Patients with bile reflux may experience significant epigastric pain and burning-like sensation, also accompanied by nausea and vomiting. Repeated irritation may also induce intestinal spasm and bile duct spasm, and patients may also experience significant right upper abdominal pain radiating to the right shoulder and back. Repeated episodes of reflux can also affect the function of the digestive tract, and the patient may develop diarrhea, even steatorrhea. The patient’s laboratory tests may also reveal a significant increase in blood and neutrophils, as well as abnormalities in liver function. The examination may also reveal significant pressure pain in the right upper abdomen and, in the acute phase, signs of limited peritonitis, with rebound pain and muscle tension.