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.
Dyspepsia or indigestion is a severe uncomfortable pain in the stomach accompanied by heartburn, burping, flatulence and vomiting. Symptoms of dyspepsia include upper abdominal fullness, bloating, nausea, belching and heartburn. Often dyspepsia is caused due to GERD. In some persons, dyspepsia symptoms are due to medications for high blood pressure and angina. Corticosteroids and NSAIDs can cause dyspepsia. Gallstones or duodenal ulcers can cause dyspepsia. Alcohol, caffeine and smoking aggravate the dyspepsia condition. Sometimes food allergies might trigger indigestion. Stress and anxiety contribute to dyspepsia symptoms. There is tenderness on palpitation of abdomen.
If there is blood in vomit or abdominal swelling, further investigations would be necessary. Tests are done to detect the presence of H. pylori bacteria. A gastrointestinal endoscopy can help detect peptic ulcer disease or other ulcerations with tissue and culture specimen. Barium studies aid in detecting any gastrointestinal disease. Treating dyspepsia is based on the causative factors. Antacids provide immediate relief from dyspepsia symptoms. They might be combined with alginates to reduce acid reflux. Lifestyle changes help in reducing discomfort and recurrence of indigestion symptoms. Cutting on fatty food and tea and coffee provides relief. Losing weight and reducing stress help tackle chronic indigestion symptoms.
Early pregnancy symptoms vary from woman to woman. Some are able to experience pregnancy signs and symptoms within days of conception whereas it takes weeks for others to experience even the earliest sign of pregnancy.
Nausea and Vomiting: Many women experience illness in the morning as the early symptom of pregnancy. Though this particular symptom is referred to as morning sickness, some women tend to feel nauseous throughout the day. This early sign of pregnancy can be tackled to some extent by eating small frequent meals. This earliest symptom of pregnancy is at its peak around 8 to 10 weeks when the hormone levels are highest. Hyperemesis gravidarum is a severe form of morning sickness that affects some women and results in dehydration and even hospitalization.
Increased sensitivity: Another early symptom of pregnancy is tenderness in the breasts. Increasing amount of HCG (Human Chorionic Gonadotropin) hormone is responsible for this symptom. A pregnant woman may find herself highly sensitive to certain aromas and smells. This symptom of pregnancy is also a result of the increasing estrogen in the system. Food aversions and cravings are common when a woman is pregnant. This may manifest itself in the early period of pregnancy or last throughout the pregnancy.
Frequent urination:Since a growing uterus applies pressure on the bladder, there may be a need for frequent urination. This early sign of pregnancy is felt within a week or two of conception.
Fainting or Dizzy spells: Blood pressure may drop on account of the growing fetus compressing the major arteries. HCG levels move from 0 - 250, 000 in a short span of time. This is accompanied by increased amounts of progesterone in the body, which accounts for tiredness and sluggishness when a woman is pregnant.
Mild bleeding: Spotting sometimes can occur when the fertilized egg burrows into the endometrial lining. This pregnancy symptom leads many a woman to believe that they have had their menstrual period. This is referred to as 'implantation bleeding' and is experienced by only few women when they are pregnant.
Heartburn and Constipation: Bowel functions are slowed so as to gain maximum absorption time for vitamins and nutrients. This condition can sometimes last throughout the pregnancy. A swollen uterus along with increasing levels of HCG lead to slower digestion and heartburn is a resultant condition.
Missed period: This is the most obvious and early sign and symptom of pregnancy. This will also coincide with high basal body temperature. A home pregnancy test can be taken to confirm the pregnancy by women if they think they are pregnant. There are rare cases of women even women having their period throughout their pregnancy.
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Bibliography / Reference
Collection of Pages - Last revised Date: November 17, 2019