***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: AIM To assess the efficacy and safety of a compound containing alginic acid plus antacid ( Topaal ) compared to equal-strength antacid ( Nacid ) in patients with endoscopy-negative reflux disease ( ENRD ) . METHODS A total of 121 patients with ENRD were r and omized to receive Topaal ( 65 patients ) or Nacid ( 56 patients ) for 6 weeks , with a consultation every 3 weeks . The primary end-point assessment was the change in the severity of heartburn as evaluated using a visual analog scale ( VAS ) at 6 weeks . The secondary end-point assessment s were the VAS at 3 weeks , the change of frequency of the reflux symptom , the change of quality of life and the adverse effects . RESULTS Demographics of r and omized subjects in each treatment group were comparable except that the Topaal group included more males . The baseline characteristics between the groups were similar . After 6 weeks of treatment , the reduction of VAS of heartburn was more prominent in the Topaal group ( -6.29 cm vs -4.11 cm ) . At the 3rd week , Topaal group showed greater reduction of VAS for heartburn ( P=0.0016 ) , regurgitation ( P=0.0006 ) , vomiting ( P=0.0373 ) , and belching ( P<0.0001 ) . The patients of the Topaal group had lower frequency of heartburn ( P=0.0015 ) and pain ( P=0.0163 ) at the end of the 6-week treatment period . From the doctor 's point of view , the Topaal group also showed significant reduction in the severity of heartburn ( P=0.0020 ) , regurgitation ( P=0.0081 ) , vomiting ( P=0.0182 ) , and belching ( P=0.0018 ) at the end of the treatment . The improvement of the quality of life was more remarkable in the Topaal group at the end of the 6-week treatment period ( P<0.0001 ) . For the adverse effect , there was no difference in both the groups . CONCLUSION Topaal is more effective than Nacid for the treatment of symptoms presented by patients with ENRD Abstract Three r and omised groups of 20 patients with gastro-œsophageal reflux were studied using 15-hour recordings of lower œsophageal pH , before and after two weeks ' treatment , either with an alginate/antacid compound ( ' Gaviscon ' ) , antacids alone , or a placebo tablet . Significant reduction in the number of reflux episodes and percentage time during which the lower œsophageal pH was acid was noted in the gaviscon group after treatment , whereas no significant changes occurred in the other two groups . Symptoms reported by patients during the second test were fewer after gaviscon treatment than after antacid alone The aims of the present study were to compare effects of sodium alginate and the antacid magaldrate anhydrous in adults with gastroesophageal reflux ( GOR ) symptoms . Patients with heartburn and /or acid regurgitation for at least 3 days in the week before the study started ( n=203 ) were r and omized to receive a single dose of sodium alginate or magaldrate anhydrous at the onset of symptoms during a 3-day run-in period . Patients with symptoms during the run-in ( n=191 ) were rer and omized to receive a 14-day treatment with either drug given as four daily doses . A speed of action ≤30 min was significantly more frequent among patients in the alginate group ( 49.4 % vs. 40.4 % ; P=0.0074 ) . A trend toward a more prolonged duration of action ( median : 16.5 vs. 12.7 hr ) and a greater sum of the symptom intensity difference ( median : 40.0 vs. 31.0 ) was observed in the sodium alginate  group . Total disappearance of symptoms was reported in 81.6 % and 73.9 % of patients in the sodium alginate group and magaldrate group , respectively . We conclude that sodium alginate was faster than magaldrate in relieving GRO symptoms and showed a tendency toward a more prolonged duration of action and a higher level of efficacy Background Medical management of GERD mainly uses proton pump inhibitors . Alginates also have proven efficacy . The aim of this trial was to compare short-term efficacy of an alginate ( Gaviscon ® , 4 × 10 mL/day ) and omeprazole ( 20 mg/day ) on GERD symptoms in general practice . Methods A 14-day