Antacid & Alginate is more effective than antacid in controlling post-prandial oesophageal acid exposure in GERD patients
Heartburn is a cardinal symptom of gastro-oesophageal reflux disease (GERD) and is among the most common patient complaints encountered by physicians.
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This study compared the effect of Antacid & Alginate Liquid to an antacid in controlling post-prandial acid reflux in GERD patients.
The current investigation demonstration that the effect of an alginate–antacid combination was above and beyond that of antacid after the first 30 min and persisted for at least 2.5 h after the meal.
Antacids neutralize gastric acid in a short time frame after ingestion but the effect is soon overcome by meal-stimulated acid secretion. An alginate-antacid combination creates a ‘raft’ floating on top of the ingested chyme that co-localises in the region of the acid pocket, potentially offering more effective targeted therapy.
Authors found that Antacid & Alginate decreased post-prandial acid exposure in the distal oesophagus. Antacid & Alginate did not, however, decrease the number of reflux events or the proximal extent of reflux within the oesophagus.
Antacid & Alginate effectively relief Heartburn than Antacid
A Double Action Antacid & Alginate Liquid was more effective than an Antacid in controlling postprandial esophageal acid exposure in GERD patients.
This suggests that this main effectiveness related to its co-localization with and displacement/neutralization of the post-prandial acid pocket, rather than preventing reflux.
Many reflux patients remain symptomatic on a standard dose of proton pump inhibitor (PPI). In some patients, especially those with nonerosive reflux disease or atypical GERD symptoms, acid-suppressive therapy with PPIs is not as successful.
In patients with residual reflux symptoms despite PPI treatment, adding an alginate plus antacid offers additional decrease in the burden of reflux symptoms.
This combination of Antacid plus Alignate is used to relieve the symptoms of gastro-oesophageal reflux, such as heartburn and acid regurgitation.
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Background
Recent studies have shown that Antacid & Alginate Double Action Liquid (a combination alginate-antacid) administered post-prandially co-localises with the acid pocket, the ‘reservoir’ for post-prandial acid reflux.
Aim
To compare the effectiveness of Antacid & Alginate Double Action Liquid to an equivalent strength antacid without alginate in controlling post-prandial acid reflux in GERD patients.
Methods
Fourteen GERD patients undertook two 3.5-h high-resolution manometry/pH-impedance studies during which they ate a standardised meal. In a double-blinded randomised crossover design they then took Gaviscon or CVS brand antacid, each with ~18 mmol/L acid neutralising capacity. The primary outcome was distal oesophageal acid exposure; secondary outcomes were number of reflux events, proximal extent of reflux, nadir pH of the refluxate, mechanism of reflux and reflux symptoms scored with a validated instrument.
Results
Ten patients completed the study. Antacid & Alginate studies had significantly less distal oesophageal acid exposure and greater nadir refluxate pH in the 30–150 min post-prandial period than antacid studies. There were no differences in the number of reflux events (acid or weakly acidic) or the number of proximal reflux events (15–17 cm above the LES) with either study medication.
Conclusions
Antacid & Alginate Double Action Liquid is more effective than an antacid without alginate in controlling post-prandial oesophageal acid exposure. However, the number and spatial distribution of reflux events within the oesophagus are similar. This suggests that Antacid & Alginate main effectiveness relates to its co-localisation with and displacement/neutralisation of the post-prandial acid pocket, rather than preventing reflux.
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