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Backgroundâ€‚ Recently, an 'acid pocket' has been described in the proximal stomach, particularly evident postprandially in GERD patients, when heartburn is common. By creating a low density gel 'raft' that floats on top of gastric contents, alginate-antacid formulations may neutralise the 'acid pocket'. Aimâ€‚ To assess the ability of a commercial high-concentration alginate-antacid formulation to neutralize and/or displace the acid pocket in GERD patients Methodsâ€‚ The 'acid pocket' was studied in ten symptomatic GERD patients. Measurements were made using concurrent stepwise pH pull-throughs, high resolution manometry and fluoroscopy in a semi-recumbent posture. Each subject was studied in three conditions: fasted, 20â€ƒmin after consuming a high-fat meal and 20â€ƒmin later after a 20â€ƒmL oral dose of an alginate-antacid formulation (Gaviscon Double Action Liquid, Reckitt Benckiser Healthcare, Hull, UK). The relative position of pH transition points (pH >4) to the EGJ high-pressure zone was analysed. Resultsâ€‚ Most patients (8/10) exhibited an acidified segment extending from the proximal stomach into the EGJ when fasted that persisted postprandially. Gaviscon neutralised the acidified segment in six of the eight subjects shifting the pH transition point significantly away from the EGJ. The length and pressure of the EGJ high-pressure zone were minimally affected. Conclusionsâ€‚ Gaviscon can eliminate or displace the 'acid pocket' in GERD patients. Considering that EGJ length was unchanged throughout, this effect was likely attributable to the alginate 'raft' displacing gastric contents away from the EGJ. These findings suggest the alginate-antacid formulation to be an appropriately targeted postprandial GERD therapy.
Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
This article was published in the following journal.
Name: Alimentary pharmacology & therapeutics
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Guideline for determining when it is morally permissible to perform an action to pursue a good end with knowledge that the action will also bring about bad results. It generally states that, in cases where a contemplated action has such double effect, the action is permissible only if: it is not wrong in itself; the bad result is not intended; the good result is not a direct causal result of the bad result; and the good result is "proportionate to" the bad result. (from Solomon, "Double Effect," in Becker, The Encyclopedia of Ethics, 1992)
The action by which the surface of a liquid where it contacts a solid is elevated or depressed, because of the relative attraction of the molecules of the liquid for each other and for those of the solid. (McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed)
Selective grinding of occlusal surfaces of the teeth in an effort to eliminate premature contacts and occlusal interferences; to establish optimal masticatory effectiveness, stable occlusal relationships, direction of main occlusal forces, and efficient multidirectional patterns, to improve functional relations and to induce physiologic stimulation of the masticatory system; to eliminate occlusal trauma; to eliminate abnormal muscle tension; to aid in the stabilization of orthodontic results; to treat periodontal and temporomandibular joint problems; and in restorative procedures. (From Jablonski, Dictionary of Dentistry, 1992)
A method of separation of two or more substances by repeated distribution between two immiscible liquid phases that move past each other in opposite directions. It is a form of liquid-liquid chromatography. (Stedman, 25th ed)
An inorganic compound that occurs in nature as the mineral brucite. It acts as an antacid with cathartic effects.
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