Throwing Up Bile – It’s More Dangerous Than You Think
Throwing up bile or bile reflux occurs when bile moves up into your stomach and then from the stomach to the esophagus. This disease is common in patients who are suffering from gastroesophageal reflux disease. If not treated early, it can cause serious complications such as gastric ulcer, stomach cancer, barrett’s esophagus and esophageal cancer.
What are the bile’s functions?
Bile is a green or yellow fluid that made in the liver and stored in the gallbladder. The bile will move to the small intestine to perform digestive function with the following roles:
- Digests fats and vitamin dissolved in oil (A, D, K, E)
- Stimulates the secretion of digestive enzymes of pancreas and intestinal fluids as well as activates them.
- Create an alkaline environment in the intestine, stimulate intestinal motility, inhibit the activity of bacteria rotten in the upper intestine.
- In addition to digestive function, bile also removes bilirubin – a degradation product of hemoglobin (a substance in red blood cells) which makes the color of bile.
Causes of bile reflux disease
When pyloric valve is suffered and does not close properly, throwing up bile phenomenon will happen and damages gastric mucosa. If the patient is suffering from the gastroesophageal reflux, the bile backs up to the esophagus can spread to the throat and larynx. The reasons causing this phenomenon are:
- Complications of gastric bypass surgery: After gastric bypass surgery, the functions of pyloric valve are affected, causing bile and acid reflux.
- Peptic ulcer: Stomach injuries make pyloric sphincter muscle function weaker, leading to throwing up bile.
- Gallbladder surgery: Bile reflux often happens on people who have undergone cholecystectomy surgery, however, there are not many details related to this reason.
Because the symptoms are quite similar so people often confuse between bile reflux and gastroesophageal reflux. As a result, they don’t have an appropriate treatment method. In some cases, these two diseases can occur simultaneously. Some common signs and symptoms of this disease are:
- Heartburn accompanied with bitter tasting in mouth: Patients often feel burning in the chest, hurt at the upper abdomen and bitter taste in the mouth.
- Vomiting yellow or green fluid.
- Sore throat, hoarse voice and cough because the vocal cord is injured when bile is moved up into the lower throat area and throat.
- Lose weight
For patients who are getting both with bile reflux and gastroesophageal reflux, having a healthy lifestyle is very important.
1. Precautionary measures
- Changing your diet: you should eat small meals and only lie down after eating 2 – 3 hours to the food digested. Don’t eat foods that promote acid and bile reflux such as fatty foods, coffee, vinegar, pepper, chocolate, carbonated drinks, etc.
- Don’t drink alcohol: Alcohol will stimulate the esophagus and increase Lower Esophageal Tone, which is the reason causing acid reflux.
- Quit smoking: When you smoke, there will be an amount of nicotine absorbed into your body. Nicotine will increase attacking factors such as HCL, pepsin as well as decrease protective substances like prostaglandin (a substance helps to protect and restore mucus, narrow the blood vessels in the stomach)
- Take a rest: When a patient suffers from chronic stress, the protective factor (mucus) and attacking factors (HCL, pepsin) are imbalanced that make the gastric mucosa was injured, affects the digestive function of the stomach. The process of digestive food slows down, the lower esophageal sphincter has to work harder, in the long time will cause reflux disease.
- Use inclined bed: When the pyloric is weak, bile and acid reflux are very easy to occur. Raising the height of your bed head about 15 – 20 cm can help to prevent from reflux symptoms.
- Weight loss: When you make a weight loss plan, the amount of fat digested in the stomach and small intestine will decrease, throwing up bile and acid will relieve.
2. Take medicines
Drugs used to treat bile reflux disease are also used to treat acid reflux, however, their effectiveness is not high. The main categories of drug used are:
- Cholesterol lowering drugs: Questran® and Colestid® help the body remove bile.
- Proton pump inhibitors (Protonix®, AcipHex®, Nexium®, etc) are acid reducing drugs used to treat acid reflux. However, the effect of them on treatment for bile reflux is still controversial.
3. Surgical treatment option
When lifestyle changes and taking medicines are not effective in treating reflux, the patients need to undergo surgery. There are two methods of surgery used in treating throwing up bile:
- Roux-en-Y Surgery: This is a technique to connect the bile duct and the jejunum. Bile will move directly into the jejunum (the latter part of the duodenum), helping to relieve the bile reflux. The success rate approximately is 50-90%.
- Anti-reflux surgery: The portion of stomach near the esophagus is wrapped. This method helps to strengthen the lower esophageal sphincter, prevent bile and acid reflux and into esophagus. Treatment by anti-reflux surgery is often used in case of the patients are suffering from acid reflux.
Guest Author: Joyce Baker
Joyce is both a freelance graphic designer and a health writer. She graduated from the Arts and Humanities faculty at The University of Central Florida