De invloed van Gaviscon op de acid pocket en zure reflux.

The gastric acid pocket is the most important source of refluxate. It is hypothesized that very commonly used alginate-antacid formulations form a floating raft on top of the acid pocket. This is however never visualized in vivo. To visualize the alginate raft formation and to assess the effect of this raft formation on reflux parameters, we aimed to perform a randomised controlled study in which we compared Gaviscon, a alginate-antacid formulation to Antagel, a commonly used antacid.
We will compare these two over the counter medications in one postprandial measurement using pH-impedance testing to detect reflux episodes.

We hypothesize that after alginate intake a raft is formed in the proximal stomach proximal of the gastric acid pocket, and that this raft affects the gastric acid pocket regarding acidity, position and size leading to less acid reflux events.

Patients undergo 1 postprandial measurement.

1. The use of proton pump inhibitors has to be stopped 5-7 days prior to the study day;

2. On the study day, 350MBq Tc-pertechnetate is injected intravenously;

3. Randomized single oral administration of either 10 mL Gaviscon (Indium-labelled) or 10 mL Antagel;

4. Esophageal high-resolution manometry/pH-manometry to detect reflux eipsodes during 2 postprandial hours;

5. Scintigraphy.