Managing Bile Reflux

I was diagnosed with bile reflux about 2 years ago, started on nexium 40mg once a day and carafate 4 times a day and bedtime. Since then I have had some good months but continue having burning belly pain. I use the carafate prn and it usually helps, I have increased the nexium to twice a day. Is there any other treatment that would help? I wake up at night with pain and it helps if I turn over on my stomach but that is difficult due to having had cervical surgery. I am 46 years old.

[Ratnakar Kini, MD]

Hi,
Confirm whether it is acid or bile relux.
If acid reflux is present, nighttime zantac would be helpful.
For bile reflux, carafate, antacids and cholestyramine are useful. If medical therapy is not useful surgery has to be done for correcting bile reflux.