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Biliary Gastritis

  After much testing (endoscopy & biopsies), it was determined
  that I have biliary gastritis.  I continue with Cimetidine as
  most drugs disagree (arthralgias) or are less effective
  (Pantoloc, Losec).
  What are the long-term implications of biliary gastritis? I
  dislike taking meds all the time and the specialists hesitate
  to proceed with a rou-en-y procedure (spelling?) because of
  the implications of such a procedure.  
  Could long-term biliary gastritis lead to stomach cancer? On a
  less-serious scale, how good is food absorption if on long-term
  H2 antagonists?
Dear **,
The term "biliary gastritis" implies duodenogastric reflux causing bile to reflux back into the stomach and damage the lining. This clinical condition is usually a problem after surgery to remove the stomach (gastrectomy) and after drainage procedures for peptic ulcer disease. Surgery disrupts the normal anatomy so that bile in the small intestine can now  reflux back into the stomach. You did not mention whether or not you have  had such an operation in the past. Bile is an alkaline solution, therefore treatment with acid blockers would not be of benefit. On the other hand, if cimetidine is helping you, it is a fairly well tolerated drug with few side effects. The fact that cimetidine is helping may question the diagnosis of  alkaline reflux biliary gastritis. Treatment for alkaline reflux symptoms with bile acid binding agents (such as cholestyramine) or sucralfate (Carafate) may help some patients but is not uniformly successful. Severe cases of alkaline reflux gastritis require a Roux-en-Y gastojejunostomy to divert the bile from the area of the stomach. I hope you find this information helpful.
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