Q: I suffer — and I do mean suffer – from GERD. I have tried to modify my diet and while I like to have a beer or two after work, I have even switched to a gluten-free product in an attempt to ease the side effects of my condition. Is there anything on the market that might block my acid reflux and prevent what’s going on in my esophagus?
A: GERD (gastroesophageal reflux disease) affects some 60 million people in our country. Many individuals attempt to relieve their pain and suffering by taking proton pump inhibitors such as Prevacid and Prilosec, raising the head of the bed with blocks, eating smaller meals, and avoiding specific triggers such as beer and foods. While both products do suppress the formation of stomach acid, they do not block the backwash of stomach contents, bile and foods high in acid into the lining of the esophagus. These steps may be followed by antacids and H2 blockers such as cimetidine. Raft-forming alginates protect a person’s esophagus by producing a temporary physical barrier designed to block the contents of the stomach from backing up into the esophagus. As the alginate mixture expands in the stomach, it is designed to clear excess acid, while forming a p-H neutral barrier intended to lessen episodes of reflux.
Alginic acid, one component of the mixture, is a dry powder that contains carbohydrate molecules derived from brown seaweed. When it comes into contact with liquid and acid in the stomach, it forms a thick gel substance. Then when potassium bicarbonate, another component of the mixture, comes into contact with gastric acids, it produces carbon dioxide bubbles that become trapped in the gel. The expanding bubbles virtually sit on top of the stomach’s contents and prevent the backwash. Two additional ingredients, specifically magnesium carbonate and calcium carbonate, react with the soft foam and literally form a temporary, firm raft. Studies reveal that in individuals who suffer from acid reflux, the raft slides up into the lower esophagus, creating a barrier. The complete raft-forming process takes less than one minute, yet the raft can remain in the stomach for up to four hours until it is broken up and passed out of the body.
Studies reveal that alginate preparations appear very effective in reducing both the intensity and frequency of reflux attacks. Another study found vast improvement in heartburn symptoms in patients treated four times each day with 200 mg of cimetidine (Tagamet) plus 500mg of alginate than in patients treated four times each day with 400 mg of cimetidine alone. And, the healing rate and improved appearance of damaged esophagus were similar between the two groups. Other studies have revealed a marked reduction in symptom severity scores with alginates as compared to cisapride, a medication for reflux and with omeprazole (Prilosec), a commonly used oral acid blocker.
Gastrointestinal reflux is a major source of pain, suffering and reduced quality of life. The incidence of esophageal cancer has been rising and, although the cause for the rise remains unknown, gastroesophageal reflux is one of the risk factors that has been identified with one type of esophageal cancer. Raft-forming alginate creates a physical barrier “raft” that is intended to block reflux from occurring, thus protecting esophageal tissue from corrosive stomach contents. These cancers are most common in Caucasian males over the age of 50, in the obese, in smokers, and particularly in individuals with frequent symptoms of gastroesophageal reflux disease. In fact, studies reveal that individuals with recurrent symptoms of reflux have a higher risk of esophageal cancer, while those with severe, long-standing symptoms are at a 43.5 fold risk of the disease.
Speak with your gastroenterologist to determine if a “barrier” method might be right for you.
