What Is Yellow Vomit (Bile Reflux)?

Vomit with yellow liquid, often called bile reflux, happens when bile refluxes into the stomach and oesophagus. Bile, a greenish-yellow fluid synthesised by the liver and gets stored in the gallbladder, plays a crucial role in digesting fats and absorption. Bile goes from the liver via the bile duct into the small intestine. Pylorus, a one-way valve between the stomach and small intestine, when pylorus fails to function correctly, bile can enter the stomach, causing irritation and inflammation.

Throwing up bitter yellow liquid may happen when the stomach is empty, as the body expels bile when there's nothing else to vomit. This can result from various factors, including prolonged fasting, stomach irritation, or gastritis. In some cases, bilious vomiting indicate underlying health issues that require medical attention like small intestinal obstruction.

Bile reflux differs from acid reflux, although both conditions can co-occur. The combination of bile and stomach acid refluxing into the oesophagus can lead to gastroesophageal reflux disease (GERD) and damage to the oesophageal lining.

Symptoms of Yellow Vomit (Bile Reflux)

Yellow vomit can cause various uncomfortable symptoms.

• The most noticeable sign is vomiting yellow or throwing up bitter yellow liquid, which may taste sour.
• Some individuals experiencing bile reflux also report severe upper abdominal pain, which can be quite distressing.
• Heartburn is another common symptom, characterised by a burning sensation in the thoracic or chest region that may extend to the throat.
• Nausea & a foul taste in the mouth are frequently reported, along with occasional coughing or hoarseness.

Other symptoms include:

• Bloating
• Abdominal cramping
• Excessive burping
• Regurgitation of gastric content into the oesophagus and mouth
• Chest pain, although less common, can be an alarming symptom of bile reflux

It's important to note that these symptoms can be similar to acid reflux, making distinguishing between the two conditions challenging without proper medical evaluation.

Diagnosis of Yellow Vomit(Bile reflux)

Diagnosing bile reflux can be challenging, as its symptoms closely resemble those of acid reflux.

Doctors usually start by reviewing the patient's medical history and symptoms. However, some tests are often necessary to confirm the diagnosis and rule out other conditions.

• Endoscopy: During this procedure, the gasteroentrologist inserts a thin & flexible tube (with a camera) into the oral cavity and down the throat. It allows doctors to examine the oesophagus, stomach, and upper small intestine for signs of inflammation, ulcers, or damage caused by bile reflux. During the endoscopy, doctors may take tissue samples to check for complications like Barrett's oesophagus or early signs of cancer.
• Ambulatory Acid (pH) Test: This test measures when and how long acid reflux into the oesophagus. While this test can help rule out acid reflux, it doesn't detect bile reflux.
• Oesophageal Impedance Monitoring: Doctors may use oesophageal impedance monitoring for a more comprehensive assessment. This test uses a probe to measure both acidic and non-acidic reflux, including bile, providing a clearer picture of the underlying issue.

Treatment For Yellow Vomit (Bile Reflux)

Medical management is sufficient if no underlying causes are present.

• Prokinetic Agents:Helps inforward movement of intestine and thus preventing bile reflu
• Sucralfate forms a protective coating in the stomach and oesophagus, shielding them from bile irritation.

Doctors may recommend more invasive procedures for severe cases or when precancerous changes are detected.

When to See a Doctor

While occasional yellow vomit may not be cause for alarm, certain situations require immediate medical attention. Seek medical help if:

• Vomiting persists for more than a day or if diarrhoea and vomiting last over 24 hours.
• Signs of dehydration (excessive thirst or dark urine) also warrant a doctor's visit.
• Medical attention is necessary for children if vomiting lasts more than a few hours, especially when accompanied by fever or signs of dehydration.
• Severe symptoms like chest pain, blurred vision, or a high fever with a stiff neck accompany yellow vomit.
• Throwing up bitter yellow liquid with blood or a coffee-ground appearance requires immediate medical evaluation.
• If you experience persistent reflux symptoms or unexplained weight loss,  consult a doctor immediately.

Home Remedies

• More frequent meals in smaller portions can reduce bile accumulation in the stomach, lowering the risk of reflux.
• Staying upright for at least two hours after eating and elevating the head of the bed can prevent bile from flowing back into the oesophagus.
• Stress management techniques (exercise or meditation) also alleviate symptoms.
• It's crucial to avoid trigger foods like chocolate, carbonated drinks, spicy foods, and citrus.
• A low-fat diet with less oil and spice, complemented by curd, can help prevent reflux.
• Quitting smoking can substantially improve sphincter pressure, reducing the likelihood of throwing up bitter yellow liquid.
• Reflux is often recurring, so adjusting your diet and lifestyle is key to effectively managing symptoms.

Conclusion

Yellow vomit associated with bile reflux has a significant impact on one's well-being and daily life. From lifestyle changes to medications & surgical interventions, there are multiple approaches to address the discomfort and potential health risks associated with bile reflux. It's crucial to remember that while occasional yellow vomit might not be alarming, persistent symptoms or severe cases require medical attention.

Understanding the underlying causes of yellow vomit empowers individuals to take precautionary steps in managing their health. Whether adjusting diet, adopting stress-reduction techniques, or seeking professional medical advice, promptly addressing this issue can prevent complications and improve quality of life.

FAQ's

1. Should I drink water after throwing up bile?

After throwing up yellow vomit, it's crucial to stay hydrated. Sip small amounts of water or clear liquids every 15 minutes for 3-4 hours. This helps prevent dehydration and replenishes lost fluids. Avoid drinking large quantities at once, as this may trigger more vomiting.

2. What to eat after vomiting bile?

After throwing up bitter yellow liquid, stick to bland, easily digestible foods like fruits, curd rice etc. These foods help firm up stools and replace lost nutrients. Avoid dairy, sugary, or fatty foods initially, as they may trigger nausea or diarrhoea.

3. Is bile a serious problem?

While occasional yellow vomit may not be alarming, frequent bile reflux can lead to serious complications. Consult a doctor if you experience persistent symptoms or unexplained weight loss.

CARE Medical Team

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