Deraman, Mohd Adli
(2017)
An open-label antacid-controlled randomized trial on effectiveness of alginate-antacid preparation (Gaviscon®) in suppression of post-supper acid-pocket, night-time acid-reflux and symptoms in asymptomic obese participants.
Masters thesis, Universiti Sains Malaysia.
Abstract
Gastroesophageal reflux disease [GERD] with symptoms of heartburn and acid regurgitation are a common disorder in Asian population especially in overweight and obese persons. Acid pocket in the proximal part of stomach after meals has been shown to be an important mechanism of GERD.The acid pocket is increasingly recognized as a source from which acid reflux events originate. The presence of this gastric acid pocket has become an attractive therapeutic target. Proton pump inhibitors have been shown to reduce acidity of the acid pocket however alginate antacid formulation is inconsistent effects have been reported. The alginate-antacid formulations are used for the symptomatic treatment of GERD and appear to act by a unique mechanism which differs from other groups traditional antacids.
METHODOLOGY
A randomized open-label study with antacid-control performed over 48 hours by continuous pH impedance and bravo capsule monitoring. Eighteen asymptomatic obese patients were separated into either alginate antacid group and non alginate antacid group [simple antacid] were studied for 48 hours using the ambulatory wireless capsule and pH impedance. Participants took either alginate antacid [Gaviscon Advance (GA), Reckitt Benckiser, UK] or non alginate antacid [Magnesium Trisilicate (MMT) ] which had equivalent strengh of antacid after taken late night standardised meals.
OBJECTIVES
To determine post prandial suppression of the acid pocket, night time reflux and symptoms by an alginate antacid [Gaviscon Advance (GA), Reckitt Benckiser, UK] preparation compared with a non- alginate antacid preparation using ambulatory wireless capsule pH-metry and pH impedance in obese participants who took late night supper.
RESULTS
A significant difference in median pH at gastric cardia was seen with alginate antacid compared to non alginate antacid with a median difference of -2.67 (P value 0.008). Median number and duration of refluxes were also lower after alginate antacid vs. without antacid with a median difference of -2.21 (all P values < 0.05), however there were no changes in pH refluxate at 5 cm above lower esophageal sphincter (LES) .There were no differences in reflux parameters (number and duration of acid refluxes) with vs. without non alginate antacids (all P values > 0.05).
CONCLUSIONS
Compared to non-alginate antacid, alginate antacid formulation significantly suppresses acid pocket at the gastric cardia and reduces the number and duration of refluxate after late night supper although the pH at 5 cm above LES did not change.This is because the principal mechanism of alginate antacid is to displace and neutralise post-prandial acid pocket, rather than containing the reflux as previously reported.
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