Question

What does the antacid that is used for the treatment of indigestion in the stomach contain?

Answer 1

Hint: Antacids are over-the-counter (OTC) medications that assist in the neutralisation of stomach acid. They function differently than other acid reducers like $H_2$ receptor blockers and proton pump inhibitors (PPIs). These medications work by reducing or preventing stomach acid secretion.

Complete answer:
Antacids can be used to treat the following symptoms of excess stomach acid:
1) Acid reflux, which can cause regurgitation, a bitter taste, a persistent dry cough, pain when lying down, and swallowing difficulties.
2) Heartburn, caused by acid reflux, is a burning sensation in your chest or throat.
3) Indigestion, which is upper-gut pain that may feel like gas or bloating

Antacids are commonly available in the following dosage forms:
- liquid
- chewable gummy or tablet
- tablet that you dissolve in water

Antacids are the oldest and most effective heartburn medications. For centuries, chalk (calcium carbonate) has been chewed to provide some relief and is still popular.

The majority of commercially available antacids are aluminium and magnesium hydroxide mixtures. Some effervescent antacids contain sodium bicarbonate, also known as "baking soda," an old home remedy for stomach aches.

To protect the oesophagus from acid exposure, some antacids are combined with alginate [an insoluble substance that increases surface tension in liquids] to form a compound that floats on gastric fluids.
Antacid tablets are slower acting and have less neutralising power than antacid liquids. Tablets must be chewed and may react negatively with stomach acid.

Antacid Components:
1) Sodium Bicarbonate:
- Sodium bicarbonate is a weak antacid with a short half-life. While this is a generally safe home remedy, its high sodium content is a disadvantage.
- Bicarbonate reacts with stomach hydrochloric acid to produce carbon dioxide gas, which is quickly absorbed but occasionally results in a satisfying belch.
- Overuse of bicarbonate can cause an imbalance in the body's normal pH level (systemic alkalosis). Those who need to limit their sodium intake due to high blood pressure or heart disease should avoid bicarbonate.

2) Magnesium hydroxide:
- Magnesium hydroxide is commonly referred to as milk of magnesia. It is an effective laxative, similar to magnesium citrate or magnesium sulphate. If it weren't for its proclivity to cause diarrhoea, magnesium hydroxide would be the ideal antacid.
- Most manufacturers add aluminium hydroxide, which is constipating, to counteract the diarrhoea effect.
- The intestine does not absorb magnesium hydroxide. Its interaction with stomach acid, on the other hand, produces magnesium chloride, which can be absorbed.
- Magnesium performs numerous functions in human cells, including the heart, and excessive levels in the blood can be harmful. This is not a problem for people who have healthy kidneys, but magnesium should be avoided if they have renal failure.

3) Aluminium hydroxide:
- Aluminium hydroxide is a weak, slow-acting antacid when compared to magnesium hydroxide, and its acid-neutralizing effect varies between commercial products.
- Aluminium has the potential to protect the stomach lining from the damaging effects of alcohol and other irritants. Pepsin, a gastric digestive enzyme, is inactivated by aluminium hydroxide.
- The main reason for its inclusion in commercial antacid preparations, however, is to counteract the diarrhoea effect of magnesium.

4) Calcium carbonate: The most effective usable antacid is calcium carbonate (chalk). It has the ability to completely neutralise stomach acid. However, it is not always the best option for everyday use.

Note: Some antacid products may neutralise more stomach acid than others. The ability of an antacid to neutralise acid is expressed by determining the antacid's neutralising capacity (ANC). The ANC is expressed in milliequivalents (mEq) of acid neutralised and measures the antacid's ability to neutralise acids (to a ph of 3.5 to 4). An antacid must have a neutralising capacity of 5 mEq per dose, according to FDA regulations. The most effective antacids should have a high acid neutralisation capacity as well as the ability to neutralise gastric acid quickly.