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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Endoscopy showed severe bile staining. Having severe acid reflux in throat. Taking dexilant. Any ideas?

Answered by
Dr. Enrique Molina

Internal Medicine Specialist

Practicing since :2004

Answered : 364 Questions

Posted on Thu, 17 Jan 2013 in GERD
Question: Had endoscope and it showed severe bile staining. I have bad reflux to the back of my throat. I'm on dexilant and it helped the burning some but food and stuff is still backing up, how do I know for sure it's bile or acid, I had another scope three months later and didn't show much bile?
Answered by Dr. Enrique Molina 1 hour later
People can have "acid" reflux or "non-acid" reflux. Acid is produced in the stomach, but if it goes up into the esophagus it is called acid reflux and it can be felt as a burning sensation. When the reflux is advanced you can develop "esophagitis" (inflammation in the esophagus), which can be seen on an endoscopy.
The acid can be blocked by medications such as dexilant (these are called proton pump inhibitors), and this is why you felt somewhat better.
Bile, is considered a "non-acid"; Bile is produced in the duodenum (first part of the small bowel), and usually won't be the cause of major problems or symptoms. I am not sure what you mean with "bile staining" on the endoscopy.
The fact that you feel food backing up is because for some reason you are having reflux. Recommendations are: weight loss, eat meals at least 4 hours before lying flat on the bed (e.g. dinner 4 hours before going to bed), avoid foods such as chocolate, spices, alcohol, coffee, mints. If these options don't work then you should seek specialist attention.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

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