Colonic fermentation of carbohydrates influences gastric and esophageal motility in healthy subjects.
In this study, researchers investigated the effects of colonic fermentation induced by oral administration of fructooligosaccharides (FOS) in patients with gastroesophageal reflux disease (GERD).
Their findings are published in the April issue of Gastroenterology.
|Fructooligosaccharides increased the number of transient lower esophageal sphincter relaxations and reflux episodes.|
The research team performed a cross-over study, and included 9 patients with symptomatic GERD.
Patients were administered a low-residue diet (10 g fiber/day) for 2 separate 7-day periods. Each period was separated by a wash out of at least 3 weeks. In addition, patients received either 6.6 g of FOS or placebo 3 times daily after meals.
On day 7, the team recorded esophageal motility and pH in both fasting conditions and after a test meal containing the FOS or placebo.
They also monitored breath hydrogen concentrations and plasma concentrations of glucagon-like peptide 1 (GLP-1), peptide YY, and cholecystokinin.
The team found that, compared to placebo, FOS increased the number of transient lower esophageal sphincter relaxations and reflux episodes, esophageal acid exposure and the symptom score for GERD.
The integrated plasma response of GLP-1 was significantly higher after FOS than after placebo.
Dr Thierry Piche's team concluded, "Colonic fermentation of indigestible carbohydrates increases the rate of transient lower esophageal sphincter relaxations, the number of acid reflux episodes, and the symptoms of GERD".
"Although different mechanisms are likely to be involved, excess release of GLP-1 may account, at least in part, for these effects".