Biliary reflux is also known as bile reflux. This is a condition when your bile (digestive liquid produced in your livers) backs up in your stomach and tube that connects to your mouth and stomach. Some people are comparing bile reflux with acid reflux, but is good for everyone to know that these two conditions are not the same. Acid reflux happens when the stomach acids are backing up in your esophagus. Bile in many cases is suspected to be responsible for reflux when people are not having power to respond to the medications. There are not many evidences which show how bile reflux is effecting on the medications. This disease and the acid reflux cannot be completely controlled by changing your lifestyle or your diet. In some cases there is need for medications or for surgery. 
Biliary Reflux – Symptoms and Causes
Symptoms: Because bile reflux and acid reflux have many common symptoms, they are usually connected as one disease. That is reason why this disease is not easy to be diagnosed. The symptoms of the both diseases can happen in the same time. Is not clear the role of the bile in reflux conditions. Here are the signs and symptoms of the bile reflux:
- Occasionally cough
- Occasionally hoarseness
- Unintended weight loss
- Vomiting a greenish-yellow fluid (which is called bile)
- Upper abdominal pain that may be severe
- Frequent heartburn (this is feeling when you feel burning in your chest and in some cases you can feel that this feeling spreads to your throat; also you feel sour taste in your mouth) 
When to see a doctor? You should visit your doctor if you are feeling some of the symptoms that we gave you. Also you should visit your doctor if you are losing your weight without doing some exercises for it. If you have visited your doctor and you were diagnosed with GERD (gastroesophageal reflux disease) and your medications are not improving your health, then you must visit your doctor. You will need the right treatment for the bile reflux. 
What to expect from your doctor? First you should make an appointment with your doctor. He or she will ask you lot of question to be sure if you are having bile reflux or not. Your doctor can ask you:
- What kind of symptoms do you feel?
- How long do you have these symptoms?
- Have you lose weight without trying?
- Have you visited some doctor for your symptoms before?
- Do you smoke?
- Do you drink alcohol? If this answer is yes, how much are you drinking?
- What is your typical daily meal?
We gave you here some of the questions that you could be asked. You should tell the truth to your doctor about all the questions because if you are trying to hide something, it would be difficult for them to give you the right treatment. Your doctor must do all the testes that are needed to be sure if you are having this disease or not. These tests can include: endoscopy (can show if you are having inflammation in your stomach and esophagus or not); ambulatory acid tests (those are testes which are made because they can tell information about your disease such as when have appeared the symptoms and how long are you feeling them); esophageal impedance (this test can tell if you are having gas or liquids in your esophagus).
This is greenish-yellow fluid which is vital for digesting fats and for eliminating worn-out red blood cells and some toxins from your body. This liquid is produced in your liver. Bile is stored in your gallbladder. If you are eating even a small amount of meal that contains fats, they are enough signals for the gallbladder to release the bile. Bile flows through the small tubes in the upper part of your duodenum (intestine).
What leads to bile reflux? If you had gastric surgery in the past, then you have risk to have bile reflux . This is a surgery when you remove your stomach or with gastric bypass surgery in the way to lose your weight. If your pyloric valve is blocked by the peptic ulcers, then your food will be stagnant in your stomach which can increase the gastric pressure and you will have stomach acids in your esophagus. People which had gallbladder surgery (surgery when they have removed their gallbladder) have more chances to get this disease [1,5].
 Fein M, Bueter M, Sailer M, Fuchs KH. Effect of cholecystectomy on gastric and esophageal bile reflux in patients with upper gastrointestinal symptoms. Digestive Diseases and Sciences. 2008;53:1186-91.
 American College of Chest Physicians. Heartburn treatment may increase bile reflux. Science Daily. 2007. Retrieved from www.sciencedaily.com/releases/2007/02/070212185309.htm
 Clarrett DM, Hachem C. Gastroesophageal reflux disease (GERD). Missouri Medicine. 2018;115(3):214–8.
 Saarinen T, Pietilainen KH, Loimaala A, et al. Bile reflux is a common finding in the gastric pouch after one anastomosis gastric bypass. Obesity Surgery. 2020;30;875–81.
 Mercan E, Duman U, Tihan D, et al. Cholecystectomy and duodenogastric reflux: interacting effects over the gastric mucosa. Springer Plus. 2016;1970.