EFFECTS OF ALUMINUM/MAGNESIUM HYDROXIDE AND CALCIUM CARBONATE ON ESOPHAGEAL AND GASTRIC pH IN SUBJECTS WITH HEARTBURN

Decktor, Dennis L.; Robinson, Malcolm; Maton, Paul N.; Lanza, Frank L.; Gottlieb, Stanley

doi:10.1097/00045391-199508000-00006

Cited by 30 publications

(30 citation statements)

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“…In this study, as in other chewable antacid comprative studies (4)(5)(6), changes in gastric pH were trivial and did not raise the gastric pH above 4.0. The dramatic decrease in esophageal acid exposure without raising the gastric pH above a threshold of 4.0 focuses attention on a mechanism of action independent of gastric acid neutralization in the stomach.…”

supporting

confidence: 81%

“…It is well known that antacids rapidly neutralize esophageal pH when swallowed as liquid or chewed as tablets and have been proposed to work in the esophageal lumen (3,5,(15)(16)(17). We demonstrated in a previous study that esophageal reflux is prevented for up to 1 hr after chewing of calcium carbonate-containing gum (4).…”

Section: Discussionmentioning

confidence: 85%

“…We demonstrated in a previous study that esophageal reflux is prevented for up to 1 hr after chewing of calcium carbonate-containing gum (4). Trivial changes in gastric pH occurred, with the gastric pH remaining well below pH 4.0, suggesting a mechanism of action independent of gastric acid neutralization (5,6). Esophageal acid exposure was dramatically decreased, suggesting that the "strength" of the reflux barrier was improved or that peristaltic activity was improved.…”

Section: Discussionmentioning

confidence: 99%

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Calcium Carbonate Antacids Alter Esophageal Motility in Heartburn Sufferers

et al. 2004

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Chewed calcium carbonate (CaCO3) rapidly neutralizes esophageal acid and may prevent reflux, suggesting another mechanism of action independent of acid neutralization. Calcium is essential for muscle tone. Our aim was to determine if luminal calcium released from chewed antacids improved esophageal motor function in heartburn sufferers. Esophageal manometry and acid clearance (swallows and time to raise esophageal pH to 5 after a 15-ml 0.1 N HCl bolus) were performed in 18 heartburn sufferers before and after chewing two Tums EX (1500 mg CaCO3, 600 mg calcium). Subjects with hypertensive esophageal contractions or hypertensive lower esophageal sphincter pressure (LESP) were excluded. Subjects with normal to low LESP were included. Differences between parameters were determined by two-tailed paired t-tests, P < 0.05. Proximal esophageal contractile amplitude was significantly increased after CaCO3 (47.18 vs 52.97 mm Hg; P = 0.02), distal onset velocity was significantly decreased after CaCO3 (4.34 vs 3.71 cm/sec; P = 0.02), and acid clearance was significantly increased 30 min after CaCO3 (20.35 vs 11.7 swallows, [P < 0.005] and 12.19 vs 6.29 min [P < 0.007]). LESP was not altered after CaCO3 (22.70 vs 23.79 mm Hg; P = 0.551), however, LESP increased in 9 of 18 subjects. Depth of LES relaxation, medial and distal esophageal contractile amplitude, and duration of contractions were not altered by CaCO3. CaCO3 did not alter salivary secretion and pH in a subset of these subjects, and CaCO3 with secreted saliva did not neutralize a 15-ml acid bolus. The Ca2+ released after chewing of CaCO3 antacids may be partially responsible for the reduction of heartburn by significantly improving initiation of peristalsis and acid clearance.

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supporting

confidence: 81%

Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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Calcium Carbonate Antacids Alter Esophageal Motility in Heartburn Sufferers

et al. 2004

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“…CaCO 3 is also used as an antacid to relieve heartburn, as it neutralizes stomach acid. 5 When CaCO 3 is taken as an oral supplement, it requires stomach acid to dissolve it before it can be taken up by the blood stream as Ca 2+ . 6 However, the oral Other plasma proteins, like albumin, have been reported to play a role in preventing the opsonization process and to increase particle circulation times.…”

Section: Introductionmentioning

confidence: 99%

The fate of calcium carbonate nanoparticles administered by oral route: absorption and their interaction with biological matrices

