Materiały źródłowe

• #1 Bile reflux // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/bile-reflux

  Bile reflux can’t be completely controlled by changes in diet or lifestyle. Treatment involves medications or, in severe cases, surgery. […] There is little evidence assessing the effectiveness of bile reflux treatments, in part because of the difficulty of establishing bile reflux as the cause of symptoms. […] Doctors may recommend surgery if medications fail to reduce severe symptoms or there are precancerous changes in your stomach or esophagus. […] Some types of surgery can be more successful than others, so be sure to discuss the pros and cons carefully with your doctor. […] The options include: […] During this type of surgery, a doctor creates a new connection for bile drainage farther down in the small intestine, diverting bile away from the stomach. […] The part of the stomach closest to the esophagus is wrapped and then sewn around the lower esophageal sphincter. This procedure strengthens the valve and can reduce acid reflux. However, there’s little evidence about the surgery’s effectiveness for bile reflux.

• #2 Bile reflux – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bile-reflux/symptoms-causes/syc-20370115

  Bile reflux may accompany the reflux of stomach acid (gastric acid) into your esophagus. Gastric reflux may lead to gastroesophageal reflux disease (GERD), a potentially serious problem that causes irritation and inflammation of esophageal tissue. […] Unlike gastric acid reflux, bile reflux can’t be completely controlled by changes in diet or lifestyle. Treatment involves medications or, in severe cases, surgery. […] If you’ve been diagnosed with gastroesophageal reflux disease (GERD) but aren’t getting enough relief from your medications, call your doctor. You may need additional treatment for bile reflux. […] In cases of bile reflux, the valve doesn’t close properly, and bile washes back into the stomach. This can lead to inflammation of the stomach lining (bile reflux gastritis). […] Surgery complications. Stomach surgery, including total or partial removal of the stomach and gastric bypass surgery for weight loss, is responsible for most bile reflux.

• #3 Bile reflux – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bile-reflux/diagnosis-treatment/drc-20370121

  Lifestyle adjustments and medications can be very effective for acid reflux into the esophagus, but bile reflux is harder to treat. There is little evidence assessing the effectiveness of bile reflux treatments, in part because of the difficulty of establishing bile reflux as the cause of symptoms. […] Doctors may recommend surgery if medications fail to reduce severe symptoms or there are precancerous changes in your stomach or esophagus. […] Some types of surgery can be more successful than others, so be sure to discuss the pros and cons carefully with your doctor. […] During this type of surgery, a doctor creates a new connection for bile drainage farther down in the small intestine, diverting bile away from the stomach. […] However, there’s little evidence about the surgery’s effectiveness for bile reflux.

• #4 Bile reflux // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/bile-reflux

  Bile reflux can’t be completely controlled by changes in diet or lifestyle. Treatment involves medications or, in severe cases, surgery. […] There is little evidence assessing the effectiveness of bile reflux treatments, in part because of the difficulty of establishing bile reflux as the cause of symptoms. […] Doctors may recommend surgery if medications fail to reduce severe symptoms or there are precancerous changes in your stomach or esophagus. […] Some types of surgery can be more successful than others, so be sure to discuss the pros and cons carefully with your doctor. […] The options include: […] During this type of surgery, a doctor creates a new connection for bile drainage farther down in the small intestine, diverting bile away from the stomach. […] The part of the stomach closest to the esophagus is wrapped and then sewn around the lower esophageal sphincter. This procedure strengthens the valve and can reduce acid reflux. However, there’s little evidence about the surgery’s effectiveness for bile reflux.

