How to treat gastritis with bile reflux?

Modern life is stressful and busy. People must always pay attention to their physical condition because it is difficult for them to concentrate on relaxing themselves. Even the time for eating is strictly limited. As a result, gastrointestinal function is impaired and a series of symptoms appear. For example, gastritis with bile reflux is a common symptom. So, how to treat gastritis with bile reflux?

Bile reflux gastritis, also known as alkaline reflux gastritis, refers to the flow of duodenal contents containing bile, pancreatic juice, etc. into the stomach due to pyloric sphincter dysfunction or pyloric surgery, which causes inflammation, erosion and bleeding of the gastric mucosa, weakens the barrier function of the gastric mucosa, causes increased H+ diffusion, and leads to chronic lesions of the gastric mucosa.

Drug treatment:

(1) Gastrokinetic drugs: They can increase gastrointestinal motility, inhibit bile reflux into the stomach, and promote the emptying of refluxed materials.

(2) There are many types of gastric mucosal protective agents. Their main functions include combining with the mucin of the gastric mucosa to form a protective film to reduce the irritation of the gastric mucosa by refluxed bile and gastric acid, strengthen the function of the gastrointestinal mucosal barrier, promote the regeneration of the gastric mucosa, and promote the secretion of mucus by the gastric mucosa, thereby protecting the gastric mucosa and promoting the healing of inflammation.

(3) Bile salt drugs: They combine with bile acid and lysophosphatidylcholine to reduce the damage of bile salts to the gastric mucosa. They are effective in treating bile reflux gastritis and are the main drugs used in clinical practice. ② Anion exchange resins (cholestyramine) release chloride ions after oral administration and combine with bile acid to form an insoluble, non-absorbable complex, which accelerates the excretion of bile salts and feces and reduces damage to the gastric mucosa.

(4) Gastric acid inhibitors: Gastric acid and bile have additive effects and can cause strong damage to the gastric mucosa. Acid inhibitors are also effective against bile reflux. ①H2 receptor blockers (H2RA): cimetidine, ranitidine, famotidine; ②Proton pump inhibitors (PPI): omeprazole, lansoprazole, rabeprazole, toprazole, and esomeprazole, which have acid-suppressing effects far superior to H2 receptor blockers.

(5) Eradicating Helicobacter pylori infection: Bile reflux gastritis can coexist with Helicobacter pylori infection. While routinely using acid suppressants, gastric mucosal protective agents and gastrokinetic drugs for treatment, eradication of Helicobacter pylori should be considered first. It not only helps the lesions to heal, but also reduces the chance of inducing cancer.