Is it possible to have bile reflux with acid reflux?
I have been taking Nexium, 40 mg for 3 years, for acid reflux after having a chronic cough, asthma, and a lung infection. Last year in May I had erosive gastritis because of bile in the stomach. Since then I have had pain on and off in upper right quadrant under the rib cage, diarrhea (4 or more times a day) nausea, with gnawing pain and burning in the upper stomach area. After having several tests that ruled out everything, and trying 80 mgs of Nexium a day, my Dr. prescribed Cholesteramine, a bile acid blocker ( I live in Uruguay, South America.) Since I started taking this medication, I have felt much better. One month he suggested taking it every other day and I was back to the above symptoms. I started taking it every day again and began to feel much better. Now he is asking me to try taking it every other day again and reducing the Nexium to 20 mgs. I'm hesitant to do this because I do not want to be sick again. He has never used the words bile reflux, however, I'm almost convinced that this is what it is. Is bile reflux a condition that a person will continually have, or do the symptoms eventually disappear? I occasionally still have the pain in the upper right quadrant area but not as frequent as before. I have not had my gall bladder removed. Thank you for any information that anyone can give me on this. Patti
Hi Patti,
No one knows better than your doctor what to do to help you manage your care, but there is some information here that might help you when you see your doctor and help you with the questions you need to ask.
Dr. Todd Eisner is one of the resident experts here. In this posting, Dr Eisner addresses the subject of PPI's and how sometimes they fail to produce the desired result because of nonacid reflux like bile reflux. You can read his posting here.
From what I have read, bile reflux occurs mostly when someone has had a their gallbladder removed, since they move the bile duct to the stomach when they remove the gallbladder. There are postings about bile reflux (you can read one of them here, there are 134 comments with information about gall bladder removal.) Here is a posted experience from a person who had surgery for the GERD and issues afterwards that she thought might have been bile reflux.
Dr. Eisner also addresses the bile issue here in this posting about whether or not it is acid or bile reflux and the causes and treatments.
Hope this helps! Stay in touch and let us know how you are doing!
Vicki M
- Thank you for your input
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I have been taking Nexium for many years, and Prilosec previous to that, after having been diagnosed with GERD due to a "large hiatal hernia".
I later moved to another state. At one point, after an endoscopy and colonoscopy, my gastroenterologist told me that he saw no evidence of the "large hiatal hernia". How can this be, when the diagnosis was so positive about five years before that? Can he have make a mistake?
He advised me to take double the usual dose of Nexium, upped to 40 mg TWICE a day, and told me I would probably have to take it for life. As long as he was able to provide me with samples, that worked just fine in controlling the problem.
Eventually he moved his office too far away for me to continue getting the samples and my insurance refused to pay for the Nexium, which is extremely expensive. No other medication seems to give me as much relief. So I continued on the Nexium at great expense, but have had to keep my dose to 40 mg ONCE a day.
Another five years later I now find myself suffering from the addition of the following symptoms...
1) frequent coughing up of gooey phlegm, in particular when it wakes me up during the night or immediately after eating a meal, and
2) mostly recently, the addition of bile backwash into my mouth, a very foul taste. I am continually chewing gum and anything I can to relieve that horrible taste (and odor).
Since I am now dealing with a host of other serious health problems (i.e. breast cancer, pulmonary emboli, polymycitis, and sleep apnea), I hesitate to go to another gastroenterologist for more testing. I have had to add Warfarin and Prednisone to my list of meds and wonder if that total combination could be causing the additional gastric problems. I was recently prescribed a CPAP machine.
I hate that I have to go to so many DIFFERENT specialists and they do not get together to coordinate my treatment, thereby understanding how my system functions as a whole and not per individual organs or maladies.
Your advice is more than welcome........
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