Vomit

Surgical treatment of bile reflux into the stomach. Neutralization of bile in the body in simple ways

The secretion produced by the liver is considered an essential component of digestion. It is a kind of toggle switch that switches the process of food processing from gastric to intestinal. At optimal performance In the body, this fluid does not reach the epigastrium, but there are exceptions to the rules. The reflux of bile into the stomach, the symptoms and causes of the formation of pathology will be discussed further.

Bile is a liquid secreted by the liver, necessary for digesting food in the intestines. It enters this organ through the biliary tract.

Anatomically, bile belongs to the liver. However, before being sent to the intestines, it accumulates in gallbladder. Hippocrates at one time noted the enormous role that this organ plays in the life of the body. In some teachings, it is considered the starting point from which health-improving activities should begin. The purpose of the gallbladder is to solve the following tasks:

Providing the duodenum with the necessary amount of secretion.
Making a significant contribution to metabolic processes.
Formation of fluid that is part of the joint membranes.

In standard mode, this element penetrates the gallbladder and starts the digestion of products entering through the esophagus. However, in some situations, bile “goes astray” and goes directly into the stomach. Experts do not classify a failure in the food processing mechanism as an independent disease. The pathological process is considered a symptom of diseases of the gastrointestinal tract.

In the human body, this fluid is responsible for the following tasks:

leveling the organic element pepsin, which is part of the gastric juice;
revival of peristalsis;
assistance in the production of micelles;
preventing bacteria and proteins from sticking together;
formation of feces;
activation of the synthesis of intestinal hormones and mucus;
fat emulsification;
intestinal antiseptic.

However, the leading function of bile is to stimulate the transition digestive process from the stomach to the intestines.

The composition of this liquid is quite diverse, and any changes in the balance of components can lead to ailments, including the formation.

The process of bile formation

The gallbladder serves as a container that provides the duodenum with the necessary amount of secretion for processing food. The formation of bile is a constant process influenced by external and internal stimuli.

Features of the formation of liver secretions

The duration of the undeveloped stage is from 3 to 12 minutes. At the end of the meal, the rate of production of this element increases. The formation of bile is determined by the acidity of the “filling” of the stomach, the period of its presence in this organ, as well as the production of hormones responsible for the activation of bile formation.
The next stage is biliary excretion. It takes from 3 to 6 hours. With the help of special fibers, the motility of the bladder and adjacent ducts is activated, stimulating the relaxation of the sphincter of Oddi. Thanks to this, further movement of bile occurs.
When the body is not busy processing food, bile enters the gallbladder and accumulates there until the next digestive cycle.

The process of bile formation is ongoing. The transition of secretion into the duodenum is discrete, only during the digestive process.

Causes of bile reflux into the stomach

According to the design of nature and evolutionary mechanisms, the passage of food through the body is carried out only along one established course - from top to bottom. A unique protective reaction - vomiting, which makes it possible to get rid of toxic substances - does not fall under this rule.

The danger of bile being in the stomach cavity is caused by the possibility of deformation of its walls.

The food transportation scheme is as follows: oral cavity → esophagus → stomach → duodenum → remaining parts of the intestine. The sphincter prevents the food bolus from returning in the opposite direction. It is a kind of lock that allows food to pass through one-way.

If bile ends up in the stomach, then the work of the sphincter located between this organ and the intestines is impaired. Pathological processes, occurring in it, lead to a weakening of muscle tone, leading to the passage of secretions in an undesirable direction.

In addition, such a pathology may be due to the following reasons:

liver diseases;
congenital physiological abnormalities and acquired injuries;
gallbladder spasms;
the presence of hernias and tumors;
cholelithiasis;
excessive intake of muscle relaxants or antispasmodics.

More detailed information about liver diseases you can find in.

Pregnant women are at risk. During development, the fetus puts pressure on the duodenum, which provokes the reflux of bile to the wrong destination. During surgical interventions, there is a risk of injury to the sphincter muscles, which can lead to the reverse movement of digestive fluid. This is especially true for patients who have undergone gall bladder surgery.

Factors contributing to weakening of the natural valve:

regular overeating;
sleeping on the left side with a full stomach;
violation of the nutritional schedule;
increased physical activity after meals;
simultaneous intake of carbonated water and large amounts of food;
smoking;
excess weight, exceeding the permissible norm by 20 kg;
constant consumption of smoked and fried foods.

If bile enters the stomach as a result of the listed factors, the root cause should be eliminated in a timely manner. In this situation, drug therapy can be excluded.

Symptoms and possible consequences of bile reflux into the stomach

When the gastrointestinal tract works well, the fluid produced by the liver does not reach the stomach. Entering the intestines, bile neutralizes the destructive effects of stomach acid and participates in the process of fat breakdown. However, once in the stomach, it turns from a creative element into a destructive one, capable of causing the development of gastritis or erosion.

Release of bile into the stomach - symptoms

If the secretion passes into the epigastrium in a large volume, there is a risk of injury to the walls of the esophagus. As a result of exposure to the acids that make up this fluid, the tone of the sphincter that protects the food tube decreases.

