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Oesophagus
Duodenal fat intensifies the perception of heartburn
  1. J H Meyera,
  2. A Lembob,
  3. J D Elashoffc,
  4. R Fassb,
  5. E A Mayerb
  1. aDepartment of Medicine, Division of Gastroenterology at the West Los Angeles Healthcare Center of the VA Greater Los Angeles Healthcare System, UCLA School of Medicine, Los Angeles, CA, USA, bUCLA/CURE Neuroenteric Disease Program, UCLA School of Medicine, Los Angeles, CA, USA, cBiostatistics Core Research Institute at the Cedars Sinai Medical Center, UCLA School of Medicine, Los Angeles, CA, USA
  1. Dr E A Mayer, Rm 223, Bldg 115, CURE, West Los Angeles VAMC, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA. emayer{at}ucla.edu

Abstract

BACKGROUND Patients with gastro-oesophageal reflux disease (GORD) frequently report that meals high in fat worsen heartburn. Nevertheless, studies to determine whether high fat meals promote gastro-oesophageal reflux have produced conflicting and equivocal conclusions.

PATIENTS AND METHODS To determine, alternatively, whether fat in the small intestinal lumen intensifies the perception of heartburn, we studied 11 patients with typical heartburn from GORD. After being placed on omeprazole to suppress endogenous acid, these fasting subjects underwent oesophageal perfusions with graded doses of HCl at pH values of 1.0, 1.5, 2.0, and 2.5. Oesophageal perfusions were conducted while the duodenum was perfused with saline (control) and again with fat at 8 g/h.

RESULTS Time to onset, intensity, and severity of heartburn varied with dose of oesophageal acid (p<0.01). Time to onset was significantly (p<0.01) shorter, and intensity and severity of heartburn significantly (p<0.05) greater, during duodenal perfusion with fat.

CONCLUSION We conclude that duodenal fat intensifies the perception of heartburn.

  • gastro-oesophageal reflux disease
  • heartburn
  • perception
  • fat

https://doi.org/10.1136/gut.49.5.624

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