PT  - JOURNAL ARTICLE
AU  - J H Meyer
AU  - A Lembo
AU  - J D Elashoff
AU  - R Fass
AU  - E A Mayer
TI  - Duodenal fat intensifies the perception of heartburn
AID  - 10.1136/gut.49.5.624
DP  - 2001 Nov 01
TA  - Gut
PG  - 624--628
VI  - 49
IP  - 5
4099  - http://gut.bmj.com/content/49/5/624.short
4100  - http://gut.bmj.com/content/49/5/624.full
SO  - Gut2001 Nov 01; 49
AB  - 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.PATIENTS AND 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.CONCLUSION We conclude that duodenal fat intensifies the perception of heartburn.