Bile is a yellowish fluid produced & secreted by the liver that helps in the breakdown & digestion of the fat content in the food we eat. It is normally stored in the gall bladder ad flushed into the intestines when needed. When this flow becomes abnormal or reverses the direction, the bile is moved into the stomach. In some cases, it can be felt coming up from the stomach into the tube that connects the mouth & stomach, the esophagus. The condition is mostly associated with the disease GERD in which the stomach contents along with stomach acid cause heartburn & other discomforts. This is a really serious disease with long-term pathology causing irritation & inflammation to the oesophageal lining of the mucosa.
Clinical presentation includes discomforts like:
Severe and acute abdominal pain, in the upper part.
Heartburn or burning sensation inside the chest, along with sour taste in the mouth.
Burning sensation of throat & mouth
Nausea & loss of taste
Vomiting and the content is a yellow or greenish-yellow fluid that is bile itself.
In some cases. Cough or hoarseness of voice will be present
Unintentional weight loss
Causes of bile reflux
Structural causes include defective valves especially the pyloric valve or lower oesophageal sphincter that prevents the backflow of stomach contents into the esophagus.
Complications of surgical procedures including partial or total removal of the stomach, gastric bypass surgery done in intentional weight loss, etc can interrupt the normal movement of the esophagus, intestines & stomach walls, causing backflow of its contents.
Diseases like peptic ulcers affect the normal function of the pyloric valve in a bad way. In this condition, the opening and closure of the valve become defective allowing the food to stay in one place for more time at times. Such immobile food in the stomach causes higher gastric pressure and leads to the backflow of the stomach acid & bile into the esophagus.
Gall bladder surgery directly causes the disease as the normal storage and controlled emission only in need becomes non-functional. Bile flow is not regulated causing the excess flow of bile into the system n some patients causing bile reflux.
Treatment of bile reflux
In many cases, medications can suppress the signs & symptoms.
Medicines used in common cases include:
Ursodeoxycholic acid
Sucralfate
Bile acid sequestrants
In severe cases, surgery is advised and the procedures used widely include diversion surgery and anti-reflux surgery.
Complications of bile reflux
Human gastric secretions are very powerful acidic chemicals that can digest almost anything when immersed in them. Controlled and organized emission and a synchronized digestive system makes the chemicals functional in a proper way & prevents them from causing problems to their own cells.
In diseases like bile reflux, the balance is lost and may lead to complications like:
GERD
Oesophageal cancer
Carcinoma of stomach
Berret’s esophagus
Oesophageal ulcer
Preventive measures of bile reflux
Maintaining a healthy diet & lifestyle can help in preventing digestive system malfunctions including bile reflux.
Ayurvedic Concept of Bile reflux
Ayurveda considers the conditions of bile reflux as Amlapitta. It is considered a condition with increased pitta dosha and dysfunction of annavahasrotas (gastrointestinal tract). In cases of Amlapitta, main signs include Avipaaka(indigestion), Daaha in hrit & kanta(burning sensation in chest & throat), and tikta & amla udgaara(tastes like bitter and sour in the mouth while belching).
Ayurvedic Nidana of Bile reflux
Viruddhaanna paana – food items and drinks that have opposite taste, potency, and action on the body, consumed together.
Dushta anna paana – contaminated food items and drinks
Amla annapaana – food items and drinks that are sour in taste and action
Vidaahi anna paana – Food items and drinks that cause inflammation and swelling in the gastrointestinal tract or that destroys the mucosa
Foods and drinks that lead to aggravated Pitta in the abdomen
Ayurvedic treatment for Bile reflux
Cleansing the gastro-intestinal tract is the main treatment for Amlapitta. By removing the toxic metabolic waste and cleansing, the intestinal mucosa starts functioning in a better way. Peristalsis is also normalized after Ayurveda panchakarma therapies. In such a way, the muscular structures get strengthened preventing backflow of bile and stomach acids. After cleansing therapies, herbal medicines to enhance Agni are used along with dietary restrictions. Sleep, bath, and other daily activities are maintained in a healthy schedule as part of treatment.
Though most cases of Amlapitta have recurrent nausea & vomiting, the treatment starts with therapeutic emesis. Medicinal preparations with herbal drug combinations that have an emetic effects are used to initiate vomiting to clean the upper stomach from the excess bile and other secretions. This process will remove the doshas that cause the manifestation of the disease. Herbal combinations like Patoladi kwatha added with honey & rock salt are used for this purpose. These are thikta rasa and having the action of pacifying Pitta and Kapha.
If needed, medicines are given for therapeutic purgation ensuring that there is no indigestion. Herbal combinations like trivrut churna are used for this need.
After cleaning of stomach and intestines with emesis & purgation, medicated enemas are administered in suitable patients. This can be done with two types of herbal combinations. One is known as Asthapana vasti (therapeutic enema with herbal decoction, herbal paste, and other ingredients in a colloidal form at specific temperature) and the other is anuvasana vasti (therapeutic enema with medicated herbal oils &ghee). Both these medicated enemas are done in alternative order under expert supervision.
Herbal Preparations for Bile reflux
Pippalli-sringavera churna with honey
Amalaki swara
Guda-ardraka kalka
Rajanyadi churna
Side effect management of Bile reflux by Ayurveda
Long term use of some medications for bile reflux may lead to adverse effects like liver problems, diarrhoea etc. Ayurveda medicines like dooshivishari gulika and avipathi choornam can help to avoid such complications.
These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake.
Writer:
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.
Dr. Nair offers consultation at two busy clinics in and around Haripad, Alleppey, Kerala, the southern state famous worldwide for authentic ayurvedic treatment and physicians. While offering consultation on all aspects of ayurvedic treatments Dr. Nair has a special interest in Panchkarma, Yoga, and Massage.
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