Introduction
Over time, I have received a number of emails from patients regarding the best type of Gaviscon Advance they should purchase for relief of NON-acidic laryngopharyngeal reflux (LPR). The blunt answer is to get the Gaviscon Advance Suspension/Liquid made by Reckitt Benckiser which contains at least 500mg of sodium alginate in 5ml dose (1 tsp) or 1 gram in 10cc dose (2 tsps). This formula of Gaviscon Advance cannot be purchased in the United States, but instead overseas via online pharmacies located in the United Kingdom (link). Occasionally, Amazon.com does stock it.
The Gaviscon (without the "advance") sold in the United States is manufactured and distributed by GlaxoSmithKline (GSK) and not Reckitt Benckiser. The US brand of Gaviscon by GSK contains less of the key ingredient sodium alginate which helps with NON-acidic reflux. Alginate is a natural product derived from seaweed. The alginate reacts with the acid in the stomach to produce a "raft" barrier that acts as a physical block to reflux. It is the only non-surgical treatment that can physically prevent reflux disease regardless of whether it is acidic or not. Alginates work rapidly, are long lasting, inexpensive, and have no known side-effects.
Sodium Alginate
But because Gaviscon Advance is so hard to obtain in the United States, one of my patients suggested why not take just the sodium alginate and forget about the gaviscon? After all, it's the sodium alginate that's the key ingredient that is thought to help.
Great idea!
Even better is the fact that sodium alginate is easier to find and obtain.
If possible, I would stick to roughly the same amount of sodium alginate that would be ingested if Gaviscon Advance itself was taken:
500mg to 1000mg of sodium alginate after every meal and at bedtime.
Here's one product I found on Amazon.com.
DISCLAIMER!!! Please be aware that I can NOT vouch for overall effectiveness given these "supplements" have NOT been scientifically tested for clinical effectiveness nor is regulated by the FDA even though the same active ingredient sodium alginate is present. Use at your own risk!!!
References:
An evaluation of the antireflux properties of sodium alginate by means of combined multichannel intraluminal impedance and pH-metry. Aliment Pharmacol Ther. 2005 Jan 1;21(1):29-34
The value of a liquid alginate suspension (Gaviscon Advance) in the management of laryngopharyngeal reflux. Eur Arch Otorhinolaryngol. 2009 Feb;266(2):243-51. Epub 2008 May 28.
The role of an alginate suspension on pepsin and bile acids - key aggressors in the gastric refluxate. Does this have implications for the treatment of gastro-oesophageal reflux disease? J Pharm Pharmacol. 2009 Aug;61(8):1021-8.
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