Abstract
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.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Castell D. O., Harris L. D. Hormonal control of gastroesophageal-sphincter strength. N Engl J Med. 1970 Apr 16;282(16):886–889. doi: 10.1056/NEJM197004162821602. [DOI] [PubMed] [Google Scholar]
- Castell D. O., Levine S. M. Lower esophageal sphincter response to gastric alkalinization. A new mechanism for treatment of heartburn with antacids. Ann Intern Med. 1971 Feb;74(2):223–227. doi: 10.7326/0003-4819-74-2-223. [DOI] [PubMed] [Google Scholar]
- Cohen S., Lipshutz W. Hormonal regulation of human lower esophageal sphincter competence: interaction of gastrin and secretin. J Clin Invest. 1971 Feb;50(2):449–454. doi: 10.1172/JCI106512. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Debas H. T., Bedi B. S., Gillespie G., Gillespie I. E. Mechanism by which fat in the upper small intestine inhibits gastric acid. Gastroenterology. 1969 Mar;56(3):483–487. [PubMed] [Google Scholar]
- Hansky J., Cain M. D. Radioimmunoassay of gastrin in human serum. Lancet. 1969 Dec 27;2(7635):1388–1390. doi: 10.1016/s0140-6736(69)90933-7. [DOI] [PubMed] [Google Scholar]
- Hollis J. B., Levine S. M., Castell D. O. Differential sensitivity of the human esophagus to pentagastrin. Am J Physiol. 1972 Apr;222(4):870–874. doi: 10.1152/ajplegacy.1972.222.4.870. [DOI] [PubMed] [Google Scholar]
- Johnson L. R., Grossman M. I. Analysis of inhibition of acid secretion by cholecystokinin in dogs. Am J Physiol. 1970 Feb;218(2):550–554. doi: 10.1152/ajplegacy.1970.218.2.550. [DOI] [PubMed] [Google Scholar]
- Johnson L. R., Grossman M. I. Intestinal hormones as inhibitors of gastric secretion. Gastroenterology. 1971 Jan;60(1):120–144. [PubMed] [Google Scholar]
- Korman M. G., Soveny C., Hansky J. Effect of food on serum gastrin evaluated by radioimmunoassay. Gut. 1971 Aug;12(8):619–624. doi: 10.1136/gut.12.8.619. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kotrba C., Code C. F. Gastric acid secretory responses to some purified foods and to additions of sucrose or olive oil. Am J Dig Dis. 1969 Jan;14(1):1–8. doi: 10.1007/BF02239503. [DOI] [PubMed] [Google Scholar]
- Lipshutz W., Hughes W., Cohen S. The genesis of lower esophageal sphincter pressure: its identification through the use of gastrin antiserum. J Clin Invest. 1972 Mar;51(3):522–529. doi: 10.1172/JCI106840. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nebel O. T., Castell D. O. Lower esophageal sphincter pressure changes after food ingestion. Gastroenterology. 1972 Nov;63(5):778–783. [PubMed] [Google Scholar]
- SAINT-HILAIRE S., LAVERS M. K., KENNEDY J., CODE C. F. Gastric acid secretory value of different foods. Gastroenterology. 1960 Jul;39:1–11. [PubMed] [Google Scholar]
- Winans C. S., Harris L. D. Quantitation of lower esophageal sphincter competence. Gastroenterology. 1967 May;52(5):773–778. [PubMed] [Google Scholar]