Introduction
Over time, I have received a number of emails from patients regarding the best type of Gaviscon Advance or Gaviscon Double Action they should purchase for relief of NON-acidic laryngopharyngeal reflux (LPR). The blunt answer is to get the Gaviscon Advance Suspension/Liquid made by Reckitt Benckiser which contains at least 500mg of sodium alginate in 5ml dose (1 tsp) or 1 gram in 10cc dose (2 tsps). This formula of Gaviscon Advance cannot be purchased in the United States, but instead overseas via online pharmacies located in the United Kingdom (link). Occasionally, Amazon.com does stock it. Gaviscon Double Action is also good for non-acidic LPR.
The Gaviscon (without the "advance" or "double action") sold in the United States is manufactured and distributed by GlaxoSmithKline (GSK) and not Reckitt Benckiser. The US brand of Gaviscon by GSK contains less of the key ingredient sodium alginate which helps with NON-acidic reflux. Alginate is a natural product derived from seaweed. The alginate reacts with the acid in the stomach to produce a "raft" barrier that acts as a physical block to reflux. It is the only non-surgical treatment that can physically prevent reflux disease regardless of whether it is acidic or not. Alginates work rapidly, are long lasting, inexpensive, and have no known side-effects.
More recent products sold in the United States specifically made utilizing alginate for reflux therapy include Refluxly, RefluxRaft, and Reflux Gourmet.
Sodium Alginate
Historically, Gaviscon Advance has been hard to obtain in the United States, but one of my patients suggested why not take just the sodium alginate and forget about the gaviscon? After all, it's the sodium alginate that's the key ingredient that is thought to help.
Great idea!
Even better is the fact that sodium alginate is easier to find and obtain.
If possible, I would stick to roughly the same amount of sodium alginate that would be ingested if Gaviscon Advance itself was taken:
Some of these other alternative products can be found on Amazon as shown below. However, be aware that for effective reflux control, other supplemental ingredients to "activate" the alginate is required. Read here for more info.
You can make your own Gaviscon Advance or Double Action from its component ingredients commonly found in the United States here.
DISCLAIMER!!! Please be aware that I can NOT vouch for overall effectiveness of these alternatives which have NOT been scientifically tested for clinical effectiveness nor is regulated by the FDA even though the same active ingredient sodium alginate is present. Research has been done with Gaviscon Advance, but not with these alternatives. Use at your own risk!!!
References:
An evaluation of the antireflux properties of sodium alginate by means of combined multichannel intraluminal impedance and pH-metry. Aliment Pharmacol Ther. 2005 Jan 1;21(1):29-34
The value of a liquid alginate suspension (Gaviscon Advance) in the management of laryngopharyngeal reflux. Eur Arch Otorhinolaryngol. 2009 Feb;266(2):243-51. Epub 2008 May 28.
The role of an alginate suspension on pepsin and bile acids - key aggressors in the gastric refluxate. Does this have implications for the treatment of gastro-oesophageal reflux disease? J Pharm Pharmacol. 2009 Aug;61(8):1021-8.
An alginate-antacid formulation (Gaviscon Double Action Liquid) can eliminate or displace the postprandial 'acid pocket' in symptomatic GERD patients. Aliment Pharmacol Ther. 2011 Jul;34(1):59-66. doi: 10.1111/j.1365-2036.2011.04678.x. Epub 2011 May 3.
Gaviscon® Advance alone versus co-prescription of Gaviscon® Advance and proton pump inhibitors in the treatment of laryngopharyngeal reflux. Eur Arch Otorhinolaryngol. 2018 Oct;275(10):2515-2521. doi: 10.1007/s00405-018-5079-0. Epub 2018 Jul 30.
Sodium Alginate
Historically, Gaviscon Advance has been hard to obtain in the United States, but one of my patients suggested why not take just the sodium alginate and forget about the gaviscon? After all, it's the sodium alginate that's the key ingredient that is thought to help.
Great idea!
Even better is the fact that sodium alginate is easier to find and obtain.
If possible, I would stick to roughly the same amount of sodium alginate that would be ingested if Gaviscon Advance itself was taken:
1000mg of sodium alginate after every meal and at bedtime.
Some of these other alternative products can be found on Amazon as shown below. However, be aware that for effective reflux control, other supplemental ingredients to "activate" the alginate is required. Read here for more info.
