Advantages of alginate and PPI combination in relief of heartburn and regurgitation during the first days of treatment of gastroesophageal reflux disease

Aim of investigation. To estimate advantages of combined intake of proton pump inhibitor (PPI) and alginate in comparison to monotherapy by PPI in terms of symptom relief in the first days of gastroesophageal reflux disease (GERD) treatment.

Material and methods. Overall 96 patients with GERD were investigated. All patients complained of heartburn, 41 patients had regurgitation. Symptoms were estimated by Likert scale prior to onset of therapy and daily during treatment course. General well-being was evaluated by visual-analog scale (VAS) prior to therapy, at the 7th and 14th days of treatment. The first group (46 patients, 19 males, mean age — 50,2±12,7 years) received combined therapy by pantoprazole 40 mg/day and alginate (Gaviscon DD) 20 ml qid at the 1st and 2nd days of treatment followed by «on demand» mode. The second group (50 patients, 22 males, mean age 51,3±14,4 year) received pantoprazole 40 mg per day. All patients underwent esophagogastroduodenoscopy.

Results. At the 1st day of treatment heartburn has been completely relived in 61% of patients of the first group and in 14% — of the second (р<0,001), at the 2nd day — in 63% and 20% (р<0,001). At the 3rd day (alginate in «on demand» mode) the heartburn was absent in 48% of patients of the first group and in 44% — of the second (р=0,8). Regurgitation at the 1st day of treatment was relieved in 78% of patients of the first group and remained in all patients of the second group, who initially complained of it (р<0,001), at the 2nd day it stopped in 83% and 22% of patients respectively (р<0,001), at the 3rd day — in 67% and 22% (р=0,01). After the 4th day there were no intergroup differences. At the 7th day of treatment according to VAS wellbeing score in the first group increased from 57,3±9,7 to 78,1±11,2 mm (р <0,001), in the second — from 54,9±14,9 to 67,0±15,2 mm (р<0,001). The intergroup differences of the score at the 7th day was statistically significant (р<0,001). By the 14th day difference disappeared (78,8±9,7 mm vs 75,6±12,5 mm, р=0,1).

Conclusions. This study has demonstrated advantages of the combined therapy in the first days of GERD treatment in decreased terms relief of symptoms and improvement of state of health.

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