Bile reflux
DEFINITION
- ნაღვლის რეფლუქსი ნიშნავს ღვიძლში წარმოქმნილი მომნელებელი სითხის (ნაღველი) კუჭში ან საყლაპავში (კუჭისა და პირის შემაერთებელი მილი) ამოსვლას.
- ნაღვლის რეფლუქსს შესაძლოა ახლდეს მჟავას რეფლუქსიც, რაც ნიშნავს კუჭის მჟავების საყლაპავამდე ამოსვლას. ამის მიუხედავად, ნაღვლის და მჟავას რეფლუქსი სხვადასხვა დარღვევაა.
- რეფლუქსის დროს, ნაღვლის როლი საეჭვოა. ნაღვლის რეფლუქსზე ეჭვი მაშინ მიაქვთ, თუ ძლიერი მჟავასაწინააღმდეგო მედიკამენტების მიღების მიუხედავად პაციენტს რეფლუქსის პრობლემა მაინც აქვს.
- მჟავას რეფლუქსისგან განსხვავებით, ნაღვლის რეფლუქსი უფრო რთულად ექვემდებარება დიეტის ან ცხოვრების სტილის შეცვლას.მკურნალობა ძირითადად მოიცავს მედიკამენტებს, თუმცა მძიმე შემთხვევებში, ქირურგიულ ჩარევასაც.
CAUSES
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.
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.
SYMPTOMS
Bile reflux can be difficult to distinguish from acid reflux. The signs and symptoms are similar, and the two conditions may occur at the same time. It isn’t clear what role bile plays in reflux conditions.
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
- Nausea
- 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 gastroesophageal reflux disease (GERD) but aren’t getting adequate relief from your medications, call your doctor. You may need additional treatment for bile reflux
