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Inhibition of the lower oesophageal sphincter by fat— a mechanism for fatty food intolerance
  1. Otto T. Nebel,
  2. Donald O. Castell


    The effect of fat and protein meals on the lower oesophageal sphincter pressure was tested in normal subjects using an infused open-tipped manometric system. After ingestion of a minced beef meal, the mean peak pressure at the lower oesophageal sphincter increased 5·8 ± 1·5 mm Hg (± 1 SE). By contrast, ingestion of a corn oil meal resulted in a mean peak decrease of 7·8 ± 1·9 mm Hg. Following the combined minced beef/corn oil meal, mean peak pressure decreased 3·0 ± 2·1 mm Hg. Pentagastrin (3 μg/kg, subcutaneously) resulted in a mean peak increase of 20·6 ± 7·0 mm Hg when given to the subjects in the fasting state, and produced an increase of only 8·4 ± 1·7 mm Hg when given following the fat meal. Finally, after a mean peak decrease in pressure at the lower oesophageal sphincter of 6·8 ± 1·0 mm Hg 15 minutes after the corn oil meal, gastric alkalinization with 30 ml of antacid resulted in a subsequent increase in sphincter pressure of 5·2 ± 1·6 mm Hg. These data indicate: (1) Fat attenuates the effect of endogenous gastrin as well as exogenous pentagastrin stimulation of the lower oesophageal sphincter. (2) Fat-induced incompetency of the lower oesophageal sphincter can be effectively combated by gastric alkalinization in the form of antacids.

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