In healthy volunteers no difference in post-prandial LESP and GER was seen after a high fat meal compared with an isocaloric and isovolumetric low fat meal. Our results suggest that it is inappropriate to advise GER patients to reduce the fat content of their meals for symptom relief.
INTRODUCTIONIngestion of a meal decreases lower oesophageal sphincter pressure and induces gastro-oesophageal re¯ux in healthy volunteers and in patients with re¯ux disease. 1, 2 Because the high fat content of a meal and the ingestion of large meals were thought to be responsible for these meal effects, patients with re¯ux disease were advised to avoid high fat and large meals. 3±11 However, the amount of dietary fat necessary to reduce the lower oesophageal sphincter pressure seems to be rather low; whole milk (3.3±3.4% fat) but SUMMARY Background: Patients with gastro-oesophageal re¯ux disease are advised to avoid the ingestion of large meals. In healthy volunteers, a relationship between the amount of postprandial gastro-oesophageal re¯ux and the volume of a liquid meal has been demonstrated. Aim: To evaluate whether the amount of postprandial gastro-oesophageal re¯ux is also related to the calorie content of a meal, a second parameter that will be reduced by avoidance of the ingestion of large meals. Methods: Twelve healthy volunteers (six female, 19± 31 years) received two solid±liquid meals with either 842 kcal (solid 582 kcal, liquid 260 kcal) or 582 kcal (31% reduction) in a randomized order. The nutritional components (10% fat, 76% carbohydrates, 14% protein) and the volume of the meals were identical in both meals. The lower oesophageal sphincter pressure was measured continuously in the ®rst postprandial hour with a Dent sleeve, and pH-metry was performed for 3 h postprandially with a glass electrode in the distal oesophagus. Blinded to the type of ingested meal, we calculated the mean lower oesophageal sphincter pressure, the frequency of transient lower oesophageal
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