Bilious vomiting is most common immediately after gastrectomy and may settle of its own accord.
The use of substances which help to bind bile salts for example, hydrotalcite may be of value. These substances should be taken in the morning and with meals. Occasionally, the addition of prokinetic drugs, e.g. cisapride, metoclopramide, domperidone, may be beneficial.
Surgery, either some form of bile diversion or gastric reconstruction is indicated if symptoms persist.
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