Alginate-based reflux suppressants are designed to provide symptom relief by forming a physical barrier on top of the stomach contents in the form of a neutral floating gel or raft. It is equal to or significantly better than traditional antacids for relieving heartburn symptoms 7. Antacids have no teratogenic effect in animal studies and therefore considered safe to use in pregnancy 8.Īlginate-based reflux suppressants are licensed for use in pregnant women to combat the frequent symptoms of heartburn and regurgitation. However, antacids are considered as the first-line medication 1, 7. The Cochrane review in 2015, which includes nine small studies (which involved data from only four small studies), indicates that there are limited data suggesting that heartburn in pregnancy could be completely relieved by pharmaceutical treatment 2. However, there has been no evidence-based recommendation for the treatment of heartburn in pregnancy 2. Common drugs used for the treatment of heartburn in pregnancy include antacids, sucralfate, histamine 2-receptor antagonists, promotility drugs, proton pump inhibitors, and a raft-forming alginate reflux suppressant. These interventions include changes in diet, lifestyle modification and medications. Many interventions have been used for the treatment of heartburn in pregnancy. Diagnosis is usually made on symptoms alone, women with more severe illness may undergo diagnostic tests such as upper gastro-intestinal endoscopy and the condition usually resolves after delivery 3.
Abnormal gastric emptying or delayed small bowel transit might also contribute to heartburn in pregnancy 1. The normal compensatory response of the lower oesophageal sphincter to accommodate this change is impaired during pregnancy 6. In addition, the enlarging gravid uterus causes increased intra-abdominal pressure. The increased circulating progesterone during pregnancy causes lower oesophageal sphincter relaxation 4, 5.
The pathogenesis of heartburn in pregnancy involves decreasing lower oesophageal sphincter pressure. The worldwide incidence of heartburn in pregnancy is 17% to 80% 2 and it can occur in all trimesters of pregnancy 2. The symptoms of heartburn in pregnancy may be frequent, severe and distressing, but serious complications are rare 3. It is one of the most common gastrointestinal symptoms in pregnant women. Heartburn or pyrosis is a burning or painful sensation in the upper part of the digestive tract including the throat 1, 2, 3. Alginate-based reflux suppressant was not different from magnesium-aluminium antacid gel in the treatment of heartburn in pregnancy. There were also no significant differences in quality of life, maternal satisfaction, maternal side effects, pregnancy and neonatal outcomes. There was no difference between treatment and control groups in improvement of heartburn frequency (80% vs 88%, p = 0.275), 50% reduction of frequency of heartburn (56% vs 52%, p = 0.688), improvement of heartburn intensity (92% vs 92%, p = 1.000) and 50% reduction of heartburn intensity (68% vs 80% cases, p = 0.075). Primary outcome measure was the improvement of heartburn frequency after treatment and secondary outcome were the improvement of heartburn intensity, quality of life, maternal satisfaction, maternal side effects, pregnancy and neonatal outcomes. Details of heartburn were recorded before beginning the treatment and the second week of study.
One hundred pregnant women at less than 36 weeks gestation with heartburn at least twice per week were randomized to either alginate-based reflux suppressant or to magnesium-aluminium antacid gel.
#Best form of magnesium for gerd trial#
A double-blinded, randomized, controlled trial was conducted. The aim of this study was to compare the therapeutic efficacy of alginate-based reflux suppressant and magnesium-aluminium antacid gel for treatment of heartburn in pregnancy.
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