multicentre r and omised double-blind double-dummy non-inferiority trial compared Gaviscon ® ( 4 × 10 mL/day ) and omeprazole ( 20 mg/day ) in patients with 2 - 6 day heartburn episodes weekly without alarm signals . The primary outcome was the mean time to onset of the first 24-h heartburn-free period after initial dosing . Secondary outcomes were the proportion of patients without heartburn by D7 , pain relief by D7 , and reduction in pain intensity by D7 and D14 . Results 278 patients were recruited ; 120 were included in the Gaviscon ® group and 121 in the omeprazole group for the per protocol non-inferiority analysis . The mean time to onset of the first 24-h heartburn-free period after initial dosing was 2.0 ( ± 2.2 ) days for Gaviscon ® and 2.0 ( ± 2.3 ) days for omeprazole ( p = 0.93 ) ; mean intergroup difference was 0.01 ± 1.55 days ( 95 % CI = -0.41 to 0.43 ) : i.e. , less than the lower limit of the 95 % CI of -0.5 days predetermined to demonstrate non-inferiority . The mean number of heartburn-free days by D7 was significantly greater in the omeprazole group : 3.7 ± 2.3 days vs. 3.1 ± 2.1 ( p = 0.02 ) . On D7 , overall quality of pain relief was slightly in favour of omeprazole ( p = 0.049 ) . There was no significant difference in the reduction in pain intensity between groups by D7 ( p = 0.11 ) or D14 ( p = 0.08 ) . Tolerance and safety were good and comparable in both groups . Conclusion Gaviscon ® was non-inferior to omeprazole in achieving a 24-h heartburn-free period in moderate episodic heartburn , and is a relevant effective alternative treatment in moderate GERD in primary care . Trial registration IS RCT N62203233 Many patients who present with dyspepsia are prescribed antacid/alginates as their first line and often mainstay therapy . This multicentre study was design ed to assess whether early introduction of acid inhibition is an effective strategy in dyspepsia management To assess the efficacy and tolerance of sodium alginate compared to cisapride in patients suffering from reflux symptoms , without severe oesophagitis Nonerosive reflux disease ( NERD ) is the most common form of gastroesophageal reflux disease . Patients with NERD have a lower response rate to proton pump inhibitors ( PPIs ) than patients with erosive esophagitis when gauged from relief of heartburn . Sodium alginate decreases the acidity of refluxate and protects the esophageal mucosa . However , whether the addition of sodium alginate to PPI therapy can improve NERD symptoms remains unknown . Accordingly , the aim of this study was to evaluate the efficacy of adding sodium alginate to basal PPI therapy for NERD . Patients who had experienced heartburn on at least 2 days per week during the 1-month period before entering the study and had no endoscopic mucosal breaks ( grade M or N according to Hoshihara 's modification of the Los Angeles classification ) were r and omized to one of two treatments for 4 weeks : omeprazole ( 20 mg once daily ) plus sodium alginate ( 30 mL four times a day ) ( group A ) or omeprazole ( 20 mg once daily ) alone ( group B ) . Eighty-seven patients were enrolled , and 76 patients were r and omly assigned to group A ( n = 36 ) or group B ( n = 40 ) . Complete resolution of heartburn for at least 7 consecutive days by the end of treatment was significantly more common in group A ( 56.7 % ) than in group B ( 25.7 % ) . One patient from group A had mild drug-related diarrhea that was not clinical ly serious . In conclusion , omeprazole combined with sodium alginate was better than omeprazole alone in Japanese patients with NERD The aim of this study was to compare the efficacy of the sodium alginate preparation , Gaviscon Advance , with placebo in the relief of symptoms of reflux oesophagitis .  