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The effects of a weakly acidic meal on gastric buffering and postprandial gastro-oesophageal reflux.
Aliment Pharmacol Ther. 2011 Sep; 34(5):568-75.AP

Abstract

BACKGROUND

Exclusion of the meal during ambulatory pH monitoring presumes that a meal completely buffers gastric acid and reflux of acidic food content cannot be distinguished from gastric acid. However, the ability of a meal to completely buffer gastric acid remains unclear.

AIM

To determine the effect of a weakly acid meal on gastric buffering and oesophageal acid exposure.

METHODS

Patients undergoing multichannel intraluminal impedance pH studies were given a standard weakly acidic meal (pH = 5.9). Gastric and oesophageal pH was measured during the meal and in 15 min intervals for 2 h postprandially.

RESULTS

The study included 30 patients, with pathological acid reflux detected in 18 patients. Complete gastric buffering occurred in seven patients (23%) and was lost in all patients within 75 min of the meal. Oesophageal acid was detected in 33% of patients within 30 min of the meal and 81% of patients during the 2 h postprandial period. Postprandial oesophageal acid exposure was greater in patients with pathological acid reflux (9 ± 2.7% vs. 1.7 ± 0.8% P = 0.05) with a trend towards more incomplete gastric acid buffering and significant differences when measuring weak acid reflux (pH 4-5). Acid reflux rarely occurred in the absence of gastric acid, with gastric acid present in 74 of 79 (94%) fifteen minute postprandial intervals with acid reflux.

CONCLUSIONS

The ability of a meal to buffer gastric acid is poor. Early postprandial oesophageal acid reflux occurs in a substantial proportion of patients. Addition of a weakly acidic or pH neutral meal to ambulatory pH monitoring may unmask early postprandial acid reflux and provide data on gastric acid buffering.

Authors+Show Affiliations

Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester MN 55905, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21726258

Citation

Ravi, K, et al. "The Effects of a Weakly Acidic Meal On Gastric Buffering and Postprandial Gastro-oesophageal Reflux." Alimentary Pharmacology & Therapeutics, vol. 34, no. 5, 2011, pp. 568-75.
Ravi K, Francis DL, See JA, et al. The effects of a weakly acidic meal on gastric buffering and postprandial gastro-oesophageal reflux. Aliment Pharmacol Ther. 2011;34(5):568-75.
Ravi, K., Francis, D. L., See, J. A., Geno, D. M., & Katzka, D. A. (2011). The effects of a weakly acidic meal on gastric buffering and postprandial gastro-oesophageal reflux. Alimentary Pharmacology & Therapeutics, 34(5), 568-75. https://doi.org/10.1111/j.1365-2036.2011.04761.x
Ravi K, et al. The Effects of a Weakly Acidic Meal On Gastric Buffering and Postprandial Gastro-oesophageal Reflux. Aliment Pharmacol Ther. 2011;34(5):568-75. PubMed PMID: 21726258.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effects of a weakly acidic meal on gastric buffering and postprandial gastro-oesophageal reflux. AU - Ravi,K, AU - Francis,D L, AU - See,J A, AU - Geno,D M, AU - Katzka,D A, Y1 - 2011/07/05/ PY - 2011/7/6/entrez PY - 2011/7/6/pubmed PY - 2011/12/24/medline SP - 568 EP - 75 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 34 IS - 5 N2 - BACKGROUND: Exclusion of the meal during ambulatory pH monitoring presumes that a meal completely buffers gastric acid and reflux of acidic food content cannot be distinguished from gastric acid. However, the ability of a meal to completely buffer gastric acid remains unclear. AIM: To determine the effect of a weakly acid meal on gastric buffering and oesophageal acid exposure. METHODS: Patients undergoing multichannel intraluminal impedance pH studies were given a standard weakly acidic meal (pH = 5.9). Gastric and oesophageal pH was measured during the meal and in 15 min intervals for 2 h postprandially. RESULTS: The study included 30 patients, with pathological acid reflux detected in 18 patients. Complete gastric buffering occurred in seven patients (23%) and was lost in all patients within 75 min of the meal. Oesophageal acid was detected in 33% of patients within 30 min of the meal and 81% of patients during the 2 h postprandial period. Postprandial oesophageal acid exposure was greater in patients with pathological acid reflux (9 ± 2.7% vs. 1.7 ± 0.8% P = 0.05) with a trend towards more incomplete gastric acid buffering and significant differences when measuring weak acid reflux (pH 4-5). Acid reflux rarely occurred in the absence of gastric acid, with gastric acid present in 74 of 79 (94%) fifteen minute postprandial intervals with acid reflux. CONCLUSIONS: The ability of a meal to buffer gastric acid is poor. Early postprandial oesophageal acid reflux occurs in a substantial proportion of patients. Addition of a weakly acidic or pH neutral meal to ambulatory pH monitoring may unmask early postprandial acid reflux and provide data on gastric acid buffering. SN - 1365-2036 UR - https://www.unboundmedicine.com/medline/citation/21726258/The_effects_of_a_weakly_acidic_meal_on_gastric_buffering_and_postprandial_gastro_oesophageal_reflux_ L2 - https://doi.org/10.1111/j.1365-2036.2011.04761.x DB - PRIME DP - Unbound Medicine ER -