Gaviscon is a medication that relieves reflux.
It is important to know that Gaviscon’s formula varies from country to country.
The US version is not very useful. The formula sold in the UK is much more effective against reflux.
Crucial Difference: the Concentration of the Algae Extract
The US Gaviscon is mainly an antacid. The purpose of an antacid is to neutralize stomach acid.
There are numerous antacids on the market; for example, Maalox and Mylanta. They are easy to produce using a compound that can chemically counter an acid and that is safe to consume. Many substances can do that.
What makes Gaviscon special is that it contains alginates. Alginates are a natural product from the sea. They are contained in algae (seaweed) and are a part of the traditional diet in some countries like Japan. When ingested, alginates produce a foam on the stomach content, which helps to prevent reflux.
The disadvantage is that the US version of Gaviscon contains very little of these foam-producing alginates.
In the UK, a stronger version of Gaviscon is available. It is called Gaviscon Advance. Its concentration of alginates is about 10 times that of the US version.
Unfortunately, Gaviscon Advance is not marketed to the US.
Not officially, at least.
Fortunately, you can legally order Gaviscon Advance through vendors. They are importing the product from the UK. You can find a link close to the end of this article.
Gaviscon Advance is more expensive than regular US Gaviscon because of the importing process. However, it is also much more effective against reflux.
Gaviscon Advance comes in two forms: chewable tablets and liquid. Most people, including myself, prefer the liquid. Plus, all studies for Gaviscon have been done with liquid suspensions. However, effectiveness should, in theory, be comparable.
How does Gaviscon Advance Work?
Gaviscon Advance has two mechanisms against reflux. Both are based on the most important ingredient: alginates.
Barrier Effect
When the Gaviscon Advance liquid comes in contact with stomach acid, a chemical reaction is caused: the alginates create a foam. That foam floats on top of the stomach content.
The foam prevents reflux because it acts as a physical barrier. Stomach juices and gases need to get through the Gaviscon layer before they can leak back into the esophagus. As a result, reflux is less frequent and less severe.
Filter for Stomach Enzymes
A part of the reflux will still make it through the foam.
However, the alginates have a second interesting effect: they filter the reflux.
In reflux, it is not acid alone which causes damage. Bile, and the stomach enzyme pepsin play their role as well. Pepsin, especially, is infamous as the main cause of all airway-type reflux symptoms like hoarseness, chronic cough and asthma.
The alginates filter parts of those harmful substances out of the reflux. The filter effect will be strongest immediately after taking Gaviscon Advance and then wane within a few hours. That is why you should take the medication about 30 minutes after eating. For this is when the stomach enzymes are the most active and reflux is most likely.
Effect on GERD / Heartburn
Multiple studies have shown that alginates can reduce the classical symptoms of GERD – such as heartburn. Gaviscon Advance contains alginates in a highly concentrated form.
A smaller number of studies looked specifically at Gaviscon Advance. This study has shown that the medication reduces GERD symptoms more effectively than placebo.
Another study showed that Gaviscon Advance can be combined with an acid blocking medication to get even greater relief from GERD than with acid blockers alone.
Effect on Silent Reflux / LPR
Laryngopharyngeal reflux (LPR) is a disease with reflux symptoms in the airways.
There are few drugs that work against LPR. It is controversial whether proton-pump inhibitors (commonly known as acid blockers) can help against airway reflux.
However, Gaviscon Advance does help against LPR, as is proven in this study. It is no miracle cure but can make a difference together with other measures.
Are there Side Effects?
Light bowel disturbances are possible. It seems to be more common amongst people who already have trouble with their stomach and bowel. I am not sure whether this is really an effect of Gaviscon or whether anything new would upset their digestion. Just try it out to see how you react to it.
Overall, Gaviscon Advance is remarkable regarding its low side effect profile. It simply creates a physical, foam barrier on top of the stomach content when ingested. It does not need to enter the bloodstream. Most pharmaceuticals cause trouble because they are distributed through the whole body which means they cause some chaos in your biochemistry.
Unlike the US version, Gaviscon Advance does not significantly neutralize stomach acid. It is not an antacid. You need some stomach acid to digest food properly. If you neutralize too much acid, it may give short-term relief from your heartburn but may worsen your digestion in the long run. Some of my readers are voicing their concerns about antacids, as some contain aluminum, which can be harmful should it enter the bloodstream. It is a matter of discussion whether the type of aluminum used in antacids is absorbed in sufficient amounts to cause damage. However, with Gaviscon Advance it is not an issue anyway, as it is an aluminum-free formula.
Peppermint in Gaviscon: a Trigger for Reflux?
A question that I receive often is, “Why does Gaviscon come in Peppermint flavor? Isn’t peppermint one of the triggers for reflux?”.
The answer: well, it depends.
1) There are contradicting opinions over whether peppermint causes reflux.
2) I interviewed Prof. Peter Dettmar about Gaviscon recently. He was involved in developing Gaviscon and Gaviscon Advance. Professor Dettmar told me that “there is a big difference between a synthetic, man-made flavor and the natural state of peppermint or mint.” The artificial peppermint flavors used in Gaviscon do not cause reflux. You can find this and more information in the complete recorded interview through my online course.
Peppermint flavors are often added to reflux products because it has a slightly numbing effect, which relieves the symptoms of heartburn. Also, peppermint flavor makes medication taste better.
If you still want to avoid peppermint flavor: Gaviscon Advance also comes in aniseed flavor.
You Still Need to Fix the Cause of Your Reflux
The version of Gaviscon sold in the US is mostly an antacid but contains very little of the effective alginates.
Gaviscon Advance, on the other hand, is a concentrate of alginates. In the stomach, they form a foam – a physical barrier – for reflux. The medication is not absorbed into the bloodstream. That is why it rarely causes side effects. You can safely combine it with other anti-reflux medication(s).
If you live in the US, Gaviscon Advance is not readily available in local pharmacies. Luckily, there are vendors on amazon.com who import Gaviscon Advance from the UK.
It is important to keep in mind that Gaviscon only reduces the symptoms of reflux. It may completely relieve your symptoms if your reflux is weak. However, Gaviscon does not fix the cause of your reflux.
It is imperative to find out why you have reflux in the first place. Do you have bad eating habits? Are your sphincters not working correctly? Finding the root cause allows you to cure reflux permanently.