Bile Reflux

Bile reflux will usually involve abdominal symptoms and sometimes esophagus symptoms. While reflux into your esophagus is easy to diagnose based on your symptoms alone, reflux into your stomach will need to be confirmed by imaging tests. Your healthcare provider will probably order an upper endoscopy exam to look inside of your esophagus, stomach and upper small intestine. The endoscope can take tissue samples while it takes images, to test for inflammation, tissue damage and the presence of bile. For reflux into your esophagus, they may take additional tests to distinguish acid reflux from bile reflux.

What tests are used to diagnose bile reflux?

• Upper endoscopy exam. This involves placing a tube with a tiny camera attached down your throat and into your stomach and small intestine. You’ll have numbing and relaxing medication for the exam. The endoscope can also take tissue samples to analyze in the lab.
• HIDA scan. Also known as scintigraphy, the hepatobiliary iminodiacetic acid (HIDA) scan is a radiographic imaging test that tracks the flow of bile from your liver to your small intestine. This test requires you to lie inside a scanner bed for one to four hours.
• Bilitec monitoring system. This test detects bile content in esophageal reflux through a photo-colorimetric device.
• Esophageal impedance test. This test can confirm reflux into your esophagus and measure whether the content is acidic or non-acidic. For the test, a small catheter is placed in your esophagus through your nasal cavity. You’ll have medication to numb and relax your throat. The catheter stays in place for 24 hours. During this time, it measures and reflux episodes, the reflux content and notes any symptoms that result. This is a reliable test for differentiating between acid and non-acid reflux.