Fat and gastro-oesophageal reflux disease

It is common practice to prescribe avoidance of fatty foods to patients with gastro-oesophageal reflux disease; however, there is no good evidence supporting the benefit of such a prescription. Several reports looking at gastro-oesophageal reflux after meals of different fat content have been controversial probably because of differences in caloric load, volume and osmolarity, factors which may independently influence reflux. Recent observations suggest that fatty meals do not promote gastro-oesophageal reflux nor alter the competence of the oesophagogastric junction in comparison to balanced meals, provided they contain the same energy load. The possibility that fat increases heartburn by modulating perception of acid reflux seems to have little relevance. It is concluded that, in the light of present evidence, there is no sound rationale for clinicians recommending that patients with GORD follow a low-fat diet.