It is difficult to differentiate whether NERD patients have pathological acid or bile reflux according to symptoms.

Future study should also focus on bile reflux, remnant gastric cancer, and long term effectiveness of mini-gastric bypass.

Reactive or chemical gastropathy, which is often associated with nonsteroidal anti-inflammatory drug use or bile reflux, is common in most practices.

This may reflect the role of bile reflux, which is more common in BII than BI, because bile reflux interferes with colonization by H. pylori.