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Non-absorbable antacids (magnesium and aluminum preparations) adsorb hydrochloric acid. The effect after their application is achieved more slowly, but lasts longer (2.5-3 hours) than that of absorbed antacids. Aluminum salts can cause constipation, while magnesium salts, on the contrary, weaken. In modern antacid preparations, the ratio of magnesium and aluminum hydroxides is balanced, and this avoids stool disorders. Other benefits of non-absorbable antacids include.
Antacids neutralize hydrochloric acid, adsorb bile acids, and inactivate pepsin in the esophagus and stomach. But they do not eliminate the cause of heartburn - they act symptomatically, eliminating discomfort. Antacids are divided into absorbable and non-absorbable.
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The use of absorbable and aluminum-containing antacids in the elderly is undesirable due to possible adverse reactions. Adsorbents have a dual effect. they neutralize hydrochloric acid and bind bile acids, lysolecithin and pepsin, increasing the resistance of the mucosa to the damaging effect of mesalamine pills. With non-erosive reflux disease, adsorbents (Smecta, Neosmectin, Diosmectite, Endosorb, Smectite dioctahedral) can be used as monotherapy or in complex treatment (especially with mixed acid-bile reflux). They are prescribed 1 sachet three times a day.
Alginate preparations are produced with a different dose of sodium alginate, as well as in combination with an antacid. Such combinations are more effective because they have a stronger effect on heartburn relief than antacids alone. Gaviscon preparations (tablets and suspension) contain 500 mg of sodium alginate. They are prescribed as monotherapy for heartburn, which occurs 1-3 times a month, with a non-erosive form of reflux disease and with mild esophagitis.
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The drug Gaviscon Forte in the form of a suspension contains 1000 mg of sodium alginate. Recommended for patients with heartburn, which happens more than 4 times a month. It is also prescribed in the complex treatment of patients with severe GERD with esophagitis and concomitant hernia.
To buy asacol of alginates moIt should also be noted that they can be used in the group of the elderly, pregnant women and children, since they are safe and do not have systemic effects. In the II and III trimester of pregnancy, Gaviscon is recommended for 2 tbsp. spoons 4 times a day after meals. A month after treatment, its effect of action is preserved.
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Prokinetics improve the motor-evacuation function of the digestive tract. These are drugs Itomed, Ganaton, Motilium, Motilak and others. Prokinetic drugs restore the physiological state of the esophagus and stomach (increase their contractility), reduce the number of relaxations of the esophageal sphincter and increase its tone. They also positively affect the motility of the duodenum and eliminate reflux from it. Prokinetics are used in complex treatment together with proton pump inhibitors and alginates.
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Of the gastroprotectors, one can name Sukralfat-Darnitsa and Venter. The active substance of these drugs is sucralfate, which forms a protective layer on the mucosa of asacol and stomach from aggressive factors. The active substance also moderately inhibits the activity of pepsin.
Tablets are taken 1 hour before meals and at bedtime. It cannot be chewed. The course of treatment can last 3 months. If H. Pylori is detected, its eradication is carried out, despite the presence or absence of symptoms of GERD and esophagitis. Summing up, we can say that the highest treatment efficiency and long-term remissions are achieved with combined use. proton pump inhibitors + prokinetics + alginates (antacids or adsorbents).
Reflux in 50% of patients with GERD is acidic, acidic with a bile component is recorded in 39.7%, and bile reflux into the stomach and esophagus (bile reflux) occurs in 10.3% of patients. The dominance of bile reflux compels to adjust the treatment of GERD.
When bile reflux occurs, various combinations are prescribed. adsorbents, prokinetics, alginates, antacids and ursodeoxycholic acid. With mixed or biliary reflux, adsorbents and ursodeoxycholic acid preparations are leading in the treatment regimen.
The basis for the use of UDCA preparations (Ursoliv, Ursosan, Ursodez, Ursofalk, Ursodex) for esophagitis caused by duodenal reflux is their ability to bind bile acids and convert them into a water-soluble form. This reduces the aggressiveness of asacol online.