Thoughts on Bile Reflux.
The Heidelberg pH Diagnostic test analyzes the ACID PUMPING cells of the stomach, to determine if there is an abnormally low, or abnormally high, stomach acid pumping issue.
The Heidelberg pH Diagnostic test is highly valuable, particularly because both low and high stomach acid problems have similar symptoms, meaning you could have either problem but the feeling it gives you is identical. Because of this similarity of symptoms, even the most experienced of Clinicians can remain unsure if the true nature of the problem is due to the acid pumping being too rapid, or sluggish, without the Heidelberg pH Diagnostic test.
In traditional medicine, the similarity between low stomach acid (Hypochlorhydria), and high stomach acid (hyperchlorhydria), doesn’t alter the approach to treatment. When a clinician hears the symptoms, (which could be caused by either problem), consideration goes to high stomach acid. They prescribe an acid-suppressing medication to see if it helps. If it does help, they were right. If it doesn’t help, then maybe the medication dose is too low, maybe the medication didn’t work, and another is better, or, maybe - (the last resort) the stomach acid is low.
The issue with this approach is that it’s a round-a-bout way of helping someone who you suspect has a low stomach acid issue. In fact, the last thing you want to do is prescribe an acid-suppressing medication, for a low-acid issue. This is because acid is crucial for digestion. Suppressing an already sluggish acid-pumping output has the potential to make an already compromised digestive tract, MUCH worse, leading to problems with the absorption of nutrients, and bacterial overgrowth of the small bowel (SIBO).
The Heidelberg pH Test can determine if either low stomach acid, or high stomach acid is causing the symptoms, but then there is another additional HUGE advantage to having a Heidelberg pH Test, if you suspect that there is a possibility that your acid pumping is in fact low, not high. Similar to how the symptoms of both high and low stomach acid problems are similar in presentation, the same also goes for the similarities between LOW STOMACH ACID, (Hypochlorhydria), and BILE REFLUX.
Bile is an alkaline agent, that is secreted by the liver, and stored in the gallbladder. Bile enters the small intestine and travels along this region, where it assists in breaking down fats into fatty acids until it gets reabsorbed at the very end of the small intestine and sent back to the liver for recirculation. Bile should not enter the stomach, but when the small intestine has issues, it can. When bile inappropriately backs up through the pylorus, into the stomach - it is called BILE REFLUX.
Thankfully, the Heidelberg pH Test can differentiate between Bile Reflux and Hypochlorhydria. It is incredibly challenging to determine the difference between these two very different medical issues, without this test.
Here is an example of a Heidelberg pH DIagnostic test, with findings that are suggestive of Bile Reflux and Pyloric Insufficiency. The first neutralizing challenge was actually demonstrative of Hyperactive secretion of stomach acid, which is not uncommonly seen with bile reflux cases, however, as soon as reacidification of the forst challenge was complete, the pH baseline started to waver and spontaneously neutralize. Demonstrative of bile reluxing through the pylorus in to the stomach.
Fortunately this patient has an endoscopy the following morning, the findings were confirmed.
Large amounts of bile in the stomach
Comments:
When you search through the medical textbooks on Bile Reflux, you quickly realize that there really isn’t much of a focus on this problem. However, Dr. Farshid Rahbar, MD, and Dr. Michael Erdman, MBBS, have numerous cases of suspected Low Acid secretion, which has been in fact due to bile reflux.
It has been most intriguing to also observe that such patients with bile reflux, usually test positive for SIBO, SIFO, or Parasite infections of the GI Tract. It begs the question, why does bile reflux occur with such issues?
