminates this factor.
Do not wear tight, tight clothing.
Do not eat 2 hours before bedtime.
Stay upright for 30-40 minutes after eating.
Avoid heavy lifting. Especially dangerous are slopes with a barbell, lifting weights. Approach weight training with caution.
Limit the intake of sedatives, as they affect the function of the esophageal sphincters.
Limit the intake of NSAIDs (analgin, diclofenac, ibuprofen), antibiotics (doxycycline), antimalarial drugs (quinine), as they contribute to inflammation in the stomach and other organs of the gastrointestinal tract.
Quit smoking.

To prevent the release of gastric juice into the esophagus, you must constantly adhere to these simple recommendations.