An Alginate-Antacid Formulation Localizes to the Acid Pocket to Reduce Acid Reflux in Patients With Gastroesophageal Reflux Disease

Rohof, Wout O.; Bennink, Roel J.; Smout, A. J. P. M.; Thomas, E; Boeckxstaens, Guy E.

doi:10.1016/j.cgh.2013.04.046

Cited by 102 publications

(77 citation statements)

References 25 publications

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“…In a small study conducted on a group of patients with symptomatic GORD with large hiatal hernias using scintigraphy, manometry and pH–impedance monitoring, it was demonstrated that alginate-antacid raft localised the postprandial acid pocket and displaced it below the diaphragm, reducing postprandial acid reflux 105. A RCT showed that adding sodium alginate to PPI resulted in a significantly greater rate of complete resolution of heartburn in patients with NERD 106…”

Section: Resultsmentioning

confidence: 99%

Asia-Pacific consensus on the management of gastro-oesophageal reflux disease: an update focusing on refractory reflux disease and Barrett's oesophagus

Fock

Talley

Goh

et al. 2016

Gut

153

214

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Section: Resultsmentioning

confidence: 99%

Asia-Pacific consensus on the management of gastro-oesophageal reflux disease: an update focusing on refractory reflux disease and Barrett's oesophagus

Fock

Talley

Goh

et al. 2016

Gut

153

214

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“…Histamine 2 receptor antagonists, antacids, and alginate-antacid combinations can reduce postprandial exposure of the esophagus to acid 26 and thus decrease the symptoms of GERD. 22 These treatments might be utilized in an on-demand fashion by patients with moderate symptoms or as add-on treatment if symptoms occur despite PPI treatment.…”

Section: Medical Approachmentioning

confidence: 99%

The diagnosis and management of hiatus hernia

Roman

Kahrilas

2014

BMJ

144

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“…An alginate gastric raft may be able to reduce the number of acid reflux episodes (4,8,19), with this property being considered as due to the viscous barrier surface tension reducing reflux through the gastroesophageal junction. However, recent evidence suggests that the ability of the alginate raft to reduce the number of reflux episodes may be limited (6).…”

mentioning

confidence: 99%

Topical protection of human esophageal mucosal integrity

Woodland

Batista‐Lima

Lee

et al. 2015

American Journal of Physiology-Gastrointestinal and Liver Physi

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Patients with nonerosive reflux disease exhibit impaired esophageal mucosal integrity, which may underlie enhanced reflux perception. In vitro topical application of an alginate solution can protect mucosal biopsies against acid-induced changes in transepithelial electrical resistance (TER). We aimed to confirm this finding in a second model using 3D cell cultures and to assess prolonged protection in a biopsy model. We assessed the protective effect of a topically applied alginate solution 1 h after application. 3D cell cultures were grown by using an air-liquid interface and were studied in Ussing chambers. The apical surface was "protected" with 200 μl of either alginate or viscous control or was unprotected. The tissue was exposed to pH 3 + bile acid solution for 30 min and TER change was calculated. Distal esophageal mucosal biopsies were taken from 12 patients and studied in Ussing chambers. The biopsies were coated with either alginate or viscous control solution. The biopsies were then bathed in pH 7.4 solution for 1 h. The luminal chamber solution was replaced with pH 2 solution for 30 min. Percentage changes in TER were recorded. In five biopsies fluorescein-labeled alginate solution was used to allow immunohistological localization of the alginate after 1 h. In the cell culture model, alginate solution protected tissue against acid-induced change in TER. In biopsies, 60 min after protection with alginate solution, the acidic exposure caused a -8.3 ± 2.2% change in TER compared with -25.1 ± 4.5% change after protection with the viscous control (P < 0.05). Labeled alginate could be seen coating the luminal surface in all cases. In vitro, alginate solutions can adhere to the esophageal mucosa for up to 1 h and exert a topical protectant effect. Durable topical protectants can be further explored as first-line/add-on therapies for gastroesophageal reflux disease.

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An Alginate-Antacid Formulation Localizes to the Acid Pocket to Reduce Acid Reflux in Patients With Gastroesophageal Reflux Disease

Cited by 102 publications

References 25 publications

Asia-Pacific consensus on the management of gastro-oesophageal reflux disease: an update focusing on refractory reflux disease and Barrett's oesophagus

Asia-Pacific consensus on the management of gastro-oesophageal reflux disease: an update focusing on refractory reflux disease and Barrett's oesophagus

The diagnosis and management of hiatus hernia

Topical protection of human esophageal mucosal integrity

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