Hi
This my 2nd post related to LPR but I’ve started a new thread because tests have revealed (at least some) of the causes of my problem.
I have finally had an endoscopy, after 18 months of suffering horribly with ever-worsening LPR/airways reflux. The endoscopy showed a 5cm sliding hiatal hernia but also significant bile reflux. The report makes no mention of an ulcer or any other cause. A nurse talked me through the report and also showed me photos of the bile and my normal esophegus. So I now know I have bile reflux in addition to acid, which would explain why I get very limited or no relief from all the medications and lifestyle changes.
I am so utterly miserable and depressed that I told myself if a HH was found, I would have the surgery. Radical as it is, my life simply isn’t worth living right now. But now I’m unclear what to do and want to be informed when I go back to my doctor to decide what’s next. Repairing the HH would stop the acid component of my reflux but won’t the bile continue to be a problem and cause damage, even if it can’t get past the repair? Everything I read says it shouldn’t be there and is very damaging.
Obviously, I intend to talk to my doctor but I’d like to know if anyone else has experienced this and what your outcome was. Is there always a physical cause that needs ‘fixing’ for bile reflux? Do drugs like Baclofen or Ursodeoxycholic Acid work?
Bile reflux is horrible, it tastes vile (far more horrible than Acid) and chokes you when you breath it in (so does Acid mind) making you cough for days afterwards. A very low fat diet definitely helps. A Nissen Fundoplication (hernia repair op) helps both Acid and Bile reflux by tightening up the LOS (Lower Oesophageal Sphincter). My personal experience is that if Bile (and far less so Acid) just touches this sphincter it spontaneously opens - letting the reflux out - maybe this spontaneous opening is a (just my) functional disorder, dunno. Anyway (although I haven't had the op myself) I'd say the op would be well worthwhile to help stop the thing opening willy nilly and letting the vileness out...
Bile in the Stomach shouldn't cause problems, the thing is virtually indestructible by Acid / Bile (unless one is sick with that kind of thing of course, like with a H. pylori infection breaking down the protective barrier and things like)...
As for the medicines you mention. Baclofen reduces spasticity (tightness) but this spasticity is probably a good thing with regards to the LOS. Ursodeoxycholic Acid. I'm not sure, maybe it'd help, dunno. Maybe an Abdominal Ultrasound would be diagnostic,, if your Gallbladder is packed then this can cause problems? As I say a low fat diet definitely helps with Bile reflux...
Just my humble opinion. Look afters 
Thanks Benny.
Based on what I've researched so far, I'm pretty sure that bile in the stomach is not a good thing and can cause gastritis and other more serious complications. This is my dilemma - I want to be free of the LPR and make sure my oesophegus stays undamaged, as it appears to be at the moment, hence I am seriously considering the hernia repair. But the bile will still be there. That's why I'd really like to hear from anyone who's experienced both and could tell me what they did, how it worked out etc.
There are many many mentions of Nissen Fundoplication in Patient UK, have a squizz at what they say Just in case you haven't already 
https://patient.info/search.asp?searchterm=Nissen+Fundoplication&searchcoll=Discuss_Forums
Hi Alex,
I just came across your post while looking for similar information. Like you, I've been diagnosed with a hiatal hernia and bile reflux, also bile gastritis. I've only had symptoms for the last 3 months (I've never suffered with acid indigestion before) and it all started a couple of weeks after my daughter was born. Like you, there was no mention of an ulcer in my endoscopy report and I haven't had stomach or gallbladder surgery.
I came across some information about a new procedure called Linx - it's a lot less invasive than nissen fundiplication and it's reversible, but it's only just been approved by the NHS and the long term efficacy of it is unknown (because it's so new). It does sound promising though -
I've heard that Baclofen or Ursodeoxycholic Acid work well for some people. There are also natural products that seem to work for some people - licorice, slippery elm and marshmallow (but check with your GP before taking them as they can reduce the effectiveness of some prescription medications). It's probably a matter of trial and error but there are lots of things to try.
I do hope you get some relief and feel less anxious soon.
Hi,
I removed the link in above post as it is to a commercial site. If users want the link please use the Message facility or Google Linx Surgery.
I don't know if this would be useful http://www.nice.org.uk/nicemedia/live/13604/60904/60904.pdf
Regards,
Alan
Emis Moderator
Hello Clare.
Yes, I'm familiar with LINX, I'd read up on it. Unfortunately, it's not a surgical option for people with HH, certainly not HH over 3cm. It does seem to be worth considering for those with reflux but not HH.
Until I see my doctor again I'm not sure how significant the bile reflux is and it may be that I take the drug route you mentioned or, if the bile isn't a big factor, that I opt for fundoplication. It's sounds awful and not to be considered lightly but, after this much suffering, trying everything to no avail and feeling so physically and mentally wrecked, it may be what I have to do. I'm trying to think positively about it as an option. There's not much positive feedback about it on the internet but I wonder if that's because people tend to be less inclined to write about good outcomes and health forums tend to be full of people who are suffering and, therefore, sharing negative experiences because they want help/advice.
Alex
Hi Alex,
Like Clare I also came across your post while searching for people with similar symptoms. Unfortunately I am unable to give you any advice as I am at the exact same point as you are!
I have a sensation of tightness/lump/something stuck in my throat, confirmed to be irritation of the larynx with a nasolaryngoscopy. I certainly understand where you are coming from when you say you are miserable. This was followed up later with an endoscopy that found a hitus hernia (2cm) and marked bile reflux. Despite the bile in my stomach, I have never developed any abdominal pain. I am at a loss as to the cause of this bile reflux, as I have never had any surgery and there was no mention of a peptic ulcer from the endoscopy.
I was prescribed domperidone which is a prokinetic that speeds up emptying of the stomach. Unfortunately I am still suffering from symptoms of LPR. The 'lump in throat' sensation is not as severe as it was initially, but my throat occasionally closes up if I inhale with exertion, such as after a laugh (swelling?).
One interesting thing I have seen is an article by Dr Stuart Shipko that relates chronic anxiety to bile reflux, but I can't vouch for anything as I have no personal experience with any of this.
http://www.selfgrowth.com/articles/Shipko1.html
http://www.stuartshipko.com/research.html
Regards,
Tom
hey, i am a 17 year old and i have been diagnosed with bile reflux about a year ago. i had an endoscopy and i read the results form and it said "significant bile reflux" which kind of freaked me out.
but i had to coop with the change so i had to change my lifestyle and diet and relied on medication.. all was good until a few weeks ago, my medication started to be less effective and now it has no effect at all, i started to feel a burn in my chest which lasts for about 15-30 mins now, and i have what seems like a pain in my heart. did anyone experience these symptoms i need some advice plzz.. thank u
I have finally found some relief from constant nausea caused by bile gastritis. I drink carrot juice on an empty stomach in the morning. I have found the drug Ursodeoxycholic Acid (Actifal) and Great Plains Betonite Clay. I also maintain an almost liquid diet, drink licorice or camomille tea, and sleep sitting up. I hope you find relief.
Hi Alex, I have same problems as you. I also get horrendous gas ( belching that can last for hours.) ant-acids made things worse. After a lot of research I found that digestive enzymes with betaine hcl stopped the gas. They worked with the very first meal. I believe and I have seen it with my own eyes that bile reflux is caused by pressure in the bowel due to undigested food. Due to this pressure bile is forced back into the stomach where it reacts with the stomach juices. The enzymes work great but on the odd occasion that I feel the pressure, pain and gas starting to build up I take one Zantac and it stops the reaction in my stomach. When it's settled I have an enzyme with food and I'm ok again. To stop the lpr at night I have baught a bivvy bed that night anglers use. It has adjustable legs that can be set so you sleep on a slope head higher than feet. I use a 1 inch thick mattress topper and it's the most comfortable bed I've ever slept in. I also believe that constipation can cause the bowel to back up and add to the problem. Hope you find this helpful.
Hi Alex,
I have exactly the same problem a 3cm Hiatus Hernia + bile reflux wich was diagnosed after a 24hr Ph-metry. I have seen a consultant last week who gave me the diagnosis for bile reflux and told me that there is nothing to do - no surgery - no medication. He just told me to drink Yakult and eat small meals more frequently (which i have been doing for months already!). I am quite depressed about the outcome, I have no idea of the potential complications and monitoring as he did not tell me and did not arrange any follow-up appointment.
I am in pain every single day with stomach cramps, chest pains and heartburns and also embarassing belching after eating which can last for hours.
I hope you will find some relief...!
Hi Alex
Gallstones perhaps! I have had terrible bile reflux for the last 9 months coinciding with being diagnosed with gallstones. I have had a hh for 25 years with no problems by taking 20mg of omeprazole each day. But last summer I started having severe acid in my mouth etc -cant taste things properly and cant drink beer, avery serious problem. I'm having my gall bladder out next week and cant wait. Took me a while to work it out as bile reflux is not listed as a gallstones symptom. Basically the stones can limit the release of bile into the duodenum, so you can get concentrated bile released that then aggravqates the pyloric sphincter allowing bile back up into the stomach. If youve got a hh which is very common, then the concentrated bile come s up the gullet-horrible. Ranitadine plus omeprazole just to make life partially bearable until you can get surgery sorted out. I sympathise greatly.
