Burning and belching all the time :(

Have you had a stomach emptying test?

In 1833, Dr William Beaumont wrote: "I have observed that when the use of fat or oily food has been perservered in for some time, there is generally the presence of bile in the gastric fluids".

Your problems could be partly to do with your diet - eg processed meats but may also be to do with gastroparesis (slow stomach emptying) which can exacerbate reflux.

Belching may be caused by ingestion of air as you eat but may also be a symptom of gastroparesis since foods remaining in the stomach too long may start to ferment.

For now, I would suggest cutting down on fatty foods, eat only small portions, slowly, and more frequently. Gentle upright exercise, like walking, will aid peristalsis but avoid bending or anything that will stress the stomach.

I know some of this is easier said than done when you're a teacher. That was my profession for 30 years and it's not easy managing acid reflux issues at the same time.

Reflux of acid and bile over time can lead to Barrett's oesophagus (as it did with me) which in some people can mutate to cancer.

I feel your pain! Although I was relieved my endoscopy came out clear except for excess acid in my stomach I still suffer every day. It's horrible and it suddnly just came on this summer. I insisted on more testing to determine why I had so much acid/bile in my stomach. My doctor ordered an abdominal ultrasound which can look at the surrounding bile producing organs and a stomach emptying test. Turns out my stomach doesn't empty correctly. It empties really slow causing all the burn in my stomach all the way up to my nose. It's called gastroparesis. You might want to look in to that to rule it out. I was pretty sure I didn't have it because my only symptom was burning but I did. I'm 34 and consider myself fairly healthy.

The fact that when they did the endoscopy they found bile would suggest that you have something called bile reflux. Bile is very alkaline and its presence in the stomach does not respond to Proton Pump Inhibitors or antacids because of its alkalinity. Only acid reflux responds to these meds. Over time it can cause inflammation in the same way that excess acid in the stomach does and the symptoms of both conditions are the very similar, so it can be difficult to differentiate. If you haven't been referred to a gastroenterologist you need referring so that they can do some tests to determine if you actually do have bile reflux and if you don't find out what the cause is so that you can receive the proper treatment. Maybe your doctor could prescribe some form of pain relief that isn't heavy on the stomach in order to make things a little more comfortable and allow you to sleep until you have had some diagnostic tests done- pain creates stress which creates more stomach problems in the long run

Hoping that things settle down for you soon.

Bile is an emulsifier. In a similar way to detergent permitting water molecules to latch onto grease molecules to permit washing up, bile permits the hydrochloric acid molecules to attach to the animal tissue of meats to permit them to be broken down.

That is why, as Willam Beaumont discovered 180 years ago, Bile is sometimes permitted to enter the stomach to assist with the break down of fatty foods.

But it's bad news if it refluxes along with acid.

Acid + Bile + Reflux can produce Barrett's Oesophagus (which in some people can lead to cancer). Research shows this is not possible with acid nor bile alone.

PPIs reduce the acid by stopping the production of some of the proton pumps that manufacture it in the gastric mucosa. There are no drugs to reduce the bile nor drugs to reduce the reflux, but take one element of the three out of the equation and the development of Barrett's is probably averted.