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My EGD last week revealed Bile Reflux as if I need any more issues to deal with.
I have been reading A lot on it but that's black and white.
I was wondering what works and what does not.
I know its the same old story of MC that the research is limited.
Saturday was like A day in hell I felt old and dying(almost went to the ER) today was better.(back to A bland diet)
When the bile reflux was bad I used H2 blockers to get through the day, and a Potassium/magnesium/bicarb drink
(i could not bend down to put socks on without getting bile in my mouth)
High doses of Vit D3 helped, and then when i resolved magnesium deficiency i no longer had to take H2 blockers...
both the hiatus hernia and bile reflux is no longer and issue
Gabes Ryan
"Anything that contradicts experience and logic should be abandoned"
Dalai Lama
Suzy has asked quite a few questions about this subject in the past fortnight, if you go through the main message board and look at the discussions Tex and others offer information.
Gabes Ryan
"Anything that contradicts experience and logic should be abandoned"
Dalai Lama
I assume you're talking about bile reflux from your duodenum into your stomach (backwards through your pyloric sphincter). Magnesium deficiency can cause that, but there can be other causes (for example surgery on the pyloric sphincter or gastric bypass surgery). To reduce the symptoms you may need to take cholestyramine. You might need to experiment with the dose in order to take enough to control the symptoms but still be able to digest fats adequately.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
The drink sounds interesting but I still can not take mag oraly (reflux?) I have been taking 10000 iu D3 for 3 weeks.
Yes I agree I need to get more magnesium and potassium I have to many things robing my electrolytes .
My surgeon put me on Pepcid 20mg and on my discharge orders no Imodium, Pepto ,Nsaids and asprin I see him in A little over 1 week.
I have had problems with acid reflux over the years (could not even lay down without acid going to my throat) I wonder if the DX was even correct then.Yes Tex I have A picture of the bile in my stomach.Many years ago I suffered A terrible accident they patched my stomach together with mesh repaired my colon and removed 2 ' of my small intestine I now wonder if it was close to my pyloric sphincter.
I have been wondering why he did not start me on cholestyramine but maybe the H2 blocker is his first line of treatment .
I am wondering if the bile reflux is the reason why I can not take oral mag?
Thank you both for your help
Stomach surgery can definitely cause pyloric sphincter dysfunction problems.
Since your doctor is also aware of your gastric surgery (and the associated risk of compromised pyloric valve dysfunction), I'm also wondering why he would choose to reduce stomach acidity instead of deactivating the bile that should not be in the stomach in the first place. Reducing stomach acidity will compromise digestion more than a bile acid sequestrant.
However, if you are also dealing with acid reflux, then the H2 blocker will help to reduce/stop the symptoms. But in that case one would think that he would also prescribe a bile acid sequestrant (in addition to the H2 blocker) in order to reduce the presence of bile in the stomach.
If you're been taking 10,000 IU of vitamin D daily for several weeks, you might try cutting way back on that dose for a few days to see if that helps with the symptoms. Too much vitamin D can cause digestive upset. If you know that your vitamin D level is low however, then 10,000 IU per day shouldn't be a problem for at least several months.
I'm not aware of any interactions between magnesium and bile, but that doesn't mean that they might not exist.
You're very welcome,
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Yes he was informed of my surgery so I am in the dark as to why this route of treatment.
I do not have heartburn and I do not have acid going to my throat its like it just lays at the bottom of my stomach and gives me A bad gut feeling.I was off D3 for almost 2 months thought I would give it A boost but yes I will back off and see.
Terry wrote:I do not have heartburn and I do not have acid going to my throat its like it just lays at the bottom of my stomach and gives me A bad gut feeling.
If that's the case then in my strictly unprofessional opinion your doctor prescribed the wrong medication for the job. But results speak louder than words. There's a good chance that he may know something that I don't — maybe he's successfully treated similar cases in the past. Is the H2 blocker helping with the stomach pain?
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Can you tolerate Pepto-Bismol? Or have you already tried it? It tends to form a soothing coating in the stomach that can sometimes help to make it feel much better. And it also has mild antibiotic properties that can help to control certain types of bacteria (if they are a problem).
