• A De Ruigh, S Roman, J Chen, J E Pandolfino, and P J Kahrilas.
• Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Department of Gastroenterology, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
• Aliment. Pharmacol. Ther. 2014 Sep 1; 40 (5): 531-7.

BackgroundRecent 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.AimTo compare the effectiveness of Gaviscon Double Action Liquid to an equivalent strength antacid without alginate in controlling post-prandial acid reflux in GERD patients.MethodsFourteen 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.ResultsTen 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.ConclusionsGaviscon 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.© 2014 John Wiley & Sons Ltd.

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