This was a r and omised , double-blind , parallel-group , multicentre study conducted at 13 GP centres in the UK . Patients aged between 18 and 70 years , who had experienced symptoms of reflux oesophagitis within the previous 24 h , and on two other occasions within the previous week , were recruited into the study . Patients were evaluated at baseline , and then reassessed after two and four weeks of treatment with sodium alginate or placebo , for symptoms of reflux oesophagitis in the previous 24 h. Patients were required to fill out a diary card twice daily , from which frequency and severity of symptoms were assessed , and the percentage of symptom-free days and nights calculated . Of the 100 patients recruited into the study , 98 received medication ( safety population ; placebo , n = 50 ; sodium alginate , n = 48 ) and 94 were eligible for inclusion in the intention-to-treat ( ITT ) population ( placebo  , n = 48 ; sodium alginate , n = 46 ) . For this population , sodium alginate was assessed as significantly superior by both investigators and patients at week two ( p < 0.001 and p = 0.004 , respectively ) and at week four ( p = 0.001 and p < 0.001 , respectively ) . Significantly more patients in the safety population on placebo withdrew from the study ( 40 % ) compared with sodium alginate ( 21 % ; p = 0.04 ) , due primarily to lack of effect and adverse events . The sodium alginate preparation demonstrated a superior efficacy compared with placebo , which was achieved in a more acceptable volume of medication than a previous st and ard preparation , Liquid Gaviscon . The reduced dosage volume of the ' new ' preparation ( Gaviscon Advance ) may be expected to improve patient compliance , and thereby increase treatment efficacy BACKGROUND & AIMS Alginate rafts ( polysaccharide polymers that precipitate into a low-density viscous gel when they contact gastric acid ) have been reported to form at the acid pocket , an unbuffered pool of acid that floats on top of ingested food and causes postpr and ial acid reflux . We studied the location of an alginate formulation in relation to the acid pocket and the corresponding effects on reflux parameters and acid pocket positioning in patients with gastroesophageal reflux disease ( GERD ) . METHODS We r and omly assigned patients with symptomatic GERD and large hiatal hernias to groups who were given  either (111)In-labeled alginate-antacid ( n = 8 , Gaviscon Double Action Liquid ) or antacid ( n = 8 , Antagel ) after a st and ard meal . The relative positions of labeled alginate and acid pocket were analyzed for 2 hours by using scintigraphy ; reflux episodes were detected by using high-resolution manometry and pH-impedance monitoring . RESULTS The alginate-antacid label localized to the acid pocket . The number of acid reflux episodes was significantly reduced in patients receiving alginate-antacid ( 3.5 ; range , 0 - 6.5 ; P = .03 ) compared with those receiving antacid ( 15 ; range , 5 - 20 ) , whereas time to acid reflux was significantly increased in patients receiving alginate-antacid ( 63 minutes ; range , 23 - 92 ) vs those receiving antacid ( 14 minutes ; range , 9 - 23 ; P = .01 ) . The acid pocket was located below the diaphragm in 71 % of patients given alginate-antacid vs 21 % of those given antacid ( P = .08 ) . There was an inverse correlation between a subdiaphragm position of the acid pocket and acid reflux ( r = -0.76 , P < .001 ) . CONCLUSIONS In a study of 16 patients with GERD , we observed that the alginate-antacid raft localizes to the postpr and ial acid pocket and displaces it below the diaphragm to reduce postpr and ial acid reflux . These findings indicate the importance of the acid pocket in GERD pathogenesis and establish alginate-antacid as an appropriate therapy for postpr and ial acid reflux Forty-four patients with symptoms of gastro-oesophageal reflux were r and omly assigned in a crossover trial to treatment for 15-day periods with Liquid Gaviscon ( a reflux suppressant ) or an antacid gel containing magnesium and aluminium hydroxide .  Good relief of symptoms was reported by 84 % of patients during therapy with Liquid Gaviscon compared to only 23 % during antacid therapy .  Relief of symptoms was obtained within 15 minutes by 68 % of patients during therapy with Liquid Gaviscon compared to 
    Output:
    
Alginates are more effective than placebo or antacids for treating GERD symptoms