Injury, gastro-esophageal reflux

In describing an instance of the intensity of anger, could say, as a figure of speech, as the bile rose in his throat. But for some people, raises the bile, perhaps not as far as the throat, but far enough, no problems with digestion and cause severe damage to the skin of the stomach and esophagus.

The symptoms are similar to heartburn, and many patients said they gastroesophageal-reflux disease, also known as Acid Reflux. But treatment with popular measures for Acid Reflux, as the removal of acid, proton pump inhibitors of Prilosec, Nexium and Prevacid, not work or only part of the landfill.

The reason is that Acid Reflux is most cases, only part of the problem. The main culprit is bile reflux, a back-up of digestive fluid, in the small intestine where it helps digest fat.

Bile acid is not. It is an alkaline liquid, composed of bile salts, bile pigments, cholesterol and lecithin. It is managed by the liver, gallbladder and recorded intermittently released into the duodenum, the upper part of the small intestine when needed to digest fat. (Galle continue to be produced as the process of helping, even after the gallbladder is removed.)

Misdiagnosis of bile reflux and lack of control can be serious, sometimes serious life problems - bleeding ulcers and Barrett's esophagus, a possible precursor to esophageal cancer. However, misdiagnosis is widespread, even if the condition is properly identified, doctors are often fatalistic about his administration.

"Shadowland"

Kozma Raymond Staten Island, said his wife, Lynne, 52, Galle after a back operation to the removal of the gallbladder and is in constant pain everyday for the last two years.

"We have doctors saying that everything from" There is not anything like bile reflux "to" There is bile reflux, but we can not do anything "to" You only learn to live with pain "" M. Kozma wrote in an e-mail. He asked me to write about the state, stating that "thousands of people are suffering, living in a" country of the shadows ", because the refusal and the lack of medical" Galle reflux.

Although the state is certainly not unknown, it is a relative lack of information on it in major medical journals read nonspecialists. Mr. Kozma, said his wife had now Barrett's Esophagus and instead proposed treatment, said that the return in three years to another endoscopy for esophageal damage. "What should we do? Wait and see if it develops cancer?"

Person with biliary reflux should expect worse to come, even if the measures are not as simple and well known because it Acid Reflux. The state, in general, may be drugs, but severe cases, surgery may be necessary.

The symptoms and causes

Both acid reflux and bile back in May infest the same person who diagnosis a challenge. But the inflammation of the stomach, bile reflux often causes burning or pain in the upper abdomen nagende that is not the idea of acid reflux, according to experts at the Mayo Clinic. Other symptoms of reflux of bile can often heartburn (the main symptoms of acid reflux), nausea, vomiting of bile, sometimes coughing or hoarseness and weight loss.

A little lesson in anatomy, the problem of understanding. The main organs of the digestive tract by valvelike tissue, which is operating correctly, may be living and digestive fluids in one direction: downwards. Thus, as the food and liquid by the digestive processes, usually travelers from the mouth to the throat, esophagus and the stomach and into the small intestine. The opening between the esophagus and stomach, a ring of muscle called the lower esophageal sphincter, is the acidity of gastric backup. If there is disturbance, Acid Reflux - Chronic heartburn - is a normal consequence.

Similarly, the pyloric valve, musculo-Ring between the stomach and small intestine will open enough for a fraction of an ounce of food transport to the small intestine, but not enough to that the bile in the stomach. If it does not close the valve refluxed Galle gastritis can lead to irritation and inflammation of the gastric mucosa. Untreated, can lead to a bleeding stomach ulcer or even cancer.

If the esophageal sphincter disorders at the same time, or it is a creation of pressure in the stomach, bile and acid may be the lower esophagus, the lighting of those feedingstuffs sensitive organ. If the problem persists, there may be scars, esophagus, this can lead to suffocation or abnormality referred cellular Barrett esophagus, which are developing and, finally, in precancerous cancer is almost always fatal.

Gastroenterologist recently have shown that Barrett's esophagus can often be treated effectively with radiation therapy, patients like Ms. Kozma.

Biliary reflux may occur as a complication of certain operations, such as surgery of the gallbladder was Ms. Kozma. More often, however, damage to the pyloric valve results of surgery of the stomach - full withdrawal from the stomach or stomach, bypass operation for treatment of morbid obesity.

From time to time, the pyloric valve is hampered by a peptic ulcer, for example, or scar tissue, which prevents the valve from, fast enough for the transport of stomach contents into the intestine. Printing, which means that the establishment in the stomach, thus ensuring the acid and bile in the esophagus.

Diagnosis and treatment

The main diagnostic tests, an endoscopy of the esophagus and stomach to ensure that the inflammation or ulcers, a verification test of the acid into the esophagus (that would be negative if the bile reflux is the only problem), and a test for determining whether gas or liquids reflux into the esophagus.

A drug called ursodeoxycholic acid on bile flow and reduce pain and symptoms of reflux of bile. Other drugs may be used for the rate of food in the stomach.

The surgery is a treatment of last resort, use, if nothing else to reduce severe symptoms of reflux of bile or, if developed esophageal precancerous changes. The main operation of the name of Roux-en-Y-operation, creating a new connection to the hail, the bile of the stomach town.

If acid reflux is also a problem, treatment with proton pump inhibitors, as will nonmedical use, including weight loss, high limitation of dietary fat and alcohol prevention and beverages, carbonic acid, spicy foods, onions, vinegar, chocolate and mint, eat small meals, practicing stress removal techniques such as meditation or exercise, not eating within two to three hours of sleep and sleep with the upper body and head increases.