The Efficacy of a Structured Alginate Regime Prior to

Reflux Testing

Study objective

Patients undergoing diagnostic testing for gastro-oesophageal reflux disease (GORD) are typically required to stop proton pump inhibitors (PPIs) beforehand. This often leads to symptom exacerbation, poor compliance, and inaccurate test results. The study aimed to assess whether structured use of alginates (specifically Gaviscon Advance) during the PPI wash-out period could reduce symptom burden and improve adherence.

How does it address a real-world gut health problem?

PPI withdrawal is challenging for many patients, with some experiencing rebound symptoms severe enough to resume medication prematurely. This compromises the accuracy of diagnostic tests like pH monitoring and gastroscopy. Alginates, which act as a physical barrier to reflux without affecting acid production, may offer a non-pharmaceutical solution to support patients during this critical period.

Study design

Type of trial: Single-centre, randomised, open-label clinical trial

Sample size and population: 60 adult patients referred for reflux testing, all on ≥4 weeks of PPI therapy

Duration and intervention:

  • 1-week PPI and H2RA wash-out period

  • Control Group: Standard pre-test instructions with no structured guidance on alginates

  • Treatment group: Same instructions plus Gaviscon Advance (10 mL, four times daily)

Endpoints

Primary outcome:

Change in Gastro-Oesophageal Reflux Disease Health-Related Quality of Life (GERD-HRQL) score

Secondary outcomes:

  • Gastrointestinal Symptom Rating Scale (GSRS)

  • Mean Nocturnal Baseline Impedance (MNBI) from 24-hour pH/impedance testing

  • Self-reported compliance (e.g., surreptitious PPI/H2RA use)

Results

  • Control group experienced a significant increase in GERD-HRQL scores

  • Treatment group showed no significant change

Commercial relevance

How the findings support product claims:

This study supports the proactive use of alginates like Gaviscon Advance to manage reflux symptoms during PPI cessation. It demonstrates that structured alginate use can maintain symptom control, improve compliance, and potentially enhance diagnostic accuracy. These findings are particularly relevant for patients undergoing reflux studies, H. pylori testing, or gastroscopy.

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