• #5 Reflux – Acid or Bile? Know the difference | Gastrointestinal Associates

  https://gihealthcare.com/reflux-acid-or-bile-know-the-difference/

  If youre suffering from chronic heartburn or have been diagnosed with GERD that is not responding to treatment, bile reflux may be the source of your problem. […] Like GERD, identifying and treating bile reflux is important. When left untreated it can result in serious, sometimes life-threatening problems, such as esophageal ulcers that bleed and Barretts esophagus, a condition in which the cells in the lining of the esophagus transform into tissue similar to the type that lines the stomach. […] If you are undergoing treatment for GERD but are not experiencing complete relief of your symptoms, it is time to check with your physician to find out if bile reflux is the culprit. […] Unlike acid reflux, bile reflux typically does not respond to such lifestyle changes as diet, weight loss, smoking cessation and reduced alcohol consumption. Nor is it resolved by medications designed to reduce acid production (Tagamet and Zantac) or proton pump inhibitors (Prevacid and Prilosec) to block acid production. […] The most important thing to remember is this: If you are suffering from chronic heartburn or other symptoms listed in the post, it is time to see your physician for a proper diagnosis and treatment plan.

• #6 Bile reflux: Symptoms, causes, treatment and more

  https://www.medicalnewstoday.com/articles/bile-reflux

  Bile reflux does not usually improve with diet or lifestyle changes. […] Doctors may recommend medications for mild bile reflux. These may include: bile acid sequestrants to disrupt the circulation of bile, such as: cholestyramine (Prevalite), colestipol (Colestid), colesevelam (Welchol). […] For more severe bile reflux or when medications have not been effective, doctors may advise surgery. This might correct any atypical malformation in the GI system or fix any issues due to other surgical procedures. […] Surgery can also help prevent long-term consequences. […] Interventions can include diversion or anti-reflux surgery. […] With diversion surgery, the specialist creates a new connection for bile drainage further down in the small intestine. This prevents reflux from entering the stomach.

• #7 Bile Reflux: Symptoms, Causes, and Treatment

  https://www.verywellhealth.com/bile-reflux-7197821

  Changing the diet or making lifestyle changes may not help with the symptoms of bile reflux. The condition may be managed with medications, but in some cases surgery could also be needed. […] Some medications are used to treat bile reflux. Bile reflux isn’t well studied, so it may take some trial and error to find the medication that will work to help get symptoms under control. […] Having bile acids flow into the stomach or esophagus can cause damage and inflammation. If this continues for a long time, it can increase cancer risk. Surgery might be considered for people still having symptoms even after trying to treat them with medications. The types include: […] Diversion surgery: Diverting the bile duct so it connects at a different part of the small intestine is one surgical option. This means the bile flows into the small intestine farther away from the valve.

• #8 Bile Reflux: Clinical Considerations – Gastroenterology Advisor

  https://www.gastroenterologyadvisor.com/features/tips-for-distinguishing-and-treating-biliary-reflux/

  Bile reflux is often seen in patients with Barrett esophagus (BE) and severe esophagitis, both of which can be identified during an esophagoduodenoscopy (EGD). […] Identification of biliary reflux is important, as patients experiencing this can have more severe mucosal damage in the esophagus, including BE. […] A study conducted by Lake et al evaluated 262 patients to determine if bile reflux could contribute to functional dyspepsia symptoms. […] There are no formal guidelines for treating patients with DGER; therefore, they are typically treated similarly to those with traditional GERD. Treatment options include PPIs, H2RBs, prokinetics (metoclopramide), and baclofen (to reduce relaxation of the lower esophageal sphincter via gamma-aminobutyric acid B agonist action). […] When PPIs are used to treat DGER, the mechanism may be secondary to reducing gastric acid volume and overall acidity, although the alkaline nature of the bile reflux can still cause irritation of the esophagus. […] As with refractory GERD, surgery can also be considered in those patients with DGER who fail medical management.

