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. 1973 Apr;14(4):270–274. doi: 10.1136/gut.14.4.270

Inhibition of the lower oesophageal sphincter by fat— a mechanism for fatty food intolerance

Otto T Nebel, Donald O Castell
PMCID: PMC1412588  PMID: 4706907

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.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. 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]
  2. 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]
  3. 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]
  4. 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]
  5. 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]
  6. 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]
  7. 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]
  8. Johnson L. R., Grossman M. I. Intestinal hormones as inhibitors of gastric secretion. Gastroenterology. 1971 Jan;60(1):120–144. [PubMed] [Google Scholar]
  9. 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]
  10. 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]
  11. 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]
  12. Nebel O. T., Castell D. O. Lower esophageal sphincter pressure changes after food ingestion. Gastroenterology. 1972 Nov;63(5):778–783. [PubMed] [Google Scholar]
  13. 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]
  14. Winans C. S., Harris L. D. Quantitation of lower esophageal sphincter competence. Gastroenterology. 1967 May;52(5):773–778. [PubMed] [Google Scholar]

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