Peters' team found that bile that washes up from the stomach into the esophagus shuts off genes responsible for the normal, skin-like lining of the organ, and turns on genes that produce the intestine-like lining that is the hallmark of Barrett's. While previous research established that reflux components encouraged the development of intestinal tissue in the esophagus that alone was never enough to produce the changes that led to Barrett's.
"The main leap this study makes is that normal esophageal cell growth must be turned off and intestinal cell growth must be turned on in order for the disease to take hold," noted Peters, who is president elect of the International Society of Diseases of the Esophagus. "We found that bile promotes both processes."
[Emphasis mine.]The jury is still out whether treating bile reflux with medication works. According to the study's co-author, Dr. Tony Godfrey, "the only way to stop all reflux components, including bile, is to surgically reconstruct the faulty barrier between the esophagus and the stomach."
Citation: Marie Reveiller, Sayak Ghatak, Liana Toia, Irina Kalatskaya, Lincoln Stein, Mary DʼSouza, Zhongren Zhou, Santhoshi Bandla, William E. Gooding, Tony E. Godfrey, Jeffrey H. Peters. Bile Exposure Inhibits Expression of Squamous Differentiation Genes in Human Esophageal Epithelial Cells. Annals of Surgery, 2012; : 1 DOI:10.1097/SLA.0b013e3182512af9
Mayo Clinic's page on Bile Reflux