Effect of alginate in patients with GERD hiatal hernia matters

Abstract

Alginate-based formulations are frequently used as add-on proton pump inhibitor (PPI) therapy to help control of heartburn and regurgitation. There are limited data regarding the mechanisms and effects of alginate-based formulations. We aimed to evaluate the effects of the sodium alginate intake and its likely temporal relations on intraesophageal reflux events by MII-pH in patients with and without hiatal hernia (HH). Fifty GERD patients (18 with HH, 32 without HH) with heartburn or regurgitation once a week or more common were included. After combined multichannel intraluminal impedance and pH-metry (MII-pH) had been performed, all patients were asked to eat the same standard meal (double cheeseburger, 1 banana, 100 g regular yoghurt, and 200 mL water with total energy value of 744 kcal: 37.6% of carbohydrates, 21.2% of proteins, and 41.2% of lipids) during two consecutive days. On separate random two consecutive days, all patients took 10 mL of sodium alginate (GA; Gaviscon Advance; Reckitt Benckiser Healthcare, Hull, UK) or 10 mL of water, 30 minutes after the refluxogenic meal. After eating refluxogenic meal, patients were examined ½ hour for basal conditions, 1 hour in upright, and 1 hour in supine positions. Alginate significantly decreased acid reflux after intake at the first hour in comparison to water in patients with HH (6.1 vs. 13.7, P = 0.004) and without HH (3.5 vs. 5.5, P = 0.001). Weakly acid reflux were increased at the first hour in patients with HH (3.4 vs. 1.3, P = 0.019) and without HH (1.7 vs. 5, P = 0.02) compared to water. There was no distinctive effect of alginate on the height of proximal migration of reflux events in patients with HH and without HH. Alginate decreases acid reflux events within a limited time period, especially at the first hour both in patients with and without HH. Alginate has no effect on the height of reflux events along the esophagus both in patients with and without HH.

A Breathtaking Hernia: A Giant Hiatal Hernia Masquerading as Poorly Controlled Asthma

“…Proton pump inhibitor therapy will be effective in reducing any events of microaspiration from underlying gastroesophageal reflux from the underlying hiatal hernia. Additionally, arginate-based-suspensions as an adjunct to proton pump inhibitor therapy is frequently performed and has been shown to decrease acid reflux events within the first hour of administration [ 9 ]. This is presumed beneficial for our patient whose major trigger for wheezing was meal consumption.…”

Randomised clinical trial: the use of alginates during preinvestigation proton pump inhibitor wash-out and their impact on compliance and symptom burden

“…Reducing this difficulty would improve the patient experience before testing. Alginate preparations, such as Gaviscon Advance (Reckitt Benckiser, Slough, UK) may help achieve this given their raft-forming properties11 and topical protectant effects,12 13 which reduce reflux symptoms 14 15. Furthermore, alginate and antacid use does not reduce the sensitivity or specificity of Helicobacter pylori testing or gastroscopy 16.…”

Full mouth rehabilitation of a patients with gastro-oesophagealal reflux disease - A case report

“…Complications of GERD are regurgitation, chest pain, esophagitis, Barrett's esophagus, oesophageal Adenocarcinoma, cough, asthma, and dental erosion (Natali et al, 2017;Takeuchi et al, 2018). In adults, GERD is a highly prevalent disease (25%), which causes dental erosion (Vardar et al, 2017). The degree of erosion depends upon the duration of the disease, and the frequency of re lux and quantity of content re luxed (Souza et al, 2017).…”

“…While making a diagnosis of dental erosion, which is de ined as 'chemical loss of tooth structure without bacterial involvement,' it is imperative that we irst ascertain the type of erosion. Based on the source of the acid, dental erosion is differentiated into extrinsic (dietary acids) and intrinsic (acid from gastric contents in patients with bulimia or GERD) (Vardar et al, 2017). The critical ph value of enamel when it begins to dissolve is around 5.2 (Kumar et al, 2015).…”