Marcin Janiaczyk, Magdalena Ogrodowczyk

The role of antacids in diseases related to excessive secretion of hydrochloric acid
2021-09-16

Antacids are known from the earliest times. This is a group of compounds of various chemical structures and a common mechanism of action consisting in the neutralization of hydrochloric acid and raising gastric pH. An additional result is inhibition of pepsin activity. These drugs are in the form of suspensions, swallowing tablets, and chewing tablets. In their comparison, an ANC value is the most important meaning the ability of acid neutralization for a certain amount of drug. Due to the fast onset of action, antacids operate rapidly, bringing relief in ailments related to excessive secretion of hydrochloric acid. Antacids can neutralize stomach acid which got into the esophagus. The combination of antacids with alginates allowed to obtain drugs with a double mechanism of action: a physical barrier blocking the gastroesophageal reflux and chemical acid neutralization.

With the emergence of new drug groups as H2 receptor antagonists (H2RAS) and proton pump inhibitors (PPI), the use of antacids has decreased and, consequently, their popularity on the market. Despite this, these drugs still remain in use. This is due to wide availability as OTC and outside pharmacy. These drugs are still used in mild symptoms and self-healing. They are also commonly used in heartburn during pregnancy or in the initial phase of gastroesophageal reflux disease. Antacids can be additionally used in the treatment of stomach and duodenal ulcers to relieve pain symptoms or heartburn. These medicines used according to the recommendations are considered safe and the most common side effects are limited to the occurrence of constipation or diarrhea.

In 2020, the most popular substance from the H2RAS Ranithidine group was withdrawn, which caused PPI to become a major group of drugs in diseases associated with excessive acid secretion. On the other hand, there are reports of adverse effects of long-term PPI use and its abuse. This means that there is no ideal drug and long-term inhibition of hydrochloric acid production leads to serious consequences.

Keywords: gastroesophageal reflux disease, heartburn, antacids.

© Farm Pol, 2021, 77(7): 425–434