Expert consensus on the multifaceted utility of alginates in addressing diverse manifestations of acid reflux

• Published in: International Journal of Advances in Medicine
• Main Author: Palaniswamy, K. R.
• Format: Journal Article
• Language: English
• Published: 16.11.2024
• ISSN: 2349-3925; 2349-3933
• DOI: 10.18203/2349-3933.ijam20243441

Gastroesophageal reflux disease (GERD) is one of the most frequent reasons for seeking outpatient gastroenterology consultations. Current professional guidelines advocate the use of proton pump inhibitors (PPIs) as the primary medical approach to manage GERD. However, PPIs may not be as effective, especially for certain patients like those with non-erosive reflux disease (NERD). An alternative strategy for addressing symptomatic GERD involves obstructing the flow of acidic refluxate. Alginate-based pharmaceutical formulations have proven effective in alleviating symptoms of acid reflux for many years and provide rapid relief of symptoms with a long duration of action. Alginic acid derivatives, or alginates, combat acid reflux through a unique mechanism: they create a physical barrier that displaces the post-prandial acid pocket. Alginates have recently garnered renewed interest for promoting symptomatic relief especially when employed alongside antacids or PPIs. Here, the role of alginates is reviewed in the treatment of various profiles of acid reflux, including post-prandial acid reflux, nocturnal GERD, refractory GERD, and GERD during pregnancy, along with the opinion of expert gastroenterologists on the same. The experts believed that not all alginate formulations are equivalent and raft strength is the most important physicochemical property to be considered while selecting the alginate-based product. The physicochemical properties of the rafts eventually impact their effectiveness in relieving symptoms in clinical settings.