Use of antacids containing aluminum hydroxide compared with sucralfate and placebo in the treatment of postgastrectomy reflux gastritis

Medical treatment of reflux gastritis after partial gastrectomy is often unsatisfactory. Antacids containing aluminum hydroxide, as well as sucralfate, because of their reported capacity to bind bile acids and lysolecithin, may be useful in the treatment of reflux gastritis. Forty-five patients with reflux gastritis after gastrectomy were randomly treated with either antacids (Maalox® TC, 15 ml, QID), sucralfate (1 gm, TID), or placebo for eight weeks. The presence of dyspeptic symptoms and the grade of endoscopic and histologic changes were assessed before treatment and at the end of the study. Antacids were significantly better than placebo (P <0.01) in improving heartburn, nausea, and epigastric pain. Sucralfate was superior to placebo only in reducing heartburn (P = 0.03). Antacids were also significantly better than placebo in improving endoscopic features, but no changes were observed in histologic features in any group. In conclusion, antacids containing aluminum hydroxide may be an alternative treatment in patients with postgastrectomy reflux gastritis, and may even be useful in avoiding surgery.