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Richard John Torrens |
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Now that we have powerful drugs (PPIs or Proton Pump Inhibitors) that stop the stomach producing acid, many people overlook antacids - chemicals (not drugs) that react with and neutralise the stomach acid that has been already produced. Antacids have been used for thousands of years and even some animals take natural antacids such as chalk. Antacids still have much use.
If you are on PPIs and think your remaining problems are caused by acid, then antacids can (and will) give immediate relief. If they do not, then the problem is probably bile reflux which is a very common problem with PPIs. See my experiments with dosage.
Early life evolved in early oceans - which were a lot less salty than modern oceans. Life then is dependant on water. Life would not have evolved far unless it evolved a method of keeping the liquid inside its cells at the correct balance on the alkali/acid scale, somewhere probably very similar to that of the early oceans, which is mildly acid.
These chemical factories which can alter the acid/alkali balance are Proton Pumps. So they exist inside every living cell. There are several types of proton pumps, the most powerful being the type that produces relatively strong acid inside the stomachs of most animals. This strong acid kills most bacteria and breaks down meat and bone so is quite fundamental to the digestive process.
Water consists of Oxygen chemically bonded to Hydrogen, in the ratio of two molecules of Hydrogen to one of Oxygen - written H2O. Now hydrogen consists of a Proton (which is electrically charged positive) with one electron orbiting it. Electrons are negatively charged, which balances the proton's positive charge so the overall charge is zero. Oxygen has six protons with six electrons orbiting.
Now some sort of magic happens when there are eight electrons orbiting an atom. So Oxygen is "hungry" for a couple of electrons. Which is why it wants to grab a couple of hydrogen atoms to share electrons and form water.
But in water another sort of magic happens. The H2O has a tendency to be easily split into H and OH "ions". The H ion carries one electron, so is short of negative charge, therefore it is written H+ and the OH ion carries an extra electron, so has a negative charge - OH-.
In neutral water the H+ and OH- balance. If the water contains a bit of acid then there are more H+ ions than OH- ions. If there are more OH- ions than H+ ions, then the liquid is alkaline.
A proton pump can move a hydrogen ion (a Proton) across a cell wall. So the liquid on the receiving side becomes more acid. But conversely the liquid on the side that looses the proton still has the OH- ion, so becomes more alkaline. In the body this OH- ion combines with Carbon Dioxide CO2 to form an alkaline HCO3 bicarbonate ion. CO2 is a gas released by many biological processes and it is readily soluble in water (H2O) to form a mild acid H2CO3.
The measure of acid/alkali is pH. pH can range from 0 to 14, with neutral being 7. The pH scale is logarithmic, so a pH of 1 is 100 times more acid than a pH of 3.
Stomach, or Gastric fluid also contains digestive enzymes, chiefly Pepsin, to help the food processing by breaking down protein (meat).
The above is of course greatly simplified!
The reaction between acid and sodium bicarbonate is quite vigorous and releases bubbles of carbon dioxide, so is likely to cause belching. This tells you that the irritation was, indeed, caused by acid, and not solely by other gastric fluid ingredients so sodium bicarbonate can be a very good test. It is also very cheap and very easy to obtain so is clearly one of the first things you should try.
Calcium carbonate is the basic ingredient for most antacid tablets. It also in sold as tablets for bone health, with vitamin D which does not affect its antacid qualities. Being solid, it does not react immediately to neutralise acidity, so has a longer lasting effect than sodium bicarbonate. So many commercial antacids include both Calcium carbonate and sodium bicarbonate, sometimes with other antacids.
Potassium is a heavier metal than sodium so for the same effect you need about 20% more potassium bicarbonate, but dosage is not at all critical. Potassium bicarbonate has a stronger taste than sodium bicarbonate which I find less pleasant - and it is not so freely available.
Interestingly recent studies have proven that Potassium bicarbonate has very beneficial results in curing and preventing osteoporosis.
Thee are two papers from USA government medical publications:
This sounds like a good idea - but it assumes the stomach is at rest. However the stomach is a very mobile organ. It is a muscular sack which continually churns up to mix food and gastric fluid and to start breakdown of food. It also contracts to force packets of food into the intestine. So how can any raft form?
If the stomach is completely empty than a raft might conceivably form. Or might such a raft simply start the stomach churning again? In any event, the only time the stomach might be empty is at night, when asleep. In which case the raft will be horizontal and won't protect the oesophagus at all! Furthermore the fact that you get nocturnal reflux surely proves the stomach is indeed active!
I found Gaviscon (and other alginates) to be of little use compared with cheaper, simpler antacids. But what these alginate products do is to temporarily coat the oesophagus - which itself if a mobile organ, moving its contents down into the stomach. Nevertheless alginates are difficult to swallow and there is indeed a significant coating effect.
Of course, if you believe it is going to work, then it may well work - after all the brain not only controls the digestion, but it also registers the pain of indigestion.
Tests on these products is clearly done "in vitro" - which means in glass. I have not found any paper which proves the theory in a live stomach.
There are various manufacturers of H2 Receptor Blockers
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