Table 1. Symptoms of bile reflux

Symptom	Description
Aching pain in abdominal cavity	Lack of clear localization of painful sensations.
Belching	Bile provokes the formation of bad-smelling gases in the stomach, which exit the body through the oral cavity. If physiological fluid comes out at the same time as gas bubbles, the belching takes on a bitter taste.
Heartburn	If there is excessive release, the secretion from the stomach penetrates the esophagus, causing irritation of its walls and heartburn. The burning sensation is not associated with eating.
Distension in the abdomen	Caused by the pressure exerted by the liver fluid on the gastrointestinal tract.
Yellowish coating on the tongue	Occurs due to fluid from the stomach entering the oral cavity.
Vomiting bile	When the fluid overflows, the contents of the stomach come out.

This process is also accompanied by:

physical weakness and constant fatigue
increased gas formation;
feeling of heaviness in the epigastric region;
bloating;
swelling;
increased sweating;
fever after eating;
constant feeling of thirst.

If bile remains in the stomach for a long period, such a situation can be fraught with the occurrence of the following diseases:

Barrett's esophagus - a precancerous stage of the lower part of the esophagus;
reflux gastritis - release of the contents of the duodenum into the stomach;
gastroesophageal reflux disease is a regular release of stomach contents into the esophagus, causing injury to its walls.

Note! In such situations, surgical intervention is necessary.

Diagnosis and treatment

Despite many progressive research methods, accurate anamnesis and a thorough examination of the abdominal cavity are considered to be the leading methods for detecting bile in the stomach.

For these purposes, the following methods are used:

liver function tests;
magnetic resonance cholangiography to detect stones;
duodenal intubation;
cholescintigraphy;
fibrogastroduodenoscopy.

Every year, the diagnostic potential increases, and specialists are given the opportunity to promptly identify pathology.

Table 2. Treatment regimen

The primary measure for this pathology is the prescription of drugs whose action is aimed at improving the motor processes of the gastrointestinal tract.

Table 3. Drugs for improving the motor processes of the gastrointestinal tract

A drug	Description
Motilium	Stimulates peristalsis. Has an excellent antiemetic effect.
	Accelerates the movement of food throughout all areas digestive tract.
Cerucal	Keeps the gastrointestinal tract in good shape.

Motilium is given great importance in therapy. This remedy has the ability to accelerate excretion feces, improves peristalsis and function of the gallbladder, which is beneficial for the body when there is excess bile. The medication is available in several variations, including a suspension, convenient for treating small children.

Dealing with abnormal bile flow should be done in a comprehensive manner. An important factor is the use of drugs whose action is aimed at regulating the level of acidity.

Table 4. Means for regulating acidity levels

A drug	Additional properties
Phosphalugel	Neutralizes the effect of acid, envelops the walls of the stomach, protecting against irritation.
Maalox	It has carminative and choleretic properties.
	Strengthens the regenerative processes occurring in the gastric mucosa.

The use of proton pump inhibitors is very important in therapy. Medicines can reduce the pathological activity of cells and reduce the production of hydrochloric acid. This has a positive effect on sphincter motility, which prevents bile reflux. For this purpose, the following means are used.

Table 5. Proton pump inhibitors

A drug	Description
	Reduces the secretion of gastric glands. Has an antiulcer effect.
Lansoprazole	Blocks the formation of hydrochloric acid at the final stage.
	An antiulcer agent that reduces the production of hydrochloric acid.

Therapeutic diet

Compliance with therapeutic nutrition plays a huge role in preventing bile reflux. It significantly alleviates the unpleasant manifestations of diseases accompanied by the penetration of secretions into the stomach.

The principle of nutritional therapy is fractional meals. Food should be taken in small portions 5 times a day. The daily diet should be eliminated from the following components:

fried, fatty and salty foods;
smoked meats;
hot spices;
alcoholic and carbonated drinks.

It is advisable to reduce the amount of consumption vegetable oils and broths cooked using fatty meats.

To optimize the activity of the intestines and gallbladder, patients need to introduce the following products into their diet:

bran;
dried apricots;
bell pepper;
pears;
carrot;
prunes;
zucchini;

Bile is a substance that is formed as a result of the secretion of liver cells. Bile contains useful pigments, acids, and phospholipids that are involved in digestion. With its help, the intestines normally cope with the emulsification reaction of fats, with the hydrolysis of lipids, and their absorption. In this area, fat-soluble vitamins and calcium are absorbed through bile.

Normally, bile fluid from the liver passes through the ducts into the bladder, and from there into the duodenum. With the development of certain diseases, bile can enter the stomach cavity, and this causes unpleasant symptoms: belching, heartburn, pain in the abdomen, yellow coating on the tongue. Don't be overlooked this pathology, because this can cause the development of gastritis, ulcers or even oncology. Let's take a closer look at how to treat bile in the stomach.

Medicines

If heartburn occurs rarely, as such specific treatment not prescribed. In this case, all you need to do is follow a proper diet and completely avoid bad habits. If the reflux of bile into the stomach occurs on permanent basis and appears in the background developing disease in this area, appropriate therapy is prescribed. In this case, all measures are taken to eliminate the underlying pathology, normalize the outflow of bile and relieve unpleasant symptoms.

