Duodenal fat intensifies the perception of heartburn.
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.


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.


CONCLUSIONS
We conclude that duodenal fat intensifies the perception of heartburn.
Meyer
J H
JH
Department of Medicine, Division of Gastroenterology, West Los Angeles Healthcare Center, VA Greater Los Angeles Healthcare System, UCLA School of Medicine, Los Angeles, CA, USA.
Lembo
A
A
Elashoff
J D
JD
Fass
R
R
Mayer
E A
EA
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D004041:Dietary Fats / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004386:Duodenum; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D005766:Gastrointestinal Contents / Q000737:chemistry*; D006356:Heartburn / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D006851:Hydrochloric Acid / Q000008:administration & dosage; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use; D010465:Perception; D018709:Statistics, Nonparametric
D000897:Anti-Ulcer Agents; D004041:Dietary Fats; D009853:Omeprazole; D006851:Hydrochloric Acid