Can you scan the report into an image file (such as a JPG file)? Or maybe it's already in the form of an image file. If so, you can click on the "postreply" button and after you compose your message in the window that opens, just below the window (on the left side), click on the link that says "Add image to post" and the system will open another window that will allow you to browse to the image file on your computer and select it and then upload it. The proper code to allow most browsers to open the image file will be automatically added to your post.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Tex
Pepto has been part of my life I keep it at home and have A supply at work but on my discharge papers
I am to AVOID nsaids aspirin imodiun pepto ? rolaids?( hard to read his writing)don't know if just for that day or completely.Here is A article I did find I wonder if he is going to blame it on my life style and I wonder if he will rule out
H pylori? I did take pepto last night the Pepcid just is not getting it.By the way if you have bile coming out either end is
it green? Ok I think I can get this to work. http://www.healthline.com/health/gastri ... is#Causes2
Long-term use of NSAIDs can lead to gastritis, but unless you have been a heavy, long-term user, that's probably not an issue.
Bile that comes out the top end is typically green, but when it exits the other end it can be either green or yellow/straw color, depending on transit time. The more rapid the transit, the greener the color.
The good news is the pathology report doesn't indicate any serious (life-threatening) issues.
I'll list my strictly unprofessional impressions for each item listed in the pathology report.
1. The small intestine below the duodenal bulb appears normal.
2. Chronic peptic duodenitis is simply inflammation of the duodenal bulb (usually attributed to excess hydrochloric acid).
3. Relative (chemical) gastropathy refers to an abnormality due to chemical (not bacterial) damage in pyloric valve (located between stomach and duodenal bulb).
4. Ditto for lower part of stomach above pyloric valve.
5. Mucosa in main part of stomach is normal.
6. Junction between stomach and esophagus (Z-line) shows minor changes consistent with acid reflux.
I can see no evidence of H. pylori in that report.
Note that research exists to show that Crohn's can cause this type of histological damage, because Crohn's disease can affect any portion of the GI tract. Note that MC can also affect any portion of the GI tract. IOW, IMO the duodenitis reported in the pathology report could be due to lymphocytic infiltration into the duodenal mucosa (similar to what happens in the colon when MC is active).
If item 2 is correct, it suggests to me that rather than the stomach producing too much acid, the pancreas might not be producing a sufficient supply of bicarbonate, or something is preventing the bicarbonate from reaching the duodenal bulb. The duodenal bulb is located upstream of the common bile duct so it's naturally going to be exposed to full-strength stomach acid. But normally enough of the bicarbonate released through the common bile duct in the duodenal loop should reach the duodenal bulb to neutralize the acid there also, within a reasonable amount of time.
Obviously though, it bile is backflowing into the antrum (as suggested by items 3 and 4) then plenty of bile flow is available there. The pancreas releases bicarbonate into the common bile duct, so if bile is flowing backwards into the stomach antrum through the duodenal bulb, then bicarbonate should be there also (to neutralize the acid), if it is being produced in sufficient quantities by the pancreas.
So it appears that either bicarbonate production might be inadequate, or the inflammation in the duodenal bulb is caused by something else (such as MC). But this would call into question the findings for items 3 and 4. I wonder if the problem is relative chemical gastropathy (as reported), or if it might actually be due to lymphocytic infiltration. IOW I wonder if the pathologist failed to look for lymphocytes and just assumed that chemical damage caused the inflammation (based on appearances).
Normally a pathologist would never look for the markers of MC in the stomach or the duodenum because the official medical definition of the term "colitis" restricts the disease to the colon. They wouldn't waste their time looking for the markers of a disease where it couldn't exist (that is, they would assume that it couldn't exist there because of the medical meaning of the term "colitis".
However, Item 1 suggests that bicarbonate production from the pancreas is adequate. So the bottom line appears to be: there is a good chance that you do have bile backflowing into the stomach (because of the previous surgery), but I wonder if MC is not also playing a part in the inflammation. My guess is that your doctor may be blaming the damage in your stomach on NSAID or antacid use, rather than blaming it on the surgery, combined with MC. I still believe that the indicated remedy would be treatment with cholestyramine.
I hope this hasn't just confused the issue.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Tex
Thank You.
I understand it well I see the general surgeon on Wed.
Just what I thought about bile(it was green)about two months ago I got sick in the middle of the night and it came out both ends and since then I have noticed it in the stool A couple of times .
This spring I was so much better with MC calming down and since July everything was going down hill well that's two steps back its time to take care of this issue and move on I will ask my Doc about cholestyramine .
Well I met with my GS he didn't seem worried said two months on Pepcid would clear it up and he didn't restrict me on anything they always want me to give up my habits but going to give up spices for now.
He did say that his findings didn't explain my weight loss.
Have you been taking Pepcid? Or any other antacid or acid blocker? They tend to deplete magnesium. When my magnesium deficiency became severe I was losing an average of 2 pounds every week.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
they always want me to give up my habits but going to give up spices for now.