All about Biliary Gastritis

It is the inflammation and irritation of the stomach lining due to bile reflux, due to an inefficiency in the closure of the pyloric valve.

Compressing the inflammation of the stomach epithelium to the biliary return is not easy, it requires an exhaustive anamnesis , because the symptoms are almost the same as the inflammations caused by gastric juices, H. pylori infection and even stress.

Generally, there are cases where the inflammation is due to the combination of bile content with gastric juices, these irritate the stomach lining and even rise causing gastroesophageal reflux; determining greater structural damage.

To understand this imbalance we must delve a little into physiology; the functioning and anatomy of the digestive system.

Physiology

Bile is a greenish-yellow thick liquid produced in the liver, stored and concentrated in the gallbladder; which contains: water (in a lower percentage than the bile recently produced in the liver), bile salts, lecithin, bilirubin (red blood cell waste), cholesterol, fatty acids, toxins and drugs.

The pyloric valve regulates the release of chyme to the duodenum, slowly releasing an eighth of a pound (approx. 3.5 milliliters) at a time, to ensure only the exit and not the entrance to the stomach.

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Once the food enters the mouth and passes to the stomach, the contraction of the gallbladder occurs thanks to cholecystokinin , fat intake and weakly to the parasympathetic branch of the vagus nerve. Bile flows through the cystic duct, then through the common bile duct, relaxation of the sphincter of Oddi occurs and finally it is released in the second portion of the duodenum.

It must be clarified that part of the bile is released without the chyme reaching the duodenum, therefore, in the event of a failure of the pyloric valve, the intrusion of bile into the stomach occurs. With food in the duodenum, alkaline bile secretion increases, which can cause the return of bile with food.

Stimulated by secretin, bile is constantly produced in the liver, indicating that the main patients suffering from this disease are those whose gallbladder has been removed.

Why does bile irritate the mucosa?

How to Relieve Biliary Gastritis

To answer this question, the functions and characteristics of bile must be reviewed. The pH of gallbladder bile ranges from 5.0 to 7.7 weak acidic, neutral and even slightly alkaline, so one of its functions is to alkalize the chyme in the intestine. Bile is a detergent, it emulsifies fats to facilitate their absorption into micelles; it also contains waste to be excreted (bilirubin, cholesterol, toxins and drugs).

Imagine a detergent with toxins and debris eroding the mucosa. Many authors attribute the erosion to the acidification of the bile, when it does not exceed the acidic pH of the gastric juices.

Symptoms of Biliary Gastritis

  • Sickness
  • Weight loss without cause
  • Pain in the upper abdomen
  • Vomiting bile
  • Coughing or hoarseness
  • Bitterness in the mouth (metallic taste) distinctive
  • Abdominal pain after eating food
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Causes

  • Pyloric valve failure
  • Damage after surgery (gastric bypass, gastrectomy, gallbladder removal, cholecystectomy)
  • Stomach ulcers near the pylorus

Diagnosis

  • Anamnesis
  • Endoscopy, biopsy
  • Impedance of the esophagus – useful in people who regurgitate non-acidic substances (such as bile)
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Treatment

Lifestyle and diet changes:

  • Eat 5 meals a day (increase frequency, decrease quantity)
  • Banish foods with saturated fat
  • Avoid spicy foods
  • Do not ingest milk, ingest another source of calcium (sesame)
  • Chew, eat fruits, and drink plenty of water

Medicines

  • Ursodeoxycholic acid
  • Proton-pump inhibitor

Surgery

  • Anastomosis (Roux-en-Y): new connection to release bile into a further portion of the intestine, away from the stomach.

Complications

  • Gastroesophageal reflux
  • Barrett’s esophagus: Esophageal cells change their morphology (metaplasia), increasing the risk of becoming cancerous.
  • Esophagus cancer

Home Remedies for Bile Reflux:

With anti-inflammatory properties, favoring digestive functions, they stand out for bile reflux: chamomile, lemon balm, licorice (caution with prolonged use), marshmallow, slippery elm .

Avoid skipping breakfast, in order to drain bile and not increase cholesterol. If there is an increase in this, the possibility of precipitation and stone formation increases. Stones that will then have to be operated on and you may suffer biliary gastritis after surgery.

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