• #9 Rabeprazole combined with hydrotalcite is effective for patients with bile reflux gastritis after cholecystectomy

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2852226/

  Rabeprazole combined with hydrotalcite is an effective therapeutic option in the treatment of patients with bile reflux gastritis after cholecystectomy. […] The aim of the present study was to investigate the efficacy of different therapeutic regimens of rabeprazole and hydrotalcite by assessing the improvements in dyspeptic symptoms, gastric mucosal inflammation and bile reflux in patients with apparent dyspeptic symptoms caused by bile reflux after cholecystectomy. […] The present study provides further support for the use of acid suppressant therapy, which found that after treatment with rabeprazole, scores of dyspeptic symptoms and total per cent time of bilirubin absorbance greater than 0.14 units (from 49% to 38%) declined. […] With the use of rabeprazole or hydrotalcite alone, symptoms persisted in some patients because the degree of biliary reflux reduction was insufficient. […] The present study had several limitations. […] Hydrotalcite (an antacid) combined with rabeprazole (a PPI) may be a relatively more effective option for the management of postcholecystectomy BRG.

• #10 Bile Reflux- Treatment ideas?

  https://www.healingwell.com/community/default.aspx?f=45&m=4096958

  Hi Everyone,I have a very long and „eventful” (sadly) history of GERD related issues: I’ve been dealing with it in some form for almost 10 years now, but it got much worse the past 2 years or so. […] I believe it’s affecting my heart! I barely sleep, it’s just awful. […] From what I gather, there isn’t a lot to be done for bile reflux. Anyone has any experience with this and knows of any treatments options/ ideas? […] I agree with you, not sure that a PPI will solve the problem, only help a bit. […] My concern is that the longer bile sits in the stomach, the more damage it can do to the lining. […] I read that another reason for bile reflux could be a peptic ulcer that hinders the functioning of the pyloric sphincter- but that would have been noticed during the endoscopy, I would imagine?

• #11 Bile Reflux- Treatment ideas?

  https://www.healingwell.com/community/default.aspx?f=45&m=4096958

  I am going to another GI in a month or so. There has to be something out there for us. […] I have tried many medications, and the only one that has worked to some degree is metroclopramide. […] I will know my date and such this Friday at my next appointment. […] I really hope this gives you some comfort and solves the problem. […] Please keep us posted on things. Fingers crossed that this works and you get some improvement!

• #12 The Damage of Reflux (Bile, Not Acid) – The New York Times

  https://www.nytimes.com/2009/06/30/health/30brod.html

  A medication called ursodeoxycholic acid can be prescribed to promote the flow of bile and reduce the symptoms and pain of bile reflux. Other drugs might be used to speed the rate at which food leaves the stomach. […] Surgery is a treatment of last resort, used if nothing else reduces severe symptoms of bile reflux or when the esophagus develops precancerous changes. The most common operation, called Roux-en-Y surgery, involves creation of a new connection to the small intestine to keep bile away from the stomach.

• #13 Throwing Up Bile: Causes, Treatments, and Complications

  https://www.healthline.com/health/throwing-up-bile

  Vomiting bile can be caused by binge drinking, food poisoning, or certain medical conditions. Treatment depends on the cause, but may involve medications or lifestyle changes. […] One common cause is bile reflux, which happens when bile backs up from your liver into your stomach and esophagus. […] If you have bile reflux, your doctor might start by prescribing one of these medications: Ursodeoxycholic acid. This drug changes the composition of bile to help it flow more easily through your body. It can cause side effects like diarrhea. […] If medications dont control the problem, the next step might be surgery. Surgical options for treating bile reflux include Roux-en-Y gastric bypass. This procedure is also used to treat obesity. It creates a new connection to the small intestine to keep bile from draining into the stomach.

• #14 Biliary reflux – Wikipedia

  https://en.wikipedia.org/wiki/Biliary_reflux

  Biliary reflux, also called bile reflux, duodenogastroesophageal reflux (DGER) or duodenogastric reflux, is a condition that occurs when bile and/or other contents like bicarbonate and pancreatic enzymes flow upward (refluxes) from the duodenum into the stomach and esophagus. […] Ursodeoxycholic acid is an adequate treatment of bile reflux gastritis. The dosage is usually of: Adult(body-weight 47kg and above): 250mg once daily for 10-14 days, dose to be taken at bedtime. […] Biliary reflux may also be treated surgically, if medications are ineffective or if precancerous tissue is present in the esophagus.

