Persistent Epigastric Pain Due to Biliary Reflux (Internal Medicine)

Medical Case Details:

A patient presented with a long standing history of epigastric pain. Based on clinical history and physical examination, the initial diagnosis was chronic gastritis and gastroesophageal reflux disease. Despite receiving standard treatment for these conditions, the patient continued to experience persistent symptoms. To further evaluate the cause, an upper gastrointestinal endoscopy was performed. The findings revealed the presence of biliary reflux. After identifying the underlying cause, the patient was started on ursodeoxycholic acid. Following this treatment, the patient showed a good clinical response with improvement in symptoms. This case highlights the importance of considering biliary reflux as a possible cause in patients with persistent epigastric pain that does not respond to conventional treatment for gastritis or GERD.