Oesophageal Patients Association
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Bile reflux

I was told 4years ago I had an Hiatus Hernia and acid relux and have tried nearly all the PPI,s to really no help,they just made me nauseus.I don,t seem to get much heart burn or even now I,ve dropped down to one 20mgs Omeprozole every 5 days I don,t get much acid .What I do have is uncomfortabley bloated chest breathing problems and in the mornings my tongue seems to be coated in a beige coloured bile which I clean off with my toothbrush.I have recently heard of Bile reflux but can,t find out much information,does anyone on hear know what it is and what the symptoms are,I am seeing the specialist on Tuesday and would like to go with some knowledge so he can.t just fob me off after 4 years of feeling ill it,s about time I was diagnosed correctly,He just keeps trying me on different PPI,s.Any information would be appreciated.

6 Replies

If you have had your oesophagus and quite a lot of your stomach removed and then have reflux, it is possible that it might be bile rather than stomach acid. It tastes really foul, and is alkali, which is why the acid suppressing medications do not work with it. There are tests that can measure how acid or alkali your saliva / reflux is, so it might be worth asking for a test for this. There are other reasons fro bile reflux but we do not know for sure that it is bile at this stage.

The other thing you might ask your doctor about is whether you might have thrush or candidiasis in your throat.

Some people do not respond to these medications and need specialist help to sort out their reflux. As an example, and it may well not be relevant to your situation, some unusual cases need a biopsy from their oesophagus as part of the diagnosis:


I understand why you think you may be being 'fobbed off' but I would try and write out a timeline of what you have been experiencing and the various treatments you have had so that it sets the agenda of your consultation with the GP as they do not always have the time to summarise your history as helpfully as one would like. Reflux that continues after courses of medication without a proper diagnosis of the underlying cause ought to be investigated and it is reasonable to ask for this. There may also be a case for asking for an assessment to be made about whether your hiatus hernia can be repaired.


I have posted a lot about bile re-flux. Check out my postings. PPI will not not help bile reflux as they suppress acid production allowing the alkali of bile to damage the stomach lining and it makes you feel sick Check my posts to see how to tell the difference.


The posts and replies here contain some info about the different types of reflux so that you can confront your specialist armed with some authoritative background. Unfortunately it is an huge subject and until very recently was sorely neglected by the medical profession who failed to realise that it can kill. Only the widespread adoption of bariatric surgery for obesity is causing this deficiency to be addressed.

Have you undertaken the basic lifestyle changes to help yourself ?

Smaller portions/not eating late/reduced fat intake at least in the final meal/ ditto alcohol and caffeine/ raising the head of the bed-frame?

Historically you have been prescribed an huge variety of meds - where are you at now with your arrhythmia and your gastric ulcer (where exactly is that and have you been treated for H. Pylori ?)


Hi Guts,Thanks for your reply.Iv,e been tested for H.Pylori,Don,t drink or smoke or eat late at night,Iv,e cut out things that might aggravate it such as spicy food hot food and chocolate.Just got back from the specialist and he is baffled.I don,t get heart burn or acid in the throat but the middle of my chest is always bloated and congested and when I walk you can hear liquid moving in my chest.He said Iv,e only got a small HH and I asked If I could come off PPI,S and he,s put me on Ranitadine.Just before all my troubles started I got a strong acid burning on the out side of my left foot but while Iv,e been on omeprazole every day it has not bothered me and the Dr said back then that it had nothing to do with my problem but since Iv,e come down to one pill every 5 days the burning has come back so it looks as though my acid is going down not up which is baffling the specialist.Got to see him again in 6 months.


I have the same/veru similar problems. I have had GORD (Gastric Oesophageal Reflux Disease) since 2007. Omeprazole was prescribedbut not consistent in controlling the reflux. I have more recently been diagnosed viaan Endoscopy with a weak SPHINCTER (that does not open and close t the junction between my oesaphagus and stomach enabling acid reflux) and a Hiatus Hernia. I am told that my GORD may be a developmental causal link of 'Trachea Oesophageal Fistula' (an abnormal link between my oesaphagus and trachea/windpipe) which I was born with and had surgery when only a few weeks old in 1966. I am still chasing this up with my GP.


Thanks Stephie.


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