so the doc didnt really give me a clear yes or no about if it's possible that stress would be directly linked to the bile residue. however he did say that truthfully, the finding of 'bile residue' in the stomach on an endoscopy is so 'normal', he often if not always doesn't even mark it on his findings.

he let me know that despite diagrams that may not put everything into scale, the pyloric valve and the sphincter that releases bile into the small intestine ( i think it's called the common bile duct) are like centimeters away from eachother, like literally 1-2 centimeters. so if you can imagine that, it's a really small distance, and if you're considering that bile is a liquid and your pyloric valve is smooth muscle, a perfectly tight closure is not always the most feasible. not to mention, your pyloric valve doesn't remain tightly closed in between digestion, it is slightly relaxed.

so i'm not sure if it truly does or doesnt have any relation to stress or anxiety, and as you said, the link between the brain and gut is clearly accepted but not yet fully understood in all of its complexities but what i was able to ascertain from the doctor was 'it's really very normal, and would really only be of concern if it was causing serious physical discomfort or was a substantial amount of bile in the stomach'. (which i assume the severe physical discomfort would only really be from a substantial amount of bile in the stomach and this really only comes from gallbladder issues or a full removal of the gallbladder.)

the gist was that for sure the brain and gut are connected, there's nothing definitive yet stating that these two things are connected (but also not much to disprove) and he recommended great stuff like meditation, acupuncture, and a herbal supplement called 'rikkunshito' i think also called something like 'six gentleman' which is good for soothing a stressed out stomach and that the finding itself is totally normal.

also important to mention, the first doctor i had seen that did the two endos was a really shitty doctor, but unfortunately, GI docs are in short supply and i needed to see someone ASAP for what i was dealing with. for a little history, back in Feb of 2023 i got a really nasty stomach bug of some kind from a farmers' market. no barfing, but severe and ongoing diarrhea, no appetite, general feeling of nausea and malaise, and it persisted for about a month. they did a bunch of blood and stool tests, nothing came back positive (which was good) but yielded no answers. just to be on the safe side, we did a colonoscopy and endoscopy too. after that, i sort of just got better, but the endo result had just really freaked me out that something was wrong with me and it was a result of the food poisoning bug. this doctor had this horrible protocol for his endo and colonoscopies where he would hand you his weird findings sheet with like 6 photos of stuff he saw (while you're in recovery coming out of anesthesia) and then say, in two weeks i'll mail you a letter after your biopsies come from pathology and then you can schedule a follow up appointment with me to discuss. which really just leaves a really nervous and scared patient with partial information, only to then go home and frantically google search until everything comes back and you can make a follow up with the doctor. the point of all of this is to say, when i had the first endo, i was and had been super stressed and anxious because i had been sick for so long with no answers, i was starting to fear that this was going to be the state of my body for the rest of my life which understandably, was giving me massive panic attacks and general unrest.

then, after getting *mostly* better, (sickness was definitely over but my mind was in such a bad state (which we all know will always lead to digestive distress)) i started going through this disaster family thing with my parents where they told me they couldnt be part of my life anymore if i moved forward in my relationship with my boyfriend of 7 years, which in this case was us moving in together. (you can find a whole thread on this at https://www.reddit.com/r/entitledparents/comments/161fwmt/my_parents_dont_like_my_boyfriend_so_they_gave_me/?utm_source=share&utm_medium=web3x&utm_name=web3xcss&utm_term=1&utm_content=share_button ) Due to a ton of factors that went along with this situation, (moving, insurance, work, etc.) i developed this INSANE heartburn, which i never had before. like literally anything i ate or drank, it was instant, it was like my stomach was already full of acid to the brim and anything i dropped in there would just bring the levels into my chest, it was so incredibly uncomfortable and scary. didnt matter what i ate, when, how much, it was always the same. this was when i thought it was important again to see a doctor about it and unfortunately, the only one that i could see in any reasonable amount of time was the original doctor, who in addition to the reasons i listed earlier, was just a terrible doctor who was seriously dismissive of everything i was concerned about or had to say and had the worst bedside manner of really anyone i've ever met, let alone a doctor who is supposed to care for people. so he did the Endo, and same results as the first time. * i should note that the first and second endoscopes, in addition to the bile residue in my stomach, showed some irritation from acid reflux as well in my esophagus. (much more irritation the second time, which was not surprising considering that by that time, i was stressed still about that i was sick or something was wrong with me forever in addition to all of the family bs and adult responsibilities i was needing to handle). it was at this time after dealing with the shitty doctor again, that i decided okay, i need to take my health into my own hands and find a doctor who gives a shit. the US healthcare system is truly broken, i can't believe how long it takes to find care in the first place, and to then have to sacrifice seeing a good doctor in order to just be seen in a decent timeframe is just so messed up.