sodium-bicarbonate and Dyspepsia

There is a paucity of large-scale studies evaluating the clinical benefit of the Gaviscon Double Action (DA) alginate-antacid formulation for treating gastroesophageal reflux disease (GERD) symptoms.. Randomised double-blind placebo-controlled parallel-group study to evaluate efficacy and safety of Gaviscon DA in reducing heartburn, regurgitation and dyspepsia symptoms in individuals with mild-to-moderate GERD in China.. Participants with symptomatic GERD (n = 1107) were randomised to receive Gaviscon DA or placebo (two tablets four times daily) for seven consecutive days. The primary endpoint compared the change in Reflux Disease Questionnaire (RDQ) score for the GERD (heartburn + regurgitation) dimension between Gaviscon DA and placebo. Secondary endpoints compared the change in RDQ scores for individual heartburn, regurgitation and dyspepsia dimensions, overall treatment evaluation (OTE) scores and incidence of adverse events (AEs).. Mean RDQ GERD scores: 2.51 for Gaviscon DA and 2.50 for placebo at baseline; 1.25 for Gaviscon DA and 1.46 for placebo post treatment. Gaviscon DA was statistically superior to placebo in reducing GERD and dyspepsia RDQ scores [least-squares mean (LSM) difference: GERD -0.21, P < 0.0001; dyspepsia -0.18, P = 0.0004], despite a substantial placebo response. The Gaviscon DA group reported more favourable overall treatment responses than the placebo group across all OTE categories (P < 0.0001). Superior relief of GERD symptoms was observed both in those with non-erosive and those with erosive reflux disease (LSM difference -0.14 [P = 0.038] and -0.29 [P < 0.0001] respectively). Incidence of AEs was similar in both groups.. Gaviscon DA tablets provide effective and safe reduction in acid reflux and dyspepsia symptoms in Chinese individuals with mild-to-moderate GERD. ClinicalTrials.gov: NCT01869491.

Topics: Adolescent; Adult; Aged; Alginates; Aluminum Hydroxide; Antacids; Anti-Ulcer Agents; China; Double-Blind Method; Drug Combinations; Dyspepsia; Female; Gastroesophageal Reflux; Heartburn; Humans; Laryngopharyngeal Reflux; Male; Middle Aged; Placebos; Silicic Acid; Sodium Bicarbonate; Surveys and Questionnaires; Treatment Outcome; Upper Gastrointestinal Tract; Young Adult

The alginate-antacid, Gaviscon Double Action (Gaviscon DA; Reckitt Benckiser, Slough, UK) suppresses reflux after meals by creating a gel-like barrier that caps and displaces the acid pocket distal to the oesophago-gastric junction. The effect of Gaviscon DA on reflux and dyspepsia symptoms has not yet been demonstrated with a modern trial design.. A pilot study to assess the efficacy and safety of Gaviscon DA compared with matched placebo for decreasing upper gastrointestinal symptoms in symptomatic gastro-oesophageal reflux disease (GERD) patients.. A randomised, double-blind, parallel group study was performed in 110 patients with symptoms of GERD. Patients received Gaviscon DA or placebo tablets for 7 consecutive days. The primary endpoint compared the change in overall Reflux Disease Questionnaire (RDQ) symptom score (combined heartburn/regurgitation/dyspepsia). Secondary endpoints assessed individual dimensions, GERD dimension (heartburn and regurgitation) and overall treatment evaluation (OTE).. There was a greater decrease in overall RDQ symptom score in the Gaviscon DA group compared with the placebo group (Least Squares Mean difference -0.55; P = 0.0033), and for each of the dimensions independently. Patients in the Gaviscon DA group evaluated their overall treatment response higher than patients in the placebo group [mean (standard deviation) OTE 4.1 (2.44) vs. 1.9 (3.34); P = 0.0005]. No differences in the incidence of adverse events were observed between treatment groups.. Gaviscon DA decreases reflux and dyspeptic symptoms in GERD patients compared with matched placebo and has a favourable benefit-risk balance. Larger scale clinical investigations of medications targeting the acid pocket are warranted. (EudraCT, 2012-002188-84).

