Bile Back up

[Butterfly740]

I've just recently been diagnosed with having Barrett's Esophagus. When I try to sleep on my right side, bile will back up into my throat. I can only sleep on my left side. I have pain on my right side just under my rib cage. Gallbladder was removed 1996, Appendix was removed 1995. I'm nauseated quite often. Almost everything I eat burns my throat going down and I'm having to swallow alot, as well as coughing all the time, even when I don't have a cold. Acid reflux medication no longer helps. What could it be?

[Karjade]

I was diagnosed with Barrett's and a hiatus hernia last November which I had never even heard of and was very scared. I have tried a few different reflux medications and now settled on 30 mg Lanzaprazole which I take once or twice daily. I am now on a group on Facebook which has been brilliant and have learnt so much called Barrett's Esophagus Awareness. It may help to raise the top part of your bed with a couple of house bricks so the acid is kept down during the night. Some people use extra pillows but I am sure other members will tell you what they do.

[Hidden]

Bile is an alkali, and therefore what works against acid sometimes makes things worse. So, you need to establish for sure that what you taste really is bile (it is really foul, but the hospital can give you a test. Otherwise there are kits that you can buy. Ask a pharmacist as a first step). Having had your gall bladder removed will be a factor though.

Try Gaviscon, which, being an alginate, creates a protective raft against both sorts of reflux (but only for a short period). It is occasionally possible to have acid and bile reflux together, but let's not be unduly pessimistic!

Sleeping position can often have a beneficial effect. Sleeping propped up and on your left side will tend to help because the junction of the oesophagus and the stomach is to one side of the stomach, and gravity then tends to help keep it in place.

I think you need to see a gastroenterologist / surgeon to see whether anything more permanent can be done, or at the very least review the medication you are on.

It sounds as though your throat and oesophagus is inflamed and sore, probably because of the effect of the acid / bile. Reflux can cause you to have a persistent cough. What you describe does need sorting out very soon.

[gutlesswonder]

Bluntly it is the Bile, which already has given you Barretts and, which if you are one of the rare unlucky ones may progress to cancer.

Your cough results from inhalation of reflux in either liquid or aerosol form, putting you at risk of pneumonia.

You have to get to grips with this NOW TODAY.

We have the answers on this site since everybody here has been through this.

What is your age, height, weight, any other health conditions?

[Butterfly740 in reply to gutlesswonder]

Hi thanks for getting back to me. I do have an appointment with my gastroenterologist next month, but my stomach has been giving me a fit lately. I may have to see if there is another doctor there who can see me sooner. There are multiple doctors at the same practice.

I am 43 years old, 5'6", and yes I am overweight, with high blood pressure which I am working on. I have changed my diet. I don't even drink coffee anymore mostly water. I have lost 10lbs so far. I take the stairs at work instead of the elevator and I walk ALOT. So I am trying to fix my issues. My motivation are my children, although they are grown now they still need me and I them. Just to be there to lead and guide as I have always done. To spend time with them and my grandchildren. I went through a lot last year taking care of my husband who was cancer stricken until he passed on father's day. And it did cause a lot of depression as well. I just want to get to the bottom of this issue before it's too late.

[gutlesswonder]

Congratulations, you are doing everything right.

As is the usual bloody-minded perverseness of this world your gut problems may prove to be a blessing in disguise in that they provide a challenging goal to concentrate on, so ameliorating the effect of the other things you have had to endure recently.

As you still have your oesophagus I am sure it will be wise to continue taking a PPI. A cure of Barretts can take up to 5 years, if stomach acid is the main culprit.

The pain on the right side just under the margin of the rib cage is residual pain from the 1996 cholecystectomy. I still have this after 26 years.

However the real issue is the continuous flow of raw bile. Normally bile is stored in the gallbladder where it is dehydrated and aged, this concentrate only being released upon eating a fatty meal. There is no medical remedy for this but you can achieve a lot with lifestyle changes - some of which you have already started.

Unfortunately I have never encountered a GP with even the faintest notion about this issue, and even many gastroenterologist leave a lot to be desired. However, trying to be constructive, I wonder if one of the primary carers would be willing to write to the gastroenterologist, with whom you already have an appointment, to suggest a full work up for reflux. If you think that this has any merit I can brief you on the procedures.

Am I correct in thinking that you experience a lot of diarrhea?