Excess bile discharge

I have a J-Tube in place for overnight feeding for Achalasia. The last 5-6 months I have an increasing amount of bile leaking out of my J-Tube stoma site and find that I have to get up out of bed 4-5 times nightly to change my soaked dressings. Even during the day when I don't use the J-Tube but manage to swallow a little fluid and thin watery food I still find that I have to change the dressings 3 times. The bile is so acidic that it is burning the skin around the stoma site. I also have epigastric pain going under my right side and going through to my back. My stools are very loose at times and yellow coloured. What can be causing this? I am worried.

[Kevin Pho, MD]

The issues regarding the J-tube is more of a general surgery question, so you may want to inquire in that forum.

Regarding the epigastric pain, there are a variety of possibilities.  This can include various causes of dyspepsia, such as gastritis, an ulcer or GERD.  An upper endoscopy would be the most comprehensive test to evaluate for these possibilities.  

The loose stools should be sent to the lab for culture and analysis.  More specialized tests for malabsorption should be considered if this has already been done.  A colonoscopy would be the more comprehensive approach.

These options can be discussed with your personal physician.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin Pho, M.D.
www.kevinmd.com
www.twitter.com/kevinmd