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Dec 16

The Problem with Proton Sparers and Ant-Acids

Proton sparers by definition raise the pH of the stomach mucosa and they acomplish this by stopping HCl (hydrochloric acid) from being produced. The same net effect is also produced by ant-acids such as Tums, Rolaids or Mylanta that buffer the HCl that has been produced. Either way, the rate of stomach emptying is slowed, and results in putrefaction, rancification, and fermentation, aggravating GERD (gastro-esophageal reflux disease) or NERD (non-erosive reflux disease) and is even capable of causing arthritic reactions.

Guyton’s Physiology (11th Edition) p 785-786 state the pylorus controls stomach emptying by preventing “passage of food particle until they have become mixed in the chyme to almost fluid consistency.” This obviously implies the food particle have to be ground down to nothing before they can leave for the small intestine. Additionally it states “Breakdown products of protein digestion (found in the small intestine) also elicit inhibitory enterogastric reflexes; by slowing the rate of stomach emptying sufficient time is ensured for adequate protein digestion in the duodenum and small intestine.”

The whole concept of stomach emptying is complex but the overall principle is the slowest step is the rate determining step. Anything that causes food to not break down into small enough particles or stops protein or for that matter fat digestion before it is completed, causes the duodenum to slow down stomach emptying.

One needs stomach acid to break down food products directly and indirectly stomach acid lowers the pH of the stomach so that proteolytic enzymes are activated. Again as Guyton states (p 797) “Several slightly different type of pepsinogen are secreted by the peptic and mucous cells of the gastric glands. Even so, all the pepsinogens perform the same function. When the pepsinogen is first secreted, it has no digestive activity. However, as soon as it comes in contact with hydrochloric acid, it is activated for form active pepsin……Pepsin function as an active proteolytic enzyme in a highly acid medium) optimum pH 1.8 to 3.4), but above a pH of about 5 it has almost no proteolytic activity.”

The bottom line is proton inhibitors or ant-acids slow or stop gastric function causing the production of other biological acids. These can cause GERD, NERD and if absorbed can play havoc with other tissue too.

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