Treatment of Bile Reflux and Upward Reversal of Stomach Qi

Bile reflux and upward reversal of stomach qi is a term commonly used in Traditional Chinese Medicine (TCM), referring to a condition where bile and stomach contents flow upward abnormally. In TCM theory, the gallbladder and stomach function best when their energies move downward. Therefore, treatment often involves soothing the liver, promoting bile secretion, and restoring normal digestive flow. Common herbal formulas used include Chai Hu Shu Gan San, Long Dan Xie Gan Wan, and Xiao Yao San, which help regulate liver function and promote bile excretion. Additional formulas like Mu Xiang Shun Qi Wan or Xiao Chai Hu Tang may also be recommended to support digestive harmony.

From a Western medical perspective, this condition often correlates with bile reflux gastritis, a disorder caused by the relaxation of the pyloric sphincter, allowing bile and pancreatic juices to flow back into the stomach. This can lead to symptoms such as upper abdominal discomfort, nausea, and a bitter taste in the mouth. A definitive diagnosis can be made through procedures like gastroscopy, which may also reveal conditions such as reflux esophagitis.

Effective treatment options include prokinetic agents such as domperidone (Motilium) or mosapride, which help enhance gastrointestinal motility and prevent reflux. However, it's essential to rule out cardiac issues before using these medications, as they may not be suitable for individuals with heart conditions.

In addition to medication, lifestyle and dietary adjustments are crucial for managing bile reflux. Patients are advised to maintain emotional well-being, eat regular meals, and avoid stimulants such as coffee, alcohol, and strong tea, which can exacerbate symptoms. Proton pump inhibitors (PPIs) or H2 receptor antagonists are often prescribed to protect the gastric mucosa and reduce acid production, offering relief and promoting healing.

By combining medical treatment with mindful lifestyle choices, individuals can significantly improve their digestive health and reduce the frequency and severity of bile reflux episodes.