Abstract
BackgroundCurrent therapeutic options for the management of gastroesophageal reflux/reflux disease include dietary measures, reassurance, drugs (mainly proton pump inhibitors) and surgery (usually reserved for complicated cases). The role of alginates remains unclear. ObjectiveTo examine whether alginates are effective in the management of gastroesophageal reflux in children. MethodsThe MEDLINE, EMBASE, and Cochrane Library databases were searched up to August 2014 for published randomized controlled trials (RCTs) that compared the effects of a sodium alginate with placebo, no intervention, or other intervention. ResultsNine RCTs, some with methodological limitations, involving 411 children, aged 0-17 years, were included. There was variability in how outcomes were reported. Four 4 RCTs compared alginates with placebo showing inconsistent results; only 2 RCTs showed clear benefit of the alginates. One RCT found similar effect of alginates as compared with proton pump inhibitors. One RCT in children with gastroesophageal reflux and esophagitis found better efficacy of famitidine as compared with alginates. The efficacy of alginates and prokinetic drugs was similar. One RCT found better efficacy of alginate plus simethicone as compared with than thickened formula and reassurance with lifestyle changes alone. ConclusionThe efficacy of alginates for the management of children with gastroesophageal reflux/reflux disease has not been convincingly documented.
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