In the treatment of diseases that are accompanied by bile reflux into the stomach, medications are used that help relax smooth muscles, restore pressure in the bladder, change the structure of bile fluid, and improve bladder motility. Also, the drugs used are aimed at making bile less toxic to the gastric mucosa.

Besides, in mandatory they prescribe a special diet that will not only help cope with this pathology, but also prevent the reflux of bile into the stomach in the future. If conservative treatment is ineffective, surgical intervention is necessary.

Antispasmodics

Drugs that have a myotropic antispasmodic effect also have a choleretic effect.

These include Papaverine and Drotaverine.

This medicine, like Paraverin, is often prescribed if there is stagnation of bile fluid in the biliary tract, which occurred due to spasm smooth muscles. To prevent development allergic reaction, the drug is not used in case of individual intolerance to its components. If it occurs, stop taking Papaverine.

In addition, the medicine is not prescribed to children under six months of age, and in some cases up to a year, to elderly people, in order to prevent a significant increase in temperature, which is often observed at this age, as well as to patients simultaneously suffering from arterial hypotension. Papaverine should not be used if glaucoma or acute renal failure develops.

Drotaverine tablets are one of the most effective means in the treatment of gastrointestinal pathologies

The medicine Drotaverine is prescribed for spasms of the gallbladder and pain in this area. Its use is contraindicated in severe renal failure, the same form liver failure, as well as cardiac, during lactation, for children with individual intolerance to the components of the drug.

Proton pump inhibitors

The release of bile into the stomach can be eliminated by taking proton pump inhibitors, which regulate the level of hydrochloric acid in the stomach by blocking the functioning of the secreting glands. These include the drugs Nexium and Omeprazole.

Omeprazole is not used in the following cases:

if co-administration of Atazanavir or Nelfinavir is required;
with a deficiency in the body of substances such as lactase, sucrase, with their intolerance and hypersensitivity to fructose;
children under 2 years of age and weighing less than 20 kg, if treatment for conditions such as reflux esophagitis, gastroesophageal reflux disease is required;
children under 4 years of age who require treatment for a duodenal ulcer that has developed due to exposure to the bacterium H. Pylori;
children and adolescents under 18 years of age for therapy with drug capsules (10 mg);
in case of individual intolerance to Omeprazole or its constituent components.

The medicine Nexium cannot be used for diseases accompanied by reflux into the stomach in the following cases:

with glucose-galactose malabsorption;
with hereditary fructose intolerance;
while taking Atazanavir or Nelfinavir;
with sucrase-isomaltase deficiency;
children under 12 years of age;
children and adolescents aged 12-18 years, if treatment for gastroesophageal reflux disease is required.

Antacids

Such drugs help neutralize the acidity of the stomach contents by chemical interaction with hydrochloric acid. These include Almagel, which, despite high efficiency, is not used in the treatment of reflux in case of individual intolerance to its components, severe renal impairment, or Alzheimer's disease. Also, the medicine is not prescribed to children under 1 month of age, during pregnancy and lactation.

Antacid drugs include Maalox, which is no less effective than the drug Almagel. It is not prescribed for renal failure, hypersensitivity to components, fructose intolerance, children and adolescents under 15 years of age, and hypophosphatemia. Use the product with extreme caution during pregnancy and lactation. breast milk, with the development of Alzheimer's disease, in old age.

Hepatoprotectors

Hepatoprotective agents help convert bile into a water-soluble form, while eliminating unpleasant symptoms: bitterness in oral cavity, belching, heartburn and nausea. These drugs include Ursofalk, which is not prescribed if there is gallstones, if its functioning is insufficient, acute diseases inflammatory in nature, liver cirrhosis.

Also, the drug is not used in treatment gastric reflux in case of severe impairment of the functioning of the kidneys or pancreas, during pregnancy and lactation, in case of individual intolerance to the components of the drug.

The drug Ursofalk is often used in tablet form, although there is also a suspension with the same name

Hepatoprotectors include a drug such as Allochol, which should not be taken in case of hypersensitivity of its components, simultaneous development calculous cholecystitis, obstructive jaundice, acute hepatitis, acute and subacute liver dystrophy, gastric and duodenal ulcers, acute pancreatitis.

Prokinetics

The most commonly prescribed drug is from the group of prokinetics Motilium, which, through its effect on the body, helps regulate motor function gastrointestinal organs. Strengthening their secretion ensures accelerated circulation of bile fluid.

The drug is contraindicated for use in the development of prolactinoma (pituitary tumor), simultaneous treatment with Ketoconazole, Erythromycin and other inhibitors of the CYP3A4 isoenzyme (Fluconazole, Clarithromycin, Telithromycin, etc.), with gastrointestinal bleeding, children and persons weighing less than 35 kg. Special contraindications include individual intolerance to the components of the drug.

Another prokinetic drug can be called Cisapride, which is also not prescribed for hypersensitivity to components, gastric and intestinal bleeding, mechanical intestinal obstruction. The medicine is prohibited for use during pregnancy and lactation.

