Randomised clinical trial: the effectiveness of Gaviscon Advance vs non‐alginate antacid in suppression of acid pocket and post‐prandial reflux in obese individuals after late‐night supper

Abstract

Background Late‐night supper increases the risk of postprandial reflux from the acid pocket especially in obesity. An alginate‐based, raft‐forming medication may be useful for obese patients with GERD. Aims To compare the efficacy of Gaviscon Advance (Reckitt Benckiser, UK) and a non‐alginate antacid in post‐supper suppression of the acid pocket and post‐prandial reflux among obese participants. Methods Participants underwent 48 h wireless and probe‐based pH‐metry recording of the acid pocket and lower oesophagus, respectively, and were randomised to single post‐supper (10 pm) dose of either Gaviscon Advance or a non‐alginate antacid on the second night. Primary outcomes were suppression of median pH of acid pocket and lower oesophagus, measured every 10‐minutes post‐supper for 1 h. Secondary outcomes were suppression of % time pH < 4 at lower oesophagus and improvement in frequency and visual analogue score (VAS) of regurgitation. Results Of the 81 screened participants, 55 were excluded and 26 (mean age 33.5 years, males 77.8% and BMI 32.8 kg/m²) were randomised to Gaviscon Advance (n = 13) or antacid (n = 13). Median pH of the acid pocket but not the lower oesophagus was suppressed with Gaviscon Advance vs antacid (all P < 0.04) Gaviscon Advance but not antacid significantly reduced in % time pH < 4, symptom frequency and VAS on day 2 vs day 1 (all P < 0.05). Conclusions Among obese individuals, Gaviscon Advance is was superior to a non‐alginate antacid in post‐supper suppression of the acid pocket. (Clinical trial registration unique identifier: NCT03516188).