Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 4 complete abstracts (767 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
Retrograde bile flow. Reflux of bile can be from the duodenum to the stomach (duodenogastric reflux); to the esophagus (gastroesophageal reflux); or to the pancreas.
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Reflux, Bile.
Where it fits in the MeSH classification
- Broader topics
- Biliary Tract Diseases; Duodenogastric Reflux
Related concepts
- Duodenogastric Reflux
- Gastroesophageal Reflux
- Pancreas
Research landscape
PubMed indexes 882 records tagged with the MeSH heading “Bile Reflux” (counts retrieved 2026-11-04). 117 of them (13.3%) were published from 2020 onward, and the busiest period so far is through 1999 with 477 records.
Reviews account for 105 records (11.9%) and meta-analyses for 9. Randomized controlled trials number 29 (3.3%) as a share of all records on the topic.
Show the data
| Period | Records |
|---|---|
| through 1999 | 477 |
| 2000-2009 | 154 |
| 2010-2019 | 134 |
| 2020 onward | 117 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 105 | 11.9% |
| Meta-analyses | 9 | 1.0% |
| Randomized controlled trials | 29 | 3.3% |
Method: PubMed query "Bile Reflux"[MeSH Terms] with publication-type and date filters, retrieved 2026-11-04.
Reading the evidence in digestive system and liver
Gut and liver research ranges from laboratory studies of the microbiome to large trials of drugs and surgery. Symptoms such as pain, reflux or bowel change are reported by patients and overlap between conditions, and diet and microbiome studies are mostly observational. Check whether the study measured symptoms, tissue findings or long-term outcomes, how the diagnosis was made and how long people were followed. Nothing here replaces advice from a qualified clinician.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
| Study / authors | Year | Source label / design | Europe PMC citations | Licence / source |
|---|---|---|---|---|
| Bile Acid-Microbiome Interaction Promotes Gastric Carcinogenesis | 2022 | Research article Design not recorded in structured metadata | 72 | cc by PMID 35285172 · DOI · PMC9165488 |
| Bile Reflux is a Common Finding in the Gastric Pouch After One Anastomosis Gastric Bypass | 2020 | Randomized controlled trial Design not recorded in structured metadata | 60 | cc by PMID 31853864 · DOI · PMC7347680 |
| The relationship between gastric cancer, its precancerous lesions and bile reflux: A retrospective study | 2020 | Research article Design not recorded in structured metadata | 50 | cc by PMID 32187838 · DOI · PMC7317534 |
| Recurrent ascending cholangitis secondary to food reflux following transduodenal resection of an ampullary adenoma | 2026 | Research article Design not recorded in structured metadata | 1 | cc by PMID 40131729 · DOI · PMC12718741 |
Bile Acid-Microbiome Interaction Promotes Gastric Carcinogenesis [1]
Abstract reading summary — source excerpts
- Opening excerpt
- Bile reflux gastritis (BRG) is associated with the development of gastric cancer (GC), but the specific mechanism remains elusive.
- Closing excerpt
- These results reveal an important underlying mechanism by which bile reflux promotes gastric carcinogenesis and provide an alternative strategy for the prevention of GC associated with BRG.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (194 words)
Bile reflux gastritis (BRG) is associated with the development of gastric cancer (GC), but the specific mechanism remains elusive. Here, a comprehensive study is conducted to explore the roles of refluxed bile acids (BAs) and microbiome in gastric carcinogenesis. The results show that conjugated BAs, interleukin 6 (IL-6), lipopolysaccharide (LPS), and the relative abundance of LPS-producing bacteria are increased significantly in the gastric juice of both BRG and GC patients. A secondary BA, taurodeoxycholic acid (TDCA), is significantly and positively correlated with the LPS-producing bacteria in the gastric juice of these patients. TDCA promotes the proliferation of normal gastric epithelial cells (GES-1) through activation of the IL-6/JAK1/STAT3 pathway. These results are further verified in two mouse models, one by gavage of TDCA, LPS, and LPS-producing bacteria (Prevotella melaninogenica), respectively, and the other by bile reflux (BR) surgery, mimicking clinical bile refluxing. Moreover, the bile reflux induced gastric precancerous lesions observed in the post BR surgery mice can be prevented by treatment with cryptotanshinone, a plant-derived STAT3 inhibitor. These results reveal an important underlying mechanism by which bile reflux promotes gastric carcinogenesis and provide an alternative strategy for the prevention of GC associated with BRG.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 35285172 · DOI · PMC9165488
Bile Reflux is a Common Finding in the Gastric Pouch After One Anastomosis Gastric Bypass [2]
Abstract reading summary — source excerpts
- Opening excerpt
- IntroductionData on postoperative bile reflux after one anastomosis gastric bypass (OAGB) is lacking.
