Abstract
Our objective was to determine regional differences in intragastric pH after different types of meals. Ten normal subjects underwent 27-hr esophagogastric pH monitoring using a four-probe pH catheter. Meals were a spicy lunch, a high-fat dinner, and a typical bland breakfast. The fatty dinner had the highest postprandial buffering effect, elevating proximal and mid/distal gastric pH to 4.9 ± 0.4 and 4.0 ± 0.4, respectively, significantly (P< 0.05) higher compared to 4.2 ± 0.3 and 3.0 ± 0.4 for the spicy lunch and 3.0 ± 0.3 and 2.5 ± 0.8 for the breakfast. The buffering effect of the high-volume fatty meal to pH > 4 was also longer (150 min) compared to that of the spicy lunch (45 min) and the bland breakfast, which did not increase gastric pH to > 4 at any time. Proximal gastric acid pockets were seen between 15 and 90 min postprandially. These were located 3.4 ± 0.8 cm below the proximal LES border, extending for a length of 2.3 ± 0.8 cm, with a drop in mean pH from 4.7 ± 0.4 to 1.5 ± 0.9. Acid pockets were seen equally after the spicy lunch and fatty dinner but less frequently after the bland breakfast. We conclude that a high-volume fatty meal has the highest buffering effect on gastric pH compared to a spicy lunch or a bland breakfast. Buffering effects of meals are significantly higher in the proximal than in the mid/distal stomach. Despite the intragastric buffering effect of meals, focal areas of acidity were observed in the region of the cardia–gastroesophageal junction during the postprandial period.
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Fisher RS, Sher DJ, Donahue D, Knight LC, Maurer A, Urbain JL, Krevsky B: Regional differences in gastric acidity and antacid distribution: Is a single pH electrode sufficient? Am J Gastroenterology 92:263–270, 1997
McLauchaln G, Fullarton GM, Crean GP, McColl KEL: Comparison of gastric body and antral pH: a 24 hour ambulatory study in healthy volunteers. Gut 30:573–578, 1989
Fletcher J, Wirz A, Young J, Vallance R, McColl KEL: Unbuffered highly acidic gastric juice exists at the gastroesophageal junction after a meal. Gastroenterology 121:775– 783, 2001
Gardner JD, Sloan S, Miner PB, Robinson M: Meal-stimulated gastric acid secretion and integrated gastric acidity in gastro-esophageal reflux disease. Aliment Pharmacol Therapy 17:945–953, 2003
Williams MP, Sercombe J, Hamilton MI, Pounder RE: A placebo-controlled trial to assess the effects of 8 days of dosing with rabeprazole versus omeprazole on 24-hour intragastric acidity and plasma gastrin concentrations in young healthy male subjects. Aliment Pharmacol Ther 12:1079–1089, 1998
Richardson CT, Walsh JH, Hicks MI, Fordtran JS: Studies on the mechanisms of food-stimulated gastric acid secretion in normal human subjects. J Clin Invest 58:623–631, 1976
Sifrim D, Gardner JD, Zhang X, Tack J, Janssens J: Gastric emptying and postprandial gastric acidity. Gastroenterology 126:A–500, 2004 (abstract)
Kroop HS, Long WB, Alavi A, Hansell JR: Effect of water and fat on gastric emptying of solid meals. Gastroenterology 77:997–1000, 1979
Becker DJ, Sinclair J, Castell DO, Wu WC: A comparison of high and low fat meals on postprandial esophageal acid exposure. Am J Gastroenterol 84:782–786, 1989
Rodriguez S, Miner P, Robinson M, Greenwood B, Maton PN, Pappa K: Meal type affects heartburn severity. Dig Dis Sci 43:485–490, 1998
Fisher RS, Sher DJ, Donahue D, Senior J, Krevsky B: A single intragastric pH electrode does not accurately measure intragastric acidity. Am J Gastroenterol 91:1167–1172, 1996
Hila A, Bouali H, Freeman J, Castell DO: Post-prandial gastric acid layer persists with change in body position. Am J Gastroenterol 98 (Suppl):S2, 2003 (abstract)
Fletcher J, Wirz A, McColl KE: Postprandial acid pocket at the gastro-oesophageal junction—Effect of meal fat content and posture. Gastroenterology 126:A–6, 2004 (abstract)
Fletcher J, Wirz A, Henry E, McColl KEL: Studies of acid exposure immediately above the gastro-oesophageal squamocolumnar junction: evidence of short segment reflux. Gut 53:168–173, 2004
Pandolfino JE, Schreiner MA, Lee TJ, Hirano I, Kahrilas PJ: Post-prandial acid burden: Acid pocket or frequent reflux. Gastroenterology 126:A6–A7, 2004 (abstract)
Katzka DA, Gideon RM, Castell DO: Normal patterns of acid exposure at the gastric cardia: a functional midpoint between the esophagus and stomach. Am J Gastroenterol 93:1236–1242, 1998
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Simonian, H.P., Vo, L., Doma, S. et al. Regional Postprandial Differences in pH Within the Stomach and Gastroesophageal Junction. Dig Dis Sci 50, 2276–2285 (2005). https://doi.org/10.1007/s10620-005-3048-0
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DOI: https://doi.org/10.1007/s10620-005-3048-0