Antacids are first-line therapy for mild or infrequent heartburn; however, sometimes these medications will not work or are simply not appropriate. To properly understand the other options available for anti-reflux therapy, it is important to know the biology of the stomach and how it produces acid for digestion.
The stomach has multiple actions that aid in digestion of food. The stomach stores food and, with strong muscles, grinds food material into pieces less than a half inch in size. Simultaneously, fluid, acid, and digestive enzymes are secreted by the stomach lining into the mix, which starts the process of digestion. Multiple factors can stimulate production of stomach acid. The sight, smell, or taste of food will “get the juices flowing,” as will the presence of food within the stomach, which distends it. These events stimulate the brain to release different substances such as hormones that target stomach lining cells (parietal cells) to make acid. One substance made by nerves controlling acid production is called histamine.
You may commonly use an antihistamine; these medications are for allergies and sometimes colds. Allergic reactions such as hay fever with a stuffy nose, watery or itchy eyes, itchy skin, rash, and coughing are caused by extra histamine production. So, by blocking the action of histamine with an antihistamine, you block its action.
Stomach acid cells are sensitive to histamine and when exposed to histamine are stimulated to produce acid. Regular antihistamines such as those for allergies do not work on the stomach. However, a different kind of histamine blocker called a histamine-2 blocker (H2 blocker) is effective at decreasing stomach acid production.
When the stomach acid cells are stimulated by histamine, they turn on special microscopic pumps within the cell called proton pumps. These proton pumps secrete acid into the stomach. Another class of drugs available to block acid production is called proton pump inhibitors (PPIs).
To recap, there are several ways to stimulate stomach acid production and two effective classes of medications, called H2 blockers and proton pump inhibitors, or PPIs. The benefit of these drugs is they reduce or eliminate stomach acid and are very effective for the treatment of acid reflux or peptic ulcer disease (stomach or duodenal ulcers). Thus, these medications treat acid reflux before it happens and prevent it.
By Mortin - Copyright 2009
Last modification 31/12/2009
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