• #15 Bile Reflux Gastropathy – Gastritis and Gastropathy – Gastric Diseases – Gastrointestinal Diseases – Gastroenterology – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.4.5.5.

  Bile reflux gastropathy is a noninflammatory gastric mucosal injury caused by long-term exposure to bile acids and exacerbated by pancreatic enzymes and the formation of lysolecithin. […] In the absence of prior surgery, medical therapy with proton pump inhibitors (PPIs) or mucosal protectants (eg, alginic acid or sucralfate) may be helpful, but the results are variable. […] There is some limited evidence to suggest that ursodeoxycholic acid may be helpful and, possibly, more effective than PPI therapy. […] Rarely, surgical reconstruction (Roux-en-Y gastric bypass) may be considered for patients who have had prior partial gastrectomy, provided that other causes have been excluded.

• #16 Potential new heartburn drug studied at VUMC – VUMC News

  https://news.vumc.org/2020/02/26/potential-new-heartburn-drug-studied-at-vumc/

  An investigational drug that binds bile acids in the stomach can reduce the severity of heartburn symptoms in patients with treatment-resistant gastroesophageal reflux disease (GERD) when combined with a proton pump inhibitor (PPI), a new study suggests. […] These data provide strong evidence that bile acid plays a key role in refractory GERD and that IW-3718 may have the potential to make a meaningful difference for patients, he added. […] Heartburn symptoms were significantly reduced in the group receiving the highest dose, 1,500-milligrams twice daily, compared to the placebo group. Regurgitation symptoms also decreased. The drug was well tolerated. There were no drug-related serious adverse events. […] These results suggest that IW-3718 may provide a therapeutic option for refractory-GERD patients with continued symptoms despite once-daily PPI therapy, the researchers concluded.

• #17 Bile Acid Sequestrants Demonstrate Significant Benefit As Adjunctive Therapy in Refractory GERD – Endoscopy Campus

  https://www.endoscopy-campus.com/en/ec-news/bile-acid-sequestrants-demonstrate-significant-benefit-as-adjunctive-therapy-in-refractory-gerd/

  Proton pump inhibitor- (PPI) refractory GERD, accounting for about one-third of all patients with GERD, is a clinically challenging entity. […] This multicenter (n=52), randomized, double-blind placebo-controlled phase 3 study aimed to evaluate the role of IW-3718 (an extended-release formulation of the bile acid sequestrant colesevelam) as an adjuvant to PPI therapy in patients with refractory GERD. […] Targeting the bile salts and acids in the stomach to counter bile reflux is novel and appears beneficial in patients with refractory GERD.

• #18

  https://journals.lww.com/ajg/fulltext/2021/10001/s3117_pharmacological_approaches_to_bile_reflux.3121.aspx

  Bile reflux gastritis (BRG), first described in 1800s, occurs due to retrograde flow of bile resulting in clinical, endoscopic, and histologic alterations similar to reactive gastritis. BRG has no clear evidence-based pharmacological approach. We systematically reviewed the literature and analyzed treatments for BRG. […] In one placebo controlled (PC) trial, Ursodeoxycholic acid had 80% symptomatic improvement but no significant change in endoscopy or histology. Similar findings were observed in another PC trial with 72% symptomatic improvement with Pantoprazole and hydrotalcite. Sucralfate improved histology in one study with 8/11 patients, but not symptoms or endoscopy. A double-blind trial with Cisapride showed improvement in symptoms and endoscopic score but no variation in histologic score. A RCT using Rabeprazole, Hydrotalcite, and a combination, 74% symptoms were relieved, most significantly in the combination group (88%), but no significant differences in endoscopy or histology. Two PC studies involved cholestyramine and cholestyramine-alginates combination, but the results were ineffective. An RCT with sucralfate, rabeprazole, both were able to significantly reduce symptom scores (90%), endoscopic (87%), and histologic signs (85%) compared to the observation group. […] This review suggests that there is a low quality of available research to develop treatment protocols and long-term PC trials are required to more determine the efficacy of different therapies for BRG.

