Duodenal fat intensifies the perception of heartburn

Background-Patients with gastrooesophageal reflux disease (GORD) frequently report that meals high in fat worsen heartburn. Nevertheless, studies to d etermine whether high fat meals promote gastro-oesophageal reflux have prod uced 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 pat ients with typical heartburn from GORD. After being placed on omeprazole to suppress endogenous acid, these fasting subjects underwent oesophageal per fusions with graded doses of HCl at pH values of 1.0, 1.5, 2.0, and 2.5. Oe sophageal perfusions were conducted while the duodenum was perfused with sa line (control) and again with fat at 8 g/h. Results-Time to onset, intensity, and severity of heartburn varied with dos e 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 hear tburn.