Hi maloushka I am at this moment suffering with the same thing. Digestion have always been my problem but this one really bugs me I have now changed my diet and I am still burping and have chest pains I have also lost weight. I have now got a referral for endoscopy and ultra scan. I am so worried I don't sleep. And it has been like that for the past two weeks. I think the stress and worry is an affecting me big time but I don't know what else to do. Have you found some help with yours. I hope and pray that we all get better soon. From mam
Hi Marie,
I feel the pain, it took 18 months to get a diagnosis and now I'm left with no option (no treatment, no surgery) by the consultant. I am going back to my GP on Monday to get sone answers. In the meantime, as I'm French I have arranged an appointment there when I come back for holidays in May, where I will see the consultant and get an endoscopy on the spot so the consultant can directly have a look at it which makes things much quicker, I will have to pay about 100 pounds as I'm not covered anymore there by the "Social Security" (the equivalent of the NHS) as I work now in the UK, but it's still much cheaper than going private here... I hope to get some answers as apparently there are treatments according to my dad who spoke with some doctors there.... I just hope that my appointment on Monday with the GP will bring me some reflief for the time being!
I hope you get better soon too!! Keep me posted!
Hi Maloushka
Have you found any relief so far - please do post after your tests in France. PPIs are not working for me so I am guessing bile reflux as endoscopy shown gastritis.
In effect I think the reflux got less severe but now constant on PPIs. So tired and fed up. All the best
Hi Denisa,
i will do i have my appointment on the 5th of May. So far the only relief I get is from Ranitidine and gaviscon but it does not work 100%. I also take lemon balm supplements as I can get a bit bloated.
best regards
I have Been told I have reflux . Started with a cough and a feeling of not being able to get a deep breath in . I was given lansoprazole which I've taken for a month and also changed my diet to alcohol no chocolate. No heavy meals before. Bed etc . However my symptoms are still sometimes I can't get a deep breath And a pressure feeling that can change, sometimes it's high up in the chest that feels irritatedbut other times the pressure is lower down in the stomach which is worse as feel I can't get a deep breath from deep down . My symptoms don't seem typical. Does anyone have not getting a deep breath symptoms ? .thanks
hi my name is Jose from the Philippines... ive had this hiatal hernia and bile reflux for over a year and though i have not found Domperidone works by helping to move the food in your stomach through your digestive system more quickly. This helps to stop you from feeling sick.Ursodeoxycholic Acid here yet it is one of 3 option remedys from this link
http://www.mayoclinic.org/diseases-conditions/bile-reflux/basics/treatment/con-20025548
Another helpful med prescribed to me by my gastro Doc is to take Domperidone 10 3x a day before meals... this drug like motilium emptys your gut out completely after meals and keeps the acid from remaining therein causing the irritation and acid contact in areas of ur gutt that are already sensitive... and lots of water helps... i guess it entails a life style change... lose weight drop to ur BMI index is one... eating healthy more fruits and veggies, almost vegetarian works.. less meat or lean chicken no skin... less oil .. i still take decaf one to twice daily but after or w a meal... love coffe that was tough to stop for a while... but am good now... u need to understand how ur gutt works and improve the digestion process.. and this domperidone has helped a lot...will add a link on this for u to read... dont get too full and share a meal if u eat out... for those over 40 u know its harder to burn calories and lets face it our metabolism slows down in time... u need to keep running or gettin excercise.. am thankful this impairement doesnt keep me from running... hope this helps for anyone out there!! best regards and happy holidays HUGS!!! Jose
"Domperidone works by helping to move the food in your stomach through your digestive system more quickly. This helps to stop you from feeling sick."
https://patient.info/medicine/domperidone-for-sickness-motilium
I there Julie, I have had similar problems with not being able to get a deep breath. Yawning helps a lot but it's not a good habit to get into in order to breathe. In my case, and perhaps yours, it is due to acid spilling onto the vocal cords and causing Vocal Cord Dysfunction (VCD). The vocal cords will close inappropriately, causing them to close during inspiration. You are not actually respiratory compromised during a VCD attack, or at least that is what the research points to for now. Control of symptoms and VCD's attacks is to practice deep belly/diaphragm breathing. Also, make the sound "FFFF" which helps to relax your vocal cords. It took me years to get dianosed. Still gives me problems but at least now I know I am not dying during an attack.