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Bile Reflux and Gastroparesis, Are they Related?

69 YO male with gastroparesis and bile reflux. Could they be related?

I know that a malfunctioning pyloric valve causes both, but can overproduction of bile damage the pyloric valve possibly causing GP?

Many thanks,,,

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683231 tn?1467323017
Yes it could cause both

From the Mayo Clinic

“Bile reflux

Bile reflux occurs when bile — a digestive liquid produced in your liver — backs up (refluxes) into your stomach and, in some cases, into the tube that connects your mouth and stomach (esophagus).

Bile reflux may accompany the reflux (backwash) 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 (esophagitis).

Bile reflux and gastric acid reflux are separate conditions. Whether bile is important in GERD is controversial. Bile is often a suspected of contributing to GERD when people respond incompletely or not at all to powerful acid-suppressant medications. But there is little evidence pinpointing the effects of bile reflux in people.

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.

Bile reflux can be difficult to distinguish from gastric acid reflux. The signs and symptoms are similar, and the two conditions may occur at the same time.

Bile reflux signs and symptoms include:

Upper abdominal pain that may be severe
Frequent heartburn — a burning sensation in your chest that sometimes spreads to your throat, along with a sour taste in your mouth
Vomiting a greenish-yellow fluid (bile)
Occasionally, a cough or hoarseness
Unintended weight loss
When to see a doctor

Make an appointment with your doctor if you frequently experience symptoms of reflux, or if you're losing weight without trying.

If you've been diagnosed with GERD but aren't getting adequate relief from your medications, call your doctor. You may need additional treatment for bile reflux.

Illustration of stomach, pyloric valve and upper part of small intestine (duodenum)
Stomach and pyloric valve
How GERD occurs in the esophagus
How heartburn and GERD occur
Bile is a greenish-yellow fluid that is essential for digesting fats and for eliminating worn-out red blood cells and certain toxins from your body. Bile is produced in your liver and stored in your gallbladder.

Eating a meal that contains even a small amount of fat signals your gallbladder to release bile, which flows through two small tubes (cystic duct and common bile duct) into the upper part of your small intestine (duodenum).

Bile reflux into the stomach

Bile and food mix in the duodenum and enter your small intestine through the pyloric valve, a heavy ring of muscle located at the outlet of your stomach. The pyloric valve usually opens only slightly — enough to release about an eighth of an ounce (about 3.5 milliliters) of liquefied food at a time, but not enough to allow digestive juices to reflux into the stomach. In many 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).

Bile reflux into the esophagus

Bile and stomach acid can reflux into the esophagus when another muscular valve, the lower esophageal sphincter, malfunctions. The lower esophageal sphincter separates the esophagus and stomach. The valve normally opens just long enough to allow food to pass into the stomach. But if the valve weakens or relaxes abnormally, bile can wash back into the esophagus.

What leads to bile reflux?

Bile reflux may be caused by:

Surgery complications. Gastric surgery, including total removal of the stomach (gastrectomy) and gastric bypass surgery for weight loss, is responsible for most bile reflux.
Peptic ulcers. A peptic ulcer can block the pyloric valve so that it doesn't open enough to allow the stomach to empty as quickly as it should. Stagnant food in the stomach can lead to increased gastric pressure and allow bile and stomach acid to back up into the esophagus.
Gallbladder surgery (cholecystectomy). 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 and acid reflux also increases the risk of the following complications:

GERD. This condition is most often due to excess acid. Although bile has been implicated, its importance in gastric acid reflux is controversial.
Barrett's esophagus. This serious condition can occur when long-term exposure to stomach acid, or to acid and bile, damages tissue in the lower esophagus. The damaged esophageal cells have an increased risk of becoming cancerous. Animal studies have also linked bile reflux to the occurrence of Barrett's esophagus.
Esophageal cancer. This form of cancer may not be diagnosed until it's quite advanced. The possible link between bile and acid reflux and esophageal cancer remains controversial, but many experts think a direct connection exists. In animal studies, bile reflux alone has been shown to cause cancer of the esophagus.“
Helpful - 1
This was such great information.  Thank you for posting.  
Re: Flyinly
Me: male 52

I believe Statins and Apple Cider Vinegar have been helping me with nausea after eating for some reason.  It was unexpected too.  Doctors instantly fed me acid blockers suspecting acid reflux, but my body has been responding well to ACV.  I was having breathing issues at night and nutritional deficiency.  Mg deficiency led to D3 and Calcium deficiency, in order, even without acid blockers.  I avoid them usually.  Discovered D vitamins and calcium help control muscles/sphincters/lungs.  With supplements, I am doing better usually with supplements and high Mg an D3 diet.  But that may not be helping lesions.

My symptoms are improving, until I have sex.  Then all the work seems to NOT be working for a couple days after sex.  Today I read that lesions and endometriosis like conditions exist for men.  This is my new main symptomatic interest.  

I took Desert Harvest Aloe Vera for suspected IC an one time.  It seemed to help and confuse IC symptom markers.  I need an IC test but I have no urge to urinate at night, so basically it is ruled out.  Aloevera reduces inflammation and is a fiber.  AB is also an anti-inflamatory and laxative.  Laxatives cause nutritional deficiency. The only thing that makes sense currently is lesions on liver, gall bladder, or sex organ bio-network.   Yet to be proven.

Even with statins etc, everything was improving with diet, until sex.  I have read about anxiety playing a role, but I had problems before anxiety, not other way around.  Statins may have anti-inflammatory effects as well.  If that is the case, then lesions might also be the culprit, if dietary work can come to a screeching halt because of sexual intercourse.

Statins may help with gallstones and bile reflux.



But the big flag here that everyone should know is the lesions, tumors, and cancer can be behind pain in the GastroIntestinal area.   Bit when your blood tests are not much off, it could be a lesion.

Reflux and IBS can be a secondary reaction to inflammation anywhere in the GI area caused by lesions.

Apple cider vinegar might also effect salivation and sinuses, masking certain side effects post digestion.

Excellent Collection if info about ACV studies:


ACV and dry mouth trial:


ACV and inflammation and possibly sinuses:


Bromelain cured inflammation:


Many dietary cures of inflammation.


Acute markers:

If you are taking all of these natural anti-inflammatories, you might think they are helping.  This is when you should watch for sudden flare ups.  Like salt on a wound, whatever causes the flareup reveals the root of the problem.  Allergy-related, or irritant due to Ph or chemical sensitivity, consider the cause of acute, sudden pain or symptoms.

Sometimes surgery is worse than diet related changes, and new problems, lesions, and abnormal tissue growth can occur after surgery.  Consider the reason for post-amputation pain and how the body may acquire phantom pains.


The body recognizing fat in food during mastication and swallowing.  Consider desensitizing these receptors with ACV while eating.   Extra cholesterol is lost with fecal matter when not reabsorbed by the body.  That is okay.  Is it possible to confuse the receptors that recognize fat and create bile?  



Vinegar in the diet, stoole color, and cholesterol.  It maybe possible to study the way vinegar confuses the bile creation process.  Perhaps it is a receptor reaction rather than increased acid for low acid stomachs.  Vinegar is not nearly as powerful as the acid in our stomachs.  So what does it really do?   Perhaps the stomach is working fine, but bile is refluxing into the stomach and causing the symptoms of Acid reflux.  Perhaps vinegar decreases bile production?  This would account for vinegar and weight fat burning weight loss.  Perhaps we create more bile to digest food when acid is low.  Vinegar may help increase acid or have some combined effect with stomach acid to increase protein synthesis.  


Avatar universal
I was curious if you ever found out how or if they were related? I was diagnosed with Bile Reflux just a few months ago and today I was told that I also have Gastroparesis. Since both are considered rare conditions I wondered if there was a relationship myself?
Helpful - 0
It would be so great if people continued to follow up wouldn't it?  There is so much power of information in these think tanks.
Avatar universal
Yeah thanks, I read that article a while back researching bile reflux. I just wanted to know if my gastroparesis is caused by bile reflux, in which case (praying) it may be treatable. Thanks again,,,

Helpful - 0
From what I got from the article the malfunctioning pyloric valve can cause the delayed stomach emptying which in turn can cause bile reflux

My impression is both can be symptoms of the same cause the pyloric valve.
The slow stomach emptying causes the bile to back up. My assumption is to relieve symptoms you may require surgery what does your doctor recommend?
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