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Bile reflux due to badly placed small intestine, stomach badly inflamed. Gastroscopy done. Medicines to ease pain?

Apr 2013
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General Surgeon
Practicing since : 2009
Answered : 3037 Questions
My husband has bile reflux to his stomach caused from badly placed small intestine - he only has a partial stomach, some having been removed years ago because of stomach ulcer. He had a gastroscopy on Wednesday. His stomach is badly inflamed. His haemoglobin has dropped to 111. What should he eat, when, what to take to ease the pain? He has been treated for years for indigestion. I look forward to your help. XXXXXXX Slade for my husband, XXXXXXX who is 83 and has generally very good health and is quite fit.
Posted Sun, 26 May 2013 in Digestion and Bowels
Answered by Dr. Ivan R. Rommstein 1 hour later
Hi XXXXXX and welcome to XXXXXXX
Unfortunately in 1955. stomach ulcer was treated by stomach resection, today it is treated less invasive. If his bowel cancer was treated by bowel resection too, than it is to be expected that he will have severe digestion problems. He obviously have pyloric sphincter disorder or it was resected completely. Of course it can and should be treated, in first case by changing dietary habbits.
So bile gastritis is rare and pretty difficult to treat, but recommendations are similar as for stomach acid reflux.

He should eat more frequently 5-6 times per day but smaller meals. of course avoid hot and spicy food, coffee, alcohol, smoking. limit fatty food ( this is very important as fats increase bile secretion), refined and processed foods such as white flour and pasta.carbonated drinks, chocolate, citrus foods and juices, vinegar-based dressings, onions, tomato-based foods.

So what to eat? Balancing out the fluid's acidity with bread and milk/milk products can help.
Consume foods that contain flavonoids flavonoids such as apples, cranberries, celery. Also include in his diet raisins, broccoli, sea vegetables, almonds,
fish, beans, nuts, seeds, and tofu for protein.
He should drink enough water,natural one, not carbonated.

He should stay upright after eating,at least 1.5 hours . Raise his bed because sleeping with your upper body raised prevents reflux.

ALl these should be combined with medicines:
Ursodeoxycholic acid, antacids,sucralfate, Proton pump inhibitors and certain enzymes for better digestion

If all this isnt helpful surgery can be performed if he is capable for it. It can be done laparoscopicaly in some centres,but I wouldnt recommend this in his case.
Low Hgb is usualy finding in such conditions, it an be cause by microbleeding and pernicious anaemia. 111 is moderately low Hgb, and if this progress he might need blood transfusions. YOu can try to prevent it by iron and B12 supplements, but sometimes endosopic hemostasis is necessary if Hgb<100.

WIsh you good health. If you have any question I ll be glad to help.
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