The majority of patients with pancreatic problems suffer from heartburn. Sometimes this heartburn is stubborn and does not respond to common treatment with the gastric acid suppressors. Many individuals have the bitter taste in the mouth, belching, or regurgitation with the bitter taste or vomiting of bile. The common belief that heartburn is caused only by an acid reflux is not always right, especially in a case of chronic pancreatitis. In this situation, the reason for the heartburn might be a bile reflux, biliary reflux that also goes by a name of duodenogastric bile reflux.
Bile reflux is not a new condition. The surgeons frequently have found presence of bile in the stomach during surgery, for over a hundred years. The presence of bile is a regular finding by gastroscopy in persons with stomach inflammation-gastritis, ulcers, after gallbladder surgery, gastroesophageal reflux disease (GERD). In 70% of the chronic cases of heartburn and Barrett’s Esophagus there is bile reflux. Barrett’s Esophagus is a serious precancerous complication of GERD.
Nowadays, there are more evidences that bile reflux with combination with acid reflux leads to serious injury of the stomach and esophagus. This injury does not fall from the sky; therefore, as same as in case of chronic pancreatitis, bile reflux has also three stages: functional, structural and final. You understand that by reading Three Stages of Chronic Pancreatitis.
Acidic pancreas and bile– fictional stage
Pancreatic deficiency-structural stage
What can cause bile reflux in the person with the different stages of chronic pancreatitis?
Normally, the liver produces alkaline bile and pancreas manufactures very alkaline pancreatic juice filled with digestive enzymes. The alkalinity of these fluids means healthy digestion and proper movement of theses fluids.
In the picture, one may see the proper move the mix of the alkaline pancreatic juice and bile throughout the sphincter of Oddi down to duodenum to digest the food.
Opposite, acidic changes lead to poor digestion and efflux-wrong way traffic.
In the picture one may see that in the case of bile reflux, the aggressive mix of bile and pancreatic juice is thrown up into the stomach causing the “fire”-inflammation.
Why does it happen? Let us explain.
Bile is an alkaline fluid with a gentle balance of water, bicarbonates, minerals, lecithin, cholesterol, bile pigments, and bile acids and bile salts. If bile is acidic, bile acids precipitate in it. It is known; bile acids are exceptionally “aggressive” chemical substances. They make the acidic bile so corroded and irritable. The acidic bile irritates and injures the surrounding tissues, bile ducts, gallbladder, and sphincter of Oddi causing spasms, inflammation, ulcers. When the aggressive acidic mix of bile and pancreatic juice gets duodenum, it can create the chaotic spasms, and throws it up in the stomach and even into an esophagus. So there is bile reflux.
In the acidic pancreas and bile– fictional stage, there are occasional heartburns after large, fatty dinner with alcohol. Lab tests are normal, in the gastroscopy can be seen slightly inflammation in the duodenum, and stomach. Typically, a patient gets the diagnosis-GERD and treatment with the stomach acid suppressors. The person continues acidic lifestyle and alcohol consumption; thus, his condition deteriorates.
In the pancreatic deficiency-structural stage, the person suffers from stubborn heartburn with possible regurgitation of the bitter-sour content of the stomach into the throat, belching, gas, nausea, and vomiting, upper abdominal pain. Symptomatic therapy has temporal relief or does not wok at all. In the gastroscopy can be seen severe inflammation, ulcers, and deformation in the duodenum, stomach inflammation, ulcers, and traces of bile in the stomach. There are signs of inflammation in the esophagus, as well. This condition requires changes in the lifestyle, eating habits, correction of the acid-alkaline balance, reinstatement of beneficial intestinal bacteria, replacing deficiencies of the vital nutrients, improving digestion, and more by using the combination of the conventional and alternative treatments.
Ignoring that leads to the pancreatic failure. Besides the symptoms, which are described as chronic pancreatitis: constant abdominal and chest pain, indigestion with chronic diarrhea with oily stool, nausea, vomiting weight loss, fatigue, in the gastroscopy can be seen Barrett’s Esophagus.
The conventional treatment of the heartburn with stomach acid suppressors in a case of chronic pancreatitis and bile reflux maybe is not exactly right. The updated medical research shows that Proton Pump Inhibitors (PPI) such as Prilosec (Omeprazole) diminishes pancreatic function, leads to the deficiency of the vital vitamins, minerals, and trace elements. Some medical papers demonstrate that Prilosec may cause acute pancreatitis, as well. If the proton ion-H+ did not go into the stomach acid but left in the blood, it could cause whole body acidity-metabolic acidosis. You just remember that acidity kills pancreas.
It is clear that focusing on the healthy, slightly alkaline environment in the whole body and, mainly in the liver and pancreas, can lessen the bile/pancreatic reflux into the stomach and esophagus. In turn, it can minimize bile reflux and persistent heartburn in person with chronic pancreatitis.
The whole body acidity can be managed in a few ways:
Even though most persons with chronic pancreatitis know about the alkaline diet and mineral supplementation, Karlovy Vary healing mineral water is something new to Americans. Drinking healing mineral waters is extended medical practice in Europe by centuries. Karlovy Vary, in the Czech Republic, is legendary health mineral spa in the middle of Europe. Millions of individuals with digestive and pancreatic symptoms, such as heartburn, stomach fullness, nausea, cramps and chronic abdominal pain, diarrhea, constipation get help by drinking this healing mineral water. For persons, who could not go to this place, geyser water was vaporized to create mineral salt.
Drinking mineral water prepared from genuine Karlovy Vary salt is hundred years therapy for heartburn. According to Czech doctors, minerals, trace elements, and bicarbonate in this water can do dual work. At first, water can normalize the acidity in the stomach. Secondly, Karlovy Vary healing mineral water can alkalize the entire body and body’s fluids including bile and pancreatic juice.
The most of the sufferers from chronic pancreatitis and bile/pancreatic reflux also have Candida-yeast overgrowth and small intestine bacterial overgrowth (SIBO). It creates regular fermentation in the intestines with the producing a lot of toxic gasses. By its way out, gasses unlock the valve between esophagus and stomach-lower esophageal sphincter (LES). When this valve is open, it moves the stomach’s content up to esophagus with severe heartburn. This particular valve is so strong that even when healthy experienced yoga lovers stand on their head, the LES holds back the stomach contents and guards the esophagus.
The LES can open at the wrong time if the pressure inside the abdomen is high. The valve cannot stand the high pressure in the stomach, so it unlocks. Large dinner, lying down after huge meals, and wearing tight clothing may be blamed for increasing the pressure inside the stomach. Inappropriate food combinations of proteins, fats, starches, and sugars together may also create a lot of gas and heartburn.
If you suffer from chronic pancreatitis and long-term, persistent heartburn with the bitter regurgitations, if the medicines that suppress stomach acidity cannot help, there is a high chance that you have a bile reflux. There is no simple treatment for bile reflux. Alternative medicine, natural approach with the focusing on the root of the problems can be beneficial. Misdiagnosis or just symptomatic treatment of the bile reflux may bring the serious problems such as stomach and duodenum inflammation, ulcers and development of Barrett’s esophagus and esophageal cancer.
To obtain the benefits of the Biotherapy Clinic from healing chronic pancreatitis, heartburn and bile reflux one can select the following options:
Telephone consultation (415) 409-3939 or (650) 365-3640