- Closing excerpt
- Trial registrationClinical Trials Identifier NCT02882685.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (246 words)
IntroductionData on postoperative bile reflux after one anastomosis gastric bypass (OAGB) is lacking. Bile reflux scintigraphy (BRS) has been shown to be a reliable non-invasive tool to assess bile reflux after OAGB. We set out to study bile reflux after OAGB with BRS and endoscopy in a prospective series (RYSA Trial).MethodsForty patients (29 women) underwent OAGB between November 2016 and December 2018. Symptoms were reported and upper gastrointestinal endoscopy (UGE) was done preoperatively. Six months after OAGB, bile reflux was assessed in UGE findings and as tracer activity found in gastric tube and esophagus in BRS (follow-up rate 95%).ResultsTwenty-six patients (68.4%) had no bile reflux in BRS. Twelve patients (31.6%) had bile reflux in the gastric pouch in BRS and one of them (2.6%) had bile reflux also in the esophagus 6 months postoperatively. Mean bile reflux activity in the gastric pouch was 5.2% (1-21%) of total activity. De novo findings suggestive of bile reflux (esophagitis, stomal ulcer, foveolar inflammation of gastric pouch) were found for 15 patients (39.5%) in postoperative UGE. BRS and UGE findings were significantly associated (P = 0.022). Eight patients experienced de novo reflux symptoms at 6 months, that were significantly associated with BRS and de novo UGE findings postoperatively (P = 0.033 and 0.0005, respectively).ConclusionPostoperative bile reflux in the gastric pouch after OAGB is a common finding in scintigraphy and endoscopy. The long-term effects of bile exposure will be analyzed in future reports after a longer follow-up.Trial registrationClinical Trials Identifier NCT02882685.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 31853864 · DOI · PMC7347680
The relationship between gastric cancer, its precancerous lesions and bile reflux: A retrospective study [3]
Abstract reading summary — source excerpts
- Opening excerpt
- ObjectiveTo evaluate the relationship between gastric cancer (GC) and precancerous lesions and bile reflux.
- Closing excerpt
- A high grade of bile reflux may be associated with the progression of gastric mucosal diseases.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (192 words)
ObjectiveTo evaluate the relationship between gastric cancer (GC) and precancerous lesions and bile reflux.MethodsMedical records of 30 465 participants who underwent gastroscopy between January and December 2018 in our center were reviewed. Their age, sex, time of endoscopy, endoscopic/histologic diagnosis and grade of bile reflux were recorded. The participants were further divided into the chronic gastritis group (n = 27 807), a precancerous lesion group (n = 1943) and a GC group (n = 715). The χ2 tests and hierarchical analyses were performed.ResultsPatients aged 18-27 years had a higher bile reflux rate than those aged 28-37 and 68-75 years (P 0.05), but differed between morning and afternoon when they underwent the endoscopy (P = 0.000). There was an interrelationship between the severity of gastric mucosal disease and bile reflux grade (r = 0.171). After excluding the effects of sex, age and time of endoscopy on bile reflux, bile reflux rate in chronic gastritis and precancerous lesions was lower than in gastric cancer (P ConclusionsBile reflux may be a risk factor for gastric cancer and precancerous lesions. A high grade of bile reflux may be associated with the progression of gastric mucosal diseases.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 32187838 · DOI · PMC7317534
Recurrent ascending cholangitis secondary to food reflux following transduodenal resection of an ampullary adenoma [4]
Abstract reading summary — source excerpts
- Opening excerpt
- Ampullary lesions, including adenomas and early-stage carcinomas, pose a diagnostic and therapeutic challenge because of their location and proximity to the pancreatic and bile ducts.
