DGER: Bile Reflux or Non-Acid Reflux

About the Author

Dr Rajkumar JS


Dr JS Rajkumar is the Chief Surgeon with LIMA.

What is Bile Reflux?

The condition is called bile reflux, when bile or the liquid produced by the liver for digestion refluxes into the stomach and the esophagus. Previously, we have dealt with acid reflux or reflux of the acidic contents of the stomach into the oesophagus. Bile acid reflux is a different condition and may occur along with acid reflux

Symptoms of Bile Reflux

The symptoms occurring in bile reflux are similar to the ones occurring during acid reflux. They include

  • Severe pain in the upper abdomen;
  •  A burning chest sensation called as heartburn;
  •  Vomiting of a greenish yellow liquid called bile;
  •  Nausea;
  •  Coughing or hoarseness at times; and
  • Sudden weight loss

What Causes Bile to Reflux Into the Stomach?

Bile that is produced by the liver is normally stored in the gallbladder. Bile flows into the upper part of the small intestine called the duodenum from the gallbladder. It is in the duodenum that the food swallowed mixes with the bile. This mixture then enters the stomach through the pyloric valve. When the pyloric valve does not function by closing properly, the bile refluxes into the stomach.

What Causes Bile to Reflux into the Esophagus?

The oesophagus is separated from the stomach by the lower oesophageal sphincter (LES). When this sphincter malfunctions by remaining weak, then the bile refluxes into the oesophagus.

Complications due to Bile reflux

  •  GERD
  •  Barrett’s Esophagus: A condition where the esophagus is inflamed that may lead to cancer.
  •  Esophageal Cancer: A direct link is said to exist between acid/bile reflux and esophageal cancer.


GERD/LPR Expertise at LIMA

  • Our Chief Surgeon Dr. J. S. Rajkumar had authored a text book titled Modern Methods for Managing Acid Reflux/GERD. All the knowledge he used in writing this textbook are now incorporated in LIMA’s practice.
  • LIMA has all the instrumentation needed to accurately investigate and assess how mild or severe your acid reflux is
  • LIMA consultants offers the full range of Acid Reflux/GERD treatment, including
    • Behavior modification experts to help you with lifestyle changes
    • Registered dieticians to help you with a suitable diet selection
    • Functional medicine doctors to help you with nutritional support
    • Gastroenterologists to help you with medical protocol
    • The surgical group that has handled more volume than anyone else in South India

If the nature of your GERD is such that it doesn’t respond satisfactorily for lifestyle, dietary or medical interventions, then a surgical solution is your best option. If you select surgery, LIMA can give you “unparalleled advantage”:

  • Till date, we have carried out more than 2,000+ fundoplication surgeries. This is the largest volume handled by any single surgical team in South India.
  • LIMA is the only center in the Chennai where you can get the surgery done through a Scarless procedure.
  • LIMA subsidiary, MISTY, has trained largest number of surgeons in the country for
  • Currently, Dr. J. S. Rajkumar is co-authoring the first and only manual for laparoscopic surgery (14 volumes)


Listen to some of our real patients who received acid reflux/GERD treatment at LIMA:

Testimonial Videos

Even more Education

If you have read this far, we must congratulate you. You have taken your first step towards becoming an intelligent and informed patient. Very few patients have so much of dedication or put in the necessary efforts to empower themselves with the right kind of knowledge. Here are a few things you can do to further your knowledge:

  • Enroll yourself in our free newsletter about Acid Reflux/GERD management
  • Download our free ebook on Acid Reflux/GERD
  • Download our free ebook on Indian diets for GERD
  • LIKE our Facebook page on Acid Reflux/GERD to receive daily updates on this disease
  • LIKE our LIMA Facebook page to updates on other cutting edge treatments available only at LIM

Meet a Doctor

Do you think you have some of the symptoms described here. Fix an appointment with a LIMA doctor and get a thorough investigation. Unlike other chronic diseases, GERD can be easily treated if you catch it before it turns malignant.

Free eBook on GERD

Do you or someone you love has GERD (Acid Reflux). Download our free eBook specially prepared for the Indian patient, written by highly accomplished Indian surgeons, who have published several books for the international audience.

Knowledge base discussions

Go to the GERD/Acid Reflux page on our forum. Questions that patients like you asked and answers they received from LIMA or from other patients are permanently here, just frozen in time, waiting for you to benefit from the collective wisdom.