Effect of liquid meals with different volumes on gastroesophageal reflux disease.
OBJECTIVE
Patients with gastroesophageal reflux disease (GERD) are often advised to avoid large meals, based on their complaints of increased symptoms after eating too much, and epidemiological evidence of a link between high volume intake and the presence of GERD. However, the precise effects of meal volume on gastroesophageal reflux have not been well studied. We aimed to clarify the effect of meal volume on acid regurgitation and symptoms in patients with GERD.


METHODS
Fifteen patients (10 female, 5 male; mean 54 ± 10 years old) with GERD were studied twice each in random order, during 24 h ambulatory pH monitoring. On one day, they consumed a 600 mL liquid test meal three times (breakfast, lunch, and dinner), and on the other, they consumed a 300 mL test meal six times (breakfast, snack, lunch, snack, dinner, and snack). Gastric fundus and antral areas and antral contractions were measured by transabdominal ultrasound. Symptoms were recorded using questionnaires.


RESULTS
During the 600 mL regimen, there were more reflux episodes (17 ± 4 vs 10 ± 2, P = 0.03) and a greater total acid reflux time (12.5 ± 5.9% vs 5.5 ± 3.6%; P = 0.045) than the 300 mL regimen. Both the cross-sectional area of the gastric fundus (P = 0.024) and the number of antral contractions (P = 0.014) were greater for the 600 mL regimen.


CONCLUSIONS
Larger meals are associated with distension of the gastric fundus and an increase in gastroesophageal reflux when compared with smaller, more frequent meals.
Keng-Liang
KL
Wu
Christopher K
CK
Rayner
Seng-Kee
SK
Chuah
Yi-Chun
YC
Chiu
King-Wah
KW
Chiu
Tsung-Hui
TH
Hu
Cheng-Tang
CT
Chiu
D000328:Adult; D018450:Disease Progression; D004435:Eating / Q000502:physiology*; D050782:Esophageal pH Monitoring; D005260:Female; D005748:Gastric Fundus / Q000503:physiopathology; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D005769:Gastrointestinal Motility; D006801:Humans; D008297:Male; D062407:Meals; D008875:Middle Aged; D011706:Pyloric Antrum / Q000503:physiopathology; D011795:Surveys and Questionnaires