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https://hdl.handle.net/2440/8863
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Type: | Journal article |
Title: | Effect of intraduodenal fat on lower oesophageal sphincter function and gastro-oesophageal reflux. |
Author: | Holloway, R. Lyrenas, E. Ireland, A. Dent, J. |
Citation: | Gut, 1997; 40(4):449-453 |
Publisher: | BRITISH MED JOURNAL PUBL GROUP |
Issue Date: | 1997 |
ISSN: | 0017-5749 1468-3288 |
Abstract: | <h4>Background and aims</h4>Fatty foods are commonly reported to aggravate gastro-oesophageal reflux symptoms. In this study the hypothesis that fat provokes reflux by stimulating transient lower oesophageal sphincter relaxations via small intestinal receptors was investigated.<h4>Methods</h4>In 12 healthy volunteers and 11 patients with reflux oesophagitis, oesophageal motility and pH were measured over 30 minute periods during which saline or fat (10% Intralipid) were infused in random order into the duodenum. The infusion periods were separated by a 30 minute washout. The stomach was loaded with 200 ml 10% dextrose, maintained by an intragastric infusion.<h4>Results</h4>Fat decreased basal LOS pressure from 16.9 (SEM 2.1) to 12.4 (SEM 1.5) mm Hg in normal subjects but had no effect in patients with oesophagitis (18.8 (SEM 4.3) v 18.2 (SEM 3.0) mm Hg). During saline infusion, the rates of transient lower oesophageal sphincter relaxation and reflux episodes were greater in patients (4.5 (interquartile range 2-11)/30 min and 5 (2-14)/30 min respectively) than in controls (3 (2-4)/30 min and 3 (2-3.5)/30 min respectively). Fat increased the rate of reflux episodes in the reflux patients to 6.5 (3-25)/30 min. This effect was due to an increase in the incidence of reflux during transient LOS relaxations (65% v 91%), the rate of transient relaxations remaining unchanged.<h4>Conclusions</h4>Instillation of fat directly into the duodenum aggravates reflux in patients with reflux disease, by increasing the proportion of transient LOS relaxations accompanied by reflux. |
Keywords: | Duodenum Esophagus Esophagogastric Junction Humans Esophagitis, Peptic Dietary Fats Cross-Over Studies Manometry Hydrogen-Ion Concentration Adolescent Adult Aged Middle Aged Female Male |
DOI: | 10.1136/gut.40.4.449 |
Published version: | http://dx.doi.org/10.1136/gut.40.4.449 |
Appears in Collections: | Aurora harvest Medicine publications |
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