Treatment

Lifestyle adjustments and medications can be very effective for acid reflux into the esophagus, but bile reflux is harder to treat. There is little evidence assessing the effectiveness of bile reflux treatments, in part because of the difficulty of establishing bile reflux as the cause of symptoms.

Medications

• Ursodeoxycholic acid. This medication may lessen the frequency and severity of your symptoms.
• Sucralfate. This medication can form a protective coating that protects the lining of the stomach and esophagus against bile reflux.
• Bile acid sequestrants. Doctors often prescribe bile acid sequestrants, which disrupt the circulation of bile, but studies show that these drugs are less effective than other treatments. Side effects, such as bloating, may be severe.

Surgical treatments

Doctors may recommend surgery if medications fail to reduce severe symptoms or there are precancerous changes in your stomach or esophagus.

Some types of surgery can be more successful than others, so be sure to discuss the pros and cons carefully with your doctor.

The options include:

• Diversion surgery. During this type of surgery, a doctor creates a new connection for bile drainage farther down in the small intestine, diverting bile away from the stomach.
• Anti-reflux surgery. The part of the stomach closest to the esophagus is wrapped and then sewn around the lower esophageal sphincter. This procedure strengthens the valve and can reduce acid reflux. However, there's little evidence about the surgery's effectiveness for bile reflux.