# chronic constipation and now this...



## animal_lover (Nov 5, 2010)

I have been suffering from chronic constipation for about 3 years now, but over the past couple of months now my stomach burns a lot especially before i eat a meal. After I eat it goes away a little. Also my throat is sore, and I have like a sour taste in the back of my throat the whole time. I went for an endoscopy and the doctor found bile in my stomach. He first prescribed me PPI for heartburn but that didn'tt help, the burning returned and the throat issue never resolved. He says to me that I have bile reflux, and it is a very difficult condition to treat. He has given me Ursodeoxycholic acid ( used to treat bile reflux). Its not helping,and I think it made my symptoms worse, I couldn't sleep last night because my stomach felt like it was on fire. I don't know what else to do....any help will be really appreciated as I am scared of what will happen to me. The endoscopy results said I don't have the bacteria which causes gastritiss ( H Pylori). So I am really troubled on treatment to take.Do you think that it may be Crohn's in the upper digestive track? I really have no clue where to go from here...Thank you for any advise you can give. xxx


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## screeb (Jul 25, 2001)

I read something about this condition/disease that said that there is too much NO (nitric oxide) relaxing the pyloris of the stomach. UCDA is supposed to lower DCA (deoxycholic acid), concentrations, which bind to TGR5 (bile acid receptor) which when bound, causes a release of NO, relaxing the pyloris of the stomach, causing bile reflux. It has been found (in the past three weeks)that bile causes decreased GIT (gastro-intestinal transit) implying that patients with constipation have too much systemic bile, and not enough bile in the gall bladder, possibly caused by poor probiotic bacteria in the colon, increasing gall bladder firing. There is expression of TGR5 just below the pyloric sphincter in the duodenum, which when stimulated by bile, may be allowing the "Bile Reflux." I have gotten this gastritis, but I have delayed gastric emptying.


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## animal_lover (Nov 5, 2010)

Thank you s much for your great advice. It does seem to make some sense that too much bile can cause slow motility, although I have read people who have too much bile usually have diarreah not constipation. Does this mean the USDA ( medication for bile reflux) is making my condition worse becasue of the release of nitric oxide? Do you know what tests I can ask my GI doctor to do next, or what should I do next? My gallbladder is ok, I have been tested for that. Thank you so much again. xxx


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## screeb (Jul 25, 2001)

Many cases of diarrhea have been proximately caused by bile acid malabsorption, which causes intestinal secretion, further down than the ileum. Bile acid levels were increased in portal blood in anti-biotic treated mice, which also increased ileal bile acid recovery. Activia and other yougurts cause decreased bile acids by decreasing ileal bile acid transport, lowering bile acid concentrations in the systemic, portal blood. This would increase GIT and phasic/sweeping contractions treating the constipation, but not bile acid reflux.


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