Lee

Kim

et al. 2015

IJN

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Background Orally administered particles rapidly interact with biological fluids containing proteins, enzymes, electrolytes, and other biomolecules to eventually form particles covered by a corona, and this corona potentially affects particle uptake, fate, absorption, distribution, and elimination in vivo. This study explored relationships between the biological interactions of calcium carbonate particles and their biokinetics. Methods We examined the effects of food grade calcium carbonates of different particle size (nano [N-Cal] and bulk [B-Cal]: specific surface areas of 15.8 and 0.83 m 2 /g, respectively) on biological interactions in in vitro simulated physiological fluids, ex vivo biofluids, and in vivo in gastrointestinal fluid. Moreover, absorption and tissue distribution of calcium carbonates were evaluated following a single dose oral administration to rats. Results N-Cal interacted more with biomatrices than bulk materials in vitro and ex vivo, as evidenced by high fluorescence quenching ratios, but it did not interact more actively with biomatrices in vivo. Analysis of coronas revealed that immunoglobulin, apolipoprotein, thrombin, and fibrinogen, were the major corona proteins, regardless of particle size. A biokinetic study revealed that orally delivered N-Cal was more rapidly absorbed into the blood stream than B-Cal, but no significant differences were observed between the two in terms of absorption efficiencies or tissue distributions. Both calcium carbonates were primarily present as particulate forms in gastrointestinal fluids but enter the circulatory system in dissolved Ca 2+ , although both types showed partial phase transformation to dicalcium phosphate dihydrate. Relatively low dissolution (about 4%), no remarkable protein–particle interaction, and the major particulate fate of calcium carbonate in vivo gastrointestinal fluids can explain its low oral absorption (about 4%) regardless of particle size. Conclusion We conclude that calcium carbonate nanoparticles can act more actively with biological matrices in vitro and ex vivo, but that in vivo, their biological interactions and biokinetics are not affected by particle size.

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“…127 However, Johnson et al reported no differences in Mn absorption in young women who consumed diets consisting of 587 or 1336 mg Ca per day. 128 Thus, the impact of Ca on Mn uptake may be dependent on dose and pharmacological administration.…”

Section: Calciummentioning

confidence: 98%

Nutritional Requirements for Manganese

Freeland‐Graves¹,

Mousa²,

Sanjeevi³

2014

Manganese in Health and Disease

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Manganese (Mn) is a ubiquitous trace mineral that is essential for living organisms. This mineral is a cofactor of enzymes such as superoxide dismutase and arginase. It assumes a significant role in the metabolism of carbohydrates, amino acids and cholesterol, the formation of bone, digestion, and development. Food sources include whole grains, cereals, green leafy vegetables, nuts, and tea. Approaches to assess Mn requirements include metabolic balance, blood levels, and response of biomarkers. In the United States, the adequate intake (AI) of Mn is 1.8 and 2.3 mg day−1 for women and men, respectively. Negative balance has been reported in numerous studies, where Mn intake was greater than the AI; thus, the adequacy of current dietary recommendations is unclear. Factors that influence Mn requirements include life stage and gender, bioavailability (fiber, phytates, mineral interactions, polyphenolic compounds), and international considerations. Deficiency of Mn has been associated with adverse health conditions including dermatitis, osteoporosis, dyslipidemia, diabetes, metabolic syndrome, hypertension, epilepsy, cancer, asthma, problems with cognitive function, and poor birth outcomes. Toxicity of Mn may be a potential problem with contaminated drinking water, parenteral nutrition, individuals with hepatic dysfunction, and soy formula-fed infants. An understanding of Mn nutrient requirements is important for achievement of optimal health.

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EFFECTS OF ALUMINUM/MAGNESIUM HYDROXIDE AND CALCIUM CARBONATE ON ESOPHAGEAL AND GASTRIC pH IN SUBJECTS WITH HEARTBURN

Cited by 30 publications

References 0 publications

Calcium Carbonate Antacids Alter Esophageal Motility in Heartburn Sufferers

Calcium Carbonate Antacids Alter Esophageal Motility in Heartburn Sufferers

The fate of calcium carbonate nanoparticles administered by oral route: absorption and their interaction with biological matrices

Nutritional Requirements for Manganese

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