• #19 What Is Biliary Reflux?

  https://www.icliniq.com/articles/gastro-health/biliary-reflux

  Biliary reflux occurs when bile backs up into the stomach or the esophagus, a tube made up of muscle that connects the mouth and the stomach. […] Thus, if it occurs, it can be corrected only with medications or, in severe cases, surgery. […] The medications that can be used are: Ursodeoxycholic Acid: It helps promote the bile flow, reducing the symptoms of this condition. […] Sucralfate: This medication will form a protective coating on the lining of the esophagus and the stomach from biliary reflux. […] Bile Acid Sequestrants: This substance disrupts the circulation of bile. The side effect of this is bloating. […] In this procedure, the surgeon creates a passage for the bile to drain further lower to the small intestine, which diverts the bile away from the stomach. […] Bile reflux gastritis can be treated by diverting the bile away from the gastric mucosa surgically. It is the only effective treatment done to treat bile reflux gastritis. […] Yes, bile reflux may lead to stomach cancer. […] Bile reflux cannot be completely controlled. To some extent, diet and changes in lifestyle help reduce the symptoms. Medications may be required, and in severe cases, surgery may be done.

• #20

  https://journals.lww.com/10.14309/01.ajg.0000952092.97429.65

  GERD has become a heterogeneous disorder with many phenotypes and etiologies requiring different managements. […] Compiled evidence showed bile reflux could induce mucosal damage (1), Gastrin hormonal changes (2), and could be an important etiology of GERD. We aim in this study to assess the response to treatment of R-GERD patients when they received optimal therapy of combined anti-acid and anti-bile medications, based on the previously reported high prevalence of bile reflux in this group of patients (3). […] Response to combination of anti-acid/anti-bile treatment as defined was reported in 293 out of 322 patients (91%) comparing to the 60% of GERD patients who responded to PPI therapy alone, this improvement was statistically significant (P 0.01). […] This significant improvement in the treatment response added further evidence towards the recognition and treatment of bile reflux phenotype. Reporting the presence of bile liquid in the stomach or esophagus during EGD exam is an essential finding. The treatment of bile reflux could reduce the need for surgical or endoscopic intervention.

• #21 Traditional Chinese patent medicine for bile reflux gastritis: a systematic review and network meta-analysis – He – Annals of Palliative Medicine

  https://apm.amegroups.org/article/view/74269/html

  Traditional Chinese Patent Medicine (TCPM) is widely used in the treatment of bile reflux gastritis (BRG). […] We conducted a reticulated meta-analysis to compare the efficacy of TCPMs in the treatment of BRG. […] The results of the network meta-analysis showed that Weiyankang capsules combined with hydrotalcite had the best effect in the treatment of bile reflux among the 14 interventions. […] Among all the Chinese patent medicines examined, Weiyankang capsules combined with hydrotalcite appeared to be the best choice for the treatment of BRG. […] This study used a network meta-analysis to compare the most commonly used TCPMs in the treatment of BRG in clinical practice. […] The results showed that Weiyankang capsules combined with hydrotalcite had the best curative effect in the treatment of bile reflux among the 14 interventions.

• #22 Traditional Chinese patent medicine for bile reflux gastritis: a systematic review and network meta-analysis – He – Annals of Palliative Medicine

  https://apm.amegroups.org/article/view/74269/html

  The Shugan Hewei pill is a proprietary Chinese medicine. It had the lowest recurrence rate among the 5 studies that reported recurrence rates. […] Compared to conventional Western medicines, TCPMs can significantly improve the curative effect of BRG. […] Based on the present study, among the various TCPM choices available, the Weiyankang capsule provided the best treatment strategy. […] However, it is clear that TCPMs have certain advantages in improving symptoms.

