ORIGINAL ARTICLE

Effect of Gaviscon Infant on gastro-oesophageal reflux in infants assessed by combined intraluminal impedance/pH

R Del Buono¹, T G Wenzl², G Ball¹, S Keady³, M Thomson¹

¹ Centre for Paediatric Gastroenterology, Royal Free and University College Medical School, London, UK
² Kinderklinik der RWTH Aachen, Aachen, Germany
³ Pharmacy Department, Royal Free and University College Medical School, London, UK

Correspondence to:
Correspondence to:
Dr M Thomson
Centre for Paediatric Gastroenterology, Sheffield Children’s Hospital, Western Bank, Sheffield S10 2TH, UK; mike.thomson{at}sch.nhs.uk

Background: Gaviscon Infant (GI) has been recommended for gastro-oesophageal reflux (GOR) in infants. Its efficacy has not been examined with a physiologically appropriate denominator to define the degree of GOR.

Aim: To investigate the influence of Gaviscon Infant on GOR in infants using combined pH and intraluminal impedance measurement.

Methods: Twenty infants (mean age 163.5 days, range 34–319 days) exclusively bottle fed, with symptoms clinically suggestive of GOR, underwent 24 hour studies of intra-oesophageal 6 channel impedance and dual channel pH monitoring, during which six random administrations (3+3) of Gaviscon Infant (625 mg in 225 ml milk) or placebo (mannitol and Solvito N, 625 mg in 225 ml milk) were given in a double blind fashion. Impedance/pH reflux data were recorded and analysed blind by one observer.

Results: The median number of reflux events/hour (1.58 v 1.68), acid reflux events/hour (0.26 v 0.43), minimum distal or proximal pH, total acid clearance time per hour (time with pH below pH 4), and total reflux duration per hour were not significantly different after GI than after placebo. Reflux height was marginally lower after GI (median 66.6% v 77.3% oesophageal length) compared with placebo.

Conclusions: Results showed a marginal but significant difference between Gaviscon Infant and placebo in average reflux height, and raises questions regarding any perceived clinical benefit of its use.

Abbreviations: GI, Gaviscon Infant; GOR, gastro-oesophageal reflux; IMP, impedance; LOS, lower oesophageal sphincter

Keywords: Gaviscon; impedance; oesophagus; reflux

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This article has been cited by other articles:

• Tighe, M P, Cullen, M, Beattie, R M (2009). How to use: a pH study. EDUCATION AND PRACTICE 94: 18-23 [Full Text]  
• Keady, S. (2007). Update on drugs for gastro-oesophageal reflux disease. EDUCATION AND PRACTICE 92: ep114-ep118 [Full Text]  
• Vandenplas, Y., Salvatore, S., Vieira, M. C., Hauser, B. (2007). Will Esophageal Impedance Replace pH Monitoring?. Pediatrics 119: 118-122 [Abstract] [Full Text]  
• Cresi, F, Savino, F, Marinaccio, C, Silvestro, L (2006). Gaviscon for gastro-oesophageal reflux in infants: a poorly effective treatment?. Arch. Dis. Child. 91: 93-93 [Full Text]  

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