Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Alginic acid is commonly used in the management of symptoms associated with hiatal hernia, particularly gastroesophageal reflux disease (GERD), which is a frequent complication of hiatal hernia. The scientific rationale for its use is based on its unique mechanism of action: when alginic acid (usually in combination with antacids) is ingested, it reacts with gastric acid to form a viscous gel or “raft” that floats on top of the stomach contents. This raft acts as a physical barrier, preventing acid and other stomach contents from refluxing into the esophagus, thereby reducing symptoms such as heartburn and regurgitation.

Multiple randomized controlled trials and systematic reviews (such as those cited in Cochrane reviews and the British Society of Gastroenterology guidelines) have found that alginate-containing preparations are effective in reducing GERD symptoms, particularly postprandial reflux. However, the evidence specifically for hiatal hernia (as distinct from GERD in general) is more limited. Most studies include patients with GERD, some of whom have a hiatal hernia, but do not always report outcomes specifically for this subgroup. Nonetheless, because hiatal hernia frequently causes or worsens reflux, the symptomatic benefit of alginic acid for GERD is generally extrapolated to patients with hiatal hernia.

In summary, while alginic acid does not treat the anatomical defect of a hiatal hernia, there is moderate scientific evidence supporting its use for symptomatic relief of reflux, which is commonly associated with hiatal hernia.

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