Abstract：Objective To analyze the gastroscopic manifestations of bile reflux gastritis and nvestigate the therapeutic effect of aluminum hydroxide and magnesium carbonate on the condition. Methods A total of 88 patients with bile reflux gastritis treated in our hospital  from February to December 2021 were selected. According to different treatment plans, they were divided into a reference group and a research group, with 44 patients in each group. The patients in the reference group was treated with domperidone, while in the research group received additional treatment with aluminum hydroxide and magnesium carbonate. Gastroscopic manifestations were analyzed, and the overall treatment effectiveness, gastric aspirate levels, quality of life, and adverse reactions were compared between the two groups. Results The overall treatment effectiveness in the research group was higher than that in the reference group, and the difference was statistically significant（χ2＝5.091, P＜0.05）. The gastric acid secretion and bile acid levels in the gastric fluid of the research group were both lower than those in the reference group, and all quality-of-life scores were higher than in the reference group. The differences between the two groups were statistically significant （t＝8.533, 23.239, 8.108, 13.883, 9.655, 10.479, all P＜0.05）. However, there was no significant difference in the incidence of adverse reactions between the two groups （χ2＝0.138, P＞0.05）. Conclusion Gastroscopy can effectively diagnose bile reflux gastritis. Aluminum hydroxide and magnesium carbonate have shown remarkable therapeutic effects in treating patients with bile reflux gastritis, with good medication safety.