Topics: Adult; Alginates; Aluminum Hydroxide; Antacids; Double-Blind Method; Drug Combinations; Dyspepsia; Female; Gastroesophageal Reflux; Heartburn; Humans; Male; Middle Aged; Pilot Projects; Silicic Acid; Sodium Bicarbonate; Treatment Outcome

To compare the clinical efficacy of alginate drug Geviskon and aluminum-magnesium antacids to relieve symptoms of esophageal, extraesophageal syndrome and functional dyspepsia at 3 and 7 days of study in patients with GERD elderly.. An open, longitudinal, randomized, parallel-group. The study included 60 patients with "A" degree of ERD, consistently received in-patient treatment in the Municipal KGVV, mean age 79.0 +/- 6.8 years. During the first 12 hours of hospital stay by "sealed envelopes" them randomly divided into equal groups of comparison, given 3 times a day: alginate product--Geviskon forte dose of 10 ml and aluminum-magnesium antacid drug at a dose of 1 sachet. Assess the frequency and severity of esophageal symptoms, extraesophageal syndrome, functional dyspepsia at 3 and 7 days of study on 5-point scale Likert. The degree of esophageal mucosal injury was determined during endoscopy before the study.. The technique of alginate compared with antacids provided significantly more complete and earlier effect on the relief of heartburn, regurgitation, chronic cough, sore throat, and EBS. Only Geviskon influenced the symptoms of PPD in patients with GERD.. The clinical features Geviskon the frequency and timing of relief of symptoms of esophageal, extraesophageal syndrome, functional dyspepsia with GERD in the older age groups is higher than that of antacids. Suspension Geviskon may be recommended in patients with middle and old age as an effective and safe symptomatic funds in the first days of exchange rate earlier generations of PPI therapy, as well as monotherapy--to maintain remission.

Topics: Aged; Aged, 80 and over; Alginates; Aluminum Hydroxide; Antacids; Cough; Drug Combinations; Dyspepsia; Female; Gastroesophageal Reflux; Humans; Laryngitis; Male; Middle Aged; Silicic Acid; Sodium Bicarbonate; Syndrome; Treatment Outcome

Because of the multifactorial pathogenesis of functional dyspepsia, strategies alternative to antacid therapy are being sought for treating the disorder. This prospective study evaluated the benefit of treatment with a dietary integrator composed of sodium alginate, sodium bicarbonate, bromelin and essential oils.. The study population included 53 consecutive patients (22 males, 31 females; mean age, 54+/-2.5 years) with functional dyspepsia and negative for Helicobacter pylori infection. The patients were categorized into four subgroups according to predominant symptom: ulcer-like dyspepsia, motility-like dyspepsia, reflux-like dyspepsia, and nonspecific dyspepsia. All received TUBES gastro (0.80 g oral tablets bid) for a minimum of 3 months (range, 3-11). Treatment efficacy was measured by means of a Visual Analogue Scale (VAS).. Two patients were lost to follow-up; of the remaining 51 patients who completed the study, 35 (68%) showed an improvement in VAS score. The difference in scores between the initial and the final visit was -1.9+/-2.1 cm (range, -6 to +3), or 23.8+/-40.8% (range, -150% to 100%) compared to the scores at the baseline visit (P=0.0001).. The study results indicate that in the short term TUBES gastro can significantly improve dyspeptic symptoms in dyspeptic patients negative for H. pylori infection through the synergistic action of its components: alginate buffers gastric acid; bicarbonate helps to eliminate gas and rebalance pH; essential oils regulate motility; and bromelin stimulates enzymatic activity.