Medicines that relieve bile stagnation

Pathological reflux of bile into the stomach can also be cured with the help of medications that eliminate its stagnation by enhancing bladder motility. This may be the drug Pancreazym, which is prohibited for use by persons with individual intolerance to the components, if they develop acute pancreatitis, exacerbation of its chronic form. Often the drug causes the development of side symptoms: nausea and vomiting syndrome, diarrhea or constipation, pain syndrome in a stomach. In such cases, the medication must be stopped.

Another method of getting rid of gastric reflux is the use of magnesium sulfate, which is administered by injection. Such manipulation is prohibited in case of individual intolerance to the substance, high level magnesium in the body, hypotension, low heart rate, depression respiratory function, renal failure.

The oral method of administering magnesium sulfate is often used, which is contraindicated in cases of intestinal bleeding or intestinal obstruction, inflammation of the appendix, and general dehydration of the body. The medicine is used with extreme caution for concomitant pathologies. respiratory system, renal failure, inflammatory processes in the gastrointestinal tract, myasthenia gravis.

Nutrition

Treatment of bile reflux into the stomach area is recommended to be carried out in combination with proper nutrition:

Before eating, you must drink a glass of still mineral water, but in no case after it;
It is recommended to eat in small portions, but often;
dishes must have normal temperature, not be hot or excessively cold;
the basis of the diet is boiled food (porridge, vegetables, soups);
fried and fatty foods should be excluded from the diet, as well as smoked foods, fruits and vegetables, which contribute to increased gas formation;
Pickled foods, chocolate, jam, baked goods, strong coffee and tea are prohibited.

Maintaining proper nutrition is one of the most effective methods in the treatment of reflux and its prevention. The main goal of the diet is to reduce the load on gastrointestinal tract and normalization of general health.

Fried and fatty foods are specially prohibited during the period of treatment of pathology

Considering that the bile fluid is thrown into the stomach cavity, the main volume of nutrients consumed with food is not absorbed. It is for this reason that a person quickly gets tired even after minor physical activity. If he experiences systematic stress and is constantly in nervous tension, this also does not have the best effect on general condition. Therefore any stressful situations must be excluded.

When is surgery required?

Many pathological conditions that are accompanied by regular reflux of bile fluid into the stomach cavity can be corrected surgical intervention. The only exception is chronic inflammation duodenum. In order to get rid of similar pathology, the doctor may prescribe one of the following operations:

laparoscopy, which involves removing a tumor or eliminating other pathologies that are accompanied by reflux, by making small punctures in the anterior abdomen;
laparotomy, which is performed by making a large incision in the abdominal cavity (transverse or longitudinal).

Only a doctor can determine which method is suitable for a particular person to eliminate gastric reflux of bile - conservative or surgical. It is for this reason that in order to avoid the development of negative consequences, self-medication is not recommended. You need to trust a specialist in this matter.

Bile in the stomach is a pathological condition that is accompanied by a number of symptoms, including bitterness in the mouth. The disease can be one of the manifestations of GERD () or a separate pathology - DGER (duodenogastric reflux). Let's look at the main causes, symptoms and treatment methods for the reflux of bile into the stomach space.

If there are no malfunctions in the functioning of the organs of the digestive system, then bile should be “stored” in the cavity of the gallbladder and regularly enter the duodenum and begin to be thrown into the stomach, causing inflammation of the organ’s mucosa, and less often – erosion and ulcers. In medical terminology, the release of bile from the intestines into the stomach is called reflux.

The pathology is based on weakness of the pyloric sphincter. Normally, this muscle prevents the contents of the duodenum from entering the stomach back into the stomach. If the sphincter tone is reduced, then duodenal juice along with bile easily penetrates into the cavity and damages its membrane.

Common causes of reflux:

exacerbation of chronic gastroduodenitis;
functional dyspepsia;
exacerbation of duodenal ulcer;
acute cholecystitis, biliary dyskinesia;
surgical interventions on the stomach, duodenum or gall bladder;
taking certain medications (analgesics, nitrates, antispasmodics or calcium antagonists).

The appearance of reflux can also be contributed by overeating, frequent consumption of spicy foods, caffeine-containing drinks, smoking, flatulence, and prolonged stay in a bent position.

Main features

Many gastroenterologists claim that occasionally it happens that there is no a large number of Bile is normally present in the stomach for a short period of time. This is associated with physiological reverse, or retrograde, peristalsis and does not cause any subjective sensations at all

In the case of cyclically repeating casting, signs of the disease do not take long to appear.

The main symptoms look like this:

abdominal pain, which is localized in the upper segment, right hypochondrium;
recurrent bitterness in the mouth;
occasional nausea, heartburn:
spontaneous (yellow-greenish inclusions in the vomit);
thick yellow plaque on the tongue, which often indicates stagnation of bile;
loss of appetite, gradual weight loss;
feeling of heaviness in the epigastric region.

The most obvious symptoms that accompany biliary reflux are heartburn with an unpleasant bitter taste in the mouth. It can appear at rest, immediately after eating or activity (especially with frequent bending forward). The disease often occurs in conjunction with throwing gastric composition back into the lumen of the esophagus.

