Symptomatic Management of Hyperacidity (1).pptx

Management of hyperacidity

1. Symptomatic Management of Hyperacidity Dr. Ashna Maru

2. Introduction Definition Hyperacidity is also known as acid dyspepsia/acid reflux It is a condition where the stomach produces excessive amounts of gastric acid (hydrochloric acid) Increased acid production can irritate the lining of the stomach and esophagus, leading to symptoms like heartburn, indigestion, and discomfort.

3. Prevalence Global prevalence: Approximately 10 – 20% of the global population experiences hyperacidity or GERD symptoms regularly. This rate varies by region, with some Western countries reporting rates as high as 20 – 30%

4. Prevalence Age and Gender Distribution: Hyperacidity affects both genders, but there is a slightly higher prevalence among adult men and postmenopausal women . The condition becomes more common with age, particularly in those over 40 years.

5. Prevalence Impact in Specific Populations: Certain populations, such as individuals with obesity, smokers, and those with poor dietary habits, are at a higher risk of developing hyperacidity.

6. Prevalence Symptom Frequency: Up to 40% of individuals in Western populations experience heartburn at least once a month, with 10 – 20% experiencing it weekly.

7. Causes Excessive gastric acid production Gastroesophageal reflux disease Peptic ulcers Helicobacter pylori infection

8. Risk Factors Diet (spicy, fatty foods, caffeine, alcohol) Lifestyle (smoking, stress) Medications (NSAIDs, corticosteroids)

9. Symptoms of Hyperacidity Common Symptoms: Heartburn Regurgitation Bloating Nausea Belching Upper abdominal pain

10. Symptoms of Hyperacidity

11. Diagnostic Approach Clinical Evaluation: Patient history and symptom assessment Identifying triggers and patterns

12. Diagnostic Tests

13. General Management Principles

14. General Management Principles

15. Treatment if diagnosed with H.Pylori

16. Pharmacological Management Antacids: Mechanism of action: Neutralize stomach acid Examples: Magnesium hydroxide, aluminum hydroxide, Magnesium-Aluminium Amalgate

17. Pharmacological Management Antacids: Magnesium-Aluminium Amalgate Acts by neutralizing stomach acid. Also has high buffering capacity – it can maintain a relatively neutral pH in the stomach for a longer period compared to some other antacids. This prolongs its acid-neutralizing effect and enhances symptom relief.

18. Pharmacological Management

19. Pharmacological Management Antacids: Magnesium-Aluminium Amalgate Also, it promotes the production of mucus and bicarbonate from the gastric epithelium, further enhancing mucosal protection and promoting healing of any existing irritation or ulcers

20. Pharmacological Management Antacids: Magnesium-Aluminium Amalgate Additionally, amalgate can bind to bile acids and pepsin, reducing their damaging effects on the stomach lining. This particularly useful in conditions like bile reflux, where bile acids contribute to gastric irritation

21. Pharmacological Management Antacids: Magnesium-Aluminium Amalgate Amalgate provides a quick relief from hyperacidity symptoms due to its fast-acting neutralization properties. Only a small amount of almagate is absorbed into the blood stream, minimizing the risk of systemic side effects. Due to its combination of aluminum and magnesium, almagate is often considered safer for prolonged use than other antacids especially in patients with mild to moderate renal impairment.

22. Pharmacological Management Antacids: Magnesium hydroxide Acts by neutralizing the stomach acid and having an osmotic action/laxative effect in the intestines. Excessive use may lead to diarrhea due to its laxative effect Overuse can cause electrolyte imbalances (such as hypermagnesemia) in individuals with renal impairment. Its generally safe for short-term use. But its laxative properties should be considered, especially in patients prone to diarhhea or electrolyte disturbances

23. Pharmacological Management Antacids: Aaluminium hydroxide Acts bu neutralizing gastric acid, forming a protective layer, and slowing gastric emptying. Side effects: Constipation due to the astringent properties of aluminum. Overuse can lead to electrolyte imbalances, such as hypophosphatemia

24. Pharmacological Management H2 Receptor Antagonists (H2RAs): Mechanism: Reduce acid production Examples: Ranitidine, famotidine

25. Pharmacological Management Proton Pump Inhibitors (PPIs): Mechanism: Inhibit gastric acid secretion Examples: Omeprazole, esomeprazole, pantoprazole

26. Pharmacological Management Prokinetics: Mechanism: How Do Prokinetic Agents Work? If your LES isn't working properly, you may experience acid reflux or heartburn. Prokinetic agents strengthen the contractions of your LES muscles and help stimulate the other muscle contractions in the entire GI tract.   Examples: Metoclopramide, domperidone

27. Non-Pharmacological Management Dietary Recommendations: Eat small, frequent meals Avoid late-night eating Limit caffeine, alcohol, and spicy foods

28. Non-Pharmacological Management Alternative Therapies: Herbal supplements (e.g., ginger, licorice) Acupuncture Stress management techniques (e.g., yoga, meditation)

29. Choosing the Right Treatment Patient-centric Approach: Tailoring treatment based on patient symptoms, severity, and comorbidities

30. Choosing the Right Treatment Combination Therapy: When and how to use a combination of pharmacological agents

31. Choosing the Right Treatment Patient-centric Approach: Regular assessment and adjustment of therapy as needed

32. End... Questions...?