• #23

  https://link.springer.com/article/10.1007/BF02845364

  Seventy-two patients with bile reflux gastritis were treated with metoclopramide injection into Zusanli (ST 36), compared with oral Metoclopramide in 45 cases. The total effective rate were 93.1% and 77.8%, respectively. There was a significant difference (P0.01) between two groups.

• #24

  https://emorysurgicalfocus.com/2024/04/04/primary-bile-reflux-gastritis-which-treatment-is-better-roux-en-y-or-biliary-diversion/

  Various treatments for [Primary Bile Reflux Gastritis] have been proposed since its recognition. […] Currently, the most commonly applied operation is the Roux-en-Y gastrojejunostomy, which requires vagotomy and antrectomy and results in the equally disabling Roux stasis syndrome in about one-half of patients. […] This procedure was used for 16 patients with diagnosed bile reflux, and results were compared with those of a previous group of 21 patients who had been treated with Roux-en-Y gastrojejunostomy. […] In addition, they had few postoperative complaints, no further operations for either bile reflux or upper gastrointestinal stasis, and no long-term deaths due to gastrointestinal problems or malnutrition. […] It is concluded, therefore, that if a diagnosis of primary bile reflux gastritis is made, the bile diversion procedure be considered, rather than the Roux-en-Y, Henley jejunal interposition, Braun enteroenterostomy, or any of their modifications, because it is safe and curative and has few, if any, long-term ill effects.

• #25

  https://www.amerikanhastanesi.org/mayo-clinic-care-network/mayo-clinic-health-information-library/diseases-conditions/bile-reflux

  Some types of surgery can be more successful than others, so be sure to discuss the pros and cons carefully with your doctor. […] The options include: Diversion surgery. During this type of surgery, a doctor creates a new connection for bile drainage farther down in the small intestine, diverting bile away from the stomach. […] Anti-reflux surgery. The part of the stomach closest to the esophagus is wrapped and then sewn around the lower esophageal sphincter. This procedure strengthens the valve and can reduce acid reflux. However, there’s little evidence about the surgery’s effectiveness for bile reflux.

• #26 Non acid reflux and bile acid reflux | Bile reflux treatment & symptoms – RefluxUK

  https://refluxuk.com/education-hub/bile-and-non-acidic-reflux

  We very often get asked about bile reflux and non-acidic reflux. Its a source of a great deal of confusion among both patients and some doctors alike. […] The good news is that using the right tools we can often make the diagnosis of non-acidic reflux and offer help. For instance, we often find that Small Intestinal Bacterial Overgrowth is associated with LPR symptoms and will respond to treatment. Other patients will benefit from surgery. There are published studies demonstrating that in the right patients with non-acidic reflux, anti-reflux operations will be successful, often resolving their symptoms. This is certainly our experience with both fundoplication and LINX and while were always more cautious in patients who have non-acidic rather than acid reflux, we will often offer surgery.

• #27 What Are The Symptoms Of Bıle Reflux? – Assoc. Prof. Dr. Murat KANLIÖZ

  https://www.docdrmuratkanlioz.com/en/what-are-the-symptoms-of-bile-reflux/

  HOW IS Bile Reflux TREATED? […] In Bile Reflux, the stomach surface is tried to be protected by giving surface coating drugs to prevent bile from coming into contact with the stomach surface. However, bile reflux cannot be treated permanently without eliminating the main problem. To treat bile reflux, it is necessary to either restore the function of the pylorus or perform surgeries that change the anatomical structure that will prevent bile from flowing back into the stomach. We clinically apply the technique we call PYLOOR REVISION, which restores function to the pylorus by endoscopically injecting filler around the pylorus without disturbing the existing anatomy. If the pylorus cannot be restored to function, the other treatment to be performed is Duodenal Switch surgery. […] PYLORIC REVISION is an endoscopic interventional procedure performed to prevent pyloric leakage in patients whose pylorus does not close completely or at all.

