EFFECT OF INCREASING THE FAT-CONTENT BUT NOT THE ENERGY LOAD OF A MEAL ON GASTROESOPHAGEAL REFLUX AND LOWER ESOPHAGEAL SPHINCTER MOTOR FUNCTION

Background-Although fatty foods are commonly considered detrimental in patients with reflux disease, no objective data exist that substantia te this belief. Aims-To investigate the effect of fat on gastro-oesoph ageal reflux and lower oesophageal sphincter (LOS) motor activity. Sub jects-Thirteen healthy subjects and 14 patients with reflux disease. M ethods-Oesophageal pH, LOS, and oesophageal pressures were recorded fo r 180 minutes after a high fat (52% fat) and a balanced (24% fat) meal (both 3.18 MJ) on two different occasions. Eight controls and seven p atients were studied in the recumbent position and the others in the s itting position. Results-The percentage of time at pH less than 4 and the rate of reflux episodes were higher (p<0.01) in the patients than in the healthy subjects (mean 14.1% versus 1.7% and 4.4/h versus 0.8/h respectively), as was the percentage of transient LOS relaxations ass ociated with reflux (62% versus 32%, p<0.01). The high fat meal did no t increase the rate of reflux episodes nor exposure to oesophageal aci d in either group regardless of body posture. The rate of transient LO S relaxations, their association with reflux and basal LOS pressure we re also unaffected. Conclusions-Increasing fat intake does not affect gastro-oesophageal reflux or oesophagogastric competence for at least three hours after a meal.