Bile Gastritis

Bile gastritis is a stomach inflammation that starts when bile produced by the liver leaks into the stomach. Over time, the acidic fluid erodes the stomach lining and can even reach the esophagus, leading to heartburn.

Bile gastritis is rare, but people who have had their gallbladder removed or have had stomach or weight-loss surgery are at risk for it. This is because the procedures can disrupt how the body stores bile, making it more likely the fluid will surface in places that it doesn't belong.

Facts about bile gastritis

Illustration of liver and biliary system
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Bile is a greenish yellow fluid produced by the liver to break down fat, remove toxic materials, and aid in digestion. It is stored in the gallbladder and released when you eat a food containing fat. In healthy adults, the fluid moves through one of two tubes to the top part of the small intestine, or duodenum, which moves the waste to your rectum and flushes it out of your body.

But bile in the small intestine can wash back into the stomach, a condition called reflux. The acidic fluid can eat away at the stomach's mucous lining, causing redness and irritation, a condition commonly called gastritis. Over time, this can cause severe pain. It's similar to classic heartburn, in which acidic food in the stomach seeps back up into the esophagus.

The cause of bile gastritis is often a damaged pyloric valve, the ring between the stomach and small intestine. The valve is meant to open slightly so that food—but not bile—moves to the small intestine. When the valve opens too much, the bile leaks into the stomach and causes pain.

Symptoms

These are symptoms of bile gastritis:

  • Stomach pain, often severe

  • Nausea

  • Vomiting blood or waste that looks like coffee grinds

  • Weight loss

  • Gas

  • Bloating

Diagnosis

A doctor diagnoses bile gastritis by looking inside the body with a long, thin tube that contains a light and a tiny camera, a procedure known as an endoscopy, to see where bile is going.

Treatment

Bile gastritis is difficult to treat, but the body can usually heal itself if the fluid has slipped into the stomach just once or twice. Balancing out the fluid's acidity with bread and milk or trying an antacid can help.

If bile continues to backflow into the stomach on a daily basis and causes severe pain, medication is typically the next step. Doctors often prescribe sucralfate to protect the stomach from the acid so healing can occur.

If your body doesn't respond to the drug, doctors generally recommend surgery. The surgeon will move the bile duct that connects the liver and small intestine further down in the body. That way, it is more difficult for bile to seep into the stomach.

Prevention

If you are at high risk for bile gastritis, your doctor may suggest certain diet and lifestyle changes. This may include avoiding acidic foods, such as tomatoes and spicy foods, and eating small meals. Still, unlike acid reflux, these changes alone won't necessarily prevent the condition, because it is often triggered by surgery or problems with the small intestine.