throwing up bile

One morning, you get up and clean your mouth; suddenly, you vomit a bitter, greenish-yellow fluid. You are very worried and ask yourself what disease you can get. There are many causes of throwing up bile such as pregnancy, gastritis, pancreatitis, enteritis, etc. However, the most common cause is bile reflux. The information below will help you understand this vomiting situation.

The bitter, greenish-yellow fluid you throw up can be bile. Bile is produced in the liver and usually stored in the gallbladder. At meal time, the gallbladder pulsates and moves bile to the duodenum. The following roles of bile help digest food better:

– digesting fats and absorbing the vitamins A, D, E, and D,

– stimulating secretion and activation of pancreatic and intestinal fluid,

– creating an alkaline environment in the intestine and stimulating intestinal motility,

– inhibiting the activity of sulfate-reducing bacteria in the upper part of the small intestine

Apart from digestive function, bile also eliminates bilirubin – a degrading product of hemoglobin in red blood cells.

Bile reflux is a phenomenon that bile refluxes into the stomach and then the esophagus or gullet (the tube through which food passes from the mouth to the stomach) because the pyloric valve between the stomach and the small intestine is damaged and does not close tight.


Peptic ulcer disease is often easy to weaken the pylorus muscles, which cause bile reflux. Also, food is stagnant in the stomach but is not digested, which puts pressure on the pylorus muscles and cardio making bile reflux into the stomach and esophagus.

After gastric surgery, such as gastrectomy, it often makes pyloric valve act ineffectively and unsteadily so it cannot close tight and causes bile reflux. Besides, gallbladder diseases also increase the risk of bile reflux.


Bile reflux is often confused with gastroesophageal reflux (acid reflux) because their symptoms are quite similar. However, you can still recognize the bile reflux through the following symptoms and signs.

Apart from throwing up bile as mentioned above, heartburn and bitter taste in the mouth are symptoms which often come together and occur frequently. You have heartburn because bile reflux pains your upper stomach disturbingly, accompanied with a bitter taste in your mouth.

Moreover, bile moves backward, which injures the mucous membranes of the throat. Hence, you can have a cough and get hoarse. Besides, the symptom of bile reflux is unexplained weight loss.


Esophagogastroduodenoscopy (endoscopic examination of the stomach and duodenum) is an important measure to diagnose bile reflux. Anaesthesia in endoscopy should be performed as at that time, the pulsation of the stomach and the opening and closing of the pylorus or cardio is less active from the patient.

Through the endoscope, it can be seen that bile back up from the duodenum through the pyloric hole, and bile stagnates in mucous membranes of rugae and fungus. In addition, we can detect lesions of the stomach and esophagus. However, using the endoscopy only detects bile reflux at the time of examining, so there are still limitations.


According to doctors, bile reflux disease can cause harm to the body, such as:

– Because of a stomach-ache, bitter taste in the mouth and heartburn, the patient doesn’t want to eat, lose weight, which makes the body weak and mental fatigue.

– If not treated promptly and incubated for a long time, bile reflux can damage the lining of the stomach. From that, it causes the gastric ulcer, gastric bleeding or even gastric cancer.

– Those who have bile reflux associated with acid reflux may increase the risk of esophageal cancer and damage the health severely.

Bile reflux is a dangerous disease that can lead to many other serious illnesses. Thus, when having the symptoms of the disease such as throwing up bile, you should go to the hospital to be examined, diagnosed and treated as well as prevent the growth of the illness and its dangerous complications.


Medication for bile reflux is the first choice for the patient.

The drugs having a mechanism to reduce or remove bile are Questran, Colestid, and Cisapride. Of all those drugs, Cisapride is used to treat for children, but they still have certain side effects; hence, it is prudent to use it. Using ursodeoxycholic acid to relieve some symptoms of bile reflux such as stomach-ache, nausea and throwing up bile are discussed further.

Although treatment with proton pump inhibitors is not entirely supported by doctors around the world, this method is still carried out to treat bile reflux. The protesters argue that using proton pump inhibitors may limit the amount of acid secretion but increase backflow of gastric juice.

Treatment of bile reflux by surgery is another choice for the patient.

The Anti-reflux surgery is used to make good spasm of the esophagus sphincter. When the sphincter tightens, acid and bile cannot back up. A part of the stomach close to the esophagus will be wrapped and sewed around the oesophageal sphincter.

The second surgery is Roux-en-Y, but it does not guarantee the treatment of bile reflux. The ability to treat this disease with this method of surgery is fifty to ninety percent. The surgeon leads the bile duct connected to the jejunum. It means that the amount of bile will be transferred to the jejunum instead of directly jumping into the duodenum as before.

In addition, to cure bile reflux, the patient should have reasonable daily activities.

Change the diet

Divide into many small meals daily to reduce the pressure of lower oesophageal sphincter and pyloric valve. After eating, the patient is not allowed to lie down immediately but have to wait for food to digest (about 2-3 hours). Avoid using foods that increase acid and bile reflux such as fatty foods, coffee, vinegar, pepper, chocolate, citrus fruits, fizzy drinks and so on.

Limit or avoid alcohol

Alcohol stimulates the esophagus and increases the lower esophagus sphincter, which leads to bile reflux.

Quitting smoking

When you smoke, an amount of nicotine is taken into the body. The nicotine increases the secretion of attacking elements and restricts the protective element – prostaglandin – a substance that protects and restores mucous membranes, which narrows the blood vessels of the stomach; from that, damage this protective layer. Besides, cigarettes also dry the mouth reducing saliva which leads to its effect of neutralizing gastric juice reflux decreases and the patient’s burning pain increases.

Relax the spirit

The patient suffers from prolonged stress, which leads to an imbalance of the attacking elements and protective element; hence, the lining of the stomach is damaged, and it affects the function of contracting and digesting food. The process of hollowing the stomach is slow, the pressure on the lower esophagus sphincter increases, gradually causing bile reflux.

Selecting a tilt bed

When the pylorus and cardiac valve is weak, bile reflux is very easy to occur. Raising the head of the bed about 15-20 cm can prevent the symptoms of bile reflux. It is because the gravity will assist in preventing bile from backing up into the stomach and esophagus.

Lose weight

When the patient loses weight, the amount of fat pressing into the stomach and small intestine will decrease. From that, bile and acid reflux will decrease.


Author Bio:

My name’s Jasmine He. Being a person who is interested in health and beauty as well as has a strong desire for the well-being, I have a wide knowledge of this area after having the patience to learn and experience it for a couple of years. Along with my current education job, I have now been working as a freelance writer on health and beauty.

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