Treatment for Bile Reflux Gastritis After Gastrectomy

Bile reflux gastritis, also known as alkaline reflux gastritis, is a long-term complication that can occur after partial gastrectomy. One of the primary symptoms is a burning pain behind the breastbone, which tends to worsen after eating and does not respond well to antacids. Another common symptom is vomiting, which may contain food particles or appear blood-tinged. Due to poor food intake, patients often experience weight loss over time.

Initial treatment typically follows a step-by-step approach. First, conservative therapy is considered. While traditional views suggest that antacids are ineffective, recent perspectives indicate that they may help protect the stomach lining and provide some relief for alkaline reflux gastritis.

Secondly, prokinetic medications are often prescribed. Drugs such as domperidone or mosapride can enhance gastrointestinal motility, helping move food more quickly from the stomach into the intestines.

Third, bile-binding agents may be used to manage symptoms. Medications like cholestyramine or colestipol can help reduce the discomfort associated with bile reflux by binding to bile acids in the digestive tract.

If conservative treatments fail, surgery may be considered. When symptoms severely impact daily life and medication no longer provides relief, surgical intervention may be the best option. The most common procedure involves converting the original gastrojejunal anastomosis into a Roux-en-Y configuration, which can effectively resolve bile reflux and improve quality of life.

This surgical approach has shown high success rates in treating refractory cases, offering long-term relief for patients who do not respond to medical therapy. It is important for patients to work closely with their healthcare provider to determine the most appropriate treatment plan based on individual symptoms and medical history.