This isn’t exactly medical advice, but I have a feeling there is no definitive answer to this, so I put it here.
Sodium alginate is a thickener that has been shown repeatedly in studies to reduce the effects of acid reflux by coating the esophagus and acting as a sort of plug on top of stomach contents to prevent reflux. It has no known negative side effects.
And, yet, when I take it, it seems to actually cause heartburn. Not right away. It at first does seem to coat things. But, inevitably, in a few minutes, I will have heartburn.
At first I thought it might just be that I was already taking it when heartburn was bad, and it was coincidence. But this time, as an experiment, I took it when I was not feeling any heartburn. And I am now experiencing quite strong heartburn. It started low and spread upward.
You know IANAD. But I tried that for my reflux and constant partial vomiting. The flappy thing that keeps stomach stuff from coming back up was broken or loose. SA was recommended by my nutritionist. That stuff wasn’t strong enough to keep it down.
I had to have surgery to fix it last year. Man what a relief.
My opinion is it just isn’t strong enough for you.
But that’s the thing, Beck. I have less heartburn when I don’t take it. That’s what confuses me. If it just wasn’t working, that would make more sense.
I actually do have a couple hypotheses for what could be happening, but I don’t want to “prime the pump” so to speak. I want to hear other ideas first.
I will add this bit of info: my heartburn was completely under control until I wound up changing how I was taking my PPI unintentionally, taking my second dose later and later in the evening, and eventually not even eating afterwards like you’re supposed to.
It mostly seems to be getting better since I started trying to take it the way I used to.
I don’t plan on keeping taking it—at least, not any time soon. But I needed to establish for certain that it was making things worse, and it wasn’t just my imagination.
Now I’m just curious, because I can’t understand it. I was hoping some medical Dopers would chime in on theories and such.
Besides, it’s also a food additive, used as a thickener, and if I understand what the issue is, I could maybe find some way to use up the stuff I wasted my money buying. Or at least know that I should probably give it away to someone else.
NAD and just spitballing but is it possible you might be allergic to it? A couple years ago I was having a problem with hives and heartburn, regardless of my GERD being under control with a PPI. I did a little digging and realized the heartburn was related to whatever was giving me hives. I had eosinophilic esophagitis, which feels like heartburn. Taking a daily Zyrtec keeps both at bay.
Not that I know of. That is not one of the things I had considered, but it could make sense. I do have food intolerances and find certain seem to irritate my stomach. It might explain how I can get a heartburn feeling below my stomach (which I had assumed before was just referred pain).
Maybe I do have a mild allergy that takes a bit to feel after I take it.
No actual knowledge about this but as a WAG maybe your specific anatomy is such that the foam “raft” ends up in place other than near the opening, instead pushing gastric fluid up more? More than capping it in?
Not a doctor, @BigT , but this is what I was thinking too. I went through a whole slew of tests for terrible reflux, heartburn, and regurgitation. The conclusion was that the upper valve of my stomach was very weak. I never noticed SA making me have heartburn, but it didn’t work for me at all. Maybe it just holds the door open, so to speak, rather than blocking it, in some cases.
Neither here or there but it isn’t actually a valve. It is, to be precise, the lower esophageal sphincter, and in some people the sphincter is at baseline of fairly low tone, not puckering up as tightly.
Just another part losing muscle tone with age, I guess. Although, it’s gotten better, so I’m not sure how that works. I haven’t been doing any lower esophageal sphincter crunches that I know of…
This would fit an observation I had: when the heartburn got better afterwards, it felt something finally went on down that had been stuck. Almost like it got better when the raft resolved, and the acid could get back into my stomach.
Would that fit the description of what occurs however?
The description is heartburn occurring a few minutes after ingestion followed by resolution of fairly sudden onset as well like “something finally went on down that had been stuck”. …
EoE triggered by a substance wouldn’t typically have that sort of fairly rapid onset followed by fairly sudden resolution. The inflammation sticks around.
Trouble swallowing/food “sticking” is a common finding in EoE.
Whether there could be an ongoing process exacerbated by a particular substance is something that a gastroenterologist would need to rule out i.e. with endoscopy and biopsy.
That I get. What I don’t get is the specific timing only when taking the product, a few minutes after and sudden resolution, and no other times.
EoE is not so sudden and transient. Symptoms usually show up hours to days after exposure to a trigger. It resolves over time, also days at least, with avoidance of triggers and/or treatment. Not suddenly.
Although maybe there is baseline inflammation in the lower esophagus and the “raft” is expanding up into that space pressing on the inflammation causing pain. That isn’t the product causing the inflammation though; it is another physical mechanistic possibility…
That is one I wondered about. Because it would imply that, as it heals up, it could still be usable, whether for occasional heartburn or for its culinary properties.
It seems a lot like xanthan gum in how it reacts, and xanthan gum has never caused me issues.
Another thing to consider is whether you’re having a reaction to something ELSE - any other medication changes lately?
14 years back, my doctor became convinced that my increasingly-severe nighttime coughing was due to worsening reflux. I did feel like my reflux was a little worse, but QUADRUPLING my Prilosec dosage did not have any effect, and sent me down a spiral of increasing tests / medications (gastric emptying; a single dose of Reglan which as I’d warned the doc it would, worsened my restless legs) and finally a referral to a gastroenterologist.
Before that appointment, however, I put my foot down and refused to quit taking the BP medication she’d put me on… a couple of weeks before the coughing began.
Yes, it was an ACE inhibitor. And she’d warned me that a “dry cough” was a common side effect. But when it happened, she refused to believe that was the problem - and since it was nighttime only, she convinced me to go along with her opinion. I may be a well-informed civilian but I have not been to medical school.
The coughing stopped within days of stopping the ACE inhibitor.
She put me on an ARB (related, but less likely to cause coughing) and the problem never recurred.
Just as well; I know two people who have been hospitalized with severe reaction to that after having taken it for years.
