Gastroesophageal reflux disease (GERD) is one of the most common diseases which affect a significant range of society. Alginate-based anti-reflux preparations are used for symptom relief of GERD, by forming a floating raft which preventing acidic content of stomach to injured mucosal surface. Mechanism of action of alginate-based products consist of three simultaneous stages. Transforming sodium alginate to alginic acid in acidic content of stomach, divalent ions of calcium which are released from calcium carbonate provide strength of rafts and sodium bicarbonate or potassium bicarbonate react to acid and form carbon dioxide gases which transform gel to foam.This study evaluate efficacy of alginate-based products compare to placebo, antacids, histamine-2 receptor antagonists (H2RAs) or PPIs for treatment of patients with GERD symptoms.

Material of this review were obtained by searching PubMed and ScienceDirect with the following terms: alginate, gastroesophageal reflux disease, Gaviscon, alginate-based formulations. Meta-analyses were included 10 randomized clinical trial studies (N=1611) and performed by calculating odd ratio (OD) using random-effect models, even, heterogeneity was determined by I2 statistic.

The odds of GERD symptoms relief increased when alginate-based formulations compared to placebo and antacids (OR: 4.93; 95% CI 2.45-7.97) also these studies had a moderate heterogeneity (I2 = 68%, P = .001), whereas PPIs and H2RAs were more effective than these formulations (OR: 0.63; 95% CI 0.27–1.22) but they had a high degree of heterogeneity (I2 =78%, P<.001).

According to data obtained from these randomized clinical trials alginate-based formulations were superior to placebo and antacids against GERD symptoms.