Bile reflux

Reflux of bile acids into the esophagus may contribute to injury of the esophageal lining. Bile is a component of digestive juices normally present in the small intestine. Bile can reflux from the small intestine into the stomach and does so normally. However, in a subset of people who have severe GERD (backwashing of acid and bile into the esophagus), including in those who have Barrett's esophagus, there is an increase in the amount of bile back-washing into the esophagus. Although acid reflux is increased in patients who have Barrett's esophagus and plays a primary role in the development of Barrett's esophagus, there is evidence that bile reflux is also increased in patients who have Barrett's esophagus. Bile and acid reflux occur together in these patients. Bile reflux may increase the effect of acid injury to the esophagus and therefore may contribute to the development of Barrett's esophagus and possibly esophageal adenocarcinoma (cancer).

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