Understanding Bile Reflux

Bile reflux is a condition in which bile backs up into the stomach and esophagus. Bile reflux is often confused with acid reflux, but there are differences between the two conditions that frequently occur together. Bile is a digestive liquid produced by the liver. While the effects of bile reflux haven't been fully established for humans, the condition has been shown to have adverse long-term effects on lab animals, including an increased risk of esophageal cancer.

Although acid reflux can be controlled through changes in lifestyle and diet, the same thing cannot be said about bile reflux. Bile reflux often requires medication, and extreme cases may call for surgery.


Because bile reflux has similar symptoms to acid reflux, it can be difficult to distinguish the two conditions. The symptoms of bile reflux include:

  • Severe upper abdominal pain
  • Frequent heartburn
  • A sour taste in the mouth that often accompanies heartburn
  • Nausea
  • Vomiting bile, which will appear as a greenish-yellow liquid
  • Unintended weight loss
  • A cough or hoarseness

You should make an appointment with your doctor if you experience these symptoms, especially unintended weight loss. Those who have been diagnosed with gastroesophageal reflux disease (GERD) may also be susceptible to bile reflux and should see a doctor if they aren't getting adequate relief from their prescribed medication.

Treatment Options

Bile reflux is significantly more difficult to treat than acid reflux, especially since many people don't respond to the medications used to treat it. Nevertheless, medication that helps disrupt bile circulation, increase bile flow, or block acid production is often the first line of defense against bile reflux.

If medication fails to reduce bile reflux symptoms or if you have precancerous changes in your esophagus, surgery may be recommended. Surgical procedures meant to treat bile reflux often involve creating a new connection for bile drainage in the small intestine or for strengthening the valve in the lower esophageal sphincter.

Lifestyle Changes

Bile reflux is less related to lifestyle than acid reflux, but since the two conditions often happen together, doctors recommend making lifestyle changes to ease some of your symptoms. Quitting smoking, eating smaller meals, and staying up for at least two to three hours after eating will all help to reduce symptoms. Doctors also recommend cutting down on or avoiding caffeine, alcohol, citrus juices, tomato-based foods, and other "problem" foods and drinks that increase the production of stomach acid. Finally, try to relax if you are experiencing acid or bile reflux symptoms. Stress slows down digestion and can worsen reflux symptoms.

Last Updated: January 29, 2016