Topics: Alginates; Bromelains; Drug Combinations; Dyspepsia; Female; Glucuronic Acid; Hexuronic Acids; Humans; Male; Middle Aged; Oils, Volatile; Pilot Projects; Prospective Studies; Sodium Bicarbonate

In a double blind endoscopically controlled study, 100 patients with gastric ulcers were treated with either ranitidine or ranitidine plus Caved-S. On single therapy, 58% of ulcers were healed at four weeks, 92% at eight weeks and 96% at 12 weeks. Combination therapy did not alter the healing rate, nor improve on the control of dyspeptic symptoms. No difference in healing rate was found between good and poor drug compliance patients. This suggests that ranitidine may be equally effective at lower dosages. Thirty seven patients had developed their ulcer while taking non-steroidal anti-inflammatory drugs. These patients were mainly elderly women who had a higher risk of bleeding (p = 0.006) from a large ulcer (p = 0.009).

Topics: Aged; Aluminum Hydroxide; Anti-Ulcer Agents; Bismuth; Clinical Trials as Topic; Double-Blind Method; Drug Combinations; Drug Therapy, Combination; Dyspepsia; Female; Glycyrrhiza; Humans; Magnesium Hydroxide; Male; Middle Aged; Plant Extracts; Ranitidine; Sodium Bicarbonate; Stomach Ulcer

Given the limited efficacy of conventional medical therapy for functional dyspepsia, patients frequently seek alternative medical approaches. The use of suc h alternative therapies has dramatically increased during the last decades. The scope of this prospective study was to provide evidence of the clinical benefit of the treatment of functional dyspepsia with a dietary integrator composed by sodium alginate, sodium bicarbonate, bromelin and essential oils.. This study enrolled a total of 100 patients affected by functional dyspepsia diagnosed primarily on the basis of typical symptoms and the exclusion of non-functional gastrointestinal diseases (negative upper gastrointestinaltract endoscopy and negative for H. pylori infections, including acid-related diseases), non-gastrointestinal diseases, and psychiatric illness. All patients enrolled were categorized in two symptom-predominant subgroups: dysmotility-like dyspepsia (N.=60) and reflux-like dyspepsia (N.=40). Patients were treated with TUBES Gastro (0.80 g oral tablets bid after main meals) for 4 weeks, on top of their current treatment with proton pump inhibitors or not. Efficacy was measured by a Numerical Rating Scale (NRS) at baseline and after 14 and 28 days of treatment with TUBES Gastro while safety and tolerability were evaluated based on the adverse event reporting from the patients.. Sixty patients were diagnosed with dysmotility-like dyspepsia and were enrolled into the study; the majority was females (68%) with a mean age of 48.5 years (19-81). The mean baseline NRS score was 5.7 (4-8). A high statistically significant reduction of the NRS score was observed at 14 and 28 days: -1.5 (-26.3%) and -3.4 (-59.6%), respectively (P<0.0001). Forty patients were diagnosed with reflux-like dyspepsia and were enrolled into the study; the majority was males (70%) with a mean age of 49.1 years (24-80). The mean baseline NRS score was 6.8 (5-9). A high statistically significant reduction of the NRS score was observed at 14 and 28 days: -2.8 (-41.2%) and -4.8 (70.6%), respectively (P<0.0001). No side effects were collected during the study duration.. The data obtained from this four-week study indicate that TUBES Gastro treatment was effective and well tolerated in reducing the symptomatology of patients affected by functional dysmotility-like and reflux-like dyspepsia.

Topics: Administration, Oral; Adult; Aged; Aged, 80 and over; Alginates; Bromelains; Drug Combinations; Drug Therapy, Combination; Dyspepsia; Female; Gastrointestinal Agents; Gastrointestinal Motility; Humans; Male; Middle Aged; Oils, Volatile; Prospective Studies; Proton Pump Inhibitors; Sodium Bicarbonate; Treatment Outcome

A 68-year-old man presented to the Emergency Department with a severe metabolic alkalosis after ingesting large quantities of baking soda to treat his dyspepsia. His underlying pulmonary disease and a progressively worsening mental status necessitated intubation for respiratory failure. Laboratory studies revealed a hyponatremic, hypochloremic, hypokalemic metabolic alkalosis. The patient was successfully treated after cessation of the oral bicarbonate, initiation of intravenous hydration, and correction of electrolyte abnormalities.

