Guest guest Posted April 29, 2003 Report Share Posted April 29, 2003 I have BILE REFLUX and he order Carafate (Sucralfate Suspension Someone mentioned this on the AMOS message board. Is this different from Acid reflux? If so, can this be another explanation for the heartburn we have been discussing. Fay Bayuk **300/173 10/23/01 Dr. Open RNY 150 cm Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 29, 2003 Report Share Posted April 29, 2003 I have BILE REFLUX and he order Carafate (Sucralfate Suspension Someone mentioned this on the AMOS message board. Is this different from Acid reflux? If so, can this be another explanation for the heartburn we have been discussing. Fay Bayuk **300/173 10/23/01 Dr. Open RNY 150 cm Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 30, 2003 Report Share Posted April 30, 2003 Fay, In brief, bile reflux can contribute to heartburn, and it is observed and measured with an endoscopic device trade-named " Bilitec. " I have been reading up because of my son's condition (see below), and my take is that bile reflux all the way up into the esophagus is relatively rare in normal (non-surgically modified) patients. ***BUT*** an RnY reconstruction (or a DS) is often prescribed to divert bile from the stomach, and since you have an RnY already, I have a hard time understanding how bile can get up into your esophagus or pouch unless you have a SLD fistula. As for my son's condition: I just saw bile in the stomach in photos taken in my son's EGD last week. Prominent pool of yellowish fluid (bile, manufactured in the liver, stored in the gall bladder, and introduced into the distal duodenum through the common bile duct) at the bottom of his stomach. My son is 37 y.o. and thin and has had no abdominal surgery of any kind. He has been taking one form or another of the most potent acid suppressor available (most recently Nexium, but a long line of antecedents, depending on the year in question) for more than 15 years. We will see the doc this afternoon for detailed explanations (doc excised four polyps/tumors in the stomach and two in the esophagus; THANKFULLY, no malignancies or pre-cancerous cells--aka dysplasia). It is known that chronic use of proton pump inhibitors (like Prilosec, Nexium, Prevacid and others) can cause benign polyps to grown in the stomach, and this may have been the cause of my son's growths in the stomach (not sure about the esophagus, though). It is also possible that the gastric discomfort he has been experiencing was caused by bile reflux all along. If this is the case, he may have to have an RnY or duodenal switch reconstruction (but, with only minimal bypass for minimal malabsorption) to divert the bile reflux from the stomach (his pylorus may be incompetent against reflux). The doc has him swigging Carafate also. Bile consists of several " bile acids, " but I am not sure whether they act as real acids (pH <7) or as alkalis (pH >7). This is because bile (or is it " bile salts " which are compounds formed from bile acids?) emulsifies fat for absorption through the intestines, and I had always thought that it takes an alkali to do that. I am truly confused over the terminology. If anybody can help me resolve my confusion, I would appreciate it. An interesting article pertinent to your original question: From: http://www.webgerd.com/Abstract26.htm In patients with bile reflux esophagitis, the clinical, endoscopic and pathologic findings are similar to those seen with acid reflux esophagitis. When reflux symptoms are present and studies such as 24 hour pH monitoring is normal, consider ambulatory bilirubin monitoring or the use of isotope meal to confirm the presence of bile induced gastroesophageal reflux disease. At 4:52 AM -0400 4/30/03, fbayuk@... wrote: >I have BILE REFLUX and he order Carafate (Sucralfate Suspension > >Someone mentioned this on the AMOS message board. Is this different from >Acid reflux? If so, can this be another explanation for the heartburn we >have been discussing. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 30, 2003 Report Share Posted April 30, 2003 Fay, In brief, bile reflux can contribute to heartburn, and it is observed and measured with an endoscopic device trade-named " Bilitec. " I have been reading up because of my son's condition (see below), and my take is that bile reflux all the way up into the esophagus is relatively rare in normal (non-surgically modified) patients. ***BUT*** an RnY reconstruction (or a DS) is often prescribed to divert bile from the stomach, and since you have an RnY already, I have a hard time understanding how bile can get up into your esophagus or pouch unless you have a SLD fistula. As for my son's condition: I just saw bile in the stomach in photos taken in my son's EGD last week. Prominent pool of yellowish fluid (bile, manufactured in the liver, stored in the gall bladder, and introduced into the distal duodenum through the common bile duct) at the bottom of his stomach. My son is 37 y.o. and thin and has had no abdominal surgery of any kind. He has been taking one form or another of the most potent acid suppressor available (most recently Nexium, but a long line of antecedents, depending on the year in question) for more than 15 years. We will see the doc this afternoon for detailed explanations (doc excised four polyps/tumors in the stomach and two in the esophagus; THANKFULLY, no malignancies or pre-cancerous cells--aka dysplasia). It is known that chronic use of proton pump inhibitors (like Prilosec, Nexium, Prevacid and others) can cause benign polyps to grown in the stomach, and this may have been the cause of my son's growths in the stomach (not sure about the esophagus, though). It is also possible that the gastric discomfort he has been experiencing was caused by bile reflux all along. If this is the case, he may have to have an RnY or duodenal switch reconstruction (but, with only minimal bypass for minimal malabsorption) to divert the bile reflux from the stomach (his pylorus may be incompetent against reflux). The doc has him swigging Carafate also. Bile consists of several " bile acids, " but I am not sure whether they act as real acids (pH <7) or as alkalis (pH >7). This is because bile (or is it " bile salts " which are compounds formed from bile acids?) emulsifies fat for absorption through the intestines, and I had always thought that it takes an alkali to do that. I am truly confused over the terminology. If anybody can help me resolve my confusion, I would appreciate it. An interesting article pertinent to your original question: From: http://www.webgerd.com/Abstract26.htm In patients with bile reflux esophagitis, the clinical, endoscopic and pathologic findings are similar to those seen with acid reflux esophagitis. When reflux symptoms are present and studies such as 24 hour pH monitoring is normal, consider ambulatory bilirubin monitoring or the use of isotope meal to confirm the presence of bile induced gastroesophageal reflux disease. At 4:52 AM -0400 4/30/03, fbayuk@... wrote: >I have BILE REFLUX and he order Carafate (Sucralfate Suspension > >Someone mentioned this on the AMOS message board. Is this different from >Acid reflux? If so, can this be another explanation for the heartburn we >have been discussing. > Quote Link to comment Share on other sites More sharing options...
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