You can make your own Gaviscon Advance or Double Action from its component ingredients commonly found in the United States here.
DISCLAIMER!!! Please be aware that I can NOT vouch for overall effectiveness of these alternatives which have NOT been scientifically tested for clinical effectiveness nor is regulated by the FDA even though the same active ingredient sodium alginate is present. Research has been done with Gaviscon Advance, but not with these alternatives. Use at your own risk!!!
References:
An evaluation of the antireflux properties of sodium alginate by means of combined multichannel intraluminal impedance and pH-metry. Aliment Pharmacol Ther. 2005 Jan 1;21(1):29-34
The value of a liquid alginate suspension (Gaviscon Advance) in the management of laryngopharyngeal reflux. Eur Arch Otorhinolaryngol. 2009 Feb;266(2):243-51. Epub 2008 May 28.
The role of an alginate suspension on pepsin and bile acids - key aggressors in the gastric refluxate. Does this have implications for the treatment of gastro-oesophageal reflux disease? J Pharm Pharmacol. 2009 Aug;61(8):1021-8.
An alginate-antacid formulation (Gaviscon Double Action Liquid) can eliminate or displace the postprandial 'acid pocket' in symptomatic GERD patients. Aliment Pharmacol Ther. 2011 Jul;34(1):59-66. doi: 10.1111/j.1365-2036.2011.04678.x. Epub 2011 May 3.
Gaviscon® Advance alone versus co-prescription of Gaviscon® Advance and proton pump inhibitors in the treatment of laryngopharyngeal reflux. Eur Arch Otorhinolaryngol. 2018 Oct;275(10):2515-2521. doi: 10.1007/s00405-018-5079-0. Epub 2018 Jul 30.
10 comments:
When you click on Genestra - Sodium Alginate link, it says it is not available for shipment outside the US. Can you provide a link for US residents?
I just purchased a bottle from Amazon. I will come back and report if I had any success with it or not. I plan on taking just one 400 mg capsule before bedtime. That is when I seem to reflux and my voice can go from clear to hoarse almost overnight it seems. I am now eating a mostly whole foods, plant based diet advocated by Dr. John McDougall and that seems to be helping a lot also. Thank you for the information on the Sodium Alginate.
I am also having this problem! I have just ordered my alginate as well. I thought I was having allergies, or picking up viruses. The constant clearing and coughing has been driving me crazy. I am relieved to know that this may help. Have had two normal scopes which only showed mucus!
Hey Cat Lover, did it help you?
I am having the same issue. I went to my local health clinic and they gave me a cough syrup to relieve the cough but the constant coughing is back and gets irritating at this point.
You will need to take some baking soda too.
Does anyone know if sodium alginate capsules by itself works or does it need another agent (baking soda, calcium carbonate) in order to form the "raft" barrier?
Hi, I purchased Will Powder Sodium alginate from Amazon and under the comments section Top Customer Review look for title " Good for Gerd/LPR. There is a very detailed explanation how sodium alginate works and a homemade "recipe" to duplicate Gaviscon Advance.
Okay, to further help everyone on what I have found. Yes, Gaviscon Advance Works and works well. The issue is that it is expensive and takes forever to get to the United States. The price keeps going up too. The study they used to come up with this homemade recipe was found here.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3612878/
I have order two different brands of the Sodium Algenate and both are food grade. Oh, and here are the ingredients of the Gaviscon Advance liquid. I think most of the inactive ingredients are probably to help consistency and actually get people to take it, honestly I do not care how it tastes, I just want something that works.
Active Ingredients
1000mg Sodium Alginate
200 Potassium Hydrogen Carbonate
Inactive Ingredients
Calcium Carbonate
Carbomer
Mehtyl (E218) and Propyl (E216) Parahydroxybenzoates
Sodium Saccharin
Sodium Hydroxide
Peppermint Flavour
Purified Water
Yeah the taste does not bother me, the LPR bothered me. As soon as my powder comes in today I will start making this stuff in batches.
The reason you can't get Gaviscon liquid in the USA is because Glaxo-Smith-Kline and other pharmacy manufacturers want everyone in the World to be taking Zantac (also Ranitidine, Omeprazole and so on.) The stats for people with GERD acid reflux and hiatial hernias are off the scale, due to rubbish food and lack of exercise in both the USA and Europe. I'm guessing lobbying the FDA in the US is the reason these drugs are constantly being pushed at us.
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