- Closing excerpt
- We present an exceedingly uncommon case of recurrent ascending cholangitis resulting from reflux of food particles into the common bile duct that was treated successfully with a Roux-en-Y hepaticojejunostomy and gastroenterostomy.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (135 words)
Ampullary lesions, including adenomas and early-stage carcinomas, pose a diagnostic and therapeutic challenge because of their location and proximity to the pancreatic and bile ducts. Transduodenal ampullectomy offers a targeted approach for the resection of these lesions while preserving the integrity of the pancreaticobiliary system. Moreover, transduodenal ampullectomy is associated with favourable postoperative outcomes, including low rates of morbidity and mortality, as well as preservation of pancreatic and biliary function. However, potential complications such as ascending cholangitis pancreatic leakage, bleeding and duodenal stenosis can occur, which would impact the postoperative quality of life. Addressing these outcomes might require either endoscopic procedures or surgical interventions. We present an exceedingly uncommon case of recurrent ascending cholangitis resulting from reflux of food particles into the common bile duct that was treated successfully with a Roux-en-Y hepaticojejunostomy and gastroenterostomy.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 40131729 · DOI · PMC12718741
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article Pancreaticobiliary maljunction and carcinogenesis to biliary and pancreatic malignancy [5]
- Research article Mechanisms of heartburn [6]
- Research article One-Anastomosis Gastric Bypass: Why Biliary Reflux Remains Controversial? [7]
- Research article The role of acid and bile reflux in oesophagitis and Barrett's metaplasia [8]
- Research article Biliopancreatic and pancreatobiliary refluxes in cases with and without pancreaticobiliary maljunction: diagnosis and clinical implications [9]
- Research article New Causes for the Old Problem of Bile Reflux Gastritis [10]
References
- Wang S, Kuang J, Zhang H, Chen W, Zheng X, Wang J, et al.. Bile Acid-Microbiome Interaction Promotes Gastric Carcinogenesis. . 2022. PMID 35285172 · DOI · PMC9165488
- Saarinen T, Pietiläinen KH, Loimaala A, Ihalainen T, Sammalkorpi H, Penttilä A, et al.. Bile Reflux is a Common Finding in the Gastric Pouch After One Anastomosis Gastric Bypass. . 2020. PMID 31853864 · DOI · PMC7347680
- Li D, Zhang J, Yao WZ, Zhang DL, Feng CC, He Q, et al.. The relationship between gastric cancer, its precancerous lesions and bile reflux: A retrospective study. . 2020. PMID 32187838 · DOI · PMC7317534
- Fouad M, James MW, Zaitoun AM, Hanks M, Lobo DN. Recurrent ascending cholangitis secondary to food reflux following transduodenal resection of an ampullary adenoma. . 2026. PMID 40131729 · DOI · PMC12718741
- Funabiki T, Matsubara T, Miyakawa S, Ishihara S. Pancreaticobiliary maljunction and carcinogenesis to biliary and pancreatic malignancy. Langenbecks Arch Surg. 2009. PMID 18500533 · DOI
- Ang D, Sifrim D, Tack J. Mechanisms of heartburn. Nat Clin Pract Gastroenterol Hepatol. 2008. PMID 18542113 · DOI
- Bruzzi M, Chevallier JM, Czernichow S. One-Anastomosis Gastric Bypass: Why Biliary Reflux Remains Controversial?. Obes Surg. 2017. PMID 27909875 · DOI
- Souza RF. The role of acid and bile reflux in oesophagitis and Barrett's metaplasia. Biochem Soc Trans. 2010. PMID 20298181 · DOI · PMC3072824
- Kamisawa T, Okamoto A. Biliopancreatic and pancreatobiliary refluxes in cases with and without pancreaticobiliary maljunction: diagnosis and clinical implications. Digestion. 2006. PMID 16940726 · DOI
- McCabe ME, Dilly CK. New Causes for the Old Problem of Bile Reflux Gastritis. Clin Gastroenterol Hepatol. 2018. PMID 29505908 · DOI
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-11-04; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-11-04.
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Evidence strength
EvidenceHelix's computed view of the study designs behind this topic: how common meta-analyses, randomized trials and reviews are, how recent the literature is, and a plain-language reading. It describes the design mix of the literature. It is not a quality appraisal of any study, and it is not medical advice.