Gastroesophageal Bile Reflux: Causes and Contributing Factors

Under normal circumstances, the pyloric sphincter remains closed except during the process of gastric emptying. When food is ready to move from the stomach into the duodenum, the pylorus opens, allowing the passage of food contents. Once this process is complete, the pylorus closes again, effectively preventing bile from flowing back into the stomach. However, when the pyloric sphincter becomes weakened or relaxed due to various factors, bile and other duodenal contents can reflux into the stomach, leading to irritation and inflammation known as bile reflux gastritis.

One of the primary causes is the consumption of extreme or irritating foods, such as those that are excessively cold, hot, coarse, or spicy. These can negatively affect the pyloric valve's ability to function properly over time.

Another contributing factor is the intake of stimulants such as strong tea, coffee, and alcoholic beverages. These substances can interfere with the normal tone of the pyloric sphincter and increase the risk of bile backflow.

Medications like nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin and indomethacin, are also linked to bile reflux. These drugs can weaken the stomach lining and impair the function of the digestive tract, making it easier for bile to flow backward.

Infection with Helicobacter pylori (H. pylori) plays a significant role in the development of various gastric conditions, including bile reflux gastritis. This bacterial infection can cause chronic inflammation in the stomach lining, which may lead to dysfunction of the pyloric sphincter.

Psychological and neurological factors, along with lifestyle choices such as smoking, can also contribute to the condition. Stress and anxiety may disrupt normal digestive processes, while nicotine from cigarettes can relax the pyloric muscle, increasing the chance of bile reflux.

Lastly, genetic predisposition may make some individuals more susceptible to bile reflux. Those with a family history of gastrointestinal disorders may experience a higher incidence of pyloric dysfunction and related conditions.