Topics: Aged; Alkalosis; Dyspepsia; Emergency Service, Hospital; Humans; Male; Respiratory Insufficiency; Self Medication; Sodium Bicarbonate

Calves with chronic indigestion have disturbed general attitude and condition, decreased appetite, loss of hair, clay-like faeces and ruminal and metabolic acidosis. Possible causes include dysfunction of the oesophageal-groove reflex, reflux of abomasal contents into the rumen and abnormal ruminal motility. The anion gap may be increased or within normal limits. Metabolic acidosis is significantly more severe in calves that are unable to stand than in calves that can stand. Treatment of chronic indigestion consists primarily of intravenous administration of sodium bicarbonate, transfaunation of the rumen and oral administration of electrolyte solutions.

Topics: Acidosis; Animals; Cattle; Cattle Diseases; Dyspepsia; Electrolytes; Fluid Therapy; Milk; Sodium Bicarbonate

The principal clinical signs in 59 milk-fed calves with chronic indigestion were general malaise and depression, poor appetite, poor body condition, dehydration, a dull and scaly hair coat, alopecia and clay-like faeces. All the calves had metabolic acidosis, which was associated with an inability to stand up in more than half of them. There were significant differences in the severity of acidosis between the calves that could stand and those that could not. Other signs in some of the calves were dehydration, leucocytosis, and increased activities of liver enzymes.

Topics: Acidosis; Animals; Anti-Bacterial Agents; Blood Gas Analysis; Cattle; Cattle Diseases; Chronic Disease; Dyspepsia; Female; Fermentation; Liver; Male; Milk; Rumen; Severity of Illness Index; Sodium Bicarbonate; Treatment Outcome; Vitamins

A patient with a history of cerebrovascular disease, hypertension, and previous gastrectomy developed metabolic alkalosis and myoclonus. His medications included the anti-hypertensive agents nicardipine hydrochloride, delapril, prazosin; dihydroergotoxin and ticlopidine for cerebral infarction; estazolam for insomnia; azuren-L-glutamine compound and S-M powder. In addition, he had taken 12 grams per day of Ohta's Isan antacid, which contained 625 mg sodium bicarbonate per 1.3 g of antacid powder over a 6-month period. This antacid is commonly used in Japan. This is the first report of a case of metabolic alkalosis and myoclonus secondary to ingestion of a commercially available antacid in Japan.

Topics: Aged; Alkalosis; Antacids; Cardiovascular Agents; Cerebral Infarction; Dyspepsia; Gastrectomy; Humans; Hypertension; Hypnotics and Sedatives; Hypokalemia; Male; Myoclonus; Sleep Initiation and Maintenance Disorders; Sodium Bicarbonate

In a consecutive prospective series of 186 Swedish persons with the diagnosis of non-ulcer dyspepsia 71.5% were found to have gastritis and/or bulbar duodenitis in endoscopic biopsies. Gastroduodenitis was associated with campylobacter pylori (CP) in 83.5% of the cases. The double therapeutic approach using an antibiotic and a preparation containing bismuth in an uncontrolled therapeutic pilot trial resulted in improvement of the histological picture, disappearance of CP and amelioration of symptoms. It is concluded that CP-infection plays a central role in the pathogenesis of gastroduodenitis associated NUD.

Topics: Adult; Aluminum Hydroxide; Anti-Ulcer Agents; Bismuth; Campylobacter; Campylobacter Infections; Drug Combinations; Dyspepsia; Erythromycin; Female; Glycyrrhiza; Humans; Magnesium Hydroxide; Male; Plant Extracts; Prevalence; Prospective Studies; Sodium Bicarbonate; Sweden