Yellow gastric juice is reflux bile?

The article was professionally consulted with Specialist Doctor I Le Nguyen Hong Tram - Gastroenterologist - Department of Medical Examination & Internal Medicine - Vinmec Nha Trang International General Hospital.

Bile reflux is a disease that is easily confused with gastroesophageal reflux disease. These are two completely different diseases. The treatment of bile reflux is quite difficult compared to gastroesophageal reflux disease.

Bile is produced in the liver, it is cloudy yellow or greenish, liquid, bitter taste and alkaline (pH 7 to 7.7). Every day, about 700 to 800 ml of bile is secreted and stored in the gallbladder. When you eat, the gallbladder contracts to move bile from the gallbladder into the duodenum.
The role of bile is to digest fats, help the body absorb fat-soluble vitamins such as A, D, E, K; stimulates secretion and activation of pancreatic juice, intestinal fluid; creating an alkaline environment in the small intestine, stimulating intestinal peristalsis and inhibiting the activity of rotten fermenting bacteria. The pyloric valve is the wall between the stomach and duodenum that opens and closes when necessary to bring food to the small intestine in one direction, meaning that fluid and food cannot return from the small intestine to the stomach.
But for some reason, the pyloric valve does not close tightly, causing reflux of bile and food from the small intestine to the stomach. If there is an open heart valve, this bile will continue to back up into the esophagus.
The fact that bile reflux and vomiting of gastric juice often occur at the same time, but it often causes more serious damage to the esophagus.

Bile reflux is the result of the following problems:
Stomach - duodenal ulcer: Stomach - duodenal ulcer often causes reduced digestive activity, food is easy to stagnate in the stomach for a long time. thick, putting great pressure on both the pylorus and the myocardium. So after a long time with peptic ulcer disease, you will be prone to bile reflux. Complications after gastric surgery: The surgical removal of part or all of the stomach in the treatment of gastric cancer, peptic ulcer disease or weight loss in obese people can affect the pyloric and sphincter valves. Cardia. When the pyloric valve is affected, it will not close properly, from which bile will leak from the duodenum into the stomach and can back up into the esophagus. Gallbladder surgery patients: Research has shown that people who have had their gallbladder removed have a higher risk of bile reflux because bile is no longer stored and secreted as regularly as the body needs. . Bile juice produced by the liver will be secreted directly into the digestive system, easily causing overload.

Symptoms of bile reflux include:
Epigastric abdominal pain is a common symptom in bile reflux, painful or intermittent, accompanied by a burning sensation in the chest and upper abdomen. Heartburn, bitter mouth. Vomiting yellow green liquid, bitter throat. This is the most important sign suggesting bile reflux. Dry cough, hoarseness may be caused by bile reflux into the esophagus. Abdominal bloating, slow digestion and weight loss. Therefore, vomiting yellow and green gastric juice is a sign of bile reflux. Gastroduodenal endoscopy is an important method for diagnosing bile reflux. Through endoscopy, the doctor can see a direct image of bile from the duodenum overflowing through the pyloric orifice into the stomach or see yellow bile stagnation in clusters in the mucosal folds of the body and stomach. In addition, during the endoscopy, the doctor can detect lesions of the stomach and esophagus. However, if the time of endoscopy does not coincide with the time of bile reflux, nothing will be observed.

4.1. Lifestyle changes Healthy lifestyle changes are a must in the treatment of bile reflux, you need to follow your doctor's instructions to better control the disease.
Do not use stimulants such as alcohol, carbonated drinks, coffee. Divide the meal into many small meals during the day, not to be too hungry or too full after eating. No smoking. Stay away from foods that can cause bile reflux such as vinegar, tomatoes, onions, citrus, spicy foods, etc. After eating, you should sit and rest for a while, do not lie down immediately. When sleeping, you should pillow your head about 10-15 cm higher than your feet, so that bile secreted for digestion will not be refluxed into the stomach and esophagus much. Maintaining a reasonable body weight, especially for obese people, needs to follow a healthy weight loss diet. Regular exercise to improve health, however, you need to limit performing abdominal twisting movements because it makes bile reflux disease more serious. Limit staying up too late, reduce stress. 4.2. Using drugs to treat bile reflux Bile reflux disease often requires a combination of drug treatment along with lifestyle changes to quickly reduce symptoms and control ongoing disease. Medications commonly used in the treatment of bile reflux include:
Proton pump inhibitors: This is a drug commonly used in the treatment of acid reflux because of its ability to block acid secretion, but it is also indicated Determination of bile reflux is also used. Ursodeoxycholic acid: This drug works to promote bile flow, reducing symptoms and frequency of symptoms. Drugs that sequester bile: Care should be taken when using this drug because it can cause many health consequences. This medication works by temporarily disrupting the flow of bile and reducing symptoms of reflux. These drugs cannot cure the root of the disease, they can only help control the symptoms, so they should not be overused.

4.3. Surgery Surgery to treat bile reflux is usually indicated when the patient does not respond to the above measures or has very severe symptoms or a precancerous change is suspected.
Your doctor will discuss with you to choose the right surgical method for your condition:
Diversion surgery: This method is suitable for patients who have had gastric surgery and pylorectomy before. A bile duct inside the small intestine will be created to move bile out of the stomach, avoiding excessive accumulation and reflux into the esophagus. Anti-reflux surgery: The surgeon will roll up and sew around a portion of the lower esophageal sphincter, so the strengthened valve is better able to block. Prevent acid and bile reflux from causing damage to the esophagus. In summary, when vomiting yellow and green gastric juice is one of the signs of bile reflux. This condition will cause serious damage to the patient's esophagus. Therefore, when there are symptoms such as epigastric pain, heartburn, bitter mouth, vomiting green and yellow fluid, etc., the patient should go to a medical facility for examination and timely treatment measures.