The influence of rapid food intake on postprandial reflux: studies in healthy volunteers.
BACKGROUND
The postprandial increase of gastroesophageal reflux (GER) results largely from an increase in the rate of transient lower esophageal sphincter relaxations (TLESRs). Gastric distension is believed to be the most important contributing factor. The aim of this study was to determine the impact of rapid food intake on GER in healthy volunteers using combined multichannel intraluminal impedance and pH (MII-pH) testing to record both acid and nonacid reflux. Our hypothesis was that rapid food intake overstresses the gastric pressure-volume response and contributes to increased postprandial GER.


METHODS
Twenty healthy volunteers were included in the study. On two separate days the participants were asked to eat the same standard meal within 5 or 30 min in random order. Acid and nonacid reflux episodes were recorded over a 2-h postprandial period.


RESULTS
Intake of a standard meal within 5 min was associated with more reflux episodes (median = 14) than an intake within 30 min (median = 10, p= 0.021). The increase was confined to the first postprandial hour and was caused predominantly by an increase of nonacid reflux. During the entire 2-h postprandial period, 469 reflux episodes were noted in the 40 studies. During the first postprandial hour 45% (135/303) of reflux events were nonacid as opposed to 22% (37/166) noted during the second hour (p < 0.0001).


CONCLUSIONS
Since rapid food intake produces more GER in healthy volunteers, studies in GERD patients are warranted to evaluate if eating slowly may represent another "life-style modification" aimed at reducing GER.
Digestive Disease Center, Medical University of South Carolina, 96 Jonathan Lucas Street, Charleston, SC 29425, USA.
Stephan M
SM
Wildi
Radu
R
Tutuian
Donald O
DO
Castell
D000328:Adult; D015331:Cohort Studies; D005247:Feeding Behavior; D005260:Female; D005745:Gastric Acidity Determination; D005746:Gastric Emptying; D005764:Gastroesophageal Reflux / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D015994:Incidence; D008297:Male; D008365:Manometry; D008875:Middle Aged; D019518:Postprandial Period / Q000502:physiology*; D011336:Probability; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric