Antacids

[a_zed24]

Hello, there!
So we know antacids are bases and they neutralize the stomach acidity, but why antacids do not rise the pH above 4? What exactly would happen if our stomach would be neutral? I know about achlohydria and rebound acidity, but I was wondering, is there any other significant consequence?
Thanks a bunch!

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[CherryRedDracul]

Hello, there!
So we know antacids are bases and they neutralize the stomach acidity, but why antacids do not rise the pH above 4? What exactly would happen if our stomach would be neutral? I know about achlohydria and rebound acidity, but I was wondering, is there any other significant consequence?
Thanks a bunch!

Depends on the antacid. You can achieve a pH much higher than 4 (Source: https://gut.bmj.com/content/gutjnl/8/1/73.full.pdf). I guess one issue would be potentially overdosing the patient though.

If you had neutral stomach acidity, you would have difficulty absorbing iron since the acid permits the reduction of the ferric form of iron to the much more water-soluble ferrous form. Also, pepsin is denatured and deactivated at a pH of 7, and thus you will have impaired protein digestion; one issue with this is the liberation of vitamin B12 from food proteins which can lead to pernicious anemia.

There's a whole paper discussing many more functions of gastric acid: https://www.karger.com/Article/Fulltext/142726

 

[a_zed24]

Depends on the antacid. You can achieve a pH much higher than 4 (Source: https://gut.bmj.com/content/gutjnl/8/1/73.full.pdf). I guess one issue would be potentially overdosing the patient though.

If you had neutral stomach acidity, you would have difficulty absorbing iron since the acid permits the reduction of the ferric form of iron to the much more water-soluble ferrous form. Also, pepsin is denatured and deactivated at a pH of 7, and thus you will have impaired protein digestion; one issue with this is the liberation of vitamin B12 from food proteins which can lead to pernicious anemia.

There's a whole paper discussing many more functions of gastric acid: https://www.karger.com/Article/Fulltext/142726

Thank you very much!