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It can be frustrating to suffer with burning, nausea and what seems like acid reflux, only to be told you don't seem to have excess acid or you're given PPI medications that don't work for you.

Do you have any of the following symptoms?
Burning
Nausea, especially after fatty meals
Bitter taste in your mouth or the back of your throat
Nighttime reflux
Gastritis or esophagitis without a high acid level

If you do, you may be suffering from the effects of bile acids, not stomach acids.

Bile is made up primarily of bile salts which are highly alkaline and detergent-like, as they emulsify fats. They are very irritating and their enzymatic activity dissolves cell membranes when they are in a part of your body not designed for them, namely your stomach or esophagus.

When bile refluxes into your stomach it can cause gastritis, nausea and burning. When it refluxes into your esophagus it can worsen GERD or LPR (silent reflux), esophagitis or Barrett's esophagus.

Bile causes spasming and then weakening of the smooth muscle which makes up your sphincters, the valves that allow for proper movement of food and drink through your digestive tract.

When the LES is weakened, you'll get worsening reflux of acid and bile. When the pyloric sphincter (connecting your stomach to your small intestine) malfunctions, you'll get bile refluxing into the stomach.

Bile acids don't just weaken your sphincters, they also affect the nervous system in your gut (called the enteric nervous system), altering normal reflexes and sensitizing nerves. This means that your stomach and esophagus become hypersensitive to acid and bile. So you'll "feel" burning despite there being very little acid present (or bile).

It becomes a vicious cycle of motility and sphincter dysfunction: Bile acid inflammation slows motility and this worsens stasis, leading to bacterial overgrowth and more bile acid disruption.

Bile acids also impair the small intestine sphincter (ileocecal valve) and the anal sphincter, leading to bile diarrhea, so no sphincter is spared from the ill effects of bile acids.

If this sounds like you, we would be happy to assist. The best next step is to contact us for a consultation and then we can determine if what we do is a good fit for you. Call 727-335-0400.

#reflux #rootcausemedicine #hiatalhernia