• #28 What Are The Symptoms Of Bıle Reflux? – Assoc. Prof. Dr. Murat KANLIÖZ

  https://www.docdrmuratkanlioz.com/en/what-are-the-symptoms-of-bile-reflux/

  Pyloric Revision is the process of closing the opening causing leakage in the pylorus by performing filler injections around the pylorus of patients with HYPOTONIC and ATONIC pylorus by entering endoscopically under sedation anesthesia. In this way, bile content is prevented from flowing back into the stomach. The process is completed in 15 minutes in total. The patient can return to daily life on the same day. No hospitalization is required. He is discharged from the hospital 2 hours after the procedure. […] In our clinical study, the effectiveness of the Pyloric Revision performed in the control endoscopy of the patients to whom we performed Pyloric Revision during an average follow-up period of 32 months still continues in 92% of the patients. […] PYLOric REVISION was defined and applied for the first time by Assoc. Prof. Murat KANLIZ. It has been proven by scientific academic publications that bile reflux can be prevented with Pyloric Revision. Clinical study results and description of the technique were published in 2023 in the peer-reviewed American Medical journal CUREUS.

• #29 What Are The Symptoms Of Bıle Reflux? – Assoc. Prof. Dr. Murat KANLIÖZ

  https://www.docdrmuratkanlioz.com/en/what-are-the-symptoms-of-bile-reflux/

  Duodenal Switch surgery should be performed when the quality of life is severely impaired due to bile reflux and cannot be treated with any other method. Duodenal Switch is a surgery that should be considered as the last option in Alkaline Reflux Gastritis. […] There are no surgical risks in Duodenal Switch surgery […] Pyloric Revision does NOT have any disadvantages compared to Duodenal Switch surgery.

• #30 Bile Reflux – DSSurgery

  https://www.dssurgery.com/hernia-surgery/bile-reflux/

  Bile Reflux or Duodenogastroesophageal Reflux is caused by the contents of the Duodenum entering the stomach and the esophagus causing symptoms and damage to the stomach and esophagus. […] Diagnosis takes careful consideration due to the high likelihood that DGER most often happens in conjunction with GERD and the symptoms of both are similar. Medical treatment with medication to treat GERD and assist with DGER. Other important diagnostic test may include: […] Treatments options: […] Surgery for Bile Reflux: The Stand-Alone Duodenal Switch procedure without a Sleeve Gastrectomy or Gastric Bypass pouch was developed by Dr. Tom R. DeMeester in the 1980’s to treat bile-reflux gastritis, a condition in which the stomach and esophagus are irritated by bile that goes back through the pylorus to the stomach.

• #31 Acid reflux, Bile reflux, and Gallbladder Surgery – Houston Heartburn and Reflux Center

  https://houstonheartburn.com/acid-reflux-bile-reflux-and-gallbladder-surgery/

  I had my gallbladder removed a few years ago and am having a recurrence of bile reflux symptoms. […] Is Ursodiol an appropriate medication to try? […] Bile reflux typically co-exist with acid reflux. […] Ursodiol, a naturally occurring bile acid, prevents the formation of cholesterol gallstones. Ursodiol does not stop or decrease bile reflux. […] I recommend evaluation by a reflux specialist. If you suffer from GERD, laparoscopic hiatal hernia repair and Nissen fundoplication are recommended. This approach is considered the gold standard treatment for GERD. Nissen fundoplication and hiatal hernia repair when properly performed are safe, effective and durable.