REFLECTION OF BILE INTO THE ESOPHAGUS AND ORAL CAVITY

Due to the weakness of the lower esophageal sphincter, digested food, along with gastric secretions, flows back up to the oral cavity. This is the main manifestation of GERD - gastroesophageal reflux disease. It is often combined with duodenogastric reflux- reflux of bile into the stomach.

Main manifestations of the disease:

constant heartburn, worsening when lying down or bending forward;
belching air or sour;
nausea;
burning or pain in the chest;
hacking cough, bad breath.

The constant entry of gastric secretions into the mouth spoils tooth enamel, contributes to the appearance of plaque on the tongue and permanent unpleasant odor from mouth.

Reflux is confirmed using FEGDS and characteristic complaints. Treatment uses diet, medications (prokinetics, antacids), exalted position during sleep and avoiding prolonged bending forward.

What to do when casting?

In order to quickly calm down unpleasant symptoms It is recommended to take a comfortable position, standing or sitting, and drink an antacid fast action(Rennie, Almagel A), which will protect the gastric mucosa. As a complete treatment for pathology, doctors recommend:

limit coffee intake, strong tea, cocoa, spicy and fatty foods;
stop smoking, sleep with the head of the bed raised using a high pillow;
do not eat 2-3 hours before bedtime, do not take a horizontal position immediately after eating;
Avoid tight and tight clothing and excessive physical activity
reduce weight with overweight bodies.

Among the drugs prescribed are antacids or alginates (Maalox, Almagel, Phosphalugel), prokinetics (Domperidone, Duspatalin) and sometimes - sedatives. For reflux with complications, cytoprotectors are used. They increase the production of protective mucus in the stomach, improve microcirculation processes, and normalize acidity.

Possible complications

If a lot of bile appears in the stomach, this can cause serious illnesses, since not only irritation of the mucous membranes occurs, but also inflammatory processes are triggered, digestion is disrupted, and gastroduodenitis may develop.

Frequent reflux (discharge) can provoke the formation of:

. The disease is directly caused by the fact that chemically aggressive duodenal juice enters the stomach (contains bile and pancreatic enzymes).
. Complication of GERD (reaction of both bile and gastric juice into the esophagus). The disease is based on the development inflammatory process in the walls of the esophagus, the formation of erosions and ulcerative defects.
Barrett's esophagus. A precancerous condition, since the normal epithelium of the esophagus is replaced by small intestinal or gastric epithelium. In the absence of proper treatment, there is a high probability of transformation into adenocarcinoma.

How is the release of bile into the stomach treated? The choice of treatment regimen depends on the reasons causing its accumulation. Reflux is just a sign of an existing disease. If real reasons will not be eliminated, then the casting will not stop and will occur with a certain regularity.

The reflux of bile into the stomach can be cured using the following drugs:

Selective prokinetics. The drugs remove bile from the stomach cavity and also restore the functionality of the permeability sphincters. The faster duodenal juice is removed, the less damage to the mucous membrane. This category of drugs includes Motilium and Cisapride.
Proton pump inhibitors (PPIs). The higher the acidity of the digestive juice, the more damage will be caused to the stomach by bile. Therefore, PPIs are used to reduce acidity. Most effective medicines in this area - "Rabeprazole" and "Esomeprazole".
Antacids. They reduce acidity, improve mucosal protection, and have an enveloping effect. The most commonly used are Maalox, Almagel, etc.
Ursodeoxycholic acid (ursofalk). The drug changes the formula of bile, allowing it to dissolve in water. This makes her less aggressive. "Ursofalk" removes symptoms such as bitterness in the mouth, belching and vomiting.

Do not forget about the mandatory modification of lifestyle: eliminating alcohol, smoked, fried and overly spicy foods, limiting confectionery, carbonated drinks, quitting smoking; avoiding sudden bends and snacks immediately before bedtime.

If conservative treatment ineffective, surgical intervention is recommended. It is performed with the aim of reducing HDER and eliminating emerging complications (metaplasia, cancer).

SURGICAL TREATMENT

Operations are performed in two ways:

Laparoscopic correction, is carried out using an endoscope (several punctures are made in the abdominal cavity, one of which is for gas injection). The method is most often used in the case of diagnosing pyloric sphincter insufficiency.
Laparotomy– extensive access, in which the anterior abdominal wall. This technique allows the doctor to obtain more information and perform a complex operation.

To suggest changing your diet and eating oatmeal for breakfast with natural yogurt and baked apples (contain pectin, which effectively neutralizes bile acids). For severe heartburn, it is recommended to drink honey water.

- only a symptom of an existing pathology. And if typical symptoms appear, it is recommended to contact medical institution for consultation with a gastroenterologist.

During normal functioning of the digestive tract, bile from the liver passes directly into duodenum. But due to various diseases, it can be regularly thrown into the stomach. Why this happens and what to do to treat the problem will be discussed in detail in the article.

