Bile reflux gastritis is chronic inflammation caused by duodenal contents (bile, pancreatic juice) flowing back into the stomach. Core symptoms result from bile irritation and breakdown of the gastric mucosal barrier:
- Burning or persistent dull upper-abdominal pain, worse after meals and poorly relieved by antacids
- Frequent belching with bitter or sour taste; bitter mouth noticeable on waking or when fasting
- Nausea and occasional bilious vomiting—yellow-green fluid without blood
- Early satiety and post-prandial fullness: reduced gastric accommodation, feeling full after small meals
- Loss of appetite and weight: decreased intake due to prolonged discomfort
- Epigastric heat: located higher than typical heartburn, aggravated at night or when lying flat
- Emotional link: anxiety or stress may trigger or worsen symptoms
Symptoms overlap with acid reflux but respond poorly to acid suppression; morning bitterness and bilious vomiting are fairly specific clues. Chronic reflux can produce erosions and metaplasia; diagnosis requires gastroscopy.
| Symptom group | Typical description | Difference from acid reflux |
|---|---|---|
| Upper pain/burn | Persistent dull or burning, worse post-prandial | Poor response to antacids |
| Bitter mouth/bile vomit | Strong bitter taste, yellow-green vomitus | Rare in acid reflux |
| Early fullness | Full after small meals, frequent belching | Similar but more stubborn |
| Appetite/weight | Gradual decrease | Correlates with discomfort |
| Night/supine | Heat and bitterness increase | Similar |