• #32 Bile reflux – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bile-reflux/symptoms-causes/syc-20370115

  People who have had their gallbladders removed have significantly more bile reflux than do people who haven’t had this surgery. […] Bile reflux gastritis has been linked to stomach cancer. The combination of bile reflux and acid reflux also increases the risk of the following complications: […] Bile is often suspected of contributing to GERD when people respond incompletely or not at all to powerful acid-suppressant medications. […] In animal studies, bile reflux alone has been shown to cause cancer of the esophagus.

• #33 Bile and Acid Reflux After Gallbladder Removal

  https://www.drmalladi.com/acid-reflux-after-gallbladder-removal/

  It is not uncommon for patients to experience bile reflux after gallbladder removal. […] Studies show that bile reflux occurs in 80% to 90% of patients who have had gallbladder surgery. […] Bile reflux signs include the following symptoms: Upper abdominal pain and heartburn, nausea, cough and hoarseness, vomiting up greenish-yellow bile. […] If after gallbladder removal, acid reflux or bile reflux becomes a problem, there are treatment options. […] However, treatment for bile reflux usually requires either medication or surgery due to bile’s difference in chemical composition from stomach acid. […] Medication treatments are designed to help your digestive system move bile more easily through your system, reducing the odds of reflux. […] Acid reflux surgery can also be effective for bile reflux if it’s backing up all the way into your esophagus, but another procedure called Roux-en-Y diversion is also used in which your doctor will divert bile drainage further down your intestine.

• #34 Bile Reflux and treatment plan completed. – Macmillan Online Community

  https://community.macmillan.org.uk/cancer_types/stomach-cancer-forum/f/diagnosis-and-treatment/288887/bile-reflux-and-treatment-plan-completed

  My main issue over the last 2 months has been bad bile reflux for which my consultant would not prescribe medication as he wanted the bile to work and help my body absorb nutrients. […] My oncologist became concerned and to prevent me having to stop chemo she prescribed a bile binder called Colestyramine. It started to work within a week and although I still have bile issues they are minor. […] So for anyone with significant bile reflux issues there is medication that can help. […] I wish my consultant had prescribed it when I first had problems. It would have saved a few weeks of sickness and weight loss.

• #35 Medical management of acid/bile reflux before, during and after endoscopic therapy for Barrett’s esophagus: a narrative review – Jaswani – Annals of Esophagus

  https://aoe.amegroups.org/article/view/5859/html

  Uncontrolled reflux has been identified as a risk factor for recurrence after EET. […] Inadequate acid suppression defined by impedance-pH monitoring is a modifiable risk factor and increases the risk of recurrence of intestinal metaplasia (IM) after EET. […] This observation highlights the importance of aggressive pharmacologic acid suppression and also reminds us of the role of lifestyle modifications in decreasing distal esophageal reflux exposure both during and after the EET period. […] The goal of EET is complete eradication of intestinal metaplasia (CE-IM) by directly treating the neoplastic area and any at-risk areas of Barretts mucosa. […] It has been demonstrated that decreasing the total number of non-acid refluxes may also improve outcomes in patients undergoing EET. […] While there is some variation from institution to institution, general recommendations for protocols peri-EET for Barretts associated neoplasia are listed in Table 1 and include twice daily PPI, dissolved or suspension sucralfate, a topical lidocaine mixture and a liquid diet for 1-2 days followed by a soft diet for up to a week after EET. […] Once CE-IM is achieved, aggressive control of reflux is recommended as the rate of recurrence of IM after EET has been estimated to be 5-10% per year. […] Anti-reflux surgery may be considered for patients with inadequate control of reflux symptoms despite optimization of medical therapy.

• #36 Bile Reflux and What To Do About It | Refluxgate

  https://www.refluxgate.com/blog/bile-reflux/

  It is extremely important that you as the patient understand and be actively involved in the treatment of bile reflux as this condition does not get better on its own, is frequently misdiagnosed and requires very different medications and treatments than acid reflux, may involve or be caused by several other medical conditions, and is related to cancer increases.

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