Mechanism of action of antacids
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Acid Neutralization and Buffering: Primary Mechanism of Antacids
Antacids work mainly by neutralizing gastric hydrochloric acid in the stomach. This direct chemical reaction raises the pH of the stomach contents, making them less acidic and providing quick relief from symptoms like heartburn and indigestion. By increasing the pH, antacids also reduce the activity of pepsin, a digestive enzyme that can damage the stomach lining when acid levels are high. The effectiveness of an antacid is often measured by its acid neutralizing capacity and buffering ability, which determine how much and how quickly it can raise gastric pH and relieve symptoms 134610.
Cytoprotective and Mucosal Protective Actions
Beyond acid neutralization, antacids have been shown to protect the stomach lining through several additional mechanisms. Some antacids, especially those containing aluminum hydroxide, can bind and inactivate bile acids and lysolecithin, which are substances that can damage the gastric mucosa. Antacids also stimulate the production of protective mucus and bicarbonate by the stomach lining, and can increase the synthesis of prostaglandins, which help maintain mucosal integrity and promote healing 1245789.
Stimulation of Healing and Growth Factors
Antacids can accelerate the healing of erosions and ulcers in the stomach and duodenum. This is partly due to their ability to activate genes that encode growth factors and their receptors, such as epidermal growth factor (EGF), which are important for tissue repair. The stimulation of angiogenesis (formation of new blood vessels), cell proliferation, and local repair processes further supports ulcer healing 247.
Adsorptive and Enveloping Actions
Certain antacids have adsorptive properties, meaning they can bind to and neutralize harmful substances in the stomach, such as pepsin, bile acids, and toxins produced by Helicobacter pylori bacteria. This action helps reduce further injury to the stomach lining and supports the healing process 24.
Regulation of Gastric Motility
Some antacids can influence the movement of the stomach and duodenum by reducing spasms and helping regulate the evacuation of stomach contents. This can decrease pressure within the stomach and duodenum and help prevent reflux of bile and acid into the stomach, which can cause further irritation .
Conclusion
Antacids provide relief from acid-related gastrointestinal symptoms primarily by neutralizing stomach acid and reducing pepsin activity. However, they also offer important protective effects for the stomach lining, including stimulation of mucus and bicarbonate production, binding of harmful substances, activation of healing processes, and regulation of gastric motility. These combined actions make antacids effective not only for symptom relief but also for promoting mucosal healing and protection in various gastrointestinal conditions 12345678+2 MORE.
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