One of the common stomach disorders encountered is gastro esophageal reflux also known as heartburn. The stomach contains hydrochloric acid which helps in digestion of the food and subsequently killing ingested microorganisms. The acidity of the gastric HCl is 2M and any increase in the acidity leads to reflux, in which the gastric HCl travels through the cardiac sphincter muscle to the esophagus causing burning sensation and discomfort. Antacids are common choice of drugs which are administered in these conditions as they reduce the acid reflux and peptic ulcer.
Antacids act locally in the stomach region to neutralize the effect of the gastric HCl in order to prevent the onset of peptic ulcer. Most antacids are not absorbed and they are easily excreted in the stool. The predominant forms of chemicals used in the preparation of antacids include sodium bicarbonate, potassium bicarbonate, aluminum hydroxide, aluminum carbonate, magnesium carbonate, magnesium oxide and calcium carbonate. The natural forms of antacids include ginger, bananas, aloe vera, chamomile (used along with tea), carrots and turmeric. The action of antacids on the stomach is carried out throughout the wall to prevent ulcer formation.
Types of antacids
Antacids are recommended depending upon the intensity of the gastric disorder. In normal or mild conditions of acidity, non systemic antacids are recommended as they do not cause much damage. Prolonged administration of systemic antacids may lead to a condition called alkalosis in which the PH of the blood is raised leading to renal failure. Some of the common types of antacids used in the treatment of reflux and peptic ulcers are:
Sodium bicarbonate: It is recommended by many doctors to treat acid reflux and also reduce the acidity of urine and blood. Antacids which contain sodium bicarbonate also contain baking soda and hence it is not recommended for patients having congestive heart failure, hypertension, kidney disorders and gastrointestinal bleeding. Antacids containing sodium bicarbonate should be taken only after meals on a partially full stomach. The side effects include nausea, flatulence, weakness, increased thirst, black stools and irritability.
Aluminum hydroxide: Aluminum hydroxide is widely used as a non-systemic antacid and in most cases is available without prescription. The side effects of aluminum hydroxide include constipation and abdominal discomfort. In order to avoid constipation and abdominal stress, aluminum hydroxide is given in combination with magnesium hydroxide which has laxative properties along with antacid effects The combination of two such compatible antacids helps in sustained action in relieving peptic ulcers and protecting the wall of the stomach.
Calcium Carbonate: These antacids are mainly used in the treatment of indigestion, flatulence along with acidity and more commonly used as it is less expensive than other types of antacids. They are mostly recommended for children below the age of 12. In patients who have a previous history of osteoporosis or any other type of calcium deficiencies, the intake of calcium carbonate in case of acidity also helps in balancing the calcium requirement. If patients have a history of renal calculi or any other allergic reaction, calcium carbonate antacids should be avoided. The major side effect of this antacid is that it interacts with cardiac drugs. Calcium carbonate based antacids usually disintegrate and dissolute in forty minutes.
Drug side effects
Antacids react with many medications; digoxin, isoniazid, quinidine, pseudoephedrine and tetracycline. The potency and absorption of the drug reduces when the antacids interact with the corresponding drugs.
Gastritis refers to a group of conditions that are caused due to the inflammation of the stomach lining. Typical symptoms of gastritis include abdominal bloating, belching, nausea and vomiting. Another symptom of gastritis is burning ache or pain in the upper abdomen. Some cases of gastritis can lead to ulcers. Acute gastritis involves a simple inflammation with superficial ulcers. This is usually tackled with antacids and dietary changes. On the other hand, chronic gastritis may be caused due to autoimmune conditions such as hypothyroidism or anemia. Acute gastritis is characterized by epigastric pain and vomiting. There may be blood in the vomit if there are ulcers. Corrosive gastritis results when a person ingests strong acids or alkalies. When a person suffers from chronic gastritis, there will be belching, abdominal distension and unpleasant taste in the mouth in the mornings.
Possible causes of gastritis:
Blood tests help in determining any possible anemia due to bleeding in the stomach. Stool tests can detect the presence of H. pylori in the digestive tract. Upper GI Endoscopy allows the doctor to examine the stomach lining for inflammation. Making dietary changes like timely and moderate meals can help in treating gastritis. Avoid drugs that cause irritation to your stomach lining. Smoking aggravates gastritis. Limit the use of caffeine and alcohol. Antacids can keep stomach acid in check.
A hernia is a condition where a part of the body protrudes through an opening into another part of the body. Most hernias are found in the abdominal area. A hiatal hernia is usually located at the opening of the diaphragm and is an anatomical abnormality of the esophagus. Then the hiatal hernia displaces the muscle band at the lower end of the esophagus (lower esophageal sphincter) and leads to gastroesophageal reflux. As a result, stomach acid flows into the esophagus leading to esophagitis. Hiatal hernia is noticed among obese persons and those who have sustained an injury to that part of the body. Women are at increased risk and so are smokers.
Heartburn is the primary complaint of patients suffering from hiatal hernia. There is belching and feeling of vomiting. Many patients feel that there is something lodged in their chest. Coughing, vomiting or physical exertion can worsen the symptoms of hiatal hernia. The symptoms worsen during pregnancy, lying down or lifting heavy objects. In some cases, a hiatal hernia may go unnoticed. Lifestyle changes like eliminating coffee, alcohol and smoking can help relieve some of the symptoms associated with hiatus hernia. Sleeping with the head at a mild elevation can help prevent stomach acid reflux at night.
A barium x-ray can help in examining the upper digestive tract and checking for any backlash of stomach contents into the esophagus. An endoscopy helps diagnose a hiatal hernia and check for any inflammation of the esophagus. Antacids can help in neutralizing stomach acid. Drugs such as ranitidine, omeprazole or cimetidine are prescribed to reduce the secretion of stomach acid. Surgery is resorted to when there is a possibility of reduced or obstructed blood supply. This is done through laparoscopy to reduce pain, scarring and chances of infection.
Bibliography / Reference
Collection of Pages - Last revised Date: February 19, 2019