Oesophageal Patients Association

Managing bile - again

After a very bad night with this I've been thinking .....

if bile is alkaline I'm wondering if during an attack sipping lemon juice or some similar acidic drink would neutralise it and reduce the burning ?

also ...do people think that taking PPIs and reducing the stomach's acid production mean that the bile isn't " neutralised " as it would normally be ( assuming it is ,I'm guessing here ) by stomach acid ?

what do people think ?

Chemists please be forgiving of my crude attempts to apply my limited understanding !

14 Replies

Are you sure it's not acid that burns? When I get acid reflux I take 1/2 teaspoon bicarbonate (baking powder), it helps immediatly.


cortex 1 I would think again re-the Bi-carbif I were you,I suffered with acid since the age of 16 and went through almost everything on the Market to relieve it however I stumbled upon Bi-Carb when I was in my early 30s,great I thought,Instant relief, now at the age of 60 I am recovering from OC (1 year after op) my surgeon said that I could well have played a large part in where I am today,I suppose it is Logical really when you see what that stuff does to kettles and Lime scale.


I can understand where you are coming from! But they do come from different sources.

I think the answer would all depend on the details of your surgery. If you have very little stomach left, there may not be so much acid produced, and taking PPIs would reduce that further.

The bile comes into your intestine from the gall bladder. Bile gets produced to help you digest fat, and sometimes the re-arrangement of your insides means that this floats upwards. There is something called impedance monitoring that can help with diagnosing whether it is bile. If you have light brown, oily floating motions it can indicate that you are not digesting fat (steattorhea). There are things like creon that can help with this, or chlorestyramine. Excess bile does not do your system any good, and may cause diarrhoea.

Sometimes you can get a 'bounce effect' when you stop taking PPIs as the body temporarily over-compensates when the chemical effect stops.

Bile tastes vile, and I can understand that you need to have something. Gaviscon is an alginate, so it creates a protective raft inside for a few hours regardless of whether it is acid or alkali, and my inclination would be to try that rather than lemon. Stomach acid is very strong, and I suspect bile equally so, and I therefore suspect that lemon would not be strong enough to make much difference, but I would never knock anything that might help in the small hours of the night. Taking an antacid (eg Rennies, Tums) would be very unlikely to help as it is combatting the wrong thing.

So you may get some relief if you have been eating too much fat, and might get somewhere with gaviscon, but I think you ought to see your doctor to sort out the excess bile issue as you will almost certainly need a more specific medication.


Bile salts are slightly acidic (the pH is less than 7) . The stomach also produces acid. So I agree, odds are reflux is acid and not alkaline. In which case adding acid lemon juice to the mix not going to help. PPIs will block stomach acid production but won't affect any bile (if that is what is coming up). Gaviscon is a safe thing to try.

Bicarbonate of soda is a quick fix but it turns to salt in the stomach so not good to take too much of it (too much salt bad for BP and for people with certain medical conditions) - ordinary antacids are better for regular use.


I can tell the difference between bile and acid reflux and I'm talking about bile here .

I don't get it frequently . If I did I think I'd go down the nightly gaviscon route or want to take another medicine .

Thanks for the replies everyone .


Fresh lemons: If you prefer not to use baking soda, a fresh lemon added to your drinking water will also, eventually, make your purified drinking water more alkaline. Though it seems counter-intuitive to think that adding an acidic lemon to your purified drinking water could ultimately produce an alkaline result, it's important to remember that fresh lemons are also anionic. Once you drink the acidic lemon water, it will become alkaline as your body reacts with the lemons' anions during the digestive process. Use fresh lemons that haven't been exposed to air for more than 30 minutes -- not lemon juice purchased at the store or lemons that have been cut up and sitting out in the open at a restaurant all day.

I've found that one fresh lemon will make at least 3 or 4 litres of alkaline water. Yes, it does seem strange that the fruit which tastes most acidic should in fact become alkaline in the body, but there it is. One of the fruits to avoid like the plague is pineapple. Hope this helps.


I am 7year post op and up until two weeks ago I suffered with acid reflux sometimes quite badly. Two weeks ago I decided to give up drinking tea and coffee to see if that helped and I feel a different person. I have slept better than I have slept for week and have had no acid attacks during the night. I also have more energy and am not needing "nans naps" during the day. Worth a try!!!


Bile probably would not be neutralized in a chemical sense by acids. I do find that sipping orange juice helps mask the taste of the bile reflux, and it might neutralize it a bit too.

Taking acids (lemon juice, vinegar, etc) can help decrease stomach acid by activating a feedback loop. (Body senses presence of acid and realizes it doesn't have to produce as much). Because bile is mostly in the form of salts it is pretty unreactive chemically. It helps the absorption of fats by serving as a surfactant, like a detergent on a greasy dish.

I think from a chemical standpoint, mild acids won't deactivate the bile very much, but might mask the taste some with their own strong tastes.


Thanks all for your posts . Much to ponder in yours Shack ,not least the concept of negatively charged ions ....

And especial thanks to Chris for the mention of bile salts not being very reactive and bile being a surfacant .

It's all so interesting ,acid and alkaline both being stuff ( forgive the technical term ) that burns . Though bile seems to burn so much more .

From a personal point of view I think factors for a bile attack are position in bed and an overfull stomach .


For your problem take 350 mg Magnesium (Gluconate or Citrate)


azharzaidi - thanks for the suggestion ,just to be clear can I check that you are recommending this for problems with bile ?


I found my antidote to a bile attack some months ago. Very early morning, woke with foul taste, staggered to medicine cabinet saw a tube of Lockets lozenges for sore throats. In desperations popped one and the immediate rush of menthol and eucalyptol masked that nasty taste sucking the lozenge released glucose and then honey and lemon. The fire went out of my throat, so I never travel without them.


The problem with bile is not so much neutralising it as recovering from its after effects, namely the foul taste and burning sensation, which remain for several hours after the bile has gone. This may be why throat lozenges and Gaviscon, which soothe the throat, may work for some people. The best advice is to try to avoid bile by sticking to a low fat diet. Drinking less tea and coffee, as Lilia suggested, may also help.

Good luck, G


Hi Spikey ,thanks for posting . Totally agree that bile attacks take some getting over . The burning is horrendous .

Actually I'm wondering ( was it me who said I knew the difference between bile and acid reflux ? ) if it's actually acid but that I'm getting a little down into my trachea ?

Last night I was wheezing and breathing really fast following a night time attack . The other week ,when it was worse ,I was left coughing and with a rasping voice for a couple of days .

I'm not really worried - the attacks are rare so I don't imagine they can do too much damage .But very unpleasant when they happen and certainly make for a sleepless night .


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