Efficacy of an alginate versus proton pump inhibitor in the symptomatic relief of gastroesophageal reflux symptoms in pregnant women

Background: Gastroesophageal reflux disease (GERD) is frequently seen during pregnancy with prevalence of 80%. Proton pump inhibitors (PPI) are the most effective drugs used in the treatment of reflux symptoms. Alginates are natural polysaccharide polymer which builds a non-systemic barrier against acid and food reflux in the oesophagus. Aims and objectives were to compare the efficacy of alginate versus PPIs in pregnant women, and to determine the time to onset of decrease in the pain intensity of alginate to PPIs. Methods: This is a prospective randomised study conducted in pregnant women with symptoms of heartburn comparing the efficacy of alginates to PPIs in Kempegowda Institute of Medical Sciences. After subjects have signed the consent, two sachets of 10 ml liquid preparation alginate were given to the alginate group while 40 mg intravenous pantoprazole to the PPI group. Results: Among 40 patients studied, 20 were given alginates and 20 were given PPIs. 7 presented in the 1st trimester and 33 in 2nd trimester. Onset of action is faster with alginates when compared to PPIs, it was 30 min to 1 hour in patients taking alginates and 6-12 hours in patients taking PPIs, duration of action was longer for PPIs than alginates, with alginates it’s observed that it attains 24-hour symptom free interval in shorter time when compared to PPIs. Conclusions: ¬Alginates to be used for rapid symptom relief in patients with acute symptoms as an induction agent, PPIs to be used for longer duration of action as maintenance.