Could a key to better management of reflux symptoms already lie on shelves?


Around 1 in 10 Australians have been diagnosed with gastro-oesophageal reflux disease (GORD)1 and as the gold-standard therapy for moderate to severe symptoms,2 proton-pump inhibitors are widely used.3 However, after a short trial (4 to 8 weeks), the treatment should be reviewed and an attempt to step-down/off therapy trialled.2 Yet in practice, many patients may not attempt to step-down/off their PPI dose.4

Something to keep in mind is that there’s over the counter (OTC) treatments available to help with symptoms. A systematic review and meta-analysis of available studies showed an existing OTC treatment (alginate-based) is 4 times more likely to resolve the symptoms of reflux than antacids or placebo (OR 4.42; 95% CI 2.45-7.97; p=0.001).5 In Australia the only alginate-based treatments available are the Gaviscon range. They have a different mechanism of action to antacids and acid-suppressing therapies as they are the only treatment that’s been shown to physically block reflux by forming a raft over the stomach contents.6

Gaviscon® Dual Action is for the relief of heartburn and indigestion. Liquids: Contains (per 10ml dose): 500mg sodium alginate, 213mg sodium bicarbonate, 325mg calcium carbonate. Tablets: Each tablet contains 250mg sodium alginate, 106.5mg sodium bicarbonate, 187.5mg calcium carbonate. Liquid sachets: Each sachet (10mL of oral liquid suspension) contains 500mg sodium alginate, 213mg sodium bicarbonate and 325mg calcium carbonate.

Gaviscon® Double Strength is for the relief of heartburn and indigestion. Liquids: Contains (per 10ml dose): sodium alginate 1000mg, potassium bicarbonate 200mg, calcium carbonate 200mg. Tablets: Each tablet contains 500mg sodium alginate, 267mg sodium bicarbonate and 160mg calcium carbonate.

References: 1. Miller G, Pan Y. Gastro-oesophageal reflux disease. AIHW 1998 to 2008. Available at: https://www.aihw.gov.au/getmedia/d6b1b1f5-8cfc-46f1-8002-48295566d449/gep-24-10721-c16.pdf.aspx (accessed 25 February 2020). 2. Therapeutic Guidelines. Disorders of the oesophagus. eTG Complete, December 2019. 3. NPS MedicineWise. Proton pump inhibitors: PBS changes May 2019. Available at: https://www.nps.org.au/radar/articles/proton-pump-inhibitors-pbs-changes-may-2019 (accessed 25 February 2020). 4. Coyle C et al. BJGP Open 2019; DOI: 10.3399/bjgpopen19X101651. 5. Leiman DA et al. Dis Esophagus 2017;30:1-9. 6. Rohof WO et al. Clin Gastroenterol Hepatol 2013;11:1585-1591. 7. Reimer C et al. Aliment Pharmacol Ther 2016;43:899-909.

®GAVISCON is a registered trademark of the Reckitt Benckiser Group of Companies. Level 47, 680 George St, Sydney 2000, NSW Australia. Prepared February 2020. RB0099

 

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