Bile reflux (or reflux) is popularly called heartburn. Under normal conditions, food should only move in one direction, and sphincters prevent it from going back. The only exception is vomiting, which serves to rid the digestive organs of toxins. Doctors identify several causes of bile reflux:

chronic duodenitis, in which the duodenal mucosa becomes inflamed and swollen. The pressure in the organ increases and the contents can enter the stomach;
various hernias: trauma, tumors abdominal organs. For this reason, the duodenum is compressed, and bile under pressure overcomes the sphincter;
medicines. Due to the use of muscle relaxants or antispasmodics, the tone of the sphincter muscles of the pylorus may decrease, forming a lumen;
surgical interventions. Sometimes a poor-quality operation cuts through part of the muscle fibers of the pylorus, which is why bile will constantly be thrown into the stomach. Or reflux is possible due to removal of the gallbladder;
pregnancy. The pressure in the duodenum increases due to the presence of the fetus.

There are also less common causes of bile reflux. Defects of the digestive tract can be congenital.

In addition to the bile itself, other substances enter the stomach: duodenal juice, bile acids, lysolycetin, enzymes. Once on the gastric mucosa, all these components cause dystrophic and necrobiotic changes. Sometimes stomach cancer may eventually develop.

It happens that bile reflux has nothing to do with diseases of the digestive tract. Occur at healthy people it can be due to regular overeating, poor diet, drinking too much (especially carbonated drinks), eating before bed, frequent use severe and junk food. In this case, it is enough to eliminate the unpleasant symptoms folk remedies and go on a diet for a while. Reflux also occurs due to sudden movements and heavy physical activity after a meal.

Symptoms

Since three-quarters of bile consists of bile acids, after entering the stomach it neutralizes gastric juice and promotes the breakdown of fats. However, these acids also injure the mucous membrane, leading to inflammation, erosion and gastritis. If reflux is too strong, the esophagus can also be damaged, which is especially dangerous due to the degeneration of its epithelium.

There are several symptoms of bile reflux:

nausea and vomiting of bile;
nagging pain in the abdominal area;
belching, often with liquid;
thirst;
bitterness in the mouth and typical coating on the tongue;
symptoms of general fatigue.

Video “Bile Reflux”

Treatment

When treating bile reflux, you need to understand that bile reflux is only a secondary symptom and if the cause is not eliminated, the disease will remain. However, it is also important to treat symptoms, including folk remedies, in order to improve the quality of life and eliminate complications. Before the course of treatment, you need to start a diet so that the drugs work more effectively.

From effective drugs For the treatment of reflux the following are used:

selective prokinetics that increase muscle tone sphincters and improve peristalsis (motiluim, cisapride);
antacids that reduce acidity (Maalox, Almagel);
proton pump inhibitors that neutralize acid. They should be used separately from antacids. The drugs include: rabeprazole and esomeprazole;
ursofalk (changing biliary properties to water-soluble and less toxic);
various folk remedies.

Unfortunately, many diseases that lead to bile reflux require surgical treatment(with the exception of chronic duodenitis, which can be cured conservatively). Common operations include:

laparotomy. Remove the hernia or tumor that puts pressure on the duodenum and strengthen the pyloric sphincter;
laparoscopic correction. A gentle operation without opening the abdominal cavity.

Diet is also important in the treatment of bile reflux. It relieves the symptoms of the disease. You need to eat small meals, 6 times a day, and little by little. Until the end of treatment, it is advisable to exclude from the diet: fatty, smoked, spicy, fried foods, carbonated drinks and alcohol. The diet recommends boiled dishes, dietary meat, fruits, honey, and vegetables.

The most commonly used folk remedies to relieve symptoms are St. John's wort, chamomile and yarrow. They are poured with boiling water and drunk twice a day with honey. For bilious vomiting, fume powder is suitable as a folk remedy. Pour boiling water over two tablespoons of the herb, leave for an hour and take 50 ml when vomiting. You can also use a proven folk remedy - flax seed, which envelops the mucous membrane. One hundred grams of seeds are infused in cool water and drunk on an empty stomach.

Complications

The consequences of bile reflux include:

gastroesophageal reflux disease. Stomach contents regularly reflux into the esophagus and damage the walls. If the disease progresses, surgical treatment will be required;
reflux gastritis. The gastric mucosa becomes inflamed due to bile acids, especially with high acidity;
Barrett's esophagus. Dangerous complication due to the impact on lower sections esophagus bile acid. The flat multilayered epithelium of the organ is replaced by a cylindrical one. This is already a precancerous condition.

Bile reflux – serious illness, as it can cause gastroduodenal complications if treatment is not started on time.

Video “Bile in the stomach”

How bile is formed in the stomach, as well as how to cure the disease, you will learn from this video.

With the normal functioning of the digestive organs, it should pass from the liver to the duodenum and follow into the intestines. When the function of the pylorus is impaired, the pressure in the duodenum is increased (as a consequence various pathologies), bile enters the stomach.

It should be noted that the symptoms cannot be ignored; the release of bile can lead to very Negative consequences. The fact is that bile contains a large amount of acids, which have a detrimental effect on the gastric mucosa, causing gastritis, peptic ulcer and oncological diseases.

