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Heartburn and Regurgitation in Pregnancy: The Effect of Fat Ingestion

Abstract

Background

Reflux symptoms are common in pregnancy, but their association with fat ingestion is unclear.

Aim

To investigate an association of dietary fats with heartburn and regurgitation in pregnancy.

Methods

This is a prospective study in which 89 pregnant women (gestational age 34 ± 4 weeks) attending a low-risk prenatal outpatient clinic were asked to provide information on the frequency they experienced heartburn and regurgitation. Fat ingestion was estimated by means of a 24-h diet record. Symptomatic patients were compared with those with no reflux symptoms (n = 20).

Results

Heartburn once a week or more often occurred in 56 of the 89 patients (63%). The ingested amount of polyunsaturated fatty acids was higher in patients with heartburn (11.2 ± 6.4 vs. 7.7 ± 3.5 mg; P = 0.022) than in controls after adjusting for age, gain weight during pregnancy, ingestion of caffeine and vitamin C, and total energetic intake. The ingestion of monounsaturated fatty acids was higher in patients with heartburn, but with a borderline statistical significance (16.1 ± 11 vs. 11.8 ± 6.5 mg; P = 0.061). No association was observed between the consumption of fats and regurgitation.

Conclusions

This study suggests that heartburn in the third trimester of pregnancy is associated with the ingestion of polyunsaturated fatty acids.

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References

  1. 1.

    Dowswell T, Neilson JP. Interventions for heartburn in pregnancy. Cochrane Database Syst Rev. 2008;(4):CD007065.

  2. 2.

    Knudsen A, Lebech M, Hansen M. Upper gastrointestinal symptoms in the third trimester of the normal pregnancy. Eur J Obstet Gynecol Reprod Biol. 1995;60:29–33.

    Article  CAS  PubMed  Google Scholar 

  3. 3.

    Marrero JM, Goggin PM, de Caestecker JS, Pearce JM, Maxwell JD. Determinants of pregnancy heartburn. Br J Obstet Gynaecol. 1992;99:731–734.

    CAS  PubMed  Google Scholar 

  4. 4.

    Al-Amri SM. Twenty-four hour pH monitoring during pregnancy and at postpartum: a preliminary study. Eur J Obstet Gynecol Reprod Biol. 2002;102:127–130.

    PubMed  Google Scholar 

  5. 5.

    Ali RA, Egan LJ. Gastroesophageal reflux disease in pregnancy. Best Pract Res Clin Gastroenterol. 2007;21:793–806.

    Article  PubMed  Google Scholar 

  6. 6.

    Bainbridge ET, Nicholas SD, Newton JR, Temple JG. Gastro-oesophageal reflux in pregnancy. Altered function of the barrier to reflux in asymptomatic women during early pregnancy. Scand J Gastroenterol. 1984;19:85–89.

    CAS  PubMed  Google Scholar 

  7. 7.

    Baron TH, Richter JE. Gastroesophageal reflux disease in pregnancy. Gastroenterol Clin North Am. 1992;21:777–791.

    CAS  PubMed  Google Scholar 

  8. 8.

    Fisher RS, Roberts GS, Grabowski CJ, Cohen S. Inhibition of lower esophageal sphincter circular muscle by female sex hormones. Am J Physiol. 1978;234:E243–E247.

    CAS  PubMed  Google Scholar 

  9. 9.

    Hey VM, Cowley DJ, Ganguli PC, Skinner LD, Ostick DG, Sharp DS. Gastro-oesophageal reflux in late pregnancy. Anaesthesia. 1977;32:372–377.

    Article  CAS  PubMed  Google Scholar 

  10. 10.

    Van Thiel DH, Gavaler JS, Joshi SN, Sara RK, Stremple J. Heartburn of pregnancy. Gastroenterology. 1977;72:666–668.

    PubMed  Google Scholar 

  11. 11.

    Lind JF, Smith AM, McIver DK, Coopland AT, Crispin JS. Heartburn in pregnancy—a manometric study. Can Med Assoc J. 1968;98:571–574.

    CAS  PubMed  Google Scholar 

  12. 12.

    Richter JE. Review article: the management of heartburn in pregnancy. Aliment Pharmacol Ther. 2005;22:749–757.

    Article  CAS  PubMed  Google Scholar 

  13. 13.

    Lewis JH, Weingold AB. The use of gastrointestinal drugs during pregnancy and lactation. Am J Gastroenterol. 1985;80:912–923.

    CAS  PubMed  Google Scholar 

  14. 14.

    Suzuki S, Dennerstein L, Greenwood KM, Armstrong SM, Satohisa E. Sleeping patterns during pregnancy in Japanese women. J Psychosom Obstet Gynaecol. 1994;15:19–26.

    Article  CAS  PubMed  Google Scholar 

  15. 15.

    Bor S, Kitapcioglu G, Dettmar P, Baxter T. Association of heartburn during pregnancy with the risk of gastroesophageal reflux disease. Clin Gastroenterol Hepatol. 2007;5:1035–1039.

    Article  PubMed  Google Scholar 

  16. 16.

