Bile Gastritis

Bile gastritis is a bothersome condition of the abdomen that causes extreme gastrointestinal discomfort. Find out more about the ailment including its types, symptoms, causes, diagnosis, and treatment procedures.

What is Bile Gastritis?

This condition is manifested by persistent inflammation and severe erosion of the gastric mucosa – the inner layer of the stomach, comprising of essential glands for digestive purposes.

Bile Gastritis Synonyms

The condition is also known by other names like:

Picture of Bile Gastritis

Picture 1 – Bile Gastritis

  • Bile reflux gastritis
  • Alkaline reflux gastritis

Types of Bile Gastritis

The disorder is categorized into the following types:

Acute Bile Gastritis

In this type, sudden severe inflammatory changes in the gastric mucosa lead to early onset of painful symptoms. The form is further classified into erosive and non-erosive.

Chronic Bile Gastritis

The form is manifested by long-term inflammation of the mucosal lining that occurs gradually and persists for a prolonged duration. Progressive degeneration of the stomach lining may lead to serious health issues in the absence of treatment.

Bile Gastritis Symptoms

The condition can be quite discomforting, owing to its negative impact on the entire upper gastrointestinal tract. Intense abdominal pain is the most frequently observed symptom in affected patients. The pain can vary from mild to severe and may remain constant. It turns more severe between meals and at night. The other major signs of this gastrointestinal condition are:

  • Abdominal bloating
  • Nausea or vomiting
  • Heartburn
  • Indigestion
  • Cough
  • Sudden weight loss
  • Ulcers
  • Blood in vomit
  • Red blood in stool
  • Black, tarry stools
  • Hiccups

What Causes Bile Gastritis?

Bile is a greenish-brown alkaline fluid secreted by the liver that aids in digestion as well as absorption of fats. It is stored in the gallbladder and discharged into the duodenum – the first section of the small intestine, only during digestion. However, the digestive fluid regurgitates back into the stomach and esophagus in this condition – causing bile reflux. The resultant effect is irritation or erosion of the abdominal mucosa that is clinically termed as                                 “Gastritis”. It is sometimes accompanied by acid reflux that refers to backflow of stomach acids into the esophagus, causing heartburn. Ailing patients experience intolerable pain when the digestive juices seep into the esophagus. The predominant cause behind bile reflux is a faulty pyloric valve or pylorus. This particular sphincter or valve is basically a ring of smooth muscle at the end of the pyloric canal that allows food to pass from the stomach to the duodenum. The bile regurgitate backwards from the duodenum through the pylorus into the stomach if the valve gets damaged during a gastric surgery. Health experts have mainly attributed the condition to factors like:

  • Excessive intake of alcohol or cocaine
  • Consumption of non-steroidal anti-inflammatory drugs, such as Ibuprofen
  • Bacterial infections, such as Helicobacter pylori (H. pylori) infection
  • Excessive exposure to ionizing radiation
  • Pernicious anemia
  • Autoimmune gastritis
  • Cyclic Vomiting Syndrome
  • Stress

Bile Gastritis Diagnosis

Gastrointestinal endoscopy is the standard test used for diagnosing this condition. In this exam, physicians use a thin, flexible tube (with a tiny camera fixed at the end called endoscope) to examine the esophagus, stomach and duodenum. Any damage to the mucosal layer, lining the upper gastrointestinal region can be viewed with the help of a computer monitor. A biopsy of the stomach lining is necessarily conducted along with endoscopy in order to detect the presence of an ulcer or bacteria. Additional tests are usually done by clinicians to identify the exact etiology of abdominal inflammation. Some of the common techniques include:

Blood test

A complete blood count conducted on pernicious anemic patients normally show abnormal levels of red blood cells, white blood cells and platelets. These patients also have a low level of hemoglobin, which is a sign of chronic bleeding in the stomach. Elevated amount of antibodies in the blood signifies the existence of H. pylori bacteria.

Stool test

A fecal sample can help in determining the presence of H.pylori antigens in the gastrointestinal tract of the patients. Blood-laden stool precisely indicates severe abdominal bleeding. Passage of dark, tarry stools by the patients suggests upper gastrointestinal bleeding.

Upper gastrointestinal series

In this radiological test, a patient is made to swallow barium, a liquid contrast reagent that makes the digestive tract visible on standard X-rays. The technique is used to visualize the esophagus, stomach and duodenum for any changes in the mucosal lining, such as erosions or ulcers.

Bile Gastritis Treatment

Mild bile reflux does not require any treatment and has the capacity to heal on its own. However, continuous bile and acid backflow causes persistent pain that can be reduced to some extent by using medications like:

Image of Bile Gastritis

Picture 2 – Bile Gastritis Image


These drugs relieve heartburn or indigestion by neutralizing the stomach acids. Sodium bicarbonate, citric acid and aspirin are the widely-used antacids prescribed by many health professionals.

Proton pump inhibitors (PPIs)

The acid production and its reflux into the esophagus can be inhibited by using PPIs like pantoprazole, omeprazole and rabeprazole.

Histamine 2 (H2) blockers or antagonists

These drugs inhibit the action of histamine on the acid-producing stomach cells and thereby delay the process of gastric acid production. Ranitidine and famotidine are the commonly used H2 blockers that relieve the patients from constant burning pain in the stomach.

Surgery is recommendable in very severe cases. It is successfully performed through a Roux-en-Y operation. The process involves division of the stomach into a small upper pouch and a larger lower remnant pouch. The small intestine is re-arranged into a Y-configuration, which is then connected to the smaller pouch for bypassing the bile. In this way, the bile is diverted from the stomach to the rectum, preventing it from flowing in the backward direction.

Bile Gastritis Complications

Individuals affected with the chronic form of the condition are likely to suffer from various complications like:

  • Esophageal cancer
  • Malignant gastric tumors
  • Esophageal stricture
  • Barrett’s esophagus

Bile gastritis is usually related to an unhealthy lifestyle as well as improper diet. Consumption of smaller, more-frequent meals reduces the possibility of increased acid secretion. Pain relievers, that aggravate stomach inflammation, must be stopped immediately. Adequate exercise can accelerate the process of digestion. Consult a healthcare provider if you are vomiting blood or passing bright-red stools for prompt diagnosis.

Bile Gastritis Diet

Spicy foods, carbonated beverages, chocolate and decaffeinated coffee are the common irritants of the stomach and are known to increase gastric inflammation. These foods must be completely avoided and replaced with a well-balanced, low calorie diet, comprising of fruits, vegetables and whole grains. Antioxidants found in fruits and vegetables aid in low production of stomach acids. Bacterial infection can be inhibited by consuming fermented milk, miso and yogurts, consisting of probiotics (healthy bacteria that inhabit the gut).


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