1 Why does pathology occur?

Reasons why bile reflux develops:

mechanical trauma, malignant, benign neoplasms - they provoke compression of the duodenum, while the bile is under pressure, overcoming the resistance of the sphincter, and reflux of bile into the stomach occurs;
on later pregnancy, when the fetus is large enough, it puts pressure on the liver, creating the same pressure as in an injury, the consequence is that bile ends up in the stomach (this phenomenon is temporary and goes away after childbirth);
taking antispasmodics or muscle relaxants reduces the muscle tone of the sphincter, bile is released through the resulting gap between the duodenum and the stomach;
operations - in some cases with surgical intervention the muscle fibers of the pylorus are dissected, as a result - a person experiences a reflux of bile into the stomach for the rest of his life;
congenital anatomical defect in the structure of the sphincter, dystrophy in its smooth muscles;
promotes the reflux of bile into the stomach due to inflammation and swelling of the duodenal mucosa.

Bile in the stomach may be a consequence poor nutrition. In this case, a lot of bile is produced, which is simply not able to stay in the gallbladder.

Another reason for secretion to enter the stomach is overeating at night, especially in overweight people.

The presence of bile in the stomach is not a deviation from the norm and occurs even in completely healthy people. But if heartburn and discomfort often appear and these symptoms are regular, then you should immediately consult a specialist; only gastroenterologists know how to get rid of the pathology and can tell you how to treat the disease.

2 Symptoms of reflux

When bile is released and enters the stomach, a person feels:

constant feeling of thirst;
cutting, burning painful sensations in the stomach area;
- due to bile entering the esophagus;
attacks of nausea, almost always followed by vomiting;
belching of bile often occurs.

If a person experiences the symptoms described above, they should immediately consult a doctor. To relieve pain and nausea, you can first drink 200 ml of warm distilled water, taking small sips. Water will wash away bile acids from the wall of the stomach mucosa.

3 Diagnosis and treatment of bile reflux

Diagnostics, which allows you to identify bile in the stomach, includes taking an anamnesis and a complete examination of the peritoneal organs. The diagnosis is based on the basic laboratory tests functional liver tests, duodenal intubation and endoscopic ultrasonography, MRX, cholescintigraphy, ultrasound, endoscopic ultrasonography, hyperkinesia.

If a person is diagnosed with bile in the stomach, treatment is prescribed only by a doctor.

When bile enters the stomach, treatment is based on two principles - the symptoms are relieved and the functioning of the bile duct and pancreatic secretion into the intestines is normalized. For treatment, patients are prescribed medications that help relax smooth muscles, have choleretic properties, restore pressure in the gallbladder, change the structure of bile, making it water-soluble and less toxic to the liver, and improve motility of the gallbladder.

4 Diet for bile in the stomach

With such a pathology, diet is very important. At proper nutrition the person will produce less bile. The basic rules of nutrition are to eat as often as possible, approximately every 2 hours, the last meal is taken no later than 2.5 hours before bedtime. Pickles, marinades, smoked foods, fatty, fried, and spicy foods are excluded. Only with such a diet will the symptoms stop tormenting the person.

It is allowed to eat porridge, boiled lean meat, fish, vegetable broths, dishes cooked in a double boiler, slow cooker and oven. All food products should be crushed as much as possible, then they will be quickly digested and not stagnate in the gastrointestinal tract.

Diet: approximate diet for 1 week

I breakfast (09.00): oatmeal with low-fat milk, tea, diet biscuit.
II breakfast (11.00): buckwheat with veal cue, rosehip decoction.
Lunch (13.00): vegetable stew, veal cue, baked potatoes, jelly.
Afternoon snack (15.00): buckwheat porridge with skim milk, tea.
I dinner (17.00): cottage cheese casserole with carrots, jelly.
II dinner (19.00): a glass of kefir, diet bread.

I breakfast: steamed cottage cheese pancakes, tea, bread and butter;
II breakfast: milk rice porridge on skim milk, jelly.
Lunch: rice soup with vegetable broth, rabbit baked with vegetables, tea.
Afternoon snack: cottage cheese soufflé with banana, jelly;
I dinner: vegetable salad, boiled liver with rice;
II dinner: cottage cheese soufflé, tea.

I breakfast: wheat porridge with milk, tea, diet biscuit.
II breakfast: fruit salad with yogurt, jelly.
Lunch: soup with chicken meatballs, vegetarian pilaf, tea.
Afternoon snack: cottage cheese casserole with beets, chamomile infusion.
I dinner: baked quail with vegetables, tea.
II dinner: jelly, biscuit.

I breakfast: 2 bananas, yogurt, rosehip infusion.
II breakfast: 2 egg omelet, tea, bread and butter.
Lunch: rice soup with quail broth, vegetable salad.
Afternoon snack: low-fat cottage cheese with sour cream, a glass of milk.
I dinner: boiled potatoes, steamed chicken chop, jelly.
II dinner: baked fish, rice, tea.

I breakfast: buckwheat, vegetable salad, jelly.
II breakfast: 2 soft-boiled eggs, cucumber.
Lunch: cheese soup chicken broth, boiled potatoes, boiled chicken breast, jelly.
Afternoon snack: yogurt, banana.
I dinner: steamed chicken cutlet, rice porridge, tea.
II dinner: kefir, biscuit.

I breakfast: semolina with milk, banana, jelly.
II breakfast: chicken ball, vegetable salad.
Dinner: vegetable soup, baked beef with potatoes, jelly.
Afternoon snack: cottage cheese with sour cream, rosehip infusion.
I dinner: baked fish with potatoes, jelly.
II dinner: kefir, biscuit.

I breakfast: cottage cheese casserole with currants, tea or cocoa.
II breakfast: diet cookies, yogurt.
Lunch: meat stew, vegetable salad, jelly.
Afternoon snack: 2 soft-boiled eggs, cabbage salad, tea.
I dinner: fish casserole, baked vegetables, chamomile infusion.
II dinner: a glass of kefir.

The diet should not contain products that contain essential and extractive components. A high content of these substances is observed in strong meat, fish, mushroom broths, peppers, horseradish, radishes, radishes, sorrel, cold dishes (aspic, ice cream, frozen juices), carbonated water, rye bread, legumes, nuts, chocolate, sweet flour products.

Be sure to include in the diet foods that have choleretic action - fermented milk products, eggs (soft-boiled!), cabbage, fruits, cucumbers, carrots, beets, strawberries.

5 What alternative medicine offers

Treatment with folk remedies for bile in the stomach, the causes of which have not been established, can be used only after consultation with a specialist. Making decoctions, tinctures and taking them yourself is unacceptable. Do not forget that not all people are allowed to use decoctions medicinal herbs. They can cause an allergic reaction.

6 Blind probing technique

It is better to ask your doctor about how to treat pathology in this way. This method is tubeless stimulation, which improves the flow of bile in the stomach. At the same time, they are revealed bile ducts, and the bubble contracts. Thus, the secretion quickly leaves its location and is excreted into the intestines. Some people are not allowed to use this method, these include pregnant and lactating women, people suffering from cholelithiasis. Probing is carried out in the morning, without getting out of bed, and a No-Spa tablet is taken in the evening. A person should drink 250 ml of warm mineral water, turn to right side and apply to the liver area warm heating pad. Legs should be bent right hand placed behind the back. You need to lie in this position for 45 minutes, while doing 5-6 deep breaths- in this way, additional massaging of the liver with the diaphragm occurs, which improves the outflow of bile in the stomach. You can have breakfast after 35 minutes. The frequency of the procedure is determined by the doctor.

7 Decoctions of medicinal herbs

The following decoction will help relieve symptoms. Plantain (1 tbsp), thyme (0.5 tbsp), St. John's wort (0.5 tbsp), immortelle (1 tbsp) are poured into 1.5 liters of boiling water and infused for 4 hours. You need to take the strained decoction 3-4 times a day, 0.5 cups.

When throwing bile into the stomach, the following herbal mixture helps a lot. Pour barberry root (50 g), dandelion root (50 g), chicory (25 g) with water and bring to a boil over low heat. Boil for 10 minutes, cool, peel and take warm 20 minutes before eating.

When throwing bile into the stomach, it is fashionable to use a decoction, which includes: plantain (0.5 tbsp), marshmallow rhizome (1 tbsp), chamomile (2 tsp), oregano (0.5 tbsp. l.), St. John's wort (1 tsp.), caraway fruits (1 tsp.). They are poured with 2 liters of boiling water and boiled for 2-3 minutes. Leave for 5 hours. The decoction is taken before meals 15-20 minutes 4 times a day.

Treatment, the causes of which have not been established, can only be used after consultation with a specialist.

To improve the flow of bile in the stomach, you need to drink a berry decoction 30 minutes before each meal to prevent the reflux of bile into the stomach. For preparation you will need rose hips (30 g), hawthorn (25 g), red rowan (20 g), viburnum (25 g), cranberries (20 g), black currants (20 g), gooseberries (25 g). The berries are brewed like tea with 1.5 liters of boiling water, infused for 15 minutes.

Beetroot juice will help relieve unpleasant symptoms and remove bile into the intestines. It is effective in combination with cucumber and carrot juice. Before each meal, 20 minutes before, you need to make freshly squeezed juice from cucumber, carrots and beets, drink 30 g.

Milk thistle will help with the reflux of bile into the stomach. She is included in absolutely all medicines for the liver, gall bladder. The seeds of the plant are ground into powder and added to dishes, 1 tbsp. l. You can prepare a decoction from the seeds. Proportion 1 tbsp. l./0.5 l of water. After boiling, boil for 10-15 minutes. Take 30 g before meals 6 times a day.

To prevent bile reflux, you need to take decoctions of medicinal herbs that are rich in silicon. One of the representatives flora, the content of this component is very high - these are strawberries. To prepare the decoction, you need to take 2 bushes of the plant with roots and leaves (it is preferable to use strawberries during the period when they bloom), wash well, put in a liter jar and pour 1 liter of boiling water, leave for 35 minutes. Drink 0.5 cups 6 times during the day.

Don't forget that folk recipes They cannot in any way be the main treatment when there is a regular reflux of bile into the stomach, this is only an auxiliary method.