Biliary reflux gastritis is a chronic inflammation of the gastric mucosa caused by the regurgitation of bile, pancreatic juice and other duodenal contents into the stomach due to the dysfunction of the pyloric sphincter, or having had a certain surgery that results in a decrease in the function of the pylorus. Today, we invite Dr. Zhijie Xu from the Department of Gastroenterology of Peking University Third Hospital to talk about the disease of bile reflux gastritis. Is epigastric discomfort, fullness and belching bile reflux gastritis? ”Biliary reflux gastritis is not different from other types of gastritis in terms of symptoms, and it is difficult to distinguish them based on symptoms alone.” Dr. Xu said. Many patients think that “bitter mouth” is related to bile reflux because people think bile is bitter, but in fact, unless there is very severe gastroesophageal reflux, bile may reflux to the pharynx with the stomach contents, otherwise it is almost impossible for bile to reach the mouth. The symptom of “bitter mouth” is more related to poor diet, insomnia, anxiety, etc. There is no universally accepted diagnostic standard for “bile reflux gastritis,” and the current diagnosis relies mainly on gastroscopy. When a patient undergoes a gastroscopy, if the doctor finds a yellow or yellow-green pool of mucus in the stomach cavity, bile attached to the stomach wall, or yellow bile refluxed directly from the pylorus into the stomach cavity, the patient may be diagnosed with “bile reflux gastritis” in these cases. However, this diagnosis is not reliable, because many patients undergo gastroscopy and the insertion of the gastroscope through the pharynx stimulates nausea and vomiting, which can occur when bile reflux enters the stomach cavity. Generally speaking, if the above situation occurs during painless gastroscopy, or if the bile attached to the stomach wall is thick and not easily flushed out, and if the gastric mucosa is rough and uneven, then the patient may have long-term chronic bile reflux and should be treated accordingly, mainly by taking some prokinetic drugs and mucosal protectors that adsorb bile. Is there a relationship between bile reflux gastritis and reflux esophagitis? Some patients worry that long-term bile reflux gastritis will lead to reflux esophagitis. Dr. Zhijie Xu denies this worry of patients. “Because biliary reflux gastritis is a problem with the function of the pylorus, which causes the contents of the duodenum to reflux through the pylorus into the stomach; while reflux esophagitis is a dysfunction of the cardia, which is the reflux of stomach contents through the cardia into the esophagus. These are two different diseases, the occurrence of the two is not necessarily related.” Dr. Zhijie Xu said. “Of course, both are related to abnormal digestive tract dynamics, so it is possible for both to exist at the same time. At this time, the reflux of bile from gastric contents into the esophagus can aggravate the damage to the esophagus, and for this type of alkaline reflux esophagitis, instead of emphasizing only gastric acid suppression therapy, both prokinetic drugs and mucosal protective agents that adsorb bile should be given.” Can eating aggravate bile reflux? Some patients believe that eating can aggravate bile reflux, is this true or not? Dr. Xu said that bile reflux is related to the movement of the stomach and duodenum, and factors affecting gastrointestinal dynamics may aggravate bile reflux, so it is important to pay attention to a balanced diet and do not overeat. In addition, patients are advised to abstain from smoking and alcohol, exercise properly and develop good habits.