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Conventional Treatments for Heartburn and GERD



Nearly all currently available conventional treatments for heartburn and GERD are designed to reduce the acidity of the gastric juice. Most of these products can be categorized as either acid neutralizers or acid suppressors/acid blockers.
Acid Neutralizers
These classic products, commonly referred to as alkalis, rely on the fundamental chemical fact of life that acids and alkalis (also called bases) neutralize, or cancel each other out (see the picture below “Acids, Bases, and pH”). The active ingredients are typically calcium, sodium, aluminum, or magnesium salts that combine with stomach acid (hydrochloric acid, HCl), to form a “neutral” salt. Since antacids do not affect the secretion of stomach acid, their influence on the gastric acid-base balance (known as the pH) is transient, lasting only until all the antacid molecules are used up. In the meantime, the stomach continues to secrete HCl.
Antacid products are easily available without a prescription and are widely regarded as extremely safe. For occasional use, they can be useful for reducing heartburn and, when used this way, probably will not cause any harm. However, overuse, especially when prolonged, can result in serious problems. The most important adverse effect of acid neutralizers is known as the milk-alkali syndrome, which consists of excess calcium in the blood, an elevated blood pH (alkalosis), and, most importantly, kidney failure. Milk-alkali syndrome results most easily from the excessive consumption of milk (high calcium) plus an antacid over a long period of time, but it can also occur by taking excessive calcium-based acid neutralizers alone.
In the days before acid-blocking drugs, the combination of large amounts of milk and antacids was a very common conventional treatment for peptic.



acids ,bases and ph
acids,bases,and ph


Acids and bases (or alkalis) [Pronounced, AL-KUH-LIES] are the yin and yang of the chemical world. Scientists measure the relative acidity-alkalinity of a substance by using a pH scale. The pH scale ranges from 0 (most acid) to 14 (most alkaline). A pH of 7 is considered neutral.



A common way to measure pH is using strips of litmus or pH paper, which are treated with a chemical that changes color depending on the relative acidity/alkalinity of the substance it contacts. Electronic pH meters that give a numerical readout are typically used when a rapid, precise reading is required.
The HCl produced in the stomach has a pH of 0.8, which makes it an extremely potent acid. HCl is formed in the lining of the stomach by the combination of ions of hydrogen (H+) and chloride (Cl–).
A similarly powerful alkaline substance, like sodium hydroxide (also known as lye, or NaOH), has  a pH approaching 14. Get this stuff on your hands and you could get just as bad a burn as if you’d handled pure HCl. Because NaOH is so corrosive, it is widely used to unclog bathroom and kitchen drains, selling as Drano and other brand names. Another familiar, but much more benign, alkaline substance is sodium bicarbonate, also known as baking soda.
In general, our bodies tend to prefer chemicals more toward the neutral middle of the pH scale. Water, for example, has a pH of 7, squarely in the middle. Blood tends to be slightly alkaline (pH 7.4). The pH of the “resting,” or between-meal, stomach usually ranges from 1 to 3.
When we mix chemical opposites like acids and bases, they tend to neutralize each other. Let’s say we mix two powerful pH opposites like HCl and NaOH. [Please don’t try this at home!] The resulting chemical reaction produces NaCl + H2O, better known as table salt + water, or saline, which has a pH of 7.
One of the earliest means people came up with to relieve heartburn was to swallow an alkaline substance in order to neutralize the offending stomach acid. Of course, we wouldn’t want to swallow lye, but sodium bicarbonate works very well, producing not only salt water, but also the gas carbon dioxide (CO2). The CO2 can make us feel bloated and cause burping, as it fills the stomach and escapes back up the esophagus.

To the degree that they reduce the amount of acid available to reflux, these drugs can temporarily relieve the symptoms of heartburn and also prevent the damage associated with GERD. Neutralizing antacids reduce gastric (stomach) acidity only modestly, but usually enough to relieve heartburn discomfort for an hour or two. The more potent acid-suppressing drugs reduce the acid secretion by up to 90 percent or more, essentially eliminating acid from the stomach for up to twenty-four hours or longer.


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