The mechanism of oesophageal mucosal protection with sodium alginate
Research type
Research Study
Full title
To investigate the mechanism of oesophageal mucosal protection with sodium alginate in healthy subjects and patients with non-erosive reflux disease (NERD)
IRAS ID
168908
Contact name
Daniel Sifrim
Contact email
Sponsor organisation
Queen Mary University of London
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Gastro-oesophageal reflux disease (GORD) is a widespread problem affecting the health and quality of life of many people worldwide. The main symptoms are heartburn and acid regurgitation. Although many good treatments now exist, GORD is still increasingly common. Many patients do not respond to traditional treatments aiming to reduce stomach acid.
Some people with GORD have visible ulcers and inflammation within their gullet. It is easy to understand why these patients get heartburn. However up to 70% of people with heartburn and abnormally high levels of acid reflux have gullets that look normal when examined during endoscopy (camera test). Many of these patients have tiny breaks in the normal-looking internal lining of the gullet that can only be seen under a microscope. We call this subtype of GORD non-erosive reflux disease (NERD).
Studies have shown that tissue samples from the gullets of patients with NERD are more vulnerable to acid damage than those of healthy volunteers. This is because NERD samples are more porous and therefore more likely to suffer from exposure to damaging substances refluxed from the stomach (acid, bile, enzymes).
A treatment that protects this vulnerable gullet lining against acid damage would therefore seem sensible. This may already exist in the form of sodium alginate, an over-the-counter medication. Sodium alginate forms a sticky layer that works as a mechanical barrier on top of stomach contents, preventing reflux into the gullet. People have used it for many years to relieve heartburn with good results. We hypothesise that another method by which alginates relieve heartburn is by directly protecting the internal lining of the gullet.
From previous experiments in our laboratory, we know that sodium alginate protects against acid-induced damage in gullet biopsies. In this study we aim to verify this protective effect of alginate in healthy volunteers and patients with NERD.
REC name
London - Dulwich Research Ethics Committee
REC reference
15/LO/0935
Date of REC Opinion
14 Jul 2015
REC opinion
Further Information Favourable Opinion