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Sodium alginate reacts with gastric HCl to produce a low density viscous raft that floats on top of the stomach contents to physically impede their reflux back into the esophagus. Thus, the acid pepsin, bile and food all remain in the stomach.
The bicarbonate reacts with the HCl to produce bubbles of carbon dioxide that become entrapped in the raft allowing it to float on the stomach contents. The inclusion of calcium carbonate in some formulations means that the raft has considerable strength, since a cross-linked lattice is formed involving calcium ions released on reaction of calcium carbonate with HCl and the guluronate dimers in the alginic acid. The raft remains on top of the stomach contents until the stomach empties.
