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Gaviscon Double Action Liquid (antacid & alginate) is more effective than antacid in controlling post‐prandial oesophageal acid exposure in GERD patients: a double‐blind crossover study
Author(s) -
De Ruigh A.,
Roman S.,
Chen J.,
Pandolfino J. E.,
Kahrilas P. J.
Publication year - 2014
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.12857
Subject(s) - antacid , reflux , medicine , gerd , crossover study , gastroenterology , postprandial , placebo , disease , alternative medicine , pathology , insulin
Summary Background Recent studies have shown that Gaviscon 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 Gaviscon 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. Gaviscon 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 Gaviscon 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 Gaviscon main effectiveness relates to its co‐localisation with and displacement/neutralisation of the post‐prandial acid pocket, rather than preventing reflux.