    Meyer LC, Peacock JL, Bland JM, Anderson HR. Symptoms and health problems in pregnancy: their association with social factors, smoking, alcohol, caffeine and attitude to pregnancy. Paediatr Perinat Epidemiol. 1994;8:145–155.

    Article  CAS  PubMed  Google Scholar 

  17. 17.

    Holloway RH, Lyrenas E, Ireland A, Dent J. Effect of intraduodenal fat on lower oesophageal sphincter function and gastro-oesophageal reflux. Gut. 1997;40:449–453.

    CAS  PubMed  Google Scholar 

  18. 18.

    Fox M, Barr C, Nolan S, Lomer M, Anggiansah A, Wong T. The effects of dietary fat and calorie density on esophageal acid exposure and reflux symptoms. Clin Gastroenterol Hepatol. 2007;5:439–444.

    Article  PubMed  Google Scholar 

  19. 19.

    Meyer JH, Lembo A, Elashoff JD, Fass R, Mayer EA. Duodenal fat intensifies the perception of heartburn. Gut. 2001;49:624–628.

    Article  CAS  PubMed  Google Scholar 

  20. 20.

    Shapiro M, Green C, Bautista JM, et al. Assessment of dietary nutrients that influence perception of intra-oesophageal acid reflux events in patients with gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2007;25:93–101.

    CAS  PubMed  Google Scholar 

  21. 21.

    El-Serag HB, Satia JA, Rabeneck L. Dietary intake and the risk of gastro-oesophageal reflux disease: a cross sectional study in volunteers. Gut. 2005;54:11–17.

    Article  CAS  PubMed  Google Scholar 

  22. 22.

    Centro de Informática em Saúde da Escola Paulista de Medicina. Nutrition Support Program [Computer Program]. Version 2.5 DOS. São Paulo: Escola Paulista de Medicina; 2001.

    Google Scholar 

  23. 23.

    Revicki DA, Wood M, Maton PN, Sorensen S. The impact of gastroesophageal reflux disease on health-related quality of life. Am J Med. 1998;104:252–258.

    Article  CAS  PubMed  Google Scholar 

  24. 24.

    Block G, Woods M, Potosky A, Clifford C. Validation of a self-administered diet history questionnaire using multiple diet records. J Clin Epidemiol. 1990;43:1327–1335.

    Article  CAS  PubMed  Google Scholar 

  25. 25.

    Faggiano F, Vineis P, Cravanzola D, et al Validation of a method for the estimation of food portion size. Epidemiology. 1992;3:379–382.

    Article  CAS  PubMed  Google Scholar 

  26. 26.

    Nebel OT, Castell DO. Lower esophageal sphincter pressure changes after food ingestion. Gastroenterology. 1972;63:778–783.

    CAS  PubMed  Google Scholar 

  27. 27.

    Nebel OT, Castell DO. Inhibition of the lower oesophageal sphincter by fat—a mechanism for fatty food intolerance. Gut. 1973;14:270–274.

    Article  CAS  PubMed  Google Scholar 

  28. 28.

    Melone J. Vagal receptors sensitive to lipids in the small intestine of the cat. J Auton Nerv Syst. 1986;17:231–241.

    Article  CAS  PubMed  Google Scholar 

  29. 29.

    Sifrim D, Mittal R, Fass R, et al Review article: acidity and volume of the refluxate in the genesis of gastro-oesophageal reflux disease symptoms. Aliment Pharmacol Ther. 2007;25:1003–1017.

    CAS  PubMed  Article  Google Scholar 

  30. 30.

    Spence AA, Moir DD, Finlay WE. Observations on intragastric pressure. Anaesthesia. 1967;22:249–256.

    Article  CAS  PubMed  Google Scholar 

  31. 31.

    Van Thiel DH, Wald A. Evidence refuting a role for increased abdominal pressure in the pathogenesis of the heartburn associated with pregnancy. Am J Obstet Gynecol. 1981;140:420–422.

    PubMed  Google Scholar 

  32. 32.

    Broussard CN, Richter JE. Treating gastro-oesophageal reflux disease during pregnancy and lactation: what are the safest therapy options? Drug Saf. 1998;19:325–337.

    Article  CAS  PubMed  Google Scholar 

  33. 33.

    Schulze K, Christensen J. Lower sphincter of the opossum esophagus in pseudopregnancy. Gastroenterology. 1977;73:1082–1085.

    CAS  PubMed  Google Scholar 

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Acknowledgments

This study was supported by grants from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), and Fundo de Incentivo à Pesquisa e Eventos (FIPE)/Hospital de Clínicas de Porto Alegre, Brazil.

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Correspondence to Fernando Fornari.

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Dall’Alba, V., Fornari, F., Krahe, C. et al. Heartburn and Regurgitation in Pregnancy: The Effect of Fat Ingestion. Dig Dis Sci 55, 1610–1614 (2010). https://doi.org/10.1007/s10620-009-0932-z

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Keywords

  • Dietary fats
  • Fatty acids
  • Gastroesophageal reflux disease
  • Heartburn
  • Pregnancy