Acid reflux and its associated symptoms occur most frequently following the ingestion of a meal. This observation presented a dilemma as intragastric pH is at its least acidic following eating due to the buffering effect of the food. However, the observation by Fletcher et al that the proximal cardia region of the stomach escapes the buffering effect of the meal provided a rational explanation for the acidic nature of the postprandial refluxate.1 The zone of high acidity detected in the